Yini esikwaziyo mayelana nokuxhumana phakathi kwe-lupus ne-lymphoma? Siyazi okungaphezu kwalokho esikwenza eminyakeni engu-20 eyedlule, kodwa impendulo ingase ingabi "ngokwanele," ngokusho kwesigatshana seBoddu kanye nosebenza nabo eshicilelwe kuyi-intanethi ku-March 2017 inkathi ethi "Imibiko Yezindaba ku-Rheumatology."
I-Lupus, noma i-Systemic Lupus Erythematosus (SLE)
I-Lupus , noma i-systemic lupus erythematosus (SLE), isifo esiyinkimbinkimbi kakhulu esizimele esingakwazi ukufika nanoma iyiphi inombolo yezimpawu ezihluke kakhulu futhi ingafaka izinhlelo eziningi zomzimba ngaphakathi komzimba.
Noma yibaphi abantu ababili abane-lupus bangaba nezimpawu ezihluke ngokuphelele, kodwa nansi ezinye ezivamile:
- Ubuhlungu obuhlangene, ubunzima nokuvuvukala
- Ukukhathala nomkhuhlane
- Ukushona ebusweni emathunjini nasebhuloho lempumu, kuthiwa yi-butterfly, okwenziwe ngekhala njengemzimba kanye namahlathi njengamaphiko evemvane. Ukuqubuka kungase kube mnandi, kungabi kuhle noma kuyashisa.
- Ezinye izinkinga zesikhumba ezibonakala ziba zimbi kakhulu nokushisa kwelanga
- Iminwe nezinzwane zibonakala zilahlekelwa ukujikelezwa, ziphenduka ezimhlophe noma zihlaza okwesibhakabhaka emakhazeni noma ngezikhathi ezicindezelayo-lokhu kuthiwa yi-Raynaud's phenomenon
- Izimpawu ezivela ezinhlotsheni ezahlukene zesitho; ukuphefumula, ubuhlungu besifuba, amehlo omile
- Ukushaya ikhanda, ukudideka, nokulahlekelwa inkumbulo
I-Lymphoma, i-Cancer ye-White Blood Cells
I-Lymphoma ingumdlavuza wamhlophe amangqamuzana egazi, ikakhulukazi amangqamuzana egazi amhlophe aziwa ngokuthi i- lymphocytes . Izigaba ezimbili eziyisisekelo ze-lymphoma yi- Hodgkin lymphoma non-Hodgkin lymphoma , noma i-NHL. I-lymphoma iqala ngokuyinhloko kuma-lymph nodes, kodwa ingabandakanya nezitho ezihlukene, futhi ingavela ngaphakathi kwezicubu nezinhlaka ezahlukene zomzimba, hhayi nje i-lymph nodes.
Njenga-lupus, izimpawu ze-lymphoma zihlukahlukene futhi abantu abahlukene banezimpawu ezihlukahlukene ze-lymphoma. Ngezinye izikhathi, uphawu oluwukuphela kwe-lymph node:
- Ukuvuvukala okungenasiphelo kwama-lymph nodes entanyeni yakho, izimpumputhe, noma ubuhlungu
- Ukukhathala nomkhuhlane
- Ukuphuza ukuthuka ebusuku
- Ukulahlekelwa isifiso, ukulahlekelwa kwesisindo esingachazwanga-cishe amaphesenti angu-10 noma ngaphezulu kwesisindo somzimba wakho
- Isikhumba esinamahloni
- Ubuhlungu bekhanda noma isifuba, ubuhlungu besisu noma ukugcwala, ukuhlukumezeka, nokuphuza isikhumba
Yenzani Lezi Zimbalwa Zesibili?
Yebo, ngezinye izikhathi izimpawu zingase zenzeke, ngenye. Futhi zombili lezi zifo zibandakanya amasosha omzimba: Ama-Lymphocyte amaseli abalulekile emasosheni omzimba, futhi isimiso somzimba sokuzivikela sisisulu ku-SLE. Ama-lymphocytes nawo amangqamuzana anenkinga e-lymphoma.
Kodwa kukhona nalokhu: izifundo eziningi ziye zathola ukuthi abantu abane-SLE banomphumela ophakeme we-lymphoma uma kuqhathaniswa nomphakathi jikelele. Enye yezinkolelo eziningi ukuthi, esimisweni somzimba sokuzivikela omzimba esingenalo umthethonqubo ofanele (njengokunye komuntu ophethe i-SLE), ukusetshenziswa kwe-immunosuppressive therapy yokwelapha i-lupus kungabangela ukukhula kwe-lymphoma ku-SLE. Kodwa-ke, kwenziwa ucwaningo oluningi ngalolu daba, ngokuthola okuphikisanayo, futhi lokho akubonakali kuyindaba yonke.
I-Boddu kanye nozakwabo bavele baqoqa ezinye izitayela ekubuyekezeni kwabo izincwadi zezokwelapha ukuthola ulwazi ngabantu abane-SLE abahlakulela i-lymphoma. Izingozi zokuthuthukiswa kwe-lymphoma kubantu abane-SLE azicaci ngokuphelele. Abantu abanezifo ezithintekayo noma ezishaya indiza ze-SLE babonakala bengengozini enkulu ye-lymphoma, kanti ezinye izingozi ziye zachazwa ukuthi zihlobene nokusetshenziswa kwe-cyclophosphamide nokuvezwa okuphezulu kwe-steroids.
Nakuba ngezinye izikhathi kwakukhona izifundo ezimbalwa zokudweba-futhi kaningi izinombolo zabantu abaneSLE kanye ne-lymphoma zazincane kulezi zifundo-UBoddu nabacwaningi basebenzisa lokho abangakuthola ekwakheni isiteji sokuqala sokufunda okwengeziwe. Okunye okubuhlungu okubhekayo okuvela ezifundweni neziguli ze-SLE ezithuthukisa i-lymphoma.
Abantu abane-SLE abaqalile i-lymphoma:
- Abaningi babebesifazane
- Ibanga lobudala laliphakathi kweminyaka engu-57 no-61
- Ngokwesilinganiso, bebengaba ne-SLE iminyaka engu-18 ngaphambi kwe-lymphoma
- Ingozi ye-Lymphoma kubantu abane-SLE yayiphezulu kuzo zonke izinhlanga
- Izimpawu, ukutholakala kanye nokuhlolwa kwelebhu ye-lymphoma zakuqala-zeqile zanyuka kancane kulokho okubonwayo ku-SLE.
- I-Lymph node ukuvuvukala, ngezinye izikhathi uphawu olulodwa lwe-lymphoma, lubuye luvame kakhulu kubantu abane-SLE, okwenzeka ngamaphesenti angama-67.
Ama-lymphomas akhula kubantu abane-SLE:
- Uhlobo lwe-NHL oluvame kakhulu kubantu abane-SLE lwaluhlakaza i-B-cell lymphoma enkulu (i-DLBCL), okuyiyona ndlela ejwayelekile kunazo zonke ze-NHL kubantu abaningi.
- I-subtypes ye-DLBCL kulabo abane-SLE ibonakala kaningi kakhulu esigabeni esine-prognosis esimbi kakhulu-isikhungo esingezona okuhlwanyela se-B-cell-like DLBCLs.
- I-NHL ku-SLE, njenge-NHL emphakathini jikelele, ngokuvamile ivela kuma-lymph nodes, kodwa i-lymphomas eqala ngaphandle kwe-lymph nodes nayo ingenzeka kubantu abaningi nakwabo abane-SLE.
Abantu abane-SLE bavame ukuphathwa nge-glucocorticoids, okuwukuphela noma okuhlangene nezinye izidakamizwa zokuzivikela noma i-cytotoxic kubandakanya methotrexate, cyclophosphamide, ne-azathioprine ukuphatha ukubandakanya komzimba noma izimpawu ezingaphenduli ekuthatheni okusetshenziswe ekuqaleni. Ucwaningo oluningi luye lwazama ukuthola ukuthi ama-immunosuppressive agents akwandisa ingozi ye-lymphoma kubantu abane-SLE, kodwa imiphumela kaningi yocwaningo olulodwa luphikisa okulandelayo.
Kunemibono eminingi yokuthi kungani abantu abane-SLE bengase babe engozini enkulu yomdlavuza ngokujwayelekile, futhi ikakhulukazi i-lymphoma:
- Enye inkolelo enjalo ihilela ukuvuvukala okungapheli. I-DLBCL evela ku-lymphocyte esebenzayo yiyona ejwayelekile kakhulu ye-NHL subtype evela ku-SLE, ngakho umqondo wukuthi ukuvuvukala okungapheli kungakhulisa ingozi ye-lymphoma ezifweni ezizimele njenge-SLE.
- Enye inkolelo iyafana kodwa inesisekelo esiningi sezakhi zofuzo. Umcabango wukuthi ukuzimela kwe-SLE kuvuselela isimiso somzimba sokuzivikela omzimba ukuze kubangele i-lymphocytes, amangqamuzana e-lymphoma, ahlukanise futhi aqhubeke.
- Noma kunjalo enye inkolelo ihlanganisa igciwane le-Epstein-Bar, noma i-EBV. Leli gciwane elifanayo elidala i-mononucleosis, noma i-mono, isifo esivumayo. Umqondo wukuthi mhlawumbe ukutheleleka kwe-EBV okuphikisanayo, okuqhubekayo ukukhulisa isimiso somzimba wamasosha ngezindlela ezifanele, kuyingxenye yendlela ejwayelekile yezifo zombili i-SLE ne-B-cell lymphomas.
I-SLE, i-Lymphoma, namanye ama-Cancer
Kubonakala sengathi kukhona ingozi ekhulayo ye-Hodgkin ne-non-Hodgkin lymphoma kubantu abane-SLE. Ngokusho kwedatha eshicilelwe ngo-2015, kunomhlangano phakathi kwe-SLE nokuhlukumeza, hhayi kuphela ukubonisa iNHL, i-Hodgkin lymphoma, i-leukemia, namanye amakhemikhali angewona igazi, kodwa futhi kufaka phakathi i-laryngeal, amaphaphu, isibindi, ubulili, futhi kungase kube nomngcipheko omncane we-melanoma yesikhumba. Umdlavuza webele, umdlavuza wamaphaphu nomdlavuza womlomo wesibeletho, nomdlavuza we-endometrial konke kubonakala sengathi ukulandelela nge-SLE okungaphezu kwalokho okulindeleke kubantu abaningi.
Abantu abane- Sjögren's syndrome , isimo esivamile kubantu abaphethe i-SLE, bahlangabezana nengozi enkulu kakhulu ye-lymphoma, ngakho-ke kungenzeka kube khona into ebalulekile kwisifo se-SLE esixhunyaniswa nokulimala futhi ikakhulukazi i-lymphoma.
Nakuba amanye ama-immunosuppressive agents ebonakala ephephile kubantu abane-SLE ngokusekelwe ezinhlobonhlobo eziningi, kune-caveat yokuqapha ezincwadini-ukuthi i-CNS lymphoma (PCNSL) eyinhloko uhlobo oluyinqaba ye-NHL eyenzeka ekubandakanyekeni kwesistimu ephakathi ngaphandle kobufakazi we-lymphoma kwenye indawo emzimbeni. Cishe zonke izimo ze-PCSNL ezibikwe kubantu abane-SLE zihlobene nama-immunosuppressive agent, futhi i-mycophenolate ngokukhethekile.
> Imithombo:
> Boddu P, Mohammed AS, Annem C, Sequeira W. SLE kanye ne-non-Hodgkin's lymphoma: uchungechunge lwamacala nokubuyekezwa kwezincwadi. Case Rep Rheumatol. 2017: 1658473.
> Cao L, Tong H, Xu G, et al. I-Systemic Lupus Erythematous ne-Malignancy Risk: I-Meta-Analysis. I-Scheurer M, ed. PLoS ONE. 2015; 10 (4): e0122964.