I-juvenile idiopathic arthritis

I-juvenile idiopathic arthritis (JIA) igama elisetshenziselwa ukuchaza iqembu lezinkinga ezinganeni ezibandakanya isifo samathambo. Yizifo zesikhathi eside (ezingalapheki) ezidala ubuhlungu bamalunga nokuvuvukala. Amagama achaza leli qembu lezimo ashintshile emashumini eminyaka adlule njengoba kuningi okufundwayo ngalesi simo.

Imbangela yeJIA ayaziwa. Kucatshangwa ukuthi ukugula okuzenzakalelayo. Lokhu kusho ukuthi umzimba uhlasela futhi ubhubhise izicubu zomzimba ezinempilo ngephutha.

I-JIA ivame ukukhula ngaphambi kweminyaka yobudala eyi-16. Izimpawu zingaqala ezinyangeni eziyisithupha ubudala.

I-International League of Associations for Rheumatology (ILAR) iphakamise le ndlela elandelayo yokuqoqa lolu hlobo lwe-arthritis yabantwana:

• Ukuqala okuhlelekile kwe-JIA. Kuhilela ukuvuvukala okuhlangene noma ubuhlungu, imfiva nokuqubuka. Luhlobo olungajwayelekile kakhulu kepha lungaba lukhulu kakhulu. Kubonakala kwehlukile kunezinye izinhlobo ze-JIA futhi kufana ne-Adult Onset Stills Disease.
• I-polyarthritis. Kuhilela amalunga amaningi. Leli fomu le-JIA lingaphenduka isifo samathambo. Kungabandakanya amalunga ama-5 noma ngaphezulu amakhulu namancane emilenzeni nasezingalweni, kanye nomhlathi nentamo. I-rheumatoid factor ingaba khona.
• I-Oligoarthritis (ephikelelayo futhi enwetshiwe). Ibandakanya amalunga we-1 kuye ku-4, imvamisa izihlakala, noma amadolo. Kubuye kuthinte namehlo.
• I-arthritis ehlobene ne-Enthesitis. Ifanekisela i-spondyloarthritis kubantu abadala futhi imvamisa ifaka ilunga le-sacroiliac.
• I-psoriatic arthritis. Kutholwe ezinganeni ezine-arthritis ne-psoriasis noma isifo se-nail, noma enelungu lomndeni eliseduze eline-psoriasis.

Izimpawu ze-JIA zingafaka:

• Ilungu elivuvukile, elibomvu, noma elifudumele
• Ukuxhuga noma izinkinga usebenzisa isitho somzimba
• Umkhuhlane omkhulu ongazelelwe, ongabuya
• I-Rash (esiqwini nasemaphethelweni) eza futhi ihambisane nomkhuhlane
• Ukuqina, ubuhlungu, nokunyakaza okulinganiselwe kokujoyina
• Ubuhlungu obuphansi emuva obungapheli
• Izimpawu zomzimba wonke njengesikhumba esiphaphathekile, i-lymph gland evuvukile, nokubukeka okugulayo

I-JIA nayo ingadala izinkinga zamehlo ezibizwa nge-uveitis, iridocyclitis, noma i-iritis. Kungase kungabikho zimpawu. Lapho kuvela izimpawu zamehlo, zingabandakanya:

• Amehlo abomvu
• Ubuhlungu beso, obungahle buba bukhulu lapho ubheka ukukhanya (photophobia)
• Umbono uyashintsha

Ukuhlolwa komzimba kungakhombisa amalunga okuvuvukala, afudumele, kanye nethenda elibuhlungu ukunyakaza. Ingane ingaba nokuqubuka. Ezinye izimpawu zifaka:

• Sivuvukile isibindi
• Ukuvuvukala ubende
• Ama-lymph node avuvukile

Ukuhlolwa kwegazi kungafaka:

• Isici se-rheumatoid
• Izinga le-sedimentation ye-Erythrocyte (ESR)
• I-antiinuclear antibody (ANA)
• Qedela ukubalwa kwegazi (CBC)
• I-HLA-B27

Noma yikuphi noma konke lokhu kuhlolwa kwegazi kungaba okujwayelekile ezinganeni ezine-JIA.

Umhlinzeki wezokunakekelwa kwempilo angafaka inaliti encane ejoyinini elivuvukile ukususa uketshezi. Lokhu kungasiza ukuthola imbangela yesifo samathambo. Kungasiza futhi ekudambiseni izinhlungu. Umhlinzeki angajova i-steroids kujoyini ukusiza ukunciphisa ukuvuvukala.

Olunye uvivinyo olungenziwa lubandakanya:

• I-X-ray yelungu
• Ukuskena kwamathambo
• I-X-ray yesifuba
• ECG
• Ukuhlolwa kwamehlo njalo ngudokotela wezifo zamehlo - Lokhu kufanele kwenziwe noma kungekho zimpawu zamehlo.

Izidakamizwa ezingezona ukuvuvukala (ama-NSAID) ezinjenge-ibuprofen noma i-naproxen zanele ukulawula izimpawu lapho kubandakanyeka inani elincane kuphela lamajoyinti.

I-Corticosteroids ingasetshenziselwa ukuqhuma okukhulu ukusiza ukulawula izimpawu. Ngenxa yobuthi bayo, ukusetshenziswa kwesikhathi eside kwale mithi kufanele kugwenywe ezinganeni.

Izingane ezine-arthritis emajoyini amaningi, noma ezinomkhuhlane, ukuqubuka nezindlala ezivuvukele zingadinga eminye imithi. Lokhu kubizwa ngemishanguzo yokuguqula isifo (i-DMARDs) yokuguqula izifo. Bangasiza ukunciphisa ukuvuvukala emajoyintini noma emzimbeni. Ama-DMARD afaka:

• IMethotrexate
• Izidakamizwa ze-Biologic, njenge-etanercept (Enbrel), infliximab (Remicade), kanye nezidakamizwa ezihlobene

Izingane ezine-systemic JIA zizodinga i-biologic inhibitors ye-IL-1 noma i-IL-6 efana ne-anakinra noma i-tocilizumab.

Izingane ezine-JIA zidinga ukuhlala zikhuthele.

Ukuzivocavoca umzimba kuzosiza ukugcina imisipha namalunga abo kuqinile futhi kuselula.

• Ukuhamba ngezinyawo, ukuhamba ngebhayisikili nokubhukuda kungaba yimisebenzi emihle.
• Izingane kufanele zifunde ukufudumala ngaphambi kokuzivocavoca.
• Khuluma nodokotela noma owelapha ngokomzimba ngokuzivocavoca okufanele ukwenze lapho ingane yakho inezinhlungu.

Izingane ezinosizi noma intukuthelo nge-arthritis yazo zingadinga ukwesekwa okwengeziwe.

Ezinye izingane ezine-JIA zingadinga ukuhlinzwa, kufaka phakathi ukushintshwa ngokuhlanganyela.

Izingane ezinamalunga ambalwa athintekile kungenzeka zingabi nazimpawu zesikhathi eside.

Ezinganeni eziningi, lesi sifo ngeke sisebenze futhi sidale umonakalo omncane ngokuhlanganyela.

Ubukhulu besifo buxhomeke enanini lamalunga athintekile. Mancane amathuba okuthi izimpawu zizophela kulezi zimo. Lezi zingane zivame ukuba nezinhlungu zesikhathi eside (ezingapheli), ukukhubazeka, nezinkinga esikoleni. Ezinye izingane zingaqhubeka nokuba ne-arthritis lapho sezikhulile.

Izinkinga zingafaka:

• Ukugqokwa noma ukubhujiswa kwamalunga (kungenzeka kubantu abane-JIA ebucayi)
• Izinga elincane lokukhula
• Ukukhula okungalingani kwengalo noma komlenze
• Ukulahleka kombono noma ukwehla kombono kusuka ku-uveitis engapheli (le nkinga ingaba nzima, noma ngabe i-arthritis ayinamandla kakhulu)
• Ukushoda kwegazi
• Ukuvuvukala okuzungeze inhliziyo (i-pericarditis)
• Ubuhlungu besikhathi eside (obungapheli), ukungafiki kahle esikoleni
• IMacrophage activation syndrome, ukugula okunzima okungakhula nge-systemic JIA

Shayela umhlinzeki wakho uma:

• Wena, noma ingane yakho, nibona izimpawu ze-JIA
• Izimpawu ziba zimbi kakhulu noma azithuthuki ngokwelashwa
• Izimpawu ezintsha ziyakhula

Akukho ukuvimbela okwaziwayo kwe-JIA.

I-juvenile rheumatoid arthritis (JRA); I-juvenile chronic polyarthritis; Namanje izifo; I-spondyloarthritis yentsha

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