Ukuhlushwa Okuvamile Kokungabi Nabukhali Bomzimba: Izimpawu, Izimbangela, Nokwelashwa

Ukuhlushwa okuvamile kokungabi nabukhali bomzimba (CVID) kuyisimo lapho izingxube zomzimba wakho zingakhiqizi ama-antibodies anele ukulwa nokutheleleka ngokuphumelelayo. Cabanga ngama-antibodies njengabaphathi bekhwalithi bomzimba wakho ababona futhi bahlasele izinzwa eziyingozi njengebhaktheriya nezinambuzane.

Lesi simo sithinta abantu abangaba ngu-1 ku-25,000, okwenza kube yisifo esibucayi kakhulu sokungabi nabukhali bomzimba esitholakala kubantu abadala. Nakuba kungase kuzwakale kuyesabekayo, abantu abaningi abane-CVID baphila impilo egcwele, esebenzayo ngokunakekelwa komtholampilo okufanele nokwelashwa.

Iyini i-Common Variable Immunodeficiency?

I-CVID kwenzeka lapho izingxube zomzimba wakho zingakhiqizi ama-immunoglobulins anele, okuyizimpawu eziphethe ama-antibodies akho okulwa nokutheleleka. Umuthi wakho wenza izinhlobo eziningana zalezi zimpawu, kodwa ku-CVID, amazinga aphansi kakhulu kunokujwayelekile.

Igama elithi "variable" egazini libonisa ukuthi lesi simo sithinta kanjani umuntu ngamunye. Abanye abantu bahlushwa ukutheleleka okuvamile, kanti abanye bangaba nezinkinga zokungabi nabukhali bomzimba noma izinkinga zokugaya ukudla. Ubukhulu nezimpawu zingase zihluke kakhulu kumuntu ngamunye, ngisho nasemhlabeni omkhulu.

Abantu abaningi abane-CVID baqaphela eminyakeni yabo engu-20 noma engu-30, nakuba kungatholakala ebuntwaneni noma kamuva ekuphileni. Isimo sihlala njalo, okusho ukuthi siphila impilo yonke, kodwa siphatheka kakhulu ngokusekelwa komtholampilo okufanele.

Ziyini izimpawu ze-Common Variable Immunodeficiency?

Isimpawu esivamile ongayibona ukuthi ugula kaningi kunokujwayelekile, ikakhulukazi ngezifo zokuphefumula. Lezi azikona nje izikhathi ezijwayelekile - zivame ukuba zimbi kakhulu, zihlale isikhathi eside, futhi zibuyele kaningi.

Nazi izimpawu eziyinhloko abantu abane-CVID abazibonayo:

• Ukutheleleka okuvamile kwesinusesi okuhlala kubuyela
• I-pneumonia noma i-bronchitis ephindaphindayo
• Ukutheleleka okuhlala njalo kwezindlebe
• I-diarrhea ehlala njalo noma izinkinga zokugaya ukudla
• Ama-lymph nodes avuvukile angapheli
• Ukukhathala okungapheli ngokuphumula
• Ukutheleleka kwesikhumba noma izikhumba

Abanye abantu baphuthuma izimpawu zokungabi nabukhali bomzimba, lapho izingxube zomzimba zihlukanisa izicubu eziphilile. Lokhu kungase kubonakale njengokuhlunguluka kwamajozi, izinkinga zesikhumba, noma izifo zegazi.

Emacaleni amancane, ungase uhlushwe yizinkinga ezingathi sína njengokulima kwezitho zokuphefumula noma izinkinga zesibindi. Lezi zivame ukukhula ngokuhamba kwesikhathi uma ukutheleleka kungalawulwa kahle, kungakho ukuxilongwa nokwelashwa kwasekuqaleni kubalulekile kangaka.

Yini ebangela i-Common Variable Immunodeficiency?

Imbangela eqondile ye-CVID ayiqondakali ngokuphelele, kodwa abacwaningi bayazi ukuthi ihilela izinkinga zendlela izingxube zomzimba zixhumana ngayo futhi zisebenzisana. Amaseli akho e-B, abhekene nokwenza ama-antibodies, awasebenzi kahle noma angakhuli amaseli akhiqiza ama-immunoglobulins.

I-genetics idlala indima ezimweni eziningi. Cishe u-10-20% wabantu abane-CVID banezihlobo ezine-condition noma enye into yokungabi nabukhali bomzimba. Noma kunjalo, izimo eziningi zibonakala zikwenzeka ngokungahleliwe ngaphandle komlando omkhulu womndeni.

Osayensi bathole ama-genes amaningana angase ahlanganyele ku-CVID uma ashintshiwe noma eguqukile. Lezi genes ngokuvamile zisiza ukulungisa umsebenzi wezingxube zomzimba, kodwa uma zingasebenzi kahle, ukukhiqizwa kwama-antibodies kuyahlupheka.

Izici zezindawo ezingase futhi zivuselele i-CVID kubantu abathintekayo ngokufanele. Abanye abacwaningi bacabanga ukuthi ukutheleleka okukhethekile kwezinambuzane noma ezinye izinto ezingase zibangele lesi simo, nakuba lokhu kungafakazelwe.

Nini okufanele ubone udokotela nge-Common Variable Immunodeficiency?

Kufanele ucabange ukubona udokotela uma ugula kaningi ngokungajwayelekile, ikakhulukazi ngezifo zokuphefumula ezihlala njalo. Qaphela uma unezifo ezingaphezu kwezine kuya kweziyisithupha ngonyaka ezidinga ama-antibiotics.

Ezinye izimpawu zokuqaphela zihlanganisa ukutheleleka okungaphenduli kahle ekwelapheni okujwayelekile noma okuhlala kubuyela endaweni efanayo. Isibonelo, uma une-pneumonia izikhathi eziningi noma ukutheleleka okuhlala njalo kwesinusesi okungapheli.

Ungalindi uma uhlushwa yizinkinga zokugaya ukudla ezihlala njalo kanye nokutheleleka okuvamile. I-diarrhea ehlala njalo, ukwehla kwesisindo okungachazeki, noma izinkinga zesisu ezihlala njalo kanye nokutheleleka okuphindaphindayo kufanele kuhlolwe ngudokotela.

Uma unemlando womndeni wokungabi nabukhali bomzimba futhi uqaphela lezi zindlela, kubalulekile ukukhuluma nodokotela wakho. Ukuxilongwa kwasekuqaleni kungavimbela izinkinga futhi kuthuthukise kakhulu ikhwalithi yempilo yakho.

Ziyini izici ezingase zikubeke engozini ye-Common Variable Immunodeficiency?

Ukuqonda izici zakho ezingase zikubeke engozini kungakusiza wena nodokotela wakho ukuthi nibone i-CVID ngokushesha. Umlando womndeni yiyona nto ebaluleke kakhulu ekubekweni engozini, njengoba isimo singase sihambe emindenini ngisho noma imbangela ye-genetic engaziwa.

Nazi izici eziyinhloko ezingase zikubeke engozini okumele uzibone:

• Ukuba nezihlobo eziseduze ezine-CVID noma enye into yokungabi nabukhali bomzimba
• Ukuxilongwa ngezifo zokungabi nabukhali bomzimba njenge-rheumatoid arthritis noma i-inflammatory bowel disease
• Ukuba nezinguquko ezithile ze-genetic ezithinta umsebenzi wezingxube zomzimba
• Ukuba ngowesizwe saseYurophu (nakuba i-CVID ithonya wonke amaqembu ezizwe)
• Ubudala - nakuba kungase kwenzeke kunoma yiliphi iminyaka, ukuxilongwa okuningi kwenzeka phakathi kweminyaka engu-20-40

Kubalulekile ukukhumbula ukuthi ukuba nezici ezingase zikubeke engozini akusho ukuthi uzophumelela ngokuqinisekile i-CVID. Abantu abaningi abanezici ezingase zikubeke engozini abaphuthumi lesi simo, kanti abanye abangenazo izici ezingabonakali baphuthuma.

Ubulili abubonakali bubalulekile, njengoba i-CVID ithonya amadoda nabesifazane ngokulinganayo. Isimo asithwali, ngakho awukwazi ukulithatha komunye umuntu.

Ziyini izinkinga ezingase zenzeke nge-Common Variable Immunodeficiency?

Nakuba i-CVID ilawuleka, ukuqonda izinkinga ezingase zenzeke kusiza ukwazi ukuthi yini okumele uyibone nokuthi kungani ukwelashwa kubalulekile kangaka. Izinkinga eziningi zikhula uma ukutheleleka kungalawulwa kahle ngokuhamba kwesikhathi.

Izinkinga ezivamile zihlanganisa:

• Ukonakala okuhlala njalo kwezitho zokuphefumula ngenxa yokutheleleka okuphindaphindayo kokuphefumula
• Ukonakala okuhlala njalo kwesinusesi okuholela ezinkingeni eziqhubekayo
• Izinkinga zesisu ezihlanganisa i-inflammatory bowel disease
• Izifo zokungabi nabukhali bomzimba ezithinta izitho ezahlukene
• Isibungu noma isibeletho esikhulu
• Ukungena engozini enkulu yezinye izifo zomdlavuza, ikakhulukazi i-lymphoma

Izinkinga ezingavamile kodwa ezingathi sína zihlanganisa ukwenzakala okukhulu kwezitho zokuphefumula okuthiwa yi-bronchiectasis, okwenza ukuphefumula kube nzima. Abanye abantu bakhiqiza ama-granulomas, okuyizinto ezincane ezivuvukayo ezingase zikhiqizwe ezihlokweni ezahlukene.

Izindaba ezinhle ukuthi ngokwelashwa okufanele nokubhekwa, abantu abaningi abane-CVID bangavimbela noma banciphise lezi zinkinga. Ukunakekelwa komtholampilo okuvamile nokuvimbela ukutheleleka kuyisihluthulelo sokulondoloza impilo enhle.

I-Common Variable Immunodeficiency ixilongwa kanjani?

Ukuxilongwa kwe-CVID kuqala ngudokotela wakho ebuyekeza umlando wakho wezokwelapha kanye nendlela yokutheleleka oye waba nayo. Uzothanda ukwazi ngokuvamile, ubukhulu, nohlobo lokutheleleka oye waba nalo.

Ivivinyo eliyinhloko lokuxilonga lilinganisa amazinga akho e-immunoglobulin ngokuhlolwa okulula kwegazi. Udokotela wakho uzohlola amazinga e-IgG, IgA, ne-IgM - izinhlobo eziyinhloko zama-antibodies umzimba wakho okhiqizayo. Ku-CVID, la mazinga aphansi kakhulu kunokujwayelekile.

Udokotela wakho angase futhi ahlole ukuthi izingxube zomzimba wakho ziphendula kanjani ezitsheni zokugcoba. Uzokunika izitshi zokugcoba ezithile bese ehlola ukuthi umzimba wakho ukhumbula ama-antibodies ngempendulo. Ukungaphenduli kahle noma ukungabi khona kwama-antibodies kusiza ukuqinisekisa ukuxilongwa.

Ezinye izivivinyo zingase zihlanganise ukubheka inani lamaseli e-B namaseli e-T kanye nomsebenzi. Lezi zivivinyo zisiza udokotela wakho ukuthi aqonde ukuthi izingxube zomzimba zakho zithinteka kanjani futhi akhiphe ezinye izimo.

Ukuhlolwa kwe-genetic ngezinye izikhathi kunconywa, ikakhulukazi uma unezihlobo ezine-immune deficiencies. Nakuba kungadingeki ekuxilongweni, kungase kunikeze ulwazi oluwusizo ekucwaningeni komndeni nasezinqumweni zokwelapha.

Iyini ukwelashwa kwe-Common Variable Immunodeficiency?

Ukwelashwa okuyinhloko kwe-CVID yilokhu okuthiwa yi-immunoglobulin replacement therapy, enikeza umzimba wakho ama-antibodies awukwazi ukuzenza. Lokhu kwelashwa kuphumelela kakhulu futhi kunganciphisa kakhulu izinga lokutheleleka.

I-immunoglobulin therapy inganikezwa ngezindlela ezimbili. I-Intravenous immunoglobulin (IVIG) inikezwa nge-IV njalo ngemva kwamasonto angu-3-4, ngokuvamile esikhungweni sezokwelapha. I-Subcutaneous immunoglobulin (SCIG) ihlanganiswa phansi kwesikhumba masonto onke noma ngemva kwamasonto amabili futhi ngokuvamile ingenziwa ekhaya.

Udokotela wakho uzohlangana nawe ukuthola umthamo ofanele nesheduli. Abantu abaningi baqala ukuzizwa bephilile ngaphakathi kwamasonto ambalwa ngemuva kokuqala ukwelashwa, ngokutheleleka okuncane kanye namazinga amandla athuthukisiwe.

Ama-antibiotics adlala indima ebalulekile ekuphatheni i-CVID. Udokotela wakho angase awanikele esimweni sokuqala sokutheleleka noma ngisho nokuvimbela uma uthanda izinhlobo ezithile zokutheleleka. Abanye abantu bazuza ekwelapheni kwama-antibiotics isikhathi eside.

Ezinye izindlela zokwelapha zingase zihlanganise imithi yokulawula izimpawu zokungabi nabukhali bomzimba uma zikhula. Udokotela wakho uzokubheka njalo futhi alungise ukwelashwa njengoba kudingeka ukuze uhlale uphilile ngangokunokwenzeka.

Indlela yokuphatha i-Common Variable Immunodeficiency ekhaya?

Ukuphila kahle nge-CVID kuhilela ukuthatha izinyathelo zokuqapha ukuvimbela ukutheleleka nokugcina impilo yakho yonke. Imikhuba emihle yokuhlanzeka iba yibaluleke nakakhulu lapho izingxube zomzimba zakho zidinga ukusekelwa okwengeziwe.

Ukuhlanza izandla yiyona ndlela yakho yokuqala yokuzikhusela. Geza izandla zakho kaningi ngensipho namanzi okungenani imizuzwana engu-20, ikakhulukazi ngaphambi kokudla, ngemuva kokusebenzisa igumbi lokugezela, nangemuva kokuba ezindaweni zomphakathi.

Hlala ugcine izitshi zokugcoba, kodwa sebenzisana eduze nodokotela wakho ngezona zifanele kuwe. Izitshi zokugcoba eziningi ezingaphilile ziyaphilile, kodwa izitshi zokugcoba eziphilayo ngokuvamile ziqalekisiwe kubantu abane-CVID.

Nazi izindlela eziyisihluthulelo zokuphatha ekhaya:

• Gcina ukudla okunempilo okugcwele izithelo, imifino, namaprotheni ahlanzekile
• Thola ubuthongo obanele - zama amahora angu-7-9 ngobusuku
• Zivocavoca njalo, kodwa gwema ukukhathala kakhulu
• Lawula ukucindezeleka ngezindlela zokuphumula noma ngokwelashwa
• Gwema izixuku ngesikhathi sesizini ye-flu uma kungenzeka
• Ungabelani ngezinto zakho siqu njengezibulali zamazinyo noma izinkomishi zokupheka

Qaphela umzimba wakho futhi ungawagcini ama-signs okuqala kokutheleleka. Uma uqala ukwelashwa kokutheleleka ngokushesha, imiphumela yakho izoba ngcono.

Kufanele ulungiselele kanjani i-appointment yakho nodokotela?

Ukulungiselela i-appointment yakho kusiza ukuqinisekisa ukuthi uthola okuningi ngesikhathi sakho nomhlinzeki wakho wezokunakekelwa kwezempilo. Qala ngokugcina irekhodi lemininingwane yezimpawu zakho, ukutheleleka, nokuthi uzizwa kanjani usuku nosuku.

Bhala zonke izifo oye waba nazo ngonyaka odlule, kuhlanganise nokuthi zenzeke nini, ukwelashwa oye wakuthola, nokuthi zihlale isikhathi esingakanani. Lolu lwazi lusiza udokotela wakho ukubona izindlela futhi alungise ukwelashwa uma kudingeka.

Letha uhlu oluphelele lwazo zonke imithi kanye nezinye izinto ozithathayo, kuhlanganise nemithamo kanye nokuvamile. Ungakhohlwa ukufaka imithi yokuthengwa ngaphandle komthetho namavithamini.

Lungiselela imibuzo ofuna ukuyibuza udokotela wakho. Imibuzo evamile ingase ihlanganise ukukhathazeka ngezimpawu ezintsha, imibuzo mayelana nokulungiswa kokwelashwa, noma izincomo zokuphila. Ukubhala phansi kuqinisekisa ukuthi awukhohlwa izihloko ezibalulekile.

Uma ubona udokotela omusha, letha amakhophi emiphumela yokuvivinya yakamuva, amarekhodi okugcoba, kanye nesifinyezo somlando wakho wezokwelapha. Lokhu kusiza ukuthi baqonde icala lakho ngokushesha futhi banikeze ukunakekelwa okungcono.

Iyini into ebalulekile nge-Common Variable Immunodeficiency?

I-CVID yisimo esilawuleka esingadingi ukulawula impilo yakho. Ngokwelashwa okufanele, abantu abaningi abane-CVID bangaphila impilo evamile, enempilo ngokutheleleka okuncane kakhulu nezinkinga.

Into ebaluleke kakhulu okumele uyikhumbule ukuthi ukuxilongwa kwasekuqaleni nokwelashwa okuqhubekayo kwenza umehluko omkhulu. I-immunoglobulin replacement therapy iphumelela kakhulu, futhi abantu abaningi bayamangala ngokuthi bazizwa kangcono kangakanani uma beqala ukwelashwa.

Ukusebenzisana eduze nodokotela we-immunologist noma omunye ochwepheshe onolwazi ekwelapheni i-CVID kubalulekile. Bangakusiza ukuthi uhambe ngezindlela zokwelapha, uvikele izinkinga, futhi uqonde noma yikuphi ukukhathazeka okuvela.

Khumbula ukuthi ukuba ne-CVID akusho ukuthi ubuthakathaka noma ukhanyekile. Abantu abaningi abalesi simo balandela imisebenzi, uhambo, ukuzivocavoca, futhi bajabulela zonke imisebenzi abayithandayo. Isihluthulelo ukuba nolwazi, ukulandela uhlelo lwakho lokwelashwa, nokugcina ukuxhumana okuhle neqembu lakho lokunakekelwa kwezempilo.

Imibuzo evamile mayelana ne-Common Variable Immunodeficiency

Ungaphila impilo evamile nge-CVID?

Yebo, abantu abaningi abane-CVID baphila impilo egcwele, esebenzayo ngokwelashwa okufanele. I-immunoglobulin replacement therapy inganciphisa ukutheleleka kakhulu, ikuvumela ukuba usebenze, uhambe, uzivocavoce, futhi uhlanganyele ezimisebenzini eziningi ozithandayo. Isihluthulelo ukwelashwa okuqhubekayo nokusebenzisana eduze neqembu lakho lokunakekelwa kwezempilo.

Ingabe i-CVID iyefa?

I-CVID ingase ihambe emindenini, kodwa izimo eziningi zenzeka ngaphandle komlando omkhulu womndeni. Cishe u-10-20% wabantu abane-CVID banezihlobo ezine-condition noma enye into yokungabi nabukhali bomzimba. Ngisho noma kukhona i-genetic component, isimo alandeli izindlela ezilula zokudluliselwa, ngakho ukuba nelungu lomndeni eline-CVID akusho ukuthi uzophumelela.

Ukuthi kangakanani kudingeka ukwelashwa kwe-immunoglobulin?

Ukuvamile kokwelashwa kuncike ohlotsheni lwe-immunoglobulin therapy oyitholayo. I-IVIG ngokuvamile inikezwa njalo ngemva kwamasonto angu-3-4 nge-IV, kanti i-SCIG inikezwa masonto onke noma ngemva kwamasonto amabili ngokuhlanganiswa okuncane phansi kwesikhumba. Udokotela wakho uzokunquma isheduli engcono kakhulu ngokusekelwe amazinga akho e-antibody nendlela obuyela ngayo ekwelapheni.

Ingabe i-CVID ingase ibe zimbi ngokuhamba kwesikhathi?

I-CVID ngokwayo ngokuvamile ihlala njalo, kodwa izinkinga zingase zikhule uma ukutheleleka kungalawulwa kahle ngokuhamba kwesikhathi. Kungakho ukwelashwa okuqhubekayo nokubhekwa okuvamile kubalulekile kangaka. Ngokunakekelwa okufanele, abantu abaningi bagcina impilo ezinzile futhi bangase babone ngisho nokuthuthuka ezimpawu zabo nasekhwalithi yempilo.

Ingabe kukhona ukudla noma imisebenzi okumele ngiyigweme nge-CVID?

Awudingi ukulandela ukudla okukhethekile, kodwa ukugcina ukudla okunempilo kusekela impilo yakho yonke. Gwema ukudla okungaphekwa kahle noma okungaphekwa kahle okungase kube nebhaktheriya eyingozi, futhi qaphela imikhiqizo yobisi engaphekwanga. Imisebenzi eminingi evamile ilungile, kodwa ungase ufune ukugwema izixuku ngesikhathi sesizini ye-flu futhi njalo uqaphele ukuhlanzeka okuhle.