Ingabe indlala yegilo iyawathinta amehlo akho? Ake sifunde konke mayelana nesifo samehlo segilo!

Wake wezwa ukuthi izinkinga ze-thyroid zingathinta amehlo akho? Ngezinye izikhathi, isifo esisodwa singaxhunyaniswa nesinye ngezindlela esingaziqapheli. Yilokho isifo samehlo se-thyroid, noma njengoba sibizwa phakathi kodokotela, esibizwa ngakho (Isifo Samehlo Se-Thyroid - TED). Yilapho izicubu ezithambile ezizungezile amehlo akho zivuvukala. Lokhu kungabangela ukungakhululeki nobuhlungu emehlweni akho. Lesi simo sivame ukubonakala kubantu abanezifo ezihlasela i-thyroid. Lokhu kuvame kakhulu kubantu abanesifo esibizwa ngokuthi (isifo se-Graves). Yingakho odokotela ngezinye izikhathi besibiza ngokuthi i-Graves' Eye Disease.

Iyini ngempela isifo samehlo se-thyroid (TED)?

Kalula nje, i-Thyroid Eye Disease (TED) yisimo esithinta izicubu ezizungeze amehlo akho, okubangela ukuthi zivuvuke. Kuyisifo esihlasela amasosha omzimba, okusho ukuthi amasosha omzimba wakho ahlasela ngephutha i-thyroid gland kanye nezicubu ezizungeze amehlo akho.

Cabanga ngakho njengoba amasosha ethu omzimba efana nebutho elivikela izwe lethu. Kodwa ngezinye izikhathi leli butho lenza iphutha futhi lihlasele abantu balo. Yilokho okwenzekayo ezifweni ezibangelwa ukuzivikela komzimba.

I-TED akuyona inkinga efika idlule. Inezigaba ezahlukene. Ukuvuvukala nokungakhululeki kungafika kudlule iminyaka emibili noma ngaphezulu. Izimpawu ziyahlukahluka kumuntu nomuntu; abanye abantu bangase babhekane nezinkinga ezincane kakhulu, kanti abanye bangase babe nezimpawu ezinzima. Kwabaningi abantu, akukubi kangako. Kodwa-ke, uma kuba kubi kakhulu, kungabangela umonakalo ongapheli emehlweni, izinguquko ekubukekeni, kanye nokulahlekelwa umbono.

Kungenzeka ukuthi uke wezwa odokotela besebenzisa amanye amagama kulesi simo. Lawa magama afaka:

• I-thyroid ophthalmopathy
• I-orbitopathy ye-thyroid
• I-Graves' ophthalmopathy
• I-orbitopathy yamathuna

Lawa wonke amagama ahlukene ngesimo esifanayo, ngakho ungakhathazeki.

Ziyini izimpawu zesifo samehlo se-thyroid (TED)?

Manje ake sibone ukuthi ungasibona kanjani lesi simo. Bheka ukuthi unesinye noma ngaphezulu salezi zimpawu:

• I-Proptosis: Amehlo abonakala ekhulisiwe futhi ephuma.
• Amehlo avuthayo, avuthayo: Kuzwakala kungakhululekile, njengokungathi kukhona okungahambi kahle emehlweni akho.
• Ukuvuvukala nokubomvu kwamehlo (i-Blepharitis): Amaphethelo amehlo angase avuvuke futhi abe bomvu.
• Amehlo omile noma ukudabuka njalo: Abanye abantu babhekana namehlo omile, kanti abanye bamane babhekane nezinyembezi.
• Ukucwayiza njalo: Ukucwayiza njalo nokungalawuleki kwamehlo.
• Ukuzwela ukukhanya (Photophobia): Amehlo aba luhlaza okwesibhakabhaka, ngisho noma ilanga liphumile noma izibani zivuliwe, okwenza kube nzima ukubona.
• Ubuhlungu bamehlo kanye nekhanda elibuhlungu:Kungase kuhambisane nobuhlungu obuzungeze amehlo, mhlawumbe kanye nekhanda elibuhlungu.
• Ubunzima bokuhambisa amehlo: Kuzwakala sengathi kunzima ukuhambisa amehlo uma ubheka phezulu, phansi, noma emaceleni.
• I-Diplopia: Ukubona into eyodwa njengezimbili.

Lezi zimpawu zivame ukuthinta womabili amehlo, kodwa ngezinye izikhathi lezi zimpawu zingabonakala esweni elilodwa kuphela.

Yiziphi izinkinga zeSifo Samehlo Se-Graves?

Ngemva kokuba isigaba esisebenzayo sesifo samehlo se-thyroid sesiphelile, izinguquko ekubukekeni nasekuboneni kwamehlo zingase zithuthuke. Kodwa lokhu akwenzeki njalo. Ngezinye izikhathi, izicubu ezizungeze amehlo zingase zibe nezibazi futhi zingabuyeli esimweni esijwayelekile. Futhi, ezinye izingxenye zeso ezithinta umbono zingase zonakale unomphela. Kodwa ungakhathazeki, lezi zinto zingelashwa ngokuhlinzwa.

Izinguquko ezingaba khona ezihlala njalo ekubukekeni:

• Ukuhoxiswa kwejwabu leso
• Amehlo avelele
• Amehlo axegayo
• Amehlo abomvu

Izinguquko ezihlala njalo embonweni zingase zenzeke:

• Umbono ofiphele
• Umbono ophindwe kabili
• Ukulahlekelwa umbono okukhulu - Lokhu akuvamile kakhulu, kodwa kuhle ukukwazi.

Kungani sithola isifo samehlo se-thyroid (TED)?

Njengoba sishilo ngaphambili, yisifo esibangelwa ukuzivikela komzimba. Lokhu kusho ukuthi amasosha omzimba wakho ahlasela indlala yakho yegilo kanye nezicubu ezizungezile amehlo akho. Isifo sikaGraves siyimbangela evame kakhulu. Kodwa singavela nakubantu abanezinye izifo zegilo yegilo ezibangelwa ukuzivikela komzimba, njengesifo sikaHashimoto. Ngokumangalisayo, ngezinye izikhathi abantu abangenazo izinkinga zegilo kanye namazinga ajwayelekile ama-hormone egilo bangathuthukisa i-TED.

Kulezi zifo, ama-antibodies athile akhiqizwa yisimiso sakho somzimba sokuzivikela asebenza njengama-hormone e-thyroid futhi anamathela kuma-receptor ama-hormone e-thyroid. Lawa ma-receptor atholakala kakhulu endlaleni ye-thyroid, kodwa amanye atholakala nasezicutshini ezingemuva kwamehlo. Ngakho-ke, ama-antibodies afanayo athinta i-thyroid nawo ayathinta amehlo.

Ubani osengozini enkulu yokuthuthukisa lesi sifo (i-TED)?

Abanye abantu banamathuba amaningi okuthola lesi simo. Bheka ukuthi uwela yini kwesinye salezi zigaba:

• Uma ungowesifazane: Abesifazane banamathuba aphindwe kahlanu okuthola isifo se-Graves nesifo samehlo se-Graves kunabesilisa. (Kodwa-ke, uma indoda iba naso, kungenzeka ukuthi sibe sibi kakhulu.)
• Uma amazinga akho e-hormone ye-thyroid engajwayelekile:Kokubili amazinga akhuphukile (hyperthyroidism) kanye namazinga anciphile (hypothyroidism) ama-hormone e-thyroid angafaka isandla ku-TED. La ma-hormone, njengama-antibodies esixoxe ngawo ekuqaleni, avuselela ama-receptor ezicutshini zamehlo.
• Uma uke welashwa nge-radioiodine (ukwelashwa nge-RAI): Ukwelashwa nge-RAI kuyindlela eyinhloko yokwelapha i-hyperthyroidism. Kodwa-ke, kungabangela noma kube kubi kakhulu i-TED.
• Uma ubhema: Lokhu kubaluleke kakhulu. Abantu ababhemayo futhi ababhema intuthu ebhemayo basengozini enkulu kakhulu yokuthola isifo samehlo se-thyroid. Futhi, izimpawu cishe zimbi kakhulu futhi zihlala isikhathi eside kubantu ababhemayo. Uma une-TED, into engcono kakhulu ongazenzela yona ukuyeka ukubhema.

Ngingathola kanjani ukuthi kukhona odokotela (i-TED)?

Udokotela wakho angasithola lesi simo ngokwenza ukuhlolwa kwamehlo ngokomzimba nangokuhlola ngokucophelela izinkophe namehlo akho.

Uma kuvela ukusola okunjalo, bazoyala ukuhlolwa kwegazi okuningana ukuze bahlole amazinga e-hormone yakho ye-thyroid nokuthi ngabe kunama-antibodies amaningi kakhulu noma ambalwa kakhulu egazini lakho.

Ngaphezu kwalokho, udokotela angase acele ezinye izivivinyo eziningana:

• Ukuhlolwa kwamehlo nge-ultrasound
• Ukuhlolwa kwe-CT Scan (i-Computed Tomography - CT)
• Ukuhlolwa kwe-MRI (Magnetic Resonance Imaging - MRI)

Lezi zivivinyo zinganquma ukuthi izicubu ezizungeze amehlo zivuvukele kangakanani nokuthi ngabe kukhona yini ingcindezi ezinzwa.

Yiziphi izindlela zokwelapha (i-TED)?

Uhlobo lokwelashwa oludingayo luzoncika esigabeni sesifo kanye nobunzima baso. (TED) Ngesikhathi sesigaba esisebenzayo, kunezindlela zokwelapha ezingasiza ekunciphiseni izimpawu. Lokhu kungafaka phakathi amakhambi asekhaya, imithi ethengwa ngaphandle kwemithi kadokotela, noma imithi kadokotela. Ngemva kokuba isigaba esisebenzayo sesiphelile, ungadinga ukuhlinzwa ukuze ubuyisele ukubukeka kwakho noma ulungise umbono wakho.

Ukwelashwa kokuqeda izimpawu

Lezi zindlela zokwelapha zingasiza uma i-TED isebenza:

• Amaconsi Amehlo: Kunezinhlobo ezahlukene zamaconsi amehlo okuqeda amehlo omile, abomvu, noma abuhlungu.
• Izithasiselo ze-Selenium: Ukuntuleka kwe-Selenium kutholakale kwandisa izimpawu ze-TED, ngakho udokotela wakho angase akuncome lokhu.
• Amalensi e-Scleral: Lawa afana namalensi okuxhumana, kodwa amboza indawo enkulu yeso, enikeza isivikelo esengeziwe. Angasetshenziswa futhi ukunikeza imithi.
• Izinsiza zokubona:Uma ubona izinto ezimbili, udokotela wakho angase akuncome ukusebenzisa i-eye patch noma ukugqoka izibuko ezine-prism ekhethekile.
• Imithi (ye-Thionamides): Uma une-(hyperthyroidism) (ngenxa yesifo sikaGraves), imithi efana ne-(methimazole) kanye ne-(propylthiouracil) inganikezwa ukunciphisa amazinga e-hormone ye-thyroid.
• Ama-Corticosteroids: Uma izimpawu zakho zinzima, udokotela wakho angase akunike ama-corticosteroids isikhathi esifushane ukuze anciphise ukuvuvukala. Lawa anganikezwa njengamaphilisi athathwa ngomlomo noma njengomjovo emthanjeni (IV).
• (Teprotumumab - Tepezza®): Lona umuthi wokuqala othize owavunyelwa e-United States ngo-2020 ukwelapha (TED). Lona umuthi omusha ekilasini elibizwa ngokuthi (biologics) elinciphisa ukuvuvukala. Imithi eminingi efana nalena iyathuthukiswa manje.
• Ukwelashwa ngemisebe: Cabanga ngokwelashwa ngemisebe ukuze ubhubhise amangqamuzana omzimba asebenzayo ngemuva kwamehlo futhi unciphise ukuvuvukala. Udokotela wakho wamehlo angakudlulisela kudokotela wezifo zomdlavuza ngemisebe.

Khumbula, uma lezi zindlela zokwelapha zingasebenzi kuwe, ithimba lakho lezokwelapha lizokunikeza ezinye izindlela zokwelapha. Ukuhlinzwa akuvamile ukudingeka ngesikhathi sesigaba esisebenzayo sesifo samehlo sikaGraves. Esikhathini esiningi, ukuhlinzwa kucatshangelwa ngemva kokuba isimo sakho sesizinzile. Yilapho kuphela lapho singazi khona ngokuqinisekile ukuthi yiziphi izinguquko ekubukekeni nasekuboneni ezizoba khona unomphela.

Ukuhlinzwa kwe-(TED)

Kwezinye izimo, ukuhlinzwa kungadingeka:

• Ukuhlinzwa kokunciphisa ukucindezeleka kwe-orbital: Akuvamile kakhulu, lokhu kuhlinzwa kuyadingeka uma ukuvuvukala kubangela ingcindezi emthanjeni we-optic. Udokotela ohlinzayo ususa ingxenye yethambo ukuze anciphise ingcindezi. Lokhu kwenziwa futhi ukuze kuncishiswe ukuvuvuka kweso ngemva kokuba isifo sesiphelile.
• Ukususwa kwe-thyroid: Ukwelashwa kwe-hyperthyroidism enzima. Uma imithi yehluleka ukulawula amazinga e-hormone ye-thyroid, i-thyroid gland kungadingeka isuswe.
• Ukuhlinzwa kwe-eyelid: Uma amehlo akho ewele ngaphakathi, lokhu kuhlinzwa kwenzelwa ukuwabuyisela esimweni sawo sokuqala. Lokhu akugcini nje ngokuqeda ukungakhululeki kwamehlo, kodwa futhi kuthuthukisa ukubukeka kwawo futhi kuvikela iso ekuvezweni.
• Ukuhlinzwa kwemisipha yamehlo: Lokhu kuhlinzwa kungadingeka uma imisipha enyakazisa amehlo inezibazi futhi inenkinga yokunyakaza amehlo, noma uma amehlo engaqondile kahle futhi ubona ngezindlela ezimbili ezahlukene.
• Ukuhlinzwa kwe-Oculoplastic: Lokhu kuhilela ukwakhiwa kabusha kwezicubu ezithambile kanye/noma amathambo azungeze amehlo. Kungaxazulula izinkinga zobuhle njengamehlo avele kanye nezikhwama ngaphansi kwamehlo.
• Ukufakelwa kwe-cornea:Uma i-cornea yonakele kakhulu ngenxa yokuchayeka esweni ngesikhathi sesigaba esisebenzayo salesi sifo, ukufakelwa i-cornea kungacatshangwa ukuthi kuzothuthukisa ukubona.

(TED) Liyini ikusasa lalesi simo?

Kwabaningi abantu, i-TED ayinzima kakhulu, ngakho-ke isimo sengqondo sivame ukuba sihle. Abantu abaningi banezimpawu ezincane, ezivame ukuphela zodwa. Kodwa-ke, izimpawu zingaba zimbi kakhulu kubantu abaneminyaka engaphezu kwengu-50. Uma une-TED enzima, ungadinga inhlanganisela yokwelashwa ukuze uyilawule. Abanye abantu bangaba nezinguquko ezihlala njalo emehlweni abo, ezingadinga ukuhlinzwa.

Kufanele ngimbone nini udokotela?

Uma unesifo samehlo se-thyroid, kubalulekile ukwazisa ithimba lakho lezempilo uma izimpawu zakho ziba zimbi kakhulu. Kufanele futhi ubatshele uma ubona noma yiziphi izinguquko embonweni wakho. Ezinye izinguquko zingadinga ukwelashwa okuphuthumayo. Shayela udokotela wakho ngokushesha uma ubona noma yikuphi kwalokhu okulandelayo:

• Uma insimu yakho yokubona ibonakala incipha, noma uma ulahlekelwa umbono ohlangothini olulodwa.
• Uma imibala ibukeka ihlukile kunalokho okufanele ibe yikho.
• Uma uzwa ubuhlungu obukhulu emehlweni ngokuzumayo.

Isifo samehlo sikaGraves singathinta ngempela izinga lempilo yakho. Abantu abaningi abanazo izimpawu ezibucayi, kodwa kungaba yinto ekhathazayo kakhulu uma zinazo. Ukuvuvukala okuzungeze amehlo kungathinta induduzo yakho, umbono, kanye nokubukeka kwakho. Kudinga ithimba lodokotela ukukusiza ubhekane nakho konke lokhu. Kubalulekile futhi ukuba nokusekelwa empilweni yakho. Uma ungatholi ukwesekwa okudingayo, buza ithimba lakho lezokwelapha. Bangase bakwazi ukukutshela ngezinsiza ezingakusiza ngempilo yakho yengqondo.

Izinto ezibalulekile okufanele uzikhumbule (Umyalezo Wokuya Ekhaya)

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

• Isifo samehlo se-thyroid (TED) yisimo esithinta amehlo ahlotshaniswa nezinkinga ze-thyroid gland.
• Qaphela izimpawu ezifana nokuvuvuka kwamehlo, ukubomvu, ukuvuvukala, kanye nokubona kabili.
• Uma ubhema, yeka nakanjani. Lolu usizo olukhulu kakhulu ongalwenza.
• Uma izimpawu zinkulu noma uma ubona ushintsho embonweni , funa iseluleko sezokwelapha ngokushesha.
• Kwabaningi, lesi simo asibi kakhulu, futhi kunezindlela zokwelapha ezahlukahlukene ezitholakalayo. Ngakho-ke ungesabi, kodwa kubalulekile ukufuna usizo lwezokwelapha olufanele.
• Impilo yakho yengqondo nayo ibaluleke kakhulu ngalesi sikhathi. Unganqikazi ukufuna usizo nangalokho uma uludinga.

Ngiyethemba ukuthi lolu lwazi luwusizo kuwe. Hlala uphilile!

Isifo samehlo se - thyroid, isifo sikaGraves, ukuvuvukala kwamehlo, ukubomvu kwamehlo, izinkinga zokubona, i-thyroid, ama-hormone