Isifo seAntiphospholipid - APS

Isifo iAntiphospholipid syndrome (APS) sisifo esizimela komzimba esibandakanya amahlwili egazi (thromboses)Xa unale meko, amajoni akho omzimba enza iiproteni ezingaqhelekanga ezihlasela iiseli zegazi kunye nolwelwelwe lwemithambo yegazi. Ubukho bezi antibodies bunokubangela iingxaki ekuhambeni kwegazi kwaye kukhokelele kwindawo enobungozi kwimithambo yegazi emzimbeni wonke.

Isizathu ngqo se-APS asaziwa. Zombini iinguqu ezithile zofuzo kunye nezinye izinto (ezinjengosulelo) zinokubangela ukuba ingxaki ikhule.

Ihlala ifunyanwa kubantu abanezinye izifo ezizimele, ezinje nge-lupus erythematosus (SLE). Le meko ixhaphake kakhulu kwabasetyhini kunamadoda, ihlala ifunyanwa kwabasetyhini abanembali yokuphuphuma kwesisu ngokuphindaphindiweyo.

Abanye abantu baphethe izilwa-buhlungu ezichazwe apha ngasentla, kodwa abanazo ii-APS. Ezinye izinto ezinokubangela ukuba aba bantu babe negazi, kubandakanya:

• Ukutshaya
• Ukuphumla kwebhedi ixesha elide
• Ukukhulelwa
• Unyango lweHormone okanye iipilisi zolawulo lokuzalwa
• Umhlaza
• Isifo sezintso

Awunakho ukuba naziphi na iimpawu, nangona unazo izilwa-buhlungu. Iimpawu ezinokuthi zenzeke zibandakanya:

• Amahlwili egazi emilenzeni, ezingalweni okanye emiphungeni. Amahlwili anokuba semithanjeni okanye kwimithambo.
• Ukuphuma kwesisu rhoqo okanye ukuzalwa.
• Irhashalala, kwabanye abantu.

Kwiimeko ezinqabileyo, amahlwili akhula ngesiquphe kwimithambo emininzi kwithuba leentsuku. Oku kubizwa ngokuba yintsholongwane ye-anti-phospholipid syndrome (CAPS). Ingakhokelela kwisifo sokubethwa kunye nokugungxwa kwezintso, isibindi, kunye namanye amalungu emzimbeni, kunye nokulimala emalungwini.

Uvavanyo lwe-lupus anticoagulant kunye ne-antiphospholipid antibodies zinokwenziwa xa:

• Ukuqubeka kwegazi okungalindelekanga kwenzeka, njengabantu abancinci okanye abo bengenazo ezinye izinto ezinobungozi kwigazi.
• Umfazi unembali yokulahleka kokukhulelwa okuphindaphindiweyo.

Uvavanyo lwe-lupus anticoagulant luvavanyo lokunqanda igazi. Amachiza antiphospholipid (aPL) abangela ukuba uvavanyo lungaqhelekanga elebhu.

Iindidi zovavanyo lokunquma zinokubandakanya:

• Ixesha elisebenzayo le-thromboplastin (aPTT)
• Ixesha likaRussell lenyoka
• Uvavanyo lokuthintela i-Thromboplastin

Uvavanyo lwee-antiphospholipid antibodies (aPL) luyakwenziwa. Ziquka:

• Uvavanyo lwe-Anticardiolipin antibody
• Iintsholongwane kwi-beta-2-glypoprotein I (Beta2-GPI)

Umboneleli wakho wokhathalelo lwempilo uza kufumanisa isifo se-antiphospholipid antibody syndrome (APS) ukuba ngaba unokuvavanyo oluqinisekileyo lwe-APL okanye i-lupus anticoagulant, kunye nesinye okanye ezingaphezulu kwezi ziganeko zilandelayo:

• Ihlwili legazi
• Ukuphindaphindwa kwesisu

Iimvavanyo ezifanelekileyo kufuneka ziqinisekiswe emva kweeveki ezili-12. Ukuba kuvavanyo oluchanekileyo ngaphandle kwezinye izinto zesi sifo, awuzukuxilongwa yi-APS.

Unyango lwe-APS lujolise ekuthinteleni iingxaki ezivela kumahlwili egazi amatsha enza okanye amahlwili asele ekho abe mkhulu. Kuya kufuneka uthathe uhlobo oluthile lweyeza lokucheba igazi. Ukuba unesifo sokuzimela, esifana nelupus, kuyakufuneka ugcine imeko iphantsi kolawulo ngokunjalo.

Unyango oluchanekileyo luya kuxhomekeka ekubeni inzima kangakanani imeko yakho kunye neengxaki ezibangelwa yiyo.

I-ANTIPHOSPHOLIPID ANTIBODY SYNDROME (APS)

Ngokubanzi, uyakufuna unyango ngegazi elincinci ixesha elide ukuba une-APS. Unyango lokuqala lunokuba yi-heparin. La mayeza anikezelwa ngenaliti.

Kwiimeko ezininzi, i-warfarin (i-Coumadin), enikwa ngomlomo, iyaqala. Kuyimfuneko ukubeka esweni rhoqo inqanaba le-anticoagulation. Oku kuhlala kwenziwa kusetyenziswa uvavanyo lwe-INR.

Ukuba unayo i-APS kwaye ukhulelwe, kuya kufuneka ulandelwe ngokusondeleyo ngumboneleli oyingcali kule meko. Awuyi kuthatha i-warfarin ngexesha lokukhulelwa, kodwa uya kunikwa i-heparin shots endaweni yoko.

Ukuba une-SLE kunye ne-APS, umboneleli wakho uya kucebisa ukuba uthathe ihydroxychloroquine.

Okwangoku, ezinye iintlobo zamayeza okucoca igazi azikhuthazwa.

ICANDASTROPHIC ANTIPHOSPHOLIPID SYNDROME (CAPS)

Unyango lwe-CAPS olubandakanya indibaniselwano yonyango lwe-anticoagulation, iidosi eziphezulu ze-corticosteroids, kunye notshintshiselwano ngeplasma kuye kwasebenza kubantu abaninzi. Ngamanye amaxesha i-IVIG, i-rituximab okanye i-eculizumab ikwasetyenziselwa iimeko ezinzima.

UVAVANYO OLUQHELEKILEYO LUPUS ANTICOAGULANT OKANYE APL

Awuyi kufuna unyango ukuba awunayo impawu, ukulahleka kokukhulelwa, okanye ukuba awuzange ube negazi.

Thatha la manyathelo alandelayo ukunceda ukuthintela amahlwili egazi ekwenzeni:

• Gwema uninzi lweepilisi zolawulo lokuzalwa okanye unyango lwehomoni xa uyeka ukuya exesheni (abasetyhini).
• Ungatshayi okanye usebenzise ezinye iimveliso zecuba.
• Vuka uhambehamba ngexesha lokuhamba ngenqwelomoya okanye ngamanye amaxesha xa kufuneka uhlale okanye ulale ixesha elide.
• Hambisa amaqatha akho phezulu nasezantsi xa ungakwazi ukuhamba.

Uya kumiselwa amayeza okucoca igazi (njengeheparin kunye newarfarin) ukunceda ukuthintela amahlwili egazi:

• Emva kotyando
• Emva kokuqhekeka kwethambo
• Ngomhlaza osebenzayo
• Xa ufuna ukuhlala phantsi okanye ukulala ixesha elide, njengaxa uhlala esibhedlele okanye uchacha ekhaya

Kuya kufuneka ukuba uthathe abacoci gazi iiveki ezi-3 ukuya kwezi-4 emva kotyando ukunciphisa umngcipheko wamahlwili egazi.

Ngaphandle konyango, abantu abane-APS baya kuphinda bavale. Uninzi lwexesha, isiphumo silungile ngonyango olululo, olubandakanya unyango lwe-anticoagulation yexesha elide. Abanye abantu banokuba namahlwili egazi ekunzima ukuwalawula ngaphandle konyango. Oku kungakhokelela kwi-CAPS, enokusongela ubomi.

Biza umnikezeli wakho ukuba ubona iimpawu zegazi, ezinje:

• Ukudumba okanye ukuba bomvu emlenzeni
• Ukuqhawukelwa ngumphefumlo
• Intlungu, ukuba ndindisholo, kunye nombala olusu olukhanyayo engalweni okanye emlenzeni

Thetha nomboneleli wakho ukuba uphindaphinde waphulukana nokukhulelwa (ukuphuma kwesisu).

Iintsholongwane ze-Anticardiolipin; Isifo seHughes

• Inkqubo ye lupus erythematosus rash ebusweni
• Amahlwili egazi

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ICervera R, uRodríguez-Pintó I, uColafrancesco S, et al. I-14th yeHlabathi yeHlabathi kwi-Antiphospholipid Antibodies Task Force ingxelo malunga nentlekele ye-antiphospholipid syndrome. Ukuzenzela ngokuzenzekelayo Isityhi. Ngo-2014; 13 (7): 699-707. IINKCUKACHA: 24657970 www.ncbi.nlm.nih.gov/pubmed/24657970.

I-Dufrost V, i-Risse J, i-Wahl D, i-Zuily S. I-anticoagulants yomlomo ngqo esetyenziswayo kwi-antiphospholipid syndrome: ngaba la machiza ayindlela efanelekileyo nekhuselekileyo yokulwa imfazwe? Uphengululo olucwangcisiweyo loncwadi: impendulo kumagqabantshintshi. ICurr Rheumatol Rep. Ngo-2017; 19 (8): 52. IINKCUKACHA: 28741234 www.ncbi.nlm.nih.gov/pubmed/28741234.

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I-National Heart, Lung, kunye newebhusayithi yeZiko leGazi. Isifo seantibospholipid antibody syndrome. www.nhlbi.nih.gov/health-topics/antiphospholipid-antibody-syndrome. Ifunyenwe ngoJuni 5, 2019.