I-immune hemolytic anemia

I-anemia yisimo lapho umzimba ungenawo amangqamuzana egazi abomvu anele anele. Amaseli egazi abomvu ahlinzeka nge-oxygen ezicutshini zomzimba.

Amaseli abomvu egazi ahlala cishe izinsuku eziyi-120 ngaphambi kokuba umzimba uwasuse. Ku-hemolytic anemia, amaseli abomvu egazini abhujiswa ngaphambi kwesikhathi esijwayelekile.

I-immune hemolytic anemia yenzeka lapho ama-antibody akha ifomula amangqamuzana egazi abomvu omzimba futhi awabhubhise. Lokhu kwenzeka ngoba amasosha omzimba abona ngephutha lawa maseli egazi njengamanye amazwe.

Izimbangela ezingaba khona zifaka:

• Amakhemikhali athile, izidakamizwa, kanye nobuthi
• Izifo
• Ukufakwa kwegazi kusuka kumnikeli ngohlobo lwegazi olungahambelani
• Imidlavuza ethile

Lapho ama-antibodies akha amangqamuzana abomvu egazi ngaphandle kwesizathu, lesi simo sibizwa ngokuthi yi-idiopathic autoimmune hemolytic anemia.

Ama-antibody nawo angabangelwa:

• Ukucindezelwa kwesinye isifo
• Ukumpontshelwa igazi okwedlule
• Ukukhulelwa (uma uhlobo lwegazi lomntwana luhlukile koluka mama)

Izici zobungozi zihlobene nezimbangela.

Ungahle ungabi nazimpawu uma i-anemia imnene. Uma inkinga ikhula kancane, izimpawu ezingenzeka kuqala zifaka:

• Ukuzizwa ubuthakathaka noma ukhathele kaningi kunokujwayelekile, noma ngokuzivocavoca umzimba
• Ukuphathwa ikhanda
• Izinkinga ukugxila noma ukucabanga

Uma i-anemia iba yimbi, izimpawu zingafaka:

• Ikhanda elikhanyayo lapho usukuma
• Umbala wesikhumba okhanyayo (i-pallor)
• Ukuphelelwa umoya
• Ulimi olubuhlungu

Ungadinga izivivinyo ezilandelayo:

• Isibalo se-reticulocyte ngokuphelele
• Ukuhlolwa okuqondile noma okungaqondile kweCoombs
• I-hemoglobin emchameni
• I-LDH (izinga lale enzyme likhuphuka ngenxa yokulimala kwezicubu)
• Ukubalwa kwamaseli abomvu egazi (RBC), i-hemoglobin, ne-hematocrit
• Izinga le-serum bilirubin
• I-hemoglobin yamahhala ye-Serum
• I-serum haptoglobin
• Ukuhlolwa kukaDonath-Landsteiner
• Ama-agglutinins abandayo
• I-hemoglobin yamahhala ku-serum noma emchameni
• I-Hemosiderin emchameni
• Ukubalwa kweplatelet
• Amaprotheni electrophoresis - serum
• Pyruvate kinase
• Izinga le-serum haptoglobin
• Umchamo kanye nendle urobilinogen

Ukwelashwa kokuqala okuvame ukwenziwa kuvame umuthi we-steroid, njenge-prednisone. Uma umuthi we-steroid ungasithuthukisi lesi simo, kungabhekwa ukwelashwa nge-intravenous immunoglobulin (IVIG) noma ukukhishwa kobende (splenectomy).

Ungathola ukwelashwa ukucindezela amasosha akho omzimba uma ungaphenduli kuma-steroids. Kusetshenziswe izidakamizwa ezifana ne-azathioprine (Imuran), cyclophosphamide (Cytoxan), ne-rituximab (Rituxan).

Ukumpontshelwa igazi kunikezwa ngokuqapha, ngoba igazi lingahle lingahambelani futhi lingadala ukubhujiswa kwamangqamuzana egazi abomvu amaningi.

Lesi sifo singaqala ngokushesha futhi sibe sibi kakhulu, noma singahlala simnene futhi singadingi ukwelashwa okukhethekile.

Kubantu abaningi, ama-steroids noma i-splenectomy angakwazi ukulawula ngokuphelele noma ngokwengxenye i-anemia.

I-anemia enamandla ayivamile ukuholela ekufeni. Ukutheleleka okunamandla kungenzeka njengenkinga yokwelashwa ngama-steroids, eminye imithi ecindezela amasosha omzimba, noma i-splenectomy. Lezi zindlela zokwelapha zonakalisa amandla omzimba okulwa nokutheleleka.

Shayela umhlinzeki wakho wezokunakekelwa kwezempilo uma unokudinwa okungachazeki noma ubuhlungu besifuba, noma izimpawu zokutheleleka.

Ukuhlolisiswa kwama-antibody egazini elinikelwe nakumamukeli kungavimbela i-hemolytic anemia ehlobene nokumpontshelwa igazi.

I-anemia - i-immune hemolytic; I-autoimmune hemolytic anemia (AIHA)

• Amasosha omzimba

UMichel M. Autoimmune kanye ne-intravascular hemolytic anemias. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 151.

UMichel M, uJäger U. I-autoimmune hemolytic anemia. Ku: Hoffman R, Benz EJ, Silberstein LE, et al, ama-eds. I-Hematology: Izimiso Eziyisisekelo Nokuzijwayeza. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2018: isahluko 46.