Leukemoid mau mea i loko o nā keiki: nā'ano (nā'ano), nā kumu, ka'āpana algorithm o ka hō'oia'ana, ka ma'i. Leukemia a me ka ma'i leukemia: nā'oko'a

Leukemoid reactions - ho'ololi i nā hemopoiesis, e like me ke ki'i o ke koko i ka leukemia a me nā pūpū koko'ē a'e o ka pūnaewele hematopoietic. Pono e ho'omaopopo'ia ka pilikino o kēia mau hopena,'o ko lākou nānā pono'ana a me ka nele o ka ho'ololi'ana i ka hana o nā meaola. Hiki ke ho'ā'o'ia kēia mau ho'āla e nā'ano like'ole o nā mea inu, nā ma'i koko, nā ma'i, nā kinase'a o ka ma'i ma'i lolo.

He'oko'a ke'ano o ka ho'omohala'ana no nā'ano'ano like'ole: i kekahi mau kumu, he puka i loko o ke koko o nā mea uila mau loa, ma nā mea'ē a'e -'o ka ho'onui'ia o ka hana o nā kī'aha koko a i'ole ka palena o nā pūnaewele i puka i loko o nā kinikini, ai'ole i ka hiki'ana o kekahi mau hana i ka manawa ho'okahi.

He aha ka hopena o kēia ma'i?

Nui nā'ano e hiki ai ke alaka'i i nā le'ale'a leukemoid. 'O nā kumu o ko lākou ulu'ana:

• Ka hopena o ka ho'okahuli'ili'ana;
• 'O ka ma'i;
• Sepsis;
• Nā papahana Putelent;
• 'O ka ma'i kīnā;
• Lymphogranulomatosis;
• Ka wāwae i ka po'o;
• Ke kāpili hou;
• Pneumonia hau'oli;
• 'Oi;
• Ho'opi'i;
• 'O ke kuni wela;
• Ka dystrophy nui o ke akepa'a;
• Ka lā'au hō'ailona me nā homona'ele'ele;
• 'O ka lā'au'awa'awa'epona.

Ke'ano o ka ma'i

Loa'a nā'ano lekamoid mau'ano:

• Nā hāme'a mieloid.
• 'O Lymphocytic.
• Pseudoblastic.

E no'ono'o kākou i kēlā me kēia.

Mieloid

'O kēia'ano o ka ho'opi'i'ana e komo ana i nā'ano kūpono e like me neutrophilic, promyelocytic a me eosinophilic. Leukemoid 'ole i' ano like me ka poe o ka maʻi myeloid leukemia, pu ma ka intoxication a me ka loa nā mea palahēhē. 'O ka leukocytosis pūnaewele he'ano ma'alahi ia, e hele pū ana me ka hiki'ana o nā lepsis, kahi hānai inflammatory a me ka pi'i'ana o ka mahanahana o ke kino.

'O ka ho'olālā'ana i nā'eosinophi e'oi aku i ke koko, ma ke'ano he kūlana, e hana me ka pilikino i nā palapona a me nā lā'au lapa'au, nā ma'i ma'i ma'i, he'ole - me nā ma'i o ka lolopika (lymphogranulomatosis a me lymphosarcoma). 'O kēia mau ma'i leukemoid Pono kahi'imi ma'amau e ho'opau ai i nā ma'i o ka holoholo a me nā helminths.

'O nā kinipona e like me ka erythremia. 'O nā kumu o ka erythrocytosis he mau malaysia ia o ke akemāmā me ka emi'ana o ka oxygenation (oxygen ho'ohemo) o ke koko, nā pūpū pūpū, a me nā pō'ino o ke kino. I kēia kūlana, pono ka nānā'ana i ke kamepiula a me ka ultrasound.

Ua like ka myeloma i ka erythromyelosis nui, a he like'ole ia i ka'ole o nā pūpū koko'ula'ula i loko o ka iwi a me ke koko. I ka manawa pinepine, hiki ke'ike'ia me nā kinakase o ka ma'i ma ka iwi.

'O Lymphocytic

'O ia mau'ano ho'ohālikelike e hō'ike'ia i ka ho'onui nui o ka heluna o nā lymphocytes i ke koko o ke koko, ka mea i hihia pinepine no ka ho'oulu'ana o ke ake, a me nā māmā lymph a me nā mokulele.

A hiki i kēiaʻano e pili ana mononucleosis, infectious lymphocytosis, monocyte-macrophage leukemoid reactions i na keiki me ka mea koʻohune a me ka mea hoʻomaʻi nā mea palahēhē, a me nā mea palahēhē parasitic, a kiʻekiʻe koko eosinophilia (e laʻa me, helminthiasis).

Hō'ike'ia nā hanana Lymphocytic:

• I nā ma'i viral (ka pox chicken, ka rubella, ka pīpī pīpī, ka ma'i adenovirus, ka ma'i nui, ka mononucleosis pūpū);
• Nā hō'ailona palapitic (rickettsiosis, toxoplasmosis, chlamydia);
• Nā ma'i kīnā (syphilis, pertussis, tuberculosis);
• Nā mycoses;
• Nā ma'i kaulike'ole (ma'i ma'i, lupus erythematosus pūnaewele).

Lymphocyticʻano hou, he pono ole ma ka macroglobulinemia Waldenstrom, li nui, sarcoidosis. Pau nā ma'i i nā luna i ka ma'i a hiki ke ho'opilikia i ka mea ma'i ma mua o ho'okahi makahiki.

Pseudomonas

'O nā mea i loa'a i ka ma'i leukemo e hana inā e ho'omaka ana ka mea ma'i e puka mai i ka agranulocytosis immune, a'o ke kumu o ia hopena e hiki ke hana'ia ma o ka lawe'ana o sulfonamides, "Amidopyrina", "Butadione" a me nā lā'au lapa'au'ē a'e.

No kēia'ano o nā hopena, ke hele mai nei kekahi mau pū'ali pūnaewele me kahi mele like, ho'okahi nucleoli a me ka blue, kikokikona,'ole ka cytoplasm,'a'ole i loko o ke koko ākea a me ka momona o ka iwi.

'A'ole like me nā pūlala'ula'ula'ele'ele i loko o kēia mau mea'a'ohe'ōnaehana māmā ma'amau a me ke'ano o nā aho chromatin. Ho'oku'u'ia nā'ōpiopio'ole me ka'ole chemotherapy a pili i ka ma'i leukemoid i nā keiki hou me nā ma'i kūlohelohe (e like me ka Down's Syndrome).

'O nā leukemoid reactions, nā'ano i hō'ike'ia ma luna nei, i hana'ia e kū'ē i ke'ano o nā ma'i pilikino, ka mea ma'amau'ole e ho'onāukiuki i nā pilikia pilikia. I kekahi manawa, dramaticallyʻikeʻia thrombocytopenia hiki erroneously e manao like kekahi o na symptoms o huʻi leukemia. I ka huli'ana o ka lymphadenitis immunooblastic,'o ka palekana o ka hanana kūlohelohe o ka pukapili lymph, a me nā laina i ho'oholo pololei'ia o nā follicles, he mea nui loa.

Leukemia a me ka ma'i leukemia: nā'oko'a

Aia kekahi mau'oko'a ma waena o nā hopena a me ka leukemia,'o ia ho'i:

1. Me nā ma'i o ka ma'i leukemoid no ka ho'oikaika wikiwiki'ana o ka iwi o ka iwi, he metamyelocytic, a me ka ma'i leukemia he pi'i i nā puka ho'olālā. Me nā ma'i leukemoid, mālama'ia ka erythroid germ, aia kekahi leycoerythroblastic ma'amau ma'amau o 3: 1 a me 4: 1.
2. 'A'ole hō'ike'ia o ka anaplasia i nā hanu ma'i leukemeid, e like me ke'ano o ka ma'i leukemia, ke hana'ia ka protoplasm protrusion a me anomaly o ka pūpū.
3. Ma ke'ano mua, i loko o ke koko o ke koko ke pi'i i ka helu ma'amau a me ka pi'i'ana o ka pakeneka o nā kanaka kū'oko'a kū'oko'a, me ka ma'i leukemia ka pau'ana o nā mea kū'oko'a he nui, a me ka ulu nui o nā'ōpiopio, nā'ōlohelohe.
4. Ke'ike pinepine'ia ka ma'i leukemoid i ka'ahu'ona ino o nā mea kūlohelohe.
5. I ka cytochemical like leukocytes ma leukemia ka emi a kaawale o ka'ākilikai phosphatase, ma leukemoid reactions - loa haʻawina.
6. Me ka hō'eu'eu o ka ma'i leukemia metelogenous mau loa, he hopena ka hopena o ka hui eosinophilic-basophilic, me nā'ano leukemia e hala ana.
7. Me ka mieloleukemia,'ike mau'ia he high thrombocytosis, me nā lekimoid reactions,'o ka helu o nā platelets i loko o ka papahana ma'amau.
8. I ka pae mua o ka ma'i leukemia ma'amau, loa'a i kahi ma'i nui nui, a he mau manawa kīkole ka ma'i leukemoid, akā he palupalu kēia'ano a'a'ole loa e hiki i kahi nui nui.
9. Ke'ike'ia kahi ma'i leukemoid i ke'ano neoplastic i loko o ka iwi o ka iwi i nā pūkunia'au kanikau.

Leukemoid mau hana i nā keiki: kahi diagnostic algorithm

'O ke kuleana nui o ka wehewehe'ana i kēia ma'i i hā'awi'ia i ka mea kālai'ike, nāna e nānā i nā mea lā'au biopsy. Akā, i mea e pale ai i ka kuhi hewa'ole, pono e loa'a ka'ike pono o ka mea ma'i i ka'ikepili e pili ana i ka mea ma'i, e hā'awi iā ia i kahi hō'ailona i nā ho'ā'o like'ole a kau i ka lā'au ma'amau i hiki ke ho'opau i nā hopena o ka lymphadenitis. Inā pau'ole kēia mau mea, a laila'a'ole e pololei ka hō'ailona, a no laila, e pa'akikī loa ka pale'ana i kēia ma'i. Ma hope o ka mea a pau, he mea weliweli loa kēlā ma'i. I kekahi manawa no nā kiko'ī o ka hopena he mea pono ia e hana i ka lā'au ola.

'O kahi ko'iko'i nui o ka hō'ailona he ho'opuka'ana mai ka waho o ke kōpili lymph biopsy a me ka hō'ailona. Me ka lymphosarcoma,'o ka hapanui o nā erythrocytes (ma kahi o 30%) he mau pu'upu'u mau loa. Me nā lymphadenitis immunoblastic,'o ia mau erythrocytes, ma ke'ano he rula, he emi iho i ka 10 pakeneka, he'ano like'ole lākou ma ke'ano o ka basophilia o ka cytoplasm a me ke kūlana o ka pūpū.

'O ka hō'ailona pathohistological o ka ho'opi'i ho'opi'i lymph he mea pono loa a ho'āla i ka pane pololei. No ka mea,'o ka mea hana ma'i no nā ho'okolohua o nā koko he pono e ho'omaopopo pono i ka hō'ailona, a'ike'ia kēia i ka hopena. Ke la'ana, e ho'okumu i kahi hō'ailona mua o nā benign lymphomas ma kekahi mau'ano, lō'ihi ka manawa e nānā ai i ka mea ma'i a nānā hou i nā pahu lymph.

ʻike, leukemoid reactions kēia wā kaʻimiʻana monoclonal immunoglobulin kekahi manawa pono hai a me ka lōʻihi-makahiki loina o ka iwi lolo puncture. Ma mua o ka'āpono o ka hō'ailona, hō'ole'ia ka hō'ailona antitumor.

'O ka mononucleosis ma'i

Ua kapa'ia'o ka ma'i Filatov-Pfeiferra, ka ma'i wela a me ka angina monocytic. He ma'i'ino ia e hō'ike'ia ana e ka ho'ololi'ana i nā lymphocytes, ka nui o nā lymph nodes a me ke kikooho, lymphadenitis reactive, ke'ano o nā pūpū koko koko ma'ema'e i loko o ke koko. 'O ka mea nāna e ho'olālā ka'eha Epstein-Barr. Ma ke kumu o ka ma'i,'o ia ka hopena o nā lymphocytes i hopena'ia e kekahi ma'i viral.

He'oko'a ke kikowaena. Ma nā'ano ha'aha'a, pilikia ka moku'āina o ke ola no ka rhinitis. Nā hi'ohi'ona hō'ike:

• 'O Angina ("nā wela ahi");
• Ka ho'onui'ia'ana o nā'ōpili lymph a me nā pūpū o ke kino, a me ka hō'eha;
• 'O ka hanu ko'iko'i'ole i nā lā mua o ka ma'i ma muli o ka ho'oulu'ana o ka membrane mucous.

'O ke koko: ka pi'i nui o nā eosinophils, lymphocytes a monocytes.

Nā pilikia

He lawa a lawa no ka hopena o ka hō'ailona o ka ma'i i ke komo'ana i loko o ke koko o nā mononuclears kūikawā ('oi aku ma mua o 10-20%) - nā'ano like'ole i loko o ka pu'upu'u o kahi lymphocyte nui a me kahi basophilic lautele me kahi lālani kalala lilac me ka'ōlelo ho'opili perinuclear. Loa'a nā ma'i leukemoid i nā keiki a me nā mākua no nā pule hebedoma, akā ma kekahi mau'ano, ho'omau ka ho'omau'ana o ke koko i nā mahina.

Ho'omaopopo'ia nā pale i nā māmā māmā, i kekahi manawa i nā wā o kekahi mau makahiki ma hope o ke ka'ina mua. Hiki i nā pilikia ke:

• He ma'i ma'i nui;
• Encephalitis;
• Ho'opi'i;
• 'O ka'ōpiopio ma muli o ka pi'i pinepine'ana;
• 'O ka hamopili autoimmune.

'O kepera o ka ma'i leukemoid

No ka mea,'a'ole pono nā lā'au ma'i i nā lā'au lapa'au kūikawā kūikawā, no ka mea, no kekahi mau lā, ua nalowale nā hō'ailona nui o ka ma'i a ua kau'ia ke kūlana koko. Me ka ma'i lō'ihi a me ke olakino o ka mea ma'i, ho'ohana'ia ka hopena pathogenetic - kau i ka "Prednisolone" ma kahi o 20-30 milligrams i ka lā a i'ole nā lā'au'ē a'e e hana i ka lā'au lapa'au. Ho'oma'aka i nā kaukamai ma nā hihia kūpono wale nō.

Ka wānana

Kuhi ka hopena: he ha'aha'a ke aloha, a no laila e ho'omanawanui ka palekana. Eia naʻe, noho pilikia loa rupture o ka spleen. Ho'omaopopo'ia ka hoihoi'ana i ka maika'i ma ka puka'ana o nā hō'ailona o ka ho'ēmi o ke kino o ke kino, a me ka nalowale'ana o nā manawa'eha a me ka ho'olālā o ka mahana o ke kino. Inā'ike'ia ka mononucleosis ma ke'ano o ka ma'i hepatitis, pono ka hale ho'omaha o ka mea ma'i.