Kuribwa umutwe n'ibibazo byo kutabona bijyana no gusaza: Reka twige ku ndwara ya Giant Cell Arteritis (GCA) cyangwa Temporal Arteritis?

Ese hari umuntu ugeze mu za bukuru wo mu muryango wawe, wenda mama wawe, so wawe, cyangwa nyogokuru, ukunda kwinubira umutwe? Ese amaso yawe asa n'aho afite intege nke icyarimwe? Icyo gihe ni ikintu gishobora kuba ingenzi kuri wewe. Uyu munsi turimo kuvuga ku ndwara yitwa Giant Cell Arteritis (GCA) , yahoze yitwa Temporal Arteritis , ikunze kwibasira abantu bakuru. Nta cyo ugomba gutinya, icy'ingenzi ni ukumenya ibi.

GCA ni iki? Kuki ishobora guteza akaga?

Mu magambo make, indwara ya Giant Cell Arteritis (GCA) ni indwara itera kubyimba imiyoboro minini y'amaraso mu mubiri wawe (cyane cyane iyo mu mutwe, mu ijosi no mu maboko). Abaganga nabo bayita "vasculitis." Iyo imiyoboro y'amaraso ibyimbye muri ubu buryo, inkuta zayo zirushaho kuba nyinshi, bigatuma inzira y'amaraso igabanuka. Tekereza nk'umuyoboro w'amazi ufunze. Iyo amaraso atembera muri ubu buryo, bishobora kwangiza ingingo z'ingenzi n'ingingo zitangwa n'iyo miyoboro y'amaraso.

Imitsi y'amaraso iherereye ku mpande zombi z'agahanga kawe, itanga amaraso mu gahanga kawe, mu mitsi y'urwasaya, no mu mitsi y'amaso, ari na yo mitsi iguha ubushobozi bwo kureba. Iyo GCA igize ingaruka kuri iyi mitsi y'amaraso ikora, ishobora gutera ingorane zikomeye, nko kutabona . GCA ishobora no kugira ingaruka kuri aorta, umutsi munini w'amaraso mu mubiri, no ku mashami yawo. Uku kubyimba kwa aorta byitwa aortite, kandi bishobora gutera ibibazo bikomeye by'ubuzima.

GCA ishobora kugaragara hamwe n'indi ndwara yo kubyimba, Polymyalgia Rheumatica, cyangwa PMR . Tuzavuga byinshi kuri PMR nyuma.

Ese koko GCA ni indwara ikomeye?

Yego, GCA ni indwara ishobora kuba ikomeye iyo idasuzumwe ngo ivurwe hakiri kare . Ibi biterwa nuko:

• Ubushobozi bwo kubona bushobora kwangirika . Ushobora gutakaza ubushobozi bwo kubona butunguranye, cyangwa ushobora guhuma mu jisho rimwe cyangwa yombi.
• Imitsi yawe y'amaraso ishobora kwangirika . Urugero, indwara yitwa aneurysm, ari yo mitsi y'amaraso ibyimba nk'ibara ry'umuhondo ikaturika, yongera ibyago byo guturika kwayo.
• Izindi ndwara, nko gucika intege mu bwonko cyangwa indwara z’ihungabana ry’umubiri (zitwa kandi "mini-stroke"), zishobora kubaho.

Niyo mpamvu ari ingenzi cyane kumenya ibi bimenyetso.

GCA ikunze kugaragara gute?

Nubwo GCA ari imwe mu ndwara zikunze kugaragara cyane mu ndwara ya vasculitis, ni indwara idakunze kugaragara muri rusange. Dukurikije imibare yo muri Leta Zunze Ubumwe za Amerika, abantu 19-23 gusa ni bo barwara iyi ndwara ku bantu 100.000. Nubwo nta mibare nyayo ihari muri Sri Lanka, ni byiza guhangayikishwa n'ibi kuko umubare w'abantu bakuze wiyongera.

Ni ibihe bimenyetso bya GCA (Temporal Arteritis)?

Ikimenyetso nyamukuru kandi gikunze kugaragara cya GCA ni ububabare bukomeye kandi buhoraho bumeze nk'ububabare bukabije ku mpande imwe cyangwa zombi z'umutwe.Ariko uretse ibi, hari n'ibindi bimenyetso bishobora kugaragara:

• Ubwuzu iyo ushyize ikiganza cyawe ku mutwe cyangwa ku mpande zombi z'agahanga (hejuru y'amatwi).
• Kubabara mu munwa , cyane cyane iyo urya cyangwa uhekenya.
• Ibibazo byo kureba : Kureba kabiri, kutabona neza, cyangwa gutakaza amaso mu buryo butunguranye mu gihe gito.
• Umunaniro .
• Umuriro .
• Kubura ubushake bwo kurya cyangwa kugabanya ibiro .
• Ububabare bw'imitsi : Ububabare mu bitugu, mu maboko yo hejuru, mu matako, mu bibero byo hejuru, mu mugongo wo hasi no mu kibuno.

Wibuka igihe navugaga indi ndwara ikunze kujyana na GCA, Polymyalgia Rheumatica (PMR)? Iyi nayo ni indwara itera kubyimba. PMR itera ububabare bukomeye no gukomera , cyane cyane mu bitugu no mu kibuno. PMR ishobora no kubaho ubwayo (bikunze kubaho ko PMR ubwayo ibaho kurusha GCA). Ariko, abantu bagera kuri 40-60% bafite GCA nabo bazagira PMR. Nanone, 10-20% by'abantu bafite PMR bonyine bazarwara GCA mu myaka yabo y'amavuko.

Ni iki gitera GCA?

Abashakashatsi ntibaramenya impamvu nyayo ya GCA, ariko benshi bizera ko ari indwara iterwa n’ubwiyongere bw’umubiri cyangwa indwara iterwa no kubyimbirwa. Muri make, ni igihe ubudahangarwa bw’umubiri wawe bwibasira imiyoboro y’amaraso yawe imeze nabi .

Iyi ndwara ikunze kugaragara cyane mu bantu bakuze, bityo bamwe batekereza ko ifitanye isano no gusaza. Bikekwa kandi ko iterwa n'ibintu bigize imiterere y'umubiri n'ibintu bifitanye isano n'ibidukikije (nk'indwara zigira ingaruka ku budahangarwa bw'umubiri).

Ni nde ubangamirwa cyane na GCA?

Nubwo umuntu wese ashobora kugira GCA, abantu bakurikira ni bo bafite ibyago byinshi:

• Abageze mu zabukuru : GCA hafi ya buri gihe yibasira abantu barengeje imyaka 50. Ibyago byo kurwara iyi ndwara biriyongera uko imyaka igenda ishira. Ikunze kugaragara cyane ku bantu bari hagati y'imyaka 70 na 80.
• Abagore : Iyi ndwara ikunze kugaragara ku bagore kurusha abagabo. Ariko, abagabo bafite ibyago byinshi byo kutabona bitewe n'iyi ndwara.
• Abazungu : Ubushakashatsi bwagaragaje ko GCA yibasira abazungu bakomoka mu Burayi bw'Amajyaruguru kurusha andi moko. Ariko, ibi ntibivuze ko andi moko adashobora kuyiteza imbere.

GCA ipimwa ite?

Niba ufite ibimenyetso bya GCA, muganga wawe abanza kukubaza amateka y'ubuzima bwawe hanyuma akagukorera isuzuma ry'umubiri. Bazagusuzuma niba amagufwa yawe adakomeye mu maboko no mu maguru. Bazagusuzuma kandi umutwe kugira ngo barebe niba ufite ububabare mu mutwe wawe ndetse niba imitsi yo ku mpande zombi z'agahanga kawe yabyimbye.

Ni ibihe bipimo bikoreshwa mu gusuzuma GCA?

Muganga azabanza gutumiza ibipimo byinshi by'amaraso kugira ngo apime urugero rw'ububyimbirwe mu mubiri wawe. Urugero:

• (Igipimo cyo gutwika kw'amashanyarazi y'amaraso) (ESR)
• `(Poroteyine ikora C)` (CRP)

Ibi bizamini bishobora kuguha ishusho y'urugero rw'ububyimbirwe mu mubiri wawe. Bishobora kandi gupima urugero rwa hemoglobine yawe, igice gitwara ogisijeni mu turemangingo dutukura tw'amaraso yawe, kugira ngo harebwe niba ufite amaraso make.

Niba umuganga wawe akeka ko hari GCA (Temporal Arteritis), ashobora gutegeka ko hakorwa ultrasound y'imitsi yo mu gahanga, ultrasound y'imitsi yo mu gahanga. Cyangwa, ashobora gutegeka ko hakorwa biopsy y'imitsi yo mu gahanga . Ibi bisaba ko umuganga wabihuguriwe afata icyitegererezo gito cy'imitsi yo mu gahanga kawe akacyohereza ku muganga w'indwara kugira ngo asuzumwe akoresheje mikorosikopi. Ibi bizasuzuma ibimenyetso by'ububyimbirwe (vasculitis) mu mitsi. Iki ni cyo kizamini nyamukuru cyo kwemeza GCA.

Hari igihe ibi bizamini bishobora no gukenerwa:

• Ikizamini cya scan cya ``(Computed Tomography)`` cyangwa ``(CT)```
• Isuzuma rya Magnetic Resonance (MRI)
• Ultrasound y'imitsi minini
• Ikizamini cyo gupima `(Positron Emission Tomography)` cyangwa `(PET)`

Ni ubuhe buryo bwo kuvura GCA (Temporal Arteritis)?

Kuvura GCA bigomba gutangira vuba bishoboka, cyane cyane kugira ngo hirindwe ko habaho kutabona neza .

Uburyo bw'ingenzi bwo kuvura ni ubwoko bw'umuti witwa "glucocorticoid". Ubwoko bw'umuti bukunze gukoreshwa cyane ni "prednisone." Uzatangirana na miligarama 40 kugeza kuri 60 (mg) ku munsi (ukoresheje umunwa) hanyuma ugabanye buhoro buhoro urugero. Niba usanzwe ufite ibibazo byo kutabona cyangwa kutabona neza, muganga wawe ashobora kuguha doze nyinshi za "glucocorticoids" binyuze mu kanula ishyizwe mu mitsi (``(IV)'').

Icy'ingenzi: Glucocorticoids ni umuti w'ingenzi cyane mu kugenzura GCA. Ariko, iyi miti ishobora gutera ingaruka zimwe na zimwe, bityo muganga wawe azagukurikiranira hafi.

Glucocorticoids zigabanya ubudahangarwa bw'umubiri wawe, ibyo bikaba byatuma urushaho kwandura indwara kandi zikarushaho kuba mbi . Zishobora kandi kugabanya amagufwa yawe , bikongera ibyago byo kuvunika.

Izindi ngaruka mbi zishobora kubaho zirimo:

• Indwara z'amaso
• Umuvuduko ukabije w'amaraso
• Isukari nyinshi mu maraso
• Gusinzira nabi
• Guhindagurika kw'amarangamutima
• Intege nke z'imitsi no gucika intege, cyane cyane mu maguru
• Kubyimba, cyane cyane mu maso no mu maguru
• Kongera ibiro

Mu gihe ufata imiti igabanya ubukana bw'amagufwa yawe, muganga wawe ashobora kugenzura ubucucike bw'amagufwa yawe. Ashobora kandi kukugira inama yo gukora imyitozo ngororamubiri, inyunganiramirire ya kalisiyumu na vitamine D, ndetse wenda n'imiti yo kwirinda indwara ya osteoporosis (gutakaza amagufwa) kugira ngo amagufwa yawe akomeze gukomera.

Mu 2017, Ikigo gishinzwe Ibiribwa n'Imiti muri Amerika cyemeje umuti mushya w’ibinyabuzima witwa tocilizumab (Actemra®) wo kuvura GCA. Uyu muti utangwa nk'urushinge munsi y'uruhu cyangwa nk'umuti utera imiyoboro y'amaraso. Ushobora kugabanya gukenera glucocorticoids. Ariko, tocilizumab ifite ingaruka mbi zayo, muganga wawe azagusobanurira.

Ni ryari ngomba kubonana na muganga?

Niba ufite ibimenyetso bya GCA, ibimenyetso by'ubwandu, cyangwa ikindi kimenyetso gishya, hita ubonana na muganga wawe . Gusura muganga wawe buri gihe no gupimwa amaraso no gupimwa bishobora gufasha kumenya gusubira inyuma (`relapse`) hakiri kare.

Ni ibihe bibazo ngomba kubaza muganga?

Ushobora kubaza muganga wawe ibibazo nk'ibi:

• Ni ubuhe buryo bwo kuvura usaba?
• Ni izihe ngaruka mbi nkwiye kumenya mu gihe cyo kuvurwa?
• Ni iki nakora kugira ngo tugabanye ingaruka mbi zo kuvurwa?
• Ni izihe ngorane zishobora guterwa n'iyi ndwara?
• Ni gute nakurikirana uburwayi bwanjye?
• Ni ibihe bimenyetso byo gusubira inyuma kw'ikiyobyabwenge?
• Ni ibihe bimenyetso ngomba kuguhamagara?

Imyaka yo kubaho y'umuntu ufite GCA ni iyihe?

Kugira GCA ntibyagaragaye ko bigabanya igihe cyo kubaho, ariko hari ibintu bitandukanye bishobora kugira ingaruka kuri ibi. Iyo indwara igaragaye kandi ikavurwa hakiri kare, ibisubizo biba byiza cyane , kandi ibimenyetso bitangira kumera neza mu minsi mike.

Ariko, iyo idavuwe vuba, GCA ishobora gutera ingorane zishobora gushyira ubuzima mu kaga nko gutakaza ubushobozi bwo kureba burundu, kubura imitsi, no gucika intege. Kubwibyo, ni ngombwa cyane kujya kwa muganga vuba niba ufite ibimenyetso bijyanye na GCA.

Iyo ubuvuzi butangiye, ingaruka nyamukuru uhura nazo ni ingaruka mbi z'ubuvuzi . Nanone, nubwo GCA yavurwa mbere ikavurwa neza, rimwe na rimwe ishobora kugaruka (`relapse`) . Abashakashatsi ntibaramenya impamvu ibi bibaho.

Nitwara nte mu gihe mba muri GCA?

Kubana na GCA bishobora kugorana. Kugira ngo wigenzure kandi ugenzure ingaruka mbi za glucocorticoids, gerageza ibi bikurikira:

• Kurya indyo nziza kandi ifite intungamubiri : nk'inyama zitarimo ibinure, ibinyamisogwe, ibinyampeke byuzuye, imbuto n'imboga nshya.
• Kubona vitamine D na kalisiyumu bihagije kugira ngo birinde amagufwa yawe.
• Kora imyitozo ngororamubiri nibura iminota 30 ku munsi.
• Gusinzira neza nibura amasaha arindwi kugeza ku munani buri joro.
• Fata umuti wanditswe ku gihe .
• Jyana na muganga wawe buri gihe .
• Fata ingamba zo kwirinda indwara zandura .

Ni ibihe bintu nkwiye kwirinda iyo mfite GCA?

Niba ufite GCA, ni byiza kwirinda ibi bintu:

• Ibintu byongera ibyago byo kurwara : Kubera ko imiti ya GCA igabanya ubudahangarwa bw'umubiri wawe, uba ufite amahirwe menshi yo kwandura indwara. Baza muganga wawe ubundi buryo bwo kugabanya ibyago byo kwandura, nko kwirinda kurwara, gukaraba intoki kenshi, no kwirinda kwegera abantu barwaye.
• Kunywa itabi : Kunywa itabi bishobora kongera ibyago byo kurwara GCA. Ubuzima bw'imitsi yawe y'amaraso buzarushaho kuba bwiza ukimara kureka kunywa itabi, ibyo bikazakugirira akamaro ubuzima bwawe bwose.
• Kunywa inzoga : Inzoga zishobora kugira ingaruka mbi ku buzima bw'umutima wawe n'imitsi y'amaraso. Zishobora kandi kwihutisha gutakaza amagufwa no kugira ingaruka ku miti ufata ku ndwara yawe.

Ingingo zimwe na zimwe z'ingenzi cyane (Ubutumwa bwo kujyana mu rugo)

Indwara ya Giant Cell Arteritis (yahoze ari Temporal Arteritis) ishobora kuba ikibazo kigoye. Ariko, iyo upimwe kare kandi ukajya kwisuzumisha buri gihe kwa muganga wujuje ibisabwa, ushobora kugira umusaruro mwiza cyane . Ibimenyetso n'ingaruka z'ubuvuzi bishobora kugira ingaruka ku buzima bwawe bwo mu mutwe, ku kazi kawe, no ku bintu byinshi by'ubuzima bwawe. Ariko ntabwo uri wenyine. Saba muganga wawe kugufasha kubona itsinda ry'abagufasha hamwe n'abantu bahuye n'ibintu nk'ibyo. Gusangiza abandi ibyakubayeho n'inama zawe bishobora kuba isoko y'ihumure.

Wibuke ko niba ufite ibimenyetso bidasanzwe nko kuribwa umutwe, kubabara mu rwasaya, cyangwa ibibazo byo kutabona neza (cyane cyane niba urengeje imyaka 50), ntubyirengagize kandi ushake inama kwa muganga ako kanya. Guvurwa vuba bishobora gukumira ingorane zikomeye.

` Giant Cell Arteritis, Temporal Arteritis, GCA, Umutwe, Kubona, Kubyimba imiyoboro y'amaraso, Ubuzima bw'abageze mu zabukuru, Polymyalgia Rheumatica, Prednisone, Vasculitis