Buza Uchwepheshe: Ukwelapha Nokuphatha i-Chronic Idiopathic Urticaria

-Delile

• 1. Ama-antihistamine ayekile ukusebenza ukulawula izimpawu zami. Yiziphi ezinye izinketho zami?
• 2. Yimaphi okhilimu noma ama-lotion okufanele ngiwasebenzise ukuphatha ukulunywa okuqhubekayo okuvela ku-CIU?
• 3. Ngabe i-CIU yami iyoke ihambe?
• 4. Yini abacwaningi abaziyo ngalokho okungadala i-CIU?
• 5. Ingabe lukhona ushintsho ekudleni okufanele ngilwenze ukuphatha i-CIU yami?
• 6. Yiziphi izeluleko onazo zokukhomba izimbangela?
• 7. Yiziphi izindlela zokwelashwa engingazizama?
• 8. Yikuphi ukwelashwa udokotela wami angakunika?

1. Ama-antihistamine ayekile ukusebenza ukulawula izimpawu zami. Yiziphi ezinye izinketho zami?

Ngaphambi kokuyeka ama-antihistamine, ngihlala ngiqinisekisa ukuthi iziguli zami zikhulisa imithamo yazo. Kuphephile ukuthatha izikhathi eziphindwe kane umthamo ophakanyisiwe nsuku zonke wama-antihistamine angahlali phansi. Izibonelo zifaka phakathi i-loratadine, i-cetirizine, i-fexofenadine, noma i-levocetirizine.

Lapho umthamo ophakeme, ama-antihistamine angahlali phansi ehluleka, izinyathelo ezilandelayo zifaka phakathi ama-antihistamine wokuhlalisa i-hydroxyzine ne-doxepin. Noma, sizozama ama-H2 blocker, afana ne-ranitidine ne-famotidine, nama-leukotriene inhibitors afana ne-zileuton.

Ngemisipha enzima ukwelashwa, ngivame ukuphendukela kumuthi ojojwayo obizwa nge-omalizumab. Inenzuzo yokungabi yi-steroidal futhi isebenza kahle ezigulini eziningi.

I-Chronic idiopathic urticaria (CIU) yisifo esiphakathi komzimba. Ngakho-ke, ezimweni ezimbi kakhulu, ngingahle ngisebenzise ama-systemic immunosuppressants anjenge-cyclosporine.

2. Yimaphi okhilimu noma ama-lotion okufanele ngiwasebenzise ukuphatha ukulunywa okuqhubekayo okuvela ku-CIU?

Ukulunywa okuvela ku-CIU kungenxa yokukhishwa kwangaphakathi kwe-histamine. Ama-topical agents - kufaka phakathi ama-antihistamines angama-topical - awasebenzi kakhulu ekulawuleni izimpawu.

Thatha izihlambi ezifudumele njalo bese ugcoba izinto zokuthambisa nezokupholisa lapho kuqhuma isifuba futhi siluma kakhulu. I-steroid yama-topical nayo ingasiza. Kodwa-ke, ama-antihistamine omlomo kanye ne-omalizumab noma amanye ama-immune system modifiers azohlinzeka ngokukhululeka okuningi.

3. Ngabe i-CIU yami iyoke ihambe?

Yebo, cishe wonke amacala we-idiopathic urticaria engapheli agcina exazululekile. Kodwa-ke, akunakwenzeka ukubikezela ukuthi lokhu kuzokwenzeka nini.

Ubukhulu be-CIU buye buye buguquke ngokuhamba kwesikhathi, futhi ungadinga amazinga ahlukene okwelashwa ngezikhathi ezahlukahlukene. Kukhona njalo ingozi yokuba i-CIU ibuye uma isingena ekuxolelweni.

4. Yini abacwaningi abaziyo ngalokho okungadala i-CIU?

Kunemibono eminingi phakathi kwabaphenyi mayelana nokuthi yini ebangela i-CIU. Umbono ovame kakhulu ukuthi i-CIU yisimo esifana nokuzimela.

Kubantu abane-CIU, sihlala sibona ama-autoantibodies aqondiswe kumaseli akhipha i-histamine (ama-mast cell nama-basophil). Ukwengeza, laba bantu bavame ukuba nezinye izifo ezizimele ezifana nesifo se-thyroid.

Enye inkolelo ukuthi kunabalamuli abathile ku-serum noma i-plasma yabantu abane-CIU. Laba balamuli benza kusebenze ama-mast cell noma ama-basophil, ngqo noma ngokungaqondile.

Okokugcina, kukhona "inkolelo yokukhubazeka kwamaselula." Le mbono ithi abantu abane-CIU banamaphutha ekusetshenzisweni kwamasheya e-mast cell noma e-basophil, okusayina noma kokusebenza. Lokhu kuholela ekukhishweni ngokweqile kwe-histamine.

5. Ingabe lukhona ushintsho ekudleni okufanele ngilwenze ukuphatha i-CIU yami?

Asikhuthazi njalo izinguquko zokudla ukuphatha i-CIU njengoba izifundo zingakhombisanga nzuzo. Ukuguqulwa kokudla nakho akusekelwa imihlahlandlela eminingi yokuvumelana.

Ukunamathela ekudleni, njengokudla okune-histamine ephansi, nakho kunzima kakhulu ukukulandela. Kubalulekile futhi ukuqaphela ukuthi i-CIU ayiwona umphumela wokungezwani nokudla okwangempela, ngakho-ke ukuhlolwa kokungezwani komzimba nokudla akuvamile ukuthela.

6. Yiziphi izeluleko onazo zokukhomba izimbangela?

Kunezimbangela eziningi ezaziwayo ezingakhuphula isifuba sakho. Ukushisa, utshwala, ingcindezi, ukungqubuzana nokucindezeleka ngokomzwelo kubikwa ukuthi izimpawu ziba zimbi.

Ngokwengeziwe, kufanele ucabangele ukugwema i-aspirin nezinye izidakamizwa ezingezona ukuvuvukala (ama-NSAID). Bangakhulisa i-CIU ezimweni eziningi. Ungaqhubeka ukuthatha umthamo ophansi, i-aspirin yengane lapho isetshenziselwa ukuvimbela amahlule egazi.

7. Yiziphi izindlela zokwelashwa engingazizama?

Ama-antihistamine we-OTC angahlali phansi, noma ama-H1 blocker, ayakwazi ukulawula isifuba sabantu abaningi abane-CIU. Le mikhiqizo ifaka phakathi i-loratadine, i-cetirizine, i-levocetirizine, ne-fexofenadine. Ungathatha izikhathi eziphindwe kane umthamo owanconywayo wansuku zonke ngaphandle kokuthola imiphumela engemihle.

Ungazama futhi ukusebenzisa ama-antihistamine njengoba kudingeka, njenge-diphenhydramine. Ama-antihistamine we-H2, njenge-famotidine ne-ranitidine, anganikeza ukukhululeka okwengeziwe.

8. Yikuphi ukwelashwa udokotela wami angakunika?

Kwesinye isikhathi, ama-antihistamine (womabili ama-H1 kanye nama-H2 blocker) awakwazi ukuphatha isifuba nokuvuvukala okuhambisana ne-CIU. Uma lokhu kwenzeka, kungcono ukusebenzisana nodokotela noma i-immunologist eqinisekiswe yibhodi. Bangakhipha imithi enikeza ukulawula okungcono.

Udokotela wakho angazama ukwehlisa amandla okuqina, ama-antihistamines kadokotela kuqala njenge-hydroxyzine noma i-doxepin. Bangase futhi bazame i-omalizumab uma le mithi ingasebenzi ekwelapheni izimpawu zakho.

Imvamisa asincomi ama-corticosteroids omlomo kubantu abane-CIU. Lokhu kungenxa yamandla abo emiphumela emibi kakhulu. Amanye ama-immunosuppressants asetshenziswa ngezikhathi ezithile ezimeni ezinzima, ezingalawuleki.

UMarc Meth, MD, uthole iziqu zakhe zobudokotela eDavid Geffen School of Medicine e-UCLA. Uqede ukuhlala kwakhe kwi-Internal Medicine esibhedlela iMount Sinai eNew York City. Ubuye waqeda ubudlelwano e-Allergy & Immunology eLong Island Jewish-North Shore Medical Center. UDkt Meth njengamanje useClinical Faculty eDavid Geffen School of Medicine e-UCLA futhi unamalungelo eCedars Sinai Medical Center. Ungumbhalisi we-American Board of Internal Medicine kanye ne-American Board of Allergy & Immunology. UDkt Meth usebenza ngokuzimela eCentury City, eLos Angeles.