Siyini isifo samathambo esencane?

Imfundo Yezempilo

I-arthritis ukuvuvukala nokuqina kwamalunga. Lapho abantu abaningi becabanga nge-arthritis, imvamisa bacabanga ngabantu abadala asebekhulile. Kepha, iqiniso leli cishe izingane ezingama-300,000 kanye nentsha engaphansi kweminyaka eyi-16 ubudala e-United States bahlala nohlobo oluthile lwei-juvenile idiopathic arthritis (ebizwa nangokuthi i-juvenile rheumatoid arthritis).

Siyini isifo samathambo esencane?

Izinhlobo eziningi ze-juvenile idiopathic arthritis (JIA) yizifo ezizimele, laphoamasosha omzimba ahlasela ngephutha izicubu zawo nezitho zomzimba, kulokhu, amalunga.Akunasizathu esaziwayo esaziwayo salesi simo kepha kunemibono eveza ukuthi izici zofuzo, ezithathelwanayo nezemvelo zingabandakanyeka, kusho IMagdalena Cadet, MD , isazi samathambo saseNew York esisebenza kanye nozakwabo abaya eNYU Langone Medical Center.

Amaphesenti amancane kuphela amacala we-juvenile idiopathic arthritis abikwe ukuthi asebenza emindenini, kepha aingane yakini yomuntu onalesi sifo unayo cishe izikhathi eziyi-12 ingozi elinganiselwe yokuthuthukisa isifo samathambo esencane kunesabantu abaningi. Abesifazane nabo basengozini enkulu zokuthuthukai-juvenile idiopathic arthritis, njengoba zinjalo nezinye izimo ze-rheumatic.

Ziyini izimpawu zesifo samathambo esencane?

Izimpawu ze-juvenile idiopathic arthritis ziqala ngaphambi kweminyaka yobudala eyi-16, ziba ezingamahlalakhona, futhi zingafaka:

• Ukuvuvukala okuhlangene, ubuhlungu nokuqina: Ukuqina okuhlangene kungabonakala kakhulu ekuseni, noma ngemuva kwezikhathi zokungasebenzi. Ungase futhi uqaphele ingane yakho ixhuga.
• Umkhuhlane oqhubekayo
• I-Rash: Ukuqubuka kwesikhumba okubomvana kungabonakala ngokuhlangana nomkhuhlane.
• Ama-lymph node avuvukile
• Izinkinga zamehlo: Lokhu kungafakai-uveitis (ukuvuvukala kweso) noma ukungaboni kahle.

Ukwelashwa kwe-JIA / JRA kochwepheshe bezokwelapha, isiguli sizodinga ukuzwa ubuhlungu obuphindayo futhi sikhombise izimpawu zokuvuvukala okuhlangene okungenani amasonto ayisithupha, kusho ULawrence Barnard , DO, uchwepheshe oqinisekiswe yibhodi we-neuromusculoskeletal osebenza e-MAXIM ReGen. Ngokusho kukaDkt. Barnard, lesi sikhathi esibalulekile sibalulekile ngoba iningi lezingane nentsha lizwa izinhlungu ezikhulayo kuyo yonke iminyaka yobusha ezibuhlungu futhi eziphazamisayo kodwa empeleni azilona uhlobo lwesifo samathambo. Uma kusolwa ukuthi isifo samathambo sentsha, udokotela wezingane noma udokotela ojwayelekile angadlulisela isiguli kuchwepheshe we-rheumatologist ngemuva kokubheka izinto ezifana nomlando womndeni.

Yiziphi izinhlobo zesifo samathambo esencane?

Kunezigaba ezahlukahlukene zeJIA ezingasuselwa kuzici eziningi ezifana nenombolo yamajoyinti abandakanyekayo, ubudala bokuqala, ukuba khona komaka bokuzilimaza komzimba (i-rheumatoid factor noma i-antinuclear antibody), noma ezinye izici ezihlobene nomtholampilo ezifana nomkhuhlane, noma ukubandakanyeka kwamehlo, kuchaza uDkt.

Kunezinhlayiya eziyisithupha ze-juvenile idiopathic arthritis:

1. I-Oligoarthritis (ifomu elijwayeleke kakhulu): Leli fomu lithinta amalunga angaphansi kwamahlanu ezinyangeni eziyisithupha zokuqala zesifo. Kubangelaukuvuvukala kwamehlo noma i-uveitis / iritis futhi kuvame kakhulu emantombazaneni.
2. I-Polyarthritis: Leli fomu lithinta amalunga amahlanu noma ngaphezulu ezinhlangothini zombili zomzimba, lifana nesifo samathambo sabantu abadala, futhi livame kakhulu emantombazaneni.
3. I-arthritis ehlelekile: Leli fomu lesifo samathambo lingathinta umzimba wonke kubandakanya izitho zangaphakathi nezinhlelo zomzimba. Imvamisa kubangela ukukhuphuka kwemfiva, ukuqubuka, nokwandiswa kwe-lymph node.
4. Okuhlobene ne-Enthesitis: Leli fomu lidala ukuvuvukala lapho imisipha inamathela ethanjeni (entheses) kanye neminwe nezinzwane. Ngokuvamile kuthinta abafana abadala.
5. I-juvenile psoriatic arthritis: Leli fomu lidalaamabala abomvu nabukhali esikhunjeni. Ubuhlungu beqolo, ubuhlungu bamalunga, kanye nokungajwayelekile kwezipikili njengokufakwa kwezipikili kungabakhona.
6. Okungafani: Lesi yisigaba seziguli ezingangeni kwamanye ama-subtypes, noma obanigcwalisa imibandela yezinhlobo ezingaphezu kweyodwa.

Sitholakala kanjani isifo samathambo esencane?

I-juvenile idiopathic arthritis ingaba nzima ukuyihlonza futhi yehluke kwezinye izimo. Alukho uvivinyo olucacile lwe-JIA, ngakho-ke odokotela bathola isimo ngokuya ngomlando wezokwelapha, ukuhlolwa okuphelele ngokomzimba, nangokukhipha eminye imibandela. Bangabuye ba-oda lezi zivivinyo zokuxilonga ezilandelayo.

• Isivivinyo se-Rheumatoid factor: Ukuhlolwa kobukhona be-antibody ekhiqizwa amasosha omzimba okungakhombisa ukuba khona kwesifo samathambo.
• Ukuhlolwa kwamaprotheni okusebenzayo kwe-C kanye / noma isilinganiso se-erythrocyte sedimentation (ESR): Lezi zivivinyo zilinganisa ukuvuvukala emzimbeni.
• Ukuhlolwa kwe-HLA-B27: Lokhu kukala ukuhlolwa komaka wezakhi zofuzo kwe-JIA ehlobene ne-enthesitis.
• Ukuhlolwa kwe-antiinuclear antibody: Lokhu kuhlolwa kusiza ukukhombisa ubukhona bokuzimela.
• I-MRI kanye / noma i-X-ray: Lokhu kuskena kusiza ukukhipha ezinye izimo.

Eziningi zalezi zivivinyo ezishiwo ngenhla zingaba nokuhle enganeni ejwayelekile, yingakho imiphumela kufanele ihunyushwe ngudokotela ukuze enze ukuxilongwa kokugcina.

Kunconywa ukuhlolwa kwamehlo kwezinye izinhlobo ezincane zesifo samathambo esencane, futhi ngincoma ukuthi yonke ingane okusolwa ukuthi inalesi simo kufanele idluliselwe kudokotela wezifo zamehlo, kusho uDkt Cadet. Uthi kubalulekile ukuthi kuhlolisiswe kahle izingane ngaphambi kokwenza ukuxilongwa kwesifo samathambo esencane ukuze kukhishwe ezinye izifo ezifana nesifo seLyme, i-lupus, ukuphazamiseka kwamathambo, i-fibromyalgia, ukutheleleka kanye nomdlavuza.

Selashwa kanjani isifo samathambo?

Ukwelashwa kwe-juvenile idiopathic arthritis kusekelwe kuhlobo luni lwesifo samathambo ingane enaso, futhi ngokujwayelekile kubandakanya inhlanganisela yemithi nokuvivinya umzimba.Umgomo wokwelashwa ukunciphisa ubuhlungu obuhlangene nokuvuvukala, ukuvimbela ukulimala okuhlangene, nokwandisa ukuhamba ngokuhlanganyela, kusho uDkt Cadet. Uyaphawula futhi ukuthi kwesinye isikhathi lezi zingane zikhula ngaphandle kwezimpawu futhi ziye ekuxolelweni ngokwelashwa, kepha ezinye zingaqhubeka futhi ziqhubeke nokuthuthukisa isifo samathambo esidala.

Izinguquko zendlela yokuphila

Amanye amakhambi wokuphila angasiza i-arthritis yezingane afaka:

• Ukuzivocavoca umzimba
• Ukudla okunempilo
• Ukwelashwa ngokomzimba
• Ukwelashwa ngokushisa

UDkt Barnard uthi ukushisa kungasiza ngokuvuvukala nobuhlungu. Ukugeza okufudumele kungaba mnandi ikakhulukazi ezinganeni (vele ulethe amathoyizi abo abawathandayo bese wenza umcimbi kuwo!), Uthi, noma usebenzisa Ama-bunny bunies erayisi e-DIY ukwelashwa ukushisa.

Imithi

Imithi ingasiza lesi simo ngezindlela ezintathu eziyinhloko: ukuphatha ubuhlungu, ukuvimbela ukuqhubeka kwesimo, nokugwema izinkinga zokukhula. Izinketho ezitholakalayo zifaka:

• Izidakamizwa ezingezona ukuvuvukala ( ibuprofen , umabhebhana ): Ama-NSAID anqunyelwe ukuphatha izinhlungu. Abazali kumele baqaphele isicanucanu, ubuhlungu besisu, ukulinyazwa, kanye nokwanda okungenzeka kwengcindezi yegazi noma izinkinga zezinso ngalo muthi, kusho uDkt Cadet.
• Ama-ejenti wokuguqula izifo ( i-hydroxychloroquine , imethotrexate , sulfasalazine ): Le mithi ikhomba amakhemikhali athile emzimbeni abangela ukuvuvukala. Imiphumela emibi yale mithi ingaba nzima, ngakho-ke kubalulekile ukuyithatha njengokuyalelwa ngumhlinzeki wezokunakekelwa kwempilo.
• Imijovo ye-Biologic ( Humira , Umhlanganisi , I-Remicade , ICosentyx , Ocrevus ): Le mithi ivela ezintweni eziphilayo futhi ivimba izindlela zokuzivikela kumaseli.

Ngokusobala, inketho yokuqala futhi 'elula' ukuthatha i-anti-inflammatory, njenge-ibuprofen, ukubona ukuthi lokho kunciphisa yini ubukhulu bezinhlungu nokuvuvukala, kusho uDkt Barnard. Uma lokho kungasizi… ingane izokhuthazwa ukuthi ivakashele owelapha ngokomzimba noma emsebenzini ukuze aqeqeshe ukuhamba namandla.

Izinhlelo ezinhle zokwelashwa ziyi-multimodal. Ukuhlanganisa imishanguzo nokunyakaza okuphephile kodwa okungaguquguquki kungasiza ukukhulula lawo malungu, ikakhulukazi uma kubhangqwe nokuzivocavoca okuqondiwe okunikezwa ngudokotela wakho womzimba 'njengomsebenzi wesikole' phakathi kwezikhathi, uDkt Barnard uyachaza.

Ukwelashwa

Ukuphila nesifo samathambo kungaba nzima enganeni. Ukusebenza nomelaphi noma iqembu lokusekela kungasiza ekunciphiseni imiphumela yengqondo yesifo esingelapheki.

Kubalulekile ukuthi abazali nodokotela babhekane nemiphumela engokomzwelo nengokwenhlalo yalesi sifo, kusho uDkt Cadet, kanye nokuthola ukwesekwa kwezingane ngokwelulekwa ngokwengqondo noma izinhlangano ezifana ne-Arthritis Foundation ekhuthaza izingane eziphila nalesi sifo esingalapheki.

Ingabe i-arthritis yezingane ihamba?

Alikho ikhambi le-arthritis yezingane, kodwa iArthritis Foundation ithi ukuthi ngokuxilongwa kusenesikhathi nokwelashwa okunolaka, ukuxolelwa kungenzeka. Bancoma uhlelo oluhlelwe kahle olufaka phakathi imithi, ukuvivinya umzimba, izindlela zokwelapha ezihambisanayo, kanye nokudla okunempilo ukwelapha nokuvimbela ukuqhuma.