Ko iyi M protein idambudziko reitsvo dzakowo here? (Monoclonal Gammopathy of Renal Significance - MGRS) Ngatitaurei nezvazvo!

Tose tinoziva kuti itsvo dzedu nhengo inokosha zvikuru inoita basa rayo chinyararire. Zvisinei, dzimwe nguva itsvo idzi dzinogonawo kurwara chinyararire. Nhasi tichataura nezvechirwere chinokonzera chirwere cheitsvo, chingaite sechakaoma kana ukanzwa zita racho, asi chiri nyore kunzwisisa. Izvi zvinonzi MGRS (Monoclonal Gammopathy of Renal Significance) . Kunyangwe zita racho rakareba zvishoma, musazvidya moyo, ngatirinzwisisei zviri nyore.

Chii chinonzi MGRS?

Zvakanaka, ngatitarisei kuti MGRS chii. Zvichitaurwa zviri nyore, MGRS iboka rezvirwere zvinokuvadza itsvo. Kukuvara uku kunoitika nekuti mamwe masero eplasma emuviri wedu, kana kuti masero eB (aya marudzi emasero machena eropa), anoita makopi akawanda awo, kana kuti maclones . Funga nezvazvo semuchina wefotokopi unoita makopi akawanda epepa rimwe chete.

Masero eplasma anoumbwa nenzira iyi anogadzira rudzi rweantibody inonzi M protein . Mapuroteni aya eM anochengetwa munhengo dzakasiyana dzemuviri wedu, kunyanya itsvo, uye anotanga kudzikuvadza.

Chinhu chakakosha ndechekuti MGRS haisi kenza. Zvisinei, vanhu vashoma vane MGRS vanogona kuzopedzisira vava nekenza, yakadai se multiple myeloma . Saka zvakakosha kuziva izvi.

Kune mhando dzeMGRS here?

Ehe, kune marudzi anopfuura gumi nemaviri ezvirwere zveMGRS. Izvi zvinorongwa zvichienderana nechikamu chipi cheitsvo chinokanganisa puroteni yeM. Kune mapoka matatu makuru:

1. Zvirwere zveGlomerular

Rudzi rweMGRS rwakajairika iglomerulopathies . Izvi zvinokuvadza mitsipa midiki yeropa iri mukati meitsvo. Zvakafanana nemaburi ari mufiriji yemvura. Zvimwe zvezvirwere zvinowira muchikamu ichi zvinosanganisira:

• Itsvo amyloidosis. Izvi zvinosanganisira mhando dzinonzi AL amyloidosis, AH amyloidosis, uye AHL amyloidosis.
• Cryoglobulinemic glomerulonephritis (CG).
• Kuongororwa kwefibrillary glomerulopathy (FGN).
• Immunotactoid glomerulopathy (ITG).
• Zvirwere zveglomerular zvine chekuita nemapuroteni emonoclonal. Izvi zvinosanganisira zvirwere zvinonzi `light chain` uye `heavy chain deposition diseases`.

2. Zvirwere zveTubulointerstitial

Zvirwere izvi zvinokanganisa machubhu (tubules) anotakura zvinovaka muviri nemvura zvinoseferwa neitsvo zvichidzokera muropa, pamwe nenyama dzakaapoteredza. Mimwe mienzaniso inosanganisira:

• Chirwere cheFanconi chechiedza (LCFS).
• Chiketani chechiedza cheproximal tubulopathy (LCPT) chisina makristaro.
• Histiocytosis inochengeta makristaro.

3. Matambudziko anokanganisa tsinga dzeropa dziri muitsvo (Intra-renal vascular loses)

Matambudziko aya anokanganisa tsinga dzeropa dziri muitsvo. Muenzaniso ndewe atypical hemolytic uremic syndrome (aHUS) . Apa ndipo apo tsinga diki dzeropa dziri muitsvo dzinovharika nekuda kweropa rakagwamba.

MGRS yakajairika zvakadii?

MGRS chirwere chisingawanzoitiki . Zvinofungidzirwa kuti chinobata vanhu vari pasi pe1% yevanhu. Chinonyanya kuitika kuvanhu vane makore anopfuura makumi matanhatu .

Ndezvipi zviratidzo zveMGRS?

Zviratidzo zveMGRS zvinogona kusiyana zvichienderana nerudzi rweMGRS yaunayo. Zvimwe zviratidzo zvakajairika zvinosanganisira:

• Kunzwa kuneta zvakanyanya (kuneta) .
• Kuzvimba mumakumbo epasi, muzvitsitsinho, kana mutsoka. Dzimwe nguva dumbu, maoko, kana kumeso zvinogonawo kuzvimba.
• Chirwere cheNephrotic chinoitika. Izvi zvinoonekwa nekubuda kwemapuroteni muweti uye huwandu hwakawanda hwecholesterol muropa.
• Weti ine furo kana sipo . Izvi zvinogona kuva chiratidzo cheprotein muweti (proteinuria).
• Kugara uchiita weti zvinoreva kuti unoda kuita weti nguva nenguva.
• Ropa muweti (hematuria) kana weti yepingi.
• Kusvotwa nekurutsa.
• Chirwere chePOEMS . Ichi chirwere chisingawanzoitiki.
• Kunzwa kusanzwa, kukwenya, kana kushaya simba mumakumbo (izvi zviratidzo zve neuropathy).
• Kuchinja ruvara rweganda (mavara akajeka kana matema).
• Kutadza kufema zvakanaka (dyspnea).

Chii chinokonzera MGRS?

Chikonzero chikuru cheMGRS kukuvara kweitsvo kunokonzerwa nemapuroteni eM ataurwa pamusoro apa. Mapuroteni eM imhando yeantibody isingashande nemazvo, uye inogadzirwa zvisirizvo. Anogadzirwa kubva kumakopi akakuvara emasero eplasma, rudzi rwemasero machena eropa, kana masero eB.

Vamwe vanhu vanogona kuva nema clones aya emasero eplasma anogadzira mapuroteni eM pasina kukuvadza nhengo dzemuviri. Dambudziko iri rinonzi Monoclonal Gammopathy of Undetermined Significance (MGUS) . Zvisinei, kune vanhu vane MGRS, mapuroteni eM aya anoungana muitsvo uye anodzikuvadza.

Chii chinonyanya kukonzera MGRS?

Nyanzvi hadzisati dzaziva kuti chii chinokonzera MGRS. Zvirwere zve autoimmune , shanduko dzemajini , hutachiona, nezvimwe zvinhu zvinoonekwa sezviri kukonzera izvi.

Ndezvipi zvinetso zvinogona kuitika nekuda kweMGRS?

Ma clones aya eplasma cell uye MGRS zvinogona kukonzera kukuvara kweitsvo, izvo zvinogona kukonzera matambudziko akakomba. Zvimwe zvacho zvinosanganisira:

• Chirwere cheitsvo chisingaperi (CKD) .
• Chirwere cheitsvo (chekupedzisira) .
• Kukundikana kweitsvo .
• Kukura kuita zvimwe zvirwere. Mune vamwe vanhu, huwandu hwemasero eplasma hunowanda zvekuti hunogona kukura kuita mhando yekenza yemasero machena inonzi multiple myeloma (MM) . MGRS inogona zvakare kukura kuita mamwe makenza, akadai seWaldenström macroglobulinemia , chronic lymphocytic leukemia (CLL) , kana B-cell lymphoma .

MGRS inoonekwa sei?

Chiremba anogona kusimbisa MGRS nekuita biopsy yeitsvo . Izvi zvinosanganisira kutora chidimbu chidiki chenyama kubva muitsvo yako wochiyedza kana paine protein yeM. Vanogonawo kuyedza sampuro dzeropa rako, weti, kana mupfupa.

Pane mushonga weMGRS here?

Ehe, kune mishonga yekurapa MGRS. Vanachiremba vanoirapa nemishonga yakafanana nechemotherapy yekenza. Mishonga iyi inouraya masero ari kukonzera dambudziko kana kuadzivisa kugadzira mamwe makopi. Mimwe mishonga inogona kubatsira kuderedza kuzvimba. Chinangwa chikuru chekurapa ndechekuchengetedza itsvo dzako dzichishanda uye kudzimisa kukuvara.

Mune dzimwe nguva dzeMGRS, vanachiremba vanogonawo kuita stem cell transplant . Izvi zvinotsiva masero ako akakuvara nemasero ane hutano. Kana itsvo dzako dzakakuvara zvakanyanya, ungangodawo dialysis kana transplant itsvo .

Mishonga chaiyo uye marapirwo anoshandiswa pakurapa MGRS

Rudzi rwemishonga yaunopiwa runoenderana nerudzi rweMGRS yaunayo. Heano mamwe marapirwo aunogona kuita:

• Ma antibodies e monoclonal - semuenzaniso rituximab, daratumumab.
• Mishonga inodzivirira mapuroteni - semuenzaniso bortezomib, carfilzomib, ixazomib.
• Mishonga inogadzirisa muviri - semuenzaniso thalidomide, lenalidomide, pomalidomide.
• Mishonga yeAlkylating - semuenzaniso cyclophosphamide, bendamustine, melphalan.
• Corticosteroids - semuenzaniso prednisone, dexamethasone.
• Kuisirwa kwemasero emuviri e autologous.

Ndezvipi migumisiro yekurapwa?

Kurapa kwakadai se chemotherapy kunogona kukonzera migumisiro yakaipa, dzimwe nguva kutokuvadza nhengo dzemuviri. Ndosaka vanachiremba vachisarudza kurapwa nokungwarira kuti vawane rubatsiro rwakanyanya kubva makuri uye kuderedza njodzi yemigumisiro yakaipa. Mimwe yemigumisiro yaungasangana nayo inosanganisira:

• Anemia ( kushomeka kweropa).
• Kubuda ropa.
• Kuzvimba.
• Manyoka.
• Ndaneta.
• Kuwanda kwenjodzi yehutachiona hwemavhairasi, mabhakitiriya uye fungi.
• Chikafu hachina kunaka.
• Kusvotwa nekurutsa.

Ko MGRS inogona kudzivirirwa here?

Nekuti hatizivi chaizvo chinokonzera MGRS, pari zvino hapana nzira chaiyo yekudzivirira.

Chii chaungatarisira kana uine MGRS?

Kunyange hazvo MGRS iri chirwere chinorapika, kazhinji hachiperi zvachose. Chinogona kudzoka mushure mekurapwa. Kana itsvo dzako dzakakuvara zvakanyanya, ungangoda kuisirwa itsvo.

Vanhu vanosvika 18% vane MGRS vanozopedzisira vava negomarara rinonzi multiple myeloma. Saka, chiremba wako achakutarisa nguva dzose achishandisa ropa neweti, sezvo izvi zvichigona kuonekwa nekukurumidza kana zvikaitika.

Ungararama kwenguva yakareba sei neMGRS?

Nguva yaunogona kurarama neMGRS zvinoenderana nerudzi rweMGRS yaunayo, kuoma kwayo, uye kuti unopindura sei kana warapwa. Vanhu vasina kukuvara kwakanyanya kweitsvo vane maonero ari nani pane vanhu vane kukuvara kwakanyanya. Semuenzaniso, mune imwe ongororo, vanhu vane amyloidosis yakabatana neMGRS vakararama avhareji yemakore angangoita gumi mushure mekuonekwa vaine chirwere ichi. Asi vanhu vasina amyloidosis vakararama kwenguva yakareba. Uyewo, vanhu vanopindura zvakanaka kana warapwa vane mhedzisiro yakanaka.

Ndinozvitarisira sei?

Iva nechokwadi chekutevedzera chero mazano anopiwa nachiremba wako ekutarisira hutano hweitsvo dzako kumba. Izvi zvinogona kusanganisira kuderedza zvinhu zvakaita sedoro, uye kudzora njodzi dzechirwere cheitsvo, zvakaita seBP nechirwere cheshuga. Kunyange zvazvo zvinhu izvi zvisingakwanise kurapa zvakananga MGRS, zvinogona kubatsira kuderedza njodzi yekukuvara kweitsvo zvakare. Chiremba wako anogonawo kukubatsira kudzora migumisiro yekurapwa.

Ndinofanira kuona chiremba rini?

Kana uine zviratidzo zvedambudziko reitsvo, zvakaita sekuzvimba, weti ine furo kana kuti pink, kuita weti kakawanda, kana kuti kuita weti shoma, iva nechokwadi chekuti waona chiremba.

Mibvunzo ipi yandinofanira kubvunza chiremba wangu?

Zvingabatsira kubvunza chiremba wako mibvunzo iyi:

• Ndeapi marapirwo aripo emhando yeMGRS yandinayo?
• Ndingaitei kuti ndidzivise kukuvara kweitsvo?
• Ndezvipi zviratidzo zvitsva kana kuti zviri kuipa zvandinofanira kutarisa?

Chekupedzisira, chinhu chinonyanya kukosha (Mharidzo Yekuenda Kumba)

MGRS chirwere chakakomba chinogona kukuvadza itsvo nenzira inogona kuisa hupenyu panjodzi. Asi yeuka, havasi vese vane MGRS vanozobatwa nekenza. Chiremba wako achakutarisa nguva dzose uye achatora matanho ekuona nekurapa chero matambudziko matsva nekukurumidza . Kurapa kutsva kwave kuita kuti zvikwanisike kuvandudza hupenyu hwako uye kuderedza njodzi yako yekurwara zvakakomba. Saka usatya, tevera zano rachiremba wako, uye tarisana nechirwere ichi.

` MGRS, Monoclonal Gammopathy yeKukosha kweRenal, Chirwere cheItsvo, Mapuroteni eM, Masero ePlasma, Biopsy yeItsvo, Nephrotic Syndrome, Multiple Myeloma