Yintoni i-Felty Syndrome? Oku kubalulekile kwabo bane-arthritis!

Usenokuba neentlungu zamalungu, ukudumba, kunye nokuqina kancinci kwamalungu akho kusasa, akunjalo? Uninzi lwexesha, ezi zinokubangelwa yi-rheumatoid arthritis. Kodwa ubusazi ukuba kukho enye ingxaki enokubangelwa yile meko ye-arthritis, kodwa ayaziwa kangako, kodwa kubaluleke kakhulu ukuyazi? Leyo yi-Felty Syndrome. Makhe sithethe ngale nto ngeenkcukacha ezithe vetshe namhlanje.

Yintoni kanye kanye iFelty Syndrome?

Ngamafutshane, i-Felty Syndrome yindibaniselwano yeemeko ezintathu ezenzeka kunye. Nazi:

• I-Rheumatoid Arthritis - Ukudumba kwamalungu okuqheleneyo uninzi lwenu.
• I-Neutropenia - Oku kukuncipha kwenani lee-neutrophils, uhlobo lweeseli ezimhlophe zegazi egazini.
• I-Splenomegaly - Oku kuthetha ukuba i-spleen, ilungu lomzimba, iba nkulu kunesiqhelo.

Idla ngokuqala nge-rheumatoid arthritis (RA). Ezinye iimeko ezimbini zenzeka njengeengxaki ze-RA. Oogqirha bazibiza ezi 'mpawu ze-extra-articular'. Oko kukuthi, i-arthritis ayipheleli nje kumalungu, kodwa ichaphazela amalungu angaphandle kwawo. Oku kungenxa yenkqubo yokudumba ebangela i-arthritis. Nangona kuqhelekile ukuba ezi ntlobo zeziphumo zenzeke ngaphandle kwamalungu ane-RA, i-Felty Syndrome yimeko engaqhelekanga.

Oku kukuchaphazela njani?

Isifo sikaFelty siqala ngeRheumatoid Arthritis. Emva koko uba nentlungu ebuhlungu kunye nokudumba kwamalungu akho. Emva koko, xa kuvela iimeko ezifana neNeutropenia kunye neSplenomegaly, ichaphazela inkqubo yakho yomzimba . INeutropenia kukuncipha kohlobo lweseli emhlophe yegazi ebizwa ngokuba yi-neutrophils. Ezi neutrophils luhlobo olubaluleke kakhulu lweseli olukhusela imizimba yethu kwizifo. Ngoko ke xa zincipha, amathuba okukhula kwezifo ayanda. Ukwanda kwespleen kunokuba sesinye isizathu sokuncipha kwe-neutrophils.

Ixhaphake kangakanani le meko?

Isifo sikaFelty senzeka kubantu abamalunga ne-2% abane-rheumatoid arthritis. Njenge-RA, isifo sikaFelty sixhaphake ngokuphindwe kathathu kwabasetyhini kunakwamadoda. Okubangela umdla kukuba, phantse bonke abantu abane-RA abafumana isifo sikaFelty 'bane-seropositive'. Oku kuthetha ukuba uvavanyo luqinisekisa ukuba banento ebizwa ngokuba yi-rheumatoid factor antibodies egazini labo. Abantu 'abane-seronegative', oko kuthetha ukuba abantu abangenazo ezo antibodies, abafane babe ne-Felty's syndrome.

Zithini iimpawu zoku?

Amaxesha amaninzi, iimpawu zokuqala ezibonakala zezo zesifo samathambo esibizwa ngokuba yi-rheumatoid arthritis. Ezi ziquka:

• Intlungu yamalungu
• Ukudumba kwamalungu
• Ukuqina kwamalungu, ingakumbi kusasa

Abanye abantu banokufumana ezinye iimpawu ukongeza kwi-RA kumalungu abo. Umzekelo:

• Amaqhuma ayenzeka phantsi kolusu kufutshane namalungu (la abizwa ngokuba zii-rheumatoid nodules)
• Ii-lymph nodes ezivuvukileyo kwiindawo ezifana nentamo nasemakhwapheni
• Isibindi sisenokudumba kwaye sibe buhlungu xa usichukumisa.
• Amehlo nomlomo owomileyo (oku kubizwa ngokuba yi-Sjogren's syndrome)
• Amehlo abomvu, avuvukileyo (oku kubizwa ngokuba yi-episcleritis)
• Izilonda zesikhumba, ingakumbi emilenzeni
• Iimpawu zokopha phantsi kolusu
• Ubunzima bokuphefumla ngenxa yokudumba kwemiphunga
• Intlungu yesifuba ngenxa yokudumba okujikeleze intliziyo
• Ifiva
• Ukudinwa kunye nokudinwa
• Ukulahlekelwa ngumdla wokutya okanye ukunciphisa umzimba ngendlela engachazekiyo

Ukongeza kwezi, i-Felty Syndrome ikwanazo nezinye iimpawu. Ngamanye amaxesha ezi mpawu zinokuvela ngaphambi kokuba iimpawu ze-RA ziqale.

• Izifo ezixhaphakileyo nezihlala ixesha elide. Imizekelo ibandakanya umkhuhlane, ukudumba kwesisu, kunye nezifo zolusu.
• Ukudumba kwepleen. Kusenokuvakala esandleni kwaye kusenokuba buhlungu.
• Ukutshintsha kombala wolusu (njengamabala).

Kodwa into emangalisayo kukuba, ngamanye amaxesha unokufunyanwa une-Felty Syndrome ngaphandle kweempawu. Uvavanyo lwegazi kunye neeskeni zinokubonisa ukuba unazo zonke ezi meko zintathu ngaphambi kokuba uve naziphi na iimpawu.

Oku kudla ngokuqala xa uneminyaka emingaphi?

I-Felty Syndrome idla ngokukhula kubantu abadala, abaphakathi kweminyaka engama-50 ukuya kwengama-70. Kubantu abaninzi, i-Felty Syndrome ibonakala emva kokuba bebonakalise iimpawu ze-rheumatoid arthritis kangangeminyaka eli-10 ukuya kweli-15.

Kutheni i-Felty Syndrome isenzeka?

I-rheumatoid arthritis 'sisifo esihlasela umzimba'. Oku kuthetha ukuba inkqubo yethu yokuzikhusela komzimba ihlasela amalungu omzimba wethu ngokungathi lutshaba. Izazinzulu ezininzi zikholelwa ukuba i-Felty Syndrome yingxaki enkulu ye-RA. Kwezi zifo zokuzikhusela komzimba, imizimba yethu ivelisa 'ii-antibodies' ezichasene neeproteni ezithile. Ezi antibodies ziyahamba zibambe ezo proteni kwaye zibonise ukuba zitshatyalaliswe. Le yindlela ukudumba okwanda ngayo.

Ezi antibodies zisenokungabikho rhoqo kwi-RA. Nangona kunjalo, kubantu abane-Felty Syndrome, ezi antibodies ngokuqinisekileyo zikhona. Ubukho bezi antibodies sisizathu sokuba i-RA ibe nzima ngakumbi kwaye ezinye iziphumo ngaphandle kwamalungu (iimpawu ze-extra-articular) ziyanda. I-RA ene-antibodies ibizwa ngokuba yi-'seropositive RA'. Uphando lubonisa ukuba zombini i-seropositive RA kunye ne-Felty Syndrome zinxulunyaniswa 'nezinto ezithile zemfuza'. Oku kuthetha ukuba zinokudluliselwa kwizizukulwana ukuya kutsho kwinqanaba elithile.

I-rheumatoid arthritis (RA) ibangela njani i-neutropenia kunye ne-splenomegaly?

Indlela i-Neutropenia eyenzeka ngayo

I-Neutropenia kukuncipha kwenani leeseli ezimhlophe zegazi ezibizwa ngokuba zii-neutrophils. Kukho izizathu ezibini eziphambili zoku. Esinye kukuba umongo wakho wethambo awuvelisi ii-neutrophils ezaneleyo. Okanye, ii-neutrophils emzimbeni wakho ziyatshatyalaliswa. Kwi-Felty Syndrome, zombini ezi zinto zinokwenzeka. Inkqubo yokuzikhusela komzimba ekhankanyiweyo ngaphambili inokuphazamisana nokuveliswa kwee-neutrophils kumongo wethambo, kwaye ii-neutrophils esele zenziwe zinokutshatyalaliswa. Kwakhona, i-spleen ekhulisiweyo sesinye isizathu sokuncipha kwee-neutrophils.

Indlela i-Splenomegaly eyenzeka ngayo

Umsebenzi wespleen yakho kukucoca iiseli zegazi ezindala nezingenamsebenzi egazini lakho. Kodwa xa ispleen yakho iba nkulu kakhulu (i-spleen), iba negalelo elikhulu kwaye iqale ukususa iiseli zegazi ezininzi ezilungileyo. I-rheumatoid arthritis ngamanye amaxesha inokubangela i-spleen enkulu. Isizathu esichanekileyo asikacaci. Ispleen inokukhula ngaphandle kwe-neutropenia. Kwakhona, kunqabile kakhulu, i-Felty Syndrome inokwenzeka ngaphandle kwespleen enkulu.

Ziziphi iingxaki eziyingozi zeFelty Syndrome?

Ngenxa yokuba i-Felty Syndrome iyenza buthathaka inkqubo yakho yomzimba yokuzikhusela, usemngciphekweni omkhulu wokufumana usulelo oluqhelekileyo nolunzima . Nokuba uhlala unesifo esincinci esinyangwa lula, esi sifo sinokuba sibi kakhulu kangangokuba singabi sibi kwaye ngamanye amaxesha sibe yingozi ebomini. Usulelo olungabonakaliyo lweebhaktheriya lunokukhokelela kwimeko eyingozi ebizwa ngokuba yi-sepsis. Abantu abane-Felty Syndrome nabo basemngciphekweni omkhulu wokufumana iintlobo ezithile zomhlaza, njenge-lymphoma.

Kodwa ungoyiki xa usiva ezi zinto. Ezi ngozi zikhona, kodwa zinokulawulwa ngonyango olufanelekileyo nengqalelo.

Ungayiqonda njani le nto?

Oogqirha bafumanisa i-Felty Syndrome xa befumanisa ukuba kukho isifo samathambo esibizwa ngokuba yi-rheumatoid arthritis, i-neutropenia, kunye ne-splenomegaly. (Akuqhelekanga ukuba esi sifo senzeke ngaphandle kokuba i-spleen ikhuliswe.)

Iimvavanyo ezihlala zenziwa zezi:

• Uvavanyo lwegazi: Ubalo lwegazi olupheleleyo, ngokukodwa ukujonga inani lee-neutrophils.
• Ii-X-reyi zamalungu: Jonga ukuba amathambo aqala na.
• Iiskeni zespleen: Umzekelo, i-ultrasound okanye i-CT scan.
• I-biopsy yomongo wethambo:Oku kunceda ukuqinisekisa ukuba akukho ezinye iimeko zonyango.

Luluphi unyango lwale nto?

Kukho iinjongo ezintathu eziphambili xa kunyangwa i-Felty Syndrome:

• Ukulawula imeko esisiseko yeRheumatoid Arthritis.
• Ukuba i-neutropenia inzima, yinyange ngqo.
• Ukuthintela izifo kunye nokunyanga ukuba ziyenzeka.

I-Felty Syndrome inokuba ngumphumo we-rheumatoid arthritis (RA) enganyangwanga okanye engalawulwa kakuhle. Kwabaninzi, i-neutropenia ikwaphucuka njengoko i-RA yabo iphucuka. Ke ngoko, oogqirha baqala ngokukhetha amayeza asebenzayo okuguqula izifo (DMARDs) kwi-RA. Bazama nokuphepha amayeza okunciphisa amasosha omzimba kangangoko banako.

Kukho iintlobo ezahlukeneyo ze-DMARDs ezinokusetyenziselwa i-Felty Syndrome:

• I-Methotrexate kunye ne-folic acid (inciphisa iziphumo ebezingalindelekanga ze-methotrexate)
• I-Abatacept
• I-Rituximab
• I-Leflunomide

Kodwa ukuba i-neutropenia yakho ayiphucuki ngezi DMARD, okanye ukuba i-neutropenia yakho inzima kakhulu, okanye ukuba sele unosulelo, ugqirha wakho uza kuzama ezinye iindlela zonyango zokunyusa inani lakho le-neutrophil. Ezi zinokubandakanya:

• Isitofu sokugonya esibizwa ngokuba yi-G-CSF (granulocyte colony-stimulating factor).
• Amayeza e-corticosteroid exesha elifutshane.
• 'I-Splenectomy' - Oku kuthetha ukususa ngotyando i-spleen esebenza kakhulu.

Kwakhona, oogqirha baya kuthatha amanyathelo akhethekileyo okukhusela kwiintsholongwane, ingakumbi ukuba unyango lwakho luchaphazela inkqubo yakho yomzimba yokuzikhusela. Banokucebisa izinto ezifana nezi:

• Ukuthatha amayeza okubulala iintsholongwane anobubanzi obuhlukeneyo.
• Ukufumana imigonyo efunekayo.
• Nika ingqalelo ekhethekileyo kwimpilo yomlomo namazinyo akho.

Ukuba umntu one-Felty Syndrome ufumana usulelo, oogqirha baluthatha nzulu kakhulu. Ukuba oku kuyenzeka kuwe , kufuneka ufumane unyango ngoko nangoko . Ugqirha wakho uza kukunika amayeza anamandla.

Ingakanani ixesha lokuphila nge-Felty Syndrome?

Akukho zibalo zangoku malunga nobude bobomi babantu abane-Felty Syndrome. Nangona kunjalo, ngokubanzi, unyango luye lwaphucuka kakhulu kwiminyaka yakutshanje. Ngoko ke kukho ithuba elihle lokuba naluphi na unyango luya kuphumelela kuwe. Umngcipheko omkhulu wokufa kwi-Felty Syndrome usesezisulelekweni ezinzulu . Ke ngoko, ukuthatha amanyathelo okuzikhusela kwiintsholongwane kunokwenza umahluko omkhulu kwimpilo yakho yexesha elide.

I-Felty Syndrome yingxaki engaqhelekanga nehlala ingahoywa ye-rheumatoid arthritis (RA). Ukuba une-RA engalawulekiyo ixesha elide, okanye ukuba amayeza akho ayeka ukusebenza kakuhle njengangaphambili, unokuba ne-Felty Syndrome. Abanye abantu bayihlakulela ngaphandle kweempawu. Kunokuba yinto ephazamisayo ukufunda ukuba isifo esichaphazela amalungu akho sinokuchaphazela neeseli zakho zegazi.

Xa sele ujongene ne-RA, mhlawumbi nezinye iimpawu, kunokuba nzima ukufumana uxilongo olutsha. Kodwa i-Felty Syndrome ayibangeli zimpawu zintsha ezininzi, kwaye isenokungadingi naluphi na unyango olongezelelweyo. Into ebalulekileyo kukwazi iingozi. Ngokusebenzisana nogqirha wakho ukunyanga i-RA yakho nokuthintela usulelo, unokulawula i-Felty Syndrome.

Okokugqibela, izinto ekufuneka uzikhumbule

I-Felty Syndrome yimeko enokwenzeka kwabanye abantu abane-rheumatoid arthritis (RA). Ibonakala ngokuncipha kwenani leeseli ezimhlophe zegazi ezibizwa ngokuba zii-neutrophils egazini lakho (neutropenia) kunye nokwanda kwepleen (spleen).

• Umngcipheko ophambili kukwanda kwezifo, ngoko ke kubaluleke kakhulu ukuzikhusela kwiintsholongwane.
• Nangona oku kungabonakala kuyoyikisa kancinci, le meko ingalawuleka kakuhle ngonyango olufanelekileyo kunye neengcebiso .
• Ukuba une-RA, khangela ezi mpawu zongezelelekileyo. Ukuba uneengxaki , qiniseka ukuba uthetha nogqirha wakho. Baza kukwazi ukukunceda.

Isifo sikaFelty , Isifo samathambo esibizwa ngokuba yiRheumatoid Arthritis, iNeutropenia, iSplenomegaly, iArthritis, Ukudumba kwamalungu, iiNeutrophils, iSpleen, ukungakwazi ukuzikhusela komzimba