Isifo sabantu abadala

Isifo i-Adult Still (ASD) yisifo esingajwayelekile esidala imfiva ephezulu, ukuqubuka nobuhlungu bamalunga. Kungadala isifo samathambo sesikhathi eside (esingapheli).

Isifo i-Adult Still isifo esibi se-juvenile idiopathic arthritis (JIA), esenzeka ezinganeni. Abantu abadala bangaba nesimo esifanayo, yize kukuncane kakhulu. Sibizwa nangokuthi isifo sokuqala kwabantu abadala (AOSD).

Bangaphansi komuntu oyedwa kwabangu-100 000 abathuthukisa i-ASD unyaka nonyaka. Ithinta abesifazane kaningi kunabesilisa.

Imbangela yesifo sabantu abadala Isingaziwa. Azikho izici eziyingozi zalesi sifo ezitholakele.

Cishe bonke abantu abanalesi sifo bazoba nemfiva, ubuhlungu bamalunga, umphimbo obuhlungu nokuqubuka.

• Ubuhlungu obuhlangene, imfudumalo nokuvuvukala kuvamile. Ngokuvamile, amalunga amaningana abandakanyeka ngasikhathi sinye. Imvamisa, abantu abanesimo baba nokuqina kwamalunga okuhlangana ekuseni okuhlala amahora amaningana.
• Umkhuhlane ufika ngokushesha kanye ngosuku, imvamisa ntambama noma kusihlwa.
• Ukuqhuma kwesikhumba kuvame ukuba nombala osalimoni obomvana futhi kuza kudlule nemfiva.

Izimpawu ezingeziwe zifaka:

• Ubuhlungu besisu nokuvuvukala
• Ubuhlungu lapho uthatha umoya ojulile (pleurisy)
• Umphimbo obuhlungu
• I-lymph nodes evuvukile (izindlala)
• Ukwehla kwesisindo

Ubende noma isibindi singavuvukala. Ukuvuvukala kwamaphaphu nokushaya kwenhliziyo nakho kungenzeka.

I-AOSD ingatholakala kuphela ngemuva kokuthi ezinye izifo eziningi (ezinjengezifo nomdlavuza) zikhishwe ngaphandle. Ungadinga ukuhlolwa okuningi kwezokwelapha ngaphambi kokutholakala kokugcina.

Ukuhlolwa komzimba kungakhombisa umkhuhlane, ukuqubuka nesifo samathambo. Umhlinzeki wezokunakekelwa kwempilo uzosebenzisa i-stethoscope ukulalela ushintsho emisindweni yenhliziyo yakho noma amaphaphu.

Ukuhlolwa kwegazi okulandelayo kungasiza ekutholeni izifo zabantu abadala ezisekhona:

• Ukubalwa kwegazi okuphelele (i-CBC), kungakhombisa inani eliphakeme lamaseli amhlophe egazi (ama-granulocyte) kanye nenombolo encishisiwe yamaseli abomvu egazi.
• Amaprotheni asebenza nge-C (CRP), isilinganiso sokuvuvukala, azoba ngaphezulu kunokujwayelekile.
• I-ESR (isilinganiso sedimentation), isilinganiso sokuvuvukala, sizoba ngaphezulu kunokujwayelekile.
• Izinga leFerritin lizophakama kakhulu.
• Izinga le-Fibrinogen lizobe liphakeme.
• Ukuhlolwa kokusebenza kwesibindi kuzobonisa amazinga aphezulu we-AST ne-ALT.
• Isici se-rheumatoid nokuhlolwa kwe-ANA kuzoba kubi.
• Amasiko egazi nezifundo zegciwane kuzoba kubi.

Okunye ukuhlolwa kungadingeka ukuhlola ukuvuvukala kwamalunga, isifuba, isibindi, nobende:

• I-ultrasound yesisu
• I-CT scan yesisu
• Ama-X-ray amalunga, isifuba, noma indawo yesisu (isisu)

Umgomo wokwelashwa kwesifo sabantu abadala Ukulawula izimpawu zesifo samathambo. I-Aspirin nezinye izidakamizwa ezingezona ukuvuvukala (ama-NSAID), njenge-ibuprofen, zivame ukusetshenziswa kuqala.

IPrednisone ingasetshenziselwa amacala abucayi kakhulu.

Uma lesi sifo sinzima noma siqhubeka isikhathi eside (sihlala singamahlalakhona), imithi engacindezela amasosha omzimba ingadingeka. Imithi enjalo ifaka phakathi:

• IMethotrexate
• I-Anakinra (i-interleukin-1 receptor agonist)
• I-Tocilizumab (i-interleukin 6 inhibitor)
• Abaphikisi be-Tumor necrosis factor (TNF) abanjengo-etanercept (Enbrel)

Kubantu abaningi, izimpawu zingabuya izikhathi eziningana eminyakeni embalwa ezayo.

Izimpawu ziqhubeka isikhathi eside (ezingamahlalakhona) cishe engxenyeni eyodwa kwezintathu zabantu abanezifo zabantu abadala I-Still.

Isimo esingajwayelekile sesifo, esibizwa nge-macrophage activation syndrome, singaba nzima kakhulu ngemfiva ephezulu, ukugula okunzima nokubalwa kwamaseli egazi aphansi. Umongo wethambo uyabandakanyeka futhi kudingeka i-biopsy ukwenza ukuxilongwa.

Ezinye izinkinga zingafaka:

• I-arthritis emajoyini amaningana
• Isifo sesibindi
• I-Pericarditis
• Ukuchithwa kwe-Pleural
• Ukukhulisa ubende

Shayela umhlinzeki wakho uma unezimpawu zesifo sabantu abadala.

Uma usuvele utholakale unaleso simo, kufanele ushayele umhlinzeki wakho uma ukhwehlela noma uphefumula kanzima.

Akukho ukuvimbela okwaziwayo.

Isifo sika- Still - umuntu omdala; Isifo i-Adult-onset Still; I-AOSD; I-Wissler-Fanconi syndrome

U-Alonso ER, uMarques AO. Ukuqala kwabantu abadala kuseyizifo. Ku: Hochberg MC, Gravallese EM, Silman AJ, Smolen JS, Weinblatt ME, Weisman MH, abahleli. I-Rheumatology. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2019: isahluko 173.

UGerfaud-Valentin M, Maucort-Boulch D, Oshisayo A, et al. Ukuqala kwabantu abadala kuseyizifo: ukubonakaliswa, ukwelashwa, umphumela, kanye nezinto zokubikezela ezigulini ezingama-57. Imithi (iBaltimore). 2014; 93 (2): 91-99. I-PMID: 24646465 www.ncbi.nlm.nih.gov/pubmed/24646465.

UKaneko Y, Kameda H, Ikeda K, et al. I-Tocilizumab ezigulini ezinesifo sabantu abadala esisaqhubeka nokuphikisa ukwelashwa kwe-glucocorticoid: isilingo sesigaba III esilawulwa ngokungahleliwe, esiphindwe kabili, esilawulwa yi-placebo. U-Ann Rheum Dis. I-2018; 77 (12): 1720-1729. I-PMID: 30279267 www.ncbi.nlm.nih.gov/pubmed/30279267.

I-National Organisation for Rare Disorders iwebhusayithi. Izifo ezingavamile.org. Isifo sabantu abadala se-Still. rarediseases.org/rare-diseases/adult-onset-stills-disease/. Kufinyelelwe ngoMashi 30, 2019.

U-Ortiz-Sanjuán F, uBlanco R, uRiancho-Zarrabeitia L, et al. Ukusebenza kwe-anakinra ekuphikiseni isifo sabantu abadala-isifo sika-Still: ukutadisha okuningi kweziguli ezingama-41 nokubuyekezwa kwezincwadi. Imithi (iBaltimore). 2015; 94 (39): e1554. PMID: 26426623 www.ncbi.nlm.nih.gov/pubmed/26426623.