Lipodystrophy Yeura
Pfupiso
Chirwere cheWhipple chirwere chisingawanzoitika chemabhakitiriya chinonyanya kukanganisa majoini ako nehurongwa hwekudya. Chirwere cheWhipple chinokanganisa kugaya kwakajairwa nekukanganisa kupatsanurwa kwezvokudya, uye kukanganisa simba remumuviri wako rekugamuchira zvinovaka muviri, sezvakaita mafuta nemakhabohaidhiretsi.
Zviratidzo
Zviratidzo Zvakajairika nezvimwe Zvinoratidza
Zviratidzo nezvimwe zvinoratidza zvine chekuita nehurongwa hwekugaya zvinowanzoitika muWhipple chirwere uye zvinogona kusanganisira:
- Manyoka
- Marwadzo nekutambudzika kwemudumbu, izvo zvinogona kuipa mushure mekudya
- Kurasikirwa nehuremu, kunoenderana nekusakwanisa kwemuviri kunyura zvinovaka muviri
Zvimwe zviratidzo nezvimwe zvinoratidza zvinowanzoitika zvine chekuita neWhipple chirwere zvinosanganisira:
- Zvibhakera zvakaputika, kunyanya pamabvi, magaro nemabvi
- Kushaya simba
- Kushaya simba
- Anemia
Nguva yekunoona chiremba
Chirwere cheWhipple chinogona kutyisidzira hupenyu asi kazhinji chinoporedzwa. Taura nachiremba wako kana ukaona zviratidzo kana zviratidzo zvisinganzwisisike, zvakadai sekuderera kweuremu pasina tsananguro kana kurwadziwa kwemvere. Chiremba wako anogona kuita bvunzo kuti aone chikonzero chezviratidzo zvako.
Kunyangwe mushure mekunge chirwere chacho chaonekwa uye uri kugamuchira kurapwa,udza chiremba wako kana zviratidzo zvako zvisina kuvanduka. Dzimwe nguva kurapwa neantibiotic hakushande nekuti mabhakitiriya anoramba mushonga wauri kutora. Chirwere ichi chinogona kudzokazve, saka zvakakosha kutarisa zviratidzo zvinodzokazve.
Zvinokonzera
Chirwere cheWhipple chinokonzerwa nerudzi rwebhakitiriya rinonzi Tropheryma whipplei. Mabhakitiriya anokanganisa ganda remunhu mukati megurududu diki, achigadzira maronda madiki (ma lesions) mukati memadziro egurududu. Mabhakitiriya anokuvadzawo zvinhu zvidiki, zvakaita sehuremu (villi) zvinopfugama gurududu diki.
Hazvina kuzivikanwa zvakawanda nezvemabhakitiriya. Kunyangwe zvichitaridzika kuti zviri nyore kuwanikwa munzvimbo yakapoteredza, vanasayenzi havazivi kuti anobva kupi kana kuti anoparadzirwa sei kuvanhu. Hapasi munhu wese ane mabhakitiriya anorwara. Vamwe vanoongorora vanotenda kuti vanhu vane chirwere ichi vangave vane kushomeka kwemajini mukuita kwemasisitimu avo ekuzvidzivirira kunovakonzera kuti varware kana vakatarisana nemabhakitiriya.
Chirwere cheWhipple hachisi chinowanzoitika, chinotapura vanhu vashoma kupfuura 1 pamumamiriyoni emunhu.
Zvinhu zvinokonzera njodzi
Nekuita kuti zvishoma zvinonyatsozivikanwa nezve mabhakitiriya anokonzera chirwere cheWhipple, zvinokonzera chirwere ichi hazvina kuzivikanwa zvakajeka. Zvichienderana nemashoko aripo, zvinoita sekunge zvinonyanya kukanganisa:
- Varume vane makore makumi mana kusvika makumi matanhatu
- Vanhu vachena vekuNorth America neEurope
- Vafambi nevamwe vanhu vanoshanda kunze uye vane hukama hwakawanda nemarara nemvura yakasviba
Matambudziko
Mutsago wematumbu ako madiki une zvikamu zvidiki zvakaita sehuremu (villi) zvinobatsira muviri wako kuti utarise zvinovaka muviri. Chirwere cheWhipple chinokuvadza villi, zvichiita kuti kuitora zvinovaka muviri kuome. Kushayikwa kwezvinovaka muviri kunoitika kazhinji kune vanhu vane chirwere cheWhipple uye kunogona kukonzera kuneta, kushaya simba, kurasikirwa nehuremu uye kurwadziwa kwemunwe.
Chirwere cheWhipple chirwere chinokura uye chinogona kuuraya. Kunyange zvazvo chirwere ichi chisingawanzoitika, rufu rwakabatana naro richiri kunyorwa. Izvi zvinokonzerwa zvikuru nekurapa kwenguva refu uye kurapwa kwakakanganisika. Kazhinji rufu runokonzerwa nekupararira kwehutachiona kuCentral Nervous System, izvo zvinogona kukonzera kukuvara kusingaperi.
Kuongorora
Maitiro ekurapa chirwere cheWhipple anowanzo kusanganisira bvunzo idzi dzinotevera:
Biopsy. Danho rinokosha pakurapa chirwere cheWhipple kutora sampuro yetsinga (biopsy), kazhinji kubva pakavharwa kweura duku. Kuti uite izvi, chiremba wenyu anowanzoita upper endoscopy. Maitiro acho anoshandisa chubhu chakasimba, chinopindika (scope) chine chiedza nekamera yakabatanidzwa inopfuura mumuromo wako, pahuro, windpipe nemudumbu kuenda kuura duku. Scope inobvumira chiremba wako kuona nzira dzako dzekugaya nekutora sampuro dzetsoka.
Mukati memaitiro acho, vanachiremba vanobvisa sampuro dzetsoka kubva kunzvimbo dzakawanda muura duku. Chiremba anotarisa tishu iyi pasi pe microscope murabhoritari. Ano tarisa kuvapo kwemabhakitiriya anokonzera chirwere nemavanga avo (lesions), uye zvakanyanya kutarisa mabhakitiriya eTropheryma whipplei. Kana sampuro idzi dzetsoka dzisingasimbisire kurapwa, chiremba wenyu angatora sampuro yetsinga kubva ku lymph node yakakura kana kuita bvunzo dzakasiyana.
Mu zvimwe zviitiko, chiremba wenyu angakukumbira kuti umira kapusuru ine kamera duku. Kamera inogona kutora mifananidzo yenzira dzako dzekugaya kuti chiremba wako aione.
Bvunzo inobva kuDNA inozivikanwa se polymerase chain reaction, iripo mune dzimwe nzvimbo dzekurapa, inogona kuona mabhakitiriya eTropheryma whipplei mu sampuro dze biopsy kana sampuro dzemvura yemuzongoza.
- Kuongororwa kwemuviri. Chiremba wenyu anowanzo tanga nekuongororwa kwemuviri. Achatsvaka zviratidzo nezviratidzo zvinoratidza kuvapo kwechirwere ichi. Semuenzaniso, chiremba wenyu angatsvaka kusagadzikana kwemudumbu nekusviba kweganda, kunyanya pazvikamu zvemuviri wako zvinoratidzwa nezuva.
- Biopsy. Danho rinokosha pakurapa chirwere cheWhipple kutora sampuro yetsinga (biopsy), kazhinji kubva pakavharwa kweura duku. Kuti uite izvi, chiremba wenyu anowanzoita upper endoscopy. Maitiro acho anoshandisa chubhu chakasimba, chinopindika (scope) chine chiedza nekamera yakabatanidzwa inopfuura mumuromo wako, pahuro, windpipe nemudumbu kuenda kuura duku. Scope inobvumira chiremba wako kuona nzira dzako dzekugaya nekutora sampuro dzetsoka.
Mukati memaitiro acho, vanachiremba vanobvisa sampuro dzetsoka kubva kunzvimbo dzakawanda muura duku. Chiremba anotarisa tishu iyi pasi pe microscope murabhoritari. Ano tarisa kuvapo kwemabhakitiriya anokonzera chirwere nemavanga avo (lesions), uye zvakanyanya kutarisa mabhakitiriya eTropheryma whipplei. Kana sampuro idzi dzetsoka dzisingasimbisire kurapwa, chiremba wenyu angatora sampuro yetsinga kubva ku lymph node yakakura kana kuita bvunzo dzakasiyana.
Mu zvimwe zviitiko, chiremba wenyu angakukumbira kuti umira kapusuru ine kamera duku. Kamera inogona kutora mifananidzo yenzira dzako dzekugaya kuti chiremba wako aione.
Bvunzo inobva kuDNA inozivikanwa se polymerase chain reaction, iripo mune dzimwe nzvimbo dze kurapa, inogona kuona mabhakitiriya eTropheryma whipplei mu sampuro dze biopsy kana sampuro dzemvura yemuzongoza.
- Bvunzo dzeropa. Chiremba wenyu angarayirawo bvunzo dzeropa, senge kuverenga kweropa kwakakwana. Bvunzo dzeropa dzinogona kuona mamiriro ezvinhu akabatana nechirwere cheWhipple, kunyanya anemia, iyo kudonha kwehuwandu hwema cell matsvuku eropa, uye huwandu hushoma hwe albumin, puroteni iri muropa rako.
Kurapa
Kurapa chirwere cheWhipple kunoitwa neanitibayotiki, kana ari oga kana akasanganiswa, anogona kuparadza mabhakitiriya anokonzera hutachiona.
Kurapa kwenguva refu, kazhinji kwenguva yegore kana maviri, chinangwa chekuparadza mabhakitiriya. Asi kunyaradzwa kwezviratidzo kunouya nekukurumidza, kazhinji mukati mevhiki kana mbiri yokutanga. Vanhu vakawanda vasina matambudziko emuviri kana tsinga vanodzoka zvakakwana mushure mekupiwa mishonga yose yeanitibayotiki.
Pakusarudza mishonga yeanitibayotiki, vanachiremba vanowanzosarudza iyo inobvisa hutachiona mumatumbu maduku uye inopfuurawo rukoko rwe tishu rinopoteredza uropi hwako (blood-brain barrier). Izvi zvinoitwa kubvisa mabhakitiriya angave apinda mumuviri wako neuropi hwako.
Nekuda kwekuita kwenguva refu kweanitibayotiki, chiremba wako achada kutarisa mamiriro ako kuti aone kukura kwekudzivirira mishonga. Kana ukaora panguva yekurapa, chiremba wako anogona kuchinja mishonga yako yeanitibayotiki.
Muzviitiko zvizhinji, kurapwa kweWhipple chirwere kunotanga nemavhiki maviri kusvika mana e ceftriaxone kana penicillin inopiwa kuburikidza ne tsinga muruoko rwako. Mushure mekurapwa kwacho, iwe ungatora mushonga wemukanwa we sulfamethoxazole-trimethoprim (Bactrim, Septra) kwemakore rimwe kusvika maviri.
Migumisiro inogona kuitika ye ceftriaxone ne sulfamethoxazole-trimethoprim inosanganisira kuita allergic reaction, manyoka mashoma, kana kurutsa nekuvharuka.
Mishonga yakasiyana-siyana iyo yakaratidzwa sechinhu chinotsiva mune dzimwe nguva inosanganisira doxycycline yemukanwa (Vibramycin, Doryx, nezvimwe) yakasanganiswa nemushonga we antimalarial hydroxychloroquine (Plaquenil), iyo iwe ungada kutora kwemakore rimwe kusvika maviri.
Migumisiro inogona kuitika ye doxycycline inosanganisira kurasikirwa nechido chekudya, kurutsa, kurutsa uye kusagadzikana nezuva. Hydroxychloroquine inogona kukonzera kurasikirwa nechido chekudya, manyoka, kurwadziwa kwemusoro, marwadzo emudumbu uye kuzvidza.
Zviratidzo zvako zvinofanira kuvandudza mukati mevhiki imwe kusvika mbiri mushure mekutanga kurapwa kweanitibayotiki uye kuenda zvachose mukati memwedzi.
Asi kunyangwe zviratidzo zvichishanda nekukurumidza, bvunzo dze laboratori dzinogona kuratidza kuvapo kwemabhakitiriya kwemakore maviri kana kupfuura mushure mekutanga kutora mishonga yeanitibayotiki. Kuongororwa kwekuenderera mberi kuchabatsira chiremba wako kuona kana iwe unogona kurega kutora mishonga yeanitibayotiki. Kuongororwa nguva dzose kunogona kuonawo kukura kwekudzivirira mushonga chaiwo, kazhinji kunoratidzwa nekushaiwa kwekuvandudzwa kwezviratidzo.
Kunyangwe mushure mekurapwa kwakabudirira, chirwere cheWhipple chinogona kudzokazve. Vanachiremba vanowanzokurudzira kuongororwa nguva dzose. Kana wakamboona kudzokazve, iwe uchada kudzokorora kurapwa kweanitibayotiki.
Nekuda kwekusagadzikana kwekutora zvinovaka muviri zvine chekuita nechirwere cheWhipple, chiremba wako anogona kukurudzira kutora zvinowedzerwa zvevhitamini nemineral kuti uve nechokwadi chekudya kwakakwana. Muviri wako ungada vhitamini D yakawedzerwa, folic acid, calcium, iron uye magnesium.
Kugadzirira musangano wako
'Kana uine zviratidzo nezvikonzero zvinozivikanwa nechirwere cheWhipple, gara wakaita appointment nachiremba wako. Chirwere cheWhipple chinonzwisisika, uye zviratidzo nezvikonzero zvinogona kuratidza zvimwe zvirwere zvakajairika, saka zvinogona kuoma kuzodziona. Somugumisiro, kazhinji chinoonekwa mumamiriro ayo ekupedzisira. Zvisinei, kuonekwa kwekukurumidza kunoderedza njodzi yemhedzisiro yakakomba yehutano inobatanidzwa nekusaita kurapwa kwechirwere ichi.\n\nKana chiremba wako asingavimbi nezvaari kuona, anogona kukutumira kune chiremba anoziva nezvechirwere chekudya kana kune mumwe nyanzvi zvichienderana nezviratidzo zvaunazvo.\n\nHeano mamwe mashoko anokubatsira kugadzirira appointment yako, uye kuziva kuti chii chaunofanira kutarisira kubva kuchiremba wako.\n\nKune zviratidzo nezvikonzero zvinozivikanwa nechirwere cheWhipple, mimwe mibvunzo yekubvunza chiremba wako inosanganisira:\n\nUsambofa wakashamisika kubvunza chero mibvunzo ipi zvayo yaunayo.\n\nChiremba anoonekwa nechirwere cheWhipple anogona kubvunza mibvunzo yakawanda, yakadai se:\n\n* Nyora zviratidzo zvako, kusanganisira paunotanga kuzviona uye kuti zvakashanduka sei kana kuti zvakakomba sei nekufamba kwenguva.\n* Nyora ruzivo rwako rwakakosha rwehutano, kusanganisira mamwe mamiriro awo wakazivikanwa uye mazita emishonga yose, mavhitamini nezvinowedzerwa zvaunotora.\n* Nyora ruzivo rwako rwakakosha rwega, kusanganisira chero shanduko dzichangobva kuitika kana kuti zvinhu zvinokunetsa muhupenyu hwako. Aya maitiro anogona kubatana nezviratidzo zvechirwere chekudya.\n* Tora nhengo yemhuri kana shamwari pamwe chete, kana zvichibvira. Mumwe munhu anokufambidzana naye anogona kuyeuka chimwe chinhu chawakanganwa kana kuti chawakakanganwa.\n* Nyora mibvunzo yekubvunza chiremba wako. Kugadzira runyorwa rwako rwemibvunzo usati watanga kunogona kukubatsira kuti ushandise nguva yako zvakanaka nechikura wako.\n\n* Chii chinonyanya kukonzera mamiriro angu?\n* Kune mamwe makonzero ekugona mamiriro angu?\n* Ndeapi bvunzo dzekuongorora dzandinoda?\n* Ndeipi nzira yekurapa yaunokurudzira?\n* Ndine mamwe mamiriro ehutano. Ndingazviita sei pamwe chete?\n* Munguva pfupi sei unotarisira kuti zviratidzo zvangu zvivandudze nekurapwa?\n* Kwenguva yakareba sei ndichafanira kutora mishonga?\n* Ndine njodzi yekukanganiswa nechirwere ichi?\n* Ndine njodzi yekudzoka?\n* Kazhinji sei uchafanira kundiona kuti uongorore?\n* Ndinofanira kuchinja kudya kwangu?\n* Ndinofanira kutora zvinowedzerwa zvekudya here?\n* Kune shanduko dzehupenyu dzandingaita kuti ndidzikise kana kuti ndidzore zviratidzo zvangu?\n\n* Ndeapi zviratidzo zvako, uye wakazviona rini?\n* Zviratidzo zvako zvakakomba sei nekufamba kwenguva?\n* Zviratidzo zvako zvinonyanya kuipa here mushure mekudya?\n* Wakaderera uremu usina kuedza here?\n* Mabvi ako anorwadza here?\n* Unonzwa wakaneta here kana kuti uneta?\n* Une dambudziko rekufema kana kuti kukosora here?\n* Wakava nekusanzwisisa kana kuti matambudziko ekurangarira here?\n* Wakacherechedza matambudziko nemaziso ako kana kuti kuona here?\n* Pane munhu ari pedyo newe ane zviratidzo zvakafanana here munguva pfupi yapfuura?\n* Wakazivikanwa nemamwe mamiriro ehutano, kusanganisira kusagadzikana kwechikafu here?\n* Une nhoroondo yemhuri yezvirwere zvematumbo kana kuti kenza yecolon here?\n* Mishonga ipi yaunotora, kusanganisira mishonga inorayirwa nechikura uye mishonga isina kurairwa, mavhitamini, zvinomera, nezvinowedzerwa?\n* Une kusagadzikana nemishonga ipi neipi here?'
Chiziviso: August ipuratifomu yemashoko ehutano uye mhinduro dzayo haisi zano rekurapa. Gara uchibvunza nyanzvi yezvekurapa ine rezinesi pedyo newe usati waita chero shanduko.
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