Into okuthiwa abantu abane-lymphoma kanye nezinye izinhlobo zomdlavuza wegazi ngokuvamile ababhekana nazo, kungakhathaliseki ukuthi yingxenye yesifo sabo noma njengomphumela ohlangothini wezokwelapha, kunciphisa amandla omzimba nokutheleleka ekutheleleni. Ngezinye izikhathi abantu abanomdlavuza wegazi banamazinga angavamile eklasini elilodwa lama-antibodies kanti abanye banamathangi angaphezu kweyodwa abathintekile (IgA ne-IgG yizigaba ezimbili zamagciwane anziwe ngamagesi athile omzimba wegazi omhlophe ; IgM yisigaba sesithathu).
Ziyini imiphumela yalezi zinga ezingavamile, futhi zingaphathwa kanjani?
Izifo Zingabuka Emanini Aphikisana Namagciwane Angavamile
Izifo ezijwayelekile, ikakhulukazi izifo zokuphefumula, zivame ukubonwa ezigulini ezine- Waldenström's , uhlobo lwe- non-Hodgkin lymphoma , futhi zingahlotshaniswa nokuba khona kwamazinga aphansi we-antibodies-kodwa kuxhomeke kulokho.
Ngokuphathelene nabantu abangenayo i-IgA (enendima ezindaweni zomzimba ezinamaqabunga amancane, njengebhande lomoya), isixhumanisi sokutheleleka okuvamile kaningi kubonakala singenamandla. Eqinisweni, abantu abazalwa abangenalutho kuleli klasi le-anti-antibody kuphela abanaso izimpawu.
Odokotela bavame ukuhlola amazinga e- antibody njalo. Isibonelo, umsindisi kaWaldenström, uJennifer Killam, umhlalaphansi waseMoyeni wamaMandla, uthi kuso sonke isikhathi amazinga akhe e-antibody ayejwayele ukuphuma. "Odokotela bami kudingeka bahlole njalo amazinga ami e-antibody-IgA, IgG, ne-IgM.
Amazinga ami e-IgM alawulwa, kepha angisona ukuxoxwa, "kusho uKillam.
Uhlobo lwe-lymphoma lwe-Major Killam, kanye nezinye izinhlobo zegazi zamangqamuzana egazi, amangqamuzana aphethwe yizifo aveza ngokweqile inani lamaprotheni e-antibody okufaka igazi; kuleso simo, isisindo esiningi ngokweqile lama-anti-IgM.
Omunye wemithi yakhe yokwelashwa uzama ukuletha la mazinga phansi. Yize amazinga akhe e-IgM esezansi futhi esezingeni elihle, amazinga akhe omzimba we-IgG nawo aphansi kakhulu-futhi i-IgG iyinhlangano ephikisayo yokulwa nokutheleleka.
Amazinga we-IgG avamile angaphezu kuka 800 mg / dL. Amaconsi amakhulu aseKillam afika ku-200 mg / dL, okubangela ukuthi abe nesifo kakhulu. Ngakho-ke, njalo emavikini ayisithupha uya eMzini Wethemba wezokwelapha isikhathi samahora amane kuya kweyisithupha ukuze abuyele emuva emazingeni e-IgG. Uthola ukumnika okune-intravenous eyaziwa nge-IVIG.
Ukwelashwa kwe-IVIG
I-IVIG empeleni iyindlela yokwelashwa eye yaba khona amashumi eminyaka futhi isetshenziselwa ukwelapha iziguli ezinezinhlobo eziningi zezifo. I-IV imele i-intravenous futhi i-IG imele i-immunoglobulin (igama lesayensi lama-antibody amaprotheni).
I-IVIG yaboniswa kuqala ukuthi iyasebenza esikhungweni esibizwa ngokuthi i-autoimmune idiopathic thrombocytopenic purpura (ITP) ngo-1981. Kusukela ngaleso sikhathi, uhlu olude lwezifo ezibonakala ziphendula kahle i-IVIG luye lwakhula. Enye yezinto ezisetshenziswa kakhulu ze-IVIG ukushintsha amazinga omuntu womuntu, kodwa lokho akukuphela kokusebenzisa kuphela.
Ama-IVIG yimikhiqizo engasindiswa esikhwameni sokuphatha amanzi emithanjeni. Zakhiwa emzimbeni we-plasma, okusho ukuthi lezi zikhwama ziqukethe ama-IgG antibodies ezivela kubantu abahlukene, abahlinzeki abahlukahlukene abanempilo, futhi imikhiqizo ngokuvamile iqukethe amaphesenti angaphezu kwama-95 angenayo i-IgG, futhi ilandelela kuphela inani le-immunoglobulin A (IgA) noma i-immunoglobulin M ( IgM).
Ukuqoqwa kwezifo ezithinta i-IVIG kuyamangalisa futhi uhlu mhlawumbe lubonisa ukubaluleka komzimba omzimba onempilo kuzo zonke izinhlobo zezifo ezahlukene.
Ukusetshenziswa kweTherapy ye-IVIG
Nasi isampula sezisebenzisi ze-IVIG.
Ukuzivivinya umzimba: Lokhu kuhlanganisa izimo abantu abazalelwa nazo kodwa nezifo ezithatha isisindo esimisweni somzimba sokuzivikela njenge- chronic lymphocytic leukemia (CLL) kanye ne-myeloma eminingi. Futhi kufakwe amacala okuzivivinya umzimba okuhambisana nokuhlela lapho ukwelashwa kuqeda ukukhiqizwa kwama-antibody womzimba.
Izifo: Kwezinye izimo, kunezimo lapho umuntu onezifo ezijwayelekile noma eziphindaphindiwe angazuza ku-IVIG.
Izifo ezithile zegciwane, ezifana nokutheleleka okungapheli kwe-parvovirus eziyinkimbinkimbi ye-anemia, zifakiwe kulolu hlu.
Izimo ezizenzakalelayo / ezivuthayo: Ngaphezu kokuzimela ngokuzenzakalela i-idiopathic thrombocytopenic purpura, okuyi-IVIG eyaboniswa ngokuphumelelayo ngo-1981, ezinye izimo ezinjengeGuillain-Barré syndrome, izifo ze-Kawasaki nezifo ezihambisana ne-HIV ezibangelwa yizifo zifakwe kulolu hlu.
Ezinye izimo: Ezinye izifo ezibandakanya izinzwa, ezibizwa nge-neuropathies ezingapheli, zingathuthukiswa nge-IVIG. Ukusabela kwe-Transfusion kanye nokulahlwa kwe-anti-mediated organ transplant rejections kubuye kulesi sigaba.
Ukuphila Ne-Waldenström's, Ukubhekana Nezokuhweba
U-Major Killam waphawula ukuthi, ngalesi sikhathi, isifo sakhe sizinzile. Ukwelashwa kwakhe kuye kwamlethela amazinga e-IgM phansi ukuze kungadingeki akhathazeke kakhulu ngezinye zezinkinga zokuba ne-IgM ngokweqile.
Lapho inani eliningi lamaprotheni lingena egazini, odokotela bakhathazeka ngokuthi kukhona okuthiwa i-hyperviscosity syndrome, noma i-HVS. Izimpawu nezimpawu ze-HVS zihlanganisa kakhulu izinto ezintathu: ukuphuma kwegazi ngaphakathi kwe-mucosa, noma ububanzi bezitho ezihlukahlukene, izinguquko ezibukwayo, nezimpawu ezikhomba isimiso sezinzwa njengomthombo wazo. Izimpawu zomzimba jikelele ezihlanganisa ukukhathala, ukulahlekelwa isisindo noma umkhuhlane kungenzeka.
Izindlela zokwelashwa ezisetshenziselwa ukwelapha i-lymphoma nazo azikho ngaphandle kwemiphumela yabo emibi. Eminye imishanguzo yomlomo emisha iyakwazi ukuthinta ipheshana lokugaya, nge-diarrhea ngokweqile noma ukuqothulwa.
Ngokuqondene neKillam enkulu, akuyona ikhambi elilodwa elilondoloza ukuthi lihambe kodwa kunalokho liwumgogodla, futhi liphuma ezihlotsheni ezihlukahlukene, kuhlanganise nemithi yendabuko, ukukhwabanisa, ukwelashwa kwe-chiropractic, ukuzindla ne-yoga.
"Konke kuye kwaba usizo empilweni yami-futhi impilo yami nayo. O, nokuhleka-ukuhleka kusiza kakhulu. Ngakho ngezinye izikhathi, ngibheka esibukweni ngihleka! "
> Imithombo:
> Hunter ZR, Manning RJ, Hanzis C, et al. I-IgA ne-IgG i-hypogammaglobulinemia ku-macroglobulinemia yeWaldenström. Haematologica . 2010; 95 (3): 470-475.
> I-Gelfand EW.I-immune globulin engenazo izifo ezithathelwanayo nezifo ezivuthayo. N Engl J Med . 2012 Nov; 367 (21): 2015-25.