Puas yog cov protein M no yog teeb meem rau koj lub raum thiab? (Monoclonal Gammopathy of Renal Significance - MGRS) Cia peb tham txog qhov no!

Peb txhua tus paub tias peb lub raum yog ib lub cev tseem ceeb heev uas ua nws txoj haujlwm ntsiag to. Txawm li cas los xij, qee zaum cov raum no kuj tuaj yeem mob ntsiag to. Hnub no peb yuav tham txog ib yam kab mob uas ua rau muaj kab mob raum, uas yuav zoo li nyuaj me ntsis thaum koj hnov ​​lub npe, tab sis yooj yim to taub. Qhov no hu ua MGRS (Monoclonal Gammopathy of Renal Significance) . Txawm hais tias lub npe ntev me ntsis, tsis txhob txhawj, cia peb nkag siab yooj yim.

MGRS yog dab tsi yooj yim?

Zoo, cia peb saib seb MGRS yog dab tsi. Hais yooj yim xwb, MGRS yog ib pawg mob uas ua rau lub raum puas tsuaj. Qhov kev puas tsuaj no tshwm sim vim tias qee cov hlwb plasma ntawm peb lub cev, lossis B hlwb (cov no yog hom hlwb ntshav dawb), ua ntau daim qauv ntawm lawv tus kheej, lossis clones . Xav txog nws zoo li lub tshuab luam ntawv uas ua ntau daim qauv ntawm tib daim ntawv.

Cov qe ntshav dawb uas tsim los ntawm txoj kev no tsim ib hom tshuaj tiv thaiv kab mob hu ua M protein . Cov protein M no tso rau hauv ntau yam kabmob ntawm peb lub cev, tshwj xeeb tshaj yog cov raum, thiab pib ua rau lawv puas tsuaj.

Qhov tseem ceeb yog tias MGRS tsis yog mob qog noj ntshav. Txawm li cas los xij, muaj ob peb tus neeg uas muaj MGRS thaum kawg tuaj yeem mob qog noj ntshav, xws li mob multiple myeloma . Yog li ntawd, nws yog ib qho tseem ceeb uas yuav tsum paub txog qhov no.

Puas muaj hom MGRS?

Yog, muaj ntau tshaj kaum ob hom mob MGRS. Cov no raug faib ua pawg raws li qhov twg ntawm lub raum uas M protein cuam tshuam. Muaj peb pawg tseem ceeb:

1. Cov kab mob Glomerular

Hom kab mob MGRS uas feem ntau pom yog glomerulopathies . Cov no ua rau cov hlab ntsha me me hauv lub raum puas tsuaj. Lawv zoo li cov ntxaij lim dej. Qee cov kab mob uas poob rau hauv pawg no suav nrog:

• Kab mob amyloidosis raum. Qhov no suav nrog cov hom hu ua AL amyloidosis, AH amyloidosis, thiab AHL amyloidosis.
• Kab mob glomerulonephritis cryoglobulinemic (CG).
• Kab mob fibrillary glomerulopathy (FGN).
• Immunotactoid glomerulopathy (ITG).
• Cov kab mob Glomerular uas cuam tshuam nrog cov protein monoclonal. Qhov no suav nrog cov mob hu ua 'light chain' thiab 'heavy chain deposition diseases'.

2. Cov kab mob tubulointerstitial

Cov kab mob no cuam tshuam rau cov raj (tubules) uas nqa cov as-ham thiab cov kua dej uas lub raum lim rov qab mus rau hauv cov ntshav, thiab cov nqaij nyob ib puag ncig lawv. Qee qhov piv txwv suav nrog:

• Kab mob Fanconi teeb ci (LCFS).
• Cov kab mob proximal tubulopathy uas muaj cov saw hlau sib txuas (LCPT) uas tsis muaj cov siv lead ua.
• Crystal-storing histiocytosis.

3. Cov mob uas cuam tshuam rau cov hlab ntsha hauv lub raum (Cov teeb meem hlab ntsha hauv lub raum)

Cov mob no cuam tshuam rau cov hlab ntsha hauv lub raum. Ib qho piv txwv yog atypical hemolytic uremic syndrome (aHUS) . Qhov no yog thaum cov hlab ntsha me me hauv lub raum raug thaiv los ntawm cov ntshav txhaws.

MGRS feem ntau tshwm sim li cas?

MGRS yog ib qho mob tsis tshua muaj . Kwv yees li ntawm 1% ntawm cov pej xeem raug mob. Nws feem ntau tshwm sim rau cov neeg hnub nyoog tshaj 60 xyoo .

Cov tsos mob ntawm MGRS yog dab tsi?

Cov tsos mob ntawm MGRS yuav txawv nyob ntawm seb koj muaj hom MGRS li cas. Qee cov tsos mob uas pom ntau muaj xws li:

• Xav tias nkees heev (qaug zog) .
• O ntawm ob txhais ceg qis, pob luj taws, lossis taw. Qee zaum lub plab, tes, lossis lub ntsej muag kuj yuav o thiab.
• Muaj tus mob nephrotic syndrome . Qhov no yog tus yam ntxwv los ntawm kev tso cov protein tawm hauv cov zis thiab cov roj cholesterol ntau hauv cov ntshav.
• Cov zis ua npuas los yog xab npum . Qhov no tej zaum yuav yog ib qho cim qhia tias muaj protein nyob hauv cov zis (proteinuria).
• Kev tso zis ntau zaus yog qhov yuav tsum tau tso zis ntau zaus.
• Ntshav nyob rau hauv cov zis (hematuria) los yog cov zis uas hloov xim liab.
• Xeev siab thiab ntuav.
• Kab mob POEMS . Qhov no kuj yog ib qho mob tsis tshua muaj.
• Mob loog, tingling, lossis tsis muaj zog ntawm ob txhais ceg (cov no yog cov cim qhia ntawm neuropathy).
• Cov tawv nqaij tsis zoo nkauj (cov pob dawb los yog cov pob tsaus).
• Ua pa nyuaj (ua tsis taus pa).

Dab tsi ua rau muaj MGRS?

Qhov ua rau muaj MGRS yog kev puas tsuaj rau lub raum los ntawm cov protein M uas tau hais los saum toj no. Cov protein M yog ib hom tshuaj tiv thaiv kab mob uas tsis ua haujlwm zoo, thiab tsim tsis raug. Lawv yog tsim los ntawm cov clones (cov ntawv theej) ntawm cov hlwb plasma, ib hom hlwb ntshav dawb, lossis hlwb B uas puas lawm.

Ib txhia neeg muaj peev xwm muaj cov clones ntawm cov hlwb plasma uas tsim cov protein M yam tsis ua rau muaj kev puas tsuaj rau cov kab mob. Qhov mob no hu ua Monoclonal Gammopathy of Undetermined Significance (MGUS) . Txawm li cas los xij, rau cov neeg uas muaj MGRS, cov protein M no yuav sib sau ua ke hauv lub raum thiab ua rau lawv puas tsuaj.

Dab tsi yog qhov ua rau muaj MGRS?

Cov kws tshaj lij tseem tsis tau paub meej tias yog dab tsi ua rau muaj MGRS. Cov kab mob autoimmune , kev hloov pauv caj ces , kev kis kab mob, thiab cov yam ntxwv ib puag ncig puav leej yog cov ua rau muaj qhov no.

Muaj teeb meem dab tsi tshwm sim vim yog MGRS?

Cov plasma cell clones thiab MGRS no tuaj yeem ua rau muaj teeb meem loj vim yog kev puas tsuaj rau lub raum. Ib txhia ntawm cov no suav nrog:

• Kab mob raum ntev (CKD) .
• Kab mob raum theem kawg .
• Kev ua tsis tau haujlwm ntawm lub raum .
• Kev loj hlob mus rau lwm yam kab mob. Hauv qee tus neeg, tus naj npawb ntawm cov plasma cell clones nce ntau heev uas nws tuaj yeem loj hlob mus rau hauv ib hom mob qog ntshav dawb hu ua multiple myeloma (MM) . MGRS kuj tseem tuaj yeem loj hlob mus rau lwm yam mob qog noj ntshav, xws li Waldenström macroglobulinemia , chronic lymphocytic leukemia (CLL) , lossis B-cell lymphoma .

Yuav kuaj mob MGRS li cas?

Tus kws kho mob tuaj yeem paub tseeb tias muaj MGRS los ntawm kev ua qhov kev kuaj mob raum . Qhov no suav nrog kev muab ib daim nqaij me me los ntawm koj lub raum thiab kuaj nws rau M protein. Lawv kuj tseem yuav kuaj cov qauv ntawm koj cov ntshav, zis, lossis pob txha.

Puas muaj kev kho mob rau MGRS?

Yog, muaj kev kho mob rau MGRS. Cov kws kho mob kho nws nrog cov tshuaj zoo ib yam li chemotherapy rau mob qog noj ntshav. Cov tshuaj no tua cov hlwb teeb meem lossis tiv thaiv lawv kom tsis txhob ua ntau daim ntawv theej. Lwm cov tshuaj tuaj yeem pab txo qhov o. Lub hom phiaj tseem ceeb ntawm kev kho mob yog kom koj lub raum ua haujlwm thiab tiv thaiv lawv kom tsis txhob puas tsuaj.

Qee zaum ntawm MGRS, cov kws kho mob kuj tseem yuav ua qhov kev hloov pauv stem cell . Qhov no hloov koj cov cell uas puas lawm nrog cov cell noj qab nyob zoo. Yog tias koj lub raum puas tsuaj loj heev, koj kuj tseem yuav xav tau kev ntxuav lub raum lossis kev hloov raum .

Cov tshuaj thiab kev kho mob tshwj xeeb siv rau MGRS

Hom tshuaj uas koj tau txais yuav nyob ntawm hom MGRS uas koj muaj. Nov yog qee txoj kev kho mob:

• Cov tshuaj tiv thaiv monoclonal - piv txwv li rituximab, daratumumab.
• Cov tshuaj proteasome inhibitors - piv txwv li bortezomib, carfilzomib, ixazomib.
• Cov tshuaj kho mob tiv thaiv kab mob - piv txwv li thalidomide, lenalidomide, pomalidomide.
• Cov tshuaj alkylating - piv txwv li cyclophosphamide, bendamustine, melphalan.
• Cov tshuaj Corticosteroids - piv txwv li, prednisone, dexamethasone.
• Kev hloov pauv ntawm cov hlwb autologous.

Cov kev mob tshwm sim ntawm kev kho mob yog dab tsi?

Cov kev kho mob zoo li kev siv tshuaj kho mob qog nqaij hlav tuaj yeem ua rau muaj ntau yam kev mob tshwm sim tsis zoo, qee zaum txawm tias ua rau lub cev puas tsuaj. Yog vim li ntawd cov kws kho mob thiaj li xaiv cov kev kho mob kom zoo kom tau txais txiaj ntsig ntau tshaj plaws los ntawm lawv thiab txo qhov kev pheej hmoo ntawm cov kev mob tshwm sim loj. Qee qhov kev mob tshwm sim uas koj yuav ntsib suav nrog:

• Anemia ( tsis muaj ntshav txaus).
• Los ntshav.
• Cem quav.
• Mob raws plab.
• Nkees lawm.
• Kev pheej hmoo ntawm kev kis kab mob los ntawm kab mob viral, bacterial thiab fungal.
• Cov zaub mov tsis qab.
• Xeev siab thiab ntuav.

Puas tiv thaiv tau MGRS?

Vim peb tsis paub meej tias yog dab tsi ua rau muaj MGRS, tam sim no tsis muaj txoj hauv kev tshwj xeeb los tiv thaiv nws.

Yog koj muaj MGRS, koj yuav xav tau dab tsi?

Txawm hais tias MGRS yog ib yam mob uas kho tau los, feem ntau nws tsis ploj mus tag. Nws tuaj yeem rov tshwm sim dua tom qab kho. Yog tias koj lub raum puas tsuaj loj heev, koj yuav tsum tau hloov lub raum.

Kwv yees li ntawm 18% ntawm cov neeg uas muaj MGRS tom qab ntawd yuav mob qog noj ntshav hu ua multiple myeloma. Yog li ntawd, koj tus kws kho mob yuav saib xyuas koj tsis tu ncua nrog cov ntshav thiab zis kuaj, vim qhov no tuaj yeem kuaj pom thaum ntxov yog tias nws tshwm sim.

Koj tuaj yeem nyob nrog MGRS tau ntev npaum li cas?

Koj yuav nyob tau ntev npaum li cas nrog MGRS nyob ntawm seb koj muaj hom MGRS li cas, nws qhov hnyav npaum li cas, thiab koj teb li cas rau kev kho mob. Cov neeg uas muaj kev puas tsuaj tsawg dua raum muaj kev xav zoo dua li cov neeg uas muaj kev puas tsuaj hnyav dua. Piv txwv li, hauv ib txoj kev tshawb fawb, cov neeg uas muaj amyloidosis cuam tshuam nrog MGRS nyob nruab nrab li 10 xyoo tom qab kuaj pom. Tab sis cov neeg uas tsis muaj amyloidosis nyob ntev dua. Tsis tas li ntawd, cov neeg uas teb zoo rau kev kho mob muaj cov txiaj ntsig zoo tshaj plaws.

Kuv yuav saib xyuas kuv tus kheej li cas?

Nco ntsoov ua raws li cov lus qhia uas koj tus kws kho mob muab rau koj rau kev saib xyuas koj lub raum kev noj qab haus huv hauv tsev. Qhov no yuav suav nrog kev txwv cov khoom xws li cawv, thiab kev tswj cov yam uas ua rau muaj kab mob raum, xws li ntshav siab thiab ntshav qab zib. Txawm hais tias cov no tsis tuaj yeem kho MGRS ncaj qha, lawv tuaj yeem pab txo qhov kev pheej hmoo ntawm kev puas tsuaj rau lub raum ntxiv. Koj tus kws kho mob kuj tseem tuaj yeem pab koj tswj cov kev mob tshwm sim ntawm kev kho mob.

Kuv yuav tsum mus ntsib kws kho mob thaum twg?

Yog tias koj muaj cov tsos mob ntawm teeb meem raum, xws li o, zis ua npuas lossis xim liab, tso zis ntau zaus, lossis tso zis me me, nco ntsoov mus ntsib kws kho mob.

Kuv yuav tsum nug kuv tus kws kho mob li cas?

Tej zaum yuav pab tau yog koj nug koj tus kws kho mob cov lus nug no:

• Muaj kev kho mob dab tsi rau hom MGRS uas kuv muaj?
• Kuv ua tau dab tsi los tiv thaiv kev puas tsuaj rau lub raum?
• Kuv yuav tsum saib xyuas cov tsos mob tshiab lossis cov tsos mob hnyav dua li cas?

Thaum kawg, qhov tseem ceeb tshaj plaws (Cov Lus Qhia Coj Mus Tsev)

MGRS yog ib yam mob hnyav uas ua rau lub raum puas tsuaj thiab ua rau tuag taus. Tiam sis nco ntsoov tias, tsis yog txhua tus neeg uas muaj MGRS yuav mob qog noj ntshav. Koj tus kws kho mob yuav saib xyuas koj tsis tu ncua thiab ua cov kauj ruam los txheeb xyuas thiab kho cov teeb meem tshiab sai li sai tau . Cov kev kho mob tshiab tam sim no ua rau nws muaj peev xwm txhim kho koj lub neej zoo thiab txo koj txoj kev pheej hmoo ntawm cov kab mob loj. Yog li ntawd, tsis txhob ntshai, thiab ua raws li koj tus kws kho mob cov lus qhia.

MGRS , Monoclonal Gammopathy ntawm Lub Raum Tseem Ceeb, Kab Mob Raum, M Proteins, Plasma Cells, Kidney Biopsy, Nephrotic Syndrome, Multiple Myeloma