Yintoni iLangerhans Cell Histiocytosis (LCH)? Ngaba umntwana wakho omncinci usemngciphekweni?

Ngaba wakha weva ngeLangerhans Cell Histiocytosis, okanye into esiyibiza ngokuba yi-LCH ngamafutshane? Mhlawumbi igama livakala liyinkimbinkimbi kwaye liyoyikisa. Kodwa eneneni, esi sisifo esingaqhelekanga esichaphazela kakhulu abantwana bethu abancinci, ingakumbi iintsana ezisandul' ukuzalwa kunye nabantwana abangaphantsi kweminyaka eli-15 ubudala. Ngoko ke ungakhathazeki, masithethe ngaso ngokulula, ngesiSinhala onokusiqonda kakuhle, ngokweenkcukacha, ngokungathi uthetha nomhlobo osenyongweni.

Yintoni kanye kanye (i-LCH)?

Ngamafutshane, (i-LCH) yimeko eyenzeka xa umzimba womntwana uneeseli ezininzi zeLangerhans, uhlobo lweseli ekhethekileyo kwinkqubo yethu yokuzikhusela komzimba. Ezi seli zeLangerhans ngokwenene luhlobo lweeseli ezimhlophe zegazi. Umsebenzi wazo ophambili kukulwa neentsholongwane ezingena emizimbeni yethu zize zisikhusele kwizifo.

Ezi seli zihlala zifumaneka kuyo yonke imizimba yethu, ingakumbi eluswini, emiphungeni, kuma-lymph nodes, kuma-bone morrow, kwi-spleen, nakwisibindi. Nangona kunjalo, kwimeko ye-(LCH), ezi seli zeLangerhans ziqokelelana ngokugqithisileyo kwindawo enye okanye ezingaphezulu. Xa oku kusenzeka, ezi zitho zinokonakala kwaye izilonda zinokwenzeka.

Indlela esihamba ngayo esi sifo inokwahluka kumntu nomntu. Abanye abantwana bayasinda ngokupheleleyo kwesi sifo ngonyango olufanelekileyo. Okumangalisayo kukuba, ngamanye amaxesha, ingakumbi ukuba sichaphazela ulusu kuphela, sinokuphila ngaphandle konyango. Nangona kunjalo, ukuba imeko (LCH) ichaphazela amalungu abalulekileyo afana nomongo wethambo lomntwana, ipleen okanye isibindi, kunokufuneka unyango oluqatha ngakumbi.

Ngaba umhlaza (LCH) ngumhlaza?

Lo ngumbuzo abantu abaninzi abanawo. Enyanisweni, uninzi lwabaphandi lubona i-LCH njengesifo somhlaza, oko kukuthi, i-neoplasm. Nangona kunjalo, abanye oososayensi ngoku bayijonga njengesifo sokudumba. Nangona kunjalo, oogqirha be-oncologists ngoogqirha abaziingcali kumhlaza nezifo zegazi. Ngamanye amaxesha, unyango lomhlaza, olufana ne-chemotherapy, lukwasetyenziswa ukunyanga esi sifo.

Ngubani ochaphazeleka kakhulu yile meko (LCH)?

I-LCH ixhaphake kakhulu kwiintsana ezisandul’ ukuzalwa kunye nabantwana abaphakathi kweminyaka eli-1 neli-15 ubudala. I-LCH kubantu abadala inqabile kakhulu, kodwa ayiyonto ingenakwenzeka.

Kuqheleke kangakanani oku?

Ngokwezibalo, umntwana omnye okanye ababini kwisigidi ngasinye seentsana ezisandul’ ukuzalwa bachatshazelwa yi-LCH minyaka le. Kwakhona, malunga nabantwana abahlanu kwisigidi ngasinye abangaphantsi kweminyaka eli-15 ubudala bayachaphazeleka. Ngoko ke ungabona ukuba le yimeko engaqhelekanga kakhulu.

Zithini iimpawu ze-(LCH)?

Iimpawu ze-LCH zahluka kakhulu kumntu nomntu. Zinokuchaphazela indawo enye yomzimba, okanye zichaphazele iindawo ezininzi. Ngoko ke, iimpawu zixhomekeke ekubeni yeyiphi inxalenye yomzimba womntwana echaphazelekileyo.

Ukuba amathambo achaphazelekile:

Malunga nama-80% abantwana abane-LCH bakha izilonda kwelinye okanye ngaphezulu kwamathambo abo. Yintoni enokubangela oku?

• Ukudumba okanye iqhubu linokuvela kwiindawo ezifana nekhakayi, amathambo ajikeleze amehlo, amathambo endlebe, amathambo emihlathi, amalungu omzimba, umqolo, amanqe, okanye iimbambo. Oku kudumba kunokuba buhlungu okanye kuphele.
• Intloko ebuhlungu.
• Intlungu entanyeni okanye emqolo.
• Ukuqhekeka kwamalungu omzimba.
• Ubunzima bokuhamba.
• Ukuqhwalela.

Elusu:

Amaqhuqhuva adla ngokubonwa njengeempawu zesikhumba (LCH).

• Kwiintsana ezincinci, irhashalala ebonakala ngathi yi-cradle cap ingavela entlokweni.
• Kubantwana abadala nakubantu abadala, kunokubangela irhashalala ebonakala ngathi yinkwethu.
• Ezi zilonda zinokuvela nakwezinye iindawo zomzimba (ukuqaqamba, iingalo, amakhwapha, isisu, umqolo, isifuba). Zisenokuba buhlungu, zirhawuzelele, okanye ziqine.
• Abanye abantwana banokuba namaqhuqhuva aphumayo.
• Izinto ezinje ngokutshintsha kombala, ukuqina, okanye ukuxobuka kwezikhonkwane nazo zinokwenzeka.

Ngokuphathelele umlomo:

Iimpawu ezinokubonakala ngaphakathi emlonyeni ziquka:

• Ukukhuhla okanye ukuphelelwa ngamazinyo.
• Izinyo elitsaliweyo.
• Ukudumba kweentsini.
• Izilonda emilebeni, elulwimini, ngaphakathi ezidleleni, okanye eluphahleni lomlomo.

Okunxulumene nesibindi okanye i-spleen:

Ukuba la malungu achaphazelekile, iimpawu ezifana nezi:

• Ukudumba kwesisu ngenxa yokwanda kwesibindi kunye/okanye ipleen.
• Ukutyheli kwesikhumba kunye namhlophe emehlweni (i-jaundice).
• Ukurhawuzelela.
• Ukudinwa.
• Ukudumba okulula kunye/okanye ukopha.

Ukuba umongo wethambo uchaphazelekile:

Umongo wethambo kulapho kwenziwa khona iiseli zegazi. Ukuba uchaphazelekile:

• I-anemia, ulusu olukhanyayo, ukudinwa, kunye nokuphelelwa ngumdla wokutya ngenxa yokuncipha kweeseli ezibomvu zegazi.
• Usulelo oluqhelekileyo kunye nomkhuhlane obangelwa kukungabikho kweeseli ezimhlophe zegazi.
• Ukukruquka okulula kunye/okanye ukopha ngenxa yeeplatelets ezisezantsi.

Inkqubo ye-Endocrine (Inkqubo ye-Endocrine - iiHormones):

I-LCH inokuchaphazela inkqubo ye-endocrine yomntwana, apho kuveliswa khona iihomoni, njenge-pituitary gland kunye ne-thyroid gland.

• Ukuba i-pituitary gland ichaphazelekile: ukoma okugqithisileyo (i-polydipsia) kunye nokuchama rhoqo (okubizwa ngokuba yi-diabetes insipidus), ukungaphumeleli kokukhula, ukufikisa kwangethuba okanye ukulibaziseka, kunye nokunyuka kobunzima.
• Ukuba i-thyroid gland ichaphazelekile: ukudumba kwe-thyroid gland, iimpawu zamanqanaba aphantsi e-thyroid hormone (hypothyroidism), kunye nobunzima bokuphefumla.

Ngokuphathelele iindlebe:

• Usulelo lwendlebe oluhlala lukho.
• Ulwelo oluphuma ezindlebeni.
• Ububomvu.
• Ukurhawuzelela okurhawuzelelayo.
• Intlungu yendlebe.
• Ukulahlekelwa kukuva.

Ngokuphathelele amehlo:

• Amehlo avuvukileyo.
• Ukudumba ngaphezu kwamehlo.
• Iingxaki zokubona.

Ithumba:

• Ii-lymph nodes ezidumbileyo nezibuhlungu entanyeni, emakhwapheni, nasemqaleni.

Inkqubo Yemithambo-luvo Ephakathi:

Oku kuthetha ukuba ingqondo kunye/okanye umqolo ziyachaphazeleka.

• Intloko ebuhlungu.
• Isiyezi.
• Ukuhlanza.
• Ukoma kakhulu.
• Ukuchama rhoqo.
• Ubunzima bokuhamba.
• Ukulahlekelwa yibhalansi.
• Ukungakwazi ukulawula iintshukumo zomzimba (ataxia).
• Ubunzima bokuthetha okanye bokubona.
• Ukuxhuzula.
• Utshintsho kwindlela yokuziphatha kunye/okanye kwimemori.

Imiphunga:

I-Lung LCH yemiphunga, imeko echaphazela imiphunga, ixhaphake kakhulu kubantu abadala. Abantu abatshayayo basengozini enkulu.

• Iintlungu zesifuba.
• Ukukhohlela okomileyo.
• Ubunzima bokuphefumla.
• Ukukhohlela igazi.
• Ukungasebenzi kakuhle kwemiphunga (pneumothorax).

Indlela Yokugaya Amathumbu:

Ukuba isisu somntwana, amathumbu amancinci, kunye/okanye amathumbu amakhulu achaphazelekile:

• Intlungu yesisu.
• Ukuhlanza.
• Urhudo.
• Igazi esitulweni.
• Ukusilela kokukhula ngenxa yokungondleki kakuhle.

Kubalulekile: Ezi mpawu zinokubangelwa zezinye iimeko ezininzi, kungekuphela nje yi-LCH. Ngoko ke, ukuba umntwana wakho unezi mpawu, kubalulekile ukufuna ingcebiso kagqirha ngokukhawuleza ukuze afumane ukuxilongwa ngokufanelekileyo.

Zithini izizathu ze (LCH)?

Malunga nesiqingatha sabantu abane-LCH kuphela abane-somatic mutation kwi-gene ebizwa ngokuba yi-BRAF. I-Somatic mutations ziinguqu ezenzeka kwiiseli ezithile emva kokukhulelwa. Azizuzwa njengelifa kubazali, kodwa zenzeka ngokungacwangciswanga ngexesha lokukhula kwe-embryo.

I-gene (BRAF) ivelisa iproteni elawula ukukhula nophuhliso lweeseli. Ngokwesiqhelo, le proteni inokuvulwa kwaye icinywe ngokwemiqondiso yeekhemikhali. Nangona kunjalo, xa kukho utshintsho kule gene, iproteni ihlala ibambeke kwimeko "yokuvuka". Oku kubangela ukuba iiseli (ze-LCH) zikhule kwaye zahlukane kakhulu. Yile nto ibangela umonakalo wezicubu kunye neethumba.

Izazinzulu zikwafumanise ukuba utshintsho kwezinye iijini ezininzi lunokubangela esi sifo. Umzekelo, iijini (MAP2K1), (RAS), kunye (ARAF). Abanye abaphandi bakholelwa ukuba iityhefu ezikwindalo kunye nosulelo lweentsholongwane nazo zinokuba negalelo kwesi sifo.

Ziziphi izinto ezibangela umngcipheko (LCH)?

Ezinye izinto zinokunyusa umngcipheko womntwana wakho wokufumana i-LCH. Ezi ziquka:

• Ukuba nembali yosapho ene-LCH.
• Ukuba nohlanga lwamaHispanic (nangona oku kungenamsebenzi kangako kwilizwe lethu, kukhankanyiwe kwimithombo).
• Ukutshaya (ingakumbi kubantu abadala abanomhlaza wemiphunga (LCH)).
• Ukuchanabeka kwiikhemikhali ezithile ngexesha lokukhulelwa.
• Ukuchanabeka kwisinyithi, igranite, okanye uthuli lomthi kwindawo yokusebenza.
• Usulelo ngexesha losana olusandul' ukuzalwa.
• Ukungafumani zigonyo ezicetyiswayo ebuntwaneni.

Ziziphi iingxaki ezinokubakho ze-(LCH)?

Malunga ne-50% yabantwana abane-LCH bakhula neengxaki ezahlukeneyo ngenxa yesi simo. Umzekelo:

• Amanxeba.
• Ukulibaziseka kokukhula.
• Ukukhubazeka kwemisipha.
• Imeko efana nesifo seswekile (iDiabetes insipidus).
• Ukungalingani kwamahomoni.
• Ukuphazamiseka kokuva.
• Iingxaki zempilo yengqondo (ezifana nokudakumba, ixhala).
• Iingxaki zamathambo nemiphunga.
• Isifo sesibindi.
• Umhlaza wesibini (umz. i-leukemia, i-lymphoma, i-Ewing sarcoma).

Ifunyanwa njani i-LCH?

Ugqirha womntwana wakho uza kuqala abuze ngembali yezonyango zomntwana wakho aze enze uvavanyo lomzimba. Emva koko, uza kuyalela iimvavanyo ezininzi ngokuxhomekeke kwiimpawu umntwana wakho azibonayo. Ngokuxhomekeke kwiziphumo zezi mvavanyo, umntwana wakho angathunyelwa kwingcali ye-hematologist/oncologist yabantwana, eya kulungelelanisa unyango kunye nokhathalelo lomntwana wakho.

Zeziphi iimvavanyo ezenziwayo ukuze kufunyaniswe isifo?

Ngenxa yokuba i-LCH inokuchaphazela iindawo ezahlukeneyo zomzimba, kufuneka uvavanyo oluninzi ukuze kufunyaniswe isifo ngokuchanekileyo.

• Uvavanyo lwegazi:
• Ubalo lwegazi olupheleleyo (CBC): Oku kujonga amanqanaba eeseli ezibomvu zegazi, iiseli ezimhlophe zegazi, kunye neeplatelet zomntwana.
• Uvavanyo lwekhemikhali yegazi: Olu vavanyo lujonga amanqanaba ezinto ezithile ezikhutshwa ngamalungu omzimba kunye nezicubu zomzimba.
• Uvavanyo lokusebenza kwesibindi: Olu vavanyo lujonga amanqanaba ezinto ezikhutshwa sisibindi.

• Uvavanyo lomchamo:
• Uhlalutyo lomchamo: Umchamo womntwana ujongwa ubungakanani beeseli ezibomvu zegazi, iiseli ezimhlophe zegazi, iiproteni kunye neswekile.
• Uvavanyo lokungafumani manzi: Olu vavanyo luvavanya ukuba umntwana uchama kangakanani na kwaye ingaba umchamo uba mkhulu na xa enganikwa manzi.

• Iibhayoloji:
• I-Biopsy: Ugqirha uthatha isampuli yezicubu, aze ingcali yezifo iyijonge phantsi kwe-microscope ukujonga iiseli ze-LCH.
• Ukufunxwa komnkantsha wethambo kunye ne-biopsy: Inaliti engenanto isetyenziselwa ukususa umonkantsha wethambo, igazi, kunye neqhekeza elincinci lethambo kwithambo lesinqe lomntwana. Oku kukwahlolwa yingcali yezifo.

• Uvavanyo lwemfuza:
• Isampuli yegazi okanye yethishu isetyenziselwa ukujonga utshintsho kwijini (i-BRAF).

• Uvavanyo lomfanekiso:
• Ii-X-reyi: Kuthathwa imifanekiso yamathambo kunye namalungu omzimba. Ngamanye amaxesha kwenziwa uphando lwamathambo omzimba wonke ukuze kukhangelwe iingxaki.
• Ukuskena amathambo: Into enemisebe ifakwa emthanjeni kwaye kusetyenziswe iskena ukujonga iindawo ezingaqhelekanga emathanjeni. Le nto ayisasetyenziswa kakhulu.
• I-CT scan (i-computed tomography - i-CT scan): Umntwana unikwa ulwelo olukhethekileyo ukuba alusele okanye alufake emthanjeni, kwaye imifanekiso eneenkcukacha ithathwa kwiikona ezahlukeneyo ngaphakathi emzimbeni.
• I-Positron emission tomography (i-PET scan): Inani elincinci leswekile ene-radioactive (i-glucose) lifakwa emthanjeni, kwaye i-scanner ishukunyiswa emzimbeni wonke ukuze kuthathwe imifanekiso yendawo esetyenziswa kuyo iswekile. Iiseli ezinesifo zibonakala zikhanya kolu vavanyo.
• I-MRI scan (Magnetic resonance imaging - MRI scan): Into ebizwa ngokuba yi-gadolinium ifakwa emthanjeni kwaye uthotho lwemifanekiso eneenkcukacha luthathwa kusetyenziswa iimagnethi, amaza erediyo, kunye nekhompyutha. Iindawo ezinezifo zibonakala zikhanya ngakumbi.
• I-Ultrasound: Isebenzisa amaza esandi anamandla aphezulu ukwenza imifanekiso yangaphakathi lomzimba ngokubonakalisa imisindo yangasemva evela kwizitho zomzimba kunye nezicubu.

Iphathwa njani i-LCH?

Unyango lwe-LCH luxhomekeke ekubeni iiseli ze-LCH zikuphi emzimbeni womntwana nokuba isifo "sinomngcipheko omncinci" okanye "sinomngcipheko ophezulu."

Izitho zomzimba ezinobungozi obuphantsi zezi:

• Ulusu
• Ithambo
• Imiphunga
• Ithumba
• Inkqubo yesisu
• Indawo yolwimi lamathe
• Indlala yegilo
• I-Thymus

Izitho zomzimba ezinobungozi kakhulu zezi:

• Isibindi
• Ispleen
• Ummongo wethambo
• Inkqubo ye-nervous ephakathi (CNS)

Oogqirha bahlula esi sifo (LCH) njenge "single-system LCH" kunye "multi-system LCH." Oku kuthetha:

• Inkqubo enye (LCH): Iiseli ze-LCH zifumaneka kwinxalenye enye kuphela yelungu elinye okanye inkqubo yomzimba. Uhlobo oluqhelekileyo yi-LCH echaphazela amathambo kuphela.
• IiMultisystem (LCH): Kukho iiseli kwizitho ezimbini okanye ngaphezulu, okanye kuwo wonke umzimba (LCH). Oku kuncinci kancinci kune-single-system (LCH).

Kwezinye iimeko, ingakumbi ezo zichaphazela ulusu okanye amathambo kuphela (LCH), imeko inokuphela ngaphandle konyango. Kwiimeko ezinjalo, oogqirha baya kujonga isifo ukuze babone ukuba siyabuya okanye siyasasazeka na.

(LCH) Iindlela Zonyango:

• Unyango lwe-steroid: Ugqirha wakho angasebenzisa ii-steroids, ezifana ne-prednisone, ingakumbi kwi-LCH yolusu. Ezi zinciphisa ukusebenza kweeseli ezimhlophe zegazi, nto leyo enokuchaphazela neeseli ze-LCH.
• Utyando: Iithumba ze-LCH kunye nezicubu ezijikelezileyo zinokususwa ngotyando. Inkqubo ebizwa ngokuba yi-curettage ibandakanya ukukrwela iiseli ze-LCH emathanjeni ngesixhobo esibukhali, esifana necephe (i-curette).
• Unyango lweKhemotherapy: Oku kuquka ukunika iiseli zomhlaza amayeza okuzithintela ekukhuleni kwazo. Ziyabulala iiseli okanye zithintele ukwahlukana kwazo. La mayeza athathwa ngomlomo, afakwe kwimithambo okanye kwimisipha, okanye ngamanye amaxesha asetyenziswe eluswini njengekhrimu.
• Unyango ngemitha: Ii-X-reyi ezinamandla aphezulu okanye ezinye iintlobo zemitha zisetyenziselwa ukubulala iiseli zomhlaza okanye ukuzithintela ekukhuleni nasekuhlukaneni kwazo.
• Unyango lwe-Immunotherapy: Indlela yokusebenzisa amajoni omzimba omntwana ukulwa nomhlaza. Ukhuselo lwendalo lomzimba luqiniswa ngokusebenzisa izinto ezenziwe ngumzimba ngokwawo okanye ezo zenziwe elebhu.
• Unyango olujoliswe kulo: Lusebenzisa amayeza okanye ezinye izinto ukuchonga nokuhlasela iiseli ezithile zomhlaza. Umzekelo, amayeza abizwa ngokuba yi-BRAF inhibitors anokubulala iiseli zomhlaza ngokuthintela iiproteni ezifunekayo ekukhuleni kweeseli. Ii-antibodies ze-monoclonal ziiproteni zenkqubo yomzimba yokuzikhusela ezenziwe kwilebhu.
• Ukufakelwa kweeseli zesiqu: Ukufakelwa kweeseli ezintsha ukuze kuthathelwe indawo iiseli ezenza igazi ezitshatyalaliswe yi-chemotherapy.

Ngaba i-LCH ingathintelwa?

I-LCH inokuthintelwa kakhulu kuba ibangelwa kukuguquka kwezakhi zofuzo. Asinakulawula ezinye izinto ezinobungozi, njengembali yosapho kunye nohlanga. Nangona kunjalo, kukho ezinye izinto esinokuzilawula:

• Akutshaywa.
• Ukuphepha iikhemikhali ezithile eziyingozi ngexesha lokukhulelwa.
• Ukufumana zonke iigonyo ezicetyiswayo.

Ithini i-prognosis ye-(LCH)?

Imbonakalo ye-LCH ixhomekeke kwizinto ezininzi:

• Zingaphi iinkqubo okanye amalungu omzimba achaphazelekileyo?
• Zeziphi iinkqubo okanye amalungu omzimba achaphazelekileyo.
• Indlela esisabela kakuhle ngayo esi sifo kunyango.

Ngokubanzi, abantwana abane-single-system (LCH) kunye ne-multisystem (LCH) engachaphazeli isibindi, i-spleen, okanye umongo wethambo bawela kudidi "olunengozi ephantsi". Ngonyango, abantwana abakolu didi banethuba eliphantse libe yi-100% lokusinda. Nangona kunjalo, esi sifo sinokuphinda sibuye kwaye/okanye sibe nezinye iingxaki ezihlala ixesha elide.

Abantwana abane-multisystemic leukemia (LCH) echaphazela isibindi, i-spleen, okanye umongo wethambo bawela kudidi "olunobungozi obukhulu".

Umntwana wam ufanele aye nini kugqirha?

Nokuba umntwana wakho egqibile unyango, ugqirha kuya kufuneka ambone rhoqo umntwana wakho. Oku kungenxa yokuba umngcipheko wokuba isifo siphinde sivele uphezulu. Ngenxa yoko, umntwana wakho kuya kufuneka ajongwe iminyaka eliqela. Ngexesha lovavanyo olulandelayo, uvavanyo olufanayo olwenziwe xa umntwana efunyaniswa ukuba une-ultrasound, i-MRI, i-CT scan, kunye ne-PET scan, kuya kufuneka luphindwe. Ugqirha uya kukuxelela ukuba kufuneka umzise kangaphi umntwana wakho.

Yeyiphi imibuzo endifanele ndiyibuze ugqirha womntwana wam?

Usenokuba nemibuzo emininzi malunga nokuxilongwa komntwana wakho. Kungcono ukuyibhala phantsi uze nayo xa usiya kugqirha wakho olandelayo. Nazi ezinye zemibuzo onokuyibuza:

• I-Langerhans cell histiocytosis iza kumchaphazela njani umntwana wam?
• Ngaba umntwana wam udinga unyango?
• Ziziphi iindlela zonyango ezikhoyo kumntwana wam?
• Zithini iziphumo ebezingalindelekanga zonyango?
• Ngaba umntwana wam uza kunyangwa ngokupheleleyo ngolu hlobo lonyango?
• Injani imeko yempilo yomntwana wam?
• Ngaba kukho amaqela enkxaso onokuwacebisa?

Ekugqibeleni, umyalezo wokubuyela ekhaya

I-Langerhans Cell Histiocytosis (LCH) yimeko engaqhelekanga edla ngokuchaphazela abantwana. Ukuba umntwana wakho udlula kule meko, usenokuba uziva iimvakalelo ezininzi. Usenokuziva ulusizi kwaye woyika umntwana wakho. Usenokuba woyika ngaphakathi, kodwa usenokuba uzama ukuba namandla ngaphandle. Zonke iimvakalelo zakho zifanelekile. Kodwa khumbula, akufuneki uhambe wedwa kule hambo. Iqela lezonyango lomntwana wakho liyazi into odlula kuyo. Bakho ukukunceda kuyo yonke inyathelo lendlela, ukuqonda imeko yomntwana wakho, nokukunika amandla okumelana nayo.

Khumbula, ukuxilongwa kwangoko kunye nonyango olufanelekileyo kunokunika umntwana wakho impilo engcono. Musa ukoyika, jongana noku ngesibindi.

I- Langerhans Cell Histiocytosis, i-LCH, ii-pediatrics, umhlaza, utshintsho lwemfuza, iimpawu, unyango