Lupus

I-Lupus yisifo esenzeka lapho isimo somzimba sakho sokugcina umzimba sihlasele izicubu nezinye izitho zakho (isifo sokuqina komzimba). Ukuvuvukala okubangelwa yi-Lupus kungathinta izinhlelo eziningi zomzimba ezahlukene — kufaka phakathi izikhonkwane zakho, isikhumba, izinso, amangqamuzana egazi, ubuchopho, inhliziyo nemiphunga.

I-Lupus ingaba nzima ukuyihlonza ngoba izimpawu zayo nezimpawu zivame ukulingisa ezinye izifo. Uphawu olukhulu kakhulu lwe-Lupus — ukukhishwa kobuso olufana namaphiko e-butterfly oluvula kuzo zombili iimpundu — kwenzeka eziningi kodwa hhayi kuzo zonke izimo ze-Lupus.

Abanye abantu bazalwa benesifiso sokuthuthukisa i-Lupus, okungase kubangelwe ukutheleleka, imithi ethile noma ngisho nokukhanya kwelanga. Nakuba kungekho ukwelapha i-Lupus, ukwelashwa kungasiza ukulawula izimpawu.

Akekho umuntu obhemayo olufana ngempela komunye. Izimpawu nezinhlungu zingase ziqale ngokuzumayo noma kancane kancane, zingaba zinkulu noma zinzima, futhi zingaba zesikhashana noma zaphakade. Abantu abaningi abane-lupus banesifo esilula esiqanjwe yizigameko—okubizwa ngokuthi yi-flares—lapho izimpawu nezinhlungu zibe zimbi isikhathi esithile, bese ziphulukana noma ziyaphela ngokuphelele isikhathi esithile.

Izimpawu nezinhlungu ze-lupus ozibhemayo kuzoxhomeka ezinhlelweni zomzimba ezihlasela yisifo. Izimpawu nezinhlungu ezivame kakhulu zihlanganisa:

• Ukukhathala
• Ukuvuvukala
• Ubuhlungu bezingqondo, ubunzima nokukhula
• I-rash efana ne-butterfly ebusweni ehlanganisa amaphethelo nomgogodla wempumulo noma i-rashes kwenye indawo emzimbeni
• Izilonda zesikhumba ezivela noma ezibe zimbi uma zidwetshwe ilanga
• Iminwe nezinzwane eziphenduka mhlophe noma zibomvu uma zidwetshwe ubusika noma phakathi nezinsuku ezinzima
• Ukuphefumula okufushane
• Ubuhlungu esifubeni
• Amehlo omile
• Izinhlungu zikhanda, ukudideka nokulahleka kwenkumbulo

Bona udokotela uma uthola isihlungu esingachazwanga, umkhuhlane oqhubekayo, ubuhlungu obuhlala njalo noma ukukhathala.

Njengoba kuyisifo sokuzimela komzimba, i-lupus kwenzeka uma isimo sakho sokuvikela somzimba sihlasele izicubu eziphilileyo emzimbeni wakho. Kungenzeka ukuthi i-lupus ivela ngokuhlanganiswa kwezakhiwo zakho nezimo zakho ezingqongile.

Kubonakala sengathi abantu abanokuhlaliswa kwemfuyo ye-lupus bangathuthukisa leli gciwane uma beqhakambisana nento ethile endaweni ezungezile engabangela i-lupus. Nokho, imbangela ye-lupus ezigamekweni eziningi ayaziwa. Amanye ama-trigger ahlanganisa:

• Ukukhanya kwelanga. Ukubhekana nelanga kungaletha izilonda zesikhumba ze-lupus noma kubangele impendulo yangaphakathi kubantu abathintekayo.
• Ukutheleleka. Ukuba nokutheleleka kungaqala i-lupus noma kubangele ukuphindaphinda kwabanye abantu.
• Imithi. I-Lupus ingabangelwa izinhlobo ezithile zemithi yegazi, imithi yokuthambisa ukubamba, kanye ne-antibiotics. Abantu abanesi-lupus esibangelwa yimithi ngokuvamile bayaphila uma beyeka ukuthatha imithi. Ngokungavamile, izimpawu zingaphikelela ngisho nangemuva kokuba imithi iyeke.

Izici ezingase zikhulise ingozi yakho ye-lupus zihlanganisa:

• Ubulili bakho. I-Lupus ivame kakhulu kubesifazane.
• Ubudala. Nakuba i-lupus ithonya abantu bazo zonke izigaba zobudala, ivame ukutholakala phakathi kweminyaka engu-15 no-45.
• Uhlanga. I-Lupus ivame kakhulu kuma-Afrika Amerika, amaHispanik ne-Asia Amerika.

Ukuvuvukala okubangelwa yi-lupus kungaqeda izindawo eziningi zomzimba wakho, okuhlanganisa:

• Izinkalankala. I-Lupus ingabangela ukonakala okukhulu kwizinkalankala, futhi ukwehluleka kwizinkalankala kungenye yezizathu eziyinhloko zokufa phakathi kwabantu abane-lupus.
• Ubuchopho nesistimu yezinzwa eziyinhloko. Uma ubuchopho bakho buthinteka yi-lupus, ungase uhlangabezane nokuhlunguluka kwekhanda, ukukhungatheka, ukushintsha kokuziphatha, izinkinga zobuso, futhi ngisho nokushaya noma ukuhlwitha. Abantu abaningi abane-lupus bahlangabezana nezinkinga zokukhumbula futhi bangase babe nobunzima bokuveza imicabango yabo.
• Igazi nemithambo yegazi. I-Lupus ingabangela izinkinga zegazi, okuhlanganisa inani elincane lamaseli ebomvu egazi anempilo (anemia) kanye nokukhuluphala komngcipheko wokopha noma ukuqina kwegazi. Ingabangela nokuvuvukala kwemithambo yegazi.
• Amaphaphu. Ukuba ne-lupus kukhulisa amathuba akho okwakha ukuvuvukala kokugqoka komsongelwa wefulege, okungenza ukuphefumula kube buhlungu. Ukopha emaphaphwini ne-pneumonia nakho kungenzeka.
• Inhliziyo. I-Lupus ingabangela ukuvuvukala kwemisipha yenhliziyo yakho, imithambo yakho noma imembraneni yenhliziyo. Ubungozi besifo senhliziyo kanye nokushaya kwenhliziyo buyakhula kakhulu.

Ukuxilongwa kwe-lupus kunzima ngoba izimpawu nezincazelo zihlukahluka kakhulu kumuntu nomuntu. Izimpawu nezincazelo ze-lupus zingashintsha ngokuhamba kwesikhathi futhi zihambisane nezengxaki eziningi. Alukho uvivinyo olulodwa olungaxilonga i-lupus. Ukuhlanganiswa kwezivivinyo zegazi nezinye ze-urine, izimpawu nezincazelo, kanye nokuhlolwa komzimba kuholela ekuxilongweni. Izivivinyo zegazi neze-urine zingafaka: Uma udokotela wakho engabaza ukuthi i-lupus ithonya amaphaphu akho noma inhliziyo, angase aphakamise: I-Lupus ingalimaza izinkulungwane zakho ngezindlela eziningi ezahlukene, futhi ukwelashwa kungashintsha, kuye ngohlobo lolonakalo oluvela. Kwezinye izimo, kuyadingeka ukuhlola isampula encane yethishu yenkulungwane ukuze ubone ukuthi yiluphi ukwelashwa okuhle kakhulu. Isampula ingatholakala ngenhlanzi noma ngokusika okuncane. Ukuhlinzwa kwesikhumba ngezinye izikhathi kwenziwa ukuqinisekisa ukuxilongwa kwe-lupus ethinta isikhumba. * Ukubalwa kwegazi okuphelele. Lo mvivinyo uqapha inani lamaseli abomvu egazi, amaseli amhlophe egazi nama-platelets kanye nenani le-hemoglobin, iprotheni emaseleni abomvu egazi. Imiphumela ingabonisa ukuthi une-anemia, okuvamile kwenzeka e-lupus. Inani eliphansi lamaseli amhlophe egazi noma ama-platelets lingase libe khona e-lupus futhi. * Izinga lokumisa kwama-erythrocyte. Lo mvivinyo wegazi uqapha izinga lapho amaseli abomvu egazi emise phansi kwephuli ngehora. Izinga eliphakeme kunokujwayelekile lingabonisa isifo sesistimu, njenge-lupus. Izinga lokumisa aliyona into ethile yesifo esisodwa. Lingaphakama uma une-lupus, ukutheleleka, enye isimo sokuvuvukala noma umdlavuza. * Ukuhlolwa kwesibindi nenkulungwane. Izivivinyo zegazi zingahlola ukuthi izinkulungwane zakho nesibindi sakho sisebenza kahle kangakanani. I-Lupus ingathinta lezi zitho. * Ukuhlolwa kwe-urine. Ukuhlolwa kwesampula ye-urine yakho kungabonisa izinga elikhulayo leprotheni noma amaseli abomvu e-urine, okutholakala uma i-lupus ithinte izinkulungwane zakho. * Uvivinyo lwe-antibody ye-antinuclear (ANA). Uvivinyo oluhle lokuba khona kwalezi antibodies - ezikhiqizwa yisistimu yakho yokulwa nezifo - kubonisa isistimu yokulwa nezifo eshuqekile. Nakuba abantu abaningi abane-lupus banevivinyo elihle le-antibody ye-antinuclear (ANA), abantu abaningi abane-ANA enhle abanalo i-lupus. Uma uvivinywa kahle nge-ANA, udokotela wakho angase akucele ukuhlolwa okukhethekile kwe-antibody. * I-X-ray yesifuba. Umfanekiso wesifuba sakho ungabonisa izithunzi ezingavamile ezibonisa ukugcwala noma ukuvuvukala emaphaphwini akho. * I-Echocardiogram. Lo mvivinyo usebenzisa amaza omsindo ukukhiqiza izithombe zesikhathi sangempela senhliziyo yakho ebetha. Ingahlola izinkinga ngezivali zakho nezinye izingxenye zenhliziyo yakho.

Ukwelapha i-lupus kuncike ezimpawu zakho nezinhlungu. Ukuqonda ukuthi kufanele welapheke yini nokuthi yimiphi imithi okufanele uyisebenzise kudinga ukuxoxisana ngokucophelela ngezinzuzo nezingozi nodokotela wakho.

Njengoba izimpawu zakho nezinhlungu zikhanya bese zinyamalala, wena nodokotela wakho ningase nifune ukushintsha imithi noma imithamo. Imithi evame ukusetshenziswa ukulawula i-lupus ihlanganisa:

Imithi ye-Biologics. Uhlobo oluhlukile lwemithi, i-belimumab (Benlysta) enikezwa nge-intravenously, iphinda inciphise izimpawu ze-lupus kwabanye abantu. Imiphumela emibi ihlanganisa isicanucanu, isifo sohudo nokutheleleka. Ngokungavamile, ukwanda kokucindezeleka kungase kwenzeke.

IRituximab (Rituxan, Truxima) ingase ibe usizo kwabanye abantu lapho imithi enye ingabasizi khona. Imiphumela emibi ihlanganisa ukusabela okungokwe-allergic ekungenisweni kwe-intravenous nokutheleleka.

Ekuhlolweni kwezokwelapha, i-voclosporin ibonakale isebenza ekwelapheni i-lupus.

Eminye imithi engase isetshenziswe ekwelapheni i-lupus isafundwa, kuhlanganise i-abatacept (Orencia), i-anifrolumab nezinye.

• Imithi engalwi nokuvuvukala (NSAIDs). Imithi engalwi nokuvuvukala (NSAIDs) ethengiswa ngaphandle kwesikripthi, njenge-naproxen sodium (Aleve) ne-ibuprofen (Advil, Motrin IB, nezinye), ingase isetshenziswe ekwelapheni ubuhlungu, ukuvuvukala nomkhuhlane ohambisana ne-lupus. Imithi enamandla ye-NSAIDs itholakala ngesikripthi. Imiphumela emibi ye-NSAIDs ingase ihlanganise ukuphuma kwegazi esiswini, izinkinga zezinkalankala nokukhuluphala kwengozi yezinkinga zenhliziyo.
• Imithi ye-Antimalarial. Imithi evame ukusetshenziswa ekwelapheni i-malaria, njenge-hydroxychloroquine (Plaquenil), ichaphazela isimiso somzimba futhi ingasiza ekuqedeni ubungozi be-lupus flares. Imiphumela emibi ingase ihlanganise ukuphazamiseka kwesisu, futhi, ngokungavamile kakhulu, ukonakala kwe-retina yamehlo. Ukwenza izivivinyo zamehlo njalo kunconywa uma uthatha le mithi.
• Imithi ye-Corticosteroids. I-Prednisone nezinye izinhlobo ze-corticosteroids zingalwa nokuvuvukala kwe-lupus. Imithamo enkulu ye-steroids njenge-methylprednisolone (Medrol) ivame ukusetshenziswa ukulawula isifo esinzima esithinta izinkalankala nobuchopho. Imiphumela emibi ihlanganisa ukwanda kwesisindo, ukungapheli kalula, amathambo abuthakathaka, ukucindezeleka kwegazi, isifo sikashukela nokukhuluphala kwengozi yokutheleleka. Ubungozi bemiphumela emibi bukhula ngemithamo enkulu ne-therapy yesikhathi eside.
• Imithi ye-Immunosuppressants. Imithi ecindezela isimiso somzimba ingase ibe usizo ezimweni ezinzima ze-lupus. Izibonelo zihlanganisa i-azathioprine (Imuran, Azasan), i-mycophenolate (Cellcept), i-methotrexate (Trexall, Xatmep, nezinye), i-cyclosporine (Sandimmune, Neoral, Gengraf) ne-leflunomide (Arava). Imiphumela emibi engase ibe khona ingase ihlanganise ukukhuluphala kwengozi yokutheleleka, ukonakala kwesibindi, ukunciphisa ukukhulelwa nokukhuluphala kwengozi yomdlavuza.
• Imithi ye-Biologics. Uhlobo oluhlukile lwemithi, i-belimumab (Benlysta) enikezwa nge-intravenously, iphinda inciphise izimpawu ze-lupus kwabanye abantu. Imiphumela emibi ihlanganisa isicanucanu, isifo sohudo nokutheleleka. Ngokungavamile, ukwanda kokucindezeleka kungase kwenzeke.

IRituximab (Rituxan, Truxima) ingase ibe usizo kwabanye abantu lapho imithi enye ingabasizi khona. Imiphumela emibi ihlanganisa ukusabela okungokwe-allergic ekungenisweni kwe-intravenous nokutheleleka.

Thatha izinyathelo zokunakekela umzimba wakho uma une-lupus. Izinyathelo ezilula zingakusiza ukuvimbela ukuqhuma kwe-lupus, futhi, uma kwenzeka, ukubhekana kangcono nezimpawu nezibonakaliso ozibona. Zama ukwenza lokhu okulandelayo:

• Bona udokotela wakho njalo. Ukuba nokubhekwa njalo kunokuba ukubona udokotela wakho kuphela lapho izimpawu zakho zibuhlungu kungasiza udokotela wakho ukuvimbela ukuqhuma, futhi kungaba usizo ekunakekeleni izinkinga zempilo eziqondile, njengokucindezeleka, ukudla nokuzivocavoca okungasiza ekunciphiseni izinkinga ze-lupus.
• Yiba uhlakaniphile elangeni. Ngenxa yokuthi ukukhanya kwe-ultraviolet kungabangela ukuqhuma, gqoka izingubo ezivikela — njengesiqubu, ihembe elide nebhulukwe elide — bese usebenzisa i-sunscreen ene-sun protection factor (SPF) okungenani engu-55 njalo lapho uya ngaphandle.
• Zivocavoca njalo. Ukuzivocavoca kungakusiza ukugcina amathambo akho eqinile, kunciphisa ingozi yokuhlaselwa yisifo senhliziyo futhi kukhuthaze impilo enhle.
• Ungabhemi. Ukubhema kukhulisa ingozi yesifo senhliziyo futhi kungenza kube kubi imiphumela ye-lupus enhliziyweni yakho nasemiphini yakho yegazi.
• Dla ukudla okunempilo. Ukudla okunempilo kugcizelela izithelo, imifino namanye amazambane. Ngezinye izikhathi ungase ube nemiqathi yokudla, ikakhulukazi uma une-high blood pressure, ukonakala kwesibindi noma izinkinga zesisu.
• Buza udokotela wakho uma udinga izithasiselo ze-vitamin D ne-calcium. Kukhona ubufakazi obukhombisa ukuthi abantu abane-lupus bangase bazuze ekuthatheni i-vitamin D eyengeziwe. Isithasi sel-calcium singakusiza uhlangabezane nesilinganiso sempilo esikhuthazwayo samasonto onke angu-1,000 milligrams kuya ku-1,200 milligrams — kuye ngobudala bakho — ukukusiza ukugcina amathambo akho eqinile.