He M protein hi i kal tan pawh harsatna a ni em? (Monoclonal Gammopathy of Renal Significance - MGRS) Hemi chungchang hi han sawi ila!

Kan kal (kidney) hi taksa peng pawimawh tak, ngawi renga a hna thawk thei a ni tih kan hre vek. Mahse, a chang chuan heng kal (kidney) te hi ngawi rengin a na thei bawk. Vawiin hian kal natna thlentu natna, a hming i hriat chuan a buaithlak deuhin a lang thei a, mahse hriatthiam awlsam tak a ni tih kan sawi dawn a ni. Hei hi MGRS (Monoclonal Gammopathy of Renal Significance) an ti a. A hming hi sei deuh mah se, lungngai suh, awlsam takin i hrethiam ang u.

MGRS hi eng nge ni mai?

Okay, MGRS hi eng nge a nih i en ang u. A awlsam zawngin sawi ila, MGRS hi kal (kidney) tichhe thei chi hrang hrang a ni. Hetiang chhiatna hi kan taksa plasma cell , a nih loh leh B cell thenkhat (hengte hi thisen var chi hrang hrang) te hian anmahni copy tam lutuk, a nih loh leh clone an siam vang a ni. Photocopy machine-in phek khata copy tam tak a siam ang maiin han ngaihtuah teh.

Chutianga plasma cell lo awm hian antibody chi khat M protein an siam chhuak a ni. Heng M protein te hi kan taksa peng hrang hrang, a bik takin kal (kidney) ah te an awm a, an tichhe tan thin.

A pawimawh ber chu MGRS hi cancer a ni lo. Mahse, MGRS vei mi tlemte chuan a tâwpah chuan cancer, multiple myeloma . Chuvangin hei hi hriat chian a pawimawh.

MGRS chi hrang hrang a awm em?

Ni e, MGRS condition chi hrang hrang sawmhnih chuang a awm. Chungte chu M protein hian kal (kidney) eng hmun nge a nghawng tih a zirin an thliar hrang a ni. Category lian pathum a awm a, chungte chu:

1. Glomerular natna te

MGRS chi hrang hrang awm tam ber chu glomerulopathies a ni . Chungte chuan kal chhunga thisen kalna kawng te te te chu a tichhia a ni. Tui filter-a mesh awm ang mai an ni. Hemi zingah hian natna dang thenkhat chu:

• Renal amyloidosis a awm thin. Hei hian AL amyloidosis, AH amyloidosis, leh AHL amyloidosis tih chi hrang hrang a huam a ni.
• Cryoglobulinemic glomerulonephritis (CG) natna a ni a, a natna hi a inang lo hle.
• Fibrillary glomerulopathy (FGN) a awm a, a natna hi a awm lo.
• A rilru a hah lutuk chuan a rilru a buai em em a.
• Glomerular natna hi monoclonal proteins nena inzawm a ni. Hei hian `light chain` leh `heavy chain deposition diseases` tih te pawh a huam tel a ni.

2. Tubulointerstitial natna te

Heng natnate hian kal (kidney)-in a filter chhuah nutrient leh fluid te thisenah a phur kir lehtu tube (tubules) te, leh a chhehvela tissue te a nghawng a ni. Entirna thenkhat chu:

• Light chain Fanconi natna (LCFS) natna a ni.
• Crystal awm lo light chain proximal tubulopathy (LCPT) a ni.
• Crystal-a dahkhawmna histiocytosis a awm.

3. Kal chhunga thisen kalna kawng (Intra-renal vascular lesions) .

Heng dinhmunte hian kal chhunga thisen kalna kawngte a nghawng a ni. Entirnan , atypical hemolytic uremic syndrome (aHUS) tih hi a ni. Hei hi kal chhunga thisen kalna kawng te tak te te chu thisen zam (blood clots) in a tihkhawtlai hun a ni.

MGRS hi engtiang chiahin nge a awm?

MGRS hi a takah chuan a awm lo hle . Mipui 1% aia tlem loin a nghawng nia chhut a ni. Kum 60 chunglam ah a tam hle .

MGRS natna lanchhuahna chu engte nge ni?

MGRS i neih chi hrang hrang a zirin MGRS symptoms hi a danglam thei. A lan chhuah dan tlangpui thenkhat chu:

• Chau lutuk (chau) tih hriatna .
• Ke hnuai lam, ke ruh leh ke hnuai lam a hring . A châng chuan pum, kut emaw, hmai emaw pawh a hring thei bawk.
• Nephrotic syndrome a awm thin. Hei hi zun atanga protein chhuak leh thisen a cholesterol level sang vang a ni.
• Foamy emaw sahbawn nei emaw zun. Hei hi zun chhunga protein awm (proteinuria) chhinchhiahna a ni thei.
• Zun tam hi zun tam a tulna a ni.
• Zun chhunga thisen (hematuria) emaw, zun pink a lo awm emaw.
• Nausea leh luak chhuak.
• POEMS syndrome tih hi a ni . Hei pawh hi thil awm lo tak a ni.
• Ka taksa peng hrang hranga rilru hahna, tingling, emaw chak lohna (hengte hi neuropathy chhinchhiahna a ni).
• Vun rawng a danglam (a hring emaw, a dum emaw).
• Thâwk harsa (dyspnea).

Eng thilin nge MGRS hi a thlen?

MGRS thlentu ber chu a chunga kan sawi tak M proteins te avanga kal (kidney) chhiatna a ni. M proteins hi antibody chi khat a ni a, a thawk tha lo a, a siam dik lo bawk. Plasma cell, thisen var chi khat emaw, B cell emaw clone (copy) chhia atanga siam an ni.

Mi thenkhat chuan heng plasma cell clone te hian M protein siamin taksa peng engmah tichhe lovin an nei thei a ni. Hetiang dinhmun hi Monoclonal Gammopathy of Undetermined Significance (MGUS) an ti a. Mahse, MGRS vei teah chuan heng M protein te hi kal (kidney) ah an pungkhawm a, an tichhe thin.

MGRS hi eng nge a chhan ber?

Mithiamte chuan MGRS hi eng nge a thlen tih chiang takin an la hre lo. Autoimmune disorders , genetic changes , infections, leh environment factors te hian a thlen vek niin an ngai.

MGRS vang hian eng harsatna nge thleng thei?

Heng plasma cell clone leh MGRS te hian kal a chhiat avangin harsatna lian tak a thlen thei a ni. Chung zinga ṭhenkhat chu:

• Kal natna rei tak (CKD) .
• End-stage renal (kidney) natna .
• Kidney tha lo a awm .
• Natna dangah hmasawnna. Mi ṭhenkhatah chuan plasma cell clone a pung nasa hle a, chu chu thisen var cancer chi khat , multiple myeloma (MM) -ah a lo chang thei a ni. MGRS hi cancer dang, Waldenström macroglobulinemia , chronic lymphocytic leukemia (CLL) , emaw B-cell lymphoma -ah te pawh a lo chang thei bawk.

Engtin nge MGRS hi hmuhchhuah a nih?

Doctor chuan MGRS hi kidney biopsy hmangin a nemnghet thei a ni . Hei hian i kal atanga tissue te tak te la chhuakin M protein a awm leh awm loh test a huam a ni. I thisen, zun emaw, ruhro emaw sample an test thei bawk.

MGRS enkawlna tur a awm em?

Ni e, MGRS enkawlna tur a awm. Doctor-te chuan cancer enkawlna chemotherapy ang chi damdawi hmangin an enkawl a ni. Heng damdawi te hian harsatna nei cell te chu a that emaw, copy tam zawk siamna tur a titawp emaw a ni. Damdawi dangte hian swelling tihziaawmna kawngah a pui thei bawk. Enkawlna tum ber chu i kal (kidney) te hnathawh tir leh a chhiat lohna tura ven hi a ni.

MGRS vei ṭhenkhatah chuan doctor-te chuan stem cell transplant an ti thei bawk . Hei hian i cell chhia te chu cell hrisel takin a thlak a ni. I kal a chhiat nasat chuan dialysis emaw, kal thlak emaw pawh i mamawh thei bawk .

MGRS atana damdawi leh enkawlna bik hman dan

Damdawi pek i nih dan tur chu MGRS i neih chi hrang hrangah a innghat ang. Enkawl dan tur thenkhat chu hetiang hi a ni:

• Monoclonal antibody - e.g. rituximab, daratumumab tih a ni.
• Proteasome inhibitor - e.g. bortezomib, carfilzomib, ixazomib te a awm bawk.
• Immunomodulatory damdawi - e.g. thalidomide, lenalidomide, pomalidomide tih te hi a awm a.
• Alkylating agents - e.g. cyclophosphamide, bendamustine, melphalan tih te hi a awm a.
• Corticosteroids - e.g. prednisone, dexamethasone tih a ni.
• Autologous stem cell hmanga enkawl a ni.

Enkawlna hian eng side effect nge a neih?

Chemotherapy ang chi enkawlna hian side effect duhawm lo tam tak a thlen thei a, a chang chuan taksa peng hrang hrang a tichhe thei bawk. Chuvang chuan doctor-te chuan enkawlna tur uluk takin an thlang a, chu chu a hlawkna tam ber an hmuh theih nan leh side effect na tak tak an neih theihna tur tihtlem nan an hmang thin. I tawn theih side effect thenkhat chu:

• Anemia ( thisen tlakchhamna).
• Thisen chhuak.
• Ek khal.
• Kawthalo.
• Chau.
• Viral, bacteria leh fungal infection neih theihna a sang.
• Chaw chu a thlum lo.
• Nausea leh luak chhuak.

MGRS hi ven theih a ni em?

MGRS hi eng nge a thlen tih chiang taka kan hriat loh avangin tun dinhmunah chuan ven dan tur chiang tak a awm lo.

MGRS i neih chuan eng nge i beisei theih ang?

MGRS hi enkawl theih ni mahse, a tlangpuiin a bo vek lo. Enkawl hnuah a lo lang leh thei a ni. I kal a chhiat nasat chuan kal thlak a ngai mai thei.

MGRS vei zinga 18% vel chuan a hnuah cancer an vei ang a, chu chu multiple myeloma an ti a ni. Chuvangin, i doctor chuan thisen leh zun sample hmangin a lo en reng ang che, hei hi a lo awm a nih chuan a hmaa hriat theih a nih avangin.

MGRS nen hian eng chen nge i dam theih ang?

MGRS i dam rei theih dan chu MGRS i neih chi hrang hrang, a nasat dan leh enkawlna i dawn danah a innghat a ni. Kidney chhiatna tlem zawkte hian chhiatna nasa zawk nei te aiin hmalam hun an nei tha zawk. Entirnan, zirchianna pakhatah chuan MGRS nena inzawm amyloidosis vei te chu an hmuhchhuah atanga a vaiin kum 10 vel an dam a ni. Mahse amyloidosis nei lote chu an dam rei zawk hle. Tin, enkawlna dawng tha mi te hian rah tha ber an nei bawk.

Engtin nge ka in enkawl ang?

In lama i kal hriselna enkawlna atana i doctor-in rawtna a pek che apiang chu zawm ngei ang che. Hei hian zu ang chi thil tihtlem te, kal natna thlen thei thil, thisen sang leh zunthlum te control te a huam thei a ni. Heng thilte hian MGRS hi direct-a a enkawl theih loh laiin, kal (kidney) chhiatna nasa zawk a thlen theihna tur a tihziaawm thei a ni. I doctor hian enkawlna avanga side effects te pawh a enkawl thei bawk.

Engtikah nge Doctor ka hmuh ang?

Kidney problem symptoms i neih chuan, a hring, foamy emaw pink urine emaw, zun tam emaw, zun tlem lutuk emaw i neih chuan doctor pan ngei ngei tur a ni.

Doctor hnenah eng zawhna nge ka zawh ang?

I doctor hnenah heng zawhnate hi zawh hi a \angkai thei ang:

• MGRS ka neih chi hrang hrang atan hian eng enkawlna nge awm?
• Kidney chhiat loh nan eng nge ka tih theih ang?
• Eng symptom thar emaw, a zual zel emaw nge ka en tur?

A tawp berah chuan a pawimawh ber (Take-Home Message) .

MGRS hi natna khirh tak a ni a, kal (kidney) hi nunna atana hlauhawm thei khawpin a tichhe thei a ni. Mahse, MGRS vei zawng zawng hian cancer an vei vek dawn lo tih hre reng ang che. I doctor chuan a enkawl reng ang che , harsatna thar i neih chuan a rang thei ang bera hriatchhuah leh enkawl turin hma a la ang che . Tunah chuan enkawlna tharte chuan i nunphung a tichangtlung thei tawh a, natna khirh tak i neih theihna pawh a ti tlem thei tawh bawk. Chuvangin hlau suh, i doctor thurawn zawm la, he dinhmun hi hmachhawn rawh.

` MGRS, Monoclonal Gammopathy of Renal Significance, Kal natna, M Proteins, Plasma Cells, Kal Biopsy, Nephrotic Syndrome, Multiple Myeloma te a ni