Hemolytic-uremic chirwere

Shiga-senge toxin inogadzira E coli hemolytic-uremic syndrome (STEC-HUS) chirwere chinowanzoitika kana hutachiona muhurongwa hwekuzeya huchigadzira zvinhu zvine chepfu.Izvi zvinhu zvinoparadza masero matsvuku eropa uye zvinokuvadza itsvo.

Hemolytic-uremic syndrome (HUS) inowanzoitika mushure mehutachiona hwemudumbu E coli mabhakitiriya (Escherichia coli O157: H7). Zvisinei, mamiriro acho akave akabatanidzwa kune zvimwe zvirwere zvepamuviri, kusanganisira shigella uye salmonella. Yakave zvakare yakabatana ne nongastrointestinal hutachiona.

HUS yakajairika muvana. Ndicho chikonzero chinowanzoitika cheakanyanya itsvo kutadza muvana. Kuputika kukuru kwakakura kwakabatanidzwa kune nyama isina kubikwa yehamburger nyama yakasvibiswa nayo E coli.

E coli inogona kutapurirana kuburikidza:

• Taura kubva kune mumwe munhu uchienda kune mumwe
• Kudya chikafu chisina kubikwa, senge zvigadzirwa zvemukaka kana nyama yemombe

STEC-HUS haifanire kuvhiringidzwa ne atypical HUS (aHUS) iyo isiri yehutachiona-inoenderana. Izvo zvakafanana nechimwe chirwere chinonzi thrombotic thrombocytopenic purpura (TTP).

STEC-HUS kazhinji inotanga nekurutsa uye manyoka, ayo anogona kunge ane ropa. Mukati mevhiki, munhu anogona kushaya simba uye kushatirwa. Vanhu vane chirwere ichi vanogona kuita weti zvishoma pane zvakajairwa. Urine inobuda inogona kumira.

Ropa dzvuku reropa rinoparadza rinotungamira kune zviratidzo zvekushaya ropa.

Zviratidzo zvekutanga:

• Ropa muzvigaro
• Kushatirwa
• Kupindwa nechando
• Lethargy
• Kusvipa nemanyoka
• Kushaya simba

Gare gare zviratidzo:

• Kutuka
• Kuderera kwekuziva
• Wakaderera weti kubuda
• Hapana weti kuburitsa
• Pallor
• Kufenda - kushoma
• Kuputika kweganda kunoratidzika kunge kwakatsvuka mavara (petechiae)

Anopa hutano anoita bvunzo dzepanyama. Izvi zvinogona kuratidza:

• Chiropa kana spleen kuzvimba
• Kutya system inochinja

Rabhoritari bvunzo dzicharatidza zviratidzo zvehemolytic kupererwa neropa uye kwakanyanya renal kutadza. Miedzo inogona kusanganisira:

• Ropa rekuvhara miedzo (PT uye PTT)
• Yakakwana metabolic pani inogona kuratidza yakawedzera mazinga eBUN uye creatinine
• Yakazara huwandu hweropa (CBC) inogona kuratidza yakawedzera chena yeropa masero kuverenga uye kudzikira masero eropa masero
• Platelet kuverenga inowanzo kuderedzwa
• Urinalysis inogona kuratidza ropa uye mapuroteni mumuguta
• Urine protein bvunzo inogona kuratidza huwandu hwepuroteni mumugini

Mimwe bvunzo:

• Stool tsika inogona kuve yakanaka kune imwe mhando ye E coli mabhakitiriya kana mamwe mabhakitiriya
• Colonoscopy
• Itsvo biopsy (mune zvisingawanzoitika zviitiko)

Kurapa kunogona kusanganisira:

• Dialysis
• Mishonga, yakadai secorticosteroids
• Kutungamira kwemvura uye electrolyte
• Kuwedzerwa kwemasero matsvuku eropa uye maplatelet

Ichi chirwere chakakomba muvana nevakuru, uye chinogona kukonzera rufu. Nokurapwa kwakakodzera, vanopfuura hafu yevanhu vachapora. Mhedzisiro yacho iri nani muvana pane vakuru.

Zvinetso zvinogona kusanganisira:

• Matambudziko ekuvhara ropa
• Hemolytic kupererwa neropa
• Itsvo kutadza
• Hypertension inotungamira mukubatwa, kusagadzikana, uye mamwe matambudziko ehurongwa
• Maplatelet mashoma kwazvo (thrombocytopenia)
• Uremia

Fonera mupiki wako kana iwe ukava nezviratidzo zve HUS. Emergency zviratidzo zvinosanganisira:

• Ropa muzvigaro
• Hapana kuita weti
• Kuderedza kusvinura (kuziva)

Fonera mupiki wako kana iwe uine episode ye HUS uye yako weti kuburitsa inoderera, kana iwe ukaita zvimwe zviratidzo zvitsva.

Unogona kudzivirira inozivikanwa chikonzero, E coli, nekubika hamburger nedzimwe nyama zvakanaka. Iwe unofanirwa zvakare kudzivirira kusangana nemvura isina kuchena uye uteedzere nzira dzakakodzera dzekugeza maoko.

HUS; STEC-HUS; Hemolytic-uremic chirwere

• Urume urinary system

Alexander T, Licht C, Smoyer WE, Rosenblum ND. Zvirwere zveitsvo uye yepamusoro urineti muvana. Mune: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, eds. Brenner uye Rector Iyo Itsvo. 11th ed. Philadelphia, PA: Elsevier; 2020: chitsamba: 72.

Mele C, Noris M, Remuzzi G.Hemolytic uremic chirwere. Muna: Ronco C, Bellomo R, Kellum JA, Ricci Z, eds. Kuchengetedza Kwakakosha Nephrology. 3rd ed. Philadelphia, PA: Elsevier; 2019: chitsiko 50.

Schneidewend R, Epperla N, Friedman KD. Thrombotic thrombocytopenic purpura uye iyo hemolytic uremic syndromes. Muna: Hoffman R, Benz EJ, Silberstein LE, et al, eds. Hematology: Basic Misimboti uye Maitiro. 7th ed. Philadelphia, PA: Elsevier; 2018: chits. 134.