Uyazazi yini izifo zikaWhipple? Ake sixoxe ngaleli gciwane elingavamile ngamazwi alula!

Ingabe ngezinye izikhathi uzizwa sengathi umzimba wakho ubuthakathaka kakhulu, unezinkinga zesisu, unesihlungu samalunga, kodwa awukwazi ukuthola isizathu salokho? Mhlawumbe lesi yisifo abantu abaningi abangakaze bezwe ngaso, kodwa kubalulekile ukusazi. Namuhla sizokhuluma ngesifo esingavamile kangaka, kodwa uma selashwa kahle, esingelapheka. Leso yisifo sikaWhipple.

Iyini isifo sikaWhipple?

Kalula nje, isifo sikaWhipple siwukutheleleka okungavamile kwamagciwane okwenzeka emathunjini akho amancane . Lokhu kubangelwa ukudla okudlayo okungagaywa kahle kanye nezakhamzimba ezikudingayo ezingamuncwa emzimbeni wakho (lokhu kubizwa ngokuthi "i-malabsorption"). Cabanga ngakho, sidla ukudla ukuze sithole amandla nokudla okunempilo emizimbeni yethu. Ngakho-ke uma kungamuncwa kahle, kungavela izinkinga eziningi. Lesi sifo senzeka lapho igciwane elibizwa ngokuthi "i-Tropheryma whipplei" lingena emzimbeni. Leli gciwane livame ukutholakala enhlabathini, okungukuthi, emhlabathini. Kodwa izindaba ezinhle ukuthi "ngama-antibiotic" afanele, leli gciwane lingasuswa emzimbeni, kuncishiswe izimpawu, futhi belapheke ngokuphelele .

Sivame kangakanani isifo sikaWhipple?

Nansi into ebalulekile. Nakuba amabhaktheriya abangela lesi sifo ((Tropheryma whipplei)) etholakala eningi endaweni ezungezile, ikakhulukazi enhlabathini, isifo sikaWhipple siyisimo esingavamile kakhulu . Ngokusho kwabacwaningi bezokwelapha, ngisho nasezweni elifana neMelika, kulinganiselwa ukuthi cishe abantu abayisishiyagalolunye kwabayisigidi bayasithola. Lokhu kusho ukuthi akuwona wonke umuntu ovezwa yileli gciwane othola lesi sifo. Imbangela eqondile ayaziwa.

Ziyini izimpawu zesifo sikaWhipple?

Izimpawu zesifo sikaWhipple azibonakali ngokuzumayo. Zikhula kancane kancane ngezigaba eziningana .

Izimpawu zesigaba sokuqala (isigaba se-Prodromal)

Kuqala ngobuhlungu obukhulu bamalunga . Lobuhlungu bungafika budlule. Buthinta kakhulu amalunga akho amakhulu - amaqakala akho, izindololwane, izinqe, amadolo, namahlombe . Odokotela ngezinye izikhathi babiza lesi sigaba sokuqala ngokuthi "isigaba sokukhula." Lokhu kungahlala iminyaka eyisikhombisa noma eyisishiyagalombili , bese kuvela ezinye izimpawu. Cabanga ukuthi kunzima kangakanani ukuba nobuhlungu bamalunga iminyaka eminingi ngaphandle kokuthola imbangela.

Izimpawu zakamuva

Ngemva kwesikhathi esithile, izimpawu ezilandelayo zingase zivele:

• Ubuhlungu besisu: Akuyona nje ubuhlungu besisu obuvamile, kungaba ubuhlungu obuba bubi kakhulu ngemva kokudla noma obuqhubekayo.
• Uhudo (indle enamanzi): Indle enamanzi eyenzeka izikhathi eziningana ngosuku. Lokhu kungabangela ukuphelelwa amanzi emzimbeni okukhulu kanye nokulahlekelwa izakhamzimba emzimbeni.
• Ukuvuvukala (Ukuvuvuka): Ungase uqaphele ukuvuvukala, ikakhulukazi emilenzeni nasemaqakaleni. Uma kuzwakala sengathi kuyisicaba uma ukucindezela ngomunwe wakho, kungaba ukuvuvuka.
• Ukukhathala okuvamile:Kungakhathaliseki ukuthi ulala kangakanani, umzimba wakho uzizwa ungenampilo futhi awufuni ukwenza lutho.
• Umkhuhlane: Ukuzizwa ushisa ngaphandle kwesizathu.
• Ukushintsha kombala wesikhumba: Ezinye izindawo, ikakhulukazi lezo ezivezwe elangeni, zingase zibe mnyama kunokuvamile.
• Ama-lymph node avuvukele: Amaqhubu amancane ezindaweni ezifana nentamo, emakhwapheni, nasesinqeni.
• Ukwehlisa isisindo okungachazeki: Ukwehlisa isisindo ngaphandle kokunciphisa ukudla noma ukuzivocavoca.

Izinkinga Zesistimu Yezinzwa Ephakathi

Abantu abaphakathi kuka-20% no-40% abanesifo sikaWhipple baba nezinkinga zesimiso sezinzwa esiyinhloko . Lesi yisimo esibi kakhulu. Izimpawu zingase zihlanganise:

• Izinkinga zokulinganisela: Uzizwa ungazinzile lapho uhamba futhi awukwazi ukuma uqonde.
• Ukudideka: Ukulahlekelwa ukwazi ukuthi ukuphi, isikhathi, ngisho nabantu obaziyo.
• Ubunzima bokugwinya: Ukuzizwa sengathi uyaminyana lapho ugwinya ukudla noma isiphuzo.
• Ukulahlekelwa yinkumbulo: Ukukhohlwa ngisho nezenzakalo zakamuva.
• Ukushintsha kobuntu: Ukuzizwa sengathi awuseyena umuntu ofana nalowo owawunguye ngaphambili, ukuthukuthela kalula, nokucasuka.
• Ukuquleka: Ukulahlekelwa ingqondo ngokuzumayo kanye nokuquleka.
• Izithiyo zokukhuluma: Ukungakwazi ukukhuluma kahle, ukungakwazi ukukhuluma kahle.

Yini ebangela isifo sikaWhipple?

Ngokwazi kodokotela, lesi sifo sibangelwa uhlobo oluthile lwebhaktheriya (i-Tropheryma whipplei) oluvame kakhulu enhlabathini . Noma ubani ochayeke kuleli bhaktheriya usengozini yokutheleleka. Kodwa-ke, njengoba sishilo ngaphambili, isifo sikaWhipple asivamile kakhulu. Ngakho-ke, akukacaci ukuthi kungani abanye abantu kuphela abasihlakulelayo .

Kodwa-ke, ucwaningo luthole ukuthi izici ezilandelayo zingandisa ingozi yokuthola lesi sifo :

• Ubudala: Isifo sikaWhipple sibonakaliswe ukuthi sivame ukuthinta abantu abaneminyaka ephakathi kuka-65 no-84 , kodwa singaba khona nakubantu abangaphansi kwalokho.
• Ukuchayeka enhlabathini noma ekukhuliseni izilwane: Ucwaningo lubonisa ukuthi abantu abasebenza ngenhlabathi noma ekukhuliseni izilwane basengozini enkulu yokuthola lesi sifo. Ngokukhethekile, abantu abalima, abangadini, noma abasebenza nezilwane bangase babe sengozini enkulu. Ungase uchayeke ngisho naleli gciwane uma utshala into encane engadini yakho yasekhaya.
• Ukuguqulwa kwezakhi zofuzo:Kukhona ukuxhumana phakathi kwesifo sikaWhipple kanye nesakhi sofuzo esenza iphrotheni `(IFR4)`. Le phrotheni isiza amangqamuzana omzimba wethu omzimba, njenge `(amangqamuzana e-B)` kanye `(amangqamuzana e-T)`, ukuba akhule. Kutholakale nokuthi ihlotshaniswa nokuguquka kwesakhi sofuzo `(HLA-B27)`. Lokhu kujule kancane, kodwa kalula nje, izinguquko ezithile ezakhini zofuzo zethu zingasenza sibe nalokhu.
• Isimiso somzimba esibuthakathaka: Uma unesifo esithinta isimiso somzimba wakho somzimba (njenge-HIV), noma uma uthatha imithi yokucindezela amasosha omzimba (lena inikezwa izifo ezithile, ngezinye izikhathi izinto ezifana nesifo samathambo, noma ngemva kokufakelwa isitho), usengozini enkulu yokuthola lesi sifo.

Yiziphi izinkinga ezingaba khona ngenxa yesifo sikaWhipple?

Njengoba sishilo ngaphambili, isifo sikaWhipple sibangelwa ukungakwazi komzimba ukumunca kahle amafutha, ama-carbohydrate, amavithamini, nezinye izakhamzimba ezivela ekudleni okudlula emathunjini akho amancane. Kuyisifo esiqhubekayo esiba sibi ngokuhamba kwesikhathi . Lokhu kusho ukuthi uma singelashwa, kungavela izinkinga ezintsha zempilo ezinkulu.

Izinkinga ezinjalo zingaba khona:

• I-anemia (inani eliphansi lamaseli abomvu egazi): Lokhu kungabangela ukukhathala okuqhubekayo, ubuthakathaka, kanye nokuphaphatheka.
• I-Dementia (ukulahlekelwa yinkumbulo nokusebenza kwengqondo): Lokhu kungenzeka uma uhlelo lwezinzwa luthinteka.
• Ukububula kwenhliziyo: Lokhu kungazwakala uma udokotela ekuxilonga nge-stethoscope.
• I-Oculomasticatory myorhythmia: Lesi yisibonakaliso esiqondile kakhulu, lapho amehlo nomhlathi kubonakala sengathi kuhamba ndawonye .
• Ukuphuma kwegazi: Lokhu kungabangela ubunzima bokuphefumula.
• I-Uveitis: Izimpawu zingase zihlanganise ukubomvu, ubuhlungu, kanye nokungaboni kahle.

Okubaluleke kakhulu, uma isifo sikaWhipple sithinta uhlelo lwakho lwezinzwa oluphakathi, singabulala. Ngakho-ke kubalulekile ukubona udokotela ngokushesha uma unezimpawu.

Odokotela basithola kanjani isifo sikaWhipple?

Uma uya kudokotela, uzoqala ngokukuhlola ngokomzimba . Bese, bazobuza ngomlando wakho wezokwelapha , okuhlanganisa nanoma yiziphi izinkinga zempilo zamanje noma ezedlule. Bangase futhi bakubuze nganoma yimiphi imithi oyiphuzayo nokuthi ngabe kukhona yini emndenini wakho oke waba nanoma iyiphi yalezi zimo. Ngaphezu kwalokho, bangenza izivivinyo ezilandelayo:

• Ukubalwa Kwegazi Okuphelele (i-CBC) : Lokhu kuhlola isimo samaseli egazi omzimba, ukuthi kukhona yini i-anemia, nokuthi ngabe kukhona yini izimpawu zokutheleleka.
• I-endoscopy ephezulu yamathumbu amancane: Kulokhu, kufakwa ipayipi elinekhamera encane ngomlomo bese libhekwa ngaphakathi emathunjini amancane. Ngale ndlela, noma yiziphi izinguquko lapho, izimpawu zokutheleleka, zingahlolwa. Uzolaliswa ngaphambi kokuba lokhu kwenziwe, ukuze ungezwa ubuhlungu.
• Ukuhlolwa kwe-Polymerase Chain Reaction (PCR) : Lokhu ukuhlolwa okukhethekile okungasiza ekunqumeni ukuthi ngabe igciwane (T. whipplei) likhona yini. Kungenziwa esicutshini sezicubu esithathwe ku-biopsy noma mhlawumbe kolunye uketshezi lomzimba.
• I-biopsy yamathumbu amancane : Ngesikhathi se-endoscopy, kuthathwa ingxenye encane yezicubu emathunjini amancane bese ihlolwa ngaphansi kwe-microscope. Lokhu kuvame ukusetshenziselwa ukuqinisekisa isifo sikaWhipple. Kungabheka izinguquko ezithile ezicutshini zamathumbu ezibangelwa yibhaktheriya.

Isifo sikaWhipple siphathwa kanjani?

Kuthatha isikhathi ukuqeda ngokuphelele amagciwane abangela isifo sikaWhipple emzimbeni. Ngakho-ke, ukwelashwa kuthatha isikhathi eside. Kodwa uma ubekezela, ungathola imiphumela emihle.

Lezi yizinto eziyinhloko ezenziwa njengokwelashwa:

• Ama-antibiotic : Ukwelashwa kuvame ukuqala ngama-antibiotic e-intravenous (IV) amasonto amabili kuya kwamane . Lokhu kuvame ukwenziwa esibhedlela. Ngemva kwalokho, kuzodingeka uthathe ama-antibiotic omlomo okungenani izinyanga ezingu-12 ezizayo . Ngezinye izikhathi, kungadingeka uwathathe isikhathi eside, kuze kube yiminyaka emibili. Kubaluleke kakhulu ukuthatha imithi njengoba nje udokotela wakho ekuyalele.
• Ukufakwa koketshezi : Uma uphelelwe amanzi emzimbeni ngenxa yohudo, unganikwa uketshezi lwe-IV ukuze uluyeke. Noma, ungatshelwa ukuthi uphuze iziphuzo ze-electrolyte (njengeJeevani) ukuze kufakwe uketshezi nosawoti olahlekile.
• Amavithamini kanye nezithako zokudla : Udokotela wakho angase akuncome ukuthi uthathe izithako zokudla ukuze ugcwalise amavithamini kanye nezakhamzimba amathumbu akho angakwazi ukuzimunca kahle (njengevithamini D, i-B12, kanye nensimbi). Kuvamile ukuthi kube nokuntuleka kokudla okunempilo kulesi sifo.

Ingabe ikhona imiphumela emibi yokwelashwa?

Yebo, eminye imiphumela emibi ingenzeka, ikakhulukazi ngama-antibiotic. Kodwa lokhu akwenzeki kuwo wonke umuntu, futhi noma kwenzeka, ngokuvamile akubi kakhulu.

• Uhudo (ubuhlungu besisu)
• Isiyezi
• Isicanucanu nokuhlanza
• Ukuqhuma kwesikhumba
• Ukutheleleka kwemvubelo (ikakhulukazi esithweni sangasese kwabesifazane)

Uma kwenzeka into efana nale, kubalulekile ukutshela udokotela wakho . Bangase bakwazi ukushintsha imithi noma bakunike okunye ukuze banciphise imiphumela emibi.

Yini eyenzeka kumuntu onesifo sikaWhipple?

Njengabantu abaningi, naweUma usuqalile ukwelashwa, uzoqala ukuzwa impumuzo ngokushesha. Ubuhlungu besisu kanye nobuhlungu bamalunga buzophela kancane kancane. Kodwa-ke, kungathatha iminyaka emibili ukuthi amathumbu akho amancane alulame ngokugcwele. Ngakho-ke, kubalulekile ukuba nesineke ngokwelashwa.

Esikhathini esiningi , isifo sikaWhipple siyaphulukiswa ngokuphelele ngokwelashwa . Kodwa-ke, ngezinye izikhathi lesi sifo singaphinde sibuye ngemva kokwelashwa sekuqediwe. Yingakho odokotela bezoqhubeka nokukuhlola.

Udokotela wakho uzokucela ukuthi uze uzohlolwa njalo isikhathi eside. Isibonelo, ungase ucelwe ukuthi wenze i-endoscopy ephezulu:

• Njalo ezinyangeni eziyisithupha ngonyaka wokuqala wokwelashwa.
• Kanye ngonyaka eminyakeni emithathu ezayo .
• Bese kuba kanye njalo eminyakeni emithathu impilo yakho yonke .

Lokhu kwenzelwa ukuhlola ukuthi isifo sesiphinde sabuya yini. Ngakho-ke, ungaphuthelwa ukuvakashelwa okulandelayo njengoba kunconywe udokotela.

Ingabe isifo sikaWhipple singavinjelwa?

Kunzima ukukusho lokho. Ngoba amagciwane abangela isifo sikaWhipple atholakala cishe kuyo yonke indawo endaweni yethu, ikakhulukazi enhlabathini . Kodwa-ke, akuwona wonke umuntu obhekene naso othola isifo sikaWhipple.

Kodwa-ke, abantu abanesimiso somzimba sokuzivikela esibuthakathaka noma labo abathatha imithi yokucindezela amasosha omzimba basengozini enkulu yokuthola lesi sifo. Uma ungomunye walaba bantu, kuwumqondo omuhle ukugqoka amagilavu ​​​​noma nini lapho usebenza ngomhlabathi noma ngodaka, futhi ugeze izandla zakho kahle ngemva komsebenzi . Qaphela ikakhulukazi uma ulima ingadi noma usebenza nezilwane.

Ngizinakekela kanjani?

Into ebaluleke kakhulu ukuthatha ama-antibiotic njengoba nje udokotela emyalile, isikhathi sonke . Ungaphuthelwa usuku olulodwa, bese uthatha imithi isikhathi sonke udokotela amyalile. Iningi labantu kuzodingeka lithathe ama-antibiotic okungenani unyaka wonke ngemva kokuxilongwa. Abanye abantu kungadingeka bathathe ama-antibiotic impilo yabo yonke. Lokho kuncike kudokotela ukuthi anqume.

Uma unesifo sikaWhipple, umzimba wakho ungase ulahlekelwe izakhamzimba eziningi ezibalulekile . Ngisho noma uthola impumuzo ekwelashweni, kusengumqondo omuhle ukubonisana nodokotela wezokudla mayelana nokuthi yini okufanele uyidle futhi uyiphuze . Lokhu kuzokusiza ukuthi uthole ukudla okufanele futhi ugcine isisindo sakho siphilile.

Kufanele ngiphinde ngimbone nini udokotela?

Uma uqhubeka nokuba nezimpawu zesifo sikaWhipple ngemva kokuqala ukwelashwa, noma uma izimpawu zibuya ngokushesha ngemva kokuphela kokwelashwa (isibonelo, uma unezinhlungu esiswini noma emalungeni), qiniseka ukuthi ubona udokotela wakho. Ungalibali. Lokhu kungasho ukuthi lesi sifo sesibuyile, noma ukuthi kungase kube nenye inkinga.

Kungani lesi sifo sibizwa ngokuthi "isifo se-Whipples"?

Kuhle ukwazi lokhu. Lesi sifo kanye namagciwane asibangelayo aqanjwe ngegama likaGeorge H. Whipple, isazi sezifo owaqala ukuchaza izimpawu ngo-1907. Kwaze kwaba yiminyaka engama-80 kamuva lapho abacwaningi bathola khona amagciwane asibangelayo. Baqamba igciwane ngokuthi i-Tropheryma whipplei. Leli gama liyinhlanganisela yamagama amabili esiGreki, elithi "trophe" elisho ukudla okunempilo kanye nelithi "eryma" elisho ukuvinjelwa . Kusho ukuthi kubangela ukungamuncwa kahle . Akulona yini igama elifanele?

Amabhaktheriya akhona yonke indawo esizungezile (nangaphakathi emizimbeni yethu). Ngokuvamile, amabhaktheriya esihlangana nawo nsuku zonke awasikhathazi. Kodwa lokhu kutheleleka okungavamile kwamabhaktheriya, isifo sikaWhipple, kuhlukile kancane. Kubangelwa ibhaktheriya evamile etholakala enhlabathini ebizwa ngokuthi iTropheryma whipplei.

Ungachayeka kuleli gciwane (T. whipplei) emsebenzini noma ngenkathi ulima ingadi. Kodwa-ke, akuwona wonke umuntu ochayeka kulo ozoba nesifo sikaWhipple. Ngenhlanhla, lesi simo singelapheka uma sitholakala kusenesikhathi futhi selashwa kahle.

Izinto ezibaluleke kakhulu okudingeka uzikhumbule

Isifo sikaWhipple siwukutheleleka okungavamile kwamagciwane , kodwa singelapheka uma selashwa kahle .

• Uma izimpawu ezifana nobuhlungu bamalunga, ukucasuka kwesisu, isifo sohudo, kanye nokwehla kwesisindo kuqhubeka, qiniseka ukuthi ubona udokotela. Ungazinaki lezi.
• Ukwelashwa kuhilela ukuthatha ama-antibiotic isikhathi eside . Kubaluleke kakhulu ukuwalandela kahle.
• Uma usebenza ngenhlabathi, ikakhulukazi uma unesimiso somzimba esibuthakathaka, geza izandla zakho kahle bese usebenzisa amagilavu .
• Ngisho nangemva kokuba isifo sesipholile, kubalulekile ukuya kohlolwa njalo ('ukulandelwa') njengoba kunqunywe udokotela.

Ungesabi lesi sifo. Kubalulekile ukwaziswa nokufuna iseluleko sezokwelapha. Awuwedwa, futhi kukhona odokotela abangakusiza nganoma iyiphi inkinga. Uma unokungabaza, ungangabazi ukukhuluma nodokotela.

Isifo sikaWhipple , Ukutheleleka Kwamagciwane, Amathumbu Amancane, Ukungamuncwa Kwamafutha, I-Tropheryma whipplei, Ubuhlungu Bamalunga