Hemolytic-uremic maʻi maʻi

Ke hana nei i nā toxin like Shiga E coli he hemolytic-uremic syndrome (STEC-HUS) kahi maʻi e pinepine pinepine ʻia ke hana ʻia kahi maʻi i ka ʻōnaehana digestive i nā lāʻau ʻona.Hoʻopau kēia mau mea i nā hunaola ʻulaʻula a hōʻeha i nā puʻupaʻa.

Hana pinepine ʻo Hemolytic-uremic syndrome (HUS) ma hope o ka maʻi gastrointestinal me E coli koʻohune (Escherichia coli O157: H7). Eia naʻe, ua pili pū ke ʻano i nā maʻi gastrointestinal ʻē aʻe, e like me shigella a me salmonella. Ua hoʻopili ʻia i nā maʻi nongastrointestinal.

ʻO HUS ka mea maʻamau i nā keiki. ʻO ia ke kumu maʻamau o ka hōʻino ʻole o ka hakuʻala i nā keiki. Ua hoʻopili ʻia kekahi mau maʻi nui i ka ʻiʻo hamburger i ʻai ʻole ʻia E coli.

E coli hiki ke hoʻoili ʻia ma o:

• Hoʻokaʻaʻike mai kekahi kanaka i kekahi
• ʻO ka ʻai ʻana i ka meaʻai i hoʻomoʻa ʻole ʻia, e like me nā huahana waiū a i ʻole pipi

ʻAʻole e huikau ʻo STEC-HUS me Hyp (aHUS) pili ʻole i pili ʻole i ka maʻi. Ua like ia me kekahi maʻi ʻē aʻe i kapa ʻia thrombotic thrombositopenic purpura (TTP).

Hoʻomaka pinepine ʻo STEC-HUS me ka luaʻi a me ka palahī, a he koko paha. I loko o hoʻokahi pule, e lilo paha ke kanaka i mea nāwaliwali a huhū. Hiki i nā poʻe me kēia ʻano ke mimiki liʻiliʻi ma mua o ka maʻamau. ʻAneʻane pau paha ka puka o ka mimi.

ʻO ka luku ʻana o ke koko ʻulaʻula e alakaʻi i nā ʻōuli o ka anemia.

Nā ʻōuli mua:

• Koko i nā noho
• Huhū
• Fiva
• Lethargy
• ʻO ka luaʻi a me ka diarrhea
• Nawaliwali

Nā hōʻailona hope:

• ʻUpala
• Hoemi i ka ʻike
• Puka mimi haʻahaʻa
• ʻAʻohe puka mimi
• Pallor
• Ka hopu ʻana - kākaʻikahi
• ʻO ka ʻili e like me nā ʻulaʻula maikaʻi (petechiae)

E hana ka mea mālama ola i kahi hoʻokolohua kino. Hōʻike paha kēia:

• Hū a pehu paha
• Hoʻololi ka ʻōnaehana nervous

E hōʻike nā hoʻokolohua Laboratory i nā hōʻailona o ka hemolytic anemia a me ka hōʻeha hōʻino koʻikoʻi. E komo pū paha nā hoʻāʻo:

• Nā hoʻāʻo ʻana o ke kāpili koko (PT a me PTT)
• Hōʻike ka panel metabolic Comprehensive i nā pae hoʻonui o BUN a me ka creatinine
• Hiki i ka helu piha o ke koko (CBC) ke hōʻike i ka hoʻonui ʻia o ka helu o ke koko keʻokeʻo a hoʻemi i ka helu o ke koko ʻulaʻula
• Hoʻemi pinepine ʻia ka helu platelet
• Hōʻike paha ka urinalysis i ke koko a me ka protein i ka mimi
• Hiki i ka hōʻike protein urine ke hōʻike i ka nui o nā protein i ka mimi

Nā hoʻāʻo ʻē aʻe:

• Kūpono paha ka moʻomeheu Stool no kekahi ʻano o E coli koʻohune a i ʻole bacteria ʻē aʻe
• Kolonekia
• ʻO ka biopsy hakuʻala (i nā manawa kakaikahi)

Hoʻopili paha ka mālama ʻana:

• Dialysis
• ʻO nā lāʻau, e like me nā corticosteroids
• Ka mālama ʻana i nā wai a me nā electrolytes
• Nā transfusions o nā ʻulaʻula koko piha a me nā platelet

He maʻi nui kēia i nā keiki a me nā mākua, a he mea ia e make ai. Me ka lapaʻau kūpono, ʻoi aku ka hapa o ka poʻe e ola. ʻOi aku ka maikaʻi o ka hopena i nā keiki ma mua o nā mākua.

Komo pū nā pilikia:

• Nā pilikia pili koko
• Hemolytic anemia
• Hewa ʻole nā ​​hakuʻala
• ʻO ke kiʻekiʻe kiʻekiʻe e alakaʻi ana i ka hopu ʻana, ka huhū, a me nā pilikia ʻōnaehana ʻē aʻe
• ʻOi loa nā platelet (thrombositopenia)
• Uremia

Kāhea i kāu mea hāʻawi inā hoʻomōhala ʻoe i nā ʻōuli o HUS. ʻO nā hōʻailona kūpilikiʻi me:

• Koko i loko o ka pahu
• ʻAʻohe urination
• Hoemi i ka makaʻala (ʻike)

Kāhea i kāu mea hāʻawi inā loaʻa iā ʻoe kahi mahele o HUS a hoʻemi ʻia kāu puka mimi, a i ʻole e hoʻomohala i nā hōʻailona hou ʻē aʻe.

Hiki iā ʻoe ke pale i ke kumu i ʻike ʻia, E coli, e ka kuke ʻana i ka hamburger a me nā ʻiʻo ʻē aʻe maikaʻi. Pono ʻoe e hōʻalo i ka launa ʻana me ka wai haumia a ukali i nā ʻano holoi lima kūpono.

HUS; STEC-HUS; Hemolytic-uremic maʻi maʻi

• ʻŌnaehana mimi kāne

ʻO Alexander T, Licht C, Smoyer WE, Rosenblum ND. Nā maʻi o ka puʻuwai a me ka urinary tract luna i nā keiki. I: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, eds. ʻO Brenner a me Rector's The Kidney. 11th hua. Piladelapia, PA: Elsevier; 2020: chap: 72.

Mele C, Noris M, Remuzzi G. Hemolytic uremic maʻi. I: Ronco C, Bellomo R, Kellum JA, Ricci Z, eds. Manaʻo koʻikoʻi koʻikoʻi nephrology. ʻEkolu huaʻōlelo. Piladelapia, PA: Elsevier; 2019: chap 50.

ʻO Schneidewend R, Epperla N, Friedman KD. ʻO Thrombotic thrombositopenic purpura a me nā hemolytic uremic syndrome. I: Hoffman R, Benz EJ, Silberstein LE, et al, eds. Hematology: Nā Kumumanaʻo a me ka Hoʻomeheu. ʻEpekema 7 Piladelapia, PA: Elsevier; 2018: chap 134.