Buza ingcali: Ukunyanga nokuLawula i-Urticaria engapheliyo ye-Idiopathic

Umxholo

• 1. Ii-antihistamines ziyekile ukusebenza ukulawula iimpawu zam. Zeziphi ezinye iindlela zam?
• 2. Zeziphi iikhrimu okanye into yokuthambisa ekufuneka ndiyisebenzisile ukulawula ukurhawuzelela okungapheliyo okuvela kwi-CIU?
• 3. Ngaba i-CIU yam iya kuze ihambe?
• 4. Yintoni abaphandi abayaziyo malunga nento enokubangela i-CIU?
• 5. Ngaba lukhona utshintsho kwindlela enditya ngayo ekufuneka ndiyenzile ukulawula i-CIU yam?
• 6. Zeziphi iingcebiso onazo zokuchonga ezibangela?
• 7. Luluphi unyango lwamayeza endinokuluzama?
• 8. Loluphi unyango anokuluyalelwa ngugqirha wam?

1. Ii-antihistamines ziyekile ukusebenza ukulawula iimpawu zam. Zeziphi ezinye iindlela zam?

Ngaphambi kokuyeka i-antihistamines, ndihlala ndiqinisekisa ukuba abaguli bam bayayinyusa idosi yabo. Kukhuselekile ukuthatha ukuya kwizihlandlo ezine idosi ekucetyiswa ngayo yonke imihla ye-antihistamines engahlali. Imizekelo ibandakanya i-loratadine, cetirizine, fexofenadine, okanye levocetirizine.

Xa idosi ephezulu, ii-antihistamines ezingasebenziyo zisilela, amanyathelo alandelayo abandakanya i-antihistamine ye-sedating efana nehydroxyzine kunye ne-doxepin. Okanye, siza kuzama i-H2 blocker, ezinje nge-ranitidine kunye ne-famotidine, kunye ne-leukotriene inhibitors ezinje zileuton.

Kwiinyosi ezinzima ukunyanga, ndihlala ndibhenela kwiyeza elitofwayo elibizwa ngokuba yi-omalizumab. Inesibonelelo sokungabinayo i-steroidal kwaye isebenza kakhulu kwizigulana ezininzi.

Isifo esinganyangekiyo se-urticaria (CIU) sisifo esichasene nomzimba. Ke, kwiimeko ezigabadeleyo, ndingasebenzisa inkqubo yokunyanga imithambo njengecyclosporine.

2. Zeziphi iikhrimu okanye into yokuthambisa ekufuneka ndiyisebenzisile ukulawula ukurhawuzelela okungapheliyo okuvela kwi-CIU?

Ukurhawuzelela okuvela kwi-CIU kungenxa yokukhululwa kwangaphakathi kwe-histamine. Iiarhente zentloko-kubandakanya ii-antihistamines ezingumxholo- ubukhulu becala azisebenzi ekulawuleni iimpawu.

Thatha rhoqo iishawari ezidikidiki kwaye uthambise into yokuthambisa nepholisayo xa kuqhuma irhasi kwaye irhawuzela kakhulu. I-steroid yezihloko nayo inokunceda. Nangona kunjalo, ii-antihistamines zomlomo kunye ne-omalizumab okanye ezinye iinguqulelo zenkqubo yomzimba yokuzikhusela ziya kunika ukukhululeka okukhulu.

3. Ngaba i-CIU yam iya kuze ihambe?

Ewe, phantse onke amatyala e-urticaria engapheliyo ye-idiopathic ekugqibeleni asombulule. Nangona kunjalo, akunakwenzeka ukuqikelela ukuba oku kuyakwenzeka nini.

Ubungqongqo be-CIU buye buye buguquke kunye nexesha, kwaye unokufuna amanqanaba ohlukeneyo onyango ngamaxesha ahlukeneyo. Kuhlala kukho umngcipheko wokuba i-CIU ibuye yakuba iye kuxolelo.

4. Yintoni abaphandi abayaziyo malunga nento enokubangela i-CIU?

Kukho iingcamango ezininzi phakathi kwabaphandi malunga nokuba yintoni ebangela i-CIU. Eyona ithiyori ixhaphakileyo kukuba i-CIU yimeko efana nokuzimela.

Kubantu abane-CIU, sihlala sibona ii-autoantibodies ezijolise kwiiseli ezikhupha i-histamine (iiseli zemasti kunye ne-basophils). Ukongeza, aba bantu bahlala benezinye iingxaki zokuzimela komzimba ezinjengesifo se-thyroid.

Enye ithiyori kukuba kukho abalamli abathile kwi-serum okanye iplasma yabantu abane-CIU. Aba balamli basebenzise iiseli zemasti okanye ii-basophil, ngokuthe ngqo okanye ngokungathanga ngqo.

Okokugqibela, kukho "inkolelo yesiphene." Le ithi ithi abantu abane-CIU baneziphene kwiselfowuni okanye ukurhweba nge-basophil, ukusayina, okanye ukusebenza. Oku kukhokelela ekukhululweni kwe-histamine engaphezulu.

5. Ngaba lukhona utshintsho kwindlela enditya ngayo ekufuneka ndiyenzile ukulawula i-CIU yam?

Asihlali sicebisa utshintsho kwindlela yokutya yokulawula i-CIU njengoko izifundo zingakhange zibonise sibonelelo. Uhlengahlengiso kwidayari aluxhaswanga sisikhokelo semvumelwano.

Ukunamathela kwizidlo, njengokutya okune-histamine esezantsi, kunzima kakhulu ukulandela. Kukwabalulekile ukuba uqaphele ukuba i-CIU ayisosiphumo sokwaliwa kokutya okuyinyani, ngoko ke ukuvavanywa kokutya nokwaliwa komzimba kunqabile ukuba kuvelise iziqhamo.

6. Zeziphi iingcebiso onazo zokuchonga ezibangela?

Zininzi izinto ezaziwayo ezinokubangela ukuba imingxunya yakho inyuke. Ubushushu, utywala, uxinzelelo, ukungqubana, kunye noxinzelelo lweemvakalelo zixeliwe kakuhle ukuba zisiba mandundu iimpawu.

Ukongeza, kuya kufuneka uthathele ingqalelo ukuphepha i-aspirin kunye nezinye iziyobisi ezichasayo (ii-NSAID). Banokwenza mandundu i-CIU kwiimeko ezininzi. Ungaqhubeka nokuthatha idosi ephantsi, iasprini yosana xa isetyenziselwa ukunqanda amahlwili egazi.

7. Luluphi unyango lwamayeza endinokuluzama?

I-OTC non-sedating antihistamines, okanye ii-H1 blockers, ziyakwazi ukulawula imingxunya kubantu abaninzi abane-CIU. Ezi mveliso zibandakanya i-loratadine, i-cetirizine, i-levocetirizine, kunye ne-fexofenadine. Unokuthatha ukuya kuthi ga izihlandlo ezine idosi yemihla ngemihla ekhuthazwayo ngaphandle kokuphucula iziphumo ebezingalindelekanga.

Unokuzama ukuthambisa ii-antihistamine njengoko kufuneka, njenge-diphenhydramine. I-H2-blocking antihistamines, ezinje nge-famotidine kunye ne-ranitidine, inokubonelela ngoncedo olongezelelekileyo.

8. Loluphi unyango anokuluyalelwa ngugqirha wam?

Ngamanye amaxesha, ii-antihistamines (zombini i-H1 kunye ne-H2 blockers) azikwazi ukulawula imihlathi kunye nokudumba okunxulunyaniswa ne-CIU. Xa oku kusenzeka, kungcono ukusebenzisana nebhodi eqinisekisiweyo ye-allergist okanye i-immunologist. Banokuyalela amayeza abonelela ngolawulo olungcono.

Ugqirha wakho unokuzama ukuhlala ngokuqina ngakumbi, amayeza ama-antihistamines kuqala njengehydroxyzine okanye doxepin. Banokuthi kamva bazame i-omalizumab ukuba la machiza awasebenzi ekunyangeni iimpawu zakho.

Sihlala singacebisi i-corticosteroids yomlomo kubantu abane-CIU. Oku kungenxa yokuba nakho kwabo ukuba neziphumo ebezingalindelekanga ezibalulekileyo. Ezinye ii-immunosuppressants zihlala zisetyenziswa kwiimeko ezinzima, ezingalawulekiyo.

UMarc Meth, MD, ufumene isidanga sakhe kwezonyango kwiDavid Geffen School of Medicine e-UCLA. Wagqiba ukuhlala kwakhe kwiMedicine yangaphakathi kwiSibhedlele iMount Sinai kwisiXeko saseNew York. Emva koko wagqiba ubudlelwane kwi-Allergy kunye ne-Immunology kwiZiko lezoNyango laseLong Island lamaJuda. Ugqirha Meth ngoku ukwiklinikhi yeFakhalthi kwiDavid Geffen School of Medicine e-UCLA kwaye unamalungelo eCedars Sinai Medical Centre. UngumDiplomate weBhodi yaseMelika yoNyango lwaNgaphakathi kunye neBhodi yaseMelika yeAllergy & Immunology. UGqirha Meth ukwindawo yabucala eCentury City, eLos Angeles.