Pfupiso
Neonatal alloimmune thrombocytopenia (NAIT) haisi chinhu chakajairika cheplatelet chisingaiti pakati peamai nechechecheche. Panguva yekuzvitakura, amai vanoita zvirwere zvinorwisa uye zvinoparadza maplatelet zvichiita kuti chirwere chinokonzera chirwere chakakomba (pasi shoma count) uye kubuda mumucheche. Izvo zvakafanana neHemolytic Disease yeMucheche, chirwere chemasero matsvuku eropa.
NAIT haifaniri kusanganiswa neonatal autoimmune thrombocytopenia. Neonatal autoimmune thrombocytopenia inowanikwa munaamai vane immune thrombocytopenia (ITP) kana lupus. Amai vane mapepa emaplatelet mumasangano ayo anorwisa mapepa ake. Izvi zvinopfurikidza kutenderera kumucheche kuburikidza ne-placenta zvichikonzera kuparadzwa kweaaaaaaaaaaaaaaaaaaaaaaaaaaaa.
Zviratidzo
Zviratidzo izvi zvinoenderana ne platelet count. Kazhinji mumimba yekutanga, hapana matambudziko kusvikira mwana aberekwa. Muvhiki yekutanga, thrombocytopenia inowedzera. Sezvo maplatelet achidonha, kuwedzera kuputika, petechiae (maduku maduku matsvuku paganda), kana kubuda ropa kunogona kuonekwa.
Kugadzirisa kwakakomba kwe NAIT kunobuda ropa muuropi inonzi intracranial hemorrhage (ICH). Izvi zvinoitika mu10 - 20% yevana. Vacheche vane mapepa epasiketi zvakaderera vanoongororwa neICH nemakumbo echidimbu.
Mune pamuviri munguva yemberi, thrombocytopenia inogona kuva yakanyanya uye ICH inogona kuitika musati yaberekwa (mukati mumuviri).
Nei Izvi Zvichiitika?
Maplatelet edu akafukidzwa nemaantijeni, zvinhu zvinoita kuti zvirwere zvemuviri zvirwe. MuAIDS, kacheche inowana nhaka yeAlatelet antigen kubva kuna baba iyo amai vasina.
Muchiedza chekuzvidzivirira kubva mumuviri chinoziva kuti uyu antigen se "kune imwe nyika" uye anokurudzira zvirwere zvinopesana nazvo. Izvi zvinotapurirwa kubva kuna amai kusvika kumucheche kuburikidza nelacentre apo vanobatanidza pamaplatelet, vachivaisa kuti vaparadzwe. Kusiyana neHemolytic Disease yeChechecheche, izvi zvinogona kuitika nehutachiona hwekutanga.
Inozivikanwa Sei?
Pane runyararo rurefu rwezvikonzero zvinokonzerwa neThrombocytopenia muchechecheche. Zvizhinji zvezvi izvi zvinokonzerwa nehutachiona hwakafanana neukama CMV , congenital rubella, kana sepsis (utachiona hutachiona hwakanyanya). Mumamiriro ezvinhu aya kazhinji, mwana ari kurwara zvikuru. NAIT inofanira kutaridzwa mumucheche unoita zvakanaka ane thrombocytopenia yakawanda (platelet count inopfuura 50,000 masero per microliter).
MuAIDS mucheche anogamuchira kurapwa asati aongororwa sezvinotsigira kuti chirwere chacho chinotora mavhiki mashoma. Kutsigira NAIT kunoda kuongororwa ropa kwevabereki, kwete mwana. Amai vachange vane chidimbu cheplatelet chiyero sezvo mishonga inorwisana isingarwisi maplatelet. Ropa rinotumirwa kubasa rinokosha kuti riongorore kuti amai nababa vari kushandisa zvisina kufanira mapeti antigens uye kana amai vachiita zvirwere zveplatelet antigen inowanikwa muna baba. Kana NAIT inenge ichifungidzirwa, kana zvakakosha kusimbisa kuongororwa kwekusununguka kwemazuva anotevera kunogona kunyanya kunetseka ne-thrombocytopenia yakanyanya uye kusagadzikana kwehutachiona mu utero (vasati vaberekwa).
Izvi Zvinotorwa Sei?
Kunyatsorarisa vacheche vangave vasingadi kurapwa. Mune zvimwe zvakanyanya kuvhiringidza vana, chinangwa chekurapa ndechekudzivirira kana kurega kubuda ropa, kunyanya muuropi.
- Platelet kuwedzerwa: Nemhaka yokuti mahwendefa eamai haafaniri kugadzirisa antigen uye naizvozvo haazoparadzwi, zvakakodzera, maplatelet anoiswa ropa kumucheche aizouya kubva kuna amai kana kubva kumubatsiri akafanana naamai. Izvi zvinogona kutora nguva refu uye haisi nguva dzose inoshanda muupenyu chaihwo. Kana iyo thrombocytopenia yakaoma (<20,000 masero nema microliter) kana kubuda ropa, kuwedzerwa kweplatelet kunobva kumunhu anozvipa mupi anopiwa. Izvi zvinowanzotarisirwa panguva yakafanana neyekudzivirira immune globulin kupedzera upenyu hweplatelets.
- Intravenous immune globulin (IVIG): IVIG inogona kuiswa mucheche kuti iparadzise masimba ezvirwere. IVIG ine mishonga yakasiyana-siyana inobva kune vanopa vakawanda. Izvi zvinopesana nehutachiona hwehutachiona uye zvinononoka kuparadzwa kwemaplatelets, akafanana nekurapa kweTIP. Izvi zvinoshandiswa pamwe chete ne platelet transfusions.
- Kupa mazano: Vabereki vane mwana ne NAIT vanofanira kurangana pamusoro pekuda kweizvi zvichiitika munguva inotevera pamuviri. Zvichipa njodzi iyi, kutora pamuviri munguva yemberi kunofanira kuongororwa nechekudzivirira hutachiona. IVIG inogona kugoverwa kumamai panguva yekudzivirirwa kana kuwedzerwa kweplatelet kunogona kupiwa kumucheche inenge ichiri kukura kuitira kudzivirira ropa rakakura. Chikamu cheCesarean chinokurudzirwa kuendesa kunodzivirira kubuda ropa.
> Ref
> Karen S. Fernandez naPedro de Alarcon. Neonatal Thrombocytopenia. NeoReviews. 2013.