Uke wezwa ngalesi sifo? Ake sixoxe ngokuthi iyini i-Microscopic Polyangiitis (MPA)!

Sawubona! Namuhla sizokhuluma ngesimo esingavamile ukuzwakala ngaso, kodwa esingaba sibaluleke kakhulu. Sibizwa ngokuthi i-microscopic polyangiitis, noma ngesiNgisi `(Microscopic Polyangiitis)`, noma `(MPA)` ngamafuphi. Nakuba igama lingase lizwakale liyinkimbinkimbi kancane, ake sizame ukuliqonda kalula. Ungakhathazeki, ngilapha ukuzochaza kuwe.

Iyini ngempela le MPA?

Kalula nje, i-MPA yisifo esingavamile lapho imithambo yegazi emincane kakhulu emzimbeni wethu ivuvukala, noma njengoba odokotela bekubiza kanjalo, ivuvukala. Lokhu kuvuvukala kwemithambo yegazi kuvame ukubizwa ngokuthi i-vasculitis . Cabanga nje, kunemithambo eminingi emincane emzimbeni wethu ethwala igazi njengamapayipi amanzi. Lapho imithambo enjalo ivuvukala ngaphakathi, igazi eligeleza kuyo liyavaleka. Kwenzekani-ke? Izinhlelo zethu ezibalulekile zomzimba, okungukuthi, izingxenye zomzimba ezidinga ukondliwa yilezo mithambo yegazi, zingonakala. Izindawo ezivame ukuthinteka yi-MPA yilezi:

• Izinso
• Amaphaphu
• Isimiso sezinzwa (izinto ezifana nezinzwa zethu)
• Isikhumba
• Amalunga (lapho amathambo ethu ehlangana khona)

Kuhle ukwazi ukuthi kukhona olunye uhlobo lwe-vasculitis olunezimpawu ezifana neze-MPA, olubizwa ngokuthi i-Granulomatosis ene-Polyangiitis (GPA). Ngaphambilini lwalubizwa ngokuthi i-Wegener's granulomatosis. Ukwelashwa kwazo zombili lezi zifo kufana kakhulu.

Ngakho-ke, iyini ngempela le 'Vasculitis'?

I-Vasculitis, njengoba ngishilo ekuqaleni, ukuvuvukala kwemithambo yegazi. Uma lokhu kwenzeka, izindonga zale mithambo yegazi zingaba buthakathaka. Ngezinye izikhathi zingaba buthakathaka futhi zikhukhumale njengebhaluni - odokotela bakubiza lokhu ngokuthi i-aneurysm. Ngezinye izikhathi, lezi zindonga zemithambo yegazi zingaba ncane kakhulu futhi ziqhume. Lokhu kubangela ukuthi igazi livuza ezicutshini ezizungezile. Njengoba nje ipayipi lamanzi livalwa yi-clot, i-vasculitis ibangela ukuthi imithambo yegazi inciphe futhi ngezinye izikhathi ivaleke ngokuphelele. Njengoba igazi lingakwazi ukugeleza kuzo, izitho ezithola umoya-mpilo nezinye izakhamzimba ezivela kulowo mthambo wegazi ziyalimala. I-MPA ithinta kakhulu imithambo yegazi emincane nephakathi .

Ubani okungenzeka kakhulu ukuthi athuthukise le MPA?

Empeleni lesi yisifo esingavamile kakhulu. Ngokwezibalo, kuthiwa phakathi kwabantu abayi-13 no-19 kwabayizigidi (izinkulungwane eziyishumi) banesifo. Lokho kusho ukuthi asivamile kakhulu, akunjalo? Lesi sifo singakhula kunoma ubani wanoma yimuphi ubudala , futhi akukho mehluko phakathi kwabesilisa nabesifazane , bobabili bangasikhula ngokulinganayo.

Kungani le MPA yadalwa?

Odokotela abakayitholi imbangela ethile yokuthuthukiswa kwe-MPA.. Lokhu akusiwo umdlavuza, akusiwo isifo esithelelanayo, futhi akusiwo isifo esivame ukusabalala emindenini. Kodwa-ke, ucwaningo luye lwathola ukuthi amasosha ethu omzimba yiwo abangela lokhu. Kalula nje, amasosha omzimba, afana nesosha okufanele livikele imizimba yethu ezifweni, aqala ngephutha ukuhlasela imithambo yegazi yalo . Yilapho le mithambo yegazi ivuvukala khona, ibangele umonakalo ezithweni zomzimba. Akukubi lokho?

Ziyini izimpawu ze-MPA? Sizibona kanjani?

Ngenxa yokuthi i-MPA ingathinta izinhlelo eziningi zezitho zomzimba, izimpawu ziyahlukahluka kakhulu . Akuwona wonke umuntu ozoba nezimpawu ezifanayo. Abanye abantu bangase babe nezimpawu ezivamile ezifana nalezi:

• Ukuzizwa ukhathele ngaso sonke isikhathi, uzizwa uvilapha
• Imfiva
• Isifiso sokudla
• Ukwehlisa isisindo

Ngaphezu kwalokho, izimpawu ezithile zingavela kuye ngokuthi isitho sithintekile. Isibonelo:

• Uma amaphaphu ethintekile: Ubunzima bokuphefumula, noma ukukhwehlela igazi elincane.
• Uma uhlelo lwezinzwa luthintekile: imizwa engavamile njengokungazweli emilenzeni, ukulahlekelwa umuzwa kamuva kulezo zindawo, noma ukwehla kwamandla emilenzeni.
• Uma kuthinta isikhumba: Ukuqubuka kwesikhumba, okungukuthi, amabala afana ne -eczema .
• Uma imisipha namalunga kuthinteka: ubuhlungu kulezo zindawo.

Into ebalulekile ukuthi noma ngabe i-MPA ilimaze izinso, ingase ingakhombisi zimpawu ezigabeni zokuqala! Isiguli singase singakuboni kuze kube yilapho ukusebenza kwezinso kuphazamiseka kakhulu . Yingakho kubaluleke kakhulu ukuthi odokotela benze ukuhlolwa komchamo kunoma yisiphi isimo se- 'vasculitis' .

Izimpawu eyodwa noma ngaphezulu zingase zenzeke kanyekanye.

Odokotela bayixilonga kanjani i-MPA?

Ukuxilonga i-MPA kufana nophenyo oluyimfihlo. Odokotela baqoqa ulwazi emithonjeni eminingi ehlukene. Uma kusolwa ukuthi lesi sifo sikhona, benza okulandelayo:

• Babuza ngomlando wakho wezokwelapha: yiziphi izimpawu onazo nokuthi usunesikhathi esingakanani unazo.
• Kuhlolwa ngokomzimba: ukuthola ukuthi yiziphi izingxenye zomzimba ezithintekile nokukhipha ezinye izifo ezingaba nezimpawu ezifanayo.
• Ukuhlolwa kwegazi : ukubona ukuthi yiziphi izitho zomzimba ezithintekile, ikakhulukazi 'ama-antineutrophil cytoplasmic antibodies (ANCA)'Ukuhlola ukuthi ngabe kukhona yini ama-antibodies egazini. Uma lokhu kuhlolwa kwe-`(ANCA)` ku-`positive`, kuwubufakazi obuhle ukusola ukuthi kukhona isifo se-`(MPA)`. Kodwa-ke, lokhu kuhlolwa kwegazi kukodwa akukwazi ukufakazela ukuthi i-`(MPA)` ikhona, futhi akukwazi ukutshela ukuthi lesi sifo sisebenza kangakanani.
• Ukuhlolwa komchamo: Hlola amaprotheni noma amaseli abomvu egazi angaphezulu komchamo (lokhu kubaluleke kakhulu ukwazi ukuthi izinso zithintekile yini).
• Ukuhlolwa kwezithombe: Kungenziwa ama-X-ray, ama-computed tomography (CT) scan, noma ama-magnetic resonance scan (MR) scan ukuze kubhekwe ukukhubazeka ezindaweni ezifana namaphaphu.

Uma sekusolwa i-MPA, kuthathwa ingcezu encane yezicubu esithweni esithintekile bese ihlolwa (i-biopsy) . Lena ukuphela kwendlela yokuqinisekisa ukuthi une-vasculitis. Kodwa-ke, i-biopsy yenziwa kuphela uma kukhona ukuphazamiseka okuvela ezivivinyweni zezokwelapha, kuma-scan, noma ekuhlolweni ngokomzimba.

Yiziphi izindlela zokwelapha i-MPA? (Ukwelashwa)

Umgomo oyinhloko wokwelashwa kwe-MPA ukulawula amasosha omzimba ethu, okuyinto engasebenzi kahle. Imithi yokucindezela amasosha omzimba iyimithi eyinhloko esetshenziselwa lokhu. Kunezinhlobo eziningana zale mithi, kodwa umuthi ngamunye unemiphumela emibi, ngakho-ke kufanele usetshenziswe kuphela ngaphansi kweseluleko sikadokotela.

• Uma i-MPA ithinte kakhulu izinhlelo ezibalulekile zomzimba , ama-corticosteroids avame ukunikezwa kanye nomunye umuthi wokucindezela amasosha omzimba, njenge-cyclophosphamide (Cytoxan®) noma i-rituximab (Rituxan®).
• Uma lesi sifo singesibi kakhulu , umuthi obizwa ngokuthi "i- Methotrexate " ungasetshenziswa kuqala kanye "ne-Corticosteroids".

Umgomo oyinhloko wokwelashwa ukuvimba wonke umonakalo obangelwa yi-MPA nokuletha lesi sifo endaweni lapho silawulwa khona ngokuphelele. Lokhu kubizwa ngokuthi "ukuxolelwa." Uma lesi sifo sibonakala sithuthuka, odokotela banciphisa kancane kancane umthamo wama-corticosteroids futhi ekugcineni bazama ukuwayeka ngokuphelele. Uma kusetshenziswa i-cyclophosphamide, inikezwa kuphela kuze kube yilapho kufinyelelwa ukuxolelwa (ngokuvamile izinyanga ezintathu kuya kweziyisithupha). Bese, ukuze kugcinwe ukuxolelwa, esinye isidakamizwa sokucindezela amasosha omzimba sishintshelwa ku-methotrexate, kusetshenziswa i-azathioprine (Imuran®) noma i-mycophenolate mofetil (Cellcept®). Ubude balokhu kwelashwa kokunakekelwa bungahluka kumuntu nomuntu. Ezimweni eziningi, okungenani unyaka noma emibili.Le mithi iyanikezwa, bese odokotela bezama ukunciphisa umthamo bese bewuyeka. Cabanga ngakho, eminye yemithi esetshenziswa kulezi zindlela zokwelapha isetshenziswa nakwezinye izifo. Isibonelo, imithi ebizwa ngokuthi `(Azathioprine)` kanye `(Mycophenolate mofetil)` inikezwa ukuvimbela umzimba ukuthi wenqabe isitho ngemva kokufakelwa isitho. Imithi ebizwa ngokuthi `(Methotrexate)` inikezwa futhi ezifweni ezifana ne-rheumatoid arthritis kanye ne-psoriasis. Imithi ebizwa ngokuthi `(Cyclophosphamide)` kanye `(Methotrexate)` nayo inikezwa ngemithamo ephezulu yezinhlobo ezithile zomdlavuza, futhi ngaleso sikhathi ibizwa nangokuthi `(chemotherapy)`. Kodwa ungesabi , inikezwa `i-vasculitis` ngemithamo ephansi ngokuphindwe kayi-10 kuya kweyi-100 kunemithamo enikezwa umdlavuza. Lapha, umsebenzi oyinhloko wale mithi akukhona ukubulala amangqamuzana omdlavuza, kodwa ukulawula umsebenzi wesimiso sokuzivikela komzimba. I-Rituximab umuthi osesigabeni semithi ebizwa ngokuthi ama-biologic agents. Isebenza ngokubhekisa engxenyeni ethile yesistimu yokuzivikela komzimba. Ucwaningo lwamuva nje luthole ukuthi i-Rituximab iyasebenza njenge-Cyclophosphamide ekwelapheni i-MPA enzima.

Ngenxa yokuthi le mithi ibuthakathaka isimiso somzimba sokuzivikela , kunengozi yokuthola izifo ezinkulu. Ngaphezu kwalokho, kunemiphumela emibi etholakala emuthini ngamunye wokucindezela amasosha omzimba. Ngakho-ke, kubaluleke kakhulu ukuba ngaphansi kokuqashwa njalo kwezokwelapha ngemiphumela emibi lapho usebenzisa le mithi. Ngisho noma umuthi ubekezelelwa ekuqaleni, isimo singashintsha ngokuhamba kwesikhathi. Ngakho-ke, kubaluleke kakhulu ukuqhubeka nokulandela iseluleko sezokwelapha nokwenza izivivinyo ezidingekayo. Ngezinye izikhathi, ngisho nangemva kokuyeka umuthi, kufanele uqaphele ngemiphumela emibi yesikhathi eside.

Ayini amathuba okululama kweziguli ze-MPA? (I-Outlook)

Ngenxa yokuthi i-MPA iyisifo esingavamile, kunzima ukunikeza izibalo eziqondile zokululama. Kodwa-ke, ngokwesilinganiso, abantu abangaphezu kuka-80% abane-MPA bakhululekile emiphumeleni yesifo ngemva kweminyaka emihlanu. Le miphumela iyahlukahluka kuye ngokuthi lesi sifo sibucayi kangakanani. I-MPA ingaqhubeka kancane, futhi nakuba kuyisifo esibi kakhulu, iziguli eziningi ziyalulama kahle kakhulu . Ngokuqala ukwelashwa kusenesikhathi futhi ziqashwe ngokucophelela ngudokotela, umonakalo ezithweni zomzimba ungancishiswa. Ngisho nalabo abanezimo ezinzima kakhulu ze-MPA bangafinyelela isikhathi sokululama uma beqala ukwelashwa kusenesikhathi futhi benze lokho odokotela babo ababatshela ukuthi bakwenze. Ngisho nangemva kwesikhathi sokululama, i-MPA isengabuya. Lokhu kubizwa ngokuthi "ukubuyela emuva." Lokhu kwenzeka kubantu abangaba ngu-50% abane-MPA. Lokhu kubuyela emuva kungase kufane nezimpawu owawunazo lapho utholakala okokuqala, noma kungase kuhluke. Ukuze kuncishiswe ingozi yokuphindeka okukhulu,Uma uthola izimpawu ezintsha, kubalulekile ukuzibika kudokotela wakho ngokushesha. Kubalulekile futhi ukubona udokotela wakho njalo ukuze ahlolwe igazi futhi ahlolwe izithombe. Ukwelashwa kokubuyela emuva kuyafana nokwalowo osanda kutholakala ukuthi unalesi sifo. Abantu abaningi abane-MPA bangaphinde baphumule.

Ngakho-ke, yiziphi izinto ezibaluleke kakhulu okufanele uzikhumbule kulokho esikhulume ngakho?

Kulungile, sesikhulume kakhulu ngale `(MPA)` manje. Izinto ezibaluleke kakhulu okudingeka uzikhumbule kukho konke lokhu yilezi:

• (i-MPA) yisifo esingavamile kodwa esingaba yingozi lapho imithambo yegazi emincane yomzimba ivuvukala ngenxa yokungasebenzi kahle kwesimiso somzimba sokuzivikela.
• Ngokuvamile kuthinta izinso, amaphaphu, imizwa, isikhumba, kanye namalunga . Nakuba izinso zithinteka kakhulu, kungase kungabi nazimpawu ekuqaleni .
• Kubaluleke kakhulu ukuxilonga lesi sifo bese uqala ukwelashwa kusenesikhathi.
• Ukwelashwa kuhilela imithi ecindezela amasosha omzimba. Ukuqapha njalo nokuhlolwa kwezokwelapha kubalulekile uma usebenzisa lokhu.
• Ngisho noma lesi sifo siphela (ukuxolelwa), singabuya (ukubuyela emuva) . Ngakho-ke qaphela izimpawu ezintsha.
• Khuluma nodokotela wakho ngokukhululekile , ubuze imibuzo, futhi wabelane ngemizwa yakho. Yilokho okungcono kakhulu ongakwenza.

Ngiyethemba ukuthi lolu lwazi luzokusiza. Uma unenkinga nganoma yiziphi izimpawu, sicela ungakhohlwa ukufuna iseluleko sezokwelapha.