Ikhanda elibuhlungu nezinkinga zokubona ezihambisana nokuguga: Ake sifunde nge-Giant Cell Arteritis (GCA) noma i-Temporal Arteritis?

Ingabe umuntu osekhulile emndenini wakho, mhlawumbe umama wakho, ubaba, noma ugogo, uvame ukukhononda ngekhanda elibuhlungu? Ingabe ukubona kwakho kubonakala kubuthakathaka kancane ngesikhathi esifanayo? Lokhu kungaba yinto ebalulekile kuwe. Namuhla sikhuluma ngesifo esibizwa ngokuthi i-Giant Cell Arteritis (GCA) , esaziwa ngokuthi i-Temporal Arteritis , esivame ukuhlasela abantu abadala. Akukho okufanele ukwesabe, into ebaluleke kakhulu ukuqaphela lokhu.

Iyini i-GCA? Kungani ingaba yingozi?

Kalula nje, i-Giant Cell Arteritis (GCA) yisimo esibangela ukuvuvukala emithanjeni yegazi emikhulu emzimbeni wakho (ikakhulukazi leyo esekhanda, entanyeni nasezingalweni). Odokotela baphinde bakubize ngokuthi "i-vasculitis." Uma imithambo yegazi ivuvuka ngale ndlela, izindonga zayo zijiya, zinciphise indlela yegazi. Cabanga ngayo njengepayipi lamanzi elivinjiwe ekugelezeni. Uma ukugeleza kwegazi kuphazamiseka ngale ndlela, kungalimaza izitho ezibalulekile nezicubu ezinikezwa igazi yilezo mithambo yegazi.

Imithambo yegazi yesikhashana, etholakala kuzo zombili izinhlangothi zebunzi lakho, inikeza igazi ekhanda lakho, emisipheni yomhlathi, kanye ne-optic nerve, okuyi-nerve ekunika umbono. Uma i-GCA ithinta le mithambo yegazi yesikhashana, ingabangela izinkinga ezinkulu, njengokungaboni . I-GCA ingathinta ne-aorta, umthambo wegazi omkhulu kunayo yonke emzimbeni, kanye namagatsha awo. Lokhu kuvuvukala kwe-aorta kubizwa ngokuthi i-aortitis, futhi kungabangela izinkinga ezinkulu zempilo.

I-GCA ingenzeka kanye nesinye isifo sokuvuvukala, i-Polymyalgia Rheumatica, noma i-PMR . Sizoxoxa kabanzi nge-PMR kamuva.

Ingabe i-GCA iyisimo esibucayi ngempela?

Yebo, i-GCA yisimo esingaba sibi kakhulu uma singaxilongwa futhi selashwe kusenesikhathi . Lokhu kungenxa yokuthi:

• Amehlo akho angase onakale . Ungase ulahlekelwe umbono wakho ngokuzumayo, noma ungase ube yimpumputhe kwelinye noma kuwo womabili amehlo.
• Imithambo yakho yegazi ingonakala . Isibonelo, isimo esibizwa ngokuthi i-aneurysm, okuwumthambo wegazi ovuvukala njengebhaluni bese uqhuma, sandisa ingozi yokuthi uqhume.
• Ezinye izimo, njengokuhlaselwa yisifo sohlangothi noma ukuhlaselwa yisifo sohlangothi okungapheli (okubizwa nangokuthi "ama-mini-stroke"), zingase zenzeke.

Yingakho kubaluleke kakhulu ukuqaphela lezi zimpawu.

Ivame kangakanani i-GCA?

Nakuba i-GCA ingenye yezinhlobo ezivame kakhulu ze-vasculitis, iyisifo esingavamile kakhulu . Ngokwezibalo e-United States, abantu abangu-19-23 kuphela kwabangu-100,000 abaphethwe yilesi sifo. Nakuba kungekho zibalo eziqondile eSri Lanka, kuhle ukukhathazeka ngalokhu njengoba inani labantu asebekhulile landa.

Ziyini izimpawu ze-GCA (Temporal Arteritis)?

Uphawu oluyinhloko noluvame kakhulu lwe-GCA ikhanda elibuhlungu elibi nelihlala njalo elizwakala njengobuhlungu obuhlabayo ohlangothini olulodwa noma zombili zekhanda.Kodwa ngaphezu kwalokhu, kungase kuvele ezinye izimpawu:

• Ubuhlungu lapho ubeka isandla sakho ekhanda noma ohlangothini lwebunzi (ngaphezu kwezindlebe).
• Ubuhlungu bomhlathi , ikakhulukazi uma udla noma uhlafuna.
• Izinkinga zokubona : Ukubona kabili, ukubona okufiphele, noma ukulahlekelwa umbono ngokuzumayo isikhathi esifushane.
• Ukukhathala .
• Imfiva .
• Ukulahlekelwa yisifiso sokudla noma ukwehla kwesisindo .
• Ubuhlungu bemisipha : Ubuhlungu emahlombe, ezingalweni ezingaphezulu, ezinqeni, emathangeni aphezulu, emhlane ongezansi, nasemaqakaleni.

Uyakhumbula lapho ngikhuluma ngesinye isimo esivame ukuhambisana ne-GCA, i-Polymyalgia Rheumatica (PMR)? Lesi futhi yisimo esibangela ukuvuvukala. I-PMR ibangela ubuhlungu obukhulu nokuqina , ikakhulukazi emahlombe nasezinqeni. I-PMR ingenzeka futhi yodwa (kuvame kakhulu ukuthi i-PMR izenzekele yodwa kune-GCA). Kodwa-ke, cishe abantu abangu-40-60% abane-GCA nabo bazoba ne-PMR. Futhi, abantu abangu-10-20% abane-PMR yodwa bazoba ne-GCA kamuva ekuphileni.

Yini ebangela i-GCA?

Abacwaningi abakayazi imbangela eqondile ye-GCA, kodwa abaningi bakholelwa ukuthi yisifo sokuzivikela komzimba noma ukuvuvukala komzimba. Kalula nje, yilapho amasosha omzimba wakho ehlasela ngephutha imithambo yegazi yakho enempilo .

Lesi sifo sivame kakhulu kubantu abadala, ngakho abanye abantu bacabanga ukuthi sihlobene nokuguga. Kucatshangwa ukuthi sibangelwa izici zofuzo kanye nezici zemvelo (njengokutheleleka okuthinta amasosha omzimba).

Ubani othinteka kakhulu yi-GCA?

Nakuba noma ubani engaba ne-GCA, abantu abalandelayo basengozini enkulu:

• Asebekhulile : I-GCA cishe njalo ithinta abantu abangaphezu kweminyaka engu-50. Ingozi yokuthola lesi sifo iyanda njengoba iminyaka ikhula. Sivame kakhulu kubantu abaneminyaka ephakathi kuka-70 no-80.
• Abesifazane : Lesi sifo sivame kakhulu kwabesifazane kunakwabesilisa. Kodwa-ke, amadoda asengozini enkulu yokuba yimpumputhe ngenxa yalesi sifo.
• Abantu abamhlophe : Ucwaningo lukhombisile ukuthi i-GCA ithinta abantu abamhlophe abadabuka eNyakatho Yurophu kaningi kunezinye izizwe. Kodwa-ke, lokhu akusho ukuthi ezinye izizwe azikwazi ukuyithuthukisa.

Ihlolwa kanjani i-GCA?

Uma unezimpawu ze-GCA, udokotela wakho uzoqala akubuze ngomlando wakho wezokwelapha bese enza ukuhlolwa ngokomzimba. Bazohlola ukushaya kwenhliziyo okubuthakathaka ezingalweni nasemilenzeni yakho. Bazohlola nekhanda lakho ukuze babone ukuthi unesifo esibuhlungu ekhanda lakho nokuthi imithambo yegazi ezinhlangothini zombili zebunzi lakho ivuvukele yini.

Yiziphi izivivinyo ezisetshenziswa ukuxilonga i-GCA?

Udokotela uzoqala ngokuyalela ukuhlolwa kwegazi okuningana ukuze alinganise izinga lokuvuvukala emzimbeni wakho. Isibonelo:

• (Izinga Lokuthuthwa Kwegazi Eliphuma Egazini) (ESR)
• `(Iphrotheni Esabelayo ye-C)` (i-CRP)

Lezi zivivinyo zingakunikeza umbono wezinga lokuvuvukala emzimbeni wakho. Zingalinganisa namazinga akho e-hemoglobin, ingxenye ethwala umoya-mpilo yamaseli akho abomvu egazi, ukuze kubonakale ukuthi une-anemia yini.

Uma udokotela wakho esola i-GCA (i-Temporal Arteritis), angase acele i-temporal artery ultrasound, i-ultrasound yemithambo esebunzini lakho. Noma, angase acele i- temporal artery biopsy . Lokhu kuhilela udokotela oqeqeshiwe ukuthatha isampula encane yomthambo osebunzini lakho bese eyithumela kudokotela wezifo ukuze ayihlole ngaphansi kwe-microscope. Lokhu kuzohlola izimpawu zokuvuvukala (i-vasculitis) emthambo. Lesi yisilingo esiyinhloko sokuqinisekisa i-GCA.

Ngezinye izikhathi lezi zivivinyo zingadingeka futhi:

• Ukuhlolwa kokuskena kwe-``(Computed Tomography)`` noma ``(CT)```
• Ukuskena kwe-Magnetic Resonance Imaging (MRI)
• I-Ultrasound yemithambo emikhulu
• Ukuhlolwa kokuskena kwe-`(Positron Emission Tomography)` noma `(PET)`

Yiziphi izindlela zokwelapha i-GCA (Temporal Arteritis)?

Ukwelashwa kwe-GCA kufanele kuqale ngokushesha okukhulu, ikakhulukazi ukuvimbela ukulahlekelwa umbono .

Ukwelashwa okuyinhloko uhlobo lomuthi olubizwa ngokuthi "i-glucocorticoid". Uhlobo lomuthi oluvame kakhulu yi- "prednisone." Uzoqala ngama-milligram angu-40 kuya kwangu-60 (mg) ngosuku (ngomlomo) bese wehlisa kancane kancane umthamo. Uma usuvele unezinkinga zokubona noma ukulahlekelwa umbono, udokotela wakho angakunika imithamo ephezulu ye-"glucocorticoids" nge-cannula efakwe emthanjeni (``(IV)'').

Okubalulekile: Ama-Glucocorticoids ayimithi ebaluleke kakhulu yokulawula i-GCA. Kodwa-ke, le mithi ingabangela imiphumela emibi, ngakho udokotela wakho uzokuqapha ngokucophelela.

Ama-glucocorticoids anciphisa amasosha omzimba wakho, okungenza ube sengozini enkulu yokuthola izifo futhi kuzenze zibe zimbi kakhulu . Anganciphisa namathambo akho , okwandisa ingozi yakho yokuqhekeka.

Eminye imiphumela emibi engase ivele ifaka:

• Ama-cataract
• Umfutho wegazi ophakeme
• Ushukela ophezulu egazini
• Ukungalali
• Ukushintshashintsha kwemizwa
• Ubuthakathaka bemisipha kanye nokuncipha komzimba, ikakhulukazi emilenzeni
• Ukuvuvukala, ikakhulukazi ebusweni nasemilenzeni
• Ukwanda kwesisindo

Ngesikhathi uthatha ama-glucocorticoids, udokotela wakho angase ahlole ukuqina kwamathambo akho. Angase futhi ancome ukuzivocavoca umzimba, izithasiselo ze-calcium ne-vitamin D, kanye nemithi yokuvimbela i-osteoporosis (ukulahlekelwa amathambo) ukuze ugcine amathambo akho eqinile.

Ngo-2017, i-U.S. Food and Drug Administration yagunyaza umuthi omusha we-biologic obizwa ngokuthi i-tocilizumab (Actemra®) wokwelapha i-GCA. Lo muthi unikezwa njengomjovo ngaphansi kwesikhumba noma njenge-IV. Ungasiza ekunciphiseni isidingo sama-glucocorticoids. Kodwa-ke, i-tocilizumab inemiphumela yayo emibi, udokotela wakho azoyichaza kuwe.

Kufanele ngimbone nini udokotela?

Uma unezimpawu ze-GCA, izimpawu zokutheleleka, noma yiziphi izimpawu ezintsha, bona udokotela wakho ngokushesha . Ukuvakashela udokotela wakho njalo kanye nokuhlolwa kwegazi kanye nokuskena kungasiza ekutholeni ukubuyela emuva (`ukubuyela emuva`) kusenesikhathi.

Yimiphi imibuzo okufanele ngiyibuze udokotela?

Ungabuza udokotela wakho imibuzo efana nale:

• Yikuphi ukwelashwa okuncomayo?
• Yimiphi imiphumela emibi okufanele ngiyiqaphele ngesikhathi sokwelashwa?
• Yini engingayenza ukuze nginciphise imiphumela emibi yokwelashwa?
• Yiziphi izinkinga ezingaba khona ngenxa yalesi simo?
• Ngingasiqapha kanjani isimo sami?
• Ziyini izimpawu zokubuyela emuva kwesifo?
• Yiziphi izimpawu okufanele ngixhumane nawe ngazo?

Ingakanani iminyaka yokuphila komuntu one-GCA?

Ukuba ne-GCA akutholakalanga ukuthi kunciphisa isikhathi sokuphila, kodwa izici ezahlukahlukene zingathinta lokhu. Uma lesi sifo sitholakala futhi selashwa kusenesikhathi, imiphumela iba mihle kakhulu , futhi izimpawu ziqala ukuthuthuka zingakapheli izinsuku ezimbalwa.

Kodwa-ke, uma ingelashwa ngokushesha, i-GCA ingaholela ezinkingeni ezisongela ukuphila njengokulahlekelwa umbono unomphela, ukukhubazeka kwemithambo yegazi, kanye nokukhubazeka. Ngakho-ke, kubaluleke kakhulu ukubona udokotela ngokushesha uma unezimpawu ezihlobene ne-GCA.

Uma ukwelashwa sekuqalile, ingozi enkulu obhekene nayo imiphumela emibi yokwelashwa . Futhi, noma ngabe i-GCA iqale yelashwe ngokwelashwa okuphumelelayo, ngezinye izikhathi ingabuya (`ukubuyela emuva`) . Abacwaningi abakazi ukuthi kungani lokhu kwenzeka.

Ngizinakekela kanjani ngesikhathi ngihlala ne-GCA?

Ukuphila ne-GCA kungaba yinselele. Ukuze uphathe isimo sakho futhi ulawule imiphumela emibi ye-glucocorticoids, zama lezi zinto:

• Yidla ukudla okuhle nokunomsoco : izinto ezifana nenyama engenamafutha amaningi, ubhontshisi, okusanhlamvu okuphelele, izithelo nemifino emisha.
• Thola i-vitamin D ne-calcium eyanele ukuvikela amathambo akho.
• Yenza umsebenzi womzimba okungenani imizuzu engama-30 ngosuku.
• Lala kahle okungenani amahora ayisikhombisa kuya kwayisishiyagalombili njalo ebusuku.
• Thatha umuthi owunikezwe ngesikhathi .
• Bona udokotela wakho njalo .
• Thatha izinyathelo zokuzivikela ezifweni .

Yiziphi izinto okufanele ngizigweme uma ngine-GCA?

Uma une-GCA, kungcono ukugwema lezi zinto:

• Izici ezandisa ingozi yakho yokugula : Ngenxa yokuthi imithi ye-GCA yenza buthaka amasosha omzimba wakho, kungenzeka kakhulu ukuthi uthole izifo. Buza udokotela wakho ngezinye izindlela zokunciphisa ingozi yakho yokutheleleka, njengokugwema ukugula, ukugeza izandla zakho njalo, nokuhlala kude nabantu abagulayo.
• Ukubhema : Ukubhema kungandisa ingozi yakho yokuthola i-GCA. Impilo yemithambo yegazi yakho izothuthuka ngokushesha nje lapho uyeka ukubhema, okuzokuzuzisa impilo yakho yonke.
• Ukusetshenziswa kotshwala : Utshwala bungathinta kabi impilo yenhliziyo yakho kanye nemithambo yegazi. Bungasheshisa nokulahlekelwa amathambo futhi busebenzisane nemithi oyiphuzayo yesimo sakho.

Amaphuzu abaluleke kakhulu (Umyalezo Wokuya Ekhaya)

I-Giant Cell Arteritis (eyayikade i-Temporal Arteritis) ingaba yisimo esinzima. Kodwa-ke, uma utholakala kusenesikhathi futhi uhlolwa njalo nodokotela oqeqeshiwe, ungaba nomphumela ongcono kakhulu . Izimpawu nemiphumela emibi yokwelashwa kungathinta impilo yakho yengqondo, umsebenzi wakho, kanye nezici eziningi zokuphila kwakho. Kodwa awuwedwa. Cela udokotela wakho akusize uthole iqembu lokusekelana nabantu abaye badlula ezintweni ezifanayo. Ukwabelana ngolwazi lwakho kanye nezeluleko nabanye kungaba umthombo wenduduzo.

Khumbula, uma unezimpawu ezingavamile njengekhanda elibuhlungu, ubuhlungu bomhlathi, noma izinkinga zokubona (ikakhulukazi uma uneminyaka engaphezu kwengu-50), ungakuzibi futhi ufune iseluleko sezokwelapha ngokushesha. Ukwelashwa okusheshayo kungavimbela izinkinga ezinkulu.

I- Giant Cell Arteritis, i-Temporal Arteritis, i-GCA, ikhanda elibuhlungu, ukubona, ukuvuvukala kwemithambo yegazi, impilo yabantu abadala, i-Polymyalgia Rheumatica, i-Prednisone, i-Vasculitis