Indwara ya Castleman ni iki? Reka tubiganireho mu buryo bworoshye!

Ese wigeze ubona ko urwara utu tubyimba duto ku ijosi cyangwa mu kwaha? Hari igihe bibaho iyo urwaye ibicurane cyangwa grippe. Ariko, ibi ntabwo ari ibintu byoroshye nk'ibyo. Iki ni ikibazo kidasanzwe ariko cy'ingenzi ugomba kumenya. Tucyita indwara ya Castleman .

Muri make, indwara ya Castleman ni indwara ituma ubudahangarwa bw'umubiri wacu burushaho gukora cyane . Tekereza, iyo mikorobe itera indwara yinjiye mu mubiri wacu, ubudahangarwa bwacu burayirwanya nk'umusirikare ugiye ku rugamba. Iyo indwara ikize, uwo musirikare yongera guceceka. Ariko ku muntu urwaye indwara ya Castleman, ubu budahangarwa bw'umubiri buhora 'bukora'. Ibi bitera ububyimbirwe bw'igihe kirekire mu mubiri, bushobora kwangiza ingingo zacu.

Muri iki gihe, utudomo twa lymphatic - utwo tubyimba duto ni two twita - dukora nk'akayunguruzo. Utunyangingo twose n'uturemangingo tw'ubudahangarwa bw'umubiri turayungururwamo. Rero, kubera ko ubudahangarwa bw'umubiri buhora bukora, utu duto duto dukora n'igihe kirekire. Hanyuma uturemangingo turimo turakura cyane, kandi utudomo duto turabyimba. Si uku kubyimba gusa, ahubwo no muri Castleman Disease, hari n'impinduka mu ngingo z'utu duto duto.

Iyi ni indwara idakunze kugaragara cyane. Urugero, muri Leta Zunze Ubumwe za Amerika, abantu 4,300 kugeza ku 5,200 ni bo bandura buri mwaka. Bityo abaganga baracyamenya byinshi kuri iyi ndwara. Ariko, niba uyirwaye, uzahabwa uburyo bwihariye bwo kuyivura.

Ni ubuhe bwoko bw'ingenzi bw'indwara ya Castleman?

Hari ubwoko bubiri bw'ingenzi bw'iyi ndwara.

Indwara ya Castleman isanzwe (UCD)

Indwara ya Castleman isanzwe (UCD) ni iyo hari agace gato k'umubiri wawe gafite imiterere y'uturemangingo tw'umubiri . Tekereza ku ijosi ryawe gusa, cyangwa ku maha yawe gusa. Abagera kuri bitatu bya kane by'abarwayi ba Castleman bari muri iki cyiciro.

Indwara ya Castleman ishingiye ku moko menshi (MCD)

Indwara ya Castleman ifite ibice byinshi (MCD) ni indwara aho imitsi ibyimbye mu bice byinshi by'umubiri, aho kubyimba mu bice bimwe gusa. Mu by'ukuri, abaganga bagabanya ubwoko bw'iyi ndwara muri ibi bikurikira:

• MCD ifitanye isano n'IBIVUGO: IBIVUGO ni indwara idakunze kugaragara mu maraso. Hari igihe, IBIVUGO bishobora kubaho hamwe na MCD.
• MCD ifitanye isano na HHV-8: Ubu bwoko buterwa n'ubwandu bwa virusi yitwa Human Herpes Virus-8 (HHV-8) . Niba ufite ubwandu bwa virusi itera SIDA cyangwa ufite ubudahangarwa bw'umubiri, ushobora kwandura ubwo bwoko bwa MCD.
• MCD y’impamvu itazwi (Idiopathic MCD - iMCD):Ubu ni bwo bwoko bwa MCD bukunze kugaragara cyane. 'Idiopathic' bivuze ko impamvu nyayo itazwi.

Noneho iyi mpamvu itazwi iMCD ifite ibice bitatu:

• iMCD ifitanye isano na TAFRO syndrome: Hari igihe iMCD ishobora guherekezwa n'indwara yitwa TAFRO syndrome. Izina TAFRO rikomoka ku nyuguti za mbere z'ibimenyetso byayo. Izi ni: Thrombocytopenia (udukoko duke mu maraso), Anasarca (kubyimba umubiri hamwe n'amazi), Umuriro , Impyiko zidakora neza, na Organomegaly (ubwiyongere bw'agashishwa k'umwijima cyangwa urwagashya).
• iMCD ifite Idiopathic Plasmacytic Lymphadenopathy (iMCD-IPL): Muri uru rwego, platelets zishobora kuba nyinshi. Uturemangingo tw'amaraso yawe tw'umweru natwo dushobora gukora uturemangingo twinshi cyane.
• iMCD itavuzwe ukundi (iMCD-NOS): Impamvu nyayo y'ubu bwoko bw'indwara, yitwa iMCD-NOS, nayo ntabwo izwi, kandi ntabwo ifitanye isano na TAFRO.

Ni ibihe bimenyetso by'indwara ya Castleman?

Ibimenyetso by'indwara ya Castleman biratandukanye bitewe n'ubwoko bw'indwara ufite. Kenshi na kenshi, niba ufite indwara ya Castleman (UCD) isanzwe, ushobora kutagira ibimenyetso bikomeye ufite. Kubyimba kw'imitsi bishobora kuba ari cyo kimenyetso cyonyine ubona. Ariko, rimwe na rimwe ibimenyetso bishobora kubaho iyo imitsi ya lymph yabyimbye ikandagiye ku rundi rugingo ruri hafi.

Ariko, niba ufite MCD, ibimenyetso biragaragara cyane. Uretse kubyimba kw'uturemangingo tw'imitsi, ushobora kubona ibimenyetso nka:

• Umuriro
• Umunaniro (iki gishobora kuba ikimenyetso cy'amaraso make)
• Kubira ibyuya nijoro
• Isesemi no kuruka
• Kugabanya ibiro nta mpamvu
• Kubyimba ibirenge, utubyimba tw'amaguru, cyangwa inda
• Urwagashya (splenomegaly) cyangwa umwijima mwinshi (hepatomegaly)
• Kubura ibinya mu biganza no mu birenge (peripheral neuropathy)

Ni iki gitera indwara ya Castleman?

Impamvu nyayo itera indwara ya Castleman (UCD) isanzwe ntabwo iramenyekana, ariko kwandura virusi yitwa HHV-8 byagaragaye ko ari yo mpamvu ituma indwara ya Castleman ikwirakwira mu bice byinshi by’umubiri (MCD).

Abahanga mu bya siyansi baracyakora ubushakashatsi ku zindi mpamvu zishobora gutera UCD na iMCD. Urugero, barimo gusuzuma izindi ndwara zitari HHV-8, impinduka mu ngirabuzimafatizo , ndetse n'ingaruka z'ubwiyongere bw'umubiri .

Ni nde uri mu kaga gakomeye ko kurwara iyi ndwara?

Ibintu byihariye bishobora gutera UCD cyangwa iMCD ntibiramenyekana. Ariko, niba ufite ubwandu bwa virusi itera SIDA cyangwa indi ndwara ituma ubudahangarwa bw'umubiri wawe bugabanuka, uba uri mu kaga ko kurwara MCD ifitanye isano na HHV-8.

Indwara ya Castleman ishobora kugaragara mu myaka iyo ari yo yose, ariko ikunze kugaragara cyane mu bantu bari hagati y'imyaka 30 na 60 .

Ni izihe ngorane zishobora guterwa n'indwara ya Castleman?

Indwara ya Castleman yongera ibyago byo kurwara kanseri, cyane cyane lymphoma .

Nanone, nubwo bidakunze kubaho cyane, abantu barwaye UCD baba bafite ibyago byo kurwara indwara ikomeye yitwa Paraneoplastic Pemphigus (PNP) . MCD yongera ibyago byo kurwara indwara zishobora kwangiza ingingo zawe. Iyi ndwara ishobora gushyira ubuzima mu kaga iyo idavuwe neza.

Ntugahangayike, muganga wawe azahora akurikirana ikibazo cyawe kandi agufashe kwirinda izo ngorane igihe cyose bishoboka.

Ni gute abaganga bapima indwara ya Castleman?

Ibimenyetso bya Castleman Disease bishobora gusa n’iby’izindi ndwara zisanzwe, nka grippe cyangwa grippe. Bityo muganga wawe azabanza agaragaze izo ndwara. Hanyuma, azakora ibizamini kugira ngo amenye indwara ya Castleman hanyuma amenye ubwoko bwayo.

Ibizamini n'uburyo bwo kubisuzuma bishobora kuba bikubiyemo:

• Ibizamini byo muri laboratwari: Muganga wawe azasuzuma umubare w'uturemangingo tw'amaraso yawe kugira ngo arebe ko nta kibazo n'ibindi bimenyetso bifatika by'indwara ya Castleman. Bashobora kandi gutegeka ko upimwa agakoko gatera SIDA . Niba ufite MCD ifitanye isano na HHV-8, ikizamini cyawe cya virusi itera SIDA gishobora kuba cyaranduye.
• Ibizamini byo gupima: Ibizamini nka CT scan na PET scan bishobora gufasha kubona utunyangingo twa lymph twabyimbye mu mubiri wawe, ndetse no gusuzuma ibindi bimenyetso by'indwara ya Castleman, nko kwiyongera k'umwijima cyangwa urwagashya.
• Kugenzura imiyoboro y'amaraso mu maraso: Uburyo bwonyine bwo kumenya neza niba urwaye indwara ya Castleman ni ugusuzuma imiyoboro y'amaraso mu maraso. Ibi bikubiyemo gufata agace gato k'umubiri mu maraso no kugasuzuma hifashishijwe mikorosikopi. Ibi bizagaragaza niba hari ibimenyetso by'indwara.

Indwara ya Castleman ivurwa ite?

Uburyo bwo kuvura indwara ya Castleman buratandukanye bitewe n'ubwoko bw'indwara ufite.

Uburyo bwo kuvura indwara ya Unicentric Castleman Disease (UCD)

Uburyo bw'ingenzi bwo kuvura UCD ni ukubaga node zangiritse. Hari igihe ushobora gukenera ubuvuzi bushingiye ku mirasire cyangwa ubuvuzi bw'imyuka mbere yo kubagwa. Ubu buryo bugabanya ibyimbirwa mu node za lymph, bigatuma byoroha kuzikuraho.

Ariko niba abaganga babaga badashobora gukuraho urugingo rwangiritse, kandi wowe udafite ibimenyetso, muganga wawe ashobora kurukurikirana aho kuvura. Niba ufite ibimenyetso kandi udashobora kubagwa, bashobora kukugira inama yo kuvura MCD.

Kuvura indwara ya Castleman ifata ibice byinshi (MCD)

MCD iragoye kuvura kurusha UCD. Kubera ko ikwirakwira mu mubiri wose, kubaga cyangwa gukoresha imirasire ntibikunze gukoreshwa. Ahubwo, kuvura biterwa niba ufite ubwandu bwa HHV-8 n'ubukana bw'indwara.

Muganga wawe ashobora gukoresha uburyo bwo kuvura nk'ubu:

• Corticosteroids: Iyi miti ifasha kugabanya ububyimbirwe no kugabanya ibimenyetso.
• Imiti ivura indwara ya chimiotherapie: Imiti ivura indwara ya chimiotherapie igenzura ukwiyongera kw'uturemangingo mu mitsi yawe. Rituximab ni umuti ukunze kwandikirwa MCD ifitanye isano na HHV-8.
• Ubudahangarwa bw'umubiri: Ubu buryo bwo kuvura bukoresha ibintu nka antibodiste za monoclonal . Izi zifasha gutuza ubudahangarwa bw'umubiri wawe. Siltuximab (Sylvant®) ni bwo buryo bwonyine bwemewe n'Ikigo gishinzwe ibiribwa n'imiti muri Amerika (FDA) kuri iMCD.
• Imiti igabanya ubukana bwa virusi: Niba ufite MCD ifitanye isano na HHV-8, ushobora gukenera imiti igabanya ubukana bwa virusi kugira ngo uvure ubwandu bwa virusi itera SIDA cyangwa HHV-8.

Ni ryari ngomba kujya kwa muganga?

Niba ubonye ikibyimba cyangwa ikibyimba mu ijosi, mu kwaha, cyangwa mu kibuno, hita ubonana na muganga . Nanone, niba ufite ikindi kimenyetso cy'indwara ya Castleman cyavuzwe haruguru kidakira nyuma y'ibyumweru bike, bwira muganga wawe ibyacyo.

Ushobora kumarana igihe kingana iki n'iyi ndwara?

Ku bantu benshi barwaye UCD, imiterere y'indwara ni nziza cyane. Gukuraho utunyangingo tw'imitsi byangiritse bishobora gukiza iyi ndwara. Iyo umuntu avuwe, UCD ubusanzwe ntigira ingaruka ku mibereho ye.

Ariko uko abantu barwaye MCD bahagaze biterwa n'ubwoko bwa MCD bafite n'uburemere bw'iyi ndwara. Kuri bamwe, ibimenyetso bishobora kugaragara mu buryo butunguranye bikaba byashyira ubuzima mu kaga. Ku bandi, ibimenyetso bishobora kumara igihe kirekire. Hagati ya 65% na 75% by'abantu basanzwe barwaye MCD baracyariho nyuma y'imyaka itanu . Hamwe n'imiti mishya, hari icyizere cy'uko iki kibazo kizagenda neza.

Nta bisubizo byoroshye bihari ku bijyanye n'indwara ya Castleman. Ubunararibonye bwawe buzaterwa n'ubwoko bw'indwara ya Castleman ufite. Izindi ndwara, nka virusi itera SIDA, cyangwa izindi ndwara zijyanye nayo, nka TAFRO na POEMS, na zo zishobora kugira ingaruka ku bunararibonye bwawe. Hari igihe kubagwa no kwitegereza neza bishobora kuba ari byo byonyine bikenewe. Cyangwa, ushobora gukenera uburyo butandukanye bwo kuvura mu buzima bwawe bwose kugira ngo wirinde ingorane. Baza muganga wawe uburyo indwara yawe izagira ingaruka ku buvuzi bwawe n'uko ubona ibintu.

None se, ni ibihe bintu by'ingenzi tugomba kwibuka muri ibi?

• Indwara ya Castleman ni indwara idakunze kugaragara ariko ishobora kuba ikomeye aho ubudahangarwa bwacu bw'umubiri bukora cyane.
• Hari ubwoko bubiri bw'ingenzi: UCD na MCD. Muri UCD, imitsi ibyimba ahantu hamwe, mu gihe muri MCD, ibyimba ahantu henshi.
• Ibimenyetso biratandukanye. Hari igihe nta bimenyetso na gato bihari, hari n'ikibyimba cyabyimbye gusa. Cyangwa hari ibimenyetso nk'umuriro, umunaniro, no kugabanya ibiro.
• Impamvu ntizihora zigaragara neza, ariko virusi ya HHV-8 yagaragaye ko itera MCD. Abantu bafite ubwandu bwa virusi itera SIDA bari mu kaga gakomeye.
• Kumenya kare no kuvurwa neza akenshi bishobora gutuma habaho umusaruro mwiza. Niba rero ubonye ikibyimba kidasanzwe, kubyimba, cyangwa ibindi bimenyetso bidasanzwe ku mubiri wawe, shaka ubufasha bwa muganga ako kanya. Icy'ingenzi ni ukumenya amakuru no kudatinya.

Indwara ya Castleman , Udukoko twa Lymphadenopathy, Ubudahangarwa bw'umubiri, UCD, MCD, HHV-8, Ibimenyetso, Uburyo bwo kuvura