Iyini i-Felty Syndrome? Lokhu kubalulekile kulabo kini abane-arthritis!

Ungase ube nobuhlungu bamalunga, ukuvuvukala, kanye nokuqina kancane ezithweni zakho ekuseni, akunjalo? Isikhathi esiningi, lokhu kungabangelwa yi-rheumatoid arthritis. Kodwa bewazi ukuthi kukhona enye inkinga engahambisana nalesi simo se-arthritis, kodwa ayaziwa kangako, kodwa kubaluleke kakhulu ukwazi ngayo? Leyo yi-Felty Syndrome. Ake sixoxe ngalokhu ngemininingwane ethe xaxa namuhla.

Iyini ngempela i-Felty Syndrome?

Kalula nje, i-Felty Syndrome iyinhlanganisela yezimo ezintathu ezenzeka ndawonye. Lezi yizi:

• I-Rheumatoid Arthritis - Ukuvuvukala kwamalunga abaningi kini abajwayelene nakho.
• I-Neutropenia - Lokhu ukwehla kwenani lama-neutrophil, uhlobo lweseli elimhlophe legazi egazini.
• I-Splenomegaly - Lokhu kusho ukuthi i-spleen, isitho emzimbeni, iba nkulu kunokuvamile.

Ngokuvamile kuqala nge-rheumatoid arthritis (RA). Ezinye izimo ezimbili zenzeka njengezinkinga ze-RA. Odokotela babiza lokhu ngokuthi 'ukubonakaliswa okungaphandle kwe-articular'. Okusho ukuthi, i-arthritis ayigcini nje emalungeni, kodwa ithinta amalunga angaphandle kwawo. Lokhu kungenxa yenqubo yokuvuvukala ebangela i-arthritis. Nakuba kuvamile ukuthi lezi zinhlobo zemiphumela zenzeke ngaphandle kwamalunga ane-RA, i-Felty Syndrome iyisimo esingavamile.

Lokhu kukuthinta kanjani?

I-Felty's syndrome iqala nge-Rheumatoid Arthritis. Bese uba nobuhlungu obukhulu nokuvuvukala emalungeni akho. Bese kuthi, lapho kuvela izimo ezifana ne-Neutropenia ne-Splenomegaly, kuthinte amasosha omzimba wakho. I-Neutropenia ukwehla kohlobo lweseli elimhlophe legazi elibizwa ngokuthi ama-neutrophils. Lawa ma-neutrophils awuhlobo olubaluleke kakhulu lweseli oluvikela umzimba wethu ezifweni. Ngakho-ke uma ehla, amathuba okukhula kwezifo ayanda. Ukwanda kwe-spleen kungaba esinye isizathu salokhu kwehla kwama-neutrophils.

Sivame kangakanani lesi simo?

I-Felty's syndrome yenzeka kubantu abangaba ngu-2% abane-rheumatoid arthritis. Njenge-RA, i-Felty's syndrome ivame kakhulu ngokuphindwe kathathu kwabesifazane kunakwabesilisa. Ngokuthakazelisayo, cishe bonke abantu abane-RA abathola i-Felty's syndrome 'bane-seropositive'. Lokhu kusho ukuthi ukuhlolwa kuqinisekisa ukuthi banento ebizwa ngokuthi ama-rheumatoid factor antibodies egazini labo. Abantu 'abane-seronegative', okusho ukuthi abantu abangenawo lawo ma-antibodies, abavamile ukuba ne-Felty's syndrome.

Ziyini izimpawu zalokhu?

Ngokuvamile, izimpawu zokuqala ezibonakala yizo ze-rheumatoid arthritis. Lezi zimpawu zifaka:

• Ubuhlungu bamalunga
• Ukuvuvukala kwamalunga
• Ukuqina kwamalunga, ikakhulukazi ekuseni

Abanye abantu bangase babe nezinye izimpawu ngaphezu kwe-RA emalungeni abo. Isibonelo:

• Amaqhubu akheka ngaphansi kwesikhumba eduze kwamalunga (lawa abizwa ngokuthi amaqhubu e-rheumatoid)
• Ama-lymph node avuvukele ezindaweni ezifana nentamo nasemakhwapheni
• Isibindi singase sivuvuke futhi sibe buhlungu uma usithinta.
• Amehlo nomlomo owomile (lokhu kubizwa ngokuthi i-Sjogren's syndrome)
• Amehlo abomvu, avuvukele (lokhu kubizwa ngokuthi i-episcleritis)
• Izilonda zesikhumba, ikakhulukazi emilenzeni
• Izimpawu zokuphuma kwegazi ngaphansi kwesikhumba
• Ubunzima bokuphefumula ngenxa yokuvuvukala kwamaphaphu
• Ubuhlungu besifuba obubangelwa ukuvuvukala okuzungeze inhliziyo
• Imfiva
• Ukukhathala kanye nokuzola
• Ukulahlekelwa yisifiso sokudla noma ukwehla kwesisindo okungachazeki

Ngaphezu kwalokhu, i-Felty Syndrome inezinye izimpawu. Ngezinye izikhathi lezi zimpawu zingase zivele ngaphambi kokuqala kwezimpawu ze-RA.

• Izifo ezivame ukwenzeka isikhathi eside. Izibonelo zifaka phakathi umkhuhlane, ukucasuka kwesisu, kanye nezifo zesikhumba.
• Ukuvuvukala kwe-spleen. Kungase kuzwakale esandleni futhi kungaba buhlungu.
• Ukushintsha kombala wesikhumba (njengamabala).

Kodwa into emangalisayo ukuthi, ngezinye izikhathi ungatholakala une-Felty Syndrome ngaphandle kwezimpawu. Ukuhlolwa kwegazi kanye nokuskena kungabonisa ukuthi unazo zonke lezi zimo ezintathu ngaphambi kokuba uzizwe ngisho nezimpawu.

Lokhu kuvame ukuqala eneminyaka emingaki?

I-Felty Syndrome ivame ukukhula kubantu abadala, abaneminyaka ephakathi kuka-50 no-70. Kubantu abaningi, i-Felty Syndrome ivela ngemva kokuba sebenezimpawu ze-rheumatoid arthritis iminyaka engaba ngu-10 kuya ku-15.

Kungani kwenzeka i-Felty Syndrome?

I-rheumatoid arthritis 'isifo esihlasela umzimba'. Lokhu kusho ukuthi amasosha ethu omzimba ahlasela izingxenye zomzimba wethu njengokungathi ziyisitha. Ososayensi abaningi bakholelwa ukuthi i-Felty Syndrome iyinkinga enkulu ye-RA. Kulezi zifo ezihlasela umzimba, imizimba yethu ikhiqiza 'ama-antibodies' ngokumelene namaprotheni athile. Lawa ma-antibodies ayahamba ayobamba lawo maprotheni bese ewabonisa ukuthi abhujiswe. Yile ndlela ukuvuvukala okwanda ngayo.

Lawa ma-antibodies kungenzeka angabi khona njalo ku-RA. Kodwa-ke, kubantu abane-Felty Syndrome, lawa ma-antibodies akhona nakanjani. Ukuba khona kwala ma-antibodies kuyisizathu esenza i-RA ibe nzima kakhulu futhi eminye imiphumela ngaphandle kwamalunga (ukubonakaliswa kwe-extra-articular) yande. I-RA enama-antibodies ibizwa ngokuthi 'i-seropositive RA'. Ucwaningo lubonisa ukuthi kokubili i-seropositive RA kanye ne-Felty Syndrome kuhlotshaniswa 'nezici ezithile zofuzo'. Lokhu kusho ukuthi zingadluliselwa ezizukulwaneni ngezinga elithile.

I-rheumatoid arthritis (RA) iyibangela kanjani i-neutropenia kanye ne-splenomegaly?

Indlela i-Neutropenia Eyenzeka Ngayo

I-Neutropenia ukwehla kwenani lamaseli amhlophe egazi abizwa ngokuthi ama-neutrophils. Kunezizathu ezimbili eziyinhloko zalokhu. Esinye ukuthi umongo wakho wethambo awukhiqizi ama-neutrophils anele. Noma, ama-neutrophils emzimbeni wakho ayabhujiswa. Ku-Felty Syndrome, zombili lezi zingenzeka. Inqubo yokuzivikela komzimba okukhulunywe ngayo ngaphambili ingaphazamisa ukukhiqizwa kwama-neutrophils emnothweni wethambo, kanti ama-neutrophils asevele ekhiqizwa angabhujiswa. Futhi, udende olukhulisiwe lungenye yezizathu zokwehla kwama-neutrophils.

Indlela i-Splenomegaly Eyenzeka Ngayo

Umsebenzi wobende lakho ukuhlunga amangqamuzana egazi amadala, angenamsebenzi egazini lakho. Kodwa uma ubende lakho liba likhulu kakhulu (i-splenomegaly), liba matasa kakhulu futhi liqale ukususa amangqamuzana egazi amaningi amahle. I-rheumatoid arthritis ngezinye izikhathi ingabangela ubende elikhulu. Imbangela eqondile ayikacaci okwamanje. Ubende lungakhula futhi ngaphandle kwe-neutropenia. Futhi, akuvamile kakhulu, i-Felty Syndrome ingenzeka ngaphandle kobende elikhulu.

Yiziphi izinkinga eziyingozi ze-Felty Syndrome?

Ngenxa yokuthi i-Felty Syndrome yenza buthaka amasosha omzimba wakho, usengozini enkulu yokuthola izifo ezivame ukwenzeka futhi ezingathi sína . Ngisho noma uvame ukuba nesifo esincane esingelashwa kalula, lesi simo singaba sibi ngokwanele ukuba siqhubeke futhi ngezinye izikhathi sibe yingozi empilweni. Ukutheleleka ngamagciwane okungalawulwa kungaholela esimweni esiyingozi esibizwa ngokuthi i-sepsis. Abantu abane-Felty Syndrome nabo basengozini enkulu yokuthola izinhlobo ezithile zomdlavuza, njenge-lymphoma.

Kodwa ungesabi uma uzwa lezi zinto. Lezi zingozi zikhona, kodwa zingalawulwa ngokuphathwa kahle nokunakwa.

Ungakubona kanjani lokhu?

Odokotela bathola i-Felty Syndrome uma bethola ukuthi kukhona isifo samathambo esibizwa ngokuthi i-rheumatoid arthritis, i-neutropenia, kanye ne-splenomegaly. (Akuvamile ukuthi lesi sifo sitholakale ngaphandle kokuba ne-spleen ekhulisiwe.)

Ukuhlolwa okwenziwa ngokuvamile yilokhu:

• Ukuhlolwa kwegazi: Ukubalwa kwegazi okuphelele, ikakhulukazi ukuhlola inani lama-neutrophils.
• Ama-X-ray amalunga: Hlola ukuthi awunaso isifo samathambo.
• Ukuskena kwe-spleen: Isibonelo, i-ultrasound noma i-CT scan.
• Ukuhlolwa komnkantsha wethambo:Lokhu kusiza ukuqinisekisa ukuthi azikho ezinye izimo zezokwelapha.

Iyini indlela yokwelapha lokhu?

Kunemigomo emithathu eyinhloko lapho ukwelapha i-Felty Syndrome:

• Ukulawula isimo esiyisisekelo se-Rheumatoid Arthritis.
• Uma i-neutropenia inzima kakhulu, yelaphe ngqo.
• Ukuvimbela izifo kanye nokwelapha uma zivela.

I-Felty Syndrome ingaba umphumela we-rheumatoid arthritis (RA) engalashwanga noma engalawulwa kahle. Kwabaningi, i-neutropenia nayo iyathuthuka njengoba i-RA yabo ithuthuka. Ngakho-ke, odokotela baqala ngokubheka ukukhetha imithi yokulwa namathambo ephumelelayo eguqula izifo (DMARDs) ye-RA. Bazama nokugwema imithi yokucindezela amasosha omzimba ngangokunokwenzeka.

Kunezinhlobo eziningana ze-DMARD ezingasetshenziswa kwi-Felty Syndrome:

• I-Methotrexate kanye ne-folic acid (kunciphisa imiphumela emibi ye-methotrexate)
• I-Abatacept
• I-Rituximab
• I-Leflunomide

Kodwa uma i-neutropenia yakho ingathuthuki ngalezi DMARD, noma uma i-neutropenia yakho inzima kakhulu, noma uma usuvele unegciwane, udokotela wakho uzozama ezinye izindlela zokwelapha ukwandisa inani lakho le-neutrophil. Lokhu kungafaka:

• Umuthi wokugoma obizwa ngokuthi i-G-CSF (i-granulocyte colony-stimulating factor).
• Imithi ye-corticosteroid yesikhathi esifushane.
• 'I-Splenectomy' - Lokhu kusho ukususa ngokuhlinzwa ubende osebenza ngokweqile.

Futhi, odokotela bazothatha izinyathelo ezikhethekile zokukuvikela ezifweni, ikakhulukazi uma ukwelashwa kwakho kuthinta amasosha omzimba wakho. Bangase batuse izinto ezifana nalezi:

• Ukuthatha ama-antibiotic e-broad spectrum.
• Ukuthola imijovo edingekayo.
• Naka ngokukhethekile impilo yomlomo namazinyo akho.

Uma umuntu one-Felty Syndrome ethola ukutheleleka, odokotela bakubheka njengento ebaluleke kakhulu. Uma lokhu kwenzeka kuwe , udinga ukwelashwa ngokushesha . Udokotela wakho uzokunikeza imithi enamandla.

Iyini isikhathi sokuphila nge-Felty Syndrome?

Azikho izibalo zamanje mayelana nokulindeleke kokuphila kwabantu abane-Felty Syndrome. Kodwa-ke, ngokuvamile, ukwelashwa kuthuthuke kakhulu eminyakeni yamuva. Ngakho-ke kunethuba elihle lokuthi noma yikuphi ukwelashwa kuzophumelela kuwe. Ingozi enkulu yokufa ku-Felty Syndrome isesekuthelelekeni okukhulu . Ngakho-ke, ukuthatha izinyathelo zokuzivikela ekuthelelekeni kungenza umehluko omkhulu empilweni yakho yesikhathi eside.

I-Felty Syndrome iyinkinga engavamile futhi evame ukunganakwa ye-rheumatoid arthritis (RA). Uma une-RA engalawuleki isikhathi eside, noma uma imithi yakho iyeka ukusebenza njengoba yayisebenza, ungase ube ne-Felty Syndrome. Abanye abantu bayihlakulela ngaphandle kwezimpawu. Kungaba yinto edidayo kancane ukwazi ukuthi isifo esithinta amalunga akho singathinta namaseli akho egazi.

Uma usuvele ubhekene ne-RA, futhi mhlawumbe nezinye izimpawu, kungaba nzima ukuthola ukuxilongwa okusha. Kodwa i-Felty Syndrome ayibangeli izimpawu eziningi ezintsha, futhi ingase ingadingi ukwelashwa okwengeziwe. Into ebalulekile ukuqaphela izingozi. Ngokusebenzisana nodokotela wakho ukwelapha i-RA yakho nokuvimbela ukutheleleka, ungaphatha i-Felty Syndrome.

Okokugcina, izinto okufanele uzikhumbule

I-Felty Syndrome yisimo esingaba khona kwabanye abantu abane-rheumatoid arthritis (RA). Sibonakala ngokuncipha kwenani lamaseli amhlophe egazi abizwa ngokuthi ama-neutrophils egazini lakho (i-neutropenia) kanye nokwanda kwe-spleen (i-splenomegaly).

• Ingozi enkulu ukutheleleka njalo, ngakho-ke kubaluleke kakhulu ukuzivikela ezifweni.
• Nakuba lokhu kungase kubonakale kusabisa kancane, lesi simo singalawulwa kahle ngokwelashwa okufanele kanye neseluleko .
• Uma une-RA, qaphela lezi zimpawu ezengeziwe. Uma unenkinga , qiniseka ukuthi ukhuluma nodokotela wakho. Bazokwazi ukukusiza.

Isifo sikaFelty , Isifo Sokuqaqamba Kwamalunga, I-Neutropenia, I-Splenomegaly, I-Arthritis, Ukuvuvukala Kwamalunga, Ama-Neutrophils, I-Spleen, Ukungavikeleki Emzimbeni