He aha ka Felty Syndrome? He mea nui kēia no ʻoukou me ka maʻi ʻāʻī!

Hiki paha iā ʻoe ke loaʻa ka ʻeha o nā hono, ka pehu ʻana, a me ka ʻoʻoleʻa iki i kou mau lālā i ke kakahiaka, ʻeā? ʻO ka hapa nui o ka manawa, hiki ke hana ʻia kēia mau mea e ka rheumatoid arthritis. Akā ua ʻike anei ʻoe aia kekahi pilikia ʻē aʻe e hiki mai me kēia maʻi arthritis, akā ʻaʻole i ʻike nui ʻia, akā he mea nui loa ia e ʻike e pili ana? ʻO ia ka Felty Syndrome. E kamaʻilio kākou e pili ana i kēia me nā kikoʻī hou aku i kēia lā.

He aha maoli ka Felty Syndrome?

I ka ʻōlelo maʻalahi, ʻo Felty Syndrome ka hui pū ʻana o ʻekolu mau kūlana e kū pū ana. ʻO lākou kēia:

• ʻO ka Rheumatoid Arthritis - He mumū o nā hono i ʻike ʻia e ka hapa nui o ʻoukou.
• ʻO Neutropenia - ʻO kēia ka emi ʻana o ka nui o nā neutrophils, kahi ʻano o nā keʻokeʻo koko keʻokeʻo i loko o ke koko.
• Splenomegaly - ʻO ke ʻano kēia, ʻo ka spleen, kahi ʻōkana i loko o ke kino, e lilo i mea nui aʻe ma mua o ka maʻamau.

Hoʻomaka pinepine ia me ka rheumatoid arthritis (RA). ʻO nā kūlana ʻelua ʻē aʻe e kū mai ana ma ke ʻano he mau pilikia o ka RA. Kāhea nā kauka i kēia mau 'extra-articular manifestations'. ʻO ia hoʻi, ʻaʻole i kaupalena ʻia ka arthritis i nā hono, akā hoʻopilikia i nā hono ma waho o lākou. ʻO kēia ma muli o ke kaʻina hana mumū e hoʻoulu ai i ka arthritis. ʻOiai he mea maʻamau no kēia mau ʻano hopena e kū mai ma waho o nā hono me RA, he ʻano laha ʻole ka Felty Syndrome.

Pehea kēia e pili ai iā ʻoe?

Hoʻomaka ka maʻi Felty me ka Rheumatoid Arthritis. A laila loaʻa iā ʻoe ka ʻeha nui a me ka pehu ʻana i kou mau hono. A laila, ke kū mai nā kūlana e like me Neutropenia a me Splenomegaly, hoʻopilikia ia i kāu ʻōnaehana pale . ʻO Neutropenia ka emi ʻana o kahi ʻano o ke koko keʻokeʻo i kapa ʻia ʻo neutrophils. ʻO kēia mau neutrophils kahi ʻano nui o ke kelepona e pale ai i ko mākou kino mai nā maʻi. No laila, ke emi lākou, piʻi ka manawa e loaʻa ai nā maʻi. Hiki i ka spleen i hoʻonui ʻia ke kumu ʻē aʻe no kēia emi ʻana o nā neutrophils.

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Pehea ka maʻamau o kēia ʻano?

Loaʻa ka maʻi Felty ma kahi o 2% o ka poʻe me ka rheumatoid arthritis. E like me RA, ʻekolu manawa ka nui o ka maʻi Felty i nā wahine ma mua o nā kāne. ʻO ka mea hoihoi, ʻaneʻane pau ka poʻe me RA e loaʻa ana i ka maʻi Felty he 'seropositive'. ʻO ia hoʻi, ua hōʻoia nā hoʻokolohua he mea i kapa ʻia ʻo rheumatoid factor antibodies i loko o ko lākou koko. ʻO ka poʻe 'seronegative', ʻo ia hoʻi ka poʻe ʻaʻohe o lākou antibodies, ʻaʻole pinepine lākou e loaʻa i ka maʻi Felty.

He aha nā hōʻailona o kēia?

ʻO ka pinepine, ʻo nā hōʻailona mua e ʻike ʻia ʻo ia nā hōʻailona o ka rheumatoid arthritis. ʻO kēia mau mea:

• ʻEha hui
• Pehu hui
• ʻOʻoleʻa o nā hui, ʻoi aku hoʻi i ke kakahiaka

Hiki i kekahi poʻe ke ʻike i nā hōʻailona ʻē aʻe ma waho aʻe o ka RA i loko o ko lākou mau hono. Eia kekahi laʻana:

• Nā puʻupuʻu e hana ʻia ma lalo o ka ʻili kokoke i nā hono (ua kapa ʻia kēia he nodules rheumatoid)
• Nā ʻōpū lymph pehu ma nā wahi e like me ka ʻāʻī a me nā armpits
• Hiki ke pehu ke akepaʻa a ʻeha ke hoʻopā aku.
• Nā maka maloʻo a me ka waha (ua kapa ʻia kēia ʻo Sjogren's syndrome)
• Nā maka ʻulaʻula a pehu (ua kapa ʻia kēia he episcleritis)
• Nā ʻeha ʻili, ʻoi aku hoʻi ma nā wāwae
• Nā hōʻailona o ke kahe koko ma lalo o ka ʻili
• Ka paʻakikī o ka hanu ʻana ma muli o ka pehu ʻana o ka māmā
• ʻEha umauma ma muli o ka pehu ʻana a puni ka puʻuwai
• kuni
• Luhi a me ka palaualelo
• Ka nalowale o ka makemake a i ʻole ka pohō kaumaha i wehewehe ʻole ʻia

Ma waho aʻe o kēia mau mea, loaʻa pū kekahi mau hōʻailona ʻē aʻe o ka Felty Syndrome. I kekahi manawa e ʻike ʻia kēia mau hōʻailona ma mua o ka hoʻomaka ʻana o nā hōʻailona RA.

• Nā maʻi pinepine a lōʻihi. ʻO nā hiʻohiʻona e komo pū me ke anu, ka ʻōpū ʻeha, a me nā maʻi ʻili.
• Pehu ʻana o ka ʻōpū. Hiki ke ʻike ʻia ma ka lima a he ʻeha paha.
• Ka loli ʻana o ka ʻili (e like me nā kiko).

Akā ʻo ka mea kupaianaha, i kekahi manawa hiki ke ʻike ʻia ʻoe me Felty Syndrome me ka ʻole o nā hōʻailona. Hiki i nā hoʻokolohua koko a me nā scan ke hōʻike ua loaʻa iā ʻoe nā maʻi ʻekolu ma mua o kou manaʻo ʻana i kekahi mau hōʻailona.

I ka makahiki hea e hoʻomaka pinepine ai kēia?

ʻO ka maʻamau, ulu ka Felty Syndrome i nā poʻe ʻelemakule, ma waena o 50 a me 70 mau makahiki. No ka hapa nui o nā kānaka, ʻike ʻia ka Felty Syndrome ma hope o ko lākou loaʻa ʻana o nā hōʻailona o ka rheumatoid arthritis no kahi o 10 a 15 mau makahiki.

No ke aha e kū mai ai ʻo Felty Syndrome?

He 'maʻi autoimmune' ka ʻāʻī rheumatoid. ʻO ke ʻano kēia, hoʻouka ko kākou ʻōnaehana pale ponoʻī i nā ʻāpana o ko kākou kino me he mea lā he ʻenemi lākou. Manaʻo ka nui o nā kānaka ʻepekema he pilikia koʻikoʻi ʻo Felty Syndrome o ka RA. I loko o kēia mau maʻi autoimmune, hana ko kākou kino i nā 'antibodies' e kūʻē i kekahi mau protein. Hele kēia mau antibodies a hopu i kēlā mau protein a hōʻailona iā lākou e luku ʻia. Penei ka hoʻonui ʻana o ka mumū.

ʻAʻole paha e loaʻa mau kēia mau antibodies i ka RA. Eia nō naʻe, i loko o ka poʻe me Felty Syndrome, aia maoli kēia mau antibodies. ʻO ke alo o kēia mau antibodies ke kumu e lilo ai ka RA i mea koʻikoʻi a hoʻonui i nā hopena ʻē aʻe ma waho o nā hono (nā hōʻike extra-articular). Ua kapa ʻia ʻo RA me nā antibodies ʻo 'seropositive RA'. Hōʻike ka noiʻi ua pili nā seropositive RA a me Felty Syndrome me kekahi mau 'mea genetic'. ʻO ia hoʻi, hiki ke hoʻoili ʻia i nā hanauna i kekahi ʻano.

Pehea e hoʻoulu ai ka rheumatoid arthritis (RA) i ka neutropenia a me ka splenomegaly?

Pehea e hana ai ʻo Neutropenia

ʻO ka Neutropenia ka emi ʻana o ka helu o nā hunaola koko keʻokeʻo i kapa ʻia he neutrophils. ʻElua kumu nui no kēia. ʻO kekahi, ʻaʻole lawa ka hana ʻana o kou iwi iwi i nā neutrophils. A i ʻole, ke luku ʻia nei nā neutrophils i loko o kou kino. I ka Felty Syndrome, hiki i kēia mau mea ʻelua ke hana. Hiki i ke kaʻina hana autoimmune i ʻōlelo ʻia ma mua ke hoʻopilikia i ka hana ʻana o nā neutrophils i loko o ka iwi iwi, a hiki ke luku ʻia nā neutrophils i hana mua ʻia. Eia kekahi, ʻo ka spleen i hoʻonui ʻia kekahi kumu no ka emi ʻana o nā neutrophils.

Pehea e hana ai ka Splenomegaly

ʻO ka hana a kou spleen, ʻo ia ke kānana i nā hunaola koko kahiko a pono ʻole mai kou koko. Akā, i ka wā e nui loa ai kou spleen (splenomegaly), lilo ia i mea hana nui a hoʻomaka e wehe i nā hunaola koko maikaʻi he nui. Hiki i ka Rheumatoid arthritis ke hoʻonui i ka spleen i kekahi manawa. ʻAʻole maopopo ke kumu pololei. Hiki i ka spleen ke hoʻonui ʻia me ka ʻole o ka neutropenia. Eia kekahi, he mea kakaikahi loa, hiki ke loaʻa ka Felty Syndrome me ka ʻole o ka spleen i hoʻonui ʻia.

He aha nā pilikia weliweli o ka Felty Syndrome?

Ma muli o ka hoʻonāwaliwali ʻana o ka Felty Syndrome i kou ʻōnaehana pale, ʻoi aku ka nui o kou pilikia o ka loaʻa ʻana o nā maʻi pinepine a koʻikoʻi . ʻOiai inā loaʻa iā ʻoe kahi maʻi liʻiliʻi e maʻalahi ke mālama ʻia, hiki i kēia ʻano ke lilo i mea koʻikoʻi e hoʻomau a i kekahi manawa e hoʻoweliweli i ke ola. Hiki i nā maʻi bacteria i kāohi ʻole ʻia ke alakaʻi i kahi ʻano weliweli i kapa ʻia ʻo sepsis. ʻOi aku ka nui o ka pilikia o ka poʻe me Felty Syndrome i ka loaʻa ʻana o kekahi mau ʻano maʻi kanesa, e like me ka lymphoma.

Akā, mai makaʻu ʻoe ke lohe ʻoe i kēia mau mea. Aia kēia mau pilikia, akā hiki ke kāohi ʻia me ka mālama pono ʻana a me ka nānā pono ʻana.

Pehea e ʻike ai i kēia?

Hoʻomaopopo nā kauka i ka Felty Syndrome ke ʻike lākou he rheumatoid arthritis, neutropenia, a me splenomegaly nā mea a pau. (I kekahi manawa, hiki ke hana ʻia ka hōʻailona me ka ʻole o ka spleen i hoʻonui ʻia.)

ʻO nā hoʻokolohua i hana pinepine ʻia:

• Nā hoʻāʻo koko: He helu koko piha, e nānā pono i ka helu o nā neutrophils.
• Nā kukuna X-ray o nā hono: E nānā no ka maʻi ʻaʻai.
• Nā scan spleen: No ka laʻana, he ultrasound a i ʻole CT scan.
• ʻO ka biopsy iwi:Kōkua kēia i ka hōʻoia ʻana ʻaʻohe pilikia olakino ʻē aʻe.

He aha ka lāʻau lapaʻau no kēia?

ʻEkolu mau pahuhopu nui i ka mālama ʻana iā Felty Syndrome:

• Ke kaohi nei i ke kūlana kumu o ka Rheumatoid Arthritis.
• Inā koʻikoʻi ka neutropenia, e mālama pololei iā ia.
• Ke pale ʻana i nā maʻi a me ka mālama ʻana iā lākou inā loaʻa.

Hiki i ka Felty Syndrome ke hopena o ka rheumatoid arthritis (RA) i mālama ʻole ʻia a i ʻole kaohi ʻole ʻia. No nā poʻe he nui, hoʻomaikaʻi pū ka neutropenia i ka hoʻomaikaʻi ʻana o kā lākou RA. No laila, nānā mua nā kauka e koho i nā lāʻau antirheumatic hoʻololi maʻi kūpono (DMARDs) no RA. Hoʻāʻo pū lākou e pale i nā immunosuppressants i ka hiki.

Aia kekahi mau ʻano DMARD e hiki ke hoʻohana ʻia no ka Felty Syndrome:

• ʻO Methotrexate a me ka waikawa folic (e hōʻemi i nā hopena ʻaoʻao o ka methotrexate)
• ʻAbatacept
• ʻO Rituximab
• ʻO Leflunomide

Akā inā ʻaʻole e hoʻomaikaʻi kāu neutropenia me kēia mau DMARD, a inā he koʻikoʻi loa kāu neutropenia, a inā paha ua loaʻa iā ʻoe kahi maʻi, e hoʻāʻo kāu kauka i nā lāʻau lapaʻau ʻē aʻe e hoʻonui i kāu helu neutrophil. Hiki i kēia mau mea ke komo pū me:

• He lāʻau pale i kapa ʻia ʻo G-CSF (granulocyte colony-stimulating factor).
• Nā lāʻau corticosteroid pōkole.
• 'Splenectomy' - ʻO ke ʻano kēia o ka wehe ʻana i ka spleen hana nui ma ke ʻoki ʻana.

Eia kekahi, e hana nā kauka i nā hana kūikawā e pale aku iā ʻoe mai nā maʻi, ʻoiai inā pili kāu lāʻau i kāu ʻōnaehana pale. Hiki iā lākou ke paipai i nā mea e like me:

• ʻO ka lawe ʻana i nā antibiotics ākea ākea.
• Ke loaʻa ʻana o nā lāʻau pale e pono ai.
• E makaʻala pono i ke olakino o kou waha a me kou mau niho.

Inā loaʻa i kekahi me Felty Syndrome kahi maʻi, lawe koʻikoʻi nā kauka iā ia. Inā hana kēia iā ʻoe , pono ʻoe e loaʻa koke ka lāʻau lapaʻau . E kuhikuhi kāu kauka i nā lāʻau ikaika.

He aha ke kūlana o ke ola no ka poʻe me ka Felty Syndrome?

ʻAʻohe helu helu o kēia manawa e pili ana i ka manaʻolana ola o ka poʻe me Felty Syndrome. Eia nō naʻe, ma ke ʻano laulā, ua hoʻomaikaʻi nui ʻia nā koho lapaʻau i nā makahiki i hala iho nei. No laila, aia kahi manawa kūpono e holomua ai kekahi lapaʻau nou. ʻO ka pilikia nui o ka make ma Felty Syndrome mai nā maʻi koʻikoʻi nō ia . No laila, ʻo ka hana ʻana i nā hana e pale aku iā ʻoe iho mai nā maʻi hiki ke hana i kahi ʻokoʻa nui i kou olakino lōʻihi.

ʻO ka Felty Syndrome kahi pilikia kakaikahi a nānā pinepine ʻole ʻia o ka rheumatoid arthritis (RA). Inā loaʻa iā ʻoe ka RA i kāohi ʻole ʻia no ka manawa lōʻihi, a inā paha e pau ka hana ʻana o kāu mau lāʻau lapaʻau e like me ka wā ma mua, hiki iā ʻoe ke loaʻa iā Felty Syndrome. Loaʻa i kekahi poʻe me ka ʻole o nā hōʻailona. Hiki ke lilo i mea hopohopo iki ke ʻike ʻana he hiki i kahi maʻi e hoʻopilikia i kou mau hono ke hoʻopilikia i kāu mau hunaola koko.

Ke hana nei ʻoe me ka RA, a me nā hōʻailona ʻē aʻe paha, hiki ke paʻakikī ke loaʻa kahi hōʻailona hou. Akā, ʻaʻole hana ʻo Felty Syndrome i nā hōʻailona hou he nui, a ʻaʻole paha e pono kekahi lāʻau lapaʻau hou. ʻO ka mea nui, ʻo ia ka makaʻala i nā pilikia. Ma ka hana pū ʻana me kāu kauka e mālama i kāu RA a pale i nā maʻi, hiki iā ʻoe ke hoʻokele i ka Felty Syndrome.

ʻO ka mea hope loa, nā mea e hoʻomanaʻo ai

ʻO ka Felty Syndrome kahi maʻi e hiki ke loaʻa i kekahi poʻe me ka rheumatoid arthritis (RA). Hōʻike ʻia ia e ka emi ʻana o ka helu o nā hunaola koko keʻokeʻo i kapa ʻia he neutrophils i loko o kou koko (neutropenia) a me ka spleen i hoʻonui ʻia (splenomegaly).

• ʻO ka pilikia nui ka maʻi pinepine, no laila he mea nui loa ia e pale iā ʻoe iho mai nā maʻi.
• ʻOiai paha he mea weliweli iki kēia, hiki ke hoʻomalu maikaʻi ʻia kēia ʻano me ka mālama lapaʻau kūpono a me nā ʻōlelo aʻoaʻo .
• Inā loaʻa iā ʻoe ka RA, e makaʻala i kēia mau hōʻailona hou aʻe. Inā he mau hopohopo kāu , e kamaʻilio me kāu kauka. E hiki iā lākou ke kōkua iā ʻoe.

ʻO Felty Syndrome, Rheumatoid Arthritis, Neutropenia, Splenomegaly, Arthritis, Mumū o nā hono, Neutrophils, Spleen, Palekana