I-Polymyositis - umuntu omdala

I-Polymyositis ne-dermatomyositis yizifo ezingavamile zokuvuvukala. (Lesi simo sibizwa ngokuthi i-dermatomyositis uma sibandakanya isikhumba.) Lezi zifo ziholela ekubeni buthakathaka kwemisipha, ukuvuvukala, isisa, nokulimala kwezicubu. Bayingxenye yeqembu elikhudlwana lezifo ezibizwa nge-myopathies.

I-Polymyositis ithinta imisipha yamathambo. Kuyaziwa nangokuthi i-idiopathic inflammatory myopathy. Isizathu ngqo asaziwa, kepha kungenzeka ukuthi sihlobene nokuphendula okuzenzakalelayo noma ukutheleleka.

I-Polymyositis ingathinta abantu nganoma yisiphi isikhathi. Kuvame kakhulu kubantu abadala abaphakathi kweminyaka engama-50 nengama-60, nasezinganeni ezindala. Ithinta abesifazane ngokuphindwe kabili kunabesilisa. Kuvame kakhulu kubantu base-Afrika baseMelika kunabantu abamhlophe.

I-Polymyositis yisifo se-systemic. Lokhu kusho ukuthi kuthinta umzimba wonke. Ubuthakathaka bemisipha nobumnene kungaba yizimpawu ze-polymyositis. Ukuqhuma kuwuphawu lwesimo esihlobene, i-dermatomyositis.

Izimpawu ezivamile zifaka:

• Ubuthakathaka bemisipha emahlombe nasezinqeni. Lokhu kungenza kube nzima ukuphakamisa izingalo phezu kwekhanda, ukuvuka endaweni yokuhlala, noma ukukhuphuka izitebhisi.
• Kunzima ukugwinya.
• Ubuhlungu bemisipha.
• Izinkinga ngezwi (ezibangelwa imisipha yomphimbo ebuthakathaka).
• Ukuphelelwa umoya.

Ungase futhi ube:

• Ukukhathala
• Imfiva
• Ubuhlungu obuhlangene
• Ukuphelelwa isifiso sokudla
• Ukuqina kwasekuseni
• Ukwehla kwesisindo
• Ukuqhuma kwesikhumba ngemuva kweminwe, kumajwabu amehlo, noma ebusweni

Ukuhlolwa kungafaka:

• Ukuzivikela kwamagciwane okuzenzakalelayo nokuhlolwa kokuvuvukala
• CPK
• I-Serum aldolase
• I-Electromyography
• I-MRI yemisipha ethintekile
• Imisipha biopsy
• I-Myoglobin emchameni
• ECG
• I-x-ray yesifuba ne-CT scan esifubeni
• Ukuhlolwa komsebenzi wePulmonary
• Ucwaningo lokugwinya lwe-Esophageal
• I-Myositis ethize nama-autoantibodies ahambisanayo

Abantu abanalesi simo nabo kufanele babhekwe ngokucophelela izimpawu zomdlavuza.

Ukwelashwa okuyinhloko ukusetshenziswa kwemithi ye-corticosteroid. Umthamo womuthi ususwa kancane kancane njengoba amandla emisipha eba ngcono. Lokhu kuthatha cishe amaviki amane kuya kwayisithupha. Uzohlala kumthamo ophansi wemithi ye-corticosteroid ngemuva kwalokho.

Imithi yokucindezela amasosha omzimba ingasetshenziswa ukufaka ama-corticosteroids. Le mithi ingafaka i-azathioprine, methotrexate noma i-mycophenolate.

Izifo ezihlala zisebenza naphezu kwama-corticosteroids, i-gamma globulin efakwa emithanjeni iye yazama ngemiphumela exubekile. Izidakamizwa ze-biologic nazo zingasetshenziswa. URituximab ubonakala ethembisa kakhulu. Kubalulekile ukukhipha ezinye izimo kubantu abangayiphenduli imishanguzo. I-biopsy ephindaphindwayo yemisipha ingadingeka ukwenza lokhu kuxilongwa.

Uma isimo sihlotshaniswa nesimila, singathuthuka uma isisu sisuswa.

Impendulo ekwelashweni iyahlukahluka, ngokuya ngezinkinga. Umuntu oyedwa kwabahlanu angafa kungakapheli iminyaka emihlanu etholwe nalesi simo.

Abantu abaningi, ikakhulukazi izingane, bayalulama ekuguleni futhi abadingi ukwelashwa okuqhubekayo. Kubantu abadala abaningi, noma kunjalo, imishanguzo yokuvikela izifo iyadingeka ukulawula lesi sifo.

Umbono wabantu abanezifo zamaphaphu nge-anti-MDA-5 antibody mubi naphezu kokwelashwa kwamanje.

Kubantu abadala, ukufa kungavela ku:

• Ukungondleki
• Inyumoniya
• Ukwehluleka kokuphefumula
• Ubuthakathaka obukhulu, besikhathi eside bemisipha

Izimbangela ezinkulu zokufa ngumdlavuza nesifo samaphaphu.

Izinkinga zingafaka:

• Ukufakwa kwe-calcium emisipheni ethintekile, ikakhulukazi ezinganeni ezinesifo
• Umdlavuza
• Isifo senhliziyo, isifo samaphaphu, noma izinkinga zesisu

Shayela umhlinzeki wakho wezokunakekelwa kwezempilo uma unezimpawu zalesi sifo. Funa ukwelashwa okuphuthumayo uma uphefumula kanzima futhi unenkinga yokugwinya.

• Imisipha yangaphandle engaphezulu

U-Aggarwal R, umgibeli we-LG, uRuperto N, et al. 2016 American College of Rheumatology / European League Against Rheumatism Criteria for Minimal, Moderate, and Major Clinical Response in Adult Dermatomyositis and Polymyositis: An International Myositis Assessment and Clinical Studies Group / Pediatric Rheumatology International Trials Organisation Inhlanganoative Yokubambisana. I-Arthritis Rheumatol. 2017; 69 (5): 898-910. I-PMID: 28382787 www.ncbi.nlm.nih.gov/pubmed/28382787.

UDalakas MC. Izifo zemisipha ezivuthayo. N Engl J Med. 2015; 373 (4): 393-394. I-PMID: 26200989 www.ncbi.nlm.nih.gov/pubmed/26200989.

IGreenberg SA. I-myopathies yokuvuvukala. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-25. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 269.

INagaraju K, iGladue HS, iLundberg IE.Izifo ezivuthayo zemisipha nezinye i-myopathies. Ku: Firestein GS, Budd RC, Gabriel SE, McInnes IB, O'Dell JR, abahleli. Incwadi kaKelley noFirestein yeRheumatology. Umhlaka 10. IPhiladelphia, PA: Elsevier; 2017: isahluko 85.

UYoshida N, Okamoto M, Kaieda S, et al. Inhlangano ye-anti-aminoacyl-transfer RNA synthetase antibody kanye ne-anti-melanoma umahluko ohambelana nesakhi sofuzo 5 nempendulo yokwelapha yesifo samaphaphu esihambisana nesifo samaphaphu. Umphenyi Womphefumulo. 2017; 55 (1): 24-32. I-PMID: 28012490 www.ncbi.nlm.nih.gov/pubmed/28012490.