Dis M protin na prɔblɛm fɔ yu kidni dɛn bak? (Monoclonal Gammopathy of Renal Significance - MGRS) Lɛ wi tɔk bɔt dis!

Wi ɔl no se wi kidni na wan rili impɔtant ɔgan we de du in wok kwayɛt wan. Bɔt sɔntɛnde, dɛn kidni ya kin sik bak kwayɛt wan. Tide wi go tɔk bɔt wan sik we kin mek pɔsin gɛt sik na in kidni, we kin tan lɛk se i kɔmplikt smɔl we yu yɛri di nem, bɔt i izi fɔ ɔndastand. Dɛn kɔl dis MGRS (Monoclonal Gammopathy of Renal Significance) . Pan ɔl we di nem lɔng smɔl, nɔ wɔri, lɛ wi ɔndastand am simpul wan.

Wetin na MGRS simpul wan?

Okay, mek wi luk wetin MGRS bi. Fɔ tɔk am simpul wan, MGRS na wan grup we de pwɛl di kidni dɛn. Dis damej kin apin bikɔs sɔm pan wi bɔdi in plasma sɛl dɛn , ɔ B sɛl dɛn (dɛn na kayn wayt blɔd sɛl dɛn ya), kin mek tumɔs kɔpi fɔ dɛnsɛf, ɔ klon . Tink bɔt am lɛk fotokɔpi mashin we de mek bɔku kɔpi dɛn fɔ di sem pepa.

di plasma sεl dεm we de fכm dis we de mek wan kayn antibodi we dεn kכl M protin . dis M protin dεm de dכpכt insay difrεn כgan dεm na wi bכdi, spεshal wan di kidni dεm, εn bigin fכ pwεl dεm.

Di impɔtant tin na dat MGRS nɔto kansa. Bɔt smɔl pipul dɛn we gɛt MGRS kin gɛt kansa lɛk mɔltipɛl mayloma . So i impɔtant fɔ no bɔt dis.

Yu tink se kayn MGRS de?

Yes, i pas wan duzin kayn MGRS kɔndishɔn. dεn kכl dεn tin dεm ya akɔdin to us pat pan di kidni di M protin de afekt. Tri men kategori dɛn de:

1. Glomerular sik dɛn

Di kayn MGRS we kɔmɔn pas ɔl na glomerulopathies . Dɛn tin ya kin pwɛl di smɔl smɔl blɔd vesel dɛn we de insay di kidni dɛn. Dɛn tan lɛk di mɛsh dɛn we de insay wata filta. Sɔm pan di ɔda sik dɛm wae de insay dis kayn sik na:

• Renal amyloidosis we de mek pɔsin gɛt sik. dis inklud di kayn dεm we dεn kכl AL amyloidosis, AH amyloidosis, εn AHL amyloidosis.
• Krayoglobulinemik glomerulonephritis (CG) we gɛt di sik.
• Fibrila glomerulopati (FGN) we de mek pɔsin gɛt sik.
• Imyunotaktoid glomerulopati (ITG) we gɛt fɔ du wit am.
• Glomerular sik dεm we de asai wit monoklonal protin dεm. dis inklud kכndishכn dεm we dεn kכl `layt chen` εn `hεvi chen dεposishכn sik dεm`.

2. Tubulointerstitial sik dεm

dis sik dεm de afekt di tכb dεm (tubules) we de kכri nyutriεnt dεm εn wata we di kidni dεm filta bak insay di bכdi, εn di tisu dεm we de rawnd dεm. Sɔm ɛgzampul dɛn na:

• Layt chen Fanconi sindrom (LCFS) we gɛt di sik.
• Layt chen proksimal tubulopathy (LCPT) we nɔ gɛt kristal.
• Histiocytosis we de stכr kristכl.

3. di kכndishכn dεm we de afekt di bכdi vεsul dεm insay di kidni (Intra-rεnal vaskulεr lεshכn dεm) .

Dɛn tin ya kin afɛkt di blɔd vesel dɛn na di kidni dɛn. Wan ɛgzampul na di atypical hemolytic uremic syndrome (aHUS) . Dis na we di smɔl smɔl blɔd vesel dɛn we de na di kidni dɛn kin blok bikɔs blɔd kin klɔt.

Aw kɔmɔn tin fɔ MGRS?

MGRS na rili wan sik we nɔ kin apin so ɔltɛm . Dɛn se i kin afɛkt less dan 1% pan di pipul dɛm. I kin mɔna pipul dɛn we dɔn pas 60 ia .

Wetin na di sayn dɛm fɔ MGRS?

Di sayn dɛm fɔ MGRS kin difrɛn difrɛn wan bay di kayn MGRS we yu gɛt. Sɔm sayn wae kin kam pan pɔrsin wae gɛt dis sik na:

• Fɔ fil taya bad bad wan (taya) .
• Swel na di lכw leg, ankכl, כ fut. Sɔntɛnde, di bɛlɛ, an, ɔ fes kin swel bak.
• Nefrotic syndrome kin apin. dis kin bi bay we di protin we de kכmכt na di urine εn di kכlestכl lεvεl we de na di bכdi de go כp.
• Urin we gɛt fom ɔ we gɛt sop . dis kin bi sayn fכ protin we de insay di urine (proteinuria).
• Fɔ pis bɔku tɛm na di nid fɔ pis bɔku tɛm.
• Blɔd we de na di urine (hematuria) ɔ di urine we de tɔn pink.
• Nɔs ɛn vɔmit.
• POEMS sindrom we dɛn kɔl . Dis na tin bak we nɔ kin apin so ɔltɛm.
• di limb dεm we de sכmtεm sכmtεm, sכmtεm sכmtεm, כ wik (dεn tin ya na sayn dεm fכ nyuropathy).
• Di kɔlɔ we di skin kin chenj (layt ɔ dak spat dɛn).
• I nɔ izi fɔ blo (dyspnea).

Wetin kin mek pɔsin gɛt MGRS?

di men tin we de mek MGRS na di kidni dεm we de damej we di M protin dεm we wi bin dכn tכk bכt. M protin dεm na wan kayn antibodi we nכ de wok fayn, εn we dεn de prodyuz kכrekt wan. Dɛn kin mek dɛn wit klon (kɔpi) dɛn we dɔn pwɛl pan plasma sɛl dɛn, wan kayn wayt blɔd sɛl, ɔ B sɛl dɛn.

sכm pipul dεn kin gεt dεn klon dεm ya fכ plasma sεl dεm we de mek M protin dεm we nכ de ambɔg εni כgan dεm. Dɛn kɔl dis sik Monoclonal Gammopathy of Undetermined Significance (MGUS) . כltu, pan pipul dεm we gεt MGRS, dεn M protin dεm ya de bil na di kidni dεm εn de pwεl dεm.

Wetin na di men tin we kin mek pɔsin gɛt MGRS?

Di masta sabi pipul dɛn stil nɔ no bɛtɛ bɛtɛ wan wetin kin mek pɔsin gɛt MGRS. Dɛn tink se di sik we de mek pɔsin nɔ ebul fɔ fɛt insɛf , di chenj we pɔsin kin chenj in jɛnɛtiks , di sik dɛn we pɔsin kin gɛt, ɛn di tin dɛn we de apin na di say we i de, ɔl dis kin mek i apin.

Us kɔmplikɛshɔn dɛn kin apin bikɔs ɔf MGRS?

dis plasma sεl klon dεm εn MGRS kin mek siriכs kכmplikεshכn bikoz fכ di kidni dεm we dεn dכn pwεl. Sɔm pan dɛn tin ya na:

• Krɔnik kidni sik (CKD) .
• End-stej rεnal (kidni) sik .
• Kidni we nɔ de wok fayn .
• Divεlכpmεnt to כda sik dεm. Insay sɔm pipul dɛn, di nɔmba fɔ di plasma sɛl klon dɛn kin bɔku so dat i kin bi wan kayn wayt blɔd sɛl kansa we dɛn kɔl multiple myeloma (MM) . MGRS kin bi ɔda kansa dɛn bak, lɛk Waldenström macroglobulinemia , chronic lymphocytic leukemia (CLL) , ɔ B-cell lymphoma .

Aw dɛn kin no MGRS?

Dɔktɔ kin kɔnfɔm MGRS bay we i du wan kidni bayɔpsi . dis involv fכ tek sכm sכm tisu frכm yu kidni εn tεst am fכ M protin. Dɛn kin tɛst yu blɔd, yu urine, ɔ bon mɛrɔ bak.

Tritmɛnt de fɔ MGRS?

Yes, tritmɛnt dɛn de fɔ MGRS. Dɔktɔ dɛn kin trit am wit mɛrɛsin dɛn we fiba kemotɛrapi fɔ kansa. Dɛn drɔgs ya kin kil di prɔblɛm sɛl dɛn ɔ stɔp dɛn fɔ mek mɔ kɔpi. Ɔda mɛrɛsin dɛn kin ɛp fɔ ridyus di swɛlin. Di men gol fɔ tritmɛnt na fɔ mek yu kidni dɛn kɔntinyu fɔ wok ɛn stɔp dɛn fɔ mek dɛn nɔ pwɛl.

Sɔntɛnde, dɔktɔ dɛn kin du stem sɛl transplant bak . Dis kin tek di ples fɔ yu sɛl dɛn we dɔn pwɛl wit sɛl dɛn we gɛt wɛlbɔdi. If yu kidni dɛn dɔn pwɛl bad bad wan, yu kin nid bak fɔ dayalaysis ɔ fɔ transplant yu kidni .

Spɛsifi k mɛrɛsin ɛn tritmɛnt dɛn we dɛn kin yuz fɔ MGRS

Di kayn mɛrɛsin we dɛn go gi yu go dipen pan di kayn MGRS we yu gɛt. Na sɔm tritmɛnt dɛn ya:

• Monoklonal antibodi dεm - fכ egzampl. rituximab, we dɛn kɔl daratumumab.
• Proteasom inhibito dεm - fכ egzampl. bכtεzomib, kכrfilzomib, iksazomib.
• Imyunmodulatory dכg dεm - fכ egzampl. talidomyd, lenalidomyd, pomalidomid.
• Alkylating ejen dεm - fכ egzampl. sayklofosfamid, bɛndamustin, mɛlfalan.
• Kɔtikosterɔyd dɛn - ɛgz. prɛdnizɔn, dɛksametazɔn.
• Ɔtɔlɔg stem sɛl transplant.

Wetin na di sayd ɛfɛkt dɛm we di tritmɛnt kin gɛt?

Tritmɛnt lɛk kemotɛrapi kin mek bɔku sayd ɛfɛkt dɛn we nɔ fayn, sɔntɛnde kin ivin pwɛl di ɔgan dɛn. Na dat mek dɔktɔ dɛn kin tek tɛm pik di tritmɛnt dɛn fɔ gɛt di bɛst bɛnifit frɔm dɛn ɛn fɔ ridyus di risk fɔ gɛt siriɔs sayd ɛfɛkt. Sɔm pan de sayd ɛfɛkt dɛm wae yu kin gɛt na:

• Anemia ( we pɔsin nɔ gɛt blɔd).
• Blɔd we de kɔmɔt.
• Banbɛlɛ.
• Rɔnbɛlɛ.
• Taya.
• Di risk fɔ gɛt vayral, baktri ɛn fɔngal infɛkshɔn kin bɔku.
• Di it nɔ de te.
• Nɔs ɛn vɔmit.

Yu tink se dɛn kin ebul fɔ stɔp MGRS?

Bikɔs wi nɔ no bɛtɛ bɛtɛ wan wetin kin mek pɔsin gɛt MGRS, naw, no patikyula we nɔ de fɔ mek i nɔ gɛt am.

Wetin yu kin ɛkspɛkt if yu gɛt MGRS?

Pan ɔl we MGRS na sik we pɔsin kin trit, bɔku tɛm i nɔ kin kɔmɔt kpatakpata. I kin kam bak afta dɛn dɔn trit am. If yu kidni dɛn dɔn pwɛl bad bad wan, yu kin nid fɔ transplant yu kidni.

Na lɛk 18% pan di pipul dɛm wae gɛt MGRS go leta gɛt kansa wae dɛn kɔl multiple myeloma. So, yu dɔktɔ go de wach yu ɔltɛm wit blɔd ɛn urine sɛmpul, bikɔs dɛn kin no dis kwik kwik wan if i apin.

Aw lɔŋ yu kin liv wit MGRS?

Aw lɔng yu kin liv wit MGRS de dipen pan di kayn MGRS we yu gɛt, aw i siriɔs, ɛn aw yu de ansa to tritmɛnt. Pipul wae nɔr gɛt bɔrku kidni damej kin gɛt bɛtɛ lukin-grɔn pas pipul dɛm wae gɛt bɔrku damej. Fɔ ɛgzampul, insay wan stɔdi, pipul dɛn we gɛt amyloidosis we gɛt fɔ du wit MGRS bin liv lɛk 10 ia so afta dɛn dɔn no se dɛn gɛt di sik. Bɔt pipul dɛn we nɔ gɛt amyloidosis bin liv lɔng pas dat. Dɔn bak, pipul dɛm wae de du wɛl pan tritmɛnt kin gɛt di bɛst tin fɔ du.

Aw a kin kia fɔ misɛf?

Mek shɔ se yu fala ɛni advays we yu dɔktɔ gi yu fɔ kia fɔ yu kidni wɛlbɔdi na os. Dis kin inklud fɔ stɔp tin dɛn lɛk rɔm, ɛn fɔ kɔntrol di tin dɛn we kin mek pɔsin gɛt sik na in kidni, lɛk ay blɔd prɛshɔn ɛn dayabitis. Pan ɔl we dɛn tin ya nɔ kin ebul fɔ trit MGRS dairekt wan, dɛn kin ɛp fɔ ridyus di risk fɔ mek di kidni pwɛl mɔ. Yu dɔktɔ kin ɛp yu bak fɔ kɔntrol di sayd ɛfɛkt dɛn we di tritmɛnt kin gɛt.

Ustɛm a fɔ go to dɔktɔ?

If yu gɛt sayn dɛn we de sho se yu gɛt prɔblɛm wit yu kidni, lɛk fɔ swel, fɔm ɔ pink urine, fɔ pis ɔltɛm, ɔ fɔ pis smɔl, mek shɔ se yu go to dɔktɔ.

Us kwɛstyɔn dɛn a fɔ aks mi dɔktɔ?

I go fayn fɔ aks yu dɔktɔ dɛn kwɛstyɔn ya:

• Us tritmɛnt dɛn de fɔ di kayn MGRS we a gɛt?
• Wetin a kin du fɔ mek di kidni nɔ pwɛl?
• Us nyu ɔr sik dɛn we de wɔs a fɔ wach fɔ?

Fɔ dɔn, di tin we impɔtant pas ɔl (Take-Home Message) .

MGRS na siriɔs sik we kin pwɛl di kidni dɛn di kayn we we kin mek pɔsin in layf de pan denja. Bɔt mɛmba se nɔto ɔlman we gɛt MGRS go gɛt kansa. Yu dɔktɔ go de wach yu ɔltɛm ɛn tek step fɔ no ɛn trit ɛni nyu prɔblɛm kwik kwik wan . Nyu tritmɛnt dɛn dɔn mek am pɔsibul naw fɔ mek yu layf bɛtɛ ɛn fɔ mek yu nɔ gɛt siriɔs sik dɛn. So nɔ fred, ɛn fala yu dɔktɔ in advays.

` MGRS, Monoclonal Gammopathy of Renal Significance, Kidni Disiz, M Protein, Plasma Sεl, Kidni Bayopsi, Nεfrotik Sindrom, Mכltipכl Mayloma