Lupus

ʻO ka lupus kahi maʻi e kū mai ana i ka wā e hoouka ai ke ʻōnaehana pale kino o kou kino i kou mau pūnaewele a me nā ʻōnaehana (maʻi autoimmune). Hiki i ka mumū i hana ʻia e ka lupus ke hoʻopilikia i nā ʻōnaehana kino he nui - me kāu mau hono, ʻili, nā puʻupaʻa, nā keʻena koko, ka lolo, ka naʻau a me nā māmā.

He paʻakikī paha ke ʻike i ka lupus no ka mea ua hoʻohālikelike pinepine ʻia kona mau hōʻailona a me nā hōʻailona i nā maʻi ʻē aʻe. ʻO ka hōʻailona ʻoi loa o ka lupus - kahi ʻili ma ka maka e like me nā ʻēheu o ka pepeke e wehe ana ma nā papalina ʻelua - e kū mai ana i nā hihia he nui akā ʻaʻole nā ​​hihia a pau o ka lupus.

Ua hānau ʻia kekahi poʻe me ka manaʻo e loaʻa iā lākou ka lupus, kahi e hoʻonāukiuki ʻia paha e nā maʻi, nā lāʻau lapaʻau a i ʻole ka lā. ʻOiai ʻaʻohe lāʻau lapaʻau no ka lupus, hiki i nā lāʻau lapaʻau ke kōkua i ka kaohi ʻana i nā hōʻailona.

ʻAʻohe hihia lupus ʻelua e like maoli. Hiki ke hele koke mai nā hōʻailona a me nā ʻōuli a i ʻole e ulu mālie, hiki ke māmā a i ʻole koʻikoʻi, a hiki ke lilo i manawa pōkole a mau loa. ʻO ka hapa nui o nā kānaka me ka lupus he maʻi māmā ia i hōʻailona ʻia e nā hanana - i kapa ʻia ʻo nā flares - i ka wā e ʻoi aku ai ka nui o nā hōʻailona a me nā ʻōuli no kekahi manawa, a laila e hoʻomaikaʻi a i ʻole e nalowale loa no kekahi manawa.

E hilinaʻi nā hōʻailona a me nā ʻōuli o ka lupus āu e ʻike ai i nā ʻōnaehana kino i hoʻopilikia ʻia e ka maʻi. ʻO nā hōʻailona a me nā ʻōuli maʻamau loa e komo pū ana:

• Luhi
• Fieber
• ʻEha o nā hono, paʻakikī a me ka pehu
• ʻIli pua nānā e like me ka pepeke ma ka maka e uhi ana i nā papalina a me ke alahaka o ka ihu a i ʻole nā ​​ʻili ʻē aʻe ma ke kino
• Nā ʻeha ʻili e ʻike ʻia a i ʻole e ʻoi aku ka maikaʻi me ka hoʻolaha ʻana i ka lā
• Nā manamana lima a me nā manamana wāwae e lilo i keʻokeʻo a i ʻole uliuli i ka wā e hōʻike ʻia ai i ke anu a i ʻole i nā manawa pilikia
• Pōkole o ka hanu
• ʻEha umauma
• Maluhia nā maka
• ʻO ka poʻo ʻeha, ka huikau a me ka nalowale o ka hoʻomanaʻo

E hele i ke kauka inā loaʻa iā ʻoe kahi ʻili ʻili maopopo ʻole, kahi kuni mau loa, ka ʻeha mau loa a i ʻole ka luhi.

Ma ke ʻano he maʻi autoimmune, ʻo ka lupus ka mea e hoʻouka ai kou ʻōnaehana pale kino i nā pūnaewele olakino i loko o kou kino. He mea maopopo paha ia e loaʻa mai ana ka lupus mai ka hui pū ʻana o kāu mau genetics a me kou wahi e noho ai.

Me he mea lā e loaʻa paha i nā kānaka me ka predisposition i hoʻoilina ʻia no ka lupus ka maʻi ke komo lākou i kahi mea i loko o ke kaiapuni e hiki ke hoʻoulu i ka lupus. ʻAʻole ʻike ʻia ke kumu o ka lupus i ka hapanui o nā hihia, akā naʻe. ʻO kekahi mau mea hoʻoulu e hiki ke loaʻa:

• Lā. Hiki i ka ʻike ʻana i ka lā ke lawe mai i nā lesions ʻili lupus a i ʻole e hoʻoulu i ka pane kūloko i nā kānaka i loaʻa ka maʻi.
• Nā maʻi bacteria. Hiki i ka loaʻa ʻana o ka maʻi ke hoʻomaka i ka lupus a i ʻole e hoʻoulu i ka relapse i kekahi poʻe.
• Nā lāʻau lapaʻau. Hiki i ka lupus ke hoʻoulu ʻia e kekahi mau ʻano o nā lāʻau lapaʻau koko kiʻekiʻe, nā lāʻau lapaʻau anti-seizure a me nā antibiotics. E maikaʻi ana nā kānaka i loaʻa ka lupus i hoʻoulu ʻia e ka lāʻau lapaʻau ke pau kā lākou inu ʻana i ka lāʻau lapaʻau. ʻAʻole pinepine, hiki ke mau nā hōʻailona a hiki ma hope o ka pau ʻana o ka lāʻau lapaʻau.

Nā kumu e hoʻonui ai i kou pilikia o ka lupus, ʻo ia hoʻi:

• Kou wahine kāne. ʻOi aku ka nui o ka lupus i nā wāhine.
• Makahiki. ʻOiai ke pā i nā kānaka o nā makahiki a pau ka lupus, ʻoi aku ka pinepine o ka ʻike ʻia ʻana ma waena o 15 a me 45 mau makahiki.
• Lāhui. ʻOi aku ka nui o ka lupus i nā ʻAmelika ʻApelika, nā Paniolo a me nā ʻAmelika ʻAsia.

Hiki i ka mumū i hana ʻia e ka lupus ke hoʻopilikia i nā wahi he nui o kou kino, me kēia mau mea:

• Nā puʻupaʻa. Hiki i ka lupus ke hana i ka pōʻino nui i nā puʻupaʻa, a ʻo ka hāʻule ʻana o nā puʻupaʻa kekahi o nā kumu nui o ka make ma waena o nā kānaka me ka lupus.
• Lolo a me ka ʻōnaehana hoʻoikaika kikowaena. Inā pili kou lolo i ka lupus, hiki iā ʻoe ke ʻike i nā poʻo ʻeha, nā poʻo wili, nā loli o ka ʻano, nā pilikia o ka maka, a hiki i nā hahau a i ʻole nā ​​​​hoʻoulu. He nui nā kānaka me ka lupus e ʻike i nā pilikia hoʻomanaʻo a hiki ke paʻakikī ke hōʻike i ko lākou mau manaʻo.
• Ke koko a me nā kīʻaha koko. Hiki i ka lupus ke alakaʻi i nā pilikia koko, me ka emi ʻana o ka nui o nā pūnaewele ʻulaʻula olakino (anemia) a me ka hoʻonui ʻia o ka pilikia o ke kahe koko a i ʻole ka hoʻopaʻa koko. Hiki nō hoʻi ke hana i ka mumū o nā kīʻaha koko.
• Na māmā. Ke loaʻa iā ʻoe ka lupus, e hoʻonui ʻia kou mau manawa e loaʻa ai ka mumū o ka papa o loko o ka umauma, kahi e hiki ai ke hana i ka ʻeha o ka hanu. Hiki nō hoʻi ke kahe koko i loko o nā māmā a me ka pneumonia.
• Na naʻau. Hiki i ka lupus ke hana i ka mumū o kou ʻiʻo naʻau, kou mau arteries a i ʻole ka membrane naʻau. E hoʻonui nui ʻia ka pilikia o ka maʻi cardiovascular a me nā hoʻouka naʻau.

He nui ka paʻakikī o ka ʻike ʻana i ka lupus no ka mea he ʻano like ʻole nā ​​hōʻailona a me nā hōʻailona mai ke kanaka a i ke kanaka. Hiki i nā hōʻailona a me nā hōʻailona o ka lupus ke loli i ka manawa a hui pū me nā mea o nā maʻi ʻē aʻe he nui.

ʻAʻohe hoʻokolohua hoʻokahi e hiki ke ʻike i ka lupus. ʻO ka hui pū ʻana o nā hoʻokolohua koko a me ka mimi, nā hōʻailona a me nā hōʻailona, ​​a me nā ʻike o ka nānā kino e alakaʻi i ka ʻike ʻana.

Hiki i nā hoʻokolohua koko a me ka mimi ke komo:

Inā manaʻo kāu kauka ua hoʻopilikia ka lupus i kou mau māmā a i kou naʻau paha, hiki iā ia ke manaʻo:

Hiki i ka lupus ke hōʻino i kou mau puʻupaʻa ma nā ʻano like ʻole, a hiki ke ʻokoʻa nā lāʻau lapaʻau, ma muli o ke ʻano o ka hōʻino e hana ʻia. I kekahi mau hihia, pono e hoʻokolohua i kahi ʻāpana liʻiliʻi o ka ʻiʻo puʻupaʻa e hoʻoholo i ka lāʻau lapaʻau maikaʻi loa. Hiki ke kiʻi ʻia ka ʻāpana me ka nila a ma o kahi ʻoki liʻiliʻi.

Hoʻokō ʻia ka biopsy ʻili i kekahi manawa e hōʻoia i ka ʻike ʻana o ka lupus e hoʻopilikia ana i ka ʻili.

• Helu koko piha. Ke ana nei kēia hoʻokolohua i ka nui o nā pūnaewele koko ʻulaʻula, nā pūnaewele koko keʻokeʻo a me nā platelets, a me ka nui o ka hemoglobin, kahi protein i nā pūnaewele koko ʻulaʻula. Hiki i nā hopena ke hōʻike iā ʻoe he anemia, kahi mea maʻamau i ka lupus. Hiki ke emi ka nui o nā pūnaewele koko keʻokeʻo a i ʻole nā ​​platelets i ka lupus pū kekahi.

• Ka nui o ka erythrocyte sedimentation. Ke hoʻoholo nei kēia hoʻokolohua koko i ka nui o ka hoʻonohonoho ʻana o nā pūnaewele koko ʻulaʻula i ka lalo o kahi tube i hoʻokahi hola. Hiki i ka nui wikiwiki ma mua o ka maʻamau ke hōʻike i kahi maʻi systemic, e like me ka lupus. ʻAʻole kūikawā ka nui o ka sedimentation no kekahi maʻi hoʻokahi. Hiki ke kiʻekiʻe inā loaʻa iā ʻoe ka lupus, kahi maʻi, kekahi kūlana inflammatory a i ʻole ka maʻi kanesa.

• Loiloi puʻupaʻa a me ke akepaʻa. Hiki i nā hoʻokolohua koko ke loiloi i ka hana maikaʻi ʻana o kou mau puʻupaʻa a me kou akepaʻa. Hiki i ka lupus ke hoʻopilikia i kēia mau kino.

• Urinalysis. Hiki i ka nānā ʻana i kahi ʻāpana o kou mimi ke hōʻike i ka nui o ka protein a i ʻole nā ​​pūnaewele koko ʻulaʻula i loko o ka mimi, kahi mea hiki ke hana inā ua hoʻopilikia ka lupus i kou mau puʻupaʻa.

• Hoʻokolohua antibody antinuclear (ANA). Ke hōʻike nei kahi hoʻokolohua maikaʻi no ka loaʻa ʻana o kēia mau antibodies - i hana ʻia e kou ʻōnaehana pale - i kahi ʻōnaehana pale i hoʻoulu ʻia. ʻOiai ʻo ka hapa nui o nā kānaka me ka lupus he hoʻokolohua antibody antinuclear (ANA) maikaʻi, ʻo ka hapa nui o nā kānaka me ka ANA maikaʻi ʻaʻole loaʻa iā lākou ka lupus. Inā he maikaʻi kāu hoʻokolohua no ANA, hiki i kāu kauka ke aʻo aku i ka hoʻokolohua antibody kikoʻī hou aku.

• X-ray umauma. Hiki i kahi kiʻi o kou umauma ke hōʻike i nā aka ʻano ʻole e hōʻike ana i ka wai a i ʻole ka mumū i kou mau māmā.

• Echocardiogram. Ke hoʻohana nei kēia hoʻokolohua i nā nalu kani e hana i nā kiʻi manawa maoli o kou naʻau e kuʻi ana. Hiki iā ia ke nānā i nā pilikia me kou mau valves a me nā ʻāpana ʻē aʻe o kou naʻau.

ʻO ke ʻano o ka mālama ʻana i ka lupus e hilinaʻi ana i kāu mau hōʻailona a me nā hōʻailona. ʻO ka hoʻoholo ʻana inā pono ʻoe e mālama ʻia a me nā lāʻau lapaʻau e hoʻohana ʻia e pono ai kahi kūkākūkā akahele e pili ana i nā pōmaikaʻi a me nā pilikia me kāu kauka.

Ke piʻi a emi mai kāu mau hōʻailona a me nā hōʻailona, hiki iā ʻoe a me kāu kauka ke ʻike e pono paha iā ʻoe ke hoʻololi i nā lāʻau lapaʻau a i ʻole nā ​​mea nui. ʻO nā lāʻau lapaʻau i hoʻohana pinepine ʻia e kaohi i ka lupus:

Biologics. He ʻano lāʻau lapaʻau ʻē aʻe, ʻo belimumab (Benlysta) i hāʻawi ʻia ma o ka intravenously, e hōʻemi pū ana i nā hōʻailona lupus i kekahi poʻe. ʻO nā hopena ʻaoʻao e komo pū ana me ka nausea, ka diarrhea a me nā maʻi. I nā manawa kūikawā, hiki ke ʻoi aku ka maikaʻi o ka ʻehaʻeha.

Hiki iā Rituximab (Rituxan, Truxima) ke pōmaikaʻi i kekahi poʻe i ʻole i kōkua nā lāʻau lapaʻau ʻē aʻe. ʻO nā hopena ʻaoʻao e komo pū ana me ka maʻi ʻili i ka intravenous infusion a me nā maʻi.

I nā hoʻokolohua klinika, ua hōʻike ʻia ʻo voclosporin he pono i ka mālama ʻana i ka lupus.

Ke noiʻi ʻia nei nā lāʻau lapaʻau ʻē aʻe e mālama i ka lupus, e komo pū ana me abatacept (Orencia), anifrolumab a me nā mea ʻē aʻe.

• Nā lāʻau lapaʻau anti-inflammatory nonsteroidal (NSAIDs). Hiki ke hoʻohana ʻia nā lāʻau lapaʻau anti-inflammatory nonsteroidal (NSAIDs) ma luna o ka counter, e like me naproxen sodium (Aleve) a me ibuprofen (Advil, Motrin IB, nā mea ʻē aʻe), e mālama i ka ʻeha, ka pehu a me ka wela e pili ana i ka lupus. Loaʻa nā NSAIDs ikaika ma o ka palapala kauoha. ʻO nā hopena ʻaoʻao o nā NSAIDs e komo pū ana me ke koko o ka ʻōpū, nā pilikia o ka puʻupaʻa a me ka hoʻonui ʻia o ka pilikia o nā pilikia o ka naʻau.
• Nā lāʻau antimalarial. ʻO nā lāʻau lapaʻau i hoʻohana pinepine ʻia e mālama i ka malaria, e like me hydroxychloroquine (Plaquenil), e hoʻopilikia i ka ʻōnaehana pale a hiki ke kōkua i ka hōʻemi ʻana i ka pilikia o nā lupus flares. Hiki i nā hopena ʻaoʻao ke komo pū me ka huhū o ka ʻōpū a, i nā manawa kūikawā loa, ka hōʻino ʻana i ka retina o ka maka. Paipai ʻia nā nānā maka maʻamau i ka wā e lawe ana i kēia mau lāʻau lapaʻau.
• Corticosteroids. Hiki iā Prednisone a me nā ʻano corticosteroids ʻē aʻe ke kūʻē i ka mumū o ka lupus. Hoʻohana pinepine ʻia nā nui o nā steroids e like me methylprednisolone (Medrol) e kaohi i ka maʻi koʻikoʻi e pili ana i nā puʻupaʻa a me ka lolo. ʻO nā hopena ʻaoʻao e komo pū ana me ka loaʻa kaumaha, ka maʻalahi o ka ʻeha, ka lahilahi o nā iwi, ke koko kiʻekiʻe, ka maʻi diabetes a me ka hoʻonui ʻia o ka pilikia o ka maʻi. Hoʻonui ka pilikia o nā hopena ʻaoʻao me nā nui kiʻekiʻe a me ka lōʻihi o ka mālama ʻana.
• Immunosuppressants. Hiki ke kōkua nā lāʻau lapaʻau e hoʻohaʻahaʻa i ka ʻōnaehana pale i nā hihia koʻikoʻi o ka lupus. ʻO nā laʻana e komo pū ana me azathioprine (Imuran, Azasan), mycophenolate (Cellcept), methotrexate (Trexall, Xatmep, nā mea ʻē aʻe), cyclosporine (Sandimmune, Neoral, Gengraf) a me leflunomide (Arava). Hiki i nā hopena ʻaoʻao ke komo pū me ka hoʻonui ʻia o ka pilikia o ka maʻi, ka hōʻino ʻana i ke ake, ka emi ʻana o ka hānau keiki a me ka hoʻonui ʻia o ka pilikia o ka maʻi kanesa.
• Biologics. He ʻano lāʻau lapaʻau ʻē aʻe, ʻo belimumab (Benlysta) i hāʻawi ʻia ma o ka intravenously, e hōʻemi pū ana i nā hōʻailona lupus i kekahi poʻe. ʻO nā hopena ʻaoʻao e komo pū ana me ka nausea, ka diarrhea a me nā maʻi. I nā manawa kūikawā, hiki ke ʻoi aku ka maikaʻi o ka ʻehaʻeha.

Hiki iā Rituximab (Rituxan, Truxima) ke pōmaikaʻi i kekahi poʻe i ʻole i kōkua nā lāʻau lapaʻau ʻē aʻe. ʻO nā hopena ʻaoʻao e komo pū ana me ka maʻi ʻili i ka intravenous infusion a me nā maʻi.

E mālama pono i kou kino inā loaʻa iā ʻoe ka lupus. Hiki i nā hana maʻalahi ke kōkua iā ʻoe e pale aku i nā hōʻailona o ka lupus a, inā loaʻa lākou, e hoʻomaʻamaʻa maikaʻi i nā hōʻailona a me nā ʻōuli āu e ʻike ai. E ho'āʻo e:

• E hele mau i ke kauka. ʻO ka hele mau ʻana i nā nānā ma mua o ka hele wale ʻana i ke kauka i ka wā e ʻino ai kou mau ʻōuli, hiki ke kōkua i kāu kauka e pale aku i nā hōʻailona, ​​a he mea pono ia i ka mālama ʻana i nā pilikia olakino maʻamau, e like me ke kaumaha, ka ʻai a me ka hoʻoikaika kino e hiki ke kōkua i ka pale ʻana i nā pilikia o ka lupus.
• E akahele i ka lā. No ka mea, hiki i ka mālamalama ultraviolet ke hoʻoulu i kahi hōʻailona, ​​e komo i nā lole pale - e like me ka pāpale, ka pālule lima lōʻihi a me nā pālule lōʻihi - a e hoʻohana i ka sunscreen me kahi kumu pale lā (SPF) o ka liʻiliʻi loa he 55 i kēlā me kēia manawa āu e hele ai i waho.
• E hoʻoikaika kino mau. Hiki i ka hoʻoikaika kino ke kōkua i ka hoʻoikaika ʻana i kou mau iwi, e hoʻemi i kou pilikia o ka maʻi naʻau a me ka hoʻoikaika ʻana i ka maikaʻi maʻamau.
• Mai puhi paka. Hoʻonui ka puhi paka i kou pilikia o ka maʻi cardiovascular a hiki ke hoʻoino i ka hopena o ka lupus ma kou naʻau a me nā kīʻaha koko.
• E ʻai i ka meaʻai olakino. Hoʻoikaika ka meaʻai olakino i nā hua, nā huaʻai a me nā huaola holoʻokoʻa. I kekahi manawa, loaʻa paha iā ʻoe nā palena ʻai, ʻoiai inā loaʻa iā ʻoe ke koko kiʻekiʻe, ka hōʻino ʻana o ka puʻupaʻa a i ʻole nā ​​pilikia gastrointestinal.
• E nīnau i kāu kauka inā pono ʻoe i nā mea hoʻohui o ka hua D a me ka calcium. Aia kekahi hōʻike e hōʻike ana he pono paha nā kānaka me ka lupus i ka hua D hoʻohui. Hiki i ka mea hoʻohui calcium ke kōkua iā ʻoe e hoʻokō i ka nui o ka ʻai i ʻōlelo ʻia i kēlā me kēia lā o 1,000 milligrams a 1,200 milligrams - ma muli o kou makahiki - e kōkua i ka mālama ʻana i kou mau iwi i ke olakino.