Kangakanani Kangathi I-Monoclonal Gammopathy Yokubaluleka Okunganqunyelwe (MGUS)?

-Delile

• Yini iMGUS?
• I-MGUS itholakala kanjani?
• Yini ebangela i-MGUS?
• Ngabe i-MGUS iqhubeka kanjani ngokuhamba kwesikhathi?
• Ingabe kukhona ukwelashwa kwe-MGUS?
• Uyini umbono?

Yini iMGUS?

I-MGUS, efushane nge-monoclonal gammopathy yokubaluleka okunganqunyelwe, yisimo esidala ukuthi umzimba wakhe amaprotheni angajwayelekile. Le protein ibizwa nge-monoclonal protein, noma i-M protein. Kwenziwa ngamaseli amhlophe egazi abizwa ngama-plasma cells emnkantsheni wethambo lomzimba.

Imvamisa, i-MGUS ayisona isizathu sokukhathazeka futhi ayinayo imiphumela emibi yezempilo. Kodwa-ke, abantu abane-MGUS banengozi eyenyuka kancane yokuthola izifo zegazi kanye nomnkantsha. Lokhu kufaka phakathi umdlavuza wegazi onzima, njenge-myeloma eminingi noma i-lymphoma.

Kwesinye isikhathi, amaseli aphilile emnkantsheni wethambo angagcwala lapho umzimba wenza inani elikhulu kakhulu lamaprotheni e-M. Lokhu kungaholela ekulimaleni kwezicubu emzimbeni wonke.

Odokotela bavame ukuncoma ukuqapha abantu abane-MGUS ngokwenza ukuhlolwa kwegazi njalo ukubheka noma yiziphi izimpawu zomdlavuza noma izifo, ezingakhula ngokuhamba kwesikhathi.

I-MGUS itholakala kanjani?

I-MGUS imvamisa ayiholeli kunoma yiziphi izimpawu zokugula. Odokotela abaningi bathola amaprotheni e-M egazini labantu abane-MGUS ngenkathi behlolela ezinye izimo. Abanye abantu bangaba nezimpawu ezifana nokuqubuka, ukuba ndikindiki, noma ukuhayiza emzimbeni.

Ukuba khona kwamaprotheni e-M emchameni noma egazini kuyisibonakaliso esisodwa se-MGUS. Amanye amaprotheni nawo aphakanyisiwe egazini lapho umuntu ene-MGUS. Lokhu kungaba yizimpawu zezinye izimo zezempilo, njengokuphelelwa ngamanzi emzimbeni kanye ne-hepatitis.

Ukukhipha ezinye izimo noma ukubona ukuthi i-MGUS ibangela izinkinga zakho zempilo, udokotela angahle enze ezinye izivivinyo. Lezi zivivinyo zifaka:

• Ukuhlolwa kwegazi okuningiliziwe. Ezinye izibonelo zifaka ukubalwa kwegazi okuphelele, ukuhlolwa kwe-serum creatinine, nokuhlolwa kwe-serum calcium. Ukuhlolwa kungasiza ukuhlola ukungalingani kwamaseli egazi, amazinga aphezulu e-calcium, nokwehla kokusebenza kwezinso.Lezi zimpawu zivame ukuhlotshaniswa nezimo ezihlobene kakhulu ne-MGUS, njenge-myeloma eminingi.
• Ukuhlolwa kwamaprotheni okuhlola amahora angu-24. Lokhu kuhlolwa kungabona ukuthi ngabe amaprotheni e-M akhishwa yini emchameni wakho futhi ahlole noma yikuphi ukulimala kwezinso, okungaba wuphawu lwesimo esibi esihlobene neMGUS.
• Ukuhlola ukuhlolwa. I-CT scan noma i-MRI ingahlola umzimba ukuthi ayifani yini nokungahleleki kwethambo okuhambisana nezimo ezihlobene neze-MGUS.
• I-bone marrow biopsy. Udokotela usebenzisa le nqubo ukuhlola izimpawu zomdlavuza womnkantsha kanye nezifo ezihambisana neMGUS. I-biopsy ivame ukwenziwa kuphela uma ukhombisa izimpawu zokushoda kwegazi okungaqondakali, ukwehluleka kwezinso, izilonda zamathambo, noma amazinga aphezulu e-calcium, njengoba lezi kuyizimpawu zesifo.

Yini ebangela i-MGUS?

Ochwepheshe abaqiniseki kahle ukuthi yini ebangela i-MGUS. Kucatshangwa ukuthi izinguquko ezithile zofuzo kanye nezimo zemvelo kungathinta ukuthi umuntu uyasiveza lesi simo noma cha.

Lokho odokotela abakwaziyo ukuthi i-MGUS ibangela amangqamuzana e-plasma angajwayelekile emnkantsheni wethambo ukukhiqiza i-M protein.

Ngabe i-MGUS iqhubeka kanjani ngokuhamba kwesikhathi?

Abantu abaningi abane-MGUS abagcini ngokuba nezinkinga zezempilo ezihlobene nalesi simo.

Kodwa-ke, ngokusho kweMayo Clinic, cishe iphesenti elilodwa labantu abane-MGUS bahlakulela isimo sempilo esibi kakhulu minyaka yonke. Uhlobo lwezimo ezingakhula lincike ekutheni hlobo luni lwe-MGUS onalo.

Kunezinhlobo ezintathu ze-MGUS, ngayinye ehlotshaniswa nengozi ephakeme yezimo ezithile zezempilo. Lokhu kufaka phakathi:

• I-non-IgM MGUS (ifaka i-IgG, i-IgA noma i-IgD MGUS). Lokhu kuthinta isibalo esiphezulu sabantu abane-MGUS. Kukhona ithuba elandayo lokuthi i-non-IgM MGUS izokhula ibe yi-myeloma eminingi. Kwabanye abantu, i-non-IgM MGUS ingaholela kwezinye izinkinga ezinkulu, njenge-immunoglobulin light chain (AL) amyloidosis noma isifo se-light chain deposition.
• IgM MGUS. Lokhu kuthinta cishe amaphesenti ayi-15 alabo abane-MGUS. Lolu hlobo lwe-MGUS lunengozi yomdlavuza ongavamile obizwa ngokuthi iWaldenstrom macroglobulinemia, kanye ne-lymphoma, AL amyloidosis, ne-myeloma eminingi.
• Uchungechunge lokukhanya MGUS (LC-MGUS). Lokhu kuhlukaniswe kuphela muva nje. Kubangela ukutholakala kwamaprotheni e-M emchameni, futhi kungaholela ekukhanyeni okuningana kwe-myeloma, AL amyloidosis, noma isifo se-light chain deposition.

Izifo ezibangelwe yi-MGUS zingadala ukuphuka kwamathambo, amahlule egazi, nezinkinga zezinso ngokuhamba kwesikhathi. Lezi zinkinga zingenza ukuphatha isimo nokwelapha noma yiziphi izifo ezihambisana nakho kube nzima kakhulu.

Ingabe kukhona ukwelashwa kwe-MGUS?

Ayikho indlela yokwelapha i-MGUS. Ayizihambeli yodwa, kepha imvamisa ayibangeli zimpawu noma ikhule ibe sesimeni esibi.

Udokotela uzoncoma ukuhlolwa njalo nokuhlolwa kwegazi ukuze unake impilo yakho. Imvamisa, lokhu kuhlolwa kuqala izinyanga eziyisithupha ngemuva kokuthola kuqala i-MGUS.

Ngaphandle kokuhlola igazi ekushintsheni kwamaprotheni e-M, udokotela uzobheka izimpawu ezithile ezingakhombisa ukuthi lesi sifo siyaqhubeka. Lezi zimpawu zifaka:

• i-anemia noma okunye okungahambi kahle kwegazi
• ukopha
• izinguquko embonweni noma ekuzweni
• umkhuhlane noma ukujuluka ebusuku
• ikhanda kanye nesiyezi
• Izinkinga zenhliziyo nezinso
• ubuhlungu, kufaka phakathi ubuhlungu bezinzwa nobuhlungu bethambo
• ukuvuvukala kwesibindi, ama-lymph node, noma ubende
• ukukhathala noma ngaphandle kobuthakathaka
• ukuncipha kwesisindo ngokungenhloso

Ngoba i-MGUS ingaholela ezimeni eziwohloka ubukhulu bethambo, udokotela angancoma ukuthi uthathe umuthi wokwengeza ukuqina kwamathambo akho uma une-osteoporosis. Eminye yale mithi ifaka:

• i-alendronate (Binosto, Fosamax)
• i-risedronate (Actonel, Atelvia)
• ibandronate (Boniva)
• i-zoledronic acid (i-Reclast, iZometa)

Uyini umbono?

Iningi labantu abane-MGUS alithuthukisi izimo ezibucayi zegazi nomnkantsha wamathambo. Kodwa-ke, ingozi yakho ingalinganiselwa kangcono ngokuvakashela odokotela njalo nokuhlolwa kwegazi. Udokotela wakho futhi anganquma ubungozi bakho be-MGUS ukuqhubekela kwesinye isifo ngokucabangela:

• Isibalo, uhlobo, nosayizi wamaprotheni akwa-M atholakala egazini lakho. Amaprotheni amakhulu futhi amaningi M angakhombisa isifo esandayo.
• Izinga lamaketanga wokukhanya wamahhala (olunye uhlobo lwamaprotheni) egazini lakho. Amazinga aphezulu wamaketanga wokukhanya wamahhala angesinye isibonakaliso sesifo esikhulayo.
• Iminyaka otholwe ngayo. Uma uke waba ne-MGUS isikhathi eside, inkulu ingozi yokuba nesifo esibi.

Uma wena noma othandekayo kutholakala ukuthi une-MGUS, qiniseka ukuthi ulandela izinhlelo zikadokotela wakho zokuqapha isimo sakho.

Ukuhlala ngaphezulu kwe-MGUS yakho kunganciphisa ubungozi bezinkinga. Kungakhuphula namathuba akho omphumela omuhle uma kwenzeka uthuthukisa noma yisiphi isifo esihlobene neMGUS.

Ukugcina indlela yokuphila enempilo nakho kungaholela emiphumeleni engcono. Ungakwenza lokhu ngokulala ngokwanele nokuzivocavoca umzimba, ukunciphisa ukucindezeleka, nokudla ukudla okunempilo njengezithelo nemifino.