Isimo esingavamile esithinta ubuchopho: Uyazi nge-PML? (Progressive Multifocal Leukoencephalopathy - PML)

Wake wezwa ngesimo esibizwa ngokuthi i-PML (Progressive Multifocal Leukoencephalopathy)? Ungase ungalazi leli gama. Isizathu ukuthi i-PML iyisifo esingavamile kakhulu esithinta ubuchopho bethu. Okwenzekayo kulokhu ukuthi amangqamuzana akhiqiza i-myelin, isivikelo esizungeze amangqamuzana ezinzwa ebuchosheni bethu, ayabhujiswa kancane kancane. I-Myelin iyinto efana namafutha. Yilokhu okuvikela ama-neurons ebuchosheni kanye nomgogodla (isimiso sethu sezinzwa esiphakathi). Ngakho-ke lapho le myelin ilahleka, into emhlophe ebuchosheni iyalimala.

Lisho ukuthini igama elithi PML?

Manje ake sibone ukuthi izinhlamvu ezikuleli gama elithi PML zisho ukuthini. Ukuqonda lokhu kuzokunikeza umbono oqondile ngalesi sifo.

• P — Okuqhubekayo: Lokhu kusho ukuthi lesi sifo siya siba sibi kancane kancane. Lokhu kusho ukuthi izimpawu zingase zande ngokuhamba kwesikhathi.
• M — Multifocal: Lokhu kusho ukuthi lesi sifo asigcini endaweni eyodwa yobuchopho, kodwa sithinta izindawo eziningi . Kufana nokuthi kunezilonda ezincane ezindaweni eziningi zobuchopho.
• L — I-Leukoencephalopathy: Leli gama lizwakala liyinkimbinkimbi kancane, akunjalo? Kalula nje, lisho ukuthi lesi sifo sithinta kakhulu i-myelin, noma into emhlophe, ebuchosheni .

Ngakho-ke, i-PML ibangela ukulimala kobuchopho. Lo monakalo ungaholela ezinkingeni ezahlukahlukene zezinzwa. Isibonelo, ukukhubazeka kwengqondo, izinkinga zokubona, kanye nobunzima bokuhamba. Ngenxa yokuthi i-PML iyisifo esiqhubekayo, ingaba yimbi kakhulu ngokuhamba kwesikhathi. Kodwa-ke, kwabanye abantu, ukwelashwa kusenesikhathi kunganciphisa ukuqhubeka kwesifo.

Ziyini izimpawu zokuqala ze-PML?

Kwabaningi, izimpawu ze-PML ziqala kancane kakhulu. Futhi, izimpawu zingahluka kuye ngokuthi iyiphi ingxenye yobuchopho ethintekile yilesi sifo. Cabanga ngakho njengokuthi lapho igatsha lomuthi lifa, yonke eminye imisebenzi kulelo gatsha iyayeka ukusebenza.

Izimpawu zokuqala ze-PML zingafaka:

• Ukungahleleki noma ukuntuleka kokuxhumana
• Ubunzima bokukhuluma noma ukucabanga
• Ukuzizwa ubuthakathaka emzimbeni

Njengoba ukutheleleka kuqhubeka, ungase ube nezimpawu ezifana nalezi:

• I-Dementia, ukulahlekelwa yinkumbulo
• Ukulahlekelwa yinkulumo
• Ukulahlekelwa umbono
• Izinguquko zokuziphatha kanye nobuntu

Abanye abantu bangase babe nekhanda noma ukuxhuzula, kodwa lokhu akuvamile. Ngeshwa, i-PML ivame ukuba yimbi kakhulu ngokuhamba kwesikhathi, futhiKungaba yingozi kakhulu. Kodwa-ke, imiphumela ingahluka kuye ngezimo zezokwelapha eziyisisekelo zesiguli kanye nendlela esisabela ngayo ekwelashweni.

Yini ebangela i-PML?

I-PML ibangelwa igciwane elibizwa ngokuthi i-JC virus (JCV) . Leli gciwane liqanjwe ngohlamvu lokuqala lwegama lomuntu owaqala ukutheleleka yileli gciwane (uJohn Cunningham). Leli gciwane liyaziwa nangokuthi i-human polyomavirus 2.

Ngokumangalisayo, cishe abantu abadala abangu-85% banegciwane le-JC emizimbeni yabo. Kodwa ochwepheshe abakaqiniseki ukuthi leli gciwane lidluliselwa kanjani kubantu. Kunobufakazi bokuthi izingane zingalithola ngokudla noma ngamanzi. Leli gciwane litholakale nasezivivinyweni zomchamo. Ngakho-ke, kungenzeka ukuthi lingadluliselwa ngokungcola komchamo nomlomo.

Nokho, nakuba abantu abaningi benegciwane le-JC emizimbeni yabo, alisebenzi, limane lilale lithule. Ngakho-ke, azikho izimpawu ezenzekayo. Kodwa-ke, kumuntu onesimiso somzimba esibuthakathaka, leli gciwane lingaba lisebenza emzimbeni futhi likhule libe yi-PML. Lifana nesitha esilele esivukayo sisihlasele lapho sibuthakathaka.

Ubani osengozini enkulu yokuthola lesi sifo?

I-PML ivame ukwenzeka kuphela kubantu abanezivikeli mzimba ezibuthakathaka kakhulu. Ungase ube sengozini yokuthola lesi sifo uma unezinye zezimo ezilandelayo:

• Ukutheleleka nge-HIV/AIDS
• Umdlavuza wegazi kanye nomnkantsha wamathambo, isibonelo, i-leukemia
• Umdlavuza wesistimu ye-lymphatic, isibonelo, i-lymphoma noma isifo se-Hodgkin
• Izifo ezizenzakalelayo, njenge-rheumatoid arthritis, i-multiple sclerosis (MS), noma i-lupus

Futhi, uma ungumnikeli wezitho zomzimba futhi uthatha imithi yokucindezela amasosha omzimba ukuvimbela umzimba wakho ekwenqabeni isitho, ungase ube sengozini.

Odokotela bayixilonga kanjani i-PML?

Udokotela wakho uzoqala akuhlole futhi alalele ngokucophelela izimpawu zakho. Ngemuva kwalokho, angaqinisekisa i-PML ngokwenza izivivinyo eziningana ezihlola ubuchopho bakho kanye nomgogodla. Kungadingeka ukuthi ube nezivivinyo ezinjengalezi:

• I-Brain MRI scan: Lokhu kungathatha izithombe zezilonda endabeni emhlophe yobuchopho. Kufana nekhamera ebheka ngaphakathi kobuchopho.
• Ukubhoboza umgogodla/umgogodla: Lokhu kuhilela ukuthatha isampula encane yoketshezi lwakho lwe-cerebrospinal (CSF), uketshezi oluzungeze ubuchopho bakho kanye nomgogodla. Lokhu kungahlola ukuba khona kwegciwane le-JC.
• Ukuhlolwa kobuchopho: Lokhu kwenziwa kaningi kakhulu. Kwenziwa kuphela uma kunzima ukuqinisekisa ukuxilongwa.

Iphathwa kanjani i-PML?

Umgomo oyinhloko wokwelapha i-PML ukuqinisa amasosha omzimba wakho. Khumbula, izifo zenzeka lapho izivikelo zomzimba wethu zibuthakathaka. Ngakho-ke, into ebaluleke kakhulu ukuqinisa leso sivikelo futhi.

• Isibonelo, uma unesifo sengculazi, unganikezwa ukwelashwa ngama-antiretroviral (ART) . Le mithi isebenza ngokunciphisa inani le-HIV emzimbeni wakho. Lokhu kwelashwa kungasiza amasosha omzimba wakho ukuthi asebenze ngezinga elithile.
• Abanye abantu bangase bazuze ekwelashweni okubizwa ngokuthi ukushintshaniswa kwe-plasma . Lokhu kwelashwa kususa eminye yemithi yokucindezela amasosha omzimba egazini lakho. Lokhu kwelashwa kungasiza futhi amasosha omzimba wakho ukulwa negciwane le-JC ngokuthuthukisa ukusebenza kwalo.

Ososayensi okwamanje bahlola imithi emisha eminingana yokwelapha i-PML. I-US Food and Drug Administration (FDA) inikeze imvume ekhethekile kwabanye abantu ukuthi basebenzise le mithi, kodwa imiphumela ixubile.

Kufanele ngimbone nini udokotela?

Uma wazi ukuthi amasosha akho omzimba abuthakathaka futhi uzizwa sengathi kancane kancane uqala ukuba nezimpawu ocabanga ukuthi zingase zihlobene ne-Progressive Multifocal Leukoencephalopathy (PML), kubaluleke kakhulu ukubona udokotela ngokushesha bese uhlolwa.

Yimiphi imibuzo okufanele ngiyibuze udokotela wami?

Uma ubona udokotela wakho, ungabuza imibuzo efana nale:

• Iyini ingozi yami yokuthola i-PML?
• Ingabe kukhona engingakwenza ukuze nginciphise le ngozi?
• Yiziphi izimpawu okufanele ngiziqaphele ku-PML?
• Yiziphi izingozi zokuthatha imithi yokucindezela amasosha omzimba?
• Ingabe kukhona ezinye izindlela zokwelapha isimo sami?
• Yiziphi izingozi nezinzuzo zokwelapha kwamanje?

Ngokubuza le mibuzo, ungathola ukuqonda okungcono ngalesi sifo kanye nokwelashwa kwaso.

Iyini isikhathi sokuphila sesiguli se-PML?

Lesi yisihloko esinzima kakhulu ukukhuluma ngaso. I-PML yisifo esiqhubekayo. Lokhu kusho ukuthi izimpawu ziya ziba zimbi ngokuhamba kwesikhathi. Isikhathi sokuphila komuntu one-PML sincike ebunzimeni bokutheleleka kanye nokwelashwa akutholayo. Abantu abaphakathi kuka-30% no-50% bayafa ezinyangeni ezimbalwa zokuqala ngemva kokuxilongwa. Abantu abaphila isikhathi eside bayaqhubeka nokuba nezimpawu, futhi lezo zimpawu ziya ziba zimbi kakhulu. Lezi zimpawu zingaholela ezinkingeni ezinkulu, njengokulahlekelwa yinkulumo kanye nokulahlekelwa umbono.

Kodwa-ke, izifundo ezintsha zikhombisile ukuthi inani elincane labantu abane-PML etheleleke nge-HIV bangakwazi ukuzinzisa isifo sabo futhi baphile isikhathi eside. Ngaphambi kokufika kokwelashwa ngama-antiretroviral (ART) ukwelapha ukutheleleka nge-HIV, abantu abayi-10% kuphela abane-PML basinda isikhathi esingaphezu konyaka. Manje, nge-ART, izinga lokusinda lonyaka owodwa selikhuphuke lafika ku-50%. Kwezinye izimo, i-ART ingasiza amasosha omzimba ukulwa negciwane le-JC.

Kungenzeka yini ukululama ngokuphelele ku-PML?

Abantu abathola i-PML ngenkathi bethatha imithi yokucindezela amasosha omzimba bangase balulame ngemva kokuyeka imithi. Abantu abelashwe ngempumelelo nge-ART bangalulama futhi ku-PML. Kodwa-ke, ama-80% abantu abasinda ku-PML izimpawu zabo azibuyi. Lokhu kungenxa yokuthi i-myelin entsha ayikhiqizwa ezindaweni ezonakele. Umonakalo wezinzwa ohlala njalo uvamile. Kodwa-ke, abanye abantu bangaphila iminyaka efinyelela kwengu-15 ngemva kokuba i-PML isiphelile.

Yini elindelwe yilabo abashintshaniswa nge-plasma?

Uma izimpawu zakho ze-PML ziqale ngenxa yomuthi wokucindezela amasosha omzimba, izimpawu zakho zingase ziphele uma uyeka ukuthatha lowo muthi. Ungaphinde ube nokushintshaniswa kwe-plasma ukuze ususe eminye yemithi yokucindezela amasosha omzimba emzimbeni wakho. Umgomo wokushintshaniswa kwe-plasma ukukhulisa amasosha omzimba wakho. Kwabanye abantu, ukushintshaniswa kwe-plasma kungase kubambezele ukuqhubeka kwe-PML futhi kwandise impilo. Kodwa-ke, izinzuzo zalokhu azikaqondakali ngokugcwele.

Abantu abaningi bangase baqhubeke nokuba nezimpawu ze-PML ngemva kokuyeka umuthi noma ngemva kokuthola ukushintshaniswa kwe-plasma. Abanye bangase babe nezinkinga zezinzwa. Kukhona nezinye izingozi zokuyeka umuthi. Ngakho-ke, kubalulekile ukukhuluma nodokotela wakho lapho wenza izinqumo mayelana nemithi yakho.

Ngingazi kanjani ukuthi ngisengozini yokuthola i-Progressive Multifocal Leukoencephalopathy (PML)?

Uma unesifo esithinta amasosha omzimba wakho, buza udokotela wakho ngengozi yakho yokuthola i-PML.

Ingabe ezinye izimo zezokwelapha ziyandisa ingozi yami yokuba ne-PML?

Abantu abanezifo ezifana ne-multiple sclerosis (MS) noma isifo sikaCrohn kufanele futhi bahlolwe igazi ukuze kuhlolwe izimo ezifana ne-HIV ezandisa ingozi yokutheleleka ngegciwane le-JC.

Odokotela bavame ukukunikeza umuthi obizwa ngokuthi iNatalizumab (Tysabri®) ukwelapha i-MS noma isifo sikaCrohn. Lo muthi ungandisa ingozi yokuthola i-PML.

Ngisho noma unegciwane le-JC elingasebenzi futhi ungenazo izimpawu, ungase ukwazi ukuthatha i-natalizumab. Kodwa-ke, kubalulekile ukukhuluma nodokotela wakho ngezingozi nezinzuzo.

Okokugcina, izinto okufanele uzikhumbule (Umyalezo Wokuya Ekhaya)

I-Progressive Multifocal Leukoencephalopathy (PML) iwukutheleleka kobuchopho okungajwayelekile okubangelwa ukuvuselelwa kwegciwane le-JC. Iningi labantu liba negciwane le-JC emizimbeni yabo. Alibangeli monakalo kubantu abangenawo amasosha omzimba abuthakathaka.

Uma unesimiso somzimba esibuthakathaka, kubalulekile ukuqaphela izimpawu ze-PML bese usebenzisana nodokotela wakho ukuze wenze kanjalo.

Lesi sifo sivame ukuba sibi kakhulu ngokuhamba kwesikhathi. Kodwa-ke, kunezindlela zokwelapha ezingasiza ekunciphiseni ukuqhubeka kwalesi sifo futhi zandise impilo yakho. Ngakho-ke, ungalilahli ithemba. Into ebaluleke kakhulu ukufuna iseluleko sezokwelapha ngokushesha okukhulu.

I- PML, i-Progressive Multifocal Leukoencephalopathy, igciwane le-JC, izifo zobuchopho, isimiso somzimba sokuzivikela, izifo zezinzwa, i-myelin