Isifo seSjögren

I-Sjögren syndrome yisifo esizimele lapho izindlala ezikhiqiza izinyembezi namathe zibhujiswa khona. Lokhu kudala umlomo owomile namehlo omile. Lesi simo singathinta ezinye izitho zomzimba, kufaka phakathi izinso namaphaphu.

Imbangela yeSjögren syndrome ayaziwa. Kuyisifo sokuzimela komzimba. Lokhu kusho ukuthi umzimba uhlasela izicubu ezinempilo ngephutha. Lesi sifo sivela kakhulu kwabesifazane abaneminyaka engama-40 kuya kwengama-50. Akuvamile ezinganeni.

I-Primary Sjögren syndrome ichazwa njengamehlo omile nomlomo owomile ngaphandle kokunye ukuphazamiseka komzimba.

I-Secondary Sjögren syndrome yenzeka kanye nokunye ukuphazamiseka komzimba, njenge:

• Isifo samathambo (RA)
• Uhlelo lupus erythematosus
• I-Scleroderma
• I-Polymyositis
• I-Hepatitis C ingathinta izindlala zamathe futhi ibukeke njenge-Sjögren syndrome
• Isifo se-IgG4 singabukeka njenge-Sjogren syndrome futhi kufanele sicatshangelwe

Amehlo omile nomlomo owomile yizimpawu ezivame kakhulu zalesi sifo.

Izimpawu zamehlo:

• Amehlo alumayo
• Ukuzwa ukuthi kukhona okusesweni

Izimpawu zomlomo nomphimbo:

• Kunzima ukugwinya noma ukudla ukudla okomile
• Ukulahleka komuzwa wokunambitha
• Izinkinga ukukhuluma
• Amathe ajiyile noma acijile
• Izilonda zomlomo noma ubuhlungu
• Ukubola kwamazinyo nokuvuvukala kwezinsini
• Ukungahambi kahle

Ezinye izimpawu zingafaka:

• Ukukhathala
• Imfiva
• Shintsha umbala wezandla noma izinyawo ngokuchayeka okubandayo (i-Raynaud phenomenon)
• Ubuhlungu obuhlangene noma ukuvuvukala okuhlangene
• Izindlala ezivuvukile
• Ukuqhuma kwesikhumba
• Ukuba ndikindiki nobuhlungu ngenxa ye-neuropathy
• Ukukhwehlela nokuphefumula okuncane ngenxa yesifo samaphaphu
• Ukushaya kwenhliziyo okungajwayelekile
• Isicanucanu kanye nesilungulela
• Ukoma kwesitho sangasese sowesifazane noma ukuchama okubuhlungu

Ukuhlolwa okuphelele komzimba kuzokwenziwa. Isivivinyo siveza amehlo omile nomlomo owomile. Kungaba nezilonda zomlomo, amazinyo abolile noma ukuvuvukala kwezinsini. Lokhu kwenzeka ngenxa yokoma komlomo. Umhlinzeki wakho wokunakekelwa kwezempilo uzobheka emlonyeni wakho ukutheleleka kwefungus (candida). Isikhumba singakhombisa ukuqubuka, ukuhlolwa kwamaphaphu kungaba okungajwayelekile, isisu sizothanjiswa ngokwandiswa kwesibindi. Amalunga azohlolwa ukuthi asinaso yini isifo samathambo. Ukuhlolwa kwe-neuro kuzobheka ukusilela.

Ungahle wenze izivivinyo ezilandelayo:

• Qedela i-chemistry yegazi enama-enzyme wesibindi
• Gcwalisa inani legazi ngokuhluka
• Ukuhlolwa komchamo
• Isivivinyo se-Antinuclear antibodies (ANA)
• Ama-anti-Ro / SSA nama-anti-La / SSB amasosha omzimba
• Isici se-rheumatoid
• Ukuhlolwa kwama-cryoglobulins
• Qedela amazinga
• Amaprotheni electrophoresis
• Ukuhlolwa kwe-hepatitis C ne-HIV (uma kusengcupheni)
• Ukuhlolwa kwendlala yegilo
• Ukuhlolwa kweSchirmer kokukhiqizwa kwezinyembezi
• Ukufanekisa ngendlala yamathe: nge-ultrasound noma nge-MRI
• I-salivary gland biopsy
• I-biopsy yesikhumba uma kukhona ukuqubuka
• Ukuhlolwa kwamehlo ngudokotela wamehlo
• I-x-ray yesifuba

Umgomo ukukhulula izimpawu.

• Amehlo awomile angalashwa ngezinyembezi zokufakelwa, amafutha okuthambisa amehlo, noma i-cyclosporine liquid.
• Uma uCandida ekhona, angalashwa nge-miconazole engenawo ushukela noma ngamalungiselelo e-nystatin.
• Amaplagi amancane angafakwa emiseleni yezinyembezi yokusiza izinyembezi zihlale ebusweni beso.

Izidakamizwa zokuguqula izifo ezilwa nezifo (ama-DMARD) ezifanayo nalezo ezisetshenziselwa i-RA zingathuthukisa izimpawu zesifo seSjögren. Lokhu kufaka phakathi i-tumor necrosis factor (TNF) evimbela izidakamizwa ezifana ne-Enbrel, Humira noma i-Remicaide.

Ezinye izinto ongazenza ukunciphisa izimpawu zifaka:

• Sip amanzi usuku lonke
• Hlafuna ushingamu ongenashukela
• Gwema imithi engadala ukoma komlomo, njengama-antihistamine kanye nama-decongestants
• Gwema utshwala

Khuluma nodokotela wamazinyo mayelana:

• Ukuhlanza umlomo ukufaka amaminerali emazinyweni akho
• Okufaka amathe esikhundleni
• Izidakamizwa ezisiza izindlala zakho zamathe zenza amathe amaningi

Ukuvimbela ukubola kwamazinyo okubangelwa ukoma komlomo:

• Shayela futhi uvule amazinyo akho kaningi
• Vakashela udokotela wamazinyo ukuyohlolwa njalo nokuhlanzwa

Lesi sifo kaningi asisongeli impilo. Umphumela uncike ekutheni yiziphi ezinye izifo onazo.

Kukhona ingozi ephezulu ye-lymphoma nokufa ngaphambi kwesikhathi lapho i-Sjögren syndrome isebenze isikhathi eside kakhulu, nakubantu abane-vasculitis, ama-complements aphansi, nama-cryoglobulins.

Izinkinga zingafaka:

• Ukulimala kweso
• Izimbobo zamazinyo
• Ukwehluleka kwezinso (kuyaqabukela)
• I-Lymphoma
• Isifo samaphaphu
• I-Vasculitis (engavamile)
• I-Neuropathy
• Ukuvuvukala kwesinye

Shayela umhlinzeki wakho uma uba nezimpawu ze-Sjögren syndrome.

Xerostomia - Sjögren isifo; I-Keratoconjunctivitis sicca - iSjögren; I-Sicca syndrome

• Amasosha omzimba

I-Baer AN, i-Alevizos I. I-Sjögren syndrome. Ku: Hochberg MC, Gravallese EM, Silman AJ, Smolen JS, Weinblatt ME, Weisman MH, abahleli. I-Rheumatology. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2019: isahluko 147.

UMariette X. Sjögren syndrome. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-25. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 268.

USeror R, uBootsma H, uSaraux A, et al. Ukuchaza umsebenzi wesifo kanye nokwenza ngcono okunempilo emtholampilo weSjögren's syndrome nge-EULAR primary Sjögren's syndrome disease activity (ESSDAI) kanye nezinkomba ezibikwe iziguli (ESSPRI). U-Ann Rheum Dis. 2016; 75 (2): 382-389. I-PMID: 25480887 www.ncbi.nlm.nih.gov/pubmed/25480887.

Singh Singh, Singh S, Matteson EL. Isilinganiso, izinto ezinobungozi kanye nezimbangela zokufa kweziguli ezine-Sjögren's syndrome: ukubuyekezwa okuhlelekile nokuhlaziywa kwemeta kwezifundo zamaqoqo. I-Rheumatology (i-Oxford). 2016; 55 (3): 450-460. I-PMID: 26412810 www.ncbi.nlm.nih.gov/pubmed/26412810.

I-Turner MD. Ukubonakaliswa ngomlomo kwezifo zesistimu. Ku: Flint PW, Haughey BH, Lund V, et al, ama-eds. I-Cummings Otolaryngology. Umhlaka 6. IPhiladelphia, PA: Elsevier Saunders; 2015: isahluko 14.