Ipankriyasi Yokuzenzela

I-pancreatic yokuqina okuzenzakalelayo iwukuvuvukala e-pancreas. Kungase kubangelwe yi-immune system ehlasela i-pancreas. I-pancreatic yokuqina okuzenzakalelayo ibizwa nangokuthi yi-AIP. Kunobukhulu obu-2 be-AIP obuqanjwe manje, uhlobo 1 nohlobo 2.

Uhlobo 1 lwe-AIP lubizwa ngokuthi yi-IgG4-related disease (IgG4-RD). Lolu hlobo luhlala luthinta izitho eziningi, kufaka phakathi i-pancreas, ama-bile duct e-liver, ama-salivary glands, ama-kidneys nama-lymph nodes.

Uhlobo 2 lwe-AIP lubonakala luthinta kuphela i-pancreas, nakuba cishe ingxenye yesithathu yabantu abane-type 2 AIP bane-inflammatory bowel disease ehlobene nayo.

Uhlobo 1 lwe-AIP lungase luqondiwe ngokungalungile njengomdlavuza we-pancreatic. Lezi zimo ezimbili zinezimpawu ezifanayo, kodwa ukwelashwa okuhlukile kakhulu, ngakho kubalulekile kakhulu ukuhlukanisa enye kwenye.

I-pancreatic yokuzenzela, ebizwa nangokuthi yi-AIP, kunzima ukuyihluza. Ngokuvamile, ayibangeli zimpawu. Izimpawu ze-AIP uhlobo 1 zifana nezomdlavuza we-pancreas. Izimpawu zomdlavuza we-pancreas zingafaka: Ukwelula komchamo. Izisu ezimhlophe noma izisu ezinyakazayo eceleni. Isikhumba nemihlobiso emhlophe, okuthiwa yi-jaundice. Ubuhlungu esiswini sakho esiphezulu noma engxenyeni ephakathi yomhlane wakho. Ukuhlanza nokugabha. Ubuthakathaka noma ukukhathala okukhulu. Ukwehluleka kokudla noma imizwa yokugcwaliswa. Ukwehluleka kwesisindo ngaphandle kwesizathu esaziwayo. Uphawu oluvamile kakhulu lwe-AIP uhlobo 1 yi-jaundice engahlungu. Cishe u-80% wabantu abane-AIP uhlobo 1 bane-jaundice engahlungu. Lokhu kubangelwa yizindawo ezivinjiwe ze-bile. Abantu abane-AIP uhlobo 2 bangaba nezimo eziphindaphindayo ze-pancreatitis ebukhali. Ubuhlungu esiswini esiphezulu, uphawu oluvamile lomdlavuza we-pancreas, luvamile ukungabikho kwi-pancreatitis yokuzenzela. Ukwahluka phakathi kwe-AIP uhlobo 1 nohlobo 2 yi: Ku-AIP uhlobo 1, isifo singathinta ezinye izitho ngaphandle kwe-pancreas. I-AIP uhlobo 2 ithinta kuphela i-pancreas. I-AIP uhlobo 2 ihambisana nesimo esinye sokuzenzela esibizwa ngokuthi yi-inflammatory bowel disease. I-AIP uhlobo 1 ikhuthaza amadoda esikhathini sesithupha kuya kwesikhombisa sokuphila. I-AIP uhlobo 2 ithinta amadoda nabesifazane ngokulinganayo futhi ine-age of onset encane uma iqhathaniswa ne-AIP uhlobo 1. I-AIP uhlobo 1 inamathuba amaningi okuphinda ibuyele emuva ngemuva kokuba ukwelashwa kuye kwaqediwa. I-pancreatitis yokuzenzela ngokuvamile ayibangeli zimpawu. Noma kunjalo, bheka ochwepheshe bezempilo, uma une-weight loss engachazwanga, ubuhlungu besisu, i-jaundice noma ezinye izimpawu ezikukhathazayo.

I-pancreatic yokuqina komzimba ngokuvamile ayibangeli lutho. Kodwa-ke, bona uchwepheshe wezempilo uma ulahlekelwa yisindo ngaphandle kwesizathu, ubuhlungu besisu, isiyezi noma ezinye izimpawu ezikukhathazayo.

Odokotela abazi ukuthi yini ebangela i-autoimmune pancreatitis, kodwa kukholelwa ukuthi ibangelwa yisistimu yomzimba yokukhusela ekuhlaseleni izicubu zomzimba eziphilile. Lokhu kuyaziwa njengesiifo se-autoimmune.

Izinhlobo ezimbili ze-AIP zenzeka ngokuthi kunezinga elikhulu noma elincane kwezinye izingxenye zezwe. E-United States, cishe amaphesenti angu-80 abantu abane-autoimmune pancreatitis, okuthiwa futhi yi-AIP, banohlobo 1.

Abantu abane-AIP yohlobo 1 ngokuvamile:

• Baneminyaka engaphezu kuka-60.
• Bangabesilisa.

Abantu abane-AIP yohlobo 2:

• Bavame ukuba seminyakeni eyishumi noma emibili abancane kunalabo abanehlobo 1.
• Bafana nokuthi babe ngabesifazane njengoba bengamadoda.
• Banesiguli esikhulu sokuba nesifo sokuvuvukala sezisu, njengokuqunjelwa okuvuvukayo.

I-pancreatic yokuqina kwe-autoimmune ingabangela izinkinga ezahlukene.

• Ukwehluleka kokukhipha kwe-pancreatic exocrine. I-AIP ingathinta ikhono le-pancreas yakho lokwenza ama-enzyme anele. Izimpawu zingafaka isisu sohudo, ukulahlekelwa isisindo, isifo samathambo esingokwemetabolic, kanye nokungahlangabezani kwamalwimi noma amaminerali.
• Ubuhlungu bezinhlungu. Ngenxa yokuthi i-pancreas iwumzimba okhiqiza i-insulin, ukulimala kwayo kungabangela ubuhlungu bezinhlungu. Ungadinga ukwelashwa ngemithi yomlomo noma i-insulin.
• Ukunciphisa kwe-pancreatic ne-bile duct, okuthiwa yi-stricture.
• Ukubola kwe-pancreatic noma amatshe.

Izindlela zokwelapha i-pancreatitis yokuqina kwe-autoimmune, njengokusetshenziswa kwe-steroid isikhathi eside, zingabangela izinkinga. Noma kunjalo, ngisho nalolu hlobo lwezinkinga, abantu abaphathwa nge-pancreatitis yokuqina kwe-autoimmune banesikhathi esilinganayo sokuphila.

Ayikho inhlangano eqinisekisiwe phakathi kwe-AIP ne-cancer ye-pancreatic.

I-pancreatic yomzimba zinzima ukuyihluza, ngoba izimpawu zayo zifana kakhulu nezomdlavuza we-pancreas. Kodwa-ke, ukuxilongwa okuchaneka kubaluleke kakhulu. Umdlavuza ongaxilongwanga ungabangela ukulimala noma ukungatholi ukwelashwa okudingekayo.

Abantu abane-AIP bavame ukukhula okukhulu kwe-pancreas, kodwa bangase babe ne-mass e-pancreas. Ukuze uthole ukuxilongwa okuqondile futhi unqume uhlobo lwe-AIP, ukuhlolwa kwegazi nokwenza izithombe kuyadingeka.

Alukho uvivinyo olulodwa noma uphawu oluqondile oluhlonza i-pancreatitis yomzimba. Iziqondiso ezinconyiwe zokuxilongwa zisebenzisa ukusetshenziswa kwezithombe, ukuhlolwa kwegazi nemiphumela ye-biopsy.

Ukuhlolwa okuqondile kungafaka:

• Ukuhlolwa kwezithombe. Ukuhlolwa kwe-pancreas yakho namanye amalungu kungafaka i-CT, i-MRI, i-ultrasound ye-endoscopic (EUS) ne-endoscopic retrograde cholangiopancreatography (ERCP).
• Ukuhlolwa kwegazi. Ungase ube novivinyo lokuhlola amazinga aphezulu e-immunoglobulin ebizwa nge-IgG4. I-IgG4 ikhiqizwa yisisu sakho sokuvikela. Abantu abane-type 1 AIP bavame ukuba namanani aphezulu e-IgG4 egazini labo. Abantu abane-type 2 AIP ngokuvamile abanawo.

Kodwa-ke, ukuhlolwa okuhle akukho okusho ukuthi une-disease. Inani elincane labantu abangenayo i-pancreatitis yomzimba, okuhlanganisa abanye abane-cancer ye-pancreas, nabo banamanani aphezulu e-IgG4 egazini labo.

• I-biopsy yekhotha ye-endoscopic. Kulolu vi vinyo, ochwepheshe bezokwelapha abizwa nge-pathologist bahlola isampula yethishu ye-pancreas elabhoratri. I-AIP inokubonakala okuhlukile okungabonakala kalula ngaphansi komkhiqizo ngochwepheshe we-pathologist. Umphako omncane obizwa nge-endoscope ufakwa ngomlomo esiswini, oqondiswa yi-ultrasound. Isampula yethishu bese isuswa e-pancreas usebenzisa inhlanzi ekhethekile.

Inselele ukufumana isampula yethishu enkulu ngokwanele yokutadisha, kunokuba kube yizicubu ezimbalwa nje. Le nqubo ayitholakali kabanzi, futhi imiphumela ingase ingabi yeqiniso.

• Uvivinyo lwe-steroid. I-pancreatitis yomzimba ngokuvamile iphendula kuma-steroids; ochwepheshe bezempilo ngezinye izikhathi basebenzisa inkambo yokuhlolwa yaleli dwel ekuqinisekiseni ukuxilongwa. Kodwa-ke, le yindlela kufanele yenziwe ngaphansi kwesiqondiso sochwepheshe. Kufanele isetshenziswe kancane futhi yenziwe kuphela uma kunobubufakazi obuqinile bokusekela ukuxilongwa kwe-pancreatitis yomzimba. Ukuphendula kwe-corticosteroids kuqalwa yi-CT nokuthuthukiswa kwamanani e-serum IgG4.

Ukuhlolwa kwegazi. Ungase ube novivinyo lokuhlola amazinga aphezulu e-immunoglobulin ebizwa nge-IgG4. I-IgG4 ikhiqizwa yisisu sakho sokuvikela. Abantu abane-type 1 AIP bavame ukuba namanani aphezulu e-IgG4 egazini labo. Abantu abane-type 2 AIP ngokuvamile abanawo.

Kodwa-ke, ukuhlolwa okuhle akukho okusho ukuthi une-disease. Inani elincane labantu abangenayo i-pancreatitis yomzimba, okuhlanganisa abanye abane-cancer ye-pancreas, nabo banamanani aphezulu e-IgG4 egazini labo.

I-biopsy yekhotha ye-endoscopic. Kulolu vi vinyo, ochwepheshe bezokwelapha abizwa nge-pathologist bahlola isampula yethishu ye-pancreas elabhoratri. I-AIP inokubonakala okuhlukile okungabonakala kalula ngaphansi komkhiqizo ngochwepheshe we-pathologist. Umphako omncane obizwa nge-endoscope ufakwa ngomlomo esiswini, oqondiswa yi-ultrasound. Isampula yethishu bese isuswa e-pancreas usebenzisa inhlanzi ekhethekile.

Inselele ukufumana isampula yethishu enkulu ngokwanele yokutadisha, kunokuba kube yizicubu ezimbalwa nje. Le nqubo ayitholakali kabanzi, futhi imiphumela ingase ingabi yeqiniso.