Binciken Harkokin Cutar cututtuka, ganewar asali, da kuma Kula da Harkokin Hypereosinophilic
Bayani
Harkokin Hypereosinophilic (HES) sune rukuni na rashin tausayi wanda ke dauke da ƙananan eosinophils (eosinophilia) wanda zai haifar da lalacewar gabobin jiki (fata, huhu, zuciya, gastrointestinal tract). Yawancin mutane sun wuce shekaru 20 a ganewar asali amma zai iya faruwa a yara. Yawancin HES suna dauke da yanayi mara kyau (wadanda ba za'a iya yiwuwa) ba amma ana amfani da sashin layi na neoplasms wanda zai iya samuwa cikin ciwon daji.
Definition
Hypereosinophilia an bayyana a matsayin cikakken eosinophil ƙidaya fiye da 1500 kwayoyin / microliter akan lambobin jini guda biyu (CBC) a kan lokuta guda biyu da suka rabu da su a kalla wata daya da / ko tabbatar da hypereosinophilia nama a kan biopsy. Hypereosinophilia a cikin kyallen takarda an bayyana akan yankin biopsy. A kan kasusuwan maniyyi na kasusuwa, an kwatanta hypereosinophilia lokacin da kashi 20 cikin 100 na kwayoyin halittu sune eosinophils. A kan wasu kyallen takarda, an bayyana shi a matsayin "mai yawa" shigarwa na eosinophils zuwa cikin jiki a cikin ra'ayi na likitancin (likita na nazarin biopsy).
Yawancin yanayi zai iya haifar da eosinophilia amma waɗannan suna da wuya haifar da lalacewar nama a HES. Eosinophilia za a iya rushe zuwa sassa uku: m (500 zuwa 1500 eosinophils / microliter), matsakaicin (1500 zuwa 5000 eosinophils / microliter), da kuma mai tsanani (fiye da 5000 eosinophils / microliter.
Iri
HES za a iya raba zuwa manyan nau'o'i uku: firamare (ko neoplastic), na biyu (ko mai amsawa), da kuma idiopathic. Harkokin jari-hujja HES shine ganewar asali na cirewa, ma'anar cewa babu wani dalili na eosinophilia da za'a iya gano. A cikin HES na farko, canzawar kwayar cutar ta haifar da hawan kashi don inganta kayan aikin eosinophil kamar su polycythemia vera ko muhimmancin thrombocythemia .
A sakandare HES, yanayin da ke damuwa (ciwo na kamuwa da cuta, lymphoma, da dai sauransu) yana samar da sunadaran (wanda ake kira cytokines) wanda ke motsa aikin samar da eosinophil.
Cutar cututtuka
Hanyoyin cutar HES suna dogara ne akan yankin da ya shafi kuma zai iya haɗawa da:
- Skin: eczema, thickening na fata, amya,
- Kwanyar: tari, rashin ƙarfi na numfashi, wheezing
- Zuciya: zafi mai zafi, wahalar numfashi,
- Kwayar cutar
- Blood clots (thrombosis)
- Idanu: hangen nesa
- Gastrointestinal (GI) fili: asarar nauyi, zafi na ciki, vomiting, zawo
Sanin asali
Kamar yadda aka ambata a sama, eosinophils suna daya daga cikin nau'in jini guda biyar (kodin tsari, lymphocytes, monocytes, eosinophils da basophils). Gwajin gwajin farko shine cikakken jini. Wani eosinophil yana ƙidayar fiye da 1500 kwayoyin / microliter a lokuta biyu da dama ya tabbatar da ƙarin gwaji A farkon, ya kamata a kawar da asali mafi yawan al'amuran eosinophilia .
Da zarar ana zargin HES, ana nazari akan kimanin binciken da ake gudanarwa. Binciken zuciya zai hada da electrocardiogram (ECG) da echocardiogram (duban dan tayi). Dole ne a gudanar da gwajin aikin huhu. Za a yi amfani da kwaikwayon lissafi (CT) don bincika kowane alamun HES a cikin huhu ko ciki.
Ƙarin ƙarin gwaji za a mayar da hankali a kan ƙayyade ko akwai wani shaida ga ƙwayar miiloproliferative neoplasm. Wannan zai hada da aikin jini da kuma ɓoyayyen ɓawon ƙwayar nama . Za a gwada nama ga kasusuwa na kasusuwa don canje-canjen kwayoyin da suka shafi HES. Idan akwai yawan ƙwayoyin mast da yawa, za a aika gwaji don neman tsarin mastocytosis (wani nau'i na ƙwayar myeloproliferative neoplasm).
Jiyya
Za'a ƙayyade lafiyarka ta hanyar irin ciwo na hypereosinophilic da kuma rashin lafiya na bayyanar cututtuka. Babu sababbin bukatar kulawa da kyau a ganewar asali, amma da wuya HES mai tsanani zai buƙaci gaggawa magani.
- Steroids: Za'a iya amfani da steroid kamar prednisone da methylprednisolone.
- Imatinib: Imatinib wata magani ce ta maganin ciwon daji wanda ake kira mai hana tyrosine kinase.
- Vincristine: Vincristine ne mai ciki (IV) chemotherapy da za a iya amfani. Idan ka amsa, lambobinka na eosinophil zai iya rage a cikin sa'o'i na gwamnati.
- Hydroyxurea: Hydroxyurea wani magani ne na maganin ilimin chemotherapy. Zai yiwu har zuwa makonni 2 don ganin amsa ga wannan magani.
Idan akwai siffofi na ƙwayoyin ƙwayoyin ƙwayoyin ƙwayoyin cuta (girman bitamin B12, girma ƙararrawa, ƙwayoyin eosinophils, da dai sauransu), magani na farko shine imatinib. Idan akwai kullun zuciya, an kara magungunan steroid. Idan imatinib ba shi da tasiri, akwai magungunan magungunan da yawa da za a iya amfani dasu. Mafi yawan mutane da HES ba sa buƙatar magani amma suna bukatar kulawa da hankali ga lalacewa ta jiki, ci gaban jini (thrombosis), da kuma ci gaban cutar. Idan akwai sakon kwayoyin, magungunan sittin sune farfadowa na farko. Saboda amfani da maganin steroid na tsawon lokaci yana hade da illa mai yawa, sau ɗaya bayyanar cututtuka suna ƙarƙashin iko, ana iya canzawa zuwa wani magani kamar hydroxyurea, alpha interferon, ko methotrexate don ci gaba da kulawa.
Kamar yadda aka gani a sama, steroids sune mahimmancin magani. Kafin farawa steroids yana da matukar muhimmanci a tantance idan kana cikin haɗari don kamuwa da cuta mai ciwo da ake kira Strongyloides. Cikakkewa na iya kara damuwa da kamuwa da karfi mai ƙarfi Strongyloides. Idan kana buƙatar gaggawar magani kuma akwai damuwa da cewa kana da kamuwa da cutar Strongyloides, za a bi da ku don kamuwa da cuta (magani na maganganu na kwanaki 2).
Kalma Daga
Koyo da kake da ciwo na hypereosinophilic zai iya zama tsoratarwa. Abin farin ciki, yawancin mutane da HES ba za su bukaci magani ba. Ga wadanda suka yi, akwai zaɓuɓɓuka da yawa kuma har yanzu suna karatu a yanzu.
> Sources
> Rafosse F, Klion AD, Weller PF. Harkokin Hypereosinophilic: Harkokin Clinical, pathophysiology, da kuma ganewar asali da ciwon hypereosinophilic: Jiyya. A: UpToDate, Post TW (Ed), UpToDate, Waltham, MA. (Samun shiga a ranar 5 Yuli, 2016)