Nukae nye Felty Syndrome? Esia le vevie na mi amesiwo ŋu ƒunukpeƒetetedɔ le!

Ate ŋu adzɔ hã be ƒunukpeƒewo nave wò, avuvu, eye wò abɔwo nasẽ vie le ŋdi me, alo? Zi geɖe la, ƒunukpeƒetetedɔ ate ŋu atso nusiawo gbɔ. Gake ènya be kuxi bubu aɖe hã li si ate ŋu ado tso ƒunukpeƒetetedɔ sia me, gake womenyae nyuie nenema o, gake ele vevie ŋutɔ be nànyae? Emae nye Felty Syndrome ƒe dɔléle. Mina míaƒo nu tso esia ŋu tsitotsito vie egbea.

Nuka tututue nye Felty Syndrome?

Kpuie ko la, Felty Syndrome nye nɔnɔme etɔ̃ siwo dzɔna ɖekae. Woawoe nye:

• Rheumatoid Arthritis - Ƒunukpeƒetetedɔ si mia dometɔ geɖe nya nyuie.
• Neutropenia - Esia nye neutrophils, si nye ʋumenugbagbevi ɣi ƒomevi aɖe si le ʋu me ƒe xexlẽme dzi ɖeɖe kpɔtɔ.
• Splenomegaly - Esia fia be ƒunukpeƒe, si nye ŋutinu aɖe le ŋutilã me, lolona wu alesi wòle dzɔdzɔmee.

Zi geɖe la, edzea egɔme tso ƒunukpeƒetetedɔ (RA) dzi. Nɔnɔme eve bubuawo dzɔna abe RA ƒe kuxiwo ene. Ðɔktawo yɔa esiawo be ‘extra-articular manifestations’. Eyae nye be menye ƒunukpeƒewo koe ƒunukpeƒetetedɔ le o, ke boŋ edzea ƒunukpeƒe siwo le wo godo dzi. Esia tso dɔdzẽ ƒe dɔwɔwɔ si hea ƒunukpeƒetetedɔa vɛ gbɔ. Togbɔ be ebɔ be nusiwo gblẽa nu le ame ŋu siawo ƒomevi dzɔna le ƒunukpeƒe siwo ŋu RA le godo hã la, Felty Syndrome nye dɔléle si mebɔ kura o.

Aleke esia kpɔa ŋusẽ ɖe dziwòe?

Felty ƒe dɔlélea dzea egɔme tso Rheumatoid Arthritis dzi. Emegbe wò ƒunukpeƒewo le veve sem vevie eye wovuvuna. Emegbe ne nɔnɔmewo abe Neutropenia kple Splenomegaly ene do mo ɖa la, egblẽa nu le wò dɔlélenutsiŋutete ŋu . Neutropenia nye ʋumenugbagbevi ɣi ƒomevi aɖe si woyɔna be neutrophils ƒe ɖiɖi. Lãmenugbagbevi siawo nye lãmenugbagbevi vevi aɖe ŋutɔ si kpɔa míaƒe ŋutilã ta tso dɔlélewo me. Eyata ne wo dzi ɖe kpɔtɔ la, mɔnukpɔkpɔ si li be woaxɔ dɔlélewo dzina ɖe edzi. Aɖuɖɔtoe si lolo hã ate ŋu anye nu bubu si tae neutrophils dzi ɖena kpɔtɔna alea ɖo.

Aleke gbegbee nɔnɔme sia bɔe?

Felty ƒe dɔlélea dzɔna le amesiwo ŋu ƒunukpeƒetetedɔ le la dometɔ siwo ade 2% me . Abe RA ene la, Felty ƒe dɔlélea bɔ ɖe nyɔnuwo me abe zi gbɔ zi etɔ̃ ene wu ŋutsuwo. Enyo be míade dzesii be amesiwo katã kloe ŋu RA le siwo xɔ Felty ƒe dɔlélea nye ‘seropositive’. Esia fia be dodokpɔwo ɖo kpe edzi be nane si woyɔna be rheumatoid factor antibodies le yewoƒe ʋu me. ‘seronegative’ amewo, si fia amesiwo si dɔlékuiwutike mawo mele o la, ƒã hafi Felty ƒe dɔlélea dzea wo dzi.

Nukae nye esia ƒe dzesiwo?

Zi geɖe la, dzesi gbãtɔ siwo dzena enye ƒunukpeƒetetedɔ. Esiawo dometɔ aɖewoe nye:

• Ƒunukpeƒewo ƒe vevesese
• Ƒunukpeƒewo ƒe vuvu
• Ƒunukpeƒewo ƒe sesẽ, vevietɔ le ŋdi me

Ame aɖewo ate ŋu akpɔ dzesi bubuwo tsɔ kpe ɖe RA ŋu le woƒe ƒunukpeƒewo. Le kpɔɖeŋu me:

• Ƒunukpeƒetetedɔ siwo dzɔna le ŋutigbalẽa te le ƒunukpeƒewo gbɔ (woyɔa esiawo be ƒunukpeƒetetedɔ) .
• Lãmetsiŋusẽ ƒe ʋuka siwo vuvu le teƒewo abe kɔ kple akɔta ene
• Aklã ate ŋu avuvu eye wòase veve ne woka asi eŋu.
• Ŋku kple nu ƒe ƒuƒu (woyɔa esia be Sjogren ƒe dɔléle) .
• Ŋku siwo biã, siwo vuvu (woyɔa esia be episcleritis) .
• Ŋutilã ƒe abi, vevietɔ le afɔwo ŋu
• Dzesi siwo fia be ʋu le dodom le ŋutigbalẽa te
• Yagbɔgbɔ sesẽ le lãkusi ƒe vuvu ta
• Akɔtave le dzia ƒe vuvu ta
• Asrã
• Ðeɖiteameŋu kple kuviawɔwɔ
• Nuɖuɖu ƒe dzodzro ƒe vɔvɔ alo lolo dzi ɖeɖe kpɔtɔ si womeɖe o

Tsɔ kpe ɖe esiawo ŋu la, dzesi bubuwo hã le Felty Syndrome ŋu. Ɣeaɖewoɣi la, dzesi siawo ate ŋu adze hafi RA ƒe dzesiwo nadze egɔme.

• Dɔlékuiwo xɔxɔ enuenu, siwo nɔa anyi didi. Kpɔɖeŋu aɖewoe nye dzamezã, dɔgbo ƒe fuɖename, kple ŋutigbalẽ me dɔlékuiwo.
• Aɖuɖɔtoe ƒe vuvu. Ate ŋu ase le eɖokui me le asi me eye ate ŋu anɔ veve sem.
• Ŋutilã ƒe amadede ƒe tɔtrɔ (abe teƒeteƒewo ene).

Gake nusi wɔ nuku enye be, ɣeaɖewoɣi la, woate ŋu akpɔe be Felty Syndrome le ŋuwò dzesi aɖeke manɔmee. Ʋudodokpɔ kple ʋudodokpɔ ate ŋu aɖee afia be nɔnɔme etɔ̃awo katã le ŋuwò hafi nàse dzesi aɖeke gɔ̃ hã.

Ƒe nenie esia dzea egɔme zi geɖe?

Zi geɖe la, Felty Syndrome dzea ame tsitsiwo dzi, siwo xɔ tso ƒe 50 va ɖo ƒe 70. Le ame akpa gãtɔ gome la, Felty Syndrome dzena ne wokpɔ ƒunukpeƒetetedɔ ƒe dzesiwo abe ƒe 10 va ɖo 15 ene vɔ.

Nukatae Felty Syndrome dzɔna?

Lãmetsiŋusẽ ƒe dɔléle nye ‘ame ŋutɔ ƒe dɔlélenutsiŋutete ƒe dɔléle’. Esia fia be mía ŋutɔwo ƒe dɔlélenutsiŋutete dzea mía ŋutɔwo míaƒe ŋutilã ƒe akpa aɖewo dzi abe ɖe wonye futɔ ene. Dzɔdzɔmeŋutinunyala geɖe xɔe se be Felty Syndrome nye RA ƒe kuxi sesẽ aɖe. Le dɔléle siawo siwo dɔlélenutsiŋutete wɔna me la, míaƒe ŋutilã wɔa ‘dɔlékuiwutikewo’ ɖe protein aɖewo ŋu. Dɔlékuiwutike siawo yia ɖaléa protein mawo hewɔa dzesi na wo be woatsrɔ̃. Aleae dɔdzẽ dzina ɖe edzii.

Ðewohĩ dɔlékuiwutike siawo manɔ RA me ɣesiaɣi o. Gake le amesiwo ŋu Felty Syndrome le gome la, dɔlékuiwutike siawo nɔa anyi godoo. Dɔlékuiwutike siawo ƒe anyinɔnɔ nye nusita RA nu sẽna ɖe edzi eye nu bubu siwo dona tso ƒunukpeƒewo godo (extra-articular manifestations) dzina ɖe edzi ɖo. Woyɔa RA si me dɔlékuiwutikewo le be ‘seropositive RA’. Numekukuwo ɖee fia be seropositive RA kple Felty Syndrome siaa do ƒome kple ‘domenyiŋusẽfianu’ aɖewo. Esia fia be woate ŋu atsɔ wo ayi dzidzimewo me vaseɖe afi aɖe.

Aleke ƒunukpeƒetetedɔ (RA) hea ʋumenugbagbeviɣidɔ kple ƒunukpeƒetetedɔ vɛ?

Alesi Neutropenia Dzɔnae

Neutropenia nye ʋumenugbagbevi ɣi siwo woyɔna be neutrophils ƒe xexlẽme dzi ɖeɖe kpɔtɔ. Susu vevi eve tae wòle alea ɖo. Ðekae nye be wò ƒumeŋuɖui mele neutrophils siwo sɔ wɔm o. Alo, wole neutrophils siwo le wò ŋutilã me la tsrɔ̃m. Le Felty Syndrome me la, nusiawo evea siaa ate ŋu adzɔ. Dɔlélenutsiŋutete ƒe dɔwɔwɔ si ŋu míeƒo nu tsoe va yi ate ŋu ado kplamatse neutrophils ƒe wɔwɔ le ƒumeŋuɖui me, eye neutrophils siwo wowɔ xoxo ate ŋu atsrɔ̃. Azɔ hã, aɖuɖɔtoe si lolo hã nye susu bubu si tae neutrophils dzi ɖena kpɔtɔna ɖo.

Alesi Splenomegaly Dzɔnae

Wò dɔgbo ƒe dɔe nye be wòaɖe ʋumenugbagbevi xoxo siwo ŋu viɖe aɖeke mele o ɖa le wò ʋu me. Gake ne wò dɔgbo lolo akpa (splenomegaly) la, ewɔa dɔ akpa eye wòdzea ʋumenugbagbevi nyui geɖe ɖeɖe ɖa gɔme. Ɣeaɖewoɣi la, ƒunukpeƒetetedɔ ate ŋu ana ƒunukpeƒetetedɔ nalolo. Nusi tututu gbɔ wòtso la me mekɔ haɖe o. Aɖuɖɔtoea hã ate ŋu alolo neutropenia manɔmee. Azɔ hã, ƒã ŋutɔ be Felty Syndrome ate ŋu adzɔ ne dɔgbo mekeke o.

Nukawoe nye afɔku siwo le Felty Syndrome me?

Esi wònye be Felty Syndrome gbɔdzɔa wò dɔlélenutsiŋutete ta la, àte ŋu axɔ dɔlékui sesẽwo enuenu . Ne zi geɖe la, dɔléle sue aɖe le ŋuwò si woate ŋu ada bɔbɔe gɔ̃ hã la, nɔnɔme sia ate ŋu asẽ ale gbegbe be wòate ŋu anɔ anyi ɖaa eye ɣeaɖewoɣi ate ŋu ade wò agbe afɔku me. Dɔlékuiwo ƒe dɔléle si dzi womeɖu o ate ŋu ahe nɔnɔme si me afɔku le si woyɔna be sepsis vɛ. Amesiwo ŋu Felty Syndrome le hã ate ŋu axɔ kansa ƒomevi aɖewo abe ʋumenugbagbeviɣidɔ ene.

Gake mègavɔ̃ ne èse nya siawo o. Afɔku siawo li, gake woate ŋu aɖu wo dzi ne wowɔ atike na wo nyuie helé ŋku ɖe wo ŋu.

Aleke míawɔ ade dzesi esia?

Ðɔktawo dea dzesi Felty Syndrome ne wokpɔe be ƒunukpeƒetetedɔ, ʋumenugbagbeviɣidɔ, kple ƒunukpeƒetetedɔ katã le ame ŋu. (Ƒã hafi woate ŋu ade dzesi dɔlélea ne womedzi dɔgbo si lolo o.)

Dodokpɔ siwo wowɔna zi geɖee nye:

• Ʋudodokpɔ: Ʋudodo bliboe, vevietɔ be woatsɔ akpɔ neutrophils ƒe xexlẽme.
• X-ray siwo woɖena tso ƒunukpeƒewo ŋu: Kpɔe ɖa be ƒunukpeƒetetedɔ le ame ŋu hã.
• Aɖuɖɔtoe me fotoɖeɖe: Le kpɔɖeŋu me, ultrasound alo CT scan.
• Ƒumeŋuɖui ŋuti numekuku:Esia kpena ɖe ame ŋu be woakpɔ egbɔ be atikewɔwɔ ƒe nɔnɔme bubu aɖeke megali o.

Nukae nye esia ƒe atikewɔwɔ?

Taɖodzinu vevi etɔ̃e li ne wole Felty Syndrome dam:

• Nɔnɔme si gbɔ Rheumatoid Arthritis le la dzi ɖuɖu.
• Ne neutropenia nu sẽ la, dae tẽ.
• Mɔxexe ɖe dɔlékuiwo nu kple wo dada ne wodzɔ.

Felty Syndrome ate ŋu atso ƒunukpeƒetetedɔ (RA) si womeda o alo esi dzi womekpɔ ŋusẽ ɖo nyuie o gbɔ. Le ame geɖe gome la, neutropenia hã nyona ɖe edzi ne woƒe RA le nyonyom ɖe edzi. Eyata ɖɔktawo dina gbã be yewoatia atike nyui siwo trɔa dɔlélewo (DMARDs) na RA. Wodzea agbagba hã be yewoaƒo asa na dɔlélenutsiŋutete ƒe atikewo alesi woate ŋui.

DMARD ƒomevi vovovowo li siwo woate ŋu azã na Felty Syndrome:

• Methotrexate kple folic acid (ɖea methotrexate ƒe nugbegblẽ le ame ŋu dzi kpɔtɔna) .
• Abatacept ƒe dɔléle
• Rituximab ƒe atike
• Leflunomide si woyɔna be leflunomide

Gake ne wò ʋumenugbagbeviɣidɔ meva nyo ɖe edzi le DMARD siawo zazã me o, alo ne wò ʋumenugbagbeviɣidɔa nu sẽ ŋutɔ, alo ne dɔlékui aɖe le ŋuwò xoxo la, wò ɖɔkta ate atike bubuwo kpɔ be wòana wò ʋumenugbagbeviɣidɔ nadzi ɖe edzi. Esiawo ate ŋu anye:

• Atike si woyɔna be G-CSF (nu si doa ŋusẽ granulocyte colony-stimulating factor).
• Corticosteroid-tike siwo wozãna ɣeyiɣi kpui aɖe.
• ‘Splenectomy’ - Esia fia be woawɔ dɔ atsɔ aɖe aɖuɖɔtoe si le dɔ wɔm akpa la ɖa.

Azɔ hã, ɖɔktawo aɖe afɔ tɔxɛwo atsɔ akpɔ tawò tso dɔlékuiwo me, vevietɔ ne wò dɔdamɔnua gblẽ nu le wò dɔlélenutsiŋutete ŋu. Woate ŋu akafu nusiwo le abe:

• Dɔlékuiwutike siwo ƒe dɔwɔwɔ keke ta nono.
• Atike siwo hiã la xɔxɔ.
• Lé ŋku ɖe wò nu kple aɖuwo ƒe lãmesẽ ŋu etɔxɛe.

Ne dɔlékui aɖe dze ame aɖe si ŋu Felty Syndrome le la, ɖɔktawo bua eŋu nu vevii ŋutɔ. Ne esia dzɔ ɖe dziwò la , ele be nàxɔ atike enumake . Wò ɖɔkta aŋlɔ atike sesẽwo na wò.

Nukae nye agbenɔƒe si wokpɔ mɔ na le Felty Syndrome ŋu?

Akɔntabubu aɖeke meli fifia ku ɖe amesiwo ŋu Felty Syndrome le ƒe agbenɔƒe ŋu o. Gake le goawo katã me la, atikewɔmɔnu siwo woate ŋu azã la nyo ɖe edzi ŋutɔ le ƒe ʋɛ siwo va yi me. Eyata mɔnukpɔkpɔ nyui aɖe li be atikewɔwɔ ɖesiaɖe akpɔ dzidzedze na wò. Afɔku vevitɔ si le ku me le Felty Syndrome me gakpɔtɔ tso dɔlékui sesẽwo gbɔ . Eyata afɔɖeɖewo wɔwɔ be nàkpɔ ɖokuiwò ta tso dɔlékuiwo me ate ŋu ana tɔtrɔ gã aɖe nava wò lãmesẽ si anɔ anyi ɣeyiɣi didi me.

Felty Syndrome nye ƒunukpeƒetetedɔ (RA) ƒe kuxi si mebɔ o eye woŋea aɖaba ƒua edzi zi geɖe. Ne RA si dzi mèɖu o le ŋuwò ɣeyiɣi didi aɖe, alo ne wò atikewo dzudzɔ dɔwɔwɔ nyuie abe tsã ene la, àte ŋu axɔ Felty Syndrome. Ame aɖewo dzea eŋu dzesi aɖeke manɔmee. Ate ŋu atɔtɔ vie ne èse be dɔléle si gblẽa nu le wò ƒunukpeƒewo ŋu ate ŋu agblẽ nu le wò ʋumenugbagbeviwo hã ŋu.

Ne èle nu wɔm kple RA xoxo, eye ɖewohĩ dzesi bubuwo hã la, ate ŋu agbɔ eme be woakpɔ dɔléle yeye. Gake Felty Syndrome mehea dzesi yeye geɖe vɛ o, eye ɖewohĩ mahiã be woawɔ atike bubu aɖeke nɛ o. Nu vevitɔe nye be nànya afɔku siwo le eme. Ne èwɔ dɔ kple wò ɖɔkta tsɔ da wò RA eye nàxe mɔ ɖe dɔlékuiwo nu la, àte ŋu akpɔ Felty Syndrome gbɔ.

Mlɔeba la, nu siwo dzi wòle be woaɖo ŋkui

Felty Syndrome nye dɔléle si ate ŋu adze ame aɖewo siwo ŋu ƒunukpeƒetetedɔ (RA) le la dzi. Eƒe dzesi enye ʋumenugbagbevi ɣi siwo woyɔna be neutrophils ƒe xexlẽme dzi ɖeɖe kpɔtɔ le wò ʋu me (neutropenia) kple dɔgbo si lolo (splenomegaly).

• Afɔku vevitɔe nye dɔlékuiwo xɔxɔ enuenu, eyata ele vevie ŋutɔ be nàkpɔ ɖokuiwò ta tso dɔlékuiwo me.
• Togbɔ be esia adze nusi dzi ŋɔ vie hã la, woate ŋu aɖu nɔnɔme sia dzi nyuie ne wowɔ atike na wo nyuie eye woɖo aɖaŋu na wo .
• Ne RA le ŋuwò la, nɔ ŋudzɔ ɖe dzesi bubu siawo ŋu. Ne nane si ŋu nètsi dzi ɖo la , kpɔ egbɔ be yeƒo nu kple yeƒe ɖɔkta. Woate ŋu akpe ɖe ŋuwò.

` Felty Syndrome, Rheumatoid Arthritis, Neutropenia, Splenomegaly, Ƒunukpeƒetetedɔ, Ƒunukpeƒetetedɔ, Neutrophils, Aɖuɖɔtoe, Dɔlélenutsiŋutete