Inkqubo ye lupus erythematosus

Inkqubo ye-lupus erythematosus (SLE) sisifo esizimele. Kwesi sifo, amajoni omzimba ahlasele ngempazamo izicwili ezisempilweni. Inokuchaphazela ulusu, amalunga, izintso, ingqondo kunye namanye amalungu.

Isizathu se-SLE asaziwa ngokucacileyo. Inokudibaniswa nezi zinto zilandelayo:

• Imfuza
• Ezendalo
• IHormonal
• Amayeza athile

I-SLE ixhaphake kakhulu kwabasetyhini kunamadoda phantse i-10 ukuya kwi-1. Inokwenzeka nakweyiphi na iminyaka. Nangona kunjalo, kubonakala rhoqo kumabhinqa aselula aphakathi kweminyaka eli-15 ukuya kwengama-44. E-US, esi sifo sixhaphake kakhulu kubantu base-Afrika baseMelika, baseAsia baseMelika, baseCaribbean baseAfrika, naseMelika yaseSpain.

Iimpawu ziyahluka ukusuka komnye umntu ukuya komnye, kwaye zinokuza zidlule. Wonke umntu one-SLE uneentlungu ezidibeneyo kunye nokudumba ngamanye amaxesha. Abanye baba nesifo samathambo. I-SLE ihlala ichaphazela amalungu eminwe, izandla, izihlahla kunye namadolo.

Ezinye iimpawu eziqhelekileyo zibandakanya:

• Intlungu yesifuba xa uthatha umoya.
• Ukudinwa.
• Fever ngaphandle kwesizathu.
• Ukungakhululeki ngokubanzi, ukungonwabi, okanye ukugula (umkhuhlane).
• Ukulahleka kweenwele.
• Ukuhla ukusinda.
• Izilonda zomlomo.
• Ubuntununtunu elangeni.
• Irhashalala lolusu - "irubhabhathane" irhashalala ikhula ngesiqingatha sabantu abane-SLE. Irhashalala ibonakala kakhulu ezidleleni nakwibhulorho yempumlo. Inokusasazeka ngokubanzi. Kuya kusiba mandundu elangeni.
• I-lymph nodes ezidumbileyo.

Ezinye iimpawu kunye neempawu zixhomekeke kwiliphi ilungu lomzimba elichaphazelekayo:

• Inkqubo yobuchopho kunye ne-neva-Intloko ebuthathaka, ubuthathaka, ukuba ndindisholo, ukurhawuzelela, ukuxhuzula, iingxaki zombono, inkumbulo kunye notshintsho kubuntu
• Umgudu wokugaya - Intlungu yesisu, isicaphucaphu kunye nokugabha
• Iingxaki zentliziyo - iValve, ukudumba kwentliziyo yemisipha okanye ulwelo lwentliziyo (pericardium)
• Imiphunga - Ukwakhiwa kolwelo kwindawo yokubongoza, ukuphefumla nzima, ukukhwehlela igazi
• Ulusu - Izilonda emlonyeni
• Izintso - Ukudumba emilenzeni
• Ukujikeleza -Ukugquma emithanjeni okanye kwimithambo yegazi, ukudumba kwemithambo yegazi, ukuxinana kwemithambo yegazi ekuphenduleni kubanda (iRaynaud phenomenon)
• Ukungaqhelekanga kwegazi kubandakanya i-anemia, iseli yegazi emhlophe esezantsi okanye ubalo lweplatelet

Abanye abantu baneempawu zesikhumba kuphela. Oku kubizwa ngokuba yi-discoid lupus.

Ukuze ufumane ukuba une-lupus, kufuneka ube neempawu ezi-4 kwezili-11 zesi sifo. Phantse bonke abantu abane-lupus banovavanyo oluqinisekileyo lwe-antinuclear antibody (ANA). Nangona kunjalo, ukuba ne-ANA elungileyo kuphela akuthethi ukuba une-lupus.

Umboneleli wezempilo uya kwenza uvavanyo olupheleleyo lomzimba. Unokuba nerhashalala, isifo samathambo, okanye i-edema emaqatheni. Kunokubakho isandi esingaqhelekanga esibizwa ngokuba kukukhuhlana kwentliziyo okanye ukuruthana komlo. Umboneleli wakho uya kwenza novavanyo lweenkqubo zemithambo-luvo.

Iimvavanyo ezisetyenziselwa ukuxilonga i-SLE zingabandakanya:

• Intsholongwane yentsholongwane (ANA)
• I-CBC ngokwahluka
• I-x-ray yesifuba
• I-serum creatinine
• Uhlalutyo lomchamo

Unokuba nolunye uvavanyo ukuze ufunde ngakumbi ngemeko yakho. Ezinye zazo zezi:

• Iphaneli yeantinuclear antibody (ANA)
• Ukuzalisa izinto (C3 kunye neC4)
• Iintsholongwane kwiDNA ebambeke kabini
• Uvavanyo lweeCombs-ngqo
• Cryoglobulins
• I-ESR kunye neCRP
• Uvavanyo lwegazi kwizintso
• Uvavanyo lwegazi lesibindi
• Into yeRheumatoid
• Antiphospholipid antibodies kunye novavanyo lwe lupus anticoagulant
• Isifo sezintso
• Ukulinganisa iimvavanyo zentliziyo, ingqondo, imiphunga, amalungu, izihlunu okanye amathumbu

Alukho unyango lwe-SLE. Injongo yonyango kukulawula iimpawu. Iimpawu ezinzima ezibandakanya intliziyo, imiphunga, izintso kunye namanye amalungu zihlala zifuna unyango ziingcali. Umntu ngamnye one-SLE ufuna uvavanyo malunga:

• Sisebenza njani esi sifo
• Leliphi ilungu lomzimba elichaphazelekayo
• Loluphi uhlobo lonyango olufunekayo

Iindlela ezinobulali zesifo zinokunyangwa nge:

• Ii-NSAID zeempawu ezidibeneyo kunye ne-pleurisy. Thetha nomboneleli wakho ngaphambi kokuba uthathe la mayeza.
• Iidosi ezisezantsi ze-corticosteroids, ezinje nge-prednisone, yolusu kunye neempawu zamathambo.
• Izithambisi zecorticosteroid zolusu.
• IHydroxychloroquine, iyeza elalisetyenziselwa ukunyanga isifo seengcongconi.
• I-Methotrexate inokusetyenziselwa ukunciphisa ithamo le-corticosteroids
  
• I-Belimumab, iyeza lebhayoloji, kunokuba luncedo kwabanye abantu.

Unyango lwe-SLE eqatha inokubandakanya:

• Idosi ephezulu yecorticosteroids.
• Amayeza omzimba wokunyanga (la mayeza acinezela amajoni omzimba). La mayeza asetyenziswa ukuba une-lupus ebukhali echaphazela inkqubo yeemvakalelo, izintso okanye amanye amalungu. Zingasetyenziselwa ukuba ungangcono kwi-corticosteroids, okanye ukuba iimpawu zakho ziba zibi xa uyeka ukuthatha i-corticosteroids.
• Amayeza aqhelekileyo asetyenziswa aquka i-mycophenolate, i-azathioprine kunye ne-cyclophosphamide. Ngenxa yetyhefu yayo, i-cyclophosphamide ikhawulelwe kwikhosi emfutshane yeenyanga ezi-3 ukuya kwezi-6. I-Rituximab (Rituxan) isetyenziswa kwezinye iimeko ngokunjalo.
• Abanciphisi begazi, njenge-warfarin (i-Coumadin), yokuphazamiseka kwengxaki efana ne-antiphospholipid syndrome.

Ukuba une-SLE, kubalulekile ukuba:

• Nxiba impahla ekhuselayo, iiglasi zelanga kunye nelanga xa uselangeni.
• Fumana ukhathalelo lwentliziyo olukhuselayo.
• Hlala usesikhathini malunga nokugonywa.
• Yenza uvavanyo kuvavanyo lwamathambo (i-osteoporosis).
• Thintela icuba kwaye usele izixa ezincinane zotywala.

Iingcebiso kunye namaqela enkxaso anokunceda kwimicimbi yeemvakalelo ebandakanyekayo kwesi sifo.

Iziphumo zabantu abane-SLE ziphucukile kule minyaka idlulileyo. Abantu abaninzi abane-SLE baneempawu ezintle. Ukwenza kakuhle kangakanani kuxhomekeke ekubeni sibuhlungu kangakanani esi sifo. Uninzi lwabantu abane-SLE luza kufuna amayeza ixesha elide. Phantse zonke ziya kufuna ihydroxychloroquine ngokungenammiselo. Nangona kunjalo, e-US, i-SLE yenye yezona zinto zingama-20 zikhokelela ekufeni kwabantu basetyhini abaphakathi kweminyaka emi-5 nengama-64 ubudala. Amayeza amatsha amaninzi ayafundwa ukuphucula iziphumo zabafazi abane-SLE.

Esi sifo sihlala sisebenza ngakumbi:

• Ngexesha leminyaka yokuqala emva kokuxilongwa
• Kubantu abangaphantsi kweminyaka engama-40

Abasetyhini abaninzi abane-SLE banokukhulelwa kwaye bahambise umntwana osempilweni. Iziphumo ezilungileyo zinokubakho kwabasetyhini abafumana unyango olululo kwaye bangabinazingxaki zentliziyo okanye zezintso. Nangona kunjalo, ubukho be-SLE antibodies okanye ii-antiphospholipid antibodies eziphakamisa umngcipheko wokukhulelwa kwesisu.

ILUPUS NEPHRITIS

Abanye abantu abane-SLE banamagqabi omzimba angaqhelekanga kwiiseli zezintso. Oku kukhokelela kwimeko ebizwa ngokuba lupus nephritis. Abantu abanale ngxaki banokuphuhlisa ukusilela kwezintso. Banokufuna i-dialysis okanye ukufakelwa kwezintso.

I-biopsy yezintso iyenziwa ukubona ubungakanani bomonakalo kwizintso kunye nokunceda ukukhokela unyango. Ukuba i-nephritis esebenzayo ikho, unyango ngamayeza e-immunosuppressive kubandakanya idosi ephezulu ye-corticosteroids kunye ne-cyclophosphamide okanye i-mycophenolate iyafuneka.

EZINYE IINDAWO ZOMZIMBA

SLE kunokubangela umonakalo kwiindawo ezininzi ezahlukeneyo zomzimba, kubandakanya:

• Amahlwili egazi kwimithambo yemithambo yemilenze, imiphunga, ingqondo, okanye amathumbu
• Ukutshatyalaliswa kweeseli ezibomvu zegazi okanye i-anemia yezifo zexesha elide (ezingapheliyo)
• Ulwelo olujikeleze intliziyo (i-pericarditis), okanye ukudumba kwentliziyo (myocarditis okanye i-endocarditis)
• Ulwelo olujikeleze imiphunga kunye nokonakala kwethishu yemiphunga
• Iingxaki zokukhulelwa, kubandakanya ukuphuma kwesisu
• Ukubetha
• Umonakalo wamathumbu kunye nentlungu esiswini kunye nokuphazamiseka
• Ukudumba emathunjini
• Inani eliphantsi kakhulu leplatelet yegazi (iiplatelets ziyafuneka ukunqanda ukopha)
• Ukudumba kwemithambo yegazi

SLE NOKUKHULELWA

Zombini i-SLE kunye namanye amayeza asetyenziselwa i-SLE angonzakalisa umntwana ongekazalwa. Thetha nomboneleli wakho ngaphambi kokuba ukhulelwe. Ukuba ukhulelwe, fumana umboneleli onamava nge-lupus kunye nokukhulelwa.

Tsalela umnikezeli wakho ukuba uneempawu ze-SLE. Biza kwakhona ukuba unesi sifo kwaye iimpawu zakho ziba zimbi okanye kuvela uphawu olutsha.

Kusasazwe i-lupus erythematosus; SLE; ULupus; Ilupus erythematosus; Irhasi yebhabhathane - SLE; Ukufumanisa i-lupus

• Inkqubo ye lupus erythematosus
• I-Lupus, discoid-umbono wezilonda esifubeni
• I-Lupus-discoid ebusweni bomntwana
• Inkqubo ye lupus erythematosus rash ebusweni
• Iintsholongwane

IArntfield RT, iHick CM. Inkqubo ye-lupus erythematosus kunye ne-vasculitides. Ku: Iindonga RM, iHockberger RS, iGausche-Hill M, ii-eds. Unyango lukaRosen oluNgxamisekileyo: Iikhonsepthi kunye nokuziqhelanisa neKlinikhi. Umhla we-9. IPhiladelphia, PA: Elsevier; I-2018: isahluko 108.

Umqala MK. I-Etiology kunye ne-pathogenesis yenkqubo ye-lupus erythematosus. 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 79.

UFanouriakis A, uKostopoulou M, uAlunno A, et al. Isiseko Uhlaziyo luka-2019 lweengcebiso ze-EULAR kulawulo lwenkqubo ye-lupus erythematosus. U-Ann Rheum Dis. 2019; 78 (6): 736-745. IINKCUKACHA: 30926722 pubmed.ncbi.nlm.nih.gov/30926722/.

UHahn BH, uMcMahon MA, uWilkinson A, et al. Ikholeji yaseMelika yeRheumatology izikhokelo zovavanyo, unyango, kunye nolawulo lwe-lupus nephritis. Ukunyamekelwa kweArthritis Res (Hoboken). Ngo-2012; 64 (6): 797-808. IINKCUKACHA: 22556106 pubmed.ncbi.nlm.nih.gov/22556106/.

van Vollenhoven RF, Mosca M, Bertsias G, okqhubekayo. Unyango ekujoliswe kulo kwinkqubo ye-lupus erythematosus: iingcebiso ezivela kwiqela labasebenzi bamanye amazwe. U-Ann Rheum Dis. Ngo-2014; 73 (6): 958-967. IINKCUKACHA: 24739325 pubmed.ncbi.nlm.nih.gov/24739325/.

Yen EY, Singh RR. Ingxelo emfutshane: I-lupus-sisizathu esingaziwayo sokufa kwabasetyhini abancinci: isifundo esisekwe kubemi besebenzisa izatifikethi zokufa kwilizwe liphela, 2000-2015. Isifo samathambo Rheumatol. Ngo-2018; 70 (8): 1251-1255. IINKCUKACHA: 29671279 pubmed.ncbi.nlm.nih.gov/29671279/.