Izifo ezinxulumene Nobungozi Bokufa, Ubungozi Bobunzima
Intsholongwane kaGawulayo ingonakalisa isistim somzimba wakho; oko kucacile. Njengoko i- HIV iqhubela phambili kwaye yenza iikopi ezininzi, umonakalo ungaba nzima kakhulu, obangela ukuba kubekho umngcipheko wokwandisa izifo ezichaphazelekayo .
Esinye sezibi kakhulu sisifo esibizwa ngokuba yi- leprophytic leukoencephalopathy (PML) . Le meko ichazwa ngegama layo: "leuko" elithetha umhlophe, "encephalo" elithetha ingqondo, kwaye "indlela" echaza izifo.
Njengoko i-PML yinkcitho eqhubekayo yomcimbi omhlophe wengqondo kwiindawo ezininzi (i-multifocal).
Le mqathango ibangelwa ukutshitshiswa kancane kancane kwesigxobo se-myelin esigcina iziphelo zentsholongwane, ingakumbi umbandela omhlophe wengqondo. Njengesifo esidemelisayo, i-PML ibonakalisa kakhulu ngendlela efana ne- multiple sclerosis (MS) , nangona kunjalo.
Intsholongwane ejongene ne-PML yinto enye inabantu bonke abaye bachazwa ngokuba yi-JC virus (okanye i-virus ye-John Cunningham). Nangona kuqikelelwa ukuba i-70-90% yabemi behlabathi sele ikhulelwe ngentsholongwane, inokubangela kuphela izifo ukuba umntu unentshutshiso enkulu yokugonywa ngumzimba njengoko kwenzeka nge-AIDS.
I-PML inezinga eliphezulu lokufa xa sele lifunyenwe, kunye nabantu abangama-30-50% abafa kwiinyanga zokuqala zokuxilongwa. Abo basindayo banamaqondo ahlukeneyo okonakalisa ingqondo-ezinye zilingana, ezinye zizinzima.
I-PML inokwenzeka kakhulu xa umntu onentsholongwane kaGawulayo ene- CD4 count engaphantsi kweeseli ezili-100 / mL.
Ngenkcazo, ukuxilongwa kwe-AIDS kuyenziwa xa i-CD4 yehla ngaphantsi kweeseli 200 / mL
Iimpawu kunye neempawu ze-PML
Iimpawu neempawu ze-PML zinokufana nezinye iimeko, ngokukodwa kwizigaba zalo zokuqala. Ngokuqhelekileyo, uphawu oluphela kuphela lwenkathazo luquka:
- Ubuthakathaka obuqilileyo ezandleni okanye emilenzeni
- Ukucinga okunzima okanye ukugxila
- Ukungabikho koqhagamshelwano olungaphezulu
- Intloko
Amaxesha aphindaphindiweyo, abantu bayaphulaphula le mpawu ngenxa yokukhathala, iziphumo ezinobungozi beziyobisi, okanye i- stroke esichukumisayo okanye ukuhlaselwa kwe-ischemic . Njengoko i-PML iqhubela phambili, iimpawu ezinzulu ezinokuthi ziphuhlise, kubandakanywa intetho kunye nokuphazamiseka kombono, kwakunye nokutshintshwa kweempawu kunye nokuguquka komntu.
Kwezinye iimeko, izigulana zinokuthi zenze into ebizwa ngokuba yi- alien hand syndrome apho isandla sithatha khona ngaphandle komntu nokuba uyakwazi okanye uyakwazi ukuyilawula.
Ukuxilongwa kwe-PML
I-PML inokuthi ihlolwe ngokuqhelekileyo ngeendlela ezimbini:
- Ngokuhlolisisa umthambo wamanzi omgudu wobungqina bemfuyo ye-JC nentsholongwane exhaswa yi- MRI (magnetic resonance Imaging) ukuskena ukuqinisekisa izilonda kumbandela omhlophe wengqondo.
- Ngenye indlela, i-biopsy yengqondo ingasetyenziswa, kunye neendlela zokuqinisekisa ubungqina begciwane le-JC.
Ngaba kukho unyango lwe-PML?
Ngaphambi kokufika kweyeza-antiretroviral (ART) , i-PML yayisoloko ibulalayo phakathi kweveki ezimbalwa okanye iinyanga zokuxilongwa. Nangona okwangoku akukho ziyobisi ezinokuthi zivimbele okanye ziphilise i-PML, ukuqaliswa kwe- ART kunokunciphisa ezininzi iimpawu ngokubuyiselwa komzimba womntu.
Kuye kwaboniswa i-ART inokulondoloza ubomi bomntu kunye ne-PML iminyaka emininzi.
Kwiphepha le-flip, umngcipheko we-PML unokuthintelwa kakhulu ngokuqinisekisa ukuqaliswa kokuqala kwe-ART, ngokufanelekileyo ngexesha lokuxilongwa kwaye ngaphambi kokupheliswa komzimba.
Uninzi lwezonyango zokuhlola luye lwahlolisiswa, nangona iziphumo zixutywe okanye i-anecdotal ingcono. Ziquka ukusetyenziswa kwe-drug-anti-malarial mefloquine kunye nonyango nge-interleukin-2 (iprotheni elawula amaseli egazi ezimhlophe).
Kuza kubekho namhlanje, kuye kwaba nomntu omncinci kuphela obonakala ephilisiwe nge-PML esebenzisa i-mefloquine, ngelixa izigulane ezimbini zibonakala ziphinde zisebenzise usebenzisa iprotheni ye-immune, i-interleukin-2.
Ngelishwa, kwimeko zombini, inqanaba eliphezulu lokutywala kunye nokusetyenziswa kwezidakamizwa luyinkimbinkimbi yonyango kulabo abane-PML.
Imithombo :
Iziko zeSizwe zezeMpilo (NIH). "Inkqubela ye-Multifocal Leukoencephalopathy Information" Page "Washington, DC; hlaziywa ngoFebruwari 14, 2014; fi kelele ngoFebruwari 24, 2016.
Shackelton, L; Rambaut, A .; IPybus, G .; okqhubekayo. "I-JC Virus i-evolution kunye nokudibanisa nabantu". Journal of Virology . 2006; 80 (20): 9928-9933.
Gofton, T; Al-Khotani, A .; O'Farrell, B; okqhubekayo. "I-Mefloquine ekwonyango kwe-multifocal leukoencephalopath y". I-Journal ye-Neurology, i-Neurosurgery kunye ne-Psychiatry. Juni 2010; 82 (4): 452-455.
Buckanovich R. Liu, G .; Unzima, C; okqhubekayo. "I-almogeneic stem cell transplantation ye-almogeneic stem cell transplantation ye-refractaire i-Hodgkin's lymphoma eyinkimbinkimbi ye-interleukin-2 eqhubekayo ye-leukoencephalopathy." Unyaka weHematology. Julayi 2002: 81 (7): 410-413.