I-Reye's syndrome yisifo esingavamile esingavuvukali esingadala umonakalo omkhulu esibindini nasengqondweni. Uma lesi sifo singelashwa ngokushesha, singabangela ukulimala kwengqondo okungenakulungiseka noma kube yingozi kumuntu.

Izifundo ezivame ukuthinteka kakhulu yi-Reye's syndrome yizingane kanye nabantu abadala abancane abaneminyaka engaphansi kwengama-20. Nokho, amacala asebekhulile asehlonziwe kakade. (1)

Ukusabalala kwalesi sifo eFrance (inani lamacala alesi sifo ngesikhathi esithile, kubantu abathile) kulinganiselwa ku-0.08 ezinganeni eziyi-100.

Isixhumanisi sembangela nomthelela sibekwe phambili e-United States lapho uthatha i-aspirin kanye nokuthuthukiswa kwe-Reye's syndrome.

Lokhu kuhlobana kwabe sekuhlolwa eFrance (phakathi kuka-1995 no-1996). Lesi sakamuva savumela ukubalwa kwezingane ezingu-8 ezingaphansi kweminyaka engu-15 ubudala eziphethwe yilesi sifo kanye nokuthatha i-aspirin. Ukubuzwa kwesilinganiso senzuzo / ingozi ye-aspirin akuzange kusebenze naphezu kwesexwayiso. Lokhu kunakekelwa okukhethekile kokunikezwa kwe-aspirin kuthinta izingane ezinezifo ezibangelwa amagciwane, njengenkukhu, umkhuhlane, njll.

Ngalo mqondo, i-ANSM (Inhlangano Kazwelonke Yezempilo Nemithi) isungule iqiniso lokuthi i-acetylsalicylic acid (aspirin) akufanele inikezwe izingane ezihlushwa lolu hlobo lwegciwane ngaphandle uma zonke ezinye izinyathelo zehlulekile. . Ngaphezu kwalokho, uma kwenzeka ukuhlanza, ukuphazamiseka kwezinzwa, ukuphazamiseka kokuqaphela noma ukuziphatha okungavamile, lokhu kwelashwa kufanele kuqedwe. (3)

Izimpawu ezivame ukuhlotshaniswa ne-Reye's syndrome yilezi: (1)

- ukuhlanza ngaphandle kwesizathu;

- ukuvilapha: ukuntula intshisekelo, umdlandla namandla;

- ukozela;

- ukwanda kokuphefumula;

– isithuthwane.

Lezi zimpawu “ezijwayelekile” zivame ukuvela ezinsukwini ezimbalwa ngemuva kokutheleleka ngegciwane.

Kwezinye izimo, lezi zimpawu zakuqala zingadlulela ezibucayi kakhulu: (1)

- ukuphazamiseka kobuntu: ukucasuka, ukuyaluza, ukuziphatha okunolaka, njll.;

- isimo sokudideka nokukhathazeka okungase ngezinye izikhathi kuhlotshaniswe nokubona izinto ezingekho;

– ukulahlekelwa ukwazi okungaholela ekuqulekeni.

Ukubonisana nodokotela kufanele kusheshe kususe izinsolo zalesi syndrome enganeni.

Nakuba lezi zinhlobo zezimpawu zingahlotshaniswa ne-Reye's syndrome, kuyadingeka ukuthi kuqinisekiswe i-hypothesis ukuze kuqinisekiswe noma cha ukuthuthukiswa kwe-pathology. Kulokhu, kubalulekile ukuxwayisa udokotela ngokudla okungenzeka kwe-aspirin ebuntwaneni okungase kuhlotshaniswe nokuthuthukiswa kwalesi sifo. Ngaphezu kwalokho, uma ingane ingazange ibe nencwadi kadokotela yokuphuza i-aspirin ngaphambili, amathuba okuthuthukiswa kwalesi sifo angakwazi ukufakwa. (1)

Umsuka oqondile we-Reye's syndrome okwamanje awaziwa. Kodwa-ke, izimo eziningi zalesi sifo zithinta izingane kanye nabantu abadala abasha (abaneminyaka engaphansi kuka-20) abalulama ekuthelelekeni ngegciwane, ikakhulukazi umkhuhlane noma inkukhu. Ngaphezu kwalokho, lezi ziguli zazinencwadi kadokotela ye-aspirin ekwelapheni lokhu kutheleleka ngegciwane. Ngalo mqondo, ukwelashwa nge-aspirin ye-virosis kwenza kube imbangela evame ukutholakala.

 Isici esengeziwe ekuthuthukisweni kwalesi sifo siphumela ezakhiweni ezincane ngaphakathi kwamaseli: i-mitochondria, eyonakele.

Lezi zakhiwo zamangqamuzana zinikeza amandla adingekayo ekuthuthukisweni kwamaseli. Zibaluleke kakhulu ekusebenzeni kahle kwesibindi. Ngempela, i-mitochondria iphinde ihlunge ubuthi egazini futhi ibandakanyeka ekulawuleni ushukela wegazi (amazinga kashukela) emzimbeni.

Kumongo lapho lezi zinqubo zokulawula i-hepatic zithinteka khona, isibindi singabhujiswa. Ukubhujiswa kwesibindi kubangelwa ukukhiqizwa kwamakhemikhali anobuthi. Ngokudlula emgudwini wegazi, lobu buthi bungalimaza wonke umzimba futhi ikakhulukazi ubuchopho. (1)

Ezinye izifo zingase futhi zibe yimbangela yezimpawu ezihlobene ne-Reye's syndrome. Ngalo mqondo, ukuxilongwa kwalolu hlobo lwe-syndrome kungakhishwa ngaphansi kwezimo ezithile. Amanye ama-pathologies afaka:

- meningitis: ukuvuvukala kolwelwesi oluvikelayo oluhlanganisa ubuchopho nomgogodla;

- encephalitis: ukuvuvukala kobuchopho;

- Izifo ezihlanganisa ndawonye ukuphazamiseka kwe-metabolic ezithinta ukusabela kwamakhemikhali emzimbeni. Okuvame kakhulu yi-acyl-CoA medium chain dehydrogenase (MCDD).

Isici esiyinhloko esiyingozi se-Reye's syndrome ngokuyinhloko ukuphuza i-aspirin lapho welapha ukutheleleka ngegciwane okufana nomkhuhlane noma i-chickenpox ezinganeni noma kubantu abadala.

Ukuxilongwa kwalesi sifo kuqala ngokuxilongwa okuhlukile uma kubhekwa izimpawu ezivezwa isiguli kanye nomlando waso, ikakhulukazi mayelana nokuphuza i-aspirin ngesikhathi sokwelashwa kwegciwane lesandulela ngculazi.

Ukuhlaziywa kwegazi nomchamo nakho kungavumela ukutholakala kwe-Reye's syndrome ngomqondo wokuthi ubuthi obuwuphawu lwe-pathology bungatholakala kulolu ketshezi lomzimba. Ukuba khona kwalezi zinto eziyingozi emzimbeni kuwumthombo wokusebenza kwesibindi okungavamile.

Okunye ukuhlolwa kungase kube into yokuboniswa kwe-syndrome:

- isithwebuli, okwenza kube nokwenzeka ukugqamisa noma yikuphi ukuvuvukala ebuchosheni;

- ukubhoboza i-lumbar, lapho isampula ye-cerebrospinal fluid ithathwa emthonjeni womgogodla futhi ihlaziywe ukuze kuhlolwe ukuthi kungenzeka yini ukuba khona kwamagciwane noma amagciwane;

– i-biopsy yesibindi, lapho kuthathwa khona isampula yezicubu zesibindi futhi ihlolwe ngaphansi kwesibonakhulu ukuze kutholwe ubukhona noma ukungabikho kwamaseli ahlobene ne-Reye's syndrome.

Ukwelashwa kwalesi sifo kufanele kuqaliswe ngokushesha lapho kutholakala ukuxilongwa.

Inhloso yokwelashwa ukunciphisa izimpawu nokuvumela izitho ezibalulekile ukuba zenze imisebenzi yazo kanye nokuvikela ubuchopho emonakalweni ongase ubangelwe yilesi sifo.

Inani elikhulu lezidakamizwa linganikezwa, ngokuvamile ngomthambo, njenge:

- ama-electrolyte noketshezi, okwenza kube nokwenzeka ukubuyisela ibhalansi kasawoti, amaminerali kanye nezakhi emzimbeni (ikakhulukazi i-glycemia egazini);

- ama-diuretics: ukusiza isibindi ekusebenzeni kwaso;

- i-ammonia detoxifiers;

- ama-anticonvulsants, ekwelapheni isithuthwane.

Usizo lokuphefumula lungase lubekwe esimweni lapho ingane inobunzima bokuphefumula kwayo.

Lapho ukuvuvukala ebuchosheni sekuphelile, eminye imisebenzi ebalulekile yomzimba ngokuvamile ibuyela esimweni esivamile. (1)