Kuyini i-Langerhans Cell Histiocytosis (LCH)? Ingabe ingane yakho encane isengozini?

Wake wezwa nge-Langerhans Cell Histiocytosis, noma lokho esikubiza ngokuthi i-LCH ngamafuphi? Mhlawumbe igama lizwakala liyinkimbinkimbi futhi liyesabeka. Kodwa empeleni, lesi yisifo esingavamile kakhulu esithinta kakhulu izingane zethu ezincane, ikakhulukazi izinsana ezisanda kuzalwa nezingane ezingaphansi kweminyaka eyi-15 ubudala. Ngakho ungakhathazeki, ake sixoxe ngakho kalula, ngesiSinhala ongakuqonda kahle kakhulu, ngokuningiliziwe, njengokungathi ukhuluma nomngane oseduze.

Kuyini ngempela (i-LCH)?

Kalula nje, (i-LCH) yisimo esenzeka lapho umzimba wengane unamaseli amaningi kakhulu e-Langerhans, uhlobo lweseli elikhethekile ohlelweni lwethu lokuzivikela komzimba. Lawa maseli e-Langerhans empeleni awuhlobo lweseli elimhlophe legazi. Umsebenzi wawo oyinhloko ukulwa namagciwane angena emizimbeni yethu futhi asivikele ezifweni.

Lawa maseli avame ukutholakala kuyo yonke imizimba yethu, ikakhulukazi esikhumbeni, emaphashini, kuma-lymph node, emaqakaleni ethambo, e-spleen, nasesibindini. Kodwa-ke, uma kwenzeka i-(LCH), lawa maseli e-Langerhans aqoqana ngokweqile endaweni eyodwa noma ngaphezulu. Uma lokhu kwenzeka, lawa malungu angonakala futhi kungahle kwakheke izilonda.

Indlela lesi sifo esiqhubeka ngayo ingahluka kuye ngomuntu nomuntu. Ezinye izingane ziyalulama ngokuphelele kulesi sifo ngokwelashwa okufanele. Ngokumangalisayo, ngezinye izikhathi, ikakhulukazi uma kuthinta isikhumba kuphela, singaba ngcono ngaphandle kokwelashwa. Kodwa-ke, uma lesi simo (LCH) sithinta izitho ezibalulekile njengomongo wethambo wengane, ubende noma isibindi, kungadingeka ukwelashwa okunamandla kakhulu.

Ingabe umdlavuza (we-LCH)?

Lona umbuzo abantu abaningi abanawo. Eqinisweni, abacwaningi abaningi babheka i-LCH njengesimo somdlavuza, okungukuthi, i-neoplasm. Kodwa-ke, abanye ososayensi manje bayibheka njengesifo sokuvuvukala. Kodwa-ke, odokotela be-oncologists bangodokotela abangochwepheshe bomdlavuza nezifo zegazi. Ngezinye izikhathi, ukwelashwa komdlavuza, njenge-chemotherapy, nakho kuyasetshenziswa ukwelapha lesi simo.

Ubani othinteka kakhulu yilesi simo (i-LCH)?

I-LCH ivame kakhulu ezinsaneni ezisanda kuzalwa nasezinganeni eziphakathi kweminyaka engu-1 no-15. I-LCH kubantu abadala ayivamile, kodwa akuyona into engenakwenzeka.

Kuvamile kangakanani lokhu?

Ngokwezibalo, ingane eyodwa noma ezimbili kweziyisigidi ezisanda kuzalwa zithinteka yi-LCH minyaka yonke. Futhi, cishe izingane ezinhlanu kweziyisigidi ezingaphansi kweminyaka eyi-15 ziyathinteka. Ngakho-ke ungabona ukuthi lesi yisimo esingavamile kakhulu.

Ziyini izimpawu ze-(LCH)?

Izimpawu ze-LCH ziyahlukahluka kakhulu kumuntu nomuntu. Zingathinta indawo eyodwa nje yomzimba, noma zingathinta izindawo eziningi. Ngakho-ke, izimpawu zincike ekutheni iyiphi ingxenye yomzimba wengane ethintekile.

Uma amathambo ethintekile:

Cishe ama-80% ezingane ezine-LCH athola izilonda kwelinye noma ngaphezulu kwamathambo azo. Yini engabangela lokhu?

• Ukuvuvukala noma iqhubu kungavela ezindaweni ezifana nogebhezi, amathambo azungeze amehlo, amathambo endlebe, amathambo omhlathi, izitho zomzimba, umgogodla, izinqe, noma izimbambo. Lokhu kuvuvukala kungaba buhlungu noma kungapheli.
• Ikhanda elibuhlungu.
• Ubuhlungu entanyeni noma emhlane.
• Ukuphuka kwamathambo.
• Ubunzima bokuhamba.
• Ukuxhuga.

Esikhumbeni:

Ukuqubuka kuvame ukubonakala njengezimpawu zesikhumba (LCH).

• Ezinganeni ezincane, ukuqubuka okufana nesivalo somntwana kungase kuvele ekhanda.
• Ezinganeni ezindala nakubantu abadala, kungase kubangele ukuqubuka okufana ne-dandruff.
• Lokhu kuqubuka kungavela nakwezinye izingxenye zomzimba (ukububula, izingalo, amakhwapha, isisu, umhlane, isifuba). Kungaba buhlungu, kuyaluma, noma kube nzima.
• Ezinye izingane zingase zibe nama-blister avuzayo.
• Izinto ezifana nokushintsha kombala, ukuqina, noma ukuxebuka kwezinzipho nazo zingase zenzeke.

Ngokuphathelene nomlomo:

Izimpawu ezingabonakala ngaphakathi emlonyeni zifaka:

• Ukuxega noma ukulahlekelwa amazinyo.
• Izinyo elidonsiwe.
• Ukuvuvukala kwezinsini.
• Izilonda ezindebeni, olimini, ngaphakathi kwezihlathi, noma ophahleni lomlomo.

Okuhlobene nesibindi noma ubende:

Uma lezi zitho zithintekile, izimpawu ezifana nalezi:

• Ukuvuvukala kwesisu ngenxa yokwanda kwesibindi kanye/noma ubende.
• Ukuphuzi kwesikhumba kanye nokumhlophe kwamehlo (i-jaundice).
• Ukuluma.
• Ukukhathala.
• Ukuphuka kalula kanye/noma ukuphuma kwegazi.

Uma umongo wethambo uthintekile:

Umnkantsha yilapho kwakheka khona amaseli egazi. Uma uthintekile:

• I-anemia, isikhumba esikhanyayo, ukukhathala, kanye nokulahlekelwa yisifiso sokudla ngenxa yokuncipha kwamaseli abomvu egazi.
• Ukutheleleka okuvamile kanye nomkhuhlane obangelwa amaseli amhlophe egazi aphansi.
• Ukuphuka kalula kanye/noma ukopha ngenxa yama-platelet aphansi.

Uhlelo Lwe-Endocrine (Uhlelo Lwe-Endocrine - Ama-hormone):

I-LCH ingathinta uhlelo lwe-endocrine lwengane, okuyilapho kukhiqizwa khona ama-hormone, njenge-pituitary gland kanye ne-thyroid gland.

• Uma indlala ye-pituitary ithintekile: ukoma ngokweqile (i-polydipsia) kanye nokuchama njalo (okubizwa nangokuthi i-diabetes insipidus), ukwehluleka ukukhula, ukuthomba kusenesikhathi noma ukubambezeleka, kanye nokukhuluphala.
• Uma indlala yegilo ithintekile: ukuvuvukala kwendlala yegilo, izimpawu zamazinga aphansi amahomoni egilo (i-hypothyroidism), kanye nobunzima bokuphefumula.

Ngokuphathelene nezindlebe:

• Ukutheleleka kwendlebe okuvamile.
• Uketshezi oluphuma ezindlebeni.
• Ububomvu.
• Ukuqhuma okubuhlungu.
• Ubuhlungu bendlebe.
• Ukulahlekelwa ukuzwa.

Ngokuphathelene namehlo:

• Amehlo avuvukele.
• Ukuvuvukala ngaphezu kwamehlo.
• Izinkinga zokubona.

Ama-Lymph Node:

• Ama-lymph node avuvukele futhi abuhlungu entanyeni, emakhwapheni, kanye/noma embotsheni.

Isistimu Yezinzwa Ephakathi:

Lokhu kusho ukuthi ubuchopho kanye/noma umgogodla kuyathinteka.

• Ikhanda elibuhlungu.
• Isiyezi.
• Ukuhlanza.
• Ukoma ngokweqile.
• Ukuchama njalo.
• Ubunzima bokuhamba.
• Ukulahlekelwa yibhalansi.
• Ukungakwazi ukulawula ukunyakaza komzimba (i-ataxia).
• Ubunzima bokukhuluma noma ukubona.
• Ukuquleka.
• Izinguquko ekuziphatheni kanye/noma ekukhumbuleni.

Amaphaphu:

I-Lung LCH yamaphaphu, isimo esithinta amaphaphu, sivame kakhulu kubantu abadala. Abantu ababhemayo basengozini enkulu.

• Ubuhlungu besifuba.
• Ukukhwehlela okomile.
• Ubunzima bokuphefumula.
• Ukukhwehlela igazi.
• Ukwehluleka kwamaphaphu (i-pneumothorax).

Umgudu Wesisu:

Uma isisu sengane, amathumbu amancane, kanye/noma amathumbu amakhulu kuthintekile:

• Ubuhlungu besisu.
• Ukuhlanza.
• Uhudo.
• Igazi esitulweni.
• Ukwehluleka kokukhula ngenxa yokungondleki kahle.

Okubalulekile: Lezi zimpawu zingabangelwa yinoma yiziphi ezinye izimo eziningi, hhayi i-LCH kuphela. Ngakho-ke, uma ingane yakho inalezi zimpawu, kubalulekile ukufuna iseluleko sezokwelapha ngokushesha ukuze kutholakale ukuxilongwa okufanele.

Yiziphi izimbangela ze-(LCH)?

Cishe ingxenye yabantu abane-LCH kuphela abanokuguqulwa kwesimo somzimba ku-gene ebizwa ngokuthi i-BRAF. Ukuguqulwa kwesimo somzimba kuyizinguquko ezenzeka emaseli athile ngemva kokukhulelwa. Azizuzwa njengefa kubazali, kodwa zenzeka ngokungahleliwe ngesikhathi sokuthuthukiswa kombungu.

I-gene (BRAF) ikhiqiza iphrotheni elawula ukukhula nokuthuthukiswa kwamaseli. Ngokuvamile, le phrotheni ingavulwa futhi ivalwe ngokwezimpawu zamakhemikhali. Kodwa-ke, uma kukhona ukuguquka kwalesi gene, iphrotheni ihlala inamathele esimweni "sokuvuliwe". Lokhu kubangela amaseli (LCH) ukuba akhule futhi ahlukane ngokweqile. Yilokhu okubangela ukulimala kwezicubu kanye nokwakheka kwamathumba.

Ososayensi bathole nokuthi ukuguquka kwezakhi zofuzo eziningana nakho kungadala lesi sifo. Isibonelo, izakhi zofuzo (MAP2K1), (RAS), kanye (ARAF). Abanye abacwaningi bakholelwa ukuthi ubuthi bemvelo kanye nokutheleleka ngamagciwane nakho kungaba nomthelela kulesi sifo.

Yiziphi izici eziyingozi ze-(LCH)?

Ezinye izici zingase zandise ingozi yengane yakho yokuthola i-LCH. Lezi zifaka:

• Ukuba nomlando womndeni we-LCH.
• Ukuba nobuzwe bamaHispanic (yize lokhu kungabalulekile ezweni lethu, kukhulunywa ngakho emithonjeni).
• Ukubhema (ikakhulukazi kubantu abadala abanomdlavuza wamaphaphu (LCH)).
• Ukuchayeka kumakhemikhali athile ngesikhathi sokukhulelwa.
• Ukuchayeka ensimbini, egranite, noma othulini lwezinkuni endaweni yokusebenza.
• Ukutheleleka ngesikhathi sokuzalwa.
• Ukungatholi imijovo enconywayo ngesikhathi sobuntwana.

Yiziphi izinkinga ezingaba khona ze-(LCH)?

Cishe ama-50% ezingane ezine-LCH athola izinkinga ezahlukahlukene ngenxa yalesi simo. Isibonelo:

• Izibazi.
• Ukuncipha kokukhula.
• Ukukhubazeka kwemisipha.
• Isimo esifana nesifo sikashukela (i-Diabetes insipidus).
• Ukungalingani kwama-hormone.
• Ukukhubazeka kokuzwa.
• Izinkinga zempilo yengqondo (njengokucindezeleka, ukukhathazeka).
• Izinkinga zamathambo namaphaphu.
• Isifo sesibindi.
• Umdlavuza wesibili (isib. i-leukemia, i-lymphoma, i-Ewing sarcoma).

I-LCH itholakala kanjani?

Udokotela wengane yakho uzoqala ngokubuza ngomlando wezokwelapha wengane yakho bese enza ukuhlolwa ngokomzimba. Ngemuva kwalokho, bazoyala ukuhlolwa okuningana kuye ngezimpawu ingane yakho ebhekene nazo. Kuye ngemiphumela yalezi zivivinyo, ingane yakho ingathunyelwa kudokotela wezifo zegazi/umdlavuza wezingane, ozoqondisa ukwelashwa nokunakekelwa kwengane yakho.

Yiziphi izivivinyo ezenziwayo ukuze kutholakale ukuthi unesifo?

Ngenxa yokuthi i-LCH ingathinta izingxenye ezahlukene zomzimba, kudingeka ukuhlolwa okuningana ukuze kutholakale lesi sifo ngokunembile.

• Ukuhlolwa kwegazi:
• Ukubalwa kwegazi okuphelele (i-CBC): Lokhu kuhlola amazinga egazi abomvu, amangqamuzana amhlophe egazi, kanye nama-platelet engane.
• Ukuhlolwa kwamakhemikhali egazi: Lokhu kuhlola amazinga ezinto ezithile ezikhishwa yizitho zomzimba nezicubu.
• Ukuhlolwa kokusebenza kwesibindi: Lokhu kuhlola amazinga ezinto ezikhishwa yisibindi.

• Ukuhlolwa komchamo:
• Ukuhlolwa komchamo: Umchamo wengane uyahlolwa ukuthi unamangqamuzana abomvu egazi, amangqamuzana amhlophe egazi, amaprotheni kanye noshukela.
• Ukuhlolwa kokuntuleka kwamanzi: Lokhu kuhlola ukuthi ingane ichama kangakanani umchamo nokuthi umchamo uba mkhulu yini uma inganikwanga amanzi.

• Ukuhlolwa kwe-biopsy:
• I-Biopsy: Udokotela uthatha isampula yezicubu, bese udokotela wezifo eyibheka ngaphansi kwesibonakhulu ukuze ahlole amangqamuzana e-LCH.
• Ukufuthwa komnkantsha wethambo kanye ne-biopsy: Inaliti engenalutho isetshenziswa ukususa umnkantsha wethambo, igazi, kanye nengxenye encane yethambo ethanjeni lenqulu yengane. Lokhu kuhlolwa futhi ngudokotela wezifo.

• Ukuhlolwa kofuzo:
• Isampula yegazi noma yezicubu isetshenziswa ukuhlola izinguquko ku-gene (BRAF).

• Ukuhlolwa kwezithombe:
• Ama-X-ray: Kuthathwa izithombe zamathambo nezitho zomzimba. Ngezinye izikhathi kwenziwa ucwaningo lwamathambo kuwo wonke umzimba ukuze kubhekwe ukuthi kukhona yini okungahambi kahle.
• Ukuskena kwamathambo: Into ekhipha imisebe ifakwa emthanjeni bese kusetshenziswa isikena ukubheka amatshe angavamile emathanjeni. Lokhu akusasetshenziswa kakhulu.
• I-CT scan (i-computed tomography - i-CT scan): Ingane inikezwa uketshezi olukhethekile ukuze iluphuze noma ilufake emthanjeni, futhi izithombe ezinemininingwane zithathwa ngezindlela ezahlukene ngaphakathi emzimbeni.
• I-Positron emission tomography (i-PET scan): Inani elincane likashukela onemisebe (i-glucose) lifakwa emthanjeni, bese isithwebuli sihanjiswa emzimbeni wonke ukuze kuthathwe izithombe zalapho ushukela usetshenziswa khona. Amaseli agulayo abonakala ekhanya kulokhu kuskena.
• Ukuskena kwe-MRI (Ukufanekisa kwe-Magnetic resonance - Ukuskena kwe-MRI): Into ebizwa ngokuthi i-gadolinium ifakwa emthanjeni bese kuthathwa uchungechunge lwezithombe ezinemininingwane kusetshenziswa omaginethi, amaza omsakazo, kanye nekhompyutha. Izindawo ezigulayo zibonakala zikhanya kakhulu.
• I-Ultrasound: Isebenzisa amaza omsindo anamandla aphezulu ukudala izithombe zangaphakathi lomzimba ngokukhombisa ukuzwakala kwangemuva okuvela ezithweni nasezicutshini.

Iphathwa kanjani i-LCH?

Ukwelashwa kwe-LCH kuncike ekutheni amangqamuzana e-LCH akuphi emzimbeni wengane nokuthi ngabe lesi sifo "sisengozini encane" noma "siyingozi enkulu."

Izitho zomzimba ezisengozini encane yilezi:

• Isikhumba
• Ithambo
• Amaphaphu
• Ama-lymph node
• Uhlelo lwesisu
• Indlala ye-pituitary
• Indlala yegilo
• I-Thymus

Izitho zomzimba ezisengozini enkulu yilezi:

• Isibindi
• Ubende
• Umkantsha
• Isistimu yezinzwa ephakathi (i-CNS)

Odokotela bahlukanisa lesi simo (LCH) ngokuthi "i-single-system LCH" kanye "ne-multi-system LCH." Lokhu kusho ukuthi:

• Uhlelo olulodwa (LCH): Amaseli e-LCH atholakala engxenyeni eyodwa kuphela yesitho esisodwa noma uhlelo lomzimba. Uhlobo oluvame kakhulu yi-LCH ethinta amathambo kuphela.
• I-Multisystem (LCH): Kukhona amaseli ezithweni ezimbili noma ngaphezulu, noma kuwo wonke umzimba (LCH). Lokhu akuvamile kakhulu kune-single-system (LCH).

Kwezinye izimo, ikakhulukazi lezo ezithinta isikhumba noma amathambo kuphela (i-LCH), lesi simo singaphela ngaphandle kokwelashwa. Ezimweni ezinjalo, odokotela bazoqapha lesi sifo ukuze babone ukuthi siyabuya noma siyasakazeka yini.

Izinketho Zokwelapha (LCH):

• Ukwelashwa ngama-steroid: Udokotela wakho angasebenzisa ama-steroid, njenge-prednisone, ikakhulukazi esikhumbeni i-LCH. Lawa anciphisa ukusebenza kwamaseli amhlophe egazi, okungathinta namaseli e-LCH.
• Ukuhlinzwa: Izimila ze-LCH kanye nezicubu ezizungezile zingasuswa ngokuhlinzwa. Inqubo ebizwa ngokuthi i-curettage ihilela ukuklwebha amangqamuzana e-LCH ethanjeni ngethuluzi elibukhali, elifana nesipuni (i-curette).
• Ukwelashwa ngamakhemikhali: Lokhu kuhilela ukunikeza amangqamuzana omdlavuza imithi yokuwavimba ekukhuleni. Abulala amangqamuzana noma awavimbele ekuhlukaneni. Le mithi ithathwa ngomlomo, ifakwe emthanjeni noma emisipheni, noma ngezinye izikhathi isetshenziswe esikhumbeni njengokhilimu.
• Ukwelashwa ngemisebe: Ama-X-ray anamandla aphezulu noma ezinye izinhlobo zemisebe asetshenziselwa ukubulala amangqamuzana omdlavuza noma ukuwavimba ekukhuleni nasekuhlukaneni kwawo.
• Ukwelashwa Ngezifo Ezingalawuleki: Indlela yokusebenzisa amasosha omzimba engane ukulwa nomdlavuza. Izivikelo zemvelo zomzimba ziqiniswa ngokusebenzisa izinto ezenziwe ngumzimba ngokwawo noma lezo ezenziwe elabhorethri.
• Ukwelashwa okuqondiwe: Kusebenzisa izidakamizwa noma ezinye izinto ukuhlonza nokuhlasela amangqamuzana athile omdlavuza. Isibonelo, izidakamizwa ezibizwa ngokuthi i-BRAF inhibitors zingabulala amangqamuzana omdlavuza ngokuvimbela amaprotheni adingekayo ekukhuleni kwamangqamuzana. Ama-antibodies e-monoclonal amaprotheni esistimu yomzimba akhiqizwa elabhorethri.
• Ukufakelwa kwamaseli esiqu: Ukufakelwa kwamaseli amasha ukuze kuthathelwe indawo amaseli akha igazi abhujiswe yi-chemotherapy.

Ingabe i-LCH ingavinjelwa?

I-LCH ingavinjelwa kakhulu ngoba ibangelwa ukuguquka kwezakhi zofuzo. Asikwazi ukulawula ezinye izinto eziyingozi, njengomlando womndeni kanye nobuzwe. Kodwa-ke, kunezinto ezithile esingazilawula:

• Akubhenywa.
• Ukugwema amakhemikhali athile ayingozi ngesikhathi sokukhulelwa.
• Ukuthola yonke imijovo enconywayo.

Iyini i-prognosis ye-(LCH)?

Umbono we-LCH uncike ezintweni eziningana:

• Zingaki izinhlelo noma izitho zomzimba ezithintekile?
• Yiziphi izinhlelo zomzimba noma izitho zomzimba ezithintekile.
• Indlela lesi sifo esisabela kahle ngayo ekwelashweni.

Ngokuvamile, izingane ezine-single-system (LCH) kanye ne-multisystem (LCH) ezingathinti isibindi, i-spleen, noma umnkantsha wethambo ziwela esigabeni "esinobungozi obuphansi". Ngokwelashwa, izingane ezikulesi sigaba zinethuba elicishe libe yi-100% lokusinda. Kodwa-ke, lesi sifo singaphinde sibuye futhi/noma sibe nezinye izinkinga zesikhathi eside.

Izingane ezine-multisystemic leukemia (LCH) ethinta isibindi, ubende, noma umongo wethambo ziwela esigabeni "sengozi ephezulu".

Ingane yami kufanele imbone nini udokotela?

Ngisho nangemva kokuba ingane yakho isiqedile ukwelashwa, udokotela kuzodingeka abone ingane yakho njalo. Lokhu kungenxa yokuthi ingozi yokuthi lesi sifo siphinde sivele iphezulu. Ngakho-ke, ingane yakho kuzodingeka iqashwe iminyaka eminingana. Phakathi nalezi zivivinyo zokulandelela, izivivinyo ezifanayo ezenziwa lapho ingane itholakala, njenge-ultrasound, i-MRI, i-CT scan, kanye ne-PET scan, kuzodingeka ziphindwe. Udokotela uzokutshela ukuthi kufanele umlethe kangaki ingane yakho.

Yimiphi imibuzo okufanele ngiyibuze udokotela wengane yami?

Ungase ube nemibuzo eminingi mayelana nokuxilongwa kwengane yakho. Kungumqondo omuhle ukuyibhala phansi bese uyiletha nawe lapho udokotela wakho ekubonana naye okulandelayo. Nansi eminye imibuzo ongayibuza:

• I-Langerhans cell histiocytosis izoyithinta kanjani ingane yami?
• Ingabe ingane yami idinga ukwelashwa?
• Yiziphi izindlela zokwelapha ezitholakalayo enganeni yami?
• Iyini imiphumela emibi yokwelashwa?
• Ingabe ingane yami izophulukiswa ngokuphelele ngalezi zindlela zokwelapha?
• Iyini inhloso yokugula kwengane yami?
• Ingabe kukhona amaqembu okusekelana ongawancoma?

Ekugcineni, Umyalezo Wokuya Ekhaya

I-Langerhans Cell Histiocytosis (LCH) yisimo esingavamile esivame ukuthinta izingane. Uma ingane yakho idlula kulokhu, ungase uzizwe unemizwa eminingi. Ungase uzizwe udangele futhi wesaba ingane yakho. Ungase wesabe kakhulu ngaphakathi, kodwa ungase uzame ukuba namandla ngaphandle. Yonke imizwa yakho iyafaneleka. Kodwa khumbula, akudingeki ukuthi udlule kulolu hambo wedwa. Ithimba lezokwelapha lengane yakho liyazi ukuthi udlula kuphi. Bakhona ukukusiza kuzo zonke izinyathelo zendlela, ukuqonda isimo sengane yakho, nokukunika amandla okubhekana naso.

Khumbula, ukuxilongwa kusenesikhathi kanye nokwelashwa okufanele kunganikeza ingane yakho impilo engcono. Ungesabi, bhekana nalokhu ngesibindi.

I- Langerhans Cell Histiocytosis, i-LCH, izifo zezingane, umdlavuza, izinguquko zofuzo, izimpawu, ukwelashwa