Buza Isazi: Ukuphatha Ukwelashwa Kwakho Kwe-Idiopathic Thrombocytopenic Purpura

-Delile

• Yiziphi ezinye izindlela zokwelapha ezivamile ze-ITP?
• Ngizokwazi kanjani ukuthi umuthi wami uyasebenza? Ingabe kuzodinga ukuhlolwa?
• Ingabe kunemiphumela engemihle yokwelapha i-ITP? Izingozi?
• Ngingayilawula kanjani imiphumela emibi yokwelashwa?
• Kuzofanele ngiye kangaki kudokotela ukuyohlolwa? Kubaluleke kangakanani ukuhlolwa okuqhubekayo?
• Ngabe i-ITP ingangcono yodwa?
• Kwenzekani uma ngiyeka ukuthatha imishanguzo?
• Ingabe ukwelashwa kwami ​​kwe-ITP kuzoshintsha ngokuhamba kwesikhathi? Ngabe ngizolashwa impilo yami yonke?

Yiziphi ezinye izindlela zokwelapha ezivamile ze-ITP?

Kunezinhlobo eziningi zokwelashwa okusebenzayo kwe-ITP ukukhulisa ukubalwa kweplatelet nokunciphisa ubungozi bokuphuma kwegazi okungathi sína.

Ukuphuza ama-steroid. Ama-steroid avame ukusetshenziswa njengokwelashwa komugqa wokuqala. Bacindezela amasosha omzimba, angaphazamisa ukubhujiswa kwamaplatelet okuzenzakalelayo.

I-immunoglobulin efakwa ngaphakathi (IVIG). I-IVIG iphazamisa ukubopha kweplatelet eboshwe ngama-antibody kuma-receptors kumaseli awabhubhisayo. IVIG ingasebenza kakhulu, kepha izimpendulo zivame ukuhlala isikhathi esifushane.

Ama-anti-CD20 monoclonal antibodies (mAbs). Lokhu kubulala amangqamuzana e-B, amangqamuzana omzimba enza ama-antiplatelet antibodies.

Ama-agonists we-Thrombopoietin receptor (TPO-RA). Lokhu kulingisa isenzo sesici sokukhula kwemvelo i-thrombopoietin futhi kushukumisa umongo wethambo ukuba ukhiqize ngokweqile ama-platelet.

ISYK inhibitor. Lesi sidakamizwa siphazamisa indlela esemqoka yokusebenza kuma-macrophage, amaseli ayisizinda esiyinhloko sokubhujiswa kweplatelet.

I-Splenectomy. Lokhu kuhlinzwa okususa ubende kususa indawo eyinhloko yokwakheka kweplatelet. Kungaholela ekuthethelelweni isikhathi eside kubantu abathile.

Ngizokwazi kanjani ukuthi umuthi wami uyasebenza? Ingabe kuzodinga ukuhlolwa?

Inhloso yokwelashwa kwe-ITP ukunciphisa ingozi yokopha okungathi sína nokubulala ngokugcina ukubalwa kweplatelet kububanzi obuphephile. Ukwehla kwesibalo seplatelet, kuba sengozini enkulu yokopha. Kodwa-ke, ezinye izinto zingathinta ingozi yakho yokopha, njengobudala bakho, izinga lomsebenzi, neminye imishanguzo oyiphuzayo.

Ukuhlolwa okuphelele kokubalwa kwegazi (i-CBC) kusetshenziselwa ukuthola ukubalwa kweplatelet okwandisiwe nokunquma izimpendulo ekwelashweni.

Ingabe kunemiphumela engemihle yokwelapha i-ITP? Izingozi?

Njenganoma yisiphi isifo esingelapheki, kunezingozi, imiphumela emibi, kanye nezinzuzo zokwelapha i-ITP. Isibonelo, ukucindezela amasosha omzimba kungasebenza kahle ukwelapha izifo ezizimele. Kodwa futhi lokhu kwandisa ubungozi bokuthola izifo ezithile.

Njengoba kunezindlela eziningi zokwelashwa ze-ITP ezisebenzayo, xoxa nodokotela wakho ngazo zonke izinketho zakho. Futhi, uhlala unenketho yokushintshela ohlotsheni oluthile lwezokwelapha uma uhlangabezana nemiphumela emibi engabekezeleleki evela ekwelashweni kwakho kwamanje.

Ngingayilawula kanjani imiphumela emibi yokwelashwa?

Ithuluzi elibaluleke kakhulu lokulawula imiphumela emibi yokwelashwa ukuxhumana nodokotela wakho. Isibonelo, uma ngazi ukuthi esinye seziguli sami sibhekene nekhanda elikhubazekayo nge-IVIG noma ukuzuza okukhulu kwesisindo nokushintshashintsha kwemizwelo kusuka kuma-steroids, izincomo zami zokwelashwa zizoshintsha. Ngizofuna ezinye izindlela zokwelashwa ezingabekezeleleka.

Imiphumela emibi yokwelashwa okuthile ivame ukuphendula emithini yokwelashwa esekelayo. Futhi, amanani angalungiswa ngokuya ngemiphumela emibi.

Kuzofanele ngiye kangaki kudokotela ukuyohlolwa? Kubaluleke kangakanani ukuhlolwa okuqhubekayo?

Ubudlelwano obuqhubekayo nodokotela wegazi onolwazi bubaluleke kakhulu kunoma ngubani one-ITP. Ukuvama kokuhlolwa kuzohluka kuye ngokuthi uphuma ngamandla noma ama-platelet akho aphansi kakhulu.

Uma nje ukwelashwa okusha sekuqalisiwe, ukuhlolwa kungenziwa nsuku zonke noma masonto onke. Uma ama-platelet asebangeni eliphephile ngenxa yokuxolelwa (isb., Ngemuva kwe-steroids noma i-splenectomy) noma ngenxa yokwelashwa okusebenzayo (isb., TPO-RAs noma i-SYK inhibitors), ukuhlolwa kungenziwa njalo ngenyanga noma njalo ezinyangeni ezimbalwa.

Ngabe i-ITP ingangcono yodwa?

Kubantu abadala abane-ITP, ukuthola ukuxolelwa okuzenzekelayo ngaphandle kokwelashwa akuvamile (cishe amaphesenti angu-9 ngokusho). Kuvame kakhulu ukufeza ukuxolelwa okuqinile ngemuva kokwelashwa okusebenzayo.

Ezinye izindlela zokwelashwa zinikezwa isikhathi esichaziwe ngethemba lokuthola isikhathi esingelashwa isikhathi eside, ngasinye sinamazinga empendulo ahlukahlukene. Lokhu kufaka phakathi i-steroids, IVIG, mAbs, ne-splenectomy. Ezinye izindlela zokwelashwa zenziwa ngokuqhubekayo ukugcina ama-platelet ebangeni eliphephile. Lokhu kufaka ama-TPO-RAs, ama-SYK inhibitors, kanye nama-immunosuppressants angapheli.

Kwenzekani uma ngiyeka ukuthatha imishanguzo?

Ukumisa ukwelashwa kungadala ukwehla okungazelelwe kokubalwa kweplatelet yakho. Kungadala nengozi enkulu yokopha okungathi sína noma okubulalayo. Kushesha kanjani nokuthi amaplatelet aphansi angalahla kanjani ngemuva kokuyekisa ukwelashwa kuyehluka phakathi kwabantu abane-ITP.

Kukhona ubungozi obuncane ekumiseni ukwelashwa uma inani lakho leplatelet lisebangeni eliphephile. Ama-steroid amaningi we-high-dose adinga ukuthakwa kancane ngokuhamba kwesikhathi ukugwema inkinga ye-adrenal futhi avumele umzimba ukuthi ulungise.

Vele, kubalulekile ukuxhumana njalo nodokotela wakho mayelana nokukhathazeka nezidingo zakho.

Ingabe ukwelashwa kwami ​​kwe-ITP kuzoshintsha ngokuhamba kwesikhathi? Ngabe ngizolashwa impilo yami yonke?

Njengoba i-ITP yabantu abadala ngokuvamile iyisifo esingelapheki, abantu abaphila nalesi simo bavame ukujikeleza ngezinhlobo eziningi zokwelashwa kukho konke ukuphila kwabo.

UDkt.Ivy Altomare ungusolwazi ohlangene wezokwelapha eDuke University Medical Center. Unobuchwepheshe bemitholampilo ezimweni ezahlukahlukene ze-hematological kanye ne-oncological kanye nokuxilonga futhi ubelokhu enza ucwaningo lwezinsizakalo zemitholampilo nezempilo emkhakheni we-ITP isikhathi esingaphezu kweminyaka eyishumi. Ungumamukeli ohlonishwayo wemiklomelo yomibili ye-Junior Faculty and Senior Faculty Teaching eDuke University futhi unentshisekelo ekhethekile emfundweni yezokwelapha kuzo zombili iziguli nodokotela.