Ingabe unezinkinga ngemithambo yakho yegazi? Ake sixoxe nge-GPA (i-Granulomatosis ene-Polyangiitis)!

Ingabe ngezinye izikhathi uzizwa sengathi umzimba wakho unzima kakhulu, uzwa ubuhlungu ezindaweni ezithile ngaphandle kwesizathu, noma uhlala uzizwa sengathi unomkhuhlane, kodwa awufani nomkhuhlane ovamile? Ngezinye izikhathi, ngemuva kwalezi zinto, kungase kube nesifo esingazwakali kakhulu ngaso, kodwa kubalulekile ukusazi. Leso esinye salezo zimo esibizwa ngokuthi i-GPA.

Iyini i-GPA (i-Granulomatosis ene-Polyangiitis)? Masiyiqonde kalula!

Kulungile, manje ake sibone ukuthi iyini le GPA (i-Granulomatosis ene-Polyangiitis). Ungakhathazeki, ngizoyichaza kalula. Yayibizwa ngokuthi `(i-Wegener's Granulomatosis)`. Kodwa igama elithi `(i-Granulomatosis ene-Polyangiitis)` elisetshenziswayo manje lisho okuningi ngalesi sifo.

Kalula nje, i-GPA iwukuvuvukala noma ukuvuvukala kwemithambo yegazi yakho. Odokotela bakubiza lokhu ngokuthi "i-vasculitis." Cabanga ngale ndlela: imithambo yegazi kuyo yonke imizimba yethu ifana namapayipi amanzi. Uma kukhona okungahambi kahle ngala mapayipi, ukuhamba kwegazi kuyaphazamiseka, akunjalo? Yilokho okwenzekayo lapha.

Manje kunezinto ezimbili ezikhethekile ngale GPA:

• I-Polyangiitis: Lokhu kusho ukuthi ukuvuvukala kwenzeka emithanjeni yegazi eminingi ehlukene emzimbeni wakho, ikakhulukazi emincane . Akugcini endaweni eyodwa kuphela.
• I-Granulomatosis: Lokhu kungase kuzwakale njengegama eliyinkimbinkimbi, kodwa kusho ukuthi amaqhubu amancane, anamaqhubu, avuvukalayo abizwa ngokuthi ama-granuloma akheka emithanjeni yakho yegazi nasezithweni ezithile zomzimba. La maqhubu angalimaza imithambo yegazi nezitho zomzimba zakho.

Ngakho-ke, kunezinhlobo eziningi zalesi simo "se-vasculitis", kodwa uhlobo olubizwa ngokuthi i-GPA luthinta kakhulu imithambo yegazi emincane kakhulu emzimbeni wethu. Ngenxa yokuthi le mithambo yegazi emincane igcwele umzimba wonke, i-GPA ingabangela izinkinga ezingxenyeni eziningi zomzimba, ikakhulukazi izitho ezinemithambo yegazi eminingi emincane. Ngokuvamile, ithinta uhlelo lwakho lokuphefumula (uhlelo lokuphefumula) kanye nezinso.

Lokhu kuvuvukala kwemithambo yegazi kungabangela ukuthi ivuvuke, iqhume, futhi iphume ngisho nokopha. Futhi, imithambo yegazi ingancipha ngenxa yezibazi. Kwenzekani-ke? Izicubu zethu azitholi umoya-mpilo nezakhamzimba ezizidingayo. Ngezinye izikhathi, i-GPA ingadala ngisho nesimo esibizwa ngokuthi "i-pulmonary-renal syndrome", lapho igazi livuza khona ezinso nasemaphashini.

Yiziphi izimpawu eziba khona lapho i-GPA ikhula?

Manje cishe ucabanga ukuthi, 'Kulungile, uma lesi kuyisifo esinjengalesi, singasibona kanjani? Ziyini izimpawu?' Ake sixoxe ngalokho.

Njengoba kushiwo ngaphambili, i-GPA ivame ukuthinta uhlelo lokuphefumula kanye nezinso. Kodwa-ke, ingathinta nezinye izitho eziningi kanye nezicubu, kanye nenhlalakahle yakho iyonke. Lokhu kungenxa yokuthi ihlasela imithambo yegazi emincane kuwo wonke umzimba.

Ngezinye izikhathi, ubuhlungu bemisipha kanye nobuhlungu bamalunga (i-arthritis) kungabangelwa yi-vasculitis ezicutshini zakho ezixhumeneyo.Kanye nezinto ezinjengalezi, ungase uzizwe unesizungu . Futhi, ukukhathala okuqhubekayo, ukuphelelwa yisifiso sokudla, kanye nokwehla kwesisindo kuyizimpawu ezivamile.

Izimpawu zesistimu yokuphefumula

Abantu abaningi baqala ngokusola ukuthi bane-GPA bese befuna ukwelashwa ngenxa yezimpawu zokuphefumula. Ezigabeni zokuqala, lezi zimpawu zingase zifane nomkhuhlane ovamile, umkhuhlane, noma umkhuhlane. Kodwa-ke, zivame ukuhlala isikhathi eside kunokujwayelekile. Hlola ukuze ubone ukuthi unanoma yikuphi kwalokhu:

• Ikhanda elibuhlungu noma ingcindezi endaweni yama-sinus.
• Ukutheleleka kwama-sinus kwenzeka kaningi.
• Kukhona ikhala eligobhozayo njalo, futhi kwakheka uqweqwe oluzungeze ikhala.
• Impumulo yami izwakala igcwele.
• Ukopha igazi njalo ngaphandle kwesizathu.
• Nginobuhlungu bendlebe.
• Ngizwa ubuhlungu esifubeni sami.
• Ngikhwehlela njalo.
• Ukuzizwa uphelelwa umoya (njengokukhwehlela).

Njengoba i-GPA iba nzima kakhulu, ungase ube nokuvuvukala (i-polychondritis) kwe-cartilage ezindlebeni zakho, ekhaleni, nasemphinjeni. Lokhu kungabangela izimpawu ezingathi sína, njenge:

• Impumulo ivuvukala kakhulu kangangokuthi ingxenye ephezulu yempumulo ishona ngaphakathi (lokhu kubizwa nangokuthi ikhala lesihlalo).
• Umphimbo, noma ingxenye engenhla yomphimbo womoya, iyancishiswa (i-subglottic stenosis). Lokhu kungabangela izwi elihoshozelayo nomsindo wokukhala komoya lapho uphefumula (ukushaya komoya noma i-stridor).
• Ukuvuvukala kwendlebe yangaphakathi kungabangela isiyezi (vertigo) kanye nokulahlekelwa ukuzwa.

Futhi, kungenzeka ukuthi uphuma igazi emaphashini akho. Uma lokhu kwenzeka, ungase ube nobunzima bokuphefumula noma ukukhwehlela igazi .

Izimpawu ezihlobene nezinso

Ungase ungezwa ubuhlungu ezinso zakho uma une-GPA. Kodwa-ke, ungase uqaphele izinguquko emchameni wakho. Isibonelo, umchamo onegwebu noma igazi emchameni wakho. Futhi, ukuvuvukala kobuso noma imilenze (i-edema) kungenye impawu yesifo sezinso.

Uma une-GPA, odokotela bazohlola izinso zakho njalo, noma ngabe awukaze ube nezimpawu. Lokhu kungenxa yokuthi i-GPA ingase ingazithinti izinso zakho ezigabeni zokuqala, kodwa ngokuhamba kwesikhathi, cishe izothinta izinso zakho.

Izimpawu ezihlobene namehlo

I-GPA ingathinta namehlo akho. Ingabangela ukuvuvukala ebusweni noma ngaphakathi kweso. Lokhu kungabangela ubuhlungu bamehlo, ingcindezi, ukubomvu, nokuvuvukala . Ezimweni ezimbi kakhulu, ukulahlekelwa umbono kungenzeka.

Izimpawu zesikhumba

I-Vasculitis esikhumbeni sakho ingabangela izimpawu ezifana nalezi:

• Ubuso besikhumba bubukeka njengephethini eluhlaza okwesibhakabhaka-obomvu (isikhumba esinamabala).
• Kuvela amabala ansomi, abomvu, noma ansundu (purpura).
• Amaqhubu aqinile (amaqhubu) noma amaqhubu amancane afana nama-blister (ama-papules) angavela esikhumbeni.
• Kungase kube namanxeba angapholi (izilonda).

Izimpawu zesistimu yezinzwa

I-GPA ingathinta nohlelo lwakho lwezinzwa. Ngokuvamile, ithinta uhlelo lwakho lwezinzwa oluseceleni - izinzwa ezigijima kusukela emgogodleni wakho ziye kwezinye izingxenye zomzimba wakho.

Ukuvuvukala nokuvuvukala kungalimaza inzwa eyodwa kuphela, okubangela izimpawu endaweni eyodwa (i-mononeuropathy). Kodwa-ke, kaningi, imizwa eminingi iyathinteka (i-polyneuropathy). Izimpawu zingafaka:

• Izimpawu zemisipha: Njengobuthakathaka bemisipha.
• Izimpawu zokuzwa: ukungazweli, ukuqaqamba, noma ubuhlungu bemizwa.
• Ukungasebenzi kahle kwesimiso sezinzwa esizimele, esilawula umfutho wegazi, ukusebenza kwesinyi, noma ukujuluka.

Yiziphi izinkinga ezinkulu ezingaba khona ngenxa ye-GPA?

Uma i-GPA ingalawulwa kahle, ngezinye izikhathi ingaba yingozi empilweni futhi ibangele umonakalo omkhulu ezithweni zomzimba. Ngakho-ke kubalulekile ukuqaphela lokhu. Nazi ezinye zezinkinga ezinkulu ezingase zenzeke:

• Ukopha kwamaphaphu: Lokhu kungabangela ubunzima bokuphefumula kanye nokwehluleka kokuphefumula.
• I-glomerulonephritis ethuthuka ngokushesha: Lokhu kungaholela ekuhlulekeni kwezinso.
• Ukulahlekelwa umbono noma ukuzwa unomphela.
• Ukulahlekelwa umuzwa wesikhumba noma ukungakwazi ukulawula imisipha (i-peripheral neuropathy).

Yini ebangela ukuthi i-GPA ikhule?

Manje ungase uzibuze, 'Kungani lolu hlobo lwesifo luvela?' Empeleni, i-GPA, njengezinye izinhlobo ze-'(vasculitis)', iyi-'(isifo sokuzivikela komzimba' ). Lokhu kungase kubonakale kunzima ukukuqonda, kodwa ngizokuchaza kalula.

Ngokuvamile, amasosha omzimba wethu afana nomvikeli wethu. Alwa nezifo namagciwane ngokubangela ukuvuvukala. Kodwa-ke, kulezi zifo ezizimele, amasosha omzimba wethu aqala ngephutha ukuhlasela amangqamuzana nezicubu zethu ezinempilo. Ku-GPA, amasosha omzimba ahlasela imithambo yegazi yethu.

Yiziphi izimbangela ezithile ezibangela i-GPA?

Abacwaningi abakakazi kahle ukuthi yini ebangela izifo ezibangelwa amasosha omzimba. Kodwa-ke, bakholelwa ukuthi kunezici eziningana ezibangela lokhu. Ngezinye izikhathi, amasosha omzimba ethu afakwa ngokweqile ngenxa yokucindezeleka, okungaholela kulezi zinhlobo zokungasebenzi kahle. Ezinye izifo ezinkulu zamagciwane kanye namagciwaneUcwaningo luthole nokuthi i-GPA yenzeka ngemva...

I-GPA ingeyeqembu lezifo ezibizwa ngokuthi i-ANCA-associated vasculitis, noma i-AAV . Lezi yizinhlobo ze-vasculitis ezihilela i-antibody ethile ebizwa ngokuthi i-ANCA. Abacwaningi bakholelwa ukuthi le-ANCA idlala indima ebalulekile ekubangeleni ukuvuvukala kulezi zifo, okuhlanganisa ne-GPA.

Uthola kanjani ukuthi une-GPA?

Uma unezimpawu ze-GPA, udokotela wakho uzoqala ngokukubuza ngezimpawu zakho bese ekwenza ukuhlolwa ngokomzimba. Uma izimpawu zakho kanye nomlando wezokwelapha kubonisa ukuthi kungenzeka ukuthi une-GPA, bazoyala ukuthi kwenziwe ezinye izivivinyo ukuze kuhlolwe kabanzi.

Phakathi kwezivivinyo ezisetshenziswa ukuthola ukuthi une-GPA yini kukhona:

• Ukuhlolwa kwegazi: Lokhu kuhlola nokuba khona kwama-antibodies e-ANCA okukhulunywe ngawo ngaphambili.
• Ukuhlolwa Komchamo: Umchamo wakho uhlolwa igazi kanye neprotheni.
• Ama-X-ray esifubeni kanye nama-CT scan: Lokhu kuhlola isimo samaphaphu akho.
• I-biopsy: Kuthathwa ingxenye encane yezicubu emaphashini, ema-sinuses (emakhaleni), noma ezinso bese kuhlolwa ngaphansi kwe-microscope ukuze kubonakale ukuthi kukhona yini izimo ezithile zokuvuvukala.

Yiziphi izindlela zokwelapha i-GPA (Wegener's Granulomatosis)?

Kulungile, manje ake sibheke ukuthi i-GPA iphathwa kanjani. Odokotela belapha i-GPA ngokusebenzisa imithi enciphisa ukuvuvukala futhi icindezele amasosha omzimba (ama-corticosteroids kanye nezinye izidakamizwa zokucindezela amasosha omzimba).

Eminye yale mithi inamandla kakhulu kuneminye. Ukuhlanganiswa kwemithi udokotela wakho ayincomayo kuzoncika ebunzimeni besimo sakho kanye nengozi yakho yemiphumela emibi.

Ukwelashwa okuyisisekelo kwe-GPA esebenzayo:

• Kunikezwa imithamo ephezulu ye-corticosteroids (isb., i-prednisone). Le mithamo incishiswa kancane kancane ngokuhamba kwesikhathi.
• `(Rituximab)`: Lona umuthi omusha we-biologic. Lona manje ukwelashwa okujwayelekile okusetshenziswa kakhulu.
• I-Cyclophosphamide (ezimweni ezinzima kakhulu) noma i-methotrexate (ezimweni ezincane): Le mithi isetshenziselwa nokwelapha umdlavuza. Kodwa-ke, uma inikezwa i-GPA (ngemithamo ephansi kakhulu), isebenza njengemithi yokucindezela amasosha omzimba.
• I-Avacopan: Lo muthi ungasetshenziswa njengokwelashwa okwengeziwe ukunciphisa umthamo we-corticosteroids.

Uma unezinkinga ezinkulu, ungadinga ukwelashwa okwengeziwe. Isibonelo:

• I-Dialysis (uma izinso zingasebenzi kahle)
• Ukufakelwa isitho somzimba

Isimo se-GPAUma isigaba "sokuxolelwa" sesifinyelelwe, okusho ukuthi izimpawu seziphelile futhi isifo sesiphelile, kunikezwa imithi ethambile ukuze kugcinwe leso simo. Lokhu kuvame ukufaka:

• `(Rituximab)`
• Imithi yokucindezela amasosha omzimba emnene: Isibonelo, `(azathioprine)`, `(methotrexate)` noma `(mycophenolate mofetil)`.

Kuyo yonke indlela yokwelashwa kwakho, uzoqhubeka nokuhlolwa ukuze kuqashwe isimo sakho nokuthi usabela kanjani ekwelashweni. Udokotela wakho uzolungisa umuthi wakho kadokotela kanye nomthamo kuye ngempendulo yakho.

Khumbula, yonke imithi ingaba nemiphumela emibi. Ingenzeka nganoma yisiphi isikhathi ngesikhathi sokwelashwa. Ngakho-ke, kungadingeka ukushintsha imithi ukuze kuvinjelwe noma kuncishiswe eminye imiphumela emibi. Zonke lezi zinqumo kufanele zenziwe ngokubonisana nodokotela wakho.

Lizoba yini ikusasa ngalesi simo? (I-Outlook)

I-GPA yisimo sokuphila konke esidinga ukunakekelwa impilo yonke. Ngokwelashwa, lesi sifo singaphela futhi izimpawu zinganyamalala. Kodwa-ke, izimpawu zingabuya futhi (ukubuyela emuva).

Kungase kudingeke ukuthi uphuze imithi njalo empilweni yakho yonke ukuze ulawule ukubuyela emuva. Ngenxa yokuthi le mithi icindezela amasosha omzimba wakho, kuzodingeka futhi unakekele kakhulu ukuze uzivikele kwezinye izifo.

Kungenzeka yini ukuphila impilo ejwayelekile nge-GPA?

Ngokwelashwa okuphumelelayo, ungaphila impilo ejwayelekile nge-GPA. Njengoba kunjalo ngezifo eziningi ezingamahlalakhona, kungaba nezikhathi zokululama nokubuyela emuva. Ngakho-ke inkambo yesifo ingaba phezulu naphansi kancane.

Ingakanani iminyaka yokuphila komuntu one-GPA?

Ngaphandle kokwelashwa, isilinganiso sokuphila singaba yizinyanga ezinhlanu, kanti abantu abangaphansi kuka-50% baphila isikhathi esingaphezu konyaka. Kodwa-ke, ngokwelashwa, izifundo zokulandelela zibonisa ukuthi abantu abangaphezu kuka-80% basaphila ngemva kweminyaka eyisishiyagalombili . Ngakho-ke ungabona ukuthi kubaluleke kangakanani ukuthola ukwelashwa, akunjalo?

Iyini imbangela evame kakhulu yokufa ku-GPA?

Ngaphambi kokwelashwa, ukwehluleka kwezitho zomzimba kuyingozi enkulu yokufa ku-GPA. Ngesikhathi sokwelashwa, lapho amasosha omzimba wakho ebuthakathaka, usengozini enkulu yokutheleleka okusongela impilo .

Kufanele ngizinakekele kanjani ngenkathi ngiphila ne-GPA?

Uma uphila nesifo esingamahlalakhona sokuzivikela komzimba njenge-GPA, kubalulekile ukuba nokuqonda okuthile ngomzimba wakho. Ngisho noma uzizwa uphilile ngokuphelele, udinga ukuhlala uphephile.

Thatha izinyathelo zokuzivikela ezifweni ezivamile ngenkathi uthatha imithi yokucindezela amasosha omzimba. Uma ubona noma yiziphi izimpawu ezintsha noma ezingavamile,Yazisa udokotela wakho ngokushesha.

I-GPA ingakuthinta ngezindlela eziningi, ezinye zazo ezisongela impilo. Ukuqaphela ukuthi kukhona okungahambi kahle nokuthola ukwelashwa kusenesikhathi kungenza umehluko omkhulu.

Abantu abaningi bangaphila ngaphandle kwezimpawu, okungenani isikhathi esithile, ngokwelashwa. Kodwa ithimba lakho lezokwelapha lizoqhubeka nokuqapha isimo sakho. Bazoba abalingani bakho bokuphila konke ekugcineni impilo yakho.

Izinto ezibaluleke kakhulu okudingeka uzikhumbule kulesi sihloko (Umyalezo Wokuya Ekhaya)

Kulungile, ake ngifingqe ezinye zezinto okudingeka uzikhumbule kulokho esikhulume ngakho:

• I-GPA (i-Granulomatosis ene-Polyangiitis) yisifo esihlasela imithambo yegazi, ikakhulukazi imithambo yegazi emincane. Sivame kakhulu ukuthinta uhlelo lokuphefumula kanye nezinso.
• Izimpawu ziyahlukahluka. Izimpawu zingabandakanya izimpawu ezivamile ezifana nomkhuhlane, ubunzima bokuphefumula, ukuphuma kwegazi ekhaleni, ukuqubuka kwesikhumba, ubuhlungu bamalunga, izinkinga zamehlo, kanye nokushintsha komchamo.
• Lokhu kungaba yisimo esibucayi, ngakho-ke kubaluleke kakhulu ukufuna iseluleko sezokwelapha ngokushesha uma unezimpawu.
• Kunezindlela zokwelapha ezisebenzayo ezitholakalayo. Lezi zindlela zokwelapha zingalawula lesi sifo futhi zisigcine sikhululekile.
• Lesi yisimo esihlala impilo yonke, ngakho-ke udinga ukuqhubeka ungaphansi kokuqashwa ngudokotela, usebenzise imithi oyinikezwe ngendlela efanele, futhi unakekele umzimba wakho.
• Ungakhathazeki! Ngokwazi kanye neseluleko esifanele sezokwelapha, ungaphila impilo enhle ngalesi simo. Awuwedwa, futhi bakhona odokotela abazokusiza.

I - GPA, i-Granulomatosis ene-Polyangiitis, i-Wegener's Granulomatosis, i-Vasculitis, ukuvuvukala kwemithambo yegazi, izifo zokuzivikela komzimba, izifo zezinso, izifo zokuphefumula