Methemoglobinemia

Methemoglobinemia (MetHb) ndimatenda am'magazi momwe methemoglobin imapangidwira. Hemoglobin ndi mapuloteni m'maselo ofiira ofiira (RBCs) omwe amanyamula ndikugawa mpweya m'thupi. Methemoglobin ndi mtundu wa hemoglobin.

Ndi methemoglobinemia, hemoglobin imatha kunyamula mpweya, koma siyimatha kutulutsa bwino kumatenda amthupi.

Chikhalidwe cha MetHb chitha kukhala:

• Kudutsa m'mabanja (obadwa nawo kapena obadwa nawo)
• Zimayambitsa kukhudzana ndi mankhwala, mankhwala, kapena zakudya (zopezeka)

Pali mitundu iwiri ya MetHb yobadwa nayo. Fomu yoyamba imaperekedwa ndi makolo onse awiri. Nthawi zambiri makolo sakhala ndi vutoli. Amanyamula jini yomwe imayambitsa vutoli. Zimachitika pakakhala vuto ndi enzyme yotchedwa cytochrome b5 reductase.

Pali mitundu iwiri ya MetHb yobadwa nayo:

• Mtundu 1 (womwe umatchedwanso kuti erythrocyte reductase defence) umachitika ma RBC atasowa enzyme.
• Mtundu wachiwiri (womwe umatchedwanso kuti kuchepa kwa reductase) umachitika pamene enzyme sagwira ntchito m'thupi.

Mtundu wachiwiri wa MetHb wobadwa nawo umatchedwa hemoglobin M matenda. Zimayambitsidwa ndi zolakwika mu puloteni ya hemoglobin yomwe. Ndi kholo limodzi lokha lomwe liyenera kupatsira mwana chibadwa kuti adzalandire matendawa.

Kupeza MetHb kumakhala kofala kwambiri kuposa mitundu yobadwa nayo. Zimapezeka mwa anthu ena atakumana ndi mankhwala ndi mankhwala, kuphatikiza:

• Mankhwala oletsa ululu monga benzocaine
• Nitrobenzene
• Maantibayotiki ena (kuphatikiza dapsone ndi chloroquine)
• Nitrites (amagwiritsidwa ntchito ngati zowonjezera kuti nyama isawonongeke)

Zizindikiro za mtundu 1 MetHb ndizo:

• Mtundu wabuluu pakhungu

Zizindikiro za mtundu wa 2 MetHb ndizo:

• Kuchedwa kwakukula
• Kulephera kukula bwino
• Kulemala kwamaluso
• Kugwidwa

Zizindikiro za matenda a hemoglobin M ndi awa:

• Mtundu wabuluu pakhungu

Zizindikiro za MetHb zomwe zapezeka ndi monga:

• Mtundu wabuluu pakhungu
• Mutu
• Kudandaula
• Kusintha kwa malingaliro
• Kutopa
• Kupuma pang'ono
• Kupanda mphamvu

Mwana yemwe ali ndi vutoli amakhala ndi mtundu wabuluu (cyanosis) pobadwa kapena posakhalitsa pambuyo pake. Wothandizira zaumoyo adzayesa magazi kuti apeze vutoli. Mayeso atha kuphatikiza:

• Kuyang'ana kuchuluka kwa mpweya m'magazi (pulse oximetry)
• Kuyezetsa magazi kuti muwone kuchuluka kwa mpweya m'magazi (kusanthula magazi m'magazi ochepa)

Anthu omwe ali ndi matenda a hemoglobin M alibe zizindikiro. Chifukwa chake, sangasowe chithandizo.

Mankhwala otchedwa methylene buluu amagwiritsidwa ntchito pochiza MetHb yayikulu. Methylene buluu imatha kukhala yotetezeka kwa anthu omwe ali ndi chiopsezo cha matenda amwazi omwe amatchedwa kusowa kwa G6PD. Sayenera kumwa mankhwalawa. Ngati inu kapena mwana wanu muli ndi vuto la G6PD, nthawi zonse muuzeni omwe akukuthandizani musanalandire chithandizo.

Ascorbic acid itha kugwiritsidwanso ntchito kuchepetsa kuchuluka kwa methemoglobin.

Njira zina zimaphatikizira chithandizo cha hyperbaric oxygen, kuikidwa magazi ofiira ndikuwathirira magazi.

Nthawi zambiri pa MetHb yofatsa, palibe chithandizo chofunikira. Koma muyenera kupewa mankhwala kapena mankhwala omwe adayambitsa vutoli. Milandu yayikulu imafunika kuikidwa magazi.

Anthu omwe ali ndi mtundu wa 1 MetHb ndi matenda a hemoglobin M nthawi zambiri amachita bwino. Type 2 MetHb ndiyofunika kwambiri. Nthawi zambiri zimayambitsa imfa m'zaka zoyambirira za moyo.

Anthu omwe ali ndi MetHb omwe amapeza nthawi zambiri amachita bwino kwambiri mankhwala, chakudya, kapena mankhwala omwe adayambitsa vutoli atadziwika ndikupewa.

Zovuta za MetHb ndizo:

• Chodabwitsa
• Kugwidwa
• Imfa

Itanani omwe akukuthandizani ngati:

• Khalani ndi mbiriyakale yabanja ya MetHb
• Khalani ndi zizindikilo za matendawa

Itanani omwe akukuthandizani kapena othandizira mwadzidzidzi (911) nthawi yomweyo ngati mukulephera kupuma movutikira.

Upangiri wamtunduwu umaperekedwa kwa maanja omwe ali ndi mbiri yabanja ya MetHb ndipo akuganiza zokhala ndi ana.

Ana a miyezi isanu ndi umodzi kapena ocheperako amatha kukhala ndi methemoglobinemia. Chifukwa chake, zakudya zopangira zopangira ana zopangidwa kuchokera ku ndiwo zamasamba zokhala ndi ma nitrate ambiri achilengedwe, monga kaloti, beetroots, kapena sipinachi ziyenera kupewedwa.

Matenda a Hemoglobin M; Kuchepa kwa erythrocyte reductase; Kuperewera kwakukulu kwa reductase; MetHb

• Maselo amwazi

Benz EJ, Ebert BL. Mitundu ya Hemoglobin yokhudzana ndi kuchepa kwa magazi m'thupi, kusintha kwa kuyanjana kwa okosijeni, ndi methemoglobinemias. Mu: Hoffman R, Benz EJ, Silberstein LE, olemba., Eds. Hematology: Mfundo Zoyambira ndi Zochita. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier; 2018: mutu 43.

Letterio J, Pateva I, Petrosiute A, Ahuja S.Hematologic ndi zovuta za oncologic m'mimba mwa mwana wosabadwayo. Mu: Martin RJ, Fanaroff AA, Walsh MC, olemba., Eds. Fanaroff ndi Martin's Neonatal-Perinatal Medicine. 11th ed. Philadelphia, PA: Elsevier; 2020: chap 79.

Zikutanthauza RT. Yandikirani ku anemias. Mu: Goldman L, Schafer AI, olemba. Mankhwala a Goldman-Cecil. 26 wa. Philadelphia, PA: Elsevier; 2020: chap 149.