Uyini i-MGUS? Izimpawu, Izimbangela, Nokwelashwa

I-MGUS imele i-Monoclonal Gammopathy of Undetermined Significance. Kuyisimo lapho ubukhali bakho bomathumbu benza khona inani elikhulu le-protein olulodwa oluthiwa yi-monoclonal protein noma i-M protein. Cabanga ngakho njengomzimba wakho owenza amakhophi engeziwe e-protein efanayo, ngisho noma ungayidingi.

Abantu abaningi abane-MGUS bazizwa beqondile ngokuphelele futhi abanawo nhlobo izimpawu. Lesi simo sivame ukutholakala ngengozi ngesikhathi sezivivinyo zegazi eziqondile ngenxa yezinye izizathu. Nakuba i-MGUS ngokwayo ingavamile ukubangela izinkinga, odokotela bayilandela ngoba ngezinye izikhathi ingathuthuka ibe yizimo ezingathi sína eminyakeni eminingi.

Ziyini izimpawu ze-MGUS?

Nansi into engase ikumangalise: I-MGUS ngokuvamile ayibangeli zimpawu nhlobo. Abantu abaningi abayinayo bazizwa bephilile ngokuphelele futhi baqhubeka nokuphila kwabo kwansuku zonke ngaphandle kokwazi ukuthi banalesi simo. Ivamise ukubizwa ngokuthi “isiyoba” ngoba ngokuvamile ayizivezi ngendlela ozizwa ngayo.

Uma izimpawu zivele, ngokuvamile zibuthakathaka kakhulu futhi zingafaka ukukhathala noma ubuthakathaka. Abanye abantu bangase baphawule ukuthi bayaphuthuma kalula kunokujwayelekile. Lezi zimpawu zimbalwa kakhulu nge-MGUS futhi ngokuvamile zinazinye izichazamazwi.

Ezimweni ezingavamile kakhulu, i-protein engeziwe ingabangela izinkinga ngokuqina kwegazi noma ukusebenza kwama-nerve. Lokhu kungase kube yizimpawu ezifana nokuthimfula ezandleni noma ezinyaweni, kodwa lokhu kwenzeka kubantu abangaphansi kuka-5% abane-MGUS.

Yini ebangela i-MGUS?

Imbangela eqondile ye-MGUS ayiqondakali ngokuphelele, kodwa iqala ebukhali bakho bomathumbu lapho kwenziwa khona amaseli egazi. Ngezinye izikhathi, amaseli athile okuvikela umzimba okuthiwa ama-plasma cells aqala ukukhiqiza inani elikhulu le-protein ethile ngaphandle kwesizathu esicacile.

Ubudala buwumsebenzi obalulekile ekuthuthukiseni i-MGUS. Buya kuba yinto evamile njengoba abantu bekhula, buthinta cishe abantu abangu-3% abangaphezu kweminyaka engama-50 kanye nabantu abangu-5% abangaphezu kweminyaka engama-70. Isistimu yakho yokuvimbela umzimba ishintsha ngokwemvelo njengoba ukhula, okungase kuhlanganyele kulesi simo.

I-genetics ingase futhi ibe nomsebenzi. I-MGUS ibonakala igijima emindenini eminye, isikisela ukuthi ama-genes athile angenza umuntu abe nethuba elikhulu lokuthuthukisa. Noma kunjalo, ukuba nomuntu womndeni onayo i-MGUS akusho ukuthi uzothola nakanjani.

Ucwaningo oluthile lusikisela ukuthi ukutheleleka okungapheli noma ukukhuthazwa okungapheli kwesistimu yokuvimbela umzimba kungase kuhlanganyele ekuthuthukiseni i-MGUS. Noma kunjalo, abantu abaningi abane-MGUS abakwazi ukukhombisa imbangela ethile noma isiqalo sesimo sabo.

Ziyini izinhlobo ze-MGUS?

I-MGUS ihlelwa ngokusekelwe ohlotsheni lwe-protein engavamile eyenziwa ubukhali bakho bomathumbu. Uhlobo oluvamile kakhulu yi-IgG MGUS, oluhlanganisa cishe ama-70% azo zonke izimo futhi luvamise ukuba yilona uhlobo oluzinzile.

I-IgA MGUS yenza cishe ama-10-15% ezimo futhi isebenza ngendlela efanayo ne-IgG MGUS. I-IgM MGUS imele enye i-15-20% yezimo futhi ine-chance enkulu kancane yokuthuthuka ibe yizimo eziningi uma iqhathaniswa nezinhlobo ze-IgG ne-IgA.

I-Light chain MGUS ayivamile kodwa kubalulekile ukuyazi. Kulolu hlobo, kuphela izingxenye ze-protein zama-antibody ezenziwa ngokweqile. Lolu hlobo lufuna ukulandelelwa eduze ngoba ngezinye izikhathi lungase lithinte ukusebenza kwesibindi.

Kukhona futhi uhlobo olulodwa olulodwa oluthiwa yi-heavy chain MGUS, oluhilela izingxenye ezahlukene ze-protein. Lolu hlobo aluvamile futhi ngokuvamile lufuna ukuhlolwa okukhethekile ukuze luqondwe kahle.

Nini okufanele ubona udokotela nge-MGUS?

Uma usutholiwe une-MGUS, kufanele ubona udokotela wakho ukuze uthole ukuvakasha okuqondile njengoba kunconywe. Lezi ngokuvamile zibekwa njalo ngenyanga eziyisi-6 kuya kweziyi-12, kuye ngesimo sakho esithile nezici ezingozi.

Kufanele uxhumane nodokotela wakho ngokushesha uma uthuthukisa izimpawu ezintsha ezikukhathazayo. Lokhu kungafaka ukukhathala okungachazeki okungaphuli ngokuphumula, ubuhlungu emathanjeni obuhlala njalo, noma ukutheleleka okuvamile okubonakala kungavamile kuwe.

Shaya udokotela wakho uma uqaphela ukuphuthuma okulula noma ukuphuma kwegazi okubonakala kukhulu kakhulu. Nakuba lezi zimpawu zingaba nezizathu eziningi, kufanele zixoxwe uma une-MGUS.

Noma yiziphi izinguquko ezibalulekile endleleni ozizwa ngayo, ikakhulukazi uma zithuthuka kancane kancane emasontweni noma ezinyangeni, zifanele zithole ukunakekelwa kwezokwelapha. Udokotela wakho angakusiza aqonde uma lezi zinguquko zihlangene ne-MGUS noma into enye ngokuphelele.

Ziyini izici ezingozi ze-MGUS?

Ukuqonda izici zakho ezingozi kungakusiza wena nodokotela wakho ukuba nizenze izinqumo eziqondisiwe mayelana nokulandelela nokunakekelwa. Isici esinamandla kakhulu sokungozi lwe-MGUS yiyona iminyaka, ngesimo esiba yinto evamile ngokwanda ngemuva kweminyaka engama-50.

Nazi izici eziyinhloko ezingozi ezingandisa amathuba akho okuthuthukisa i-MGUS:

• Iminyaka engaphezu kweminyaka engama-50, ngengozi eyenyuka kakhulu ngemuva kweminyaka engama-70
• Ubulili besilisa - amadoda anethuba elikhulu lokuthuthukisa i-MGUS kunabesifazane
• Uhlanga lwase-Afrika Amerika - lesi simo sivame kabili kubantu base-Afrika Amerika
• Umlando womndeni we-MGUS noma izifo zegazi ezihlobene
• Umlando wezimo ezithile zokuvimbela umzimba noma ukutheleleka okungapheli
• Ukudalulwa kwangaphambili kwezinto ezithile ezinobuthi noma ukukhanya, nakuba lokhu kungavamile

Ukuba nalezi zici ezingozi akusho ukuthi uzothuthukisa i-MGUS. Abantu abaningi abanezici eziningi ezingozi abazithuthukisi lesi simo, kanti abanye abangenazo izici ezingozi ezicacile bayenza. Lezi zici zisiza odokotela baqonde ukuthi ubani ongenzeka abe nethuba elikhulu lokuthuthukisa i-MGUS.

Ziyini izinhlanganisela ezingaba khona ze-MGUS?

Nakuba i-MGUS ngokwayo ingavamile ukubangela izinkinga ezisheshayo, ukukhathazeka okuyinhloko ukuthi ngezinye izikhathi ingathuthuka ibe yizifo zegazi ezingathi sína ngokuhamba kwesikhathi. Lokhu kuqhubeka kwenzeka kancane, ngokuvamile eminyakeni eminingi, futhi kuthinta ingxenye encane yabantu abane-MGUS.

Inhlanganisela enkulu kakhulu engenzeka iwukuthuthuka kube yi-multiple myeloma, uhlobo lwe-blood cancer. Lokhu kwenzeka cishe ku-1% yabantu abane-MGUS unyaka ngamunye. Lokho kusho ukuthi ngemuva kweminyaka engu-10, cishe abantu abangu-10% abane-MGUS bayobe bethuthukise i-multiple myeloma.

Abanye abantu abane-MGUS bangase bathuthukise ezinye izifo zegazi ezifana ne-lymphoma noma isimo esithiwa yi-amyloidosis. Lezi zinhlobo azivamile kunama-multiple myeloma kodwa zisadinga ukulandelelwa nokwelashwa uma zivele.

Ezimweni ezingavamile, i-protein engeziwe ku-MGUS ingabangela izinkinga ngokuqina kwegazi noma iphazamise ukugqwala kwegazi okujwayelekile. Lokhu kungase kube yizinkinga zokujikeleza noma ukuphuma kwegazi okungavamile, kodwa lezi zinhlobo zithinta abantu abangaphansi kuka-5% abane-MGUS.

Kubalulekile ukukhumbula ukuthi abantu abaningi abane-MGUS abazithuthukisi lezi zinhlobo. Inhloso yokulandelela okuqondile iwukubamba noma yiziphi izinguquko ngokushesha uma zivele.

I-MGUS ihlonishwa kanjani?

I-MGUS ngokuvamile itholakala ngezivivinyo zegazi ezazingayifuni ngokukhethekile. Udokotela wakho angase anikeze lezi zivivinyo zokuhlola impilo okuqondile noma ukuhlola ezinye izimpawu ozibhekana nazo.

Ivivinyo eliyisihluthulelo libizwa ngokuthi yi-serum protein electrophoresis, ehlukanisa ama-protein ahlukene egazini lakho. Uma leli vivinyo libonisa i-protein spike engavamile, udokotela wakho uzo-oda ezinye izivivinyo ezithile ukuze aqonde ngqo ukuthi yiluphi uhlobo lwe-protein oluphakeme.

Ezinye izivivinyo zegazi zisiza ekuqondeni inani le-protein engavamile futhi ziqonde ezinye izinguquko zamaseli egazi. Lezi zivivinyo zifaka i-immunofixation electrophoresis ne-free light chain assays, ezinikeza ulwazi oluqondile ngama-protein athile ahilelekile.

Udokotela wakho angase futhi ancome i-bone marrow biopsy ukuze abheke amaseli akhiqiza lezi zinto. Lokhu kuhilela ukuthatha isampula encane yomathumbu amathambo, ngokuvamile emathanjeni akho, ukuze uhlole ngaphansi kwe-microscope. Nakuba lokhu kuzwakala kukukhathaza, ngokuvamile kwenziwa njengesiqondiso sokuphuma ngaphandle kokulala.

Izivivinyo ze-imaging ezifana ne-X-rays noma izikena eziphambili zingase zi-odwe ukuze ziqonde noma yiziphi izinguquko emathanjeni. Lezi zivivinyo zisiza ekuhlukaniseni i-MGUS ezimweni ezingathi sína ezingase zithinte amathambo.

Yini ukwelashwa kwe-MGUS?

Nansi izindaba ezithokozisayo: I-MGUS ngokwayo ngokuvamile ayidingi ukwelashwa nhlobo. Njengoba abantu abaningi abane-MGUS bezizwa bephilile futhi lesi simo singavamile ukubangela izinkinga ezisheshayo, odokotela ngokuvamile bancoma indlela “yokubuka nokulinda”.

“Ukwelashwa” okuyinhloko kwe-MGUS ukulandelelwa okuqondile ngezivivinyo zegazi. Udokotela wakho uzokubeka iziqondiso zokulandelela njalo ngenyanga eziyisi-6 kuya kweziyi-12 ukuze ahlole uma amazinga e-protein azinzile futhi abheke noma yiziphi izimpawu zokuthuthuka.

Uma uthuthukisa izimpawu ezingase zihlangene ne-MGUS, udokotela wakho angazixazulula ngokukhethekile. Isibonelo, uma i-protein engeziwe ithonya ubukhulu begazi lakho, kunezindlela zokwelapha ezitholakalayo ezisiza ekujikelezeni.

Abanye odokotela bangase bancome izindlela zempilo eziqondile ezisekela isimiso sakho sokuvikela umzimba kanye nempilo yakho jikelele. Lokhu kufaka ukugcina ukudla okunempilo, ukuzivocavoca okuqondile, nokugcina ubuyekeza ngezibalo.

Ukwelashwa kuba yinto edingekayo kuphela uma i-MGUS ithuthuka ibe yisimo esingathi sína njenge-multiple myeloma. Kulokhu, udokotela wakho uzoqala ukuxoxa ngezindlela zokwelapha ezithile ngokusekelwe ekuxilongweni okusha.

Indlela yokuphatha i-MGUS ekhaya?

Ukuphila ne-MGUS ngokuvamile kuphathelene nokulondoloza impilo yakho jikelele ngenkathi uhlala unolwazi ngesimo sakho. Njengoba i-MGUS ingavamile ukubangela izimpawu, impilo yakho yansuku zonke ingaqhubeka njengoba yayinjalo ngaphambi kokuxilongwa kwakho.

Gxila ekugcineni indlela yokuphila enempilo ngokuzivivinya okuqondile, ukudla okulinganiselayo, nokulala okwanele. Lezi zindlela zisekela isimiso sakho sokuvikela umzimba kanye nempilo yakho jikelele, okuyinto enhle noma une-MGUS noma cha.

Gcina ulandelela iziqondiso zakho zokulandelela futhi ungazisiki. Izivivinyo zegazi eziqondile yilona ithuluzi lakho elihle kakhulu lokuthola noma yiziphi izinguquko ngokushesha. Cabanga ngokubeka izikhumbuzo ocingweni lwakho noma ekhalendeni ukuze kukusize ukukhumbula lezi zivivinyo ezibalulekile.

Hlala unolwazi ngesimo sakho, kodwa gwema ukukhathazeka okweqile noma ukucinga okuningi kwi-intanethi okungase kukhulise ukukhathazeka. Udokotela wakho yilona thuluzi lakho elihle kakhulu lolwazi olunembile, oluqondene nesimo sakho esithile.

Qaphela indlela ozizwa ngayo, kodwa ungagxili kakhulu kuzo zonke izimpawu ezincane. Ubuhlungu nezinhlungu zansuku zonke azivamile ukuhlangene ne-MGUS. Xhumana nodokotela wakho uma uqaphela izinguquko ezibalulekile kwamandla akho, ubuhlungu obungavamile, noma ezinye izimpawu ezikukhathazayo.

Kufanele ulungiselele kanjani i-aphoyintimenti yakho yodokotela?

Ukulungiselela iziqondiso zakho zokulandelela i-MGUS kungakusiza ukuba wenze kakhulu isikhathi sakho nodokotela wakho. Ngaphambi kokuvakasha kwakho, bhala phansi noma yimiphi imibuzo noma ukukhathazeka ofuna ukuyixoxa, kungakhathaliseki ukuthi incinyane kangakanani.

Gcina irekhodi elilula lazo zonke izimpawu ozibonile kusukela ekuqokweni kwakho kokugcina. Faka lapho zaqala khona, isikhathi eside zithatha, nokuthi yini ebonakala ikusiza noma eyenza zibe zimbi. Ulwazi olufana nolu lusiza udokotela wakho ukuqonda noma yiziphi izinguquko esimweni sakho.

Letha uhlu lazo zonke izidakamizwa kanye nezinye izinto ozithathayo, kufaka phakathi izilinganiso nokuthi uzithatha kangaki. Ezinye izidakamizwa zingase zithinte imiphumela yezivivinyo zegazi, ngakho-ke udokotela wakho udinga ukwazi ngakho konke okukuthathayo.

Cabanga ngokuletha ilungu lomndeni noma umngani ekuqokweni kwakho, ikakhulukazi uma uzizwa ukhathazekile ngokuxilongwa kwakho. Bangakusiza ukukhumbula ulwazi oluqondile futhi banikeze ukwesekwa ngokomzwelo.

Bhala phansi imibuzo yakho ebaluleke kakhulu ngaphambili bese uyabuza ekuqaleni kokuqokwa. Lokhu kuqinisekisa ukuthi uthola izimpendulo zokuthi yini ebalulekile kuwe, ngisho noma i-aphoyintimenti ingapheli isikhathi.

Yini okufanele uyikhumbule nge-MGUS?

Into ebaluleke kakhulu okumele uyiqonde nge-MGUS ukuthi ngokuvamile iyisimo esilawuleka esingathinti kakhulu impilo yakho yansuku zonke. Nakuba igama lingase lizwakale liyesabekayo, abantu abaningi abane-MGUS baphila impilo evamile, enempilo ngaphandle kwanoma yiziphi izimpawu noma izinhlanganisela.

Ukulandelela okuqondile yilona cebo lakho elihle kakhulu lokuhlala unempilo nge-MGUS. Lezi zivivinyo eziqondile zivumela udokotela wakho ukuba alandele noma yiziphi izinguquko futhi athathe isinyathelo uma kudingeka. Cabanga ngazo njengokunakekelwa okuvimbelayo okukusiza ukubamba izinkinga ezingaba khona ngokushesha.

Khumbula ukuthi i-MGUS ithuthuka ibe yizimo ezingathi sína kuphela kubantu abancane, futhi lokhu kuqhubeka kwenzeka kancane kakhulu eminyakeni eminingi. Iningi labantu abane-MGUS abazithuthukisi noma yiziphi izinhlanganisela esimweni sabo.

Hlala uxhumene neqembu lakho lezokunakekelwa kwezempilo futhi ungangabazi ukubuza imibuzo noma ukukhuluma ukukhathazeka. Ukuqonda isimo sakho nokuzizwa usekelwe yiqembu lakho lezokwelapha kungasiza ekunciphiseni ukukhathazeka nokwenza impilo yakho ibe ngcono.

Imibuzo evamile ebuzwa nge-MGUS

Ingabe i-MGUS uhlobo lwe-cancer?

I-MGUS ayisiye i-cancer, kodwa ithathelwa ingqondo njengesimo esingaphambi kwe-cancer. Ihilela ukukhiqizwa kwe-protein engavamile ngamaseli okuvikela umzimba, kodwa la maseli awazange abe yi-cancer. Abantu abaningi abane-MGUS abazithuthukisi i-cancer, nakuba kunethuba elincane lokuthuthuka kube yi-blood cancers efana ne-multiple myeloma eminyakeni eminingi.

Ingabe i-MGUS ingaphiliswa?

Ayikho impilo ye-MGUS, kodwa lokhu akuyona inkinga ngoba abantu abaningi abadingi ukwelashwa. I-MGUS ngokuvamile iyisimo esizinzile esingadingi ukungenelela. Ukuqaphela kubaluleke kakhulu kunokwelapha, njengoba ukwelashwa ngokuvamile akuyona into edingekayo ngaphandle uma izinhlanganisela zivele.

Ingabe i-MGUS izothinta isikhathi sami sokuphila?

Kubantu abaningi, i-MGUS ayithinti kakhulu isikhathi sokuphila. Ucwaningo lubonisa ukuthi abantu abane-MGUS ezinzile banesikhathi sokuphila esifanayo nalabo abangenalo lesi simo. Ingxenye encane yabo abathuthukisa izinhlanganisela bangase babe nemiphumela ehlukile, kodwa ukutholakala ngokushesha ngokulandelela okuqondile kusiza ekuqinisekiseni ukwelashwa ngokushesha uma kudingeka.

Ngizivocavoca ngokujwayelekile nge-MGUS?

Yebo, ngokuvamile ungazivocavoca ngokujwayelekile nge-MGUS. Eqinisweni, ukuzivocavoca okuqondile kukhuthazwa njengengxenye yokugcina impilo jikelele. Ngokuvamile ayikho imikhawulo yokuzivocavoca ngaphandle uma uthuthukisa izinhlanganisela ezithile. Xoxa nodokotela wakho nganoma yikuphi ukukhathazeka, kodwa abantu abaningi abane-MGUS bangayaqhubeka nemisebenzi yabo evamile ngaphandle kwemikhawulo.

Kufanele ngitshele umndeni wami ngokuxilongwa kwami kwe-MGUS?

Ukuthi uzohlanganyela yini ukuxilongwa kwakho kuyisinqumo somuntu siqu, kodwa kungaba nezinzuzo zokutshela amalungu omndeni aseduze. I-MGUS ingaba nezingxenye ze-genetic, ngakho amalungu omndeni angase afune ukuxoxa ngokuhlola nodoctor wabo. Ngaphezu kwalokho, ukuba nokusekelwa komndeni kungaba usizo ngokomzwelo njengoba uhamba ngeziqondiso zokulandelela okuqondile.