Anemia hemolytic immune

ʻO ke Anemia kahi ʻano i lawa ʻole ke kino i nā hunaola ʻulaʻula olakino. Hāʻawi nā hunaola ʻulaʻula i ka oxygen i nā aʻa o ke kino.

Kū nā ʻula koko ʻulaʻula ma kahi o 120 mau lā ma mua o ka hemo ʻana o ke kino. I ka hemolytic anemia, hoʻopau ʻia nā hunaola ʻulaʻula i ke koko ma mua o ka maʻamau.

Hana ʻia ka anemia hemolytic immune ke hana kūpale ʻia e kūʻē i nā hunaola koko ʻulaʻula o ke kino a luku iā lākou. Hana kēia ma muli o ka ʻike kuhi hewa ʻana o ka ʻōnaehana pale pale i kēia mau huna koko ma ke ʻano he haole.

ʻO nā kumu i hiki ke hoʻopili ʻia:

• Kekahi kemika, lāʻau, a me nā mea make
• Nā maʻi ʻino
• Hoʻololi o ke koko mai kahi mea hāʻawi me kahi ʻano koko e kūlike ʻole
• Nā maʻi ʻaʻai ʻē aʻe

Ke hana kūpale i nā hunaola ʻulaʻula no ke kumu ʻole, kapa ʻia ke ʻano he idiopathic autoimmune hemolytic anemia.

Hoʻokumu pū ʻia nā mea ʻino e:

• Ka pilikia o kekahi maʻi
• Hoʻohuli koko i hala
• Hāpai keiki (inā ʻokoʻa ke ʻano o ke koko o ka pēpē mai ka makuahine)

Pili nā kumu pilikia i nā kumu.

ʻAʻole paha ʻoe e loaʻa nā ʻōuli inā akahai ka anemia. Inā hoʻomohala mālie ka pilikia, hiki i nā ʻōuli ke hana mua me:

• Manaʻo nāwaliwali a luhi paha ma mua o ka mau, a i ʻole me ka hoʻoikaika kino
• Poʻo poʻo poʻo
• Nā pilikia e noʻonoʻo ana a i ʻole ka noʻonoʻo ʻana

Inā hele a māhuahua ka anemia, hiki i nā ʻōuli ke komo pū me:

• ʻO ke kukui ke kū ʻoe i luna
• ʻO kaʻili o kaʻili pale (pallor)
• Pokole o ka hanu
• Lelo ʻeha

Pono ʻoe i kēia mau hoʻāʻo:

• Helu retikulii holoʻokoʻa
• Hōʻike Coombs pololei a pololei ʻole paha
• Hemoglobin i ka mimi
• LDH (piʻi ke kiʻekiʻe o kēia enzyme ma muli o ka hopena o ka nāʻaʻa)
• Helu helu ʻulaʻula koko (RBC), hemoglobin, a me hematocrit
• Papa pae bilirubin
• ʻO ka hemoglobin manuahi
• Serum haptoglobin
• Hōʻike Donath-Landsteiner
• ʻO nā aglutinins anuanu
• Hemoglobin manuahi i ke serum a i mimi paha
• Hemosiderin i ka mimi
• Heluna pāluna
• Protein electrophoresis - serum
• Pyruvate kinase
• ʻO ka pae haptoglobin serum
• Urino a me ka urobilinogen fecal

ʻO ka lapaʻau mua i hoʻāʻo pinepine ʻia he lāʻau steroid, e like me prednisone. Inā hoʻomaikaʻi ʻole ka lāʻau lapaʻau steroid i ke ʻano, hiki ke noʻonoʻo ʻia me ka mālama ʻana me ka immunoglobulin intravenous (IVIG) a i ʻole ka hemo ʻana o ka spleen (splenectomy).

Loaʻa paha iā ʻoe ka lāʻau e kāohi i kāu ʻōnaehana pale inā ʻaʻole ʻoe e pane i nā steroid. Hoʻohana ʻia nā lāʻau e like me azathioprine (Imuran), cyclophosphamide (Cytoxan), a me rituximab (Rituxan).

Hāʻawi ʻia ke transfusions me ke akahele, no ka mea ʻaʻole pili ke koko a he kumu ia e nui aku ai ka luku ʻia o ke koko.

E hoʻomaka koke paha ka maʻi a koʻikoʻi loa, a i ʻole e noho mālie a pono ʻole i kahi lapaʻau kūikawā.

I ka hapanui o nā kānaka, hiki i nā steroid a splenectomy paha ke kāohi a hapa paha i ka anemia.

ʻAʻole hiki i ka anemia koʻikoʻi ke alakaʻi i ka make. Hiki ke hele i kahi maʻi nui ma ke ʻano he pilikia o ka mālama ʻana me nā steroid, nā lāʻau ʻē aʻe e kāohi i ka ʻōnaehana pale, a i ʻole splenectomy. Hoʻopilikia kēia mau lapaʻau ʻana i ka hiki i ke kino ke hakakā i ka maʻi.

Kāhea i kāu mea mālama ola inā loaʻa ʻoe i ka luhi ʻole a i ʻole ka ʻeha o ka umauma, a i ʻole nā ​​hōʻailona o ka maʻi.

ʻO ka loiloi ʻana no nā mea ʻūpā i ke koko i hāʻawi ʻia a i ka mea e loaʻa ai e pale i ka anemia hemolytic e pili ana i nā transfusions koko.

Anemia - pale hemolytic; ʻO ke anemia hemolytic autoimmune (AIHA)

• Nā Antibodies

ʻO Michel M. Autoimmune a me nā anemias hemolytic intravascular. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier; 2020: chap 151.

ʻO Michel M, Jäger U. Anemia hemolytic autoimmune. I: Hoffman R, Benz EJ, Silberstein LE, et al, eds. Hematology: Nā Kumumanaʻo a me ka Hoʻomeheu. ʻEpekema 7 Piladelapia, PA: Elsevier; 2018: chap 46.