Yintoni esiyayaziyo malunga nokuqhagamshelana phakathi kwe-lupus kunye ne-lymphoma? Ewe, sisazi ngaphezu koko senza iminyaka engama-20 edlulileyo, kodwa impendulo isenokungabi "ngokwaneleyo," ngokubhekiselele kwinqaku kaBoddu kunye noogxa abashicilelweyo kwi-Intanethi ngo-Matshi 2017 umxholo othi "Iingxelo zengxelo kwiRheumatology."
Lupus, okanye i-Systemic Lupus Erythematosus (SLE)
I-Lupus , okanye i-systemic lupus erythematosus (SLE), isifo esiyinkimbinkimbi kakhulu esingazifumanayo kunye naliphi na inani leempawu ezahlukileyo kwaye linokubandakanya iinkqubo ezininzi zomzimba ngaphakathi komzimba.
Nabani na abantu ababini abane-lupus banokubonakalisa iimpawu ezahlukileyo ngokupheleleyo, kodwa zilapha ezinye eziqhelekileyo:
- Intlungu ehlangeneyo, ubunzima kunye nokuvuvukala
- Ukukhathala kunye nomkhuhlane
- Ukugqithwa ebusweni ebudeni kunye nebhulophu yempumlo, kuthiwa yi-butterfly, ephethe impumlo njengomzimba kunye nezihlathi njengamaphiko evebhathane. Ukugqithisa kungabunzima, kunokuba kukuthi, okanye kushushu.
- Ezinye iingxaki zesikhumba ezibonakala ziba nzima ngakumbi ukukhanya kwelanga
- Iminwe neenzwane zibonakala zilahlekelwa ngumjikelezo, ziphendukele ezimhlophe okanye zihlaza okwesibhakabhaka ebanda okanye ngexesha lexinzelelo-oku kuthiwa nguRaynaud
- Iimpawu ezivela kwiinkqubo ezahlukeneyo zesebe; ukuphefumula okufutshane, intlungu yesifuba, amehlo omeleyo
- Intloko, ukudideka, kunye nokulahlekelwa kwememori
I-Lymphoma, iCancer ye-White Blood Cells
I-Lymphoma ngumhlaza weeseli ezimhlophe zegazi, ngakumbi iiseli ezimhlophe zegazi ezibizwa ngokuba yi- lymphocytes . Iindidi ezibini ze-lymphoma ziyiHodgkin lymphoma kunye non-Hodgkin lymphoma , okanye i-NHL. I-lymphoma iqala ngokuqala kwii-lymph nodes, kodwa inokubandakanya izitho ezahlukileyo, kwaye inokuvela kwiintlobo ezahlukeneyo nezakhi zomzimba, kungekhona nje i-lymph nodes.
Njengoko i-lupus, iimpawu ze-lymphoma zihlukeneyo kwaye abantu abahlukileyo baneempawu ze-lymphoma ezahlukeneyo. Ngamanye amaxesha, uphawu oluphela kuphela lu-lymph node:
- Ukuvuvukala okungenasiphelo kwezitholo ezintanyeni entanyeni yakho, ukuvuthwa, okanye ukubola
- Ukukhathala kunye nomkhuhlane
- Ukugxila ebusuku
- Ukulahleka kwesidlo, ukulahlekelwa kwesisindo esingakhange sichaze-malunga neepesenti ezili-10 okanye ngaphezulu kwesisindo somzimba wakho
- Isikhumba esikhulayo
- Intlungu okanye isifuba somfuba, intlungu esiswini okanye ukuzaliswa, ukugqithisa, kunye ne-skin bumps
Ziziphi Ezi zimbini Iimeko Eziqhelekileyo?
Ewe, maxa wambi iimpawu zingaphahla, enye. Kwaye zombini izifo zibandakanya i-immune system: I-Lymphocytes iiseli eziphambili kwi-immune system, kwaye i-immune system yinto engafanelekanga kwi-SLE. I-lymphocyte nazo iiseli ezinengxaki kwi-lymphoma.
Kodwa kukho oku: iziphumo ezininzi ziye zafumanisa ukuba abantu abane-SLE baneziganeko eziphezulu ze-lymphoma xa kuthelekiswa noluntu jikelele. Enye yeengcamango ezininzi kukuba, kwi-immune system engenawo umgaqo ofanelekileyo (njengomntu ono-SLE), ukusetyenziswa kwe-immunosuppressive therapy ukuphatha i-lupus kungabangela ukwanda kwe-lymphoma kwi-SLE. Nangona kunjalo, uphando oluninzi luye lwenziwe kulo mbandela, ngokufumanisa okuphikisanayo, kwaye oko akubonakali lilonke ibali.
UBoddu kunye noogxa basebenze baqokelela iindlela ezithile ekuhlaziyweni kwabo kwincwadi yoncedo ngolwazi malunga nabantu abane-SLE abahlakulela i-lymphoma. Imiba yengozi yokuphuhliswa kwe- lymphoma kubantu abane-SLE ayifani ngokupheleleyo. Abantu abaneentsholongwane ezisebenzayo okanye ezivuthayo ezibonakalayo zisesifo se-lymphoma, kwaye ingozi ethile inqatshelwe ukuba idibene ne-cyclophosphamide kunye nokugqithisa okuphezulu kwi-steroids.
Nangona ngamanye amaxesha kwakukho izifundo ezimbalwa eziza kuhamba-kwaye ngokuphindaphindiweyo amanani abantu abane-SLE kunye ne-lymphoma babancinci kulezi zifundo-iBoddu nabaphandi basebenzisa oko bangakufumana ekwakheni iphambili yokuqala yokufunda ngokuqhubekayo. Ezinye izigulane ezivela kwizifundo kunye nezigulane ze-SLE ezenza i-lymphoma ilandele.
Abantu abane-SLE abavelise i-lymphoma:
- Uninzi lwabafazi
- Ibanga lobudala laliphakathi kweminyaka engama-57 no-61
- Ngokomyinge, bebeneminyaka eyi-18 ngaphambi kokuba i-lymphoma
- Umngcipheko we-Lymphoma kubantu abane-SLE ubuphezulu kuwo wonke ubuhlanga
- Iimpawu, iziphumo kunye neemvavanyo zebhabhi ze-lymphoma zakuqala zanyuka ngokugqithiseleyo kwizinto ezibonakalayo kwi-SLE.
- I-Lymph node ukuvuvukala, ngamanye amaxesha uphawu olulodwa lwe-lymphoma, luqheleke kakhulu kubantu abane-SLE, elifikelela kuma-67 ekhulwini.
I-Lymphomas ephuhliswa ngabantu abane-SLE:
- Uhlobo lwe-NHL oluqhelekileyo kubantu abane-SLE lwaluhambisa i-B-cell lymphoma enkulu (iDLBCL), eyona hlobo luqhelekileyo lweNHL kuluntu jikelele.
- Amagqabantshintshi e-DLBCL kulabo abane-SLE babonakala behlala bekwinqanaba elithatha isifo esibi ngakumbi-indawo engeyiyo i-B-cell-like DLBCLs.
- I-NHL kwi-SLE, njengokuba i-NHL ebantwini bonke, ngokuqhelekileyo ivela kwi-lymph nodes, nangona kunjalo i-lymphomas eqala ngaphandle kwee-lymph nodes nayo inokwenzeka nakubantu bonke kunye nakwabo abane-SLE.
Abantu abaye bahlala behlala bephathwa nge-glucocorticoids, bodwa okanye badibene nezinye izidakamizwa ezingenayo i-immunosuppressive okanye i-cytotoxic kuquka i-methotrexate, i-cyclophosphamide, kunye ne-azathioprin ukuphatha ukubandakanyeka komzimba okanye iimpawu ezingaphenduliyo kwiyeza elisetyenziswe ekuqaleni. Izifundo ezininzi ziye zazama ukugqiba ukuba ngaba i-immunosuppressive agents yandisa ingozi ye-lymphoma kubantu abane-SLE, kodwa izihlandlo zeso sifundo esinye sichasene nesilandelayo.
Kukho iingcamango ezininzi malunga nokuba kutheni abantu abane-SLE banokubeka ingozi enkulu emdlalweni jikelele, kunye ne-lymphoma ngokukodwa:
- Enye inkolelo enjalo ibandakanya ukuvuvukala okungapheliyo. I-DLBCL evela kwi-lymphocytes esebenziweyo yinto eqhelekileyo ye-NHL subtype evela kwi-SLE, ngoko ke le ngcamango kukuba ukuvutha okungapheliyo kunokuphakamisa umngcipheko we-lymphoma kwizifo ezingafaniyo njenge-SLE.
- Enye imbono iyafana kodwa inemveliso ephezulu. Ingcinga kukuba ukuzimela kwe-SLE kwakhona kuvuselela isistim somzimba sokukhuselana nomzimba ukuze kubangele i-lymphocytes, iiseli ze-lymphoma, ize ihlukane kwaye iqhubeke.
- Enye ingcamango ibandakanya igciwane le-Epstein-Bar, okanye i-EBV. Le yintsholongwane efanayo eyenza i-mononucleosis, okanye i-mono, isifo esivayo. Ingcamango kukuba mhlawumbi i-EBV intsholongwane eqhubekayo, eqhubekayo yokunyusa i-immune system ngendlela efanelekileyo, inxalenye yendlela eqhelekileyo yezifo ze-SLE kunye ne-B-cell lymphomas.
I-SLE, i-Lymphoma kunye namanye amaKhansela
Kubonakala kukho ingozi eyongeziweyo yeHodgkin kunye ne-non-Hodgkin lymphoma kubantu abane-SLE. Ngokweenkcukacha ezanyatheliswa ngo-2015, kukho umbutho phakathi kwe-SLE kunye nokugula, kungekhona nje ukubonisa i-NHL, i-Hodgkin lymphoma, i-leukemia, kunye nezinye ezingekho zegazi, kodwa kuquka ne-laryngeal, imiphunga, isibindi, ubulili, kwaye kukho nokuba nomngcipheko omncinci we-melanoma yesikhumba. Umhlaza wesifuba, umhlaza wemiphunga kunye nomhlaza womlomo wesibeleko, kunye nomhlaza wesi-endometrial konke kubonakala ukulandelelana ne-SLE ngaphezu kwezinto ezilindelwe kubemi bonke.
Abantu abane- Sjögren's syndrome , imeko eqhelekileyo kubantu abane-SLE, banomngcipheko omkhulu we-lymphoma, ngoko kunokubakho into engenazo kwisifo se-SLE esixhomekeke ekubizeni kwaye ikakhulukazi i-lymphoma.
Nangona ezinye i-immunosuppressive agents zibonakala zikhuselekileyo kubantu abane-SLE ngokusekelwe kwizifundo ezininzi, kukho i-caveat yokulumkisa kwincwadi-ye-CNS i-lymphoma (i-PCNSL) yinto engabonakaliyo ye-NHL eyenzeka kwinkqubo ye-nervous involvement ngaphandle kobu bungqina ye-lymphoma kwenye indawo emzimbeni. Phantse zonke iimeko ze-PCSNL ezichazwe kubantu abane-SLE zidibene ne-immunosuppressive agents, kunye ne-mycophenolate ngokukodwa.
> Imithombo:
> Boddu P, Mohammed AS, Annem C, Sequeira W. SLE kunye ne-non-Hodgkin's lymphoma: uluhlu lwamacala kunye nokuhlaziywa kweencwadi. I-Rep Rep. Rheumatol. 2017: 1658473.
> Cao L, Tong H, Xu G, et al. I-Lupus Erythematous ne-Risin Malignancy Risk: I-Meta-Analysis. Scheurer M, ed. PLoS ONE. 2015; 10 (4): e0122964.