Ngaba uyayazi iSifo sikaWhipple? Makhe sithethe ngolu sulelo lungaqhelekanga ngamazwi alula!

Ngaba ngamanye amaxesha uziva ngathi umzimba wakho ubuthathaka kakhulu, uneengxaki zesisu, unentlungu yamalungu, kodwa awukwazi ukufumana isizathu saloo nto? Mhlawumbi esi sisifo abantu abaninzi abangazange beve ngaso, kodwa kubalulekile ukusazi. Namhlanje siza kuthetha ngesifo esingaqhelekanga, kodwa ukuba sinyangwa ngokufanelekileyo, esinokunyangeka. Eso sisifo sikaWhipple.

Yintoni isifo sikaWhipple?

Ngamafutshane, isifo sikaWhipple sisifo esingaqhelekanga sebhaktiriya esenzeka emathunjini akho amancinci . Oku kubangelwa kukutya okutyayo okungagaywanga kakuhle kwaye izondlo ezifunekayo azingeni emzimbeni wakho (oku kubizwa ngokuba yi-"malabsorption"). Cinga ngako, sitya ukutya ukuze sifumane amandla kunye nesondlo emizimbeni yethu. Ngoko ke ukuba asingeniswanga kakuhle, iingxaki ezininzi zinokwenzeka. Esi sifo senzeka xa intsholongwane ebizwa ngokuba yi-"Tropheryma whipplei" ingena emzimbeni. Le ntsholongwane idla ngokufumaneka emhlabeni, oko kukuthi, emhlabeni. Kodwa iindaba ezimnandi zezokuba nge-"antibiotics" efanelekileyo, le ntsholongwane inokususwa emzimbeni, inciphise iimpawu, kwaye inyangeke ngokupheleleyo .

Isifo sikaWhipple sixhaphake kangakanani?

Nantsi into ebalulekileyo. Nangona iintsholongwane ezibangela esi sifo ((Tropheryma whipplei)) zininzi kwindawo esingqongileyo, ingakumbi emhlabeni, isifo sikaWhipple sisifo esingaqhelekanga kakhulu . Ngokutsho kwabaphandi bezonyango, nakwilizwe elifana neMelika, kuqikelelwa ukuba malunga nabantu abalithoba kwisigidi abasifumanayo. Oku kuthetha ukuba ayinguye wonke umntu ochaphazeleka yile ntsholongwane ofumana esi sifo. Isizathu esichanekileyo asikaziwa.

Zithini iimpawu zesifo sikaWhipple?

Iimpawu zesifo sikaWhipple azibonakali ngequbuliso. Zikhula kancinci kancinci emva kwamanqanaba aliqela .

Iimpawu zesigaba sokuqala (iSigaba seProdromal)

Iqala ngentlungu enzima yamalungu . Le ntlungu inokuza idlule. Ichaphazela ngakumbi amalungu akho amakhulu - amaqatha akho, iingqiniba, izinqe, amadolo, namagxa . Oogqirha ngamanye amaxesha babiza eli nqanaba lokuqala ngokuthi "isigaba sokukhula." Oku kunokuhlala iminyaka esixhenxe okanye esibhozo , emva koko ezinye iimpawu ziqale ukubonakala. Khawuthelekelele indlela ekunzima ngayo ukuba nentlungu yamalungu iminyaka emininzi ngaphandle kokufumana unobangela.

Iimpawu zamva

Emva kwexesha elithile, ezi mpawu zilandelayo zinokuvela:

• Intlungu yesisu: Ayisiyontlungu yesisu eqhelekileyo nje kuphela, inokuba yintlungu eba mandundu emva kokutya okanye engapheliyo.
• Urhudo (indle enamanzi): Indle enamanzi eyenzeka izihlandlo ezininzi ngemini. Oku kunokubangela ukuphelelwa ngamanzi emzimbeni kunye nokulahleka kwezondlo emzimbeni.
• Ukudumba (Ukudumba): Ungaphawula ukudumba, ingakumbi emilenzeni nasemaqatheni. Ukuba kuvakala ngathi kukho i-dimple xa uyicinezela ngomnwe wakho, kusenokuba kukudumba.
• Ukudinwa rhoqo:Nokuba ulala kangakanani na, umzimba wakho uziva ungenabomi kwaye awufuni kwenza nto.
• Umkhuhlane: Ukuziva ushushu ngaphandle kwesizathu.
• Ukutshintsha kombala wolusu: Ezinye iindawo, ingakumbi ezo zichatshazelwe lilanga, zinokuba mnyama kunesiqhelo.
• Ii-lymph nodes ezivuvukileyo: Amaqhuqhuva amancinci kwiindawo ezifana nentamo, emakhwapheni, nasemqolo.
• Ukunciphisa umzimba ngendlela engachazekiyo: Ukunciphisa umzimba ngaphandle kokunciphisa ukutya okanye ukwenza umthambo.

Iingxaki zeNkqubo yeNervous ephakathi

Phakathi kwama-20% nama-40% abantu abanesifo sikaWhipple baba neengxaki zenkqubo yemithambo-luvo ephakathi . Esi sisifo esibi kakhulu. Iimpawu zingabandakanya:

• Iingxaki zokulinganisela: Uziva ungaqinisekanga xa uhamba kwaye awukwazi ukuma uthe nkqo.
• Ukudideka: Ukungazi apho ukhoyo, ixesha, kwanabantu obaziyo.
• Ubunzima bokuginya: Ukuziva ngathi uyakrwitshwa xa uginya ukutya okanye isiselo.
• Ukulahlekelwa yinkumbulo: Ukulibala neziganeko zakutshanje.
• Utshintsho kubuntu: Ukuziva ngathi awusenguye laa mntu wawunguye ngaphambili, ukhawuleza ukucaphuka, kwaye uphazamiseke.
• Ukuxhuzula: Ukulahlekelwa zingqondo ngequbuliso kunye nokuxhuzula.
• Izithintelo zokuthetha: Ukungakwazi ukuthetha ngokucacileyo, ukungakwazi ukuthetha ngokucacileyo.

Yintoni ebangela isifo sikaWhipple?

Ngokokwazi koogqirha, esi sifo sibangelwa luhlobo oluthile lwebhaktiriya (iTropheryma whipplei) oluxhaphakileyo emhlabeni . Nabani na ochaphazeleka yile bhaktiriya usengozini yosulelo. Nangona kunjalo, njengoko besitshilo ngaphambili, isifo sikaWhipple sinqabile kakhulu. Ngoko ke, akukacaci ukuba kutheni abanye abantu besihlakulela .

Nangona kunjalo, uphando lufumanise ukuba ezi zinto zilandelayo zinokunyusa umngcipheko wokufumana esi sifo :

• Ubudala: Isifo sikaWhipple sibonakaliswe ukuba sichaphazela kakhulu abantu abaphakathi kweminyaka engama-65-84 ubudala , kodwa sinokuhlasela nabantu abangaphantsi koko.
• Ukuchatshazelwa ngumhlaba okanye ukufuya izilwanyana: Uphando lubonisa ukuba abantu abasebenza ngomhlaba okanye ukufuya izilwanyana basengozini enkulu yokufumana esi sifo. Ngokukodwa, abantu abalima, abalima igadi, okanye abasebenza nezilwanyana banokuba semngciphekweni omkhulu. Usenokuba sesichengeni sale ntsholongwane xa utyala into encinci egadini yakho yasekhaya.
• Utshintsho lwemfuza:Kukho unxibelelwano phakathi kwesifo sikaWhipple kunye nejini eyenza iproteni `(IFR4)`. Le proteni inceda iiseli zomzimba wethu ezikhusela amajoni omzimba, ezifana `(iiseli ze-B)` kunye `(iiseli ze-T)`, ukuba zikhule. Kukwafunyaniswe ukuba inxulumene notshintsho kwijini `(HLA-B27)`. Ezi zinzulu kancinci, kodwa ngokufutshane, utshintsho oluthile kwijini zethu lunokusenza sibe sesichengeni soku.
• Ubuthathaka benkqubo yomzimba yokuzikhusela: Ukuba unesifo esichaphazela inkqubo yakho yomzimba yokuzikhusela (njenge-HIV), okanye ukuba uthatha amayeza okunciphisa umzimba (ezi zinikwa izifo ezithile, ngamanye amaxesha kwizinto ezifana ne-arthritis, okanye emva kokufakelwa amalungu omzimba), usengozini enkulu yokuhlaselwa sesi sifo.

Ziziphi iingxaki ezinokubakho zesifo sikaWhipple?

Njengoko besitshilo ngaphambili, isifo sikaWhipple sibangelwa kukungakwazi komzimba ukufunxa amafutha, iicarbohydrate, iivithamini, kunye nezinye izondlo ezivela ekutyeni okudlula emathunjini amancinci. Sisifo esiqhubekayo esiba mandundu ngokuhamba kwexesha . Oku kuthetha ukuba ukuba asinyangwa, iingxaki ezintsha zempilo ezinzulu zinokuvela.

Iingxaki ezinjalo zinokwenzeka:

• I-anemia (umlinganiselo ophantsi weeseli ezibomvu zegazi): Oku kunokubangela ukudinwa rhoqo, ubuthathaka, kunye nokuphaphatheka.
• I-Dementia (ukulahlekelwa yinkumbulo nokusebenza kwengqondo): Oku kunokwenzeka ukuba inkqubo yemithambo-luvo ichaphazelekile.
• Ukugquma kwentliziyo: Oku kunokuviwa xa ugqirha ekuxilonga nge-stethoscope.
• I-Oculomasticatory myorhythmia: Olu luphawu oluthile, apho amehlo kunye nomhlathi zibonakala ngathi zihamba ngaxeshanye .
• Ukukhupha umoya ongcolileyo: Oku kunokubangela ubunzima bokuphefumla.
• I-Uveitis: Iimpawu zingabandakanya ukubomvu, iintlungu, kunye nokungaboni kakuhle.

Okubaluleke kakhulu, ukuba isifo sikaWhipple sichaphazela inkqubo yakho yemithambo-luvo, sinokubulala. Ngoko ke kubalulekile ukubona ugqirha ngoko nangoko ukuba uneempawu.

Oogqirha bayixilonga njani isifo sikaWhipple?

Xa usiya kugqirha, uya kuqala akunike uvavanyo lomzimba . Emva koko, baya kukubuza ngembali yakho yezonyango , kuquka naziphi na iingxaki zempilo zangoku okanye zangaphambili. Banokubuza nangamayeza owasebenzisayo na nokuba kukho umntu kusapho lwakho okhe waba nawo na la mayeza. Ukongeza, banokwenza olu vavanyo lulandelayo:

• Ubalo lweGazi olupheleleyo (CBC) : Oku kujonga imeko yeeseli zegazi zomzimba, ukuba kukho i-anemia, nokuba kukho na iimpawu zosulelo.
• I-endoscopy ephezulu yamathumbu amancinci: Kule nto, kufakwa ityhubhu enekhamera encinci ngomlomo ize ijongwe ngaphakathi emathunjini amancinci. Ngale ndlela, naluphi na utshintsho apho, iimpawu zosulelo, zinokujongwa. Uza kulaliswa ngaphambi kokuba oku kwenziwe, ukuze ungabi nantlungu.
• Uvavanyo lwePolymerase Chain Reaction (PCR) : Olu luvavanyo olukhethekileyo olunokunceda ekuqinisekiseni ukuba ikho na intsholongwane (T. whipplei). Lungenziwa kwisiqwenga sethishu esithathwe kwi-biopsy okanye mhlawumbi kolunye ulwelo lomzimba.
• I-biopsy yamathumbu amancinci : Ngexesha le-endoscopy, kuthathwa iqhekeza elincinci lezicubu emathunjini amancinci lize lihlolwe phantsi kwe-microscope. Oku kudla ngokusetyenziswa ukuqinisekisa isifo sikaWhipple. Kunokukhangela utshintsho oluthile kwizicubu zamathumbu olubangelwa yintsholongwane.

Isifo sikaWhipple sinyangwa njani?

Kuthatha ixesha ukuphelisa ngokupheleleyo iintsholongwane ezibangela isifo sikaWhipple emzimbeni. Ngoko ke, unyango luthatha ixesha elide. Kodwa ukuba unomonde, ungafumana iziphumo ezilungileyo.

Nazi izinto eziphambili ezenziwa njengonyango:

• Iiantibiotics : Unyango ludla ngokuqala ngee-antibiotics ezifakwa kwimithambo (IV) kangangeeveki ezimbini ukuya kwezine . Oku kudla ngokwenziwa esibhedlele. Emva koko, kuya kufuneka uthathe ii-antibiotics zomlomo ubuncinane iinyanga ezili-12 ezizayo . Ngamanye amaxesha, kunokufuneka uzithathe ixesha elide, ukuya kuthi ga kwiminyaka emibini. Kubaluleke kakhulu ukuthatha amayeza kanye njengoko ugqirha wakho ekuyalele.
• Ukutshintshwa kolwelo : Ukuba uphelelwe ngamanzi emzimbeni ngenxa yorhudo, unganikwa ulwelo lwe-IV ukunceda ekuthinteleni urhudo. Okanye, ungaxelelwa ukuba usele iziselo ze-electrolyte (ezifana neJeevani) ukuze kuthathelwe indawo ulwelo olulahlekileyo kunye neetyuwa.
• Iivithamini kunye nezongezo zesondlo : Ugqirha wakho unokucebisa ukuba uthathe izongezo zokongeza iivithamini (ezifana nevithamini D, i-B12, kunye nesinyithi) kunye nezondlo ezingenakufunxwa ngamathumbu akho ngokufanelekileyo. Kuqhelekile ukuba kubekho ukunqongophala kwezondlo kwesi sifo.

Ngaba kukho naziphi na iziphumo ebezingalindelekanga zonyango?

Ewe, ezinye iziphumo ebezingalindelekanga zinokwenzeka, ingakumbi xa usebenzisa amayeza okubulala iintsholongwane. Kodwa ezi azenzeki kuwo wonke umntu, kwaye nokuba ziyenzeka, azisoloko zimbi kakhulu.

• Urhudo (intlungu yesisu)
• Isiyezi
• Isicaphucaphu nokuhlanza
• Ukuqhambuka kwesikhumba
• Usulelo lwemvubelo (ingakumbi kwilungu lobufazi kubasetyhini)

Ukuba kwenzeka into efana nale, kubalulekile ukuxelela ugqirha wakho . Banokukwazi ukutshintsha amayeza okanye bakunike enye into yokunciphisa iziphumo ebezingalindelekanga.

Yintoni eyenzeka kumntu onesifo sikaWhipple?

Njengabantu abaninzi, naweWakuba uqalile unyango, uza kuqala ukuziva ukhululekile ngokukhawuleza. Iintlungu zesisu kunye neentlungu zamalungu ziya kuncipha kancinci kancinci. Nangona kunjalo, kungathatha ukuya kwiminyaka emibini ukuba amathumbu akho amancinci aphile ngokupheleleyo. Ke ngoko, kubalulekile ukuba nomonde ngonyango.

Ixesha elininzi , isifo sikaWhipple siyanyangeka ngokupheleleyo ngonyango . Nangona kunjalo, ngamanye amaxesha isifo sinokuphinda sibuye emva kokuba unyango lugqityiwe. Yiyo loo nto oogqirha beqhubeka nokukujonga.

Ugqirha wakho uza kukucela ukuba uze rhoqo ukuze ufumane uvavanyo lokulandelela ixesha elide. Umzekelo, unokucelwa ukuba wenze i-upper endoscopy:

• Rhoqo emva kweenyanga ezintandathu kunyaka wokuqala wonyango.
• Kanye ngonyaka kwiminyaka emithathu ezayo .
• Emva koko kube kanye emva kweminyaka emithathu ubomi bakho bonke .

Oku kwenzelwa ukujonga ukuba isifo siphinde sabuya na. Ngoko ke, ungaphoswa kutyelelo olulandelayo njengoko kucetyisiwe ngugqirha.

Ngaba isifo sikaWhipple singathintelwa?

Kunzima kancinci ukutsho oko. Kuba iintsholongwane ezibangela isifo sikaWhipple zifumaneka phantse kuyo yonke indawo kwindawo esihlala kuyo, ingakumbi emhlabeni . Nangona kunjalo, ayinguye wonke umntu ochaphazeleka sisifo sikaWhipple.

Nangona kunjalo, abantu abaneenkqubo zomzimba ezibuthathaka okanye abo bathatha amayeza okunciphisa umzimba basengozini enkulu yokuhlaselwa sesi sifo. Ukuba ungomnye waba bantu, licebo elihle ukunxiba iiglavu nanini na xa usebenza ngomhlaba okanye ngodaka, kwaye uhlambe izandla zakho kakuhle emva komsebenzi . Lumka ngakumbi ukuba usebenza egadini okanye usebenza nezilwanyana.

Ndingazinyamekela njani?

Eyona nto ibalulekileyo kukuthatha amayeza okubulala iintsholongwane kanye njengoko ugqirha emyalele, ixesha lonke . Ungaphoswa lusuku olunye, kwaye uthathe amayeza ixesha lonke njengoko ugqirha emyalele. Uninzi lwabantu kuya kufuneka bathathe amayeza okubulala iintsholongwane ubuncinane unyaka emva kokuba bexilongiwe. Abanye abantu kunokufuneka bathathe amayeza okubulala iintsholongwane ubomi babo bonke. Oko kuxhomekeke kugqirha ukuba enze isigqibo.

Xa unesifo sikaWhipple, umzimba wakho usenokuphoswa zizondlo ezininzi ezibalulekileyo . Nokuba ufumana isiqabu kunyango, kusengumbono olungileyo ukubonisana nogqirha wezondlo malunga noko ufanele ukutye nokusela . Oku kuya kukunceda ufumane isondlo esifanelekileyo kwaye ugcine ubunzima obusempilweni.

Ndifanele ndiphinde ndimbone ugqirha kwakhona?

Ukuba uyaqhubeka uneempawu zesifo sikaWhipple emva kokuba uqale unyango, okanye ukuba iimpawu zibuya emva nje kokuba unyango luphelile (umzekelo, ukuba unentlungu esiswini okanye iintlungu zamalungu), qiniseka ukuba ubona ugqirha wakho. Musa ukulibazisa. Oku kunokuthetha ukuba isifo sibuyile, okanye ukuba kunokubakho enye ingxaki.

Kutheni esi sifo sibizwa ngokuba yi "Whipples disease"?

Kulungile ukwazi oku. Esi sifo kunye neentsholongwane ezisibangelayo zithiywe ngegama likaGeorge H. Whipple, ingcali yezifo eyaqala ukuchaza iimpawu ngo-1907. Kwadlula iminyaka engama-80 abaphandi bafumanisa iintsholongwane ezisibangeleyo. Bathiya intsholongwane ngokuthi yiTropheryma whipplei. Eli gama lidityaniswe namagama amabini esiGrike, elithi "trophe" elithetha isondlo kunye nelithi "eryma" elithetha ukuvaleka . Lithetha ukuba libangela ukungafunxwa kakuhle . Asilogama lifanelekileyo na eli?

Iintsholongwane zikho kuyo yonke indawo esingqongileyo (nangaphakathi emizimbeni yethu). Ngokwesiqhelo, iintsholongwane esidibana nazo yonke imihla azisikhathazi. Kodwa olu sulelo lungaqhelekanga lwentsholongwane, isifo sikaWhipple, lwahlukile kancinci. Lubangelwa yintsholongwane eqhelekileyo efumaneka emhlabeni ebizwa ngokuba yiTropheryma whipplei.

Ungachaphazeleka yile ntsholongwane (T. whipplei) emsebenzini okanye ngelixa usebenza egadini. Nangona kunjalo, ayinguye wonke umntu ochaphazeleka yiyo oza kuba nesifo sikaWhipple. Ngethamsanqa, le meko inokuphiliswa ukuba ifunyaniswa kwangethuba kwaye inyangwe ngokufanelekileyo.

Izinto ezibaluleke kakhulu ekufuneka uzikhumbule

Isifo sikaWhipple sisifo esingaqhelekanga esibangelwa yintsholongwane , kodwa sinokunyangwa ukuba sinyangwa ngokufanelekileyo .

• Ukuba iimpawu ezifana neentlungu zamalungu, isisu esibuhlungu, urhudo, kunye nokuncipha komzimba ziyaqhubeka, qiniseka ukuba ubona ugqirha. Musa ukuzityeshela ezi zinto.
• Unyango lubandakanya ukuthatha amayeza okubulala iintsholongwane ixesha elide . Kubaluleke kakhulu ukuwalandela ngokuchanekileyo.
• Ukuba usebenza ngomhlaba, ingakumbi ukuba unenkqubo yomzimba yokuzikhusela ebuthathaka, hlamba izandla zakho kakuhle kwaye usebenzise iiglavu .
• Nokuba isifo siphelile, kubalulekile ukuya kuhlolwa rhoqo ('ukulandelela') njengoko ugqirha emyalele.

Musa ukoyika esi sifo. Kubalulekile ukuba nolwazi kwaye ufumane ingcebiso kagqirha. Awuwedwa, kwaye kukho oogqirha abanokukunceda ngayo nayiphi na ingxaki. Ukuba unamathandabuzo, ungathandabuzi ukuthetha nogqirha.

Isifo sikaWhipple , usulelo lwebhaktheriya, amathumbu amancinci, ukungafunxwa kokutya, i-tropheryma whipplei, iintlungu zamalungu