Uhlelo lupus erythematosus

Isystemic lupus erythematosus (SLE) isifo esizimele. Kulesi sifo, amasosha omzimba ahlasela ngephutha izicubu ezinempilo. Kungathinta isikhumba, amalunga, izinso, ubuchopho nezinye izitho.

Isizathu se-SLE asaziwa kahle. Ingaxhunyaniswa nezici ezilandelayo:

• Izakhi zofuzo
• Ezemvelo
• IHormonal
• Imithi ethile

I-SLE ivame kakhulu kwabesifazane kunabesilisa cishe nge-10 kuye ku-1. Kungenzeka noma ngabe isiphi isikhathi. Kodwa-ke, sivela kakhulu kwabesifazane abasebasha abaphakathi kweminyaka eyi-15 nengama-44. E-US, lesi sifo sivame kakhulu kubantu base-Afrika baseMelika, base-Asia baseMelika, baseCaribbean base-Afrika kanye naseMelika yaseSpain.

Izimpawu ziyahlukahluka kuye ngomuntu, futhi zingafika zidlule. Wonke umuntu one-SLE unezinhlungu ezihlangene nokuvuvukala ngesikhathi esithile. Abanye baba nesifo samathambo. I-SLE ivame ukuthinta amalunga eminwe, izandla, izihlakala, namadolo.

Ezinye izimpawu ezivamile zifaka:

• Ubuhlungu besifuba lapho udonsa umoya.
• Ukukhathala.
• Imfiva engenaso esinye isizathu.
• Ukungakhululeki okuvamile, ukungakhululeki, noma ukugula (malaise).
• Ukulahleka kwezinwele.
• Ukwehla kwesisindo.
• Izilonda zomlomo.
• Ukuzwela ekukhanyeni kwelanga.
• Ukuqubuka kwesikhumba - Ukuqhuma "kwevemvane" kukhula cishe cishe uhhafu wabantu abane-SLE. Ukuqhuma kubonakala kakhulu ngaphezu kwezihlathi kanye nebhuloho lamakhala. Kungasakazeka kabanzi. Kuba kubi kakhulu ekukhanyeni kwelanga.
• Ama-lymph node avuvukile.

Ezinye izimpawu nezimpawu kuncike ekutheni iyiphi ingxenye yomzimba ethintekile:

• Ubuchopho nohlelo lwezinzwa - Ukuphathwa yikhanda, ukuba buthakathaka, ukuba ndikindiki, ukugedlezela, ukuquleka, izinkinga zokubona, inkumbulo nokushintsha kobuntu
• Umgudu wokugaya - Ubuhlungu besisu, isicanucanu nokuhlanza
• Izinkinga zenhliziyo - iValve, ukuvuvukala kwemisipha yenhliziyo noma ulwelwesi lwenhliziyo (pericardium)
• Amaphaphu - Ukwakhiwa koketshezi esikhaleni sobuningi, ukuphefumula kanzima, ukukhwehlela igazi
• Isikhumba - Izilonda emlonyeni
• Izinso - Ukuvuvukala emilenzeni
• Ukujikeleza - Amahlule emithanjeni noma emithanjeni yegazi, ukuvuvukala kwemithambo yegazi, ukucinana kwemithambo yegazi ukuphendula amakhaza (into kaRaynaud)
• Ukungahleleki kwegazi kubandakanya i-anemia, iseli yegazi emhlophe ephansi noma ukubalwa kweplatelet

Abanye abantu banezimpawu zesikhumba kuphela. Lokhu kubizwa ngokuthi yi-discoid lupus.

Ukuze utholwe une-lupus, kufanele ube nezimpawu ezi-4 kwezingu-11 ezivamile zesifo. Cishe bonke abantu abane-lupus banokuhlolwa okuhle kwe-antinuclear antibody (ANA). Kodwa-ke, ukuba ne-ANA enhle kuphela akusho ukuthi une-lupus.

Umhlinzeki wezokunakekelwa kwempilo uzokwenza ukuhlolwa okuphelele ngokomzimba. Ungaba nokuqubuka, isifo samathambo, noma i-edema emaqakaleni. Kungahle kube nomsindo ongajwayelekile obizwa ngokuthi ukugcwala kwenhliziyo noma umkhuhlane wokukhuhla ukungqubuzana. Umhlinzeki wakho uzokwenza ukuhlolwa kwesistimu yezinzwa.

Ukuhlolwa okusetshenziselwa ukuxilonga i-SLE kungafaka:

• I-antiinuclear antibody (ANA)
• I-CBC enomehluko
• I-x-ray yesifuba
• I-serum creatinine
• Ukuhlolwa komchamo

Ungase ube nokunye ukuhlolwa ukuze ufunde kabanzi ngesimo sakho. Ezinye zazo yilezi:

• Iphaneli ye-Antinuclear antibody (ANA)
• Qedela izingxenye (C3 no-C4)
• Ama-antibody e-DNA eboshwe kabili
• Coombs test - ngqo
• Ama-Cryoglobulins
• I-ESR ne-CRP
• Ukuhlolwa kwegazi kusebenza kwezinso
• Ukuhlolwa kwegazi kusebenza kwesibindi
• Isici se-rheumatoid
• Amasosha omzimba we-Antiphospholipid kanye ne-lupus anticoagulant test
• Ukucubungula izinso
• Ukulingisa ukuhlolwa kwenhliziyo, ubuchopho, amaphaphu, amalunga, imisipha noma amathumbu

Alikho ikhambi le-SLE. Umgomo wokwelashwa ukulawula izimpawu. Izimpawu ezinzima ezibandakanya inhliziyo, amaphaphu, izinso nezinye izitho ngokuvamile zidinga ukwelashwa ngochwepheshe. Umuntu ngamunye one-SLE udinga ukuhlolwa maqondana nalokhu:

• Sisebenza kangakanani lesi sifo
• Iyiphi ingxenye yomzimba ethintekayo
• Yiluphi uhlobo lokwelashwa oludingekayo

Izinhlobo ezincane zesifo zingalashwa nge:

• Ama-NSAID wezimpawu ezihlangene kanye ne-pleurisy. Khuluma nomhlinzeki wakho ngaphambi kokuthatha le mithi.
• Ukweqiwa okuphansi kwama-corticosteroids, njenge-prednisone, yezimpawu zesikhumba ne-arthritis.
• Amafutha e-Corticosteroid wokuqubuka kwesikhumba.
• I-Hydroxychloroquine, umuthi obuye usetshenziselwe ukwelapha umalaleveva.
• I-Methotrexate ingasetshenziselwa ukunciphisa umthamo we-corticosteroids
  
• I-Belimumab, umuthi we-biologic, ungasiza kwabanye abantu.

Ukwelashwa kwe-SLE enzima kakhulu kungafaka:

• Ama-corticosteroids aphezulu.
• Imithi yokuzivikela emzimbeni (le mithi icindezela amasosha omzimba). Le mithi isetshenziswa uma une-lupus enamandla ethinta uhlelo lwezinzwa, izinso noma ezinye izitho. Zingasetshenziswa futhi uma ungangcono ngama-corticosteroids, noma uma izimpawu zakho ziba zimbi kakhulu lapho uyeka ukuthatha i-corticosteroids.
• Imithi esetshenziswa kakhulu ifaka phakathi i-mycophenolate, i-azathioprine ne-cyclophosphamide. Ngenxa yobuthi bayo, i-cyclophosphamide ikhawulelwe enkambweni emfushane yezinyanga ezintathu kuya kwezi-6. I-Rituximab (i-Rituxan) isetshenziswa kwezinye izimo futhi.
• Abanciphisi begazi, njenge-warfarin (i-Coumadin), yokuphazamiseka kokuqina njenge-antiphospholipid syndrome.

Uma une-SLE, kubalulekile nokuthi:

• Gqoka izingubo zokuzivikela, izibuko zelanga, nesikrini selanga uma uselangeni.
• Thola ukunakekelwa kwenhliziyo okuvimbelayo.
• Hlala usesikhathini ngokugoma.
• Yenza izivivinyo ukuze kuhlolwe ukuncipha kwamathambo (i-osteoporosis).
• Gwema ugwayi uphuze amanani amancane otshwala.

Ukwelulekwa kanye namaqembu okusekela kungasiza ngezinkinga ezingokomzwelo ezihilelekile kulesi sifo.

Umphumela wabantu abane-SLE uthuthukile eminyakeni yamuva. Abantu abaningi abane-SLE banezimpawu ezincane. Ukwenza kahle kwakho kuya ngokuthi isifo sinzima kangakanani. Abantu abaningi abane-SLE bazodinga imithi isikhathi eside. Cishe konke kuzodinga i-hydroxychloroquine unomphela. Kodwa-ke, e-US, i-SLE ingezinye zezimbangela ezihamba phambili zokufa kwabesifazane kwabangu-20 abaneminyaka ephakathi kwengu-5 nengama-64. Imithi eminingi emisha iyafundwa ukwenza ngcono imiphumela yabesifazane abane-SLE.

Lesi sifo sivame ukusebenza kakhulu:

• Phakathi neminyaka yokuqala ngemuva kokuxilongwa
• Kubantu abangaphansi kweminyaka engama-40

Abesifazane abaningi abane-SLE bangakhulelwa futhi babelethe ingane enempilo. Umphumela omuhle uvame kakhulu kwabesifazane abathola ukwelashwa okufanele futhi abangenazo izinkinga ezinkulu zenhliziyo noma zezinso. Kodwa-ke, ukuba khona kwama-antibody athile we-SLE noma ama-anti-phospholipid antibodies kukhulisa ubungozi bokukhulelwa kwesisu.

I-LUPUS NEPHRITIS

Abanye abantu abane-SLE banamasokisi omzimba angajwayelekile kumaseli ezinso. Lokhu kuholela esimweni esibizwa ngokuthi i-lupus nephritis. Abantu abanale nkinga bangaba nokuhluleka kwezinso. Bangadinga i-dialysis noma ukufakelwa izinso.

I-biopsy yezinso yenziwa ukuthola ubukhulu bomonakalo ezinso nokusiza ukuqondisa ukwelashwa. Uma i-nephritis esebenzayo ikhona, ukwelashwa ngemithi yokuzivikela emzimbeni kubandakanya imithamo ephezulu ye-corticosteroids kanye ne-cyclophosphamide noma i-mycophenolate kuyadingeka.

EZINYE IZINGXENYE ZOMZIMBA

I-SLE ingadala umonakalo ezingxenyeni eziningi ezahlukene zomzimba, kufaka phakathi:

• Amahlule egazi emithanjeni yemithambo yemilenze, amaphaphu, ubuchopho noma amathumbu
• Ukubhujiswa kwamangqamuzana abomvu egazi noma i-anemia yesifo sesikhathi eside (esingapheli)
• Uketshezi oluzungeze inhliziyo (i-pericarditis), noma ukuvuvukala kwenhliziyo (i-myocarditis noma i-endocarditis)
• Uketshezi oluzungeze amaphaphu nokulimaza izicubu zamaphaphu
• Izinkinga zokukhulelwa, kufaka phakathi ukuphuma kwesisu
• Unhlangothi
• Ukulimala kwamathumbu ngobuhlungu besisu nokuvinjelwa
• Ukuvuvukala emathunjini
• Inani eliphansi kakhulu leplatelet yegazi (amaplatelet ayadingeka ukumisa noma yikuphi ukopha)
• Ukuvuvukala kwemithambo yegazi

SLE NOKUKHULELWA

Kokubili i-SLE neminye yemithi esetshenziselwe i-SLE ingalimaza ingane engakazalwa. Khuluma nomhlinzeki wakho ngaphambi kokukhulelwa. Uma ukhulelwa, thola umhlinzeki onolwazi nge-lupus nokukhulelwa.

Shayela umhlinzeki wakho uma unezimpawu ze-SLE. Fonela futhi uma unalesi sifo futhi izimpawu zakho ziba zimbi kakhulu noma kuvele uphawu olusha.

Kusatshalaliswe i-lupus erythematosus; SLE; ILupus; I-Lupus erythematosus; Ukuqhuma kwe-Butterfly - SLE; Thola i-lupus

• Uhlelo lupus erythematosus
• I-Lupus, discoid - umbono wezilonda esifubeni
• ILupus - discoid ebusweni bengane
• Ukuqubuka kwesistimu ye-lupus erythematosus ebusweni
• Amasosha omzimba

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Igwababa MK. I-Etiology kanye ne-pathogenesis ye-systemic lupus erythematosus. Ku: Firestein GS, Budd RC, Gabriel SE, McInnes IB, O'Dell JR, abahleli. Incwadi kaKelley noFirestein yeRheumatology. Umhlaka 10. IPhiladelphia, PA: Elsevier; 2017: isahluko 79.

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