Wani bayyani
Neonatal alloimmune thrombocytopenia (NAIT) wani yanayi ne mai ban sha'awa wanda ke tsakanin mama da jariri. A lokacin yin ciki, mahaifiyar ta haifar da kwayoyin cutar da ke kai hari da kuma hallaka platelets wanda ke haifar da thrombocytopenia mai tsanani (ƙananan ƙwayar platelet) da kuma zub da jini a cikin tayin. Yana kama da cututtukan Hemolytic na jariri, rikici na jini.
NAIT ba za a dame shi ba tare da neonatal autoimmune thrombocytopenia. Neonatal autoimmune thrombocytopenia yana faruwa a cikin iyaye masu fama da thrombocytopenia (ITP) ko lupus. Uwar tana da kwayoyi masu tarin fuka a cikin wurare dabam-dabam da ke kai hari kan kanta. Wadannan kwayoyin sun canja wurin tayin ta hanyar yaduwar cutar da ta haifar da lalacewa da takalmanta.
Cutar cututtuka
Wadannan cututtuka sun dogara da ƙididdigar platelet. Sau da yawa a cikin ciki na farko, babu matsaloli sai an haifi jaririn. A lokacin makon farko, thrombocytopenia yana damuwa. Yayin da ake sauko da labarun, ƙara ƙusa, petechiae (ƙananan launin ja a fata), ko zub da jini.
Cutar NAIT mafi tsanani shine zub da jini a cikin kwakwalwa da ake kira ciwon jini na intracranial (ICH). Wannan yana faruwa a cikin 10 - 20% na jarirai. An jarraba jariran da ke dauke da ƙananan platelet na ICH tare da magunguna.
A cikin ciki na gaba, thrombocytopenia zai iya zama mafi tsanani kuma ICH zai iya faruwa kafin haihuwa (yayin da yake cikin mahaifa).
Me yasa wannan ya faru?
Mu waxannan abubuwa suna shafe su da antigens, abubuwa da ke haifar da amsawar ba tare da wata matsala ba. A cikin NAIT, jaririn ya gaji antigen platelet daga mahaifin da mahaifiyarsa ba ta da.
Kwayar rigakafin mahaifiyar ta gane wannan antigen a matsayin "kasashen waje" kuma tana tayar da kwayoyin cutar da shi. Wadannan kwayoyin sun canja wuri daga mahaifi zuwa tayin ta wurin mahaifa inda suke haɗuwa da platelets, suna nuna su lalacewa. Ba kamar kamuwa da cututtukan mahaifa ba, wannan zai iya faruwa tare da fara ciki.
Yaya aka gano shi?
Akwai jerin jerin dalilan da suka dace don thrombocytopenia a cikin jariri. Yawancin wadannan sune saboda cututtuka irin su CMV , gurguntaccen cututtuka, ko sepsis (mai tsanani na kamuwa da cutar kwayan cuta). A cikin waɗannan yanayi yawanci, jaririn ya kamu da rashin lafiya. NAIT ya kamata a yi la'akari da shi a cikin jariri mai kyau da thrombocytopenia mai tsanani (plalet count kasa da 50,000 sel da microliter).
A NAIT jariri yana karɓar magani kafin kafin ganewar asali da tabbatar da ganewar asali yana ɗaukar da yawa makonni. Tabbatar da NAIT na buƙatar gwada jini daga iyaye, ba jariri ba. Mahaifiyar za ta yi la'akari da ƙididdigar ƙwayoyin platelet kamar yadda magungunan ba su kai farmaki a kan abincinta ba. An aika da jini zuwa wani layi na musamman don tantance ko mahaifiyar da mahaifiyar suna da mummunan antigens na platelet kuma idan mahaifiyar ke yin maganin rigakafi ga antigenlet antigen a cikin mahaifin. Idan an yi la'akari da NAIT, idan yana da mahimmanci don tabbatar da ganewar asirin ciki na gaba zai iya zama mummunan cututtuka tare da cututtukan da ke ciki mai tsanani da kuma intracranial a cikin utero (kafin haihuwa).
Ta yaya ake bi wannan?
Yaran yara masu rauni bazai buƙatar magani ba. A cikin jariran da suka shafi mummunar cutar, makasudin magani shi ne ya hana ko dakatar da zub da jini, musamman a kwakwalwa.
- Fassarar ƙwararrun ƙwararrun: Saboda mahaɗan mahaifa ba su da magungunan haushin da ke ciki ba don haka ba za a lalace ba, akasin haka, plalets da aka canja zuwa ga jaririn zai fito ne daga mahaifiyarsu ko daga mai bayarwa kamar uwar. Wannan tsari na iya ɗauka lokaci mai tsawo kuma ba koyaushe a rayuwa ta ainihi ba. Idan thrombocytopenia yana da tsanani (<20,000 Kwayoyin ta microliter) ko zubar da jini na faruwa, fassarar plalet na fito ne daga tsarin bada kyauta. Wadannan ana yin amfani da su a lokaci guda kamar yadda yaduwar globulin na intravenous don yada tsawon rai.
- Rashin ciwon daji na intbulvenin (IVIG): Ana iya jigilar IVIG a jariri don ya kawar da tsarin rigakafi. IVIG yana dauke da magunguna masu yawa daga masu bada taimako. Wadannan kwayoyin cutar sun rushe tsarin da ba su da kariya kuma suna rage jinkirta lalacewar platelets, kamar maganin ITP. Anyi amfani da wannan tare da haɗin gwanin plalet.
- Jagora: Iyaye da ke da jariri tare da NAIT ya kamata a ba da shawara game da hadarin da wannan ke faruwa a cikin ciki na gaba. Idan aka ba wannan hadarin, ya kamata a lura da hawan mai ciki mai ƙananan haɗari. Ana iya ba da jigidar IVIG ga mahaifiyar lokacin haihuwa ko kuma fassarar platinis za'a iya ba da tayin tayin don hana jini mai tsanani. Kwararren Cesarean yana bada shawarar don bayarwa don hana zub da jini.
> Magana
> Karen S. Fernandez da Pedro de Alarcon. Neonatal Thrombocytopenia. NeoReviews. 2013.