Isifo se-hemolytic-uremic

Ukukhiqizwa kobuthi obufana neShiga E coli I-hemolytic-uremic syndrome (STEC-HUS) yisifo esivame ukwenzeka lapho ukutheleleka ohlelweni lokugaya ukudla kuveza izinto ezinobuthi.Lezi zinto zibulala amangqamuzana abomvu egazi futhi zidale ukulimala kwezinso.

I-Hemolytic-uremic syndrome (HUS) ivame ukuvela ngemuva kokutheleleka emathunjini nge E coli amabhaktheriya (Escherichia coli O157: H7). Kodwa-ke, lesi simo futhi sixhunyaniswe nezinye izifo zesisu, kufaka phakathi i-shigella ne-salmonella. Iphinde yaxhunyaniswa nezifo ezingezona ezemvelo.

I-HUS ivame kakhulu ezinganeni. Kuyimbangela ejwayelekile kakhulu yokwehluleka okukhulu kwezinso ezinganeni. Ukuqubuka okukhulu okuningana kuye kwaxhunyaniswa nenyama ye-hamburger engadakiwe engcoliswe ngayo E coli.

E coli ingadluliselwa nge:

• Xhumana kusuka komunye umuntu uye komunye
• Kudla ukudla okungaphekiwe, njengemikhiqizo yobisi noma inyama yenkomo

I-STEC-HUS akumele ididaniswe ne-atypical HUS (aHUS) engahlobene nokutheleleka. Sifana nesinye isifo esibizwa nge-thrombotic thrombocytopenic purpura (TTP).

I-STEC-HUS ivame ukuqala ngokuhlanza nokuhuda, okungenzeka kube negazi. Kungakapheli isonto, umuntu angase abe buthakathaka futhi acasuke. Abantu abanalesi simo bangachama ngaphansi kokujwayelekile. Ukukhishwa komchamo kungacishe kuyeke.

Ukubhujiswa kwamangqamuzana egazi abomvu kuholela ezimpawu ze-anemia.

Izimpawu zokuqala:

• Igazi ezitulweni
• Ukuthukuthela
• Imfiva
• Imikhuba emibi
• Ukuhlanza nokuhuda
• Ubuthakathaka

Izimpawu zakamuva:

• Ukulimaza
• Ukwehla kokuqonda
• Ukukhishwa komchamo ophansi
• Akukho okukhipha umchamo
• Pallor
• Ukuquleka - akuvamile
• Ukuqhuma kwesikhumba okubukeka njengamabala abomvu amahle (petechiae)

Umhlinzeki wezokunakekelwa kwempilo uzokwenza ukuhlolwa komzimba. Lokhu kungakhombisa:

• Ukuvuvukala kwesibindi noma ubende
• Izinguquko zesistimu yezinzwa

Ukuhlolwa kwelabhoratri kuzokhombisa izimpawu ze-hemolytic anemia kanye nokuhluleka okukhulu kwezinso. Ukuhlolwa kungafaka:

• Ukuhlolwa kwegazi (PT ne-PTT)
• Iphaneli yemethodi ephelele ingakhombisa amazinga akhuphukile we-BUN ne-creatinine
• Ukubalwa kwegazi okuphelele (i-CBC) kungabonisa ukwanda kwesibalo samangqamuzana amhlophe egazi kanye nokwehla kwesibalo segazi elibomvu
• Ukubalwa kweplatelet kuvame ukwehliswa
• Ukuhlolwa komchamo kungaveza igazi namaprotheni emchameni
• Ukuhlolwa kwamaprotheni okuchama kungakhombisa inani lamaprotheni emchameni

Olunye uvivinyo:

• Isiko le-Stool lingaba lihle ngohlobo oluthile lwe E coli amabhaktheriya noma amanye amabhaktheriya
• Colonoscopy
• I-biopsy yezinso (ezimweni ezingavamile)

Ukwelashwa kungafaka:

• I-Dialysis
• Imithi, efana ne-corticosteroids
• Ukuphathwa koketshezi nama-electrolyte
• Ukumpontshelwa kwamangqamuzana egazi abomvu agcwele kanye nama-platelets

Lesi yisifo esibi ezinganeni nakubantu abadala, futhi singadala nokufa. Ngokwelashwa okufanele, abantu abangaphezu kwesigamu bazolulama. Umphumela ungcono ezinganeni kunabantu abadala.

Izinkinga zingafaka:

• Izinkinga zokuvala igazi
• I-hemolytic anemia
• Ukuhluleka kwezinso
• Umfutho wegazi ophakeme oholela ekuqulekeni, ukucasuka, nezinye izinkinga zesistimu yezinzwa
• Ambalwa kakhulu amaplatelet (thrombocytopenia)
• I-Uremia

Shayela umhlinzeki wakho uma uba nezimpawu ze-HUS. Izimpawu zezimo eziphuthumayo zifaka:

• Igazi esitokisini
• Akukho ukuchama
• Ukuqwashisa okunciphisiwe (ukwazi)

Shayela umhlinzeki wakho uma ngabe uke waba nesiqephu se-HUS nokukhishwa komchamo wakho kuyehla, noma uba nezinye izimpawu ezintsha.

Ungavimbela imbangela eyaziwayo, E coli, ngokupheka i-hamburger nezinye inyama kahle. Kufanele futhi ugweme ukuxhumana namanzi angahlanzekile futhi ulandele izindlela ezifanele zokugeza izandla.

HUS; STEC-HUS; Isifo se-hemolytic-uremic

• Uhlelo lwesilisa lomchamo

U-Alexander T, uLicht C, uSmoyer WE, uRosenblum ND. Izifo zezinso nezindlela eziphezulu zomchamo ezinganeni. Ku: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, ama-eds. IBrenner neRector's The Kidney. Umhla ka-11. IPhiladelphia, PA: Elsevier; 2020: isahluko: 72.

UMele C, uNoris M, uRemuzzi G. Hemolytic uremic syndrome. Ku: Ronco C, Bellomo R, Kellum JA, Ricci Z, abahleli. Ukunakekelwa Okubalulekile I-Nephrology. 3rd ed. IPhiladelphia, PA: Elsevier; 2019: isahluko 50.

USchneidewend R, u-Epperla N, uFriedman KD. I-thrombotic thrombocytopenic purpura kanye nama-hemolytic uremic syndromes. Ku: Hoffman R, Benz EJ, Silberstein LE, et al, ama-eds. I-Hematology: Izimiso Eziyisisekelo Nokuzijwayeza. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2018: isahluko 134.