Intloko ebuhlungu kunye neengxaki zokubona ezihambisana nokwaluphala: Masifunde ngeGiant Cell Arteritis (GCA) okanye iTemporal Arteritis?

Ngaba kukho umntu omdala kusapho lwakho, mhlawumbi umama wakho, utata wakho, okanye umakhulu wakho, ohlala ekhalaza ngentloko ebuhlungu? Ngaba amehlo akho abonakala ebuthathaka kancinci ngaxeshanye? Ngoko ke le yinto enokuba yinto ebalulekileyo kuwe. Namhlanje sithetha ngesifo esibizwa ngokuba yiGiant Cell Arteritis (GCA) , esasisaziwa ngokuba yiTemporal Arteritis , esidla ngokuchaphazela abantu abadala. Akukho nto yokoyika, eyona nto ibalulekileyo kukwazi oku.

Yintoni i-GCA? Kutheni inokuba yingozi?

Ngamafutshane, iGiant Cell Arteritis (GCA) yimeko ebangela ukudumba kwimithambo yegazi emikhulu emzimbeni wakho (ingakumbi leyo isentloko, entanyeni, nasezingalweni). Oogqirha bakwayibiza ngokuba yi-"vasculitis." Xa imithambo yegazi idumba ngale ndlela, iindonga zayo zijiya, zinciphise indlela yegazi. Cinga ngayo njengombhobho wamanzi ovalekileyo ekuphumeni kwegazi. Xa ukuhamba kwegazi kuphazamiseka ngale ndlela, kunokonakalisa amalungu abalulekileyo kunye nezicubu ezibonelelwa ngegazi yimithambo yegazi.

Imithambo yegazi yexeshana, ekwicala ngalinye lebunzi lakho, inika igazi kwikhakayi lakho, kwimisipha yomhlathi, nakwi-optic nerve, engumgogodla okunika umbono. Ukuba i-GCA ichaphazela le mithambo yegazi yexeshana, inokubangela iingxaki ezinkulu, ezifana nokungaboni . I-GCA inokuchaphazela ne-aorta, umthambo wegazi omkhulu emzimbeni, kunye namasebe awo. Oku kudumba kwe-aorta kubizwa ngokuba yi-aortitis, kwaye kunokubangela iingxaki zempilo ezinkulu.

I-GCA inokwenzeka kunye nesinye isifo sokudumba, iPolymyalgia Rheumatica, okanye i-PMR . Siza kuthetha ngakumbi nge-PMR kamva.

Ingaba i-GCA yimeko enzima ngokwenene?

Ewe, i-GCA yimeko enokuba yingozi ukuba ayifunyaniswanga kwaye inyangwe kwangethuba . Oku kungenxa yokuba:

• Amehlo akho angonakala . Ungalahlekelwa kukubona ngequbuliso, okanye ungaba yimfama kwelinye okanye omabini amehlo.
• Imithambo yakho yegazi inokonakala . Umzekelo, imeko ebizwa ngokuba yi-aneurysm, engumthombo wegazi ovuthuluka njengebhaluni uze uqhume, inyusa umngcipheko wokuba iqhume.
• Ezinye iimeko, ezinje ngestroke okanye ukuhlaselwa yi-ischemic okuhamba kancinci (okubizwa ngokuba yi-"mini-strokes"), zinokwenzeka.

Kungoko ke kubaluleke kakhulu ukuzazi ezi mpawu.

Ixhaphake kangakanani i-GCA?

Nangona i-GCA yenye yezona ntlobo zixhaphakileyo ze-vasculitis, sisifo esingaqhelekanga ngokubanzi. Ngokwezibalo eMelika, ngabantu abali-19-23 kuphela kubantu abali-100,000 abanesifo. Nangona kungekho zibalo zichanekileyo eSri Lanka, kulungile ukukhathazeka ngale nto njengoko abantu abalupheleyo besanda.

Zithini iimpawu ze-GCA (Temporal Arteritis)?

Uphawu oluphambili noluqhelekileyo lwe-GCA yintloko ebuhlungu nengapheliyo evakala ngathi yintlungu ebuhlungu kwelinye okanye kumacala omabini entloko.Kodwa ukongeza koku, ezinye iimpawu zinokuvela:

• Ukuthamba xa ubeka isandla sakho entlokweni okanye kumacala omabini ebunzi (ngaphezu kweendlebe).
• Intlungu yomhlathi , ingakumbi xa usitya okanye uhlafuna.
• Iingxaki zokubona : Ukubona kabini, ukubona okufipheleyo, okanye ukulahleka ngequbuliso kombono okwethutyana elifutshane.
• Ukudinwa .
• Ifiva .
• Ukulahlekelwa ngumdla wokutya okanye ukwehla kobunzima bomzimba .
• Intlungu yemisipha : Intlungu emagxeni, ezingalweni eziphezulu, ezinqeni, emathangeni aphezulu, emqolo ongezantsi, nasezinqeni.

Uyakhumbula xa ndikhankanya enye imeko edla ngokuhamba ne-GCA, iPolymyalgia Rheumatica (PMR)? Le yimeko ebangela ukudumba. I-PMR ibangela iintlungu ezinzima kunye nokuqina , ingakumbi emagxeni nasemaqakaleni. I-PMR inokwenzeka nayo yodwa (kuqheleke kakhulu ukuba i-PMR izenzekele yodwa kune-GCA). Nangona kunjalo, malunga ne-40-60% yabantu abane-GCA nabo baya kuba ne-PMR. Kwakhona, i-10-20% yabantu abane-PMR yodwa baya kuba ne-GCA kamva ebomini.

Yintoni ebangela i-GCA?

Abaphandi abakayazi eyona nto ibangela i-GCA, kodwa uninzi lukholelwa ukuba sisifo esibangelwa kukuzikhusela komzimba okanye ukudumba komzimba. Ngamafutshane, kuxa inkqubo yomzimba wakho yokuzikhusela ihlasela ngempazamo imithambo yegazi yakho esempilweni .

Esi sifo sixhaphake kakhulu kubantu abadala, ngoko ke abanye abantu bacinga ukuba sinxulumene nokwaluphala. Kukwacingelwa ukuba sibangelwa zizinto zemfuza kunye nezinto ezingqongileyo (ezifana nosulelo oluchaphazela inkqubo yomzimba yokuzikhusela).

Ngubani ochaphazeleka kakhulu yi-GCA?

Nangona nabani na enokuba ne-GCA, aba bantu balandelayo ngabona basengozini enkulu:

• Abantu Abadala : I-GCA idla ngokuchaphazela abantu abangaphezu kweminyaka engama-50 ubudala. Umngcipheko wokufumana esi sifo uyanda ngokuhamba kweminyaka. Sixhaphake kakhulu kubantu abaphakathi kweminyaka engama-70 nama-80 ubudala.
• Abafazi : Esi sifo sixhaphake kakhulu kwabasetyhini kunamadoda. Nangona kunjalo, amadoda asengozini enkulu yokuba yimfama ngenxa yesi sifo.
• Abantu abamhlophe : Uphando lubonise ukuba i-GCA ichaphazela abantu abamhlophe abasuka kuMantla Yurophu rhoqo kunamanye amaqela eentlanga. Nangona kunjalo, oku akuthethi ukuba amanye amaqela eentlanga akanakuyiphuhlisa.

Ifunyaniswa njani i-GCA?

Ukuba uneempawu ze-GCA, ugqirha wakho uza kuqala akubuze ngembali yakho yezonyango aze emva koko enze uvavanyo lomzimba. Baza kujonga ukuba ii-pulses zakho ezibuthathaka zingalweni nasemilenzeni azikho na. Baza kuhlola nentloko yakho ukuze babone ukuba unayo na intlungu entlokweni yakho nokuba imithambo yegazi emacala omabini ebunzi lakho idumbile na.

Zeziphi iimvavanyo ezisetyenziselwa ukufumanisa i-GCA?

Ugqirha uza kuqala acele uvavanyo lwegazi oluninzi ukuze alinganise inqanaba lokuvuvukala emzimbeni wakho. Umzekelo:

• (Izinga lokuTyalwa kweNkunkuma ye-Erythrocyte) (ESR)
• `(Iproteni eSebenzayo ye-C)` (i-CRP)

Olu vavanyo lunokukunika umbono wenqanaba lokuvuvukala emzimbeni wakho. Lunokulinganisa namanqanaba akho e-hemoglobin, inxalenye ethwala ioksijini kwiiseli zakho ezibomvu zegazi, ukuze kubonwe ukuba unayo na i-anemia.

Ukuba ugqirha wakho urhanela ukuba kukho i-GCA (i-Temporal Arteritis), unokuyalela i-temporal artery ultrasound, i-ultrasound yemithambo esebunzini lakho. Okanye, banokuyalela i- temporal artery biopsy . Oku kubandakanya ugqirha oqeqeshiweyo othatha isampuli encinci yemithambo esebunzini lakho aze ayithumele kwingcali yezifo ukuze ayihlole phantsi kwe-microscope. Oku kuya kujonga iimpawu zokudumba (vasculitis) kwimithambo. Olu lolona vavanyo luphambili lokuqinisekisa i-GCA.

Ngamanye amaxesha ezi mvavanyo zinokufuneka:

• Uvavanyo lweskeni lwe-``(Computed Tomography)`` okanye ``(CT)```
• Iskeni seMagnetic Resonance Imaging (MRI)
• I-Ultrasound yemithambo emikhulu
• Uvavanyo lweskeni lwe-`(Positron Emission Tomography)` okanye `(PET)`

Ziziphi iindlela zonyango ze-GCA (Temporal Arteritis)?

Unyango lwe-GCA lufanele luqale ngokukhawuleza, ingakumbi ukuthintela ukulahleka kokubona .

Unyango oluphambili luhlobo lwamayeza abizwa ngokuba yi-"glucocorticoid". Uhlobo oluqhelekileyo lwamayeza yi- "prednisone." Uza kuqala ngee-40 ukuya kwi-60 milligrams (mg) ngosuku (ngomlomo) uze unciphise kancinci idosi. Ukuba sele uneengxaki zokubona okanye ulahlekelwe kukubona, ugqirha wakho unokukunika iidosi eziphezulu ze-"glucocorticoids" nge-cannula efakwe emthanjeni (``(IV)'').

Kubalulekile: Iiglucocorticoids ziyindlela ebaluleke kakhulu yokulawula i-GCA. Nangona kunjalo, la mayeza anokubangela ezinye iziphumo ebezingalindelekanga, ngoko ugqirha wakho uza kukubeka esweni ngokusondeleyo.

Iiglucocorticoids zenza buthathaka amasosha omzimba wakho, nto leyo enokukwenza ube sengozini yokufumana usulelo kwaye ziwenze ube qatha ngakumbi . Zinokucutha amathambo akho , zikwandise umngcipheko wakho wokuqhekeka.

Ezinye iziphumo ebezingalindelekanga ezinokubakho ziquka:

• IiCataracts
• Igazi elonyukayo
• Iswekile ephezulu egazini
• Ukungalali
• Ukuhamba kweemvakalelo
• Ubuthathaka bemisipha kunye nokuphelelwa ngamandla, ingakumbi emilenzeni
• Ukudumba, ingakumbi ebusweni nasemilenzeni
• Ukutyeba kwakho

Ngelixa usebenzisa i-glucocorticoids, ugqirha wakho unokujonga ubuninzi bamathambo akho. Angacebisa nokuzilolonga, izongezo ze-calcium kunye ne-vitamin D, kwaye mhlawumbi namayeza okuthintela i-osteoporosis (ukulahleka kwamathambo) ukugcina amathambo akho omelele.

Ngowama-2017, i-U.S. Food and Drug Administration yavuma iyeza elitsha lebhayoloji elibizwa ngokuba yi-tocilizumab (Actemra®) lokunyanga i-GCA. Eli yeza linikwa njengenaliti phantsi kolusu okanye njenge-IV. Linokunceda ukunciphisa imfuneko ye-glucocorticoids. Nangona kunjalo, i-tocilizumab ineziphumo zayo ebezingalindelekanga, eziya kucaciswa ngugqirha wakho.

Ndifanele ndimbone nini ugqirha?

Ukuba uneempawu ze-GCA, iimpawu zosulelo, okanye naziphi na iimpawu ezintsha, bona ugqirha wakho ngoko nangoko . Ukutyelela ugqirha wakho rhoqo kunye nokuhlolwa kwegazi kunye neeskeni kunokunceda ekufumaneni ukuphinda ubuye (`ukubuyela umva`) kwangethuba.

Ndingayibuza yiphi imibuzo ugqirha?

Ungabuza ugqirha wakho imibuzo efana nale:

• Loluphi unyango olucebisayo?
• Zeziphi iziphumo ebezingalindelekanga ekufuneka ndizazi ngexesha lonyango?
• Ndingenza ntoni ukunciphisa iziphumo ebezingalindelekanga zonyango?
• Ziziphi iingxaki ezinokubakho ngenxa yale meko?
• Ndingayijonga njani imeko yam?
• Zithini iimpawu zokubuyela umva kwesi sifo?
• Zeziphi iimpawu ekufuneka ndiqhagamshelane nawe ngazo?

Ingakanani iminyaka yobomi bomntu one-GCA?

Ukuba ne-GCA akukafunyaniswanga ukuba kunciphisa ixesha lokuphila, kodwa izinto ezahlukeneyo zinokuchaphazela oku. Ukuba isifo sifunyenwe kwaye sinyangwa kwangethuba, iziphumo zilungile kakhulu , kwaye iimpawu ziqala ukuphucuka kwiintsuku ezimbalwa.

Nangona kunjalo, ukuba ayinyangwa ngokukhawuleza, i-GCA inokukhokelela kwiingxaki ezisongela ubomi ezifana nokulahlekelwa yimbono engapheliyo, i-aneurysms, kunye nokukhubazeka. Ke ngoko, kubaluleke kakhulu ukubona ugqirha ngokukhawuleza ukuba uneempawu ezinxulumene ne-GCA.

Xa unyango luqalile, ingozi enkulu ojongene nayo ziziphumo ebezingalindelekanga zonyango . Kwakhona, nokuba i-GCA inyangwa ekuqaleni ngonyango oluphumelelayo, ngamanye amaxesha inokubuya (`iphinde ibuyele`) . Abaphandi abakayazi ukuba kutheni oku kusenzeka.

Ndingazinyamekela njani ngelixa ndihlala ne-GCA?

Ukuphila ne-GCA kunokuba nzima. Ukuze ulawule imeko yakho kwaye ulawule iziphumo ebezingalindelekanga ze-glucocorticoids, zama ezi zinto:

• Yitya ukutya okunempilo nokunesondlo : izinto ezifana nenyama engenamafutha, iimbotyi, iinkozo ezipheleleyo, iziqhamo nemifuno emitsha.
• Fumana i-vitamin D kunye ne-calcium eyaneleyo ukukhusela amathambo akho.
• Yenza umthambo ubuncinane imizuzu engama-30 ngosuku.
• Lala kakuhle ubuncinane iiyure ezisixhenxe ukuya kwezisibhozo ubusuku ngabunye.
• Thatha amayeza owanikiweyo ngexesha elifanelekileyo .
• Bona ugqirha wakho rhoqo .
• Thatha amanyathelo okuzikhusela kwiintsholongwane .

Zeziphi izinto ekufuneka ndiziphephe xa ndine-GCA?

Ukuba une-GCA, kungcono ukuziphepha ezi zinto:

• Izinto ezibangela umngcipheko wokugula : Ngenxa yokuba amayeza e-GCA enza buthathaka amasosha omzimba wakho, unamathuba amaninzi okufumana usulelo. Buza ugqirha wakho ngezinye iindlela zokunciphisa umngcipheko wosulelo, njengokuphepha ukugula, ukuhlamba izandla zakho rhoqo, kunye nokuhlala kude nabantu abagulayo.
• Ukutshaya : Ukutshaya kunokunyusa umngcipheko wakho wokuba ne-GCA. Impilo yemithambo yegazi yakho iya kuphucuka kwangoko nje ukuba uyeke ukutshaya, nto leyo eya kukunceda ubomi bakho bonke.
• Ukusela utywala : Utywala bunokuchaphazela kakubi impilo yentliziyo yakho kunye nemithambo yegazi. Bunokukhawulezisa ukulahleka kwamathambo kwaye busebenzisane namayeza owaselayo kwimeko yakho.

Amanqaku abaluleke kakhulu (Umyalezo Wokuya Ekhaya)

I-Giant Cell Arteritis (eyayisakuba yi-Temporal Arteritis) inokuba yimeko enzima. Nangona kunjalo, ukuba uxilongwa kwangethuba kwaye uhlolwe rhoqo ngugqirha ofanelekileyo, unokufumana iziphumo ezingcono kakhulu . Iimpawu kunye nemiphumo emibi yonyango inokuchaphazela impilo yakho yengqondo, umsebenzi wakho, kunye neenkalo ezininzi zobomi bakho. Kodwa awuwedwa. Cela ugqirha wakho akuncede ufumane iqela lenkxaso nabantu abaye badlula kwizinto ezifanayo. Ukwabelana ngamava akho kunye neengcebiso nabanye kunokuba ngumthombo wentuthuzelo.

Khumbula, ukuba uneempawu ezingaqhelekanga ezifana neentloko ebuhlungu, iintlungu zomhlathi, okanye iingxaki zokubona (ingakumbi ukuba ungaphezulu kweminyaka engama-50), musa ukuzityeshela kwaye ufune ingcebiso yezonyango ngoko nangoko. Unyango olukhawulezileyo lunokuthintela iingxaki ezinkulu.

I- Giant Cell Arteritis, i-Temporal Arteritis, i-GCA, Intloko ebuhlungu, Ukubona, Ukudumba kwemithambo yegazi, Impilo yabantu abadala, i-Polymyalgia Rheumatica, i-Prednisone, i-Vasculitis