Ese iyi poroteyine ya M ni ikibazo ku mpyiko zawe? (Monoclonal Gammopathy of Renal Significance - MGRS) Reka tubiganireho!

Twese tuzi ko impyiko zacu ari urugingo rw'ingenzi cyane rukora akazi karwo bucece. Ariko, rimwe na rimwe izi mpyiko zishobora no kurwara bucece. Uyu munsi tugiye kuvuga ku ndwara itera indwara z'impyiko, ishobora gusa n'aho igoye iyo wumvise izina, ariko ikaba yoroshye kuyumva. Iyi yitwa MGRS (Monoclonal Gammopathy of Renal Significance) . Nubwo izina ari rirerure gato, ntugahangayike, reka tubisobanukirwe mu buryo bworoshye.

MGRS ni iki mu buryo bworoshye?

Reka turebe icyo MGRS ari cyo. Mu magambo make, MGRS ni itsinda ry'indwara zangiza impyiko. Uku kwangirika kubaho kubera ko zimwe mu selile zo mu maraso z'umubiri wacu, cyangwa selile B (izi ni ubwoko bw'iselile z'amaraso zera), zikora kopi nyinshi cyane zazo, cyangwa zigahinduka clones . Tekereza nk'imashini ikora kopi nyinshi z'urupapuro rumwe.

Uturemangingo twa plasma dukora muri ubu buryo dukora ubwoko bwa antibody yitwa poroteyine ya M. Izi poroteyine za M zishyirwa mu ngingo zitandukanye z'umubiri wacu, cyane cyane impyiko, maze zigatangira kwangiza.

Igikuru ni uko MGRS atari kanseri. Ariko, umubare muto w'abantu barwaye MGRS bashobora kurwara kanseri, nka myeloma nyinshi . Bityo rero ni ngombwa kubimenya.

Ese hari ubwoko bwa MGRS?

Yego, hari ubwoko burenga icumi na bubiri bw'indwara za MGRS. Izi ndwara zishyirwa mu byiciro hakurikijwe igice cy'impyiko poroteyine ya M ikoraho. Hari ibyiciro bitatu by'ingenzi:

1. Indwara za glomeruli

Ubwoko bukunze kugaragara bwa MGRS ni glomerulopathies . Izi zangiza imiyoboro mito y'amaraso iri mu mpyiko. Zimeze nk'udusimba turi mu kayunguruzo k'amazi. Zimwe mu ndwara zigwa muri iki cyiciro zirimo:

• Amyloidosis y'impyiko. Ibi birimo ubwoko bwitwa AL amyloidosis, AH amyloidosis, na AHL amyloidosis.
• Indwara ya Cryoglobulinemic glomerulonephritis (CG).
• Indwara ya Fibrillary glomerulopathy (FGN).
• Indwara ya glomerulopathy y’imyuka idafite ubushobozi bwo kuvura indwara (ITG).
• Indwara za glomerular zifitanye isano na poroteyine za monoclonal. Ibi birimo indwara zitwa 'uruhererekane rworoheje' na 'indwara zo kubika uruhererekane rukomeye'.

2. Indwara za Tubulointerstitial

Izi ndwara zigira ingaruka ku miyoboro (tubules) itwara intungamubiri n'amazi byayunguruwe n'impyiko bikabijyana mu maraso, no mu ngingo ziyikikije. Ingero zimwe zirimo:

• Indwara ya Fanconi y'uruhererekane rw'uburibwe (LCFS).
• Udukoko tw’uruhererekane rw’uruhererekane rw’uruhererekane rw’urujya n’uruza (LCPT) tudafite kristu.
• Histiocytosis ikomeza kubika kristu.

3. Indwara zigira ingaruka ku mitsi y'amaraso iri mu mpyiko (Ibisebe byo mu mitsi y'impyiko)

Izi ndwara zigira ingaruka ku mitsi y'amaraso mu mpyiko. Urugero ni indwara idasanzwe ya hemolytic uremic syndrome (aHUS) . Ibi ni igihe imitsi mito y'amaraso mu mpyiko ifungwa n'amaraso afunganye.

MGRS ikunze kugaragara gute?

Mu by’ukuri MGRS ni indwara idakunze kugaragara cyane . Bivugwa ko yibasira munsi ya 1% by’abaturage. Ikunze kugaragara cyane cyane ku bantu barengeje imyaka 60 .

Ni ibihe bimenyetso bya MGRS?

Ibimenyetso bya MGRS bishobora gutandukana bitewe n'ubwoko bwa MGRS ufite. Bimwe mu bimenyetso bisanzwe birimo:

• Kumva unaniwe cyane (umunaniro) .
• Kubyimba amaguru yo hasi, ku tuguru, cyangwa ku birenge. Hari igihe igifu, amaboko, cyangwa isura nabyo bishobora kubyimba.
• Indwara ya Nephrotic ibaho. Ibi bigaragazwa no gusohora poroteyine mu nkari no kwiyongera kwa cholesterol mu maraso.
• Inkari zifite ifuro cyangwa isabune . Iki gishobora kuba ikimenyetso cya poroteyine mu nkari (proteinuria).
• Kwihagarika kenshi ni ngombwa ko ujya uhagarika kenshi.
• Amaraso mu nkari (hematuria) cyangwa inkari z'umutuku.
• Isesemi no kuruka.
• Indwara ya POEMS . Iyi nayo ni indwara idasanzwe.
• Kubura ibinure, gucika intege, cyangwa intege nke mu maguru (ibi ni ibimenyetso by'indwara z'imitsi).
• Guhindura ibara ry'uruhu (uduheri tw'urumuri cyangwa twijimye).
• Kugorwa no guhumeka (dyspnea).

Ni iki gitera MGRS?

Impamvu nyamukuru itera MGRS ni ukwangirika kw'impyiko guterwa na poroteyine za M zavuzwe haruguru. Poroteyine za M ni ubwoko bw'umubiri udakora neza, kandi ukorwa nabi. Zikorwa mu makopi yangiritse y'uturemangingo twa plasma, ubwoko bw'uturemangingo tw'amaraso twera, cyangwa uturemangingo twa B.

Hari abantu bashobora kugira izi clones z’uturemangingo twa plasma dukora poroteyine za M ariko ntigire ingaruka ku ngingo iyo ari yo yose. Iyi ndwara yitwa Monoclonal Gammopathy of Undetermined Significance (MGUS) . Ariko, ku bantu bafite MGRS, izi poroteyine za M zirundanya mu mpyiko zikazangiza.

Ni iyihe mpamvu nyamukuru itera MGRS?

Impuguke ntiziramenya neza icyatera MGRS. Indwara z’ubudahangarwa bw’umubiri , impinduka mu ngirabuzimafatizo , indwara zandura, n’ibidukikije byose bivugwa ko ari byo biyitera.

Ni izihe ngorane zishobora guterwa na MGRS?

Izi selile za plasma na MGRS zishobora kwangiza impyiko, bikaba byatera ingorane zikomeye. Zimwe muri zo zirimo:

• Indwara y'impyiko idakira (CKD) .
• Indwara y'impyiko (impyiko) mu cyiciro cya nyuma .
• Kunanirwa kw'impyiko .
• Itera imbere rigahinduka izindi ndwara. Kuri bamwe, umubare w’uturemangingo tw’amaraso twiyongera cyane ku buryo dushobora guhinduka kanseri y’uturemangingo tw’amaraso tw’umweru yitwa multiple myeloma (MM) . MGRS ishobora kandi guhinduka izindi kanseri, nka Waldenström macroglobulinemia , chronic lymphocytic leukemia (CLL) , cyangwa B-cell lymphoma .

Ni gute indwara ya MGRS ipimwa?

Muganga ashobora kwemeza MGRS akoze biopsy y'impyiko . Ibi bikubiyemo gufata agace gato k'umubiri mu mpyiko yawe no gupima poroteyine ya M. Bashobora kandi gupima ingero z'amaraso yawe, inkari, cyangwa umwongo w'amagufwa.

Ese hari uburyo bwo kuvura MGRS?

Yego, hari uburyo bwo kuvura MGRS. Abaganga bayivura bakoresheje imiti isa na chimiotherapie ivura kanseri. Iyi miti yica uturemangingo dufite ikibazo cyangwa ikabuza gukora izindi. Indi miti ishobora gufasha kugabanya kubyimba. Intego nyamukuru yo kuvura ni ugukomeza gukora kw'impyiko no kuzikumira kwangirika.

Mu bihe bimwe na bimwe bya MGRS, abaganga bashobora no gutera uturemangingo tw’umubiri . Ibi bisimbura uturemangingo twangiritse n’uturemangingo tuzima. Niba impyiko zawe zangiritse cyane, ushobora no gukenera dialyse cyangwa guterwa impyiko .

Imiti yihariye n'uburyo bwo kuvura bukoreshwa kuri MGRS

Ubwoko bw'imiti uhabwa buzaterwa n'ubwoko bwa MGRS ufite. Dore amwe mu mahitamo yo kuvura:

• Utunyangingo tw’umubiri twitwa monoclonal - urugero: rituximab, daratumumab.
• Imiti igabanya ubukana bwa poroteyine - urugero: bortezomib, carfilzomib, ixazomib.
• Imiti igabanya ubukana bw'umubiri - urugero: thalidomide, lenalidomide, pomalidomide.
• Ibintu bigabanya ubushyuhe - urugero nka cyclophosphamide, bendamustine, melphalan.
• Corticosteroids - urugero nka prednisone, dexamethasone.
• Gutera uturemangingo tw’umubiri twitwa Autologous.

Ingaruka mbi z'ubuvuzi ni izihe?

Uburyo bwo kuvura nka chimiotherapie bushobora gutera ingaruka mbi nyinshi, rimwe na rimwe ndetse no kwangiza ingingo. Niyo mpamvu abaganga bahitamo uburyo bwo kuvura witonze cyane kugira ngo bungukire cyane kandi bugabanye ibyago byo kugira ingaruka mbi zikomeye. Zimwe mu ngaruka mbi ushobora guhura nazo zirimo:

• Anemia ( kubura amaraso).
• Kuva amaraso.
• Kwihagarika impatwe.
• Impiswi.
• Ndananiwe.
• Ubwiyongere bw'ibyago byo kwandura virusi, bagiteri n'ibihumyo.
• Ibiryo nta buryohe bwabyo.
• Isesemi no kuruka.

Ese MGRS ishobora kwirindwa?

Kubera ko tutazi neza icyatera MGRS, nta buryo bwihariye bwo kuyirinda buriho.

Ni iki wakwitega niba ufite MGRS?

Nubwo MGRS ari indwara ishobora kuvurwa, ubusanzwe ntishira burundu. Ishobora kongera kugaruka nyuma yo kuvurwa. Iyo impyiko zawe zangiritse cyane, ushobora gukenera guterwa impyiko.

Abantu bagera kuri 18% barwaye MGRS nyuma bazarwara kanseri yitwa multiple myeloma. Kubwibyo, muganga wawe azagukurikirana buri gihe akoresheje amaraso n'inkari, kuko ibi bishobora kumenyekana hakiri kare iyo bibaye.

Ushobora kumarana igihe kingana iki na MGRS?

Igihe ushobora kumarana na MGRS giterwa n'ubwoko bwa MGRS ufite, ubukana bwayo, n'uko witwara iyo uvuwe. Abantu bafite ikibazo gito cy'impyiko bafite icyerekezo cyiza kurusha abantu bafite ikibazo gikomeye. Urugero, mu bushakashatsi bumwe, abantu bafite amyloidosis ifitanye isano na MGRS babayeho imyaka igera ku 10 nyuma yo kurwara. Ariko abantu badafite amyloidosis baramara igihe kirekire. Nanone, abantu bitabira neza iyo bavuwe bagira umusaruro mwiza.

Nitwara nte?

Menya neza ko ukurikiza inama zose muganga aguhaye zo kwita ku buzima bw'impyiko zawe mu rugo. Ibi bishobora kuba birimo kugabanya ibintu nk'inzoga, no kugenzura ibintu bishobora gutera indwara z'impyiko, nk'umuvuduko ukabije w'amaraso na diyabete. Nubwo ibi bintu bidashobora kuvura MGRS mu buryo butaziguye, bishobora kugabanya ibyago byo kwangirika kw'impyiko. Muganga wawe ashobora kandi kugufasha gucunga ingaruka mbi zo kuvurwa.

Ni ryari ngomba kujya kwa muganga?

Niba ufite ibimenyetso by'ikibazo cy'impyiko, nko kubyimba, inkari zirimo ifuro cyangwa umutuku, kwihagarika kenshi, cyangwa kwihagarika gake cyane, menya neza ko wagiye kwa muganga.

Ni ibihe bibazo ngomba kubaza muganga wanjye?

Bishobora kuba byiza kubaza muganga wawe ibi bibazo:

• Ni ubuhe buryo bwo kuvura buboneka ku bwoko bwa MGRS mfite?
• Ni iki nakora kugira ngo wirinde kwangirika kw'impyiko?
• Ni ibihe bimenyetso bishya cyangwa birushaho kuba bibi ngomba kwitondera?

Amaherezo, ikintu cy'ingenzi cyane (Ubutumwa bwo kujyana mu rugo)

MGRS ni indwara ikomeye ishobora kwangiza impyiko mu buryo bushobora gushyira ubuzima mu kaga. Ariko ibuka ko atari buri wese urwaye MGRS uzarwara kanseri. Muganga wawe azagukurikirana buri gihe kandi agafata ingamba zo kumenya no kuvura ibibazo bishya vuba bishoboka . Ubu buryo bushya bwo kuvura bwatumye ubuzima bwawe burushaho kuba bwiza kandi bukagabanya ibyago byo kurwara indwara zikomeye. Ntutinye rero, kurikiza inama za muganga wawe, kandi uhangane n'iki kibazo.

MGRS , Monoclonal Gammopathy ifite akamaro k'impyiko, Indwara z'impyiko, Poroteyine za M, Uturemangingo twa Plasma, Indwara y'impyiko, Indwara ya Nephrotic, Myeloma nyinshi