Konke Okufanele Ukwazi Nge-Poikilocytosis

-Delile

• Izimpawu poikilocytosis
• Yini ebangela i-poikilocytosis?
• Ukuhlonza i-poikilocytosis
• Yiziphi izinhlobo ezahlukahlukene ze-poikilocytosis?
• Ama-spherocyte
• Ama-Stomatocyte (amaseli omlomo)
• Ama-codocyte (amaseli aqondiwe)
• AmaLeptocyte
• Amaseli wokugula (ama-drepanocyte)
• Ama-Elliptocyte (ama-ovalocyte)
• Ama-dacryocyte (amaseli wezinyembezi)
• Ama-Acanthocyte (akhuthaza amaseli)
• Ama-Echinocyte (amaseli we-burr)
• Ama-Schizocyte (ama-schistocyte)
• Uphathwa kanjani i-poikilocytosis?
• Uyini umbono?

Yini i-poikilocytosis?

I-Poikilocytosis yigama lezokwelapha lokuba namaseli abomvu angajwayelekile (RBCs) egazini lakho. Amaseli egazi abunjwe ngokungajwayelekile abizwa ngokuthi ama-poikilocyte.

Imvamisa, ama-RBC womuntu (abuye abizwe ngokuthi ama-erythrocyte) amiswe okwediski anendawo eyisicaba ezinhlangothini zombili. Ama-poikilocytes anga:

• thopha kunokujwayelekile
• ibe mide, imise okweqanda, noma imise okwehliswa izinyembezi
• ube nokuqagela okucacile
• unezinye izici ezingavamile

Ama-RBC athwala umoya-mpilo nezakhi zomzimba ezicutshini nasemalungeni omzimba wakho. Uma ama-RBC akho enziwe ngokungajwayelekile, kungenzeka angakwazi ukuphatha umoya-mpilo owenele.

I-Poikilocytosis ivame ukubangelwa esinye isimo sezokwelapha, njenge-anemia, isifo sesibindi, ukuphuza ngokweqile, noma ukuphazamiseka kwegazi okuzuzwe njengefa. Ngalesi sizathu, ukutholakala kwama-poikilocytes nokuma kwamaseli angajwayelekile kuyasiza ekutholeni ezinye izimo zezokwelapha. Uma une-poikilocytosis, kungenzeka unesimo esingaphansi esidinga ukwelashwa.

Izimpawu poikilocytosis

Uphawu oluyinhloko lwe-poikilocytosis lunenani elikhulu (elikhulu kunamaphesenti ayi-10) lama-RBC abunjwe ngokungajwayelekile.

Ngokuvamile, izimpawu ze-poikilocytosis zincike esimweni esingaphansi. I-Poikilocytosis nayo ingabhekwa njengesimpawu sezinye izifo eziningi.

Izimpawu ezivamile zezinye izifo ezihlobene negazi, njenge-anemia, zifaka:

• ukukhathala
• isikhumba esiphaphathekile
• ubuthakathaka
• ukuphelelwa umoya

Lezi zimpawu ezithile zingumphumela wokuthi i-oxygen enganele ilethwe ezicutshini nasemalungeni omzimba.

Yini ebangela i-poikilocytosis?

I-Poikilocytosis imvamisa ingumphumela wesinye isimo. Izimo zePoikilocytosis zingazuzwa njengefa noma zitholwe. Izimo ezizuzwe njengefa zibangelwa ukuguquka kwezakhi zofuzo. Izimo ezitholakalayo zikhula kamuva empilweni.

Izimbangela zofuzo ze-poikilocytosis zifaka:

• i-sickle cell anemia, isifo sofuzo esibonakala ngama-RBCs anomumo wocezwana olungajwayelekile
• i-thalassemia, ukuphazamiseka kwegazi kwezakhi zofuzo lapho umzimba wenza khona i-hemoglobin engajwayelekile
• ukushoda kwepyruvate kinase
• IMcLeod syndrome, ukugula okungavamile kofuzo okuthinta izinzwa, inhliziyo, igazi nobuchopho. Izimpawu zivame ukufika kancane futhi ziqale lapho usumdala
• ifa elliptocytosis
• i-spherocytosis eyifa

Izimbangela ezitholakele ze-poikilocytosis zifaka:

• i-iron-defence anemia, uhlobo oluvame kakhulu lwe-anemia olwenzeka lapho umzimba ungenayo i-iron eyanele
• i-megaloblastic anemia, i-anemia evame ukubangelwa ukuntuleka kwe-folate noma i-vitamin B-12
• autoimmune hemolytic anemias, iqembu lokuphazamiseka okwenzeka lapho amasosha omzimba abulala ngephutha ama-RBC
• isifo sesibindi nesinso
• ukuphuza ngokweqile noma isifo sesibindi esihlobene notshwala
• ukuhola ubuthi
• ukwelashwa ngamakhemikhali
• izifo ezinzima
• umdlavuza
• myelofibrosis

Ukuhlonza i-poikilocytosis

Zonke izingane ezisanda kuzalwa e-United States zihlolelwa izifo ezithile zofuzo, njenge-sickle cell anemia. I-Poikilocytosis ingatholwa ngesikhathi sokuhlolwa okubizwa nge-blood smear. Lokhu kuhlolwa kungenziwa ngesikhathi sokuhlolwa komzimba okujwayelekile, noma uma uhlangabezana nezimpawu ezingachazeki.

Ngesikhathi se-smear yegazi, udokotela usakaza ungqimba oluncane lwegazi kwisilayidi semicroscope bese engcolisa igazi ukusiza ukuhlukanisa amaseli. Udokotela ube eselibheka igazi ngaphansi kwesibonakhulu, lapho kungabonakala khona ubukhulu nobukhulu bama-RBC.

Akuyona yonke i-RBC eyodwa ezothatha isimo esingajwayelekile. Abantu abane-poikilocytosis bavamise ukwakheka kwamaseli ahlanganiswe namaseli abunjwe ngokungajwayelekile. Kwesinye isikhathi, kunezinhlobo ezahlukahlukene zama-poikilocytes akhona egazini. Udokotela wakho uzozama ukuthola ukuthi yikuphi ukuma okuvame kakhulu.

Ngaphezu kwalokho, udokotela wakho cishe uzokwenza izivivinyo eziningi ukuthola ukuthi yini ebangela ama-RBC akho abunjwe ngokungajwayelekile. Udokotela wakho angakubuza imibuzo ngomlando wakho wezokwelapha. Qiniseka ukuthi ubatshela ngezimpawu zakho noma uma uthatha noma yimiphi imithi.

Izibonelo zezinye izivivinyo zokuxilonga zifaka:

• ukubalwa kwegazi okuphelele (CBC)
• amazinga wensimbi we-serum
• ukuhlolwa kwe-ferritin
• uvivinyo lukavithamini B-12
• ukuhlolwa komuntu
• ukuhlolwa kwesibindi
• umnkantsha wethambo
• ukuhlolwa kwe-pyruvate kinase

Yiziphi izinhlobo ezahlukahlukene ze-poikilocytosis?

Kunezinhlobo ezahlukahlukene ze-poikilocytosis. Uhlobo luye ngezimpawu zama-RBC abunjiwe ngokungajwayelekile. Ngenkathi kungenzeka ukuthi kube nohlobo olungaphezu kolulodwa lwe-poikilocyte olukhona egazini nganoma yisiphi isikhathi, imvamisa uhlobo olulodwa luzodlula olunye.

Ama-spherocyte

Ama-spherocyte mancane, amangqamuzana ayindilinga aminyene angenaso isikhungo esicwecwe, esinombala okhanyayo sama-RBC abunjwe njalo. Ama-spherocyte angabonakala ezimweni ezilandelayo:

• i-spherocytosis eyifa
• i-anemia ye-hemolytic ezenzakalelayo
• ukusabela kokumpontshelwa kwe-hemolytic
• ukuphazamiseka kokuhlukaniswa kwamaseli abomvu

Ama-Stomatocyte (amaseli omlomo)

Ingxenye emaphakathi yeseli le-stomatocyte yi-elliptical, noma i-slit-like, esikhundleni sokuzungeza. Ama-Stomatocyte avame ukuchazwa njengamise okwenziwe ngomlomo, futhi angabonakala kubantu abane:

• ukuphuza ngokweqile
• isifo sesibindi
• ifa le-stomatocytosis, isifo esingajwayelekile sezakhi zofuzo lapho ulwelwesi lweseli luvuza khona i-ion ne-potassium ion

Ama-codocyte (amaseli aqondiwe)

AmaCodocyte kwesinye isikhathi abizwa ngokuthi amaseli akhokhelwe ngoba avame ukufana ne-bullseye. Ama-codocyte angavela ezimeni ezilandelayo:

• thalassemia
• isifo sesibindi se-cholestatic
• ukuphazamiseka kwe-hemoglobin C.
• abantu abasanda kususwa ubende (splenectomy)

Yize kungejwayelekile, ama-codoctyes angabonakala nakubantu abane-sickle cell anemia, i-iron defence anemia, noma i-lead lead.

AmaLeptocyte

Ngokuvamile abizwa ngokuthi amangqamuzana alucwecwe, ama-leptocyte mancane, amaseli ayizicaba ane-hemoglobin onqenqemeni lweseli. Ama-leptocyte abonakala kubantu abanezifo ze-thalassemia nalabo abanezifo zesibindi ezivimbelayo.

Amaseli wokugula (ama-drepanocyte)

Amaseli wokugula, noma ama-drepanocyte, ahlukanisiwe, ama-RBCs amise okweqanda. Lawa maseli ayisici sesici se-sickle cell anemia kanye ne-hemoglobin S-thalassemia.

Ama-Elliptocyte (ama-ovalocyte)

Ama-Elliptocyte, abizwa nangokuthi ama-ovalocyte, amise okweqanda kancane kumise okogwayi onemiphetho ebuthuntu. Imvamisa, ukutholakala kwenani elikhulu lama-elliptocyte kukhombisa isimo esizuzwe njengefa elliptocytosis. Izinombolo ezilinganisiwe zama-elliptocyte zingabonakala kubantu abane:

• thalassemia
• myelofibrosis
• ukuqina kwesibindi
• i-iron-defence anemia
• i-megaloblastic anemia

Ama-dacryocyte (amaseli wezinyembezi)

Ama-erythrocyte wezinyembezi, noma ama-dacryocyte, angama-RBCs anomkhawulo owodwa oyindilinga nowokuphela okukodwa okuqondile. Lolu hlobo lwe-poikilocyte lungabonakala kubantu abane:

• beta-thalassemia
• myelofibrosis
• i-leukemia
• i-megaloblastic anemia
• i-hemolytic anemia

Ama-Acanthocyte (akhuthaza amaseli)

Ama-Acanthocyte anokuqagela okungafani nameva (okubizwa ngama-spicule) onqenqemeni lwe-membrane yeseli. Ama-acanthocyte atholakala ezimweni ezifana nalezi:

• i-abetalipoproteinemia, isimo sezakhi zofuzo esingajwayelekile esiholela ekwehlulekeni kokuthola amafutha athile okudla
• isifo esinzima sesibindi sotshwala
• ngemuva kwe-splenectomy
• i-anemia ye-hemolytic ezenzakalelayo
• isifo sezinso
• thalassemia
• Isifo seMcLeod

Ama-Echinocyte (amaseli we-burr)

Njengama-acanthocyte, ama-echinocyte nawo anokuqagela (ama-spicule) onqenqemeni lwe-membrane yeseli. Kepha lokhu kuqagela kuhlukaniswe ngokulinganayo futhi kwenzeka kaningi kunama-acanthocyte. Ama-Echinocyte abizwa nangokuthi ama-burr cells.

Ama-echinocyte angabonakala kubantu abanezimo ezilandelayo:

• ukushoda kwe-pyruvate kinase, ukuphazamiseka kokuthola umzimba okuthinta ukusinda kwama-RBC
• isifo sezinso
• umdlavuza
• ngokushesha ngemuva kokumpontshelwa kwegazi eligugile (ama-echinocyte angakheka ngesikhathi sokugcinwa kwegazi)

Ama-Schizocyte (ama-schistocyte)

Ama-Schizocyte ahlukaniswe ngama-RBC. Zivame ukubonakala kubantu abane-hemolytic anemias noma bangavela ngokuphendula imibandela elandelayo:

• sepsis
• ukutheleleka okukhulu
• ukusha
• ukulimala kwezicubu

Uphathwa kanjani i-poikilocytosis?

Ukwelashwa kwe-poikilocytosis kuncike kulokho okubangela isimo. Isibonelo, i-poikilocytosis ebangelwa amazinga aphansi kavithamini B-12, i-folate, noma i-iron cishe izophathwa ngokuthatha izengezo nokwandisa inani lalawa mavithamini ekudleni kwakho. Noma, odokotela bangaphatha isifo esiyisisekelo (njengesifo se-celiac) okungenzeka ukuthi kubangele ukuntuleka kwasekuqaleni.

Abantu abanezinhlobo ze-anemia ezizuzwe njengefa, njenge-sickle cell anemia noma i-thalassemia, bangadinga ukumpontshelwa igazi noma ukufakelwa umnkantsha ukuze belaphe isimo sabo. Abantu abanesifo sesibindi bangadinga ukufakelwa, kanti labo abanezifo ezimbi bangadinga ama-antibiotic.

Uyini umbono?

Umbono wesikhathi eside we-poikilocytosis uncike embangela nokuthi uphathwa ngokushesha kangakanani. Ukushoda kwegazi okubangelwa ukuntuleka kwensimbi kuyelapheka futhi kuyelapheka kaningi, kodwa kungaba yingozi uma kungalashwa. Lokhu kuyiqiniso ikakhulukazi uma ukhulelwe. I-anemia ngesikhathi sokukhulelwa ingadala izinkinga zokukhulelwa, kufaka phakathi ukukhubazeka okukhulu kokuzalwa (njengokukhubazeka kwe-neural tube).

I-anemia ebangelwa ukuphazamiseka kwezakhi zofuzo njenge-sickle cell anemia izodinga ukwelashwa impilo yonke, kepha intuthuko yezokwelapha yakamuva ithuthukise umbono walabo abanezinkinga ezithile zegazi zofuzo.