Ulutsha lwe-idiopathic arthritis

I-juvenile idiopathic arthritis (JIA) ligama elisetyenziselwa ukuchaza iqela lokuphazamiseka ebantwaneni elibandakanya isifo samathambo. Zizifo zexesha elide (ezingapheliyo) ezibangela iintlungu ezidibeneyo kunye nokudumba. Amagama achaza eli qela leemeko atshintshile kumashumi eminyaka adlulileyo njengoko kufundwa ngakumbi ngale meko.

Unobangela weJIA awaziwa. Kucingelwa ukuba kukugula okuzenzekelayo. Oku kuthetha ukuba umzimba uhlasela kwaye utshabalalise izicwili zomzimba ngempazamo.

I-JIA ihlala ikhula ngaphambi kweminyaka yobudala eyi-16. Iimpawu zingaqala kwinyanga ezintandathu ubudala.

I-International League yeMibutho yeRheumatology (ILAR) iphakamise le ndlela ilandelayo yokubeka olu hlobo lwe-arthritis yabantwana:

• Inkqubo ye-JIA. Kubandakanya ukudumba ngokudibeneyo okanye iintlungu, umkhuhlane kunye nerhashalala. Olu lolona hlobo luqhelekileyo kodwa lunokuba lolona luqatha. Kubonakala ngathi yahlukile kunezinye iintlobo ze-JIA kwaye iyafana ne-Adult Onset Stills Disease.
• IPolyarthritis. Ibandakanya amalungu amaninzi. Le fomu yeJIA inokujika ibe sisifo samathambo. Inokubandakanya ama-5 okanye ngaphezulu nangaphezulu kunye namalungu amancinci emilenze kunye neengalo, kunye nomhlathi nentamo. Into yeRheumatoid inokubakho.
• I-Oligoarthritis (iyaqhubeka kwaye iyandiswa). Ibandakanya amalungu 1 ukuya ku-4, amaxesha amaninzi izihlahla, okanye amadolo. Ichaphazela namehlo.
• Isifo samathambo esinxulumene ne-Enthesitis. Ibonakalisa i-spondyloarthritis kubantu abadala kwaye ihlala ibandakanya ukudityaniswa kwe-sacroiliac.
• Isifo samathambo. Ifunyaniswe kubantwana abane-arthritis kunye ne-psoriasis okanye isifo se-nail, okanye banelungu losapho elisondeleyo eline-psoriasis.

Iimpawu zeJIA zinokubandakanya:

• Ukudibanisa, obomvu, okanye ukudibanisa okufudumeleyo
• Ukuqhwalela okanye iingxaki usebenzisa ilungu
• Ngokukhawuleza umkhuhlane omkhulu onokuthi ubuye
• I-Rash (kwi-trunk kunye neempembelelo) eziza kwaye zihamba nomkhuhlane
• Ukuqina, iintlungu, kunye nokuhamba okungaphelelanga kwendibaniselwano
• Iintlungu ezisezantsi ezingapheliyo
• Iimpawu zomzimba wonke ezinje ngesikhumba esimhlophe, ukudumba kwe-lymph gland, kunye nokubonakala kokugula

I-JIA inokubangela iingxaki zamehlo ezibizwa ngokuba yi-uveitis, iridocyclitis, okanye i-iritis. Kungangabikho mpawu. Xa iimpawu zamehlo zenzeka, zinokubandakanya:

• Amehlo abomvu
• Intlungu yamehlo, enokuba mandundu xa ujonga ukukhanya (photophobia)
• Umbono utshintsha

Uvavanyo lomzimba lunokubonisa ukudumba, ukufudumala, kunye namalungu athambileyo akhathaza ukuhamba. Umntwana unokuba nokukhawuleza. Ezinye iimpawu zibandakanya:

• Isibindi esidumbileyo
• Udakada odumbileyo
• I-lymph nodes ezidumbileyo

Uvavanyo lwegazi lunokubandakanya:

• Into yeRheumatoid
• Izinga le-sedimentation ye-Erythrocyte (ESR)
• Intsholongwane yentsholongwane (ANA)
• Gcwalisa ubalo lwegazi (CBC)
• I-HLA-B27

Naluphi na okanye lonke olu vavanyo lwegazi lunokuba yinto eqhelekileyo kubantwana abane-JIA.

Umboneleli wezempilo unokubeka inaliti encinci kwindawo yokudumba ukuze asuse ulwelo. Oku kunokunceda ekufumaneni unobangela wesifo samathambo. Inokukunceda ekuthomalaliseni iintlungu. Umboneleli unokufaka i-steroids ngokudibeneyo ukunceda ukunciphisa ukudumba.

Olunye uvavanyo olunokwenziwa lunokubandakanya:

• X-reyi yelungu
• Ukuskena amathambo
• X-ray esifubeni
• ECG
• Ukuvavanywa kwamehlo rhoqo ngugqirha wamehlo- Oku kufuneka kwenziwe nokuba akukho zimpawu zamehlo.

Izidakamizwa ezichasayo ezichasayo (i-NSAID) ezifana ne-ibuprofen okanye i-naproxen inokwanela ukulawula iimpawu xa kubandakanyeka inani elincinci lamalungu.

Iicorticosteroids zinokusetyenziselwa ukuqhayisa ngakumbi ukunceda ukulawula iimpawu. Ngenxa yobuthi babo, ukusetyenziswa kwexesha elide kwala mayeza kufuneka kuthintelwe ebantwaneni.

Abantwana abanesifo samathambo kumalungu amaninzi, okanye abanomkhuhlane, ukukhawuleza kunye nokuvuvukala kwamadlala kunokufuna amanye amayeza. Oku kubizwa ngokuba sisiyobisi esiguqula i-antirheumatic drug (DMARDs). Banokunceda ukunciphisa ukudumba kumalungu okanye emzimbeni. Ii-DMARD zibandakanya:

• Imethotrexate
• Iziyobisi ze-Biologic, ezinje nge-etanercept (Enbrel), infliximab (Remicade), kunye neziyobisi ezinxulumene noko

Abantwana abane-JIA yenkqubo baya kufuna i-biologic inhibitors ye-IL-1 okanye i-IL-6 efana ne-anakinra okanye i-tocilizumab.

Abantwana abane-JIA kufuneka bahlale bekhuthele.

Ukuzilolonga kuya kunceda ukugcina izihlunu kunye namalungu omelele kwaye ahamba.

• Ukuhamba, ukuhamba ngebhayisikile, kunye nokudada kunokuba yimisebenzi elungileyo.
• Abantwana kufuneka bafunde ukufudumala ngaphambi kokuba benze umthambo.
• Thetha ugqirha okanye ugqirha ngokwasemzimbeni malunga nokwenza umthambo xa usiva iintlungu.

Abantwana abanosizi okanye abanomsindo malunga nesifo samathambo banokufuna inkxaso eyongezelelweyo.

Abanye abantwana abane-JIA banokufuna utyando, kubandakanya ukutshintshwa ngokudibeneyo.

Abantwana abanamalungu ambalwa kuphela achaphazelekayo abanakho ukungabi nazimpawu ixesha elide.

Kubantwana abaninzi, esi sifo siza kungasebenzi kwaye sibangele umonakalo omncinci ngokudibeneyo.

Ubungqongqo besifo buxhomekeke kwinani lamalungu achaphazelekayo. Kunqabile ukuba iimpawu ziya kuhamba kwezi meko. Aba bantwana bahlala befumana iintlungu zexesha elide (ezingapheliyo), ukukhubazeka kunye neengxaki esikolweni. Abanye abantwana banokuqhubeka nokuba nesifo samathambo njengabantu abadala.

Iingxaki zinokubandakanya:

• Ukunxiba okanye ukutshatyalaliswa kwamalungu (kunokwenzeka kubantu abane-JIA ebukhali)
• Ukucotha kwezinga lokukhula
• Ukukhula okungalinganiyo kwengalo okanye umlenze
• Ukulahleka kombono okanye ukunciphisa umbono ovela kwi-uveitis engapheliyo (le ngxaki ingaba nzima, nangona i-arthritis ayinzima kakhulu)
• Ukunqongophala kwegazi
• Ukuvuvukala malunga nentliziyo (i-pericarditis)
• Iintlungu zexesha elide (ezingapheliyo), ukungahambi kakuhle esikolweni
• I-Macrophage activation syndrome, isifo esibuhlungu esinokuthi sikhule ngenkqubo ye-JIA

Fowunela umnikezeli wakho ukuba:

• Wena, okanye umntwana wakho, qaphela iimpawu zeJIA
• Iimpawu ziba mandundu okanye zingaphucuki kunyango
• Iimpawu ezintsha ziyavela

Akukho sithintelo saziwayo seJIA.

I-rheumatoid arthritis (i-JRA) yolutsha; I-polyarthritis engapheliyo; Sisifo; I-spondyloarthritis yolutsha

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