Polymyositis - abadala

I-Polymyositis kunye nedermatomyositis zizifo ezinqabileyo ezinokutsha. (Imeko ibizwa ngokuba yidermatomyositis xa ibandakanya ulusu.) Ezi zifo zikhokelela kubuthathaka bemisipha, ukudumba, ukuthamba kunye nokonakala kwethishu. Ziyinxalenye yeqela elikhulu lezifo ezibizwa ngokuba yi-myopathies.

I-Polymyositis ichaphazela izihlunu zamathambo. Kwakhona kwaziwa ngokuba yi-idiopathic inflammatory myopathy. Isizathu esichanekileyo asaziwa, kodwa sinokuthi sinxulumene nokuphendula okuzenzekelayo okanye usulelo.

I-Polymyositis inokuchaphazela abantu nangaliphi na ubudala. Ixhaphake kakhulu kubantu abadala abaphakathi kweminyaka engama-50 nama-60, nakubantwana abadala. Ichaphazela abasetyhini kabini ngokufuthi njengamadoda. Kuqheleke kakhulu kubantu base-Afrika baseMelika kunabantu abamhlophe.

I-Polymyositis sisifo esiqhelekileyo. Oku kuthetha ukuba ichaphazela umzimba uphela. Ubuthathaka bemisipha kunye nokuthantamisa kunokuba yimiqondiso ye-polymyositis. Irhashalala luphawu imeko enxulumene, dermatomyositis.

Iimpawu eziqhelekileyo zibandakanya:

• Ubuthathaka bemisipha emagxeni nasezinqeni. Oku kunokwenza kube nzima ukuphakamisa iingalo phezu kwentloko, ukuphakama kwindawo yokuhlala, okanye ukunyuka izitepsi.
• Kunzima ukugwinya.
• Intlungu yezihlunu.
• Iingxaki ngelizwi (ezibangelwa yimisipha yomqala).
• Ukuqhawukelwa ngumphefumlo.

Unako kwakhona:

• Ukudinwa
• Ifiva
• Intlungu edibeneyo
• Ukuphelelwa ngumdla wokutya
• Ukuqina kwentsasa
• Ukuhla ukusinda
• Ukudumba kolusu ngasemva kweminwe, kwiinkophe, okanye ebusweni

Uvavanyo lunokubandakanya:

• Ukuzikhusela komzimba kunye novavanyo lokudumba
• I-CPK
• Iserum aldolase
• Umbane wombane
• I-MRI yezihlunu ezichaphazelekayo
• Imisipha biopsy
• I-Myoglobin kumchamo
• ECG
• I-x-ray yesifuba kunye novavanyo lwe-CT lwesifuba
• Uvavanyo lomsebenzi wePulmonary
• Isifundo sokuginya esophageal
• I-Myositis ekhethekileyo kunye ne-autoantibodies ehambelana nayo

Abantu abakule meko kufuneka bajongwe ngononophelo kwiimpawu zomhlaza.

Unyango oluphambili kukusetyenziswa kwamayeza e-corticosteroid. Idosi yeyeza icothwa kancinci njengoko amandla emisipha ephucula. Oku kuthatha malunga neeveki ezi-4 ukuya kwezi-6. Uya kuhlala kwidosi esezantsi yonyango lwecorticosteroid emva koko.

Amayeza okucinezela amajoni omzimba anokusetyenziselwa ukutshintsha ii-corticosteroids. La machiza anokubandakanya i-azathioprine, methotrexate okanye mycophenolate.

Kwisifo esihlala sisebenza ngaphandle kwe-corticosteroids, i-gamma globulin efakwa ngaphakathi iye yavavanywa ngeziphumo ezixubeneyo. Iziyobisi zebhayoloji nazo zinokusetyenziswa. IRituximab ibonakala iyeyona ithembisayo. Kubalulekile ukulawula ezinye iimeko kubantu abangayiphenduliyo unyango. Ukuphindaphinda i-biopsy yemisipha kunokufuneka ukuba kwenziwe esi sifo.

Ukuba imeko inxulunyaniswa nethumba, inokuphucula ukuba isisu sisuswe.

Impendulo kunyango iyahluka, ngokusekwe kubunzima. Baninzi kangangesi-1 kwaba-5 abantu abanokufa kwiminyaka emi-5 yokuphuhliswa kwale meko.

Abantu abaninzi, ngakumbi abantwana, bayachacha ekuguleni kwaye abadingi nyango luqhubekekayo. Kubantu abadala abaninzi, nangona kunjalo, iziyobisi ezisebenza ngokuchasene nesifo ziyafuneka ukulawula isifo.

Imbonakalo yabantu abanesifo semiphunga kunye ne-anti-MDA-5 antibody ayilunganga nangona unyango langoku.

Kubantu abadala, ukufa kunokubangelwa:

• Ukungondleki
• Ukukrala kwemiphunga
• Ukusilela kokuphefumla
• Ubunzima, ubuthathaka bexesha elide

Izizathu eziphambili zokufa ngumhlaza kunye nesifo semiphunga.

Iingxaki zinokubandakanya:

• Ukufakwa kweCalcium kwiimisipha ezichaphazelekayo, ngakumbi kubantwana abanesi sifo
• Umhlaza
• Isifo sentliziyo, isifo semiphunga, okanye iingxaki zesisu

Fowunela umboneleli wakho wezempilo ukuba uneempawu zesi sifo. Funa unyango olungxamisekileyo ukuba unomoya ophefumlayo kwaye kunzima nokuginya.

• Imisipha yangaphandle yangaphandle

UAggarwal R, uMkhweli weLG, uRuperto N, et al. Ngo-2016 i-American College ye-Rheumatology / i-European League ngokuchasene ne-Rheumatism Criteria ye-Minimal, Moderate, kunye ne-Major Clinical Response kwi-Dermatomyositis yabantu abadala kunye ne-Polymyositis: Uvavanyo lwe-International Myositis kunye neQela loPhando lweKlinikhi / i-Pediatric Rheumatology International Trials Organisation Initiative. Isifo samathambo Rheumatol. Ngo-2017; 69 (5): 898-910. IINKCUKACHA: 28382787 www.ncbi.nlm.nih.gov/pubmed/28382787.

UDalakas MC. Izifo zemisipha ezivuthayo. N Engl J Med. 2015; 373 (4): 393-394. IINKCUKACHA: 26200989 www.ncbi.nlm.nih.gov/pubmed/26200989.

IGreenberg SA. I-myopathies yokuvuvukala. Ku: IGoldman L, iSchafer AI, ii-eds. Amayeza eGoldman-Cecil. Umhla wama-25. IPhiladelphia, PA: Elsevier Saunders; I-2016: isahluko 269.

INagaraju K, Gladue HS, iLundberg IE.Izifo ezivuthayo zemisipha kunye nezinye i-myopathies. Ku: Firestein GS, Budd RC, Gabriel SE, McInnes IB, O'Dell JR, ii-eds. Incwadi kaKelley kunye neFirestein yeRheumatology. Ngomhla we-10. IPhiladelphia, PA: Elsevier; Ngo-2017: isahluko 85.

UYoshida N, Okamoto M, uKaieda S, et al. Umbutho we-anti-aminoacyl-transfer RNA synthetase antibody kunye ne-anti-melanoma umahluko onxulumene ne-5 antibody ngempendulo yonyango lwe-polymyositis / dermatomyositis-ehambelana nesifo semiphunga. Umphenyi wophando. Ngo-2017; 55 (1): 24-32. IINKCUKACHA: 28012490 www.ncbi.nlm.nih.gov/pubmed/28012490.