Ingabe unalezi zimpawu? Ake sixoxe nge-sarcoidosis!

Ingabe ngezinye izikhathi uzizwa sengathi kukhona into engavamile emzimbeni wakho, kodwa awukwazi ukuqonda kahle ukuthi iyini? Kunezifo ezithile ezivelela emzimbeni wakho ngezikhathi ezithile, kodwa uma uzazi kahle, ungazilawula. I-Sarcoidosis ingenye yezifo ezinjalo. Namuhla, sizoxoxa ngalokhu kalula, ngendlela ongayiqonda.

Kuyini i-Sarcoidosis?

Kalula nje, i-sarcoidosis yisimo lapho amasosha omzimba wakho eba matasa kakhulu futhi akhe amaqhubu amancane ezingxenyeni ezahlukene zomzimba. La maqhubu abizwa ngokuthi ama-granuloma . Izimpawu zincike ekutheni la ma-granuloma akheka kuphi kanye nobukhulu bawo. Ngezinye izikhathi kungase kungabi nazimpawu nhlobo, noma zingasukela ekungakhululeki okuncane kuya ezimpawini ezinzima. Okuyingozi kakhulu ukuthi ngezinye izikhathi la ma-granuloma angabangela izibazi zezicubu, ezibizwa ngokuthi i-fibrosis , ezingalimaza amaphaphu unomphela, isibonelo.

Lawa ma-granuloma empeleni angakheka noma kuphi emzimbeni. Kodwa avame ukutholakala emaphashini nasema-lymph node . Ngaphezu kwalokho, angakheka nasesikhumbeni, emehlweni, nasemisipheni, okubangela izimpawu.

Iyini i-granuloma?

Ungacabanga ngempi encane eqhubekayo emzimbeni wakho? I-granuloma injalo nje. Amasosha akho omzimba acabanga ukuthi kukhona okubi okungene emzimbeni wakho. Ngakho-ke, amangqamuzana amhlophe egazi abuthana azungeze leyo nto embi, ayizungeze, futhi ayihlukanise nomzimba wakho wonke. Kufana nokubamba isitha. Le nqwaba yamangqamuzana amhlophe egazi avalelekile yakha ungqimba lwezicubu ezine-fibrous ezizungezile. Yingakho i-granuloma izwakala njengeqhubu elincane uma ulithinta.

Ubani othinteka kakhulu yilesi simo?

I-Sarcoidosis ingathinta noma ubani, kodwa abanye abantu banamathuba amaningi okuba nayo. Isibonelo, lesi simo sivame kakhulu kubantu abamnyama kunakwabamhlophe. Siphinde sithinte abesifazane kancane kunabesilisa. Sivame kakhulu ukutholakala kubantu abaneminyaka ephakathi kuka-25 no-40 .

Lesi akusona isifo esizuzwe njengefa. Okusho ukuthi, akuyona into edluliselwa ngqo kumama iye kuyise. Kodwa-ke, uma isihlobo esiseduze emndenini wakho (abazali, izingane, odadewabo nodadewabo) sinalesi simo, nawe usengozini yokuba naso.

I-Sarcoidosis ibhekwa njengesifo esingavamile . Isibonelo, e-United States, kuneziguli ezingaphansi kwamakhulu amabili ezinkulungwane nganoma yisiphi isikhathi.

Ziyini izimpawu ze-Sarcoidosis?

Njengoba ngishilo ngaphambili, izimpawu zincike ekutheni ama-granuloma akheka kuphi emzimbeni. Iningi labantu liba nezimpawu emaphashini. Kodwa-ke, lezi zimpawu zingavela noma kuphi emzimbeni, esikhumbeni, emehlweni, emalungeni, empeleni. Ngezinye izikhathi kungase kube nezimpawu ezijwayelekile kuphela, njengokuzizwa ubuthakathaka nokukhathala, noma kungase kungabikho zimpawu nhlobo.

Izimpawu ezivame ukubonakala:

• Imfiva
• Ukuhlala ngikhathele, ngikhathele
• Ubuhlungu bamalunga
• Ubuhlungu noma ubuthakathaka bemisipha
• Ukujuluka ebusuku
• Ama-lymph node avuvukele
• Ukwehlisa isisindo ngaphandle kwesizathu
• Ukwakheka kwamatshe ezinso

Izimpawu ezihlobene namaphaphu:

• Ukukhwehlela (ngokuvamile ukukhwehlela okomile)
• Ubunzima bokuphefumula, ukushoda kokuphefumula (ukuphelelwa umoya)
• Ubuhlungu besifuba
• Ukushaya umoya (ukushaya ikhwela) lapho uphefumula

Izimpawu ezihlobene namehlo:

• Ukubona okufiphele noma ukulahlekelwa umbono ngokuphelele (ngenxa yezimo ezifana ne-optic neuritis)
• Ubuhlungu bamehlo
• Ukubomvu noma ukuvuvukala kwamehlo (izimo ezifana ne-'uveitis' noma i-'conjunctivitis')
• Ukuzwela ukukhanya (ukungakwazi ukubuka ukukhanya)

Izimpawu ezihlobene nesikhumba:

• Amaqhubu ngaphansi kwesikhumba azungeze izibazi noma ama-tattoo
• Amabala akhanyayo noma amnyama esikhumbeni
• Amaqhubu noma izilonda ezibomvu-onsomi ekhaleni noma ezihlathini (`lupus pernio`)
• Amaqhubu abomvu, athambile endaweni yesinqe (i-erythema nodosum)

Izimpawu ezihlobene nenhliziyo:

• Ubuhlungu besifuba
• Ukuzwa inhliziyo yakho ishaya ngendlela engavamile (ukushaya kwenhliziyo)
• Ukuphazamiseka kwesigqi senhliziyo (i-arrhythmia)
• Ukwehluleka kwenhliziyo
• Ubunzima bokuphefumula

Izimpawu ezihlobene nesistimu yezinzwa:

• Ukoma njalo noma ukuchama ngokweqile (i-Diabetes insipidus)
• Ubuthakathaka noma ukukhubazeka kwemisipha yobuso (i-Bell's palsy)
• Ikhanda elibuhlungu
• Ukuquleka

Yiziphi izigaba ze-pulmonary sarcoidosis?

I-Sarcoidosis, isimo esithinta amaphaphu, ngezinye izikhathi sichazwa ngezigaba. Lokhu kubizwa ngokuthi uhlelo lokuhlukanisa i-Siltzbach .

Kodwa kubalulekile ukukhumbula: Lezi zigaba azibonisi ngempela ukuthi lesi sifo sibucayi kangakanani. Akudingeki ukuthi uzidlule zonke. Zihlukaniswa ngokusekelwe endleleni amaphaphu akho abukeka ngayo ku-X-ray yesifuba. Okusho ukuthi, lapho ama-granuloma atholakala khona.

Umuntu one-sarcoidosis angase ahambe phakathi kwalezi zigaba, noma ama-granuloma angase anyamalale ngokuphelele. Isigaba esisodwa esingenakuguqulwa yisigaba sesine. Yilapho kwenzeka khona umonakalo ongapheli emaphashini, obizwa ngokuthi i-pulmonary fibrosis.

• Isigaba 0:Azikho izimpawu ze-sarcoidosis emaphashini ku-X-ray. Amaphaphu nama-lymph node abonakala ejwayelekile.
• Isigaba 1: Ama-granuloma atholakala kuma-lymph node kuphela.
• Isigaba sesi-2: Ama-granuloma akhona kokubili kuma-lymph node nasemaphashini.
• Isigaba 3: Ama-granuloma atholakala emaphashini kuphela.
• Isigaba 4: Ama-X-ray akhombisa i-pulmonary fibrosis, okusho ukuthi amanxeba ahlala njalo emaphashini.

Yini ebangela i-sarcoidosis?

Imbangela eqondile yalesi simo ayaziwa okwamanje. Ucwaningo lubonisa ukuthi sibangelwa inhlanganisela yezici zofuzo kanye nezici zemvelo. Lokhu kusho ukuthi amasosha omzimba abanye abantu angase asabele ngokweqile kuma -antigen athile, njengebhaktheriya namagciwane. Nakuba amasosha omzimba ehilelekile, i-sarcoidosis ayibhekwa njengesifo sokuzivikela komzimba .

Njengoba singazi kahle ukuthi yiziphi izakhi zofuzo kanye nezinto ezibangela lokhu ezihlanganayo, kunzima ukubikezela ukuthi ubani ozokwakha lokhu.

Iyini i-Löfgren syndrome?

I-Löfgren syndrome iwukuqala okungazelelwe kwe-sarcoidosis. Ibonakala ngokuhlanganiswa kwezimpawu ezithinta izingxenye eziningana zomzimba:

• I-arthritis emalungeni amaningana.
• Imfiva.
• Amaqhubu abomvu, athambile endaweni yesinqe (i-erythema nodosum).
• Ukuvuvukala kwama-lymph node esifubeni.

Izindaba ezinhle ukuthi i-Löfgren syndrome ivame ukuphela zingakapheli izinyanga eziyisithupha kuya eminyakeni emibili.

I-sarcoidosis itholakala kanjani?

I-Sarcoidosis ivame ukutholakala ngudokotela okuxilongayo (`ukuhlolwa ngokomzimba`), owenza izivivinyo zesithombe ezifana ne-X-ray yesifuba, futhi athathe isampula encane ye-granuloma esolisayo ukuze ihlolwe (i-biopsy) . Ngenxa yokuthi lesi sifo singaba nezimpawu ezifanayo nezinye izifo, udokotela wakho angase acele izivivinyo ezengeziwe ukuze asuse ezinye izimo.

Yiziphi izivivinyo zokuxilonga?

Ukuhlolwa kwezithombe kanye ne-biopsies yizivivinyo ezivame kakhulu ezisetshenziselwa ukuxilonga i-sarcoidosis, kodwa udokotela wakho angase akucele ezinye izivivinyo kuye ngezimpawu zakho.

• Ukuhlolwa kwezithombe: Lokhu kusebenzisa imishini ekhethekile ukuthatha izithombe zezinto ezingaphakathi emzimbeni wakho. Udokotela wakho angase akucele ukuthi kwenziwe i-X-ray yesifuba, ama-CT scan, noma ama-MRI.
• Ukuhlolwa kwe-biopsy:Uhlobo lwe-biopsy oluqhutshwayo luyahlukahluka kuye ngokuthi kusolwa ukuthi i-granuloma ikuphi. Ukuhlolwa kwe-biopsy esikhumbeni, i-conjunctiva, kanye namanye ama-lymph node akulona udaba olukhulu futhi kungenziwa ngaphandle kokwenza i-incision enkulu.

Ngezinye izikhathi, ukuze uthole ucezu lwezicubu emaphashini, kufanele usebenzise indlela eyinkimbinkimbi kakhulu. Lokhu kwenziwa ngokufaka amashubhu amancane, amakhamera, namathuluzi e-biopsy ngekhala noma emphinjeni, noma ngokwenza ukusika okuncane. Izibonelo:

• "Ukufuthwa kwenaliti encane ye-transbronchial eqondiswa yi-ultrasound (EBUS-TBNA)"
• "I-biopsy ye-Bronchoscopic transbronchial"
• `I-Mediastinoscopy` (Lezi izinqubo zezokwelapha eziyinkimbinkimbi, futhi zenziwa udokotela kuphela uma kudingeka)

Ezinye izivivinyo:

• Ukuhlolwa kokusebenza kwamaphaphu: Lokhu kuhlola ukuthi amaphaphu akho asebenza kahle kangakanani. Lokhu ukuhlolwa okulula.
• Ukuhlolwa kwegazi nomchamo (`Ukuhlolwa kwelebhu`): Hlola ukuthi ezinye izitho zomzimba, njengesibindi nezinso, zisebenza kanjani.
• I-Electrocardiogram (EKG noma i-ECG): Ukuhlolwa okuvamile okubheka ukusebenza kukagesi kwenhliziyo yakho.
• Ukuhlolwa kwezithombe zenuzi: Lokhu kufaka phakathi ukuskena kwe-PET kanye nokuskena kwe-gallium. Lokhu kuhlolwa kusebenzisa inani elincane lezinto ezikhipha imisebe ukuze kubhekwe ukuvuvukala emzimbeni.
• Ukuhlolwa kwe-purified protein derivative (PPD): Lokhu ukuhlolwa kwesikhumba okulula. Kuhlola ukuchayeka noma ukutheleleka ngesifo sofuba (TB). Lokhu kubalulekile ngoba ngezinye izikhathi i-TB ingabukeka njenge-sarcoidosis.
• Ukuhlolwa kwesibani esiqhekekile: Udokotela ubheka ngaphakathi kweso lakho ukuze abone ukuthi i-sarcoidosis ibangela izinkinga zamehlo yini.

Iphathwa kanjani i-sarcoidosis?

I-Sarcoidosis ivame ukwelashwa ukulawula izimpawu nokuvimbela ukulimala kwezitho zomzimba. Khumbula, ama-granuloma abangelwa ukuvuvukala okubangelwa amangqamuzana omzimba. Ngakho-ke, ukwelashwa kuhilela imithi eshintsha noma elawula isimiso somzimba sokuzivikela. Ukwelashwa kuyahlukahluka kuye ngokuthi i-granuloma ikuphi emzimbeni.

Akukho ukwelashwa okuqondile kwe-sarcoidosis. Kodwa ivame ukuba ngcono ngokwayo . Uma izimpawu zingakhathazi kakhulu noma zingasongeli impilo, ngezinye izikhathi i-sarcoidosis ayelashwa ngokushesha. Kunalokho, wena nodokotela wakho nizosebenzisana ukuqapha izimpawu zakho.

Yimiphi imithi ye-sarcoidosis?

Le mithi isebenza ngokushintsha noma ukulawula amasosha omzimba nokunciphisa ukuvuvukala. Eminye yemithi esetshenziswa kakhulu yile:

• Ama-Corticosteroids:Imithi efana ne-prednisone ne-cortisone. Le mithi inciphisa ukuvuvukala emzimbeni. Itholakala njengamaphilisi okugwinya, njenge-inhaler yokufutha emlonyeni, noma njengokhilimu wangaphandle (wesikhumba noma amehlo).
• Ama-immunosuppressants: Lawa asiza ekuvimbeleni amasosha omzimba ekulimazeni izitho zomzimba futhi abangele ukuvuvukala. I-Methotrexate uhlobo lomuthi oluvame ukusetshenziswa kwe-sarcoidosis.
• Ama-antibody e-anti-tumor necrosis factor-alpha (ama-antibody e-anti-TNF-alpha): Imithi efana ne-infliximab. Le mithi isebenza ngokuvimba ikhemikhali ethile ohlelweni lokuzivikela komzimba ukuze kuncishiswe ukuvuvukala. Le mithi inikezwa udokotela njengokufakwa (njengesixazululo se-saline) emthanjeni.
• Imithi Engavimbi Ukuvuvukala (ama-NSAID): Le mithi ihlinzeka ngokukhululeka kwesikhashana ezimpawini ezibangelwa ukuvuvukala, kodwa ngokuvamile ayinikezwa isikhathi eside.

Yiziphi izinkinga/imiphumela emibi yokwelashwa?

Ama-Corticosteroids angandisa ingozi yakho yokugula. Angabangela nemiphumela emibi eminingana. Izibonelo zifaka:

• Ukuba mkhulu kakhulu.
• Ukungalali.
• Induna.
• Ukuthuthukisa isifo sikashukela kubantu abasengozini yokuba nesifo sikashukela.
• Umfutho wegazi ophezulu.
• I-Glaucoma.
• Ama-cataract.
• Ukuncipha kwamathambo (i-Osteoporosis).
• Ukucindezeleka kanye nobunzima bokulawula imizwa.
• Isikhumba esiphuka kalula.

Ngenxa yalezi zizathu, odokotela batusa imithi ye-sarcoidosis kuphela uma izinzuzo zidlula izingozi.

Ngizozizwa ngingcono ngokushesha kangakanani ngemva kokwelashwa?

Kungathatha amasonto ambalwa kuya ezinyangeni eziningana ukuthi izimpawu zithuthuke ngemva kokuqala ukwelashwa kwe-sarcoidosis. Udokotela wakho uzokuqapha futhi angenza izivivinyo zokulandelela ukuze abone ukuthi ukwelashwa kuyasebenza yini.

Yikuphi ukudla okungafanele ukudliwe uma une-sarcoidosis?

Ucwaningo oluthile lusikisela ukuthi amaphethini athile okudla anganciphisa ukuvuvukala emzimbeni. Ukudla ukudla okuningi okusekelwe ezitshalweni njengemifino nezithelo , ukunciphisa inyama noshizi, kanye nokunciphisa ama-carbohydrate njengoshukela nesinkwa kungasiza ngezimpawu zakho ze-sarcoidosis. Kodwa qiniseka ukuthi ubuza udokotela wakho ngaphambi kokuqala ukudla okusha.

Ingabe i-sarcoidosis ingavinjelwa?

Ngenxa yokuthi imbangela eqondile ayaziwa, ayikho indlela yokuvimbela i-sarcoidosis noma ukunciphisa ingozi yokuyithola. Kodwa-ke, ukuthatha imithi njengoba kuyalelwe udokotela wakho kungasiza ekunciphiseni umonakalo ezithweni zomzimba obangelwa ama-granuloma.

Iyini inhloso ye-sarcoidosis?

I-Sarcoidosis iyahlukahluka ngobukhulu bayo. Kwabaningi, kuyisimo sesikhashana esiba ngcono ngokwaso noma ngokwelashwa. Kwabanye, ingaba yisifo sesikhathi eside ('isifo esingamahlalakhona') futhi ibangele umonakalo ohlala njalo.

Cabanga ngalokhu: Cishe izingxenye ezimbili kwezintathu zabantu abane-sarcoidosis bazolulama ngokugcwele (okungukuthi, lesi sifo sizoba `ekuphumuleni') zingakapheli iminyaka emibili kuya kwemithathu. Labo abane-Löfgren syndrome okukhulunywe ngayo ngaphambilini banethuba elingcono kakhulu lokululama, ngokuvamile zingakapheli izinyanga eziyisithupha kuya eminyakeni emibili.

Abantu abasenayo i-sarcoidosis ngemva kweminyaka emithathu banamathuba amaningi okuthola lesi sifo sesikhathi eside. Kodwa-ke, ngisho nakulabo abane-sarcoidosis yesikhathi eside, abantu abayi-10% kuya ku-20% kuphela abathola ukulimala kwezitho zomzimba unomphela. Inkinga evame kakhulu ukuba nezibazi emaphashini.

Iningi leziguli ezine-sarcoidosis liphila isikhathi esijwayelekile sokuphila. Bambalwa kakhulu abantu abafayo (1% - 5%). Ngakho-ke, akukho okufanele ukhathazeke ngakho, lesi yisimo esilawulekayo.

Ngingazinakekela kanjani ngenkathi ngiphila ne-sarcoidosis?

Into engcono kakhulu ongayenza ukulandela imiyalelo kadokotela wakho. Qhubeka uhlola izimpawu zakho njalo ukuze ubone izinguquko. Phuza imithi yakho njengoba uyalelwe. Kubalulekile futhi ukuhlala uzolile.

Kufanele ngimbone nini udokotela?

Uma uba nezimpawu ezintsha, uma izimpawu zakho ziba nzima, noma uma uphuza imithi futhi unenkinga ngemiphumela emibi, bona noma ukhulume nodokotela wakho ngokushesha.

Yimiphi imibuzo okufanele ngiyibuze udokotela wami?

Kungaba usizo ukubuza le mibuzo uma uvakashela udokotela wakho:

• Ingabe kungizuzisa kakhulu ukufuna ukwelashwa noma ukuqapha izimpawu zami?
• Kuthatha isikhathi esingakanani ukuthi izimpawu zithuthuke?
• Ngingazi kanjani ukuthi ukwelashwa kwami ​​​​kuyasebenza?
• Ingabe kudingeka ngenze izinguquko endleleni yami yokuphila?
• Kufanele ngize nini ukukubona futhi?

Ngamafuphi (Umyalezo Wokuya Ekhaya)

I-Sarcoidosis yisimo esingavamile esingabangela izimpawu ezahlukahlukene. Ungakhathazeki, isikhathi esiningi sizophela sodwa noma ngokwelashwa. Nakuba kungaba isikhathi eside, singaphathwa kahle ngemithi kanye neseluleko sezokwelapha. Khumbula, kwezinye izimo kungaba ngcono ukuqapha izimpawu zakho ngaphandle kokwelashwa. Wena nodokotela wakho ninganquma ukuthi yini engcono kakhulu kuwe. Ngakho-ke, hlala uqinile futhi ulandele iseluleko sikadokotela wakho.

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