Ciwo na Evans shine haɗuwa biyu ko fiye da nakasar cututtuka inda tsarinka na rigakafi ya kai hari ga karnukan fararen ka, da jini mai launin jini da / ko platelets. Wadannan sun hada da maganin thrombocytopenia (ITP) , anemia hemolunic hemolytic (AIHA) , da kuma / neutropenia na autoimmune (AIN). Wadannan samfurori na iya faruwa a lokaci daya amma kuma zasu iya faruwa a cikin wannan haƙuri a lokuta biyu.
Alal misali, idan an gano ku tare da ITP kuma bayan shekaru biyu bayanan da aka gano tare da AIHA, kuna da Evans Syndrome.
Cutar cututtuka
A mafi yawancin lokuta, an riga an gano ku tare da ɗayan ɓarwar mutum: ITP, AIHA, ko AIN. Evans Syndrome ya nuna kamar kowane ɓangaren mutum. Hutun cututtuka sun hada da:
Low platelet ƙidaya (thrombocytopenia) sun fi na kowa:
- Ƙara murmushi
- Ƙara yawan zub da jini: zubar da jini a cikin bakin, da hanci, da zub da jini, jini a cikin fitsari ko kuma dashi
- Ƙananan dige ja a fata da ake kira petechiae
Mutuwar:
- Wuci ko gajiya
- Rawancin numfashi
- Girman zuciya mai yawa (tachycardia)
- Samun launin fata (jaundice) ko idanun (giraguni icterus)
- Dark guba (shayi ko coca-cola masu launin)
Low neutrophil count (neutropenia):
- Fever
- Cutar cututtuka ko bakin
- Sau da yawa babu alamun cututtuka
Me yasa cutar cututtuka ta haifar da jinin da nake ciki?
Cutar cutar Evans wani cututtuka ne.
Ga wani dalili ba tare da dalili ba, tsarinka na rigakafi ba daidai ba yana gano jinsin jinin ka, plalets, da / ko neutrophils kamar "kasashen waje" kuma ya hallaka su. Ba a fahimci cikakkiyar dalilin da yasa wasu mutane kawai suna da kwayar cutar guda daya, kamar a ITP, AIHA, ko AIN, da fiye da ɗaya a Evans Syndrome.
Sanin asali
Kamar yadda mafi yawan mutane tare da Evans Syndrome sun riga sun dauki daya daga cikin maganin, wanda aka gabatar da wanda ya dace da Evans Syndrome. Alal misali, idan an gano ku tare da ITP da kuma ci gaba da anemia, likitanku zai buƙatar sanin abin da ya faru na anemia. Idan an gano anemia ya kasance saboda AIHA, za a gano ku tare da Evans Syndrome.
Saboda wadannan cututtuka sun shafi lamarin ku, adadin jini (CBC), shine mataki na farko a cikin aikin. Likitan likitanka yana neman shaida na anemia (low hemoglobin), thrombocytopenia (low plate count) ko neutropenia (ƙananan neutrophil count, wani irin jini na jini). Za a bincika jininka a ƙarƙashin microscope don kokarin gano dalilin. ITP da kuma AI suna da alamun rashin ma'anar ma'anar babu wani gwajin gwaji na musamman. Dole likitanku dole ne ya fitar da sauran abubuwan da ke faruwa a farko. An tabbatar da AIHA ta hanyar gwaje-gwaje masu yawa, musamman gwajin da ake kira DAT (gwajin antiglobulin kai tsaye). DAT na neman shaidar cewa tsarin na rigakafi yana kai hari ga jinin jinin.
Jiyya
Akwai jerin jerin lokuttan da za a iya jiyya. Ana kula da maganin wasu kwayoyin jini da kuma ko kuna da wasu alamomi (zubar da jini, rashin ƙarfi na numfashi, ƙwaƙwalwar zuciya, kamuwa da cuta):
- Magunguna: Magunguna kamar misalin da aka yi amfani dasu a cikin shekaru masu yawa a wasu cututtuka na autoimmune. Su ne maganin farko don maganin AIHA kuma ana amfani dashi a ITP. Abin takaici, idan kana da Evans Syndrome, zaka iya buƙatar sitik din na dogon lokaci wanda zai haifar da wasu al'amurran da suka shafi jini da hawan jini (hauhawar jini) da kuma jini masu yawan jini (ciwon sukari). Saboda wannan dalili, likita na iya neman hanyoyin magance hanyoyin.
- Immunoglobulin mai ciki (IVIG): IVIG shine maganin farko na ITP. Bisa ga mahimmanci, IVIG ta janye tsarinka na rigakafi na dan lokaci don kada a lalata batir ɗin da sauri. IVIG ba ta da tasiri a AIHA ko AIN.
- Splenectomy: Gwangwani shine babban wuri na halakar kwayoyin jinin jini, platelets, da neutrophils a cikin Evans Syndrome. A wasu marasa lafiya, ƙwaƙwalwar ƙwayar ƙwayar za ta iya inganta yawan jini, amma wannan yana iya zama kawai na wucin gadi.
- Rituximab: Rituximab a magani wanda ake kira antibody. Ya rage ƙananan ƙwayoyin B-lymphocytes (jini mai tsabta wanda ke sa ciwon daji), wanda zai inganta yawan jinin ku.
- G-CSF (filgrastim): G-CSF shine maganin da ake amfani dashi wajen tayar da kasusuwa na kasusu don yin karin tsaka-tsaki. Ana amfani da shi a wani lokacin don ƙara yawan ƙimar neutrophil a cikin AI, musamman idan kana da wata cuta.
- Magunguna marasa magani: Wadannan magunguna sun hana tsarin rigakafi. Wadannan sun hada da magungunan kamar likitan motar (MMF), azathioprine (Immuran), tacrolimus (Prograf).
Mene ne Yayin da zan Yi Aminiya?
Kodayake marasa lafiya zasu iya amsa maganin kowane mutum tare da kyautatawa a ƙididdigar jini, wannan amsa idan sau da yawa na wucin gadi yana buƙatar ƙarin jiyya.
> Sources:
> Schrier SL. Warm Autoimmune Anemolytic Anemia: Jiyya a UpToDatePost TW (Ed), UpToDate, Waltham, MA.