Buza Ingcali: Ukulawula unyango lwakho lwe-Idiopathic Thrombocytopenic Purpura

Umxholo

• Zeziphi ezinye zonyango oluqhelekileyo lwe-ITP?
• Ndizokwazi njani ukuba unyango lwam luyasebenza? Ngaba iya kufuna ukuvavanywa?
• Ngaba zikhona iziphumo zokunyanga i-ITP? Iingozi?
• Ndingazilawula njani iziphumo ebezingalindelekanga zonyango?
• Kuya kufuneka kangaphi ukuba ndiye kugqirha ndiyokuvavanywa? Kubaluleke kangakanani ukuvavanywa okuqhubekayo?
• Ngaba i-ITP ingangcono ngokwayo?
• Kwenzeka ntoni xa ndiyeka ukuthatha unyango?
• Ngaba unyango lwam lwe-ITP luya kutshintsha ekuhambeni kwexesha? Ngaba ndiza kuba kunyango ubomi bam bonke?

Zeziphi ezinye zonyango oluqhelekileyo lwe-ITP?

Kukho iintlobo ezininzi zonyango olusebenzayo lwe-ITP yokunyusa ukubalwa kweplatelet kunye nokunciphisa umngcipheko wokopha kakhulu.

IiSteroids. Ii-Steroids zihlala zisetyenziswa njengonyango lodidi lokuqala. Bacinezela amajoni omzimba, anokuphazamisa ukutshatyalaliswa kweplatelet okuzenzekelayo.

I-immunoglobulin efakwa ngaphakathi (IVIG). I-IVIG iphazamisa iplatelet eboshwe nge-antibody ebopha kwii-receptors kwiiseli ezibatshabalalisayo. IVIG inokusebenza kakhulu, kodwa iimpendulo zihlala zihlala ixesha elifutshane.

I-anti-CD20 monoclonal antibodies (mAbs). Oku kutshabalalisa iiseli ze-B, iiseli zamajoni omzimba ezenza ii-antiplatelet antibodies.

I-Thrombopoietin receptor agonists (TPO-RA). Oku kulinganisa isenzo sokukhula kwendalo i-thrombopoietin kunye nokukhuthaza umongo wethambo ukuba uvelise iiplatelets.

Isithinteli seSYK. Eli chiza liphazamisa indlela ephambili yokusebenza kwii-macrophages, iiseli eziyindawo ephambili yokutshatyalaliswa kweplatelet.

Splenectomy. Olu tyando lokususa udakada lususa indawo yokuqala yokwakheka kweplatelet. Ingakhokelela kuxolelo lwexesha elide kubantu abathile.

Ndizokwazi njani ukuba unyango lwam luyasebenza? Ngaba iya kufuna ukuvavanywa?

Injongo yonyango lwe-ITP kukunciphisa umngcipheko wokopha okunzulu nokubulala ngokugcina ukubalwa kweplatelet kuluhlu olukhuselekileyo. Ezantsi ukubala kweplatelet, kokukhona umngcipheko wokuba wophe. Nangona kunjalo, ezinye izinto zinokuchaphazela umngcipheko wokopha, njengobudala bakho, inqanaba lomsebenzi, kunye namanye amayeza owathathayo.

Uvavanyo olupheleleyo lwegazi (CBC) lusetyenziselwa ukufumana ukubalwa kweplatelet kunye nokujonga iimpendulo kunyango.

Ngaba zikhona iziphumo zokunyanga i-ITP? Iingozi?

Njengaso nasiphi na isifo esinganyangekiyo, kukho umngcipheko, iziphumo ebezingalindelekanga, kunye nezibonelelo zokunyanga i-ITP. Umzekelo, ukucinezela amajoni omzimba kunokusebenza kakuhle ukunyanga izifo ezizimeleyo. Kodwa oku kukwandisa umngcipheko wokufumana usulelo oluthile.

Kuba zininzi iindlela zonyango ezisebenzayo ze-ITP ezikhoyo, xoxa ngazo zonke iindlela onokukhetha kuzo nogqirha wakho. Kwakhona, uhlala unokhetho lokutshintshela kunyango olwahlukileyo ukuba ufumana iziphumo ebezingalindelekanga kunyango lwakho lwangoku.

Ndingazilawula njani iziphumo ebezingalindelekanga zonyango?

Esona sixhobo sibalulekileyo sokulawula iziphumo ebezingalindelekanga zonyango kukunxibelelana nogqirha wakho. Umzekelo, ukuba ndiyazi ukuba esinye sezigulana sam sinengxaki yokuqaqanjelwa yintloko ene-IVIG okanye ubunzima bokufumana ubunzima obukhulu kunye nokutshintsha kwemozulu kwi-steroids, iingcebiso zonyango ziya kutshintsha. Ndiza kufuna ezinye iindlela zonyango ezinganyamezeleka.

Iziphumo ebezingalindelekanga zonyango oluthile zihlala ziphendula kunyango lwamayeza oluxhasayo. Kwakhona, iidosi zinokuhlengahlengiswa ngokusekwe kwiziphumo ebezingalindelekanga.

Kuya kufuneka kangaphi ukuba ndiye kugqirha ndiyokuvavanywa? Kubaluleke kangakanani ukuvavanywa okuqhubekayo?

Ubudlelwane obuqhubekayo kunye ne-hematologist enamava kubalulekile kuye nabani na one-ITP. Ukuphindaphindwa kovavanyo kuya kwahluka ngokuxhomekeka ekubeni usopha ngokukuko okanye iiplatelets zakho ziphantsi kakhulu.

Nje ukuba unyango olutsha luqaliswe, uvavanyo lunokwenziwa yonke imihla okanye ngeveki. Ukuba iiplatelets zikuluhlu olukhuselekileyo ngenxa yokuxolelwa (umzekelo, emva kwe-steroids okanye i-splenectomy) okanye ngenxa yonyango olusebenzayo (umzekelo, i-TPO-RAs okanye i-SYK inhibitors), uvavanyo lunokwenziwa ngenyanga okanye rhoqo kwiinyanga ezimbalwa.

Ngaba i-ITP ingangcono ngokwayo?

Kubantu abadala abane-ITP, ukuxolelwa ngokukhawuleza ngaphandle kwonyango kunqabile (malunga neepesenti ezili-9 ngokutsho). Kuqheleke ngakumbi ukufezekisa ukuxolelwa okuzinzileyo emva konyango olusebenzayo.

Olunye unyango lunikwa ixesha elichaziweyo ngethemba lokufumana ixesha elingasetyenziswanga kunyango, nganye inamazinga okuphendula ahlukeneyo. Oku kubandakanya i-steroids, IVIG, mAbs, kunye ne-splenectomy. Olunye unyango luqhutywa ngokuqhubekayo ukugcina iiplatelets kuluhlu olukhuselekileyo. Oku kubandakanya i-TPO-RAs, i-SYK inhibitors, kunye ne-immunosuppressants ezingapheliyo.

Kwenzeka ntoni xa ndiyeka ukuthatha unyango?

Ukuyekisa unyango kunokubangela ukwehla ngesiquphe kubalo lweplatelet yakho. Inokukhokelela kumngcipheko omkhulu wokopha okanye ukubulala. Ukukhawuleza kunye nokuba iiplatelet ezisezantsi zinokuhla njani emva kokumisa unyango kuyahluka phakathi kwabantu abane-ITP.

Kukho umngcipheko omncinci wokumisa unyango ukuba ubalo lweplatelet yakho ikuluhlu olukhuselekileyo. Uninzi lweedosi eziphezulu zedosi kufuneka zicofwe kancinci ekuhambeni kwexesha ukunqanda ingxaki ye-adrenal kunye nokuvumela umzimba ukuba uhlengahlengise.

Ewe kunjalo, kubalulekile ukunxibelelana rhoqo nogqirha wakho malunga neenkxalabo kunye neemfuno zakho.

Ngaba unyango lwam lwe-ITP luya kutshintsha ekuhambeni kwexesha? Ngaba ndiza kuba kunyango ubomi bam bonke?

Kuba i-ITP yabantu abadala sisifo esinganyangekiyo, abantu abaphila nale meko bahlala bejikeleza ngeendlela ezininzi zonyango ebomini babo.

UGqirha Ivy Altomare unjingalwazi onxulumene neyeza kwiDuke University Medical Center. Unobuchule beklinikhi kwiimeko ezahlukeneyo ze-hematological kunye ne-oncological kunye noxilongo kwaye uqhuba uphando lweenkonzo zeklinikhi kunye nezempilo kwicandelo le-ITP ngaphezulu kweshumi leminyaka. Ungumamkeli ohloniphekileyo kuwo omabini amaFakhalthi amaJunior kunye neMfundo ePhakamileyo kwiDyunivesithi yaseDuke kwaye unomdla okhethekileyo kwimfundo yezonyango kubo bobabini abaguli kunye noogqirha.