I-Eosinophilia

I-eosinophilia yenzeka lapho umzimba ukhiqiza inani eliphakeme ngokungavamile lama-eosinophil egazini. Lesi simo sitholakala lapho kunama-eosinophil angama-500 noma ngaphezulu nge-microlitre ngayinye yegazi. Ama-eosinophils, akhiqizwa emnkantsheni, enza imisebenzi emibili eyinhloko ekuvikeleni impilo. Okokuqala, bavikela ngokumelene nokungezwani komzimba nezinto zangaphandle ezingena emzimbeni. Kamuva, bavikela ezifweni zefungal kanye ne-parasitic.

Lesi simo singahlukaniswa sibe izinhlobo ezimbili ezihlukene ngokuya ngokuthi ama-eosinophil awuthinta kanjani umzimba:

• I-Blood Eosinophilia: Ibonakala ngamazinga aphakeme ama-eosinophil egazini
• I-Tissue Eosinophilia: Imakwe ukwanda kwe-eosinophil ezicutshini ezithile zomzimba

Yiziphi Izimpawu Ze-Eosinophilia?

Ubukhulu bezimpawu zesifo se-eosinophilia buyahluka kakhulu ngokusekelwe ekubalweni kwe-eosinophil egazini nokuthi yiziphi izitho ezilimala. I-eosinophilia emaphakathi ngokuvamile ayibonisi izimpawu eziphawulekayo. Izimpawu ezivamile ze-eosinophilia zihlanganisa:

• Izinkinga Zokuphefumula: 
  • Ukushisa
  • Ukuphelelwa umoya
  • Ukukhwehlela okungapheli
  • Izinkinga zokuphefumula
  • ubuhlungu besifuba
• Izimpawu zomthethosisekelo:
  • Umkhuhlane wezinga eliphansi
  • Izithukuthuku ebusuku
  • Ukukhathala okungachazeki
  • Ukwehla kwesisindo
  • Ubuthakathaka bemisipha
  • Ukudideka
• Ukulimala kwezitho:
  • Inhliziyo, amaphaphu, ubende, isikhumba, nesimiso sezinzwa kubhekene nomthelela omkhulu kakhulu. 
• Izimpawu ze-GI:
  • Ukubonakaliswa kwe-Gastrointestinal kuvame ukuvela ngesimo esibizwa ngokuthi i-eosinophilic esophagitis, ebonakala ngokuhlanza kanye nobunzima bokugwinya. 
• Izimpawu Ezihlobene Nesikhumba:
  • Ukuqubuka kwesikhumba kanye nokulunywa okuqhubekayo, ikakhulukazi ezimeni ezixhumene ne-cutaneous T-cell lymphoma noma i-eczema.

Izimbangela kanye Nezici Zengozi Ye-Eosinophilia

Odokotela bahlukanisa i-eosinophilia ngezigaba ezimbili eziyinhloko: i-eosinophilia eyinhloko neyesibili. I-eosinophilia eyinhloko ibangelwa ukuphazamiseka okuthinta ngokuqondile ukukhiqizwa kwamangqamuzana egazi, kuyilapho i-eosinophilia yesibili iqala ukusabela kwezinye izimo zezokwelapha.

• I-Eosinophilia Eyisisekelo: Kunezici eziningana ezinomthelela ekuthuthukisweni kwe-eosinophilia eyinhloko:
  • I-eosinophilic leukemia engapheli
  • I-Myeloid ne-lymphoid neoplasms ene-rearrangements ethize yofuzo
  • I-eosinophilia yofuzo
  • Idiopathic hypereosinophilic syndrome
• I-Eosinophilia yesibili: I-eosinophilia yesibili yenzeka kaningi futhi inezimbangela eziningi eziyisisekelo:
• Ukutheleleka kwe-Parasitic: 
  • I-Ancylostomiasis
  • I-Ascariasis
  • I-cysticercosis
  • ISchistosomiasis
  • I-Strongyloidiasis
• Ukutheleleka kwe-fungal kanye ne-bacterial: 
  • I-aspergillosis ye-bronchopulmonary
  • Isifo sofuba esingamahlalakhona
  • I-coccidioidomycosis kanye ne-scarlet fever
• Izimbangela ezivamile zokungezwani komzimba:
  • Isifuba somoya
  • Imfiva ethimulisayo
  • Ukusabela ezidakamizweni noma ekudleni.
• Izimo zesikhumba:
  • I-atopic dermatitis
  • I-Eczema
  • I-Pemphigus
• Izici zofuzo: I-nucleotide polymorphism eyodwa ku-gene coding thymic stromal lymphopoietin itholakala endaweni ye-pseudoautosomal ye-X kanye ne-Y chromosomes.

Izici zobungozi ezihlobene nezinhlobo ezithile ze-eosinophilia zifaka:

• Ubulili besilisa
• Umjaho waseCaucasian
• Umlando we-atopy
• Umlando womndeni
• Izakhi zemvelo, ikakhulukazi isikhathi kanye nemvelo yokuchayeka kokudla kumasosha omzimba asathuthuka
• Izifo ze-autoimmune, kufaka phakathi isifo samathumbu esivuthayo, i-autoimmune myocarditis, i-vasculitis, kanye i-sarcoidosis, 
• Imithi ethile efana ne-interleukin-1 ne-interleukin-6 inhibitors

Izinkinga ze-Eosinophilia

Amazinga aphezulu e-eosinophil aphikelelayo angaholela ezinkingeni ezinkulu ezithinta izitho eziningi emzimbeni wonke. 

• Ukulimala kwesitho kwenzeka ngezindlela eziningi:
  • Ukungena kwezicubu
  • Ukwakhiwa kwe-fibrosis
  • Ukuthuthukiswa kwe-thrombosis
  • Ukuvuvukala kwe-Allergic
• Izinkinga Zenhliziyo: Inhliziyo ibhekana nezingozi ezithile ezivela ku-eosinophilia. Isimo esibizwa nge-Löffler endocarditis singakhula, esingase sibangele:
  • Ukwakheka kwehlule legazi
  • Ukuhluleka kwenhliziyo
  • Ukuhlaselwa yinhliziyo
  • Ukungasebenzi kahle kwe-valve
• Isistimu Yokuphefumula: Ukuvuvukala kungabangela ukulimala kwamaphaphu kanye nokuhluleka kokuphefumula
• Uhlelo Lwezinzwa: Kungase kuholele ekudidekeni kanye ne-encephalopathy
• Isikhumba: Kungabangela ukuqubuka nokuvuvukala
• I-Gastrointestinal Tract: Ithinta i-osophagus, isisu, namathumbu

Ukuxilongwa kwe-Eosinophilia

Ithuluzi lokuqala lokuxilonga isibalo segazi esiphelele (CBC) esinomehluko wesibalo samaseli amhlophe egazi.

I-eosinophilia yegazi ithola isiqinisekiso lapho ithola ama-eosinophil angaphezu kwama-500 nge-cubic millimeter yegazi. Odokotela bahlukanisa ubunzima ngamaleveli amathathu ahlukene:

• Okumaphakathi: 500-1,500 amaseli/mm³
• Okumaphakathi: 1,500-5,000 amaseli/mm³
• Kunzima: Ngaphezu kwamaseli angu-5,000/mm³

Njengoba kunikezwe ukubonakaliswa okuhlukahlukene kwe-eosinophilia, odokotela benza ukuhlolwa okuphelele ngokomzimba okugxile kulokhu okulandelayo:

• Ukuhlolwa kwenhliziyo
• Ukuhlolwa kwesikhumba
• Ukuhlolwa kwezinzwa
• Ukuhlolwa kwesistimu yamaphaphu

Ngokusekelwe kokutholwe emitholampilo, odokotela bangase batuse ukuhlolwa okwengeziwe kokuxilonga:

• Ukuhlolwa kwendle: Kuhlonza izifo ezinamagciwane
• I-X-ray yesifuba: Ithola izifo zamaphaphu, ukuvuvukala, noma izimo ezifana ne-eosinophilic pneumonia
• I-Urinalysis: Isiza ukuhlola ukubandakanyeka kwezinso noma izifo zomgudu womchamo
• Ukuhlolwa kokusebenza kwesibindi: Linganisa impilo yesibindi
• Ukuhlolwa kokusebenza kwezinso: Ihlola izifo zezinso ezingase zibe nomthelela ekukhuphukeni kwama-eosinophil
• Ukuhlolwa kwe-Cytogenetic: Kuhlonza ukungavamile kwe-chromosomal okuhambisana nokuphazamiseka kwe-hematologic
• Ukuhlaziywa kwe-FISH: Ithola ukuguqulwa kofuzo okuqondile okuxhumene ne-eosinophilic syndromes noma umdlavuza
• Ama-biopsies esikhumba ukukhomba izimo ezifana ne-pemphigoid, eczema, noma i-mycosis fungoides
• Ukuhlolwa kwe-Ultrasound: Isiza ukuhlonza isitho (isibindi, ubende, noma i-lymph node) okungavamile okuhlobene nezimo ezihlobene ne-eosinophilia
• I-Echocardiography: Ihlola ukusebenza kwenhliziyo futhi ithola i-eosinophilic myocarditis
• Amazinga e-serum troponin: Ikala ukulimala kwemisipha yenhliziyo, okungenzeka ku-eosinophilic myocarditis
• Ukuhlolwa komsebenzi wePulmonary
• Linganisa ukusebenza kwamaphaphu futhi uthole izimo zokuphefumula

Ukwelashwa

Ezimweni ezithambile, odokotela batusa ukuqapha njalo ngokuhlolwa kwaselabhorethri okuphindaphindiwe ukulandelela amazinga e-eosinophil. 

• Ezimweni lapho imithi iqala i-eosinophilia, odokotela ngokuvamile bayeluleka ukuyeka noma ukuguqula umuthi oyinkinga.
• I-Corticosteroids ihlala iyindlela yokwelapha ephumelela kakhulu yokunciphisa izibalo ze-eosinophil kokubili igazi nezicubu. I-Proton pump inhibitors ye-esophagitis ehambisana ne-asidi
• I-Fluticasone inhalers yokulawula ukuvuvukala
• I-Budesonide liquid exutshwe nama-ejenti athile
• I-Biologics yezimo ezihlukahlukene ze-eosinophilic
• Odokotela bavame ukunikeza imithi yokwelapha yokungezwani komzimba ukuze balawule ukusabela komzimba. 
• Ezimweni ezihilela izifo ezibangelwa yi-parasitic noma fungal, odokotela bagwema ngokucophelela ukwelashwa kwe-steroid, njengoba le mithi ingase ibe yimbi kakhulu isimo.
• Ukuguqulwa okuningana kwendlela yokuphila kusekela ukusebenza kahle kokwelashwa:
  • Ukugcina ukudla okunomsoco ngaphandle kokudla okune-acidic
  • Ukunciphisa amazinga okucindezeleka ngokusebenzisa amasu okuphumula
  • Ukugcina izindawo zokuhlala zihlanzekile ukuze unciphise ukuchayeka kwe-allergen
  • Ukwandisa i-vitamin D ukusetshenziswa
  • Ukufaka ukudla okuvimbela ukuvuvukala njenge-ginger ne-turmeric
• Odokotela bavame ukutusa ukudla okuyisithupha okuqeda ukudla ezigulini ezinezinkinga ze-eosinophilic ezithinta uhlelo lokugaya ukudla. Le ndlela yokudla ayibandakanyi ukudla okuvamile, okuhlanganisa amaqanda, isoya, amantongomane, inhlanzi, ubisi, i-shellfish, nokolweni.
• Ezimweni ezimbi kakhulu ezingaphenduli ekwelashweni okujwayelekile, odokotela bangase bacabangele ukufakelwa kwe-nonmyeloablative allogeneic hematopoietic stem cell, nakuba indima yako isaphenywa.

Uzoyibona Nini Udokotela

Izimpawu ezithile ze-eosinophilia zidinga ukunakwa ngokushesha, ngokuyinhloko lezo ezithinta izitho ezibalulekile:

• Izimpawu Zesistimu Yokuphefumula:
  • Ukuhefuzela okuqhubekayo
  • Ukuphefumula kanzima
  • Ukuphefumula kanzima
• Izinkomba zenhliziyo nemithambo yegazi:
  • ubuhlungu besifuba
  • Izimpawu zokuhluleka kwenhliziyo
  • Ukukhathala okungachazeki
• Izinkinga Zamathumbu:
  • Ukungakhululeki emphinjeni
  • Ubuhlungu besisu
  • Kunzima ukugwinya

Ukuvimbela i-Eosinophilia

Njengoba i-allergies ibalwa njengesiqalo esivame kakhulu samazinga e-eosinophil aphakeme, ukulawula ukungezwani komzimba kumi njengomugqa wokuqala wokuzivikela.

• Ukugcina Indawo Ehlanzekile: Ukudala indawo yokuhlala engenalo uthuli kudlala indima ebalulekile ekuvimbeleni. Izindlela zokuhlanza njalo zisiza ukunciphisa ukuchayeka ezinto ezingezwani nezivamile. Izinqubo ezibalulekile zihlanganisa:
  • Faka uthuli okungenani kanye ngesonto ukuvimbela ukunqwabelana kwezimbuzane zothuli
  • Ukugcina amafasitela evaliwe ngezikhathi zonyaka wempova
  • Ukugcina umoya ofanele
  • Ukulandela imithetho eqinile yenhlanzeko yomuntu siqu
• Ukucatshangelwa Kwezokudla: Izinketho zokudla zithonya kakhulu amazinga e-eosinophil. Indlela ebanzi yokuphatha ukudla ihlanganisa:
  • Ukugeza kahle izithelo nemifino
  • Ukugwema inyama engaphekiwe, inhlanzi nezimbaza
  • Ukugwema ama-prawns amanzi ahlanzekile, iminenke, nama-slugs
  • Ukusebenzisa uketshezi olubilisiwe kuphela
• Ukuguqulwa kwendlela yokuphila: Izinguquko eziningana zendlela yokuphila zinganciphisa ngempumelelo ingozi yokuthuthukisa i-eosinophilia:
  • Ukuyeka ukubhema
  • Ukunciphisa ukusetshenziswa kotshwala
  • Ukulandela ukudla okulinganiselayo okuphansi kokudla okune-acidic
  • Ukugcina isisindo esinempilo
• Kubantu abane-eosinophilia ehlobene ne-acid reflux, ukulungiswa kokudla kubonakala kuzuzisa. Ukudla okunconyiwe kufaka phakathi inyama engenamafutha, okusanhlamvu, nemikhiqizo emisha. Ngakolunye uhlangothi, izinto ezithile zidinga ukugwema:
  • Ukudla okuthosiwe
  • utamatisi
  • chocolate
  • Mint
  • Ugaliki
  • Anyanisi
  • Ikhofi
• Ukuphathwa Kwemithi: Ukunaka ukusetshenziswa kwemithi kusiza ukuvimbela i-eosinophilia ebangelwa izidakamizwa. Imithi ethile ehlotshaniswa nezibalo ezikhulayo ze-eosinophil ihlanganisa:
  • Amphetamine
  • I-Interferon
  • Amanye ama-antibiotics
  • Ama-laxative aqukethe i-Psyllium
  • Ama-tranquilizers

Isiphetho

Ukuqonda i-eosinophilia kusalokhu kubalulekile ekulawulweni okusebenzayo kwalesi simo. Nakuba izimo ezithambile zingase zingabonisi izimpawu, ukubalwa kwe-eosinophil ephakeme kungaholela ekulimaleni okukhulu kwesitho uma kushiywe kungalashwa. Odokotela ngokuvamile batusa izinguquko zendlela yokuphila, ukulungiswa kwemithi, noma ukwelashwa okuqondile okusekelwe ezimeni ngazinye. Ukwengeza, izinyathelo zokuvimbela ezifana nokugcina indawo ehlanzekile nokulandela iziqondiso ezifanele zokudla kusiza ukunciphisa ingozi yokuthuthukisa i-eosinophilia.

Imibuzo Evame Ukubuzwa

1. Ingabe i-eosinophilia ibucayi?

Izibalo eziphezulu ze-eosinophil zingabonisa kokubili izimo ezithambile nezibucayi. Ngaphandle kokwelashwa, i-hypereosinophilic syndrome ingaba yimbi kakhulu. Ngokungenela kwezokwelapha okufanele, ingelapheka.

2. Kungenzekani uma izibalo ze-eosinophil ziphezulu?

Amazinga e-eosinophil aphakeme angalimaza izitho eziningi ngokuvuvukala. Inhliziyo ibhekene nezingozi ezithile, ezingase zibe ne-Löffler endocarditis, eholela emahluleni egazi, ukwehluleka kwenhliziyo, kanye nezinkinga zamavalvu. Ezinye izinkinga zithinta amaphaphu, isikhumba, nesimiso sezinzwa.

3. Yini ebangela ukwanda kwama-eosinophil?

Izici eziningana zibangela ukubalwa kwe-eosinophil ephakeme. Izimbangela ezivamile zihlanganisa ukungezwani komzimba, izifo ezibangelwa amagciwane, kanye nemithi ethile. Kwezinye izimo, ukuphazamiseka kwegazi, izimo ze-autoimmune, noma izinguquko ezithile zofuzo zingase zikhuphule amazinga e-eosinophil.

4. Yikuphi ukudla okungalungile nge-eosinophilia?

Abantu abane-eosinophilia kufanele bagweme:

• Ukudla okune-Acidic
• Izinto ezithosiwe
• utamatisi
• chocolate
• Garlic no-anyanisi
• Ikhofi

5. Yikuphi ukudla okwehlisa ama-eosinophil?

Ukudla okuzuzisayo kokulawula amazinga e-eosinophil kuhlanganisa:

• Izithelo nemifino emisha
• Inyama emnandi
• Ukudla okuphelele
• Ukudla okunothe ngovithamini D
• Ama-anti-inflammatories emvelo afana noju, i-turmeric, nejinja

6. Ingabe i-eosinophilia ingelapheka?

I-Eosinophilia ihlala iyisimo esingamahlalakhona ngaphandle kokwelashwa okuqondile. 

7. Ingabe ama-eosinophil angabuyela kokujwayelekile?

Amazinga e-eosinophil avame ukubuyela kokujwayelekile ngemva kokwelapha isimo esingaphansi. Ngaphezu kwalokho, imishanguzo elwa nokuvuvukala ehambisana nezinguquko zendlela yokuphila isiza ukugcina amanani e-eosinophil enempilo. Ukuqapha njalo ngokuhlolwa kwegazi kuqinisekisa ukuthi amazinga ahlala ebangeni elijwayelekile.

UDkt. Chaitanya Challa

I-MBBS, MD (Imithi Yangaphakathi), PDCC (Ukunakekelwa Okubalulekile), i-FCCS (Ukunakekelwa Okubalulekile), iDiploma ku-Endocrinology kanye nesifo sikashukela
CARE Hospitals Outpatient Centre, Banjara Hills, Hyderabad

Ukuze Ubhukhe Isikhathi, shayela:

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