Kodi matenda a Castleman ndi chiyani? Tiyeni tikambirane mwachidule!

Kodi munayamba mwaonapo kuti mumakhala ndi ziphuphu zazing'ono pakhosi kapena m'khwapa? Nthawi zina zimachitika mukakhala ndi chimfine kapena chimfine. Koma, izi sizikutanthauza chinthu chophweka ngati chimenecho. Ichi ndi vuto losowa koma lofunika kudziwa. Timachitcha kuti Matenda a Castleman .

Mwachidule, matenda a Castleman ndi matenda omwe chitetezo cha mthupi lathu chimagwira ntchito mopitirira muyeso . Tangoganizirani, kachilombo komwe kamayambitsa matenda kakalowa m'thupi mwathu, chitetezo chathu cha mthupi chimalimbana nacho ngati msilikali wopita kunkhondo. Matendawo akachiritsidwa, msilikaliyo amakhala chete kachiwiri. Koma mwa munthu amene ali ndi matenda a Castleman, chitetezo cha mthupichi chimakhala 'chogwira' nthawi zonse. Izi zimayambitsa kutupa kwa nthawi yayitali m'thupi, komwe kungawononge ziwalo zathu.

Pa nthawiyi, tinthu ta lymph nodes zathu - tinthu tating'onoting'ono timeneti ndi timene timati - timagwira ntchito ngati fyuluta. Majeremusi onse ndi maselo oteteza thupi amasefedwa kudzera mwa iwo. Chifukwa chake, chifukwa chitetezo cha mthupi chimagwira ntchito nthawi zonse, tinthu ta lymph nodes timeneti timagwiranso ntchito nthawi yayitali. Kenako maselo omwe ali mkati mwake amakula kwambiri, ndipo tinthu ta lymph nodes timatupa. Sikuti kutupa kokha kumeneku, komanso ku Castleman Disease, palinso kusintha kwa minofu ya tinthu ta lymph nodes timeneti.

Uwu ndi matenda osowa kwambiri. Mwachitsanzo, ku United States, milandu yatsopano 4,300 mpaka 5,200 yokha imapezedwa chaka chilichonse. Choncho madokotala akuphunzirabe zambiri za izi. Komabe, ngati mutapezeka ndi matendawa, mudzalandira chithandizo chapadera chomwe chili chapadera kwa inu.

Kodi mitundu ikuluikulu ya matenda a Castleman ndi iti?

Pali mitundu iwiri ikuluikulu ya matendawa.

Matenda a Castleman Osalekeza (UCD)

Matenda a Unicentric Castleman (UCD) ndi pamene lymph node imodzi kapena zingapo m'dera limodzi la thupi lanu zimakula . Ganizirani khosi lanu lokha, kapena m'khwapa mwanu. Pafupifupi magawo atatu mwa anayi a odwala a Castleman ali m'gululi.

Matenda a Castleman a Mitundu Yosiyanasiyana (MCD)

Matenda a Multicentric Castleman (MCD) ndi matenda omwe ma lymph nodes amatupa m'malo osiyanasiyana a thupi, osati m'malo amodzi okha. Kunena zoona, madokotala amagawa mtundu uwu wa MCD m'magulu awa:

• MCD yogwirizana ndi ndakatulo: NDATU ndi matenda osowa kwambiri a magazi. Nthawi zina, NDATU imatha kuchitika limodzi ndi MCD.
• MCD yogwirizana ndi HHV-8: Mtundu uwu umayamba chifukwa cha kachilombo kotchedwa Human Herpes Virus-8 (HHV-8) . Ngati muli ndi kachilombo ka HIV kapena chitetezo chamthupi chanu chili ndi vuto, muli ndi mwayi waukulu wopeza mtundu uwu wa MCD.
• MCD yosadziwika chifukwa chake (Idiopathic MCD - iMCD):Uwu ndi mtundu wofala kwambiri wa matenda a MCD. 'Idiopathic' amatanthauza kuti chomwe chimayambitsa matendawa sichidziwika.

Tsopano chifukwa chosadziwika ichi iMCD ilinso ndi magawo atatu ang'onoang'ono:

• iMCD yogwirizana ndi matenda a TAFRO: Nthawi zina iMCD imatha kutsagana ndi matenda otchedwa TAFRO syndrome. Dzina lakuti TAFRO limachokera ku zilembo zoyambirira za zizindikiro zake. Izi ndi: Thrombocytopenia (ma platelet otsika m'magazi), Anasarca (kutupa kwa thupi ndi madzi), Malungo , Kulephera kugwira ntchito kwa impso (impso), ndi Organomegaly (kukula kwa ndulu kapena chiwindi).
• iMCD yokhala ndi Idiopathic Plasmacytic Lymphadenopathy (iMCD-IPL): Mu mtundu uwu, ma platelet amatha kukhala okwera. Maselo anu oyera a m'magazi amathanso kupanga ma antibodies ambiri.
• iMCD sinatchulidwe mwanjira ina (iMCD-NOS): Chifukwa chenicheni cha mtundu uwu, chotchedwa iMCD-NOS, sichikudziwikanso, ndipo sichikugwirizana ndi TAFRO.

Kodi zizindikiro za matenda a Castleman ndi ziti?

Zizindikiro za matenda a Castleman zimasiyana malinga ndi mtundu womwe muli nawo. Nthawi zambiri, ngati muli ndi matenda a Castleman (UCD) omwe ali m'malo amodzi, simungakhale ndi zizindikiro zazikulu. Kutupa kwa ma lymph node kungakhale chizindikiro chokhacho chomwe mumazindikira. Komabe, nthawi zina zizindikiro zimatha kuchitika ngati lymph node yotupa ikakankhira pa chiwalo china chapafupi.

Komabe, ngati muli ndi MCD, zizindikiro zake zimakhala zoonekeratu. Kuwonjezera pa kutupa kwa ma lymph nodes, mungaone zizindikiro monga:

• Malungo
• Kutopa (ichi chingakhale chizindikiro cha kuchepa kwa magazi m'thupi)
• Thukuta usiku
• Kusanza ndi kusanza
• Kuchepetsa thupi popanda chifukwa
• Kutupa m'mapazi anu, akakolo, kapena m'mimba
• Nkhumba yokulirapo (splenomegaly) kapena chiwindi chokulirapo (hepatomegaly)
• Kusanza m'manja ndi m'mapazi (peripheral neuropathy)

Kodi n’chiyani chimayambitsa matenda a Castleman?

Chifukwa chenicheni cha matenda a Castleman (UCD) omwe ali ndi unicentric sichinadziwikebe, koma kachilombo kotchedwa HHV-8 kapezeka kuti ndi komwe kamayambitsa matenda a Castleman (MCD) omwe ali ndi unicentric.

Asayansi akufufuzabe zinthu zina zomwe zingayambitse UCD ndi iMCD. Mwachitsanzo, akufufuza matenda ena kupatula HHV-8, kusintha kwa majini , ndi mayankho a autoimmune .

Ndani amene ali pachiwopsezo chachikulu chotenga matendawa?

Zinthu zinazake zomwe zingachititse kuti munthu adwale matenda a UCD kapena iMCD sizinadziwikebe. Komabe, ngati muli ndi kachilombo ka HIV kapena vuto lina lomwe limafooketsa chitetezo chamthupi chanu, muli pachiwopsezo chachikulu chotenga matenda a HHV-8-associated MCD.

Matenda a Castleman amatha kuchitika pa msinkhu uliwonse, koma amapezeka kwambiri mwa anthu azaka zapakati pa 30 ndi 60 .

Kodi mavuto omwe angakhalepo chifukwa cha matenda a Castleman ndi ati?

Matenda a Castleman amawonjezera chiopsezo chanu chokhala ndi khansa, makamaka lymphoma .

Komanso, ngakhale kuti ndi zosowa kwambiri, anthu omwe ali ndi UCD ali pachiwopsezo chotenga matenda oopsa otchedwa Paraneoplastic Pemphigus (PNP) . MCD imawonjezeranso chiopsezo chanu chokhala ndi matenda omwe angawononge ziwalo zanu. Kuwonongeka kumeneku kungakhale koopsa ngati sikuchiritsidwa bwino.

Musadandaule, dokotala wanu nthawi zonse azikuyang'anirani ndipo adzakuthandizani kupewa mavuto otere nthawi iliyonse yomwe zingatheke.

Kodi madokotala amazindikira bwanji matenda a Castleman?

Zizindikiro za matenda a Castleman zitha kufanana ndi za matenda ena ofala, monga chimfine kapena chimfine. Choncho dokotala wanu choyamba adzachotsa matenda amenewo. Kenako, adzayesa matenda a Castleman ndikupeza mtundu wake.

Mayeso ndi njira zingaphatikizepo:

• Mayeso a labu: Dokotala wanu adzayang'ana kuchuluka kwa maselo anu m'magazi kuti awone ngati pali zolakwika ndi zizindikiro zina zazing'ono za matenda a Castleman. Angakuuzeninso kuti muyesedwe ndi kachilombo ka HIV . Ngati muli ndi matenda a HHV-8, mayeso anu a HIV akhoza kukhala ndi kachilomboka.
• Mayeso ojambulira: Mayeso monga CT scans ndi PET scans angathandize kupeza ma lymph nodes otupa m'thupi lanu, komanso kuyang'ana zizindikiro zina za matenda a Castleman, monga chiwindi kapena ndulu yotupa.
• Kufufuza za matenda a lymph node: Njira yokhayo yodziwira ngati muli ndi matenda a Castleman ndikuchita kafukufuku wa matenda a lymph node. Izi zimaphatikizapo kutenga minofu yaying'ono kuchokera ku lymph node ndikuiyang'ana pansi pa maikulosikopu. Izi zimatsimikizira ngati pali zizindikiro zilizonse za matendawa.

Kodi matenda a Castleman amachiritsidwa bwanji?

Chithandizo cha matenda a Castleman chimasiyana malinga ndi mtundu wa matenda omwe muli nawo.

Chithandizo cha Matenda a Unicentric Castleman (UCD)

Chithandizo chachikulu cha UCD ndikuchotsa ma lymph nodes omwe akhudzidwa ndi opaleshoni . Nthawi zina mungafunike chithandizo cha radiation kapena immunotherapy musanachite opaleshoni. Mankhwalawa amachepetsa kukula kwa ma lymph nodes, zomwe zimapangitsa kuti zikhale zosavuta kuchotsa.

Koma ngati madokotala a opaleshoni sangathe kuchotsa lymph node yomwe yakhudzidwa, ndipo inu mulibe zizindikiro, dokotala wanu angayang'anire m'malo mochiza. Ngati muli ndi zizindikiro ndipo simungathe kuchitidwa opaleshoni, angakulangizeni chithandizo cha MCD.

Chithandizo cha matenda a Castleman ambiri (MCD)

Matenda a MCD ndi ovuta pang'ono kuchiza kuposa UCD. Chifukwa chakuti amafalikira m'thupi lonse, opaleshoni kapena chithandizo cha radiation nthawi zambiri sichigwiritsidwa ntchito. M'malo mwake, chithandizocho chimadalira ngati muli ndi kachilombo ka HHV-8 komanso momwe matendawa alili oopsa.

Dokotala wanu angagwiritse ntchito njira zotsatirazi:

• Corticosteroids: Mankhwalawa amathandiza kuchepetsa kutupa ndikupereka mpumulo ku zizindikiro.
• Mankhwala a Chemotherapy: Mankhwala a Chemotherapy amalamulira kukula kwa maselo m'thupi lanu. Rituximab ndi mankhwala omwe nthawi zambiri amaperekedwa kwa HHV-8-associated MCD.
• Chithandizo cha Immunotherapy: Chithandizochi chimaphatikizapo kugwiritsa ntchito zinthu monga ma antibodies a monoclonal . Izi zimathandiza kutonthoza chitetezo cha mthupi lanu. Siltuximab (Sylvant®) ndiye chithandizo chokhacho chomwe chavomerezedwa ndi U.S. Food and Drug Administration (FDA) cha iMCD.
• Mankhwala oletsa mavairasi: Ngati muli ndi matenda a HHV-8, mungafunike mankhwala oletsa mavairasi kuti muchiritse matenda a HIV kapena HHV-8.

Kodi ndiyenera kupita kwa dokotala liti?

Ngati muwona chotupa kapena chotupa pakhosi panu, m'khwapa, kapena m'chiuno, pitani kwa dokotala nthawi yomweyo . Komanso, ngati muli ndi zizindikiro zina za matenda a Castleman zomwe zatchulidwa pamwambapa zomwe sizikuchira patatha milungu ingapo, uzani dokotala wanu za izo.

Kodi mungakhale ndi matendawa kwa nthawi yayitali bwanji?

Kwa anthu ambiri omwe ali ndi UCD, nthawi yoti matendawa awonekere ndi yabwino kwambiri. Kuchotsa ma lymph nodes omwe akhudzidwa kungathe kuchiritsa matendawa. Ndi chithandizo, UCD nthawi zambiri simakhudza moyo wa munthu.

Koma chiyembekezo cha anthu omwe ali ndi MCD chimadalira mtundu wa MCD womwe ali nawo komanso kuopsa kwa matendawa. Kwa anthu ena, zizindikiro zimatha kuchitika mwadzidzidzi n’kukhala zoopsa. Kwa ena, zizindikiro zimatha kukhalapo kwa nthawi yayitali. Pakati pa 65% ndi 75% ya anthu omwe apezeka ndi MCD akadali ndi moyo patatha zaka zisanu . Ndi mankhwala atsopano, pali chiyembekezo chakuti vutoli lidzakhala bwino.

Palibe mayankho osavuta pankhani ya matenda a Castleman. Zomwe mukukumana nazo zidzadalira mtundu wa matenda a Castleman omwe muli nawo. Matenda ena, monga HIV, kapena matenda ena ofanana nawo, monga TAFRO ndi POEMS, angakhudzenso zomwe mukukumana nazo. Nthawi zina, opaleshoni ndi kuyang'anitsitsa bwino kungakhale kofunikira. Kapena, mungafunike chithandizo chosiyanasiyana m'moyo wanu wonse kuti mupewe mavuto. Funsani dokotala wanu momwe matenda anu angakhudzire chithandizo chanu ndi momwe mukuonera zinthu.

Kotero, ndi zinthu ziti zofunika kwambiri zomwe tiyenera kukumbukira kuchokera apa?

• Matenda a Castleman ndi matenda osowa koma omwe angakhale oopsa omwe chitetezo chathu cha mthupi chimagwira ntchito mopitirira muyeso.
• Pali mitundu iwiri ikuluikulu: UCD ndi MCD. Mu UCD, ma lymph nodes amatupa pamalo amodzi, pomwe mu MCD, amatupa malo angapo.
• Zizindikiro zimasiyana. Nthawi zina sipangakhale zizindikiro konse, kungoti chotupa. Kapena pangakhale zizindikiro monga kutentha thupi, kutopa, ndi kuchepa thupi.
• Zomwe zimayambitsa matendawa sizimveka bwino nthawi zonse, koma kachilombo ka HHV-8 kamagwirizana ndi MCD. Anthu omwe ali ndi kachilombo ka HIV ali pachiwopsezo chachikulu.
• Kuzindikira msanga ndi kulandira chithandizo choyenera nthawi zambiri kumabweretsa zotsatira zabwino. Chifukwa chake ngati muwona chotupa chosazolowereka, kutupa, kapena zizindikiro zina zachilendo m'thupi lanu, funsani upangiri wa dokotala nthawi yomweyo. Chofunika kwambiri ndikukhala ndi chidziwitso osati mantha.

Matenda a Castleman , Lymph Nodes, Lymphadenopathy, Chitetezo cha Mthupi, UCD, MCD, HHV-8, Zizindikiro, Chithandizo