Methemoglobinemia

Methemoglobinemia (MetHb) chirwere cheropa umo huwandu hwakawanda hwe methemoglobin inogadzirwa. Hemoglobin ipuroteni mumasero matsvuku eropa (RBCs) anotakura nekuparadzira oxygen kumuviri. Methemoglobin chimiro chehemoglobin.

Iine methemoglobinemia, iyo hemoglobin inogona kutakura okisijeni, asi haigone kuisunungura zvinobudirira kumatumbu emuviri.

MetHb mamiriro anogona kuva:

• Yakapfuudzwa kuburikidza nemhuri (nhaka kana kuberekwa)
• Zvinokonzerwa nekuratidzwa kune mimwe mishonga, makemikari, kana chikafu (zvakawanikwa)

Kune maviri mafomu eakagara nhaka MetHb. Fomu yekutanga inopfuudzwa nevabereki vese. Vabereki kazhinji havana mamiriro ivo pachavo. Vanotakura geni rinokonzera mamiriro acho. Izvo zvinoitika kana paine dambudziko ne enzyme inonzi cytochrome b5 reductase.

Kune maviri marudzi eakagara nhaka MetHb:

• Rudzi rwekutanga (rwunonziwo erythrocyte reductase kushomeka) runoitika kana maRBCs asisina enzyme.
• Type 2 (inonziwo generalized reductase defence) inoitika kana iyo enzyme isingashande mumuviri.

Chimiro chechipiri cheMetHb yakagara nhaka inonzi hemoglobin M chirwere. Izvo zvinokonzerwa nekuremara muhemoglobin protein pachayo. Mubereki mumwe chete ndiye anoda kupfuudza zvisina kujairika geni kuti mwana agare nhaka chirwere.

Yakawanikwa MetHb yakajairika kupfuura mafomu akagarwa nhaka. Izvo zvinoitika kune vamwe vanhu mushure mekunge vaoneswa kune mamwe makemikari nemishonga, kusanganisira:

• Anesthetics yakadai benzocaine
• Nitrobenzene
• Mimwe mishonga inorwisa mabhakitiriya (inosanganisira dapsone uye chloroquine)
• MaNitrites (anoshandiswa sezvinhu zvinowedzera kudzivirira nyama kubva pakuparadza)

Zviratidzo zverudzi 1 MetHb zvinosanganisira:

• Kuchena kweBluish kweganda

Zviratidzo zverudzi 2 MetHb zvinosanganisira:

• Kubudirira kunonoka
• Kutadza kubudirira
• Urema hwekuziva
• Kufenda

Zviratidzo zvehemoglobin M chirwere zvinosanganisira:

• Kuchena kweBluish kweganda

Zviratidzo zveMetHb zvakawanikwa zvinosanganisira:

• Kuchena kweBluish kweganda
• Kutemwa nemusoro
• Kubira
• Akachinja mafungiro
• Kuneta
• Kufema kwekufema
• Kushaya simba

Mwana ane chirwere ichi anozove neruvara rweganda rebhuruu (cyanosis) pakuzvarwa kana nguva pfupi yapfuura. Anopa hutano anozoita ongororo yeropa kuti aongorore mamiriro acho. Miedzo inogona kusanganisira:

• Kuongorora mwero weoksijeni muropa (pulse oximetry)
• Ropa bvunzo kutarisa huwandu hwemagasi muropa (arterial ropa gasi ongororo)

Vanhu vane hemoglobin M chirwere havana zviratidzo. Saka, vangangodaro vasingadi kurapwa.

Mushonga unonzi methylene bhuruu unoshandiswa kurapa zvakanyanya MetHb. Methylene bhuruu inogona kunge isina kuchengetedzeka kune vanhu vane kana vangave vari panjodzi yechirwere cheropa chinonzi kushomeka kweG6PD. Havafanirwe kutora mushonga uyu. Kana iwe kana mwana wako aine kushomeka kweG6PD, gara uchiudza mupi wako usati wawana kurapwa.

Ascorbic acid inogona zvakare kushandiswa kudzikisa huwandu hwe methemoglobin.

Dzimwe nzira dzokurapa dzinosanganisira hyperbaric oxygen therapy, tsvuku yeropa kuwedzerwa ropa uye kuchinjana kuwedzerwa.

Muzviitiko zvakawanda zveMetHb zvinyoro nyoro, hapana kurapwa kunodiwa. Asi iwe unofanirwa kudzivirira mushonga kana kemikari yakakonzera dambudziko. Mhosva dzakakomba dzinogona kuda kuwedzerwa ropa.

Vanhu vane mhando 1 MetHb uye hemoglobin M chirwere kazhinji vanoita zvakanaka. Rudzi rwechipiri MetHb rwakanyanya zvakanyanya. Zvinowanzo kukonzera kufa mukati memakore mashoma ekutanga ehupenyu.

Vanhu vane MetHb yakawanikwa vanowanzoita mushe kana mushonga, chikafu, kana kemikari yakakonzera dambudziko raonekwa uye radzivirirwa.

Zvinetso zveMetHb zvinosanganisira:

• Shock
• Kufenda
• Rufu

Fonera mupiki wako kana iwe:

• Iva nenhoroondo yemhuri yeMetHb
• Gadzira zviratidzo zveichi chirwere

Fonera mupiki wako kana ekukurumidzira services (911) ipapo kana iwe uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchiri nekufema kwakanyanya.

Genetic counselling inokurudzirwa kune vakaroorana vane nhoroondo yemhuri yeMetHb uye vari kufunga kuve nevana.

Vacheche mwedzi mitanhatu kana mudiki vane mukana wekukudziridza methemoglobinemia. Nekudaro, chikafu chevacheche chakagadzirwa chikafu kubva mumiriwo ine huwandu hwakawanda hwema nitrate echisikigo, senge makarotsi, beetroots, kana sipinashi zvinofanirwa kudzivirirwa.

Hemoglobin M chirwere; Erythrocyte reductase kushomeka; Yakajairwa reductase kushomeka; MetHb

• Masero eropa

Benz EJ, Ebert BL. Hemoglobin dzakasiyana dzakabatana nehemolytic anemia, yakachinja oksijeni kubatana, uye methemoglobinemias. Mune: Hoffman R, Benz EJ, Silberstein LE, eds. Hematology: Basic Misimboti uye Maitiro. 7th ed. Philadelphia, PA: Elsevier; 2018: chits. 43.

Letterio J, Pateva I, Petrosiute A, Ahuja S. Hematologic uye oncologic matambudziko ari muchibereko uye neonate. Mune: Martin RJ, Fanaroff AA, Walsh MC, eds. Fanaroff naMartin's Neonatal-Perinatal Mushonga. 11th ed. Philadelphia, PA: Elsevier; 2020: chitsiko 79.

Zvinoreva RT. Kusvika kune anemias. Mune: Goldman L, Schafer AI, eds. Goldman-Cecil Mushonga. 26th ed. Philadelphia, PA: Elsevier; 2020: chitsiko 149.