Ama-Amyloidosis 

Amaprotheni adlala indima ebalulekile ekugcineni umzimba unempilo, kodwa ngezinye izikhathi, angabangela izinkinga ezingalindelekile. Lapho amaprotheni angajwayelekile abizwa ngokuthi ama-amyloid enqwabelana ezithweni nasezicutshini, angaholela esimeni esibucayi esibizwa ngokuthi i-amyloidosis. 

Lesi sifo esingavamile kodwa esiyinkimbinkimbi sithinta izingxenye ezihlukahlukene zomzimba, kusukela enhliziyweni nezinso kuya esimisweni sezinzwa. Ukuqonda ukuthi lesi simo siqala kanjani, ukuqaphela izimpawu ze-amyloidosis, nokwazi izinketho zokwelashwa ezitholakalayo kuyizinyathelo ezibalulekile ekulawuleni lesi sifo ngokuphumelelayo. 

Iyini i-Amyloidosis? 

I-Amyloidosis yenzeka lapho amaprotheni angajwayelekile abizwa ngokuthi ama-amyloid enqwabelana ezicutshini nasezithweni zomzimba wonke. Lesi simo esingavamile siqala lapho amaprotheni eshintsha ukuma kwawo futhi enze izigaxa ezisontekile ezingalimaza izitho futhi ziphazamise ukusebenza kwazo okuvamile. 

Lesi simo singabonakala ngezindlela ezimbili eziyinhloko: 

• I-Systemic amyloidosis ithinta izitho eziningi kuwo wonke umzimba, okuhlanganisa inhliziyo, izinso nesibindi. 
• I-amyloidosis yendawo ihlose indawo eyodwa kuphela, ngokuvamile ethinta isikhumba, esinyeni, noma imigudu yomoya. 

Okulandelayo yizinhlobo ezivamile ze-amyloidosis: 

• AL (Primary) Amyloidosis - Kuthinta amangqamuzana e-plasma futhi ngokuvamile kuthinta inhliziyo nezinso 
• I-AA (yesibili) i-Amyloidosis - Kuvela ngenxa yokuvuvukala okungapheli 
• I-ATTR Amyloidosis - Kubandakanya amaprotheni e-transthyretin futhi angathola ifa 

Izimpawu ze-Amyloidosis 

Izimpawu ezivame kakhulu zihlanganisa: 

• Ukukhathala Okukhulu kanye Nobuthakathaka: Iziguli zivame ukukhathala kakhulu, okwenza ngisho nemisebenzi elula ibe nzima 
• Ukwehla Kwesisindo Okungachazeki: Abantu abaningi balahlekelwa amakhilogremu angu-20-25 ngaphandle kokuzama 
• Ukuvuvukala: Ibonakala ikakhulukazi emaqakaleni, emilenzeni nasezinyaweni 
• Ubunzima bokuphefumula: Ukuphelelwa umoya, ikakhulukazi phakathi nomsebenzi womzimba 
• Izinguquko Zesikhumba: Kubandakanya ukulimala okulula, amabala ansomi azungeze amehlo, nokujiya kwengcina 
• Izinkinga Zemizwa: Ukuba ndikindiki, ukuluma, noma ubuhlungu ezandleni nasezinyaweni 
• Izinkinga Zokugaya: Kufaka phakathi isifo sohudo, ukuqunjelwa, nomuzwa wokugcwala 
• Izimpawu ezihlobene nenhliziyo: Ukushaya kwenhliziyo okungajwayelekile kanye nesiyezi lapho umile 

Izinkinga ze-Amyloidosis 

Ukuthuthukiswa kwe-amyloidosis kungabangelwa izimo ezihlukahlukene ezingaphansi: 

• Izifo Ezingamahlalakhona Ezivuvukalayo: Izimo zokuvuvukala zesikhathi eside ezifana rheumatoid arthritis noma isifo samathumbu esivuvukalayo 
• Izifo Zeseli Yegazi: I-myeloma eminingi kanye nokunye okungavamile kwamaseli e-plasma 
• Izakhi zofuzo: Ukuguqulwa kofuzo okuzuzwayo okuthinta ukukhiqizwa kwamaprotheni 
• Izinguquko ezihlobene nobudala: Izinqubo zokuguga zemvelo ezithinta ukwakheka kwamaprotheni 
• Isifo sezinso: I-dialysis yesikhathi eside noma ukungasebenzi kahle kwezinso 

Izingozi Zezingozi 

Kunezici eziningana ezingandisa ingozi yomuntu yokuba ne-amyloidosis. 

• Ubudala: Izigameko eziningi zenzeka kubantu abangaphezu kweminyaka engama-60. 
• Ubulili: Amadoda abhekene nengozi enkulu uma kuqhathaniswa nabesifazane 
• Umlando Womndeni: Kubaluleka lapho kucutshungulwa izinhlobo zofuzo zesimo. 
• Izimo Zezokwelapha: Ukutheleleka okungamahlalakhona, ukuphazamiseka kwe-autoimmune, nezinhlobo ezithile zomdlavuza 
• ukutheleleka: Abantu abanomlando wokutheleleka okuphindaphindiwe noma izimo ezivuthayo babhekana nengozi ephakeme yokuthuthukisa i-amyloidosis ngokuhamba kwesikhathi. 

Izinkinga ze-Amyloidosis 

• Izinkinga Zokugaya: Uhudo, ukuqunjelwa, noma ubunzima bokumunca imisoco 
• Ukulimala Kwezinso: I-amyloidosis yesikhathi eside ingakhinyabeza ukusebenza kokuhlunga kwezinso, okungaholela ekutheni ukuhluleka kwezinso. 
• Ukwandiswa kwezitho: Ngezinye izikhathi, i-amyloidosis ingabangela ukwanda kwesibindi, okuholela ebuhlungu noma ukugcwala kwesisu. 
• I-Peripheral Neuropathy: Izinkinga ze-neurological zimelela enye yezinselele ezibaluleke kakhulu ku-amyloidosis. Lesi simo ngokuvamile sithinta isimiso sezinzwa se-peripheral, okuholela ekuphazamisekeni okuhlobene nemizwa. Iziguli zingase zibe: 
  • Imizwa ebuhlungu nokuba ndikindiki 
  • Ibhalansi ubunzima kanye nezinkinga zokuxhumanisa 
  • Ukujuluka okungajwayelekile 
  • Izinkinga zomsebenzi wocansi 

Ukuxilongwa kwe-Amyloidosis 

Ukuhlola kokuqala kuvame ukuhlanganisa: 

• Ukuhlolwa kwegazi nomchamo ukuthola amazinga amaprotheni angajwayelekile 
• Ukuhlola ukuhlolwa njengama-CT scan kanye nama-echocardiograms ukuhlola ukulimala kwesitho 
• Ukuhlolwa kofuzo ukuhlonza izinhlobo zofuzo zesimo 
• Ukuhlolwa komnkantsha ukuhlola amaprotheni athile aguquliwe abangela i-amyloidosis ehlukile 
• Isidumbu: Indlela eqondile kakhulu yokuqinisekisa i-amyloidosis ngokusebenzisa izicubu ze-biopsy. Odokotela bavame ukwenza i-abdominal fat pad biopsy, ehlasela kancane futhi ecaciswe kahle kakhulu. 

Ukwelashwa 

Izinketho zokwelashwa eziyinhloko zifaka: 

• Imithi ye-Chemotherapy njenge-melphalan ne-dexamethasone ukubhubhisa amaseli e-plasma angajwayelekile 
• Ukwelashwa okuhlosiwe, njenge-angiogenesis inhibitors, i-proteasome inhibitors, noma i-monoclonal antibody therapy, iqondise kumaprotheni athile noma izicubu ezibangela i-amyloidosis. 
• Ukudluliselwa kweseli kwabafundi abafanelekile 
• Imithi yamanoveli njenge-patisiran ne-inotersen yamafomu ofuzo 
• Ukwelashwa okusekelayo, kufaka phakathi ama-diuretics nama-compression stockings 
• Ukufakelwa izitho zomzimba ezimweni ezithile 

Ezigulini ezine-AA amyloidosis, ukwelashwa kugxile ekulawuleni isimo sokuvuvukala esicashile. Labo abane-ATTR amyloidosis yofuzo bangase bazuze emithini esanda kugunyazwa ebambezela ukuqhubeka kokwakheka kwamaprotheni. 

Uzoyibona Nini Udokotela 

Ukuqaphela isikhathi sokufuna usizo lwezokwelapha kuyadingeka ukuze ulawule i-amyloidosis ngokuphumelelayo. Abantu kufanele bathinte udokotela wabo ngokushesha uma beba nezimpawu ezingapheli ezingachazwanga, ikakhulukazi uma izimpawu eziningi zenzeka kanyekanye. 

Amakhambi Asekhaya E-Amyloidosis 

Nakuba ukwelashwa kusalokhu kubalulekile, amakhambi amaningana ahambisanayo angasiza ekulawuleni izimpawu ze-amyloidosis futhi athuthukise izinga lokuphila. 

• Ukuguqulwa kwendlela yokuphila kudlala indima ebalulekile ekusekeleni impilo yonke kanye nokuphatha isimo ngempumelelo. 
• Ukuvivinya umzimba njalo, ngaphakathi kokulinganiselwa komuntu ngamunye, kusiza ukulwa nokukhathala nokugcina amandla emisipha. Iziguli kufanele zizivocavoce kahle ngemva kokubonisana nodokotela bazo mayelana namazinga afanele okusebenza. 
• Ukuphatha ukudla kwakha ingxenye ebalulekile yokunakekelwa kwasekhaya. Iziguli ziyazuza kulokhu: 
  • Ukudla ukudla okune-fiber ephezulu ene-hydration eyanele 
  • Ukudla okuncane, okujwayelekile njalo amahora angama-2-3 
  • Kubandakanya ukudla okunomsoco njengokwatapheya namantongomane 
  • Ukugwema ukudla okugayiwe kanye noshukela ocolisisiwe 
  • Ukunciphisa ikhofi, utshwala, nokudla okubabayo 
• Izithako ezithile zisiza ukunciphisa ukuvuvukala futhi zisekele impilo yonke. Izithako zamafutha ezinhlanzi (amaphilisi angu-1,000 mg) zingasiza ekwehliseni ukuvuvukala, nakuba iziguli ezithatha imithi yokunciphisa igazi kufanele zithintane nodokotela wazo kuqala. Ukwengezwa kwe-Vitamin C kungase futhi kube yinzuzo, ngemithamo enconyiwe yansuku zonke phakathi kwe-1-2 amagremu. 
• Ukuzindla nokuzilolonga kokuphefumula okujulile, ikakhulukazi ngaphambi kwesikhathi sokulala, kungasiza ekulawuleni ingcindezi futhi kuthuthukise izinga lokulala. 
• Ezigulini ezinenkinga yokudla kwendabuko, odokotela bangase batuse izithasiselo zokudla okunomsoco noma ama-shakes okushintsha ukudla ukuze kuqinisekiswe ukudla okwanele. 

Prevention 

Ucwaningo lwamanje lwezokwelapha lubonisa ukuthi izinhlobo eziningi ze-amyloidosis azikwazi ukuvinjelwa ngokuphelele. Nokho, odokotela bagcizelela ukubaluleka kokuphatha izimo zempilo ezicashile ezingase ziholele ezinhlotsheni ezithile zalesi simo. 

Nakuba i-AL amyloidosis ihlala ingalindelekile futhi ingavimbeki, abantu ngabanye bangathatha izinyathelo ezithile zokunciphisa amathuba okuthuthukisa i-AA amyloidosis: 

• Ukwelashwa kwangaphambi kwesikhathi kwezimo ezivuthayo ezingapheli 
• Ukuqapha njalo ukusebenza kwezinso 
• Ukuphathwa kahle komndeni waseMedithera fever ngemithi enqunyiwe 
• Ukuhlolwa kwezokwelapha okungaguquki kwalabo abanezici eziyingozi 
• Ukugcina amarekhodi ezempilo anemininingwane ukuze kubonwe izimpawu zakuqala 

Isiphetho 

Impumelelo ekulawuleni i-amyloidosis incike kakhulu ekutholakaleni kusenesikhathi kanye nokungenelela kwezokwelapha okufanele. Ukuqapha njalo, ukuguqulwa kwendlela yokuphila, kanye nokubambelela ekwelashweni okunqunyiwe kusiza iziguli zigcine ikhwalithi yokuphila engcono kuyilapho zilawula izimpawu zazo ngempumelelo. Nakuba ukuvimbela okuphelele kusalokhu kuyinselele, ukuphathwa okufanele kwezici eziyingozi kanye nokugadwa njalo kwezokwelapha kunikeza indlela engcono kakhulu eya phambili kubantu abathintwe noma abasengozini ye-amyloidosis. 

FAQs 

1. Ingabe i-amyloidosis iyelapheka? 

Njengamanje, alikho ikhambi eliphelele le-amyloidosis. Kodwa-ke, odokotela bangakwazi ukuphatha lesi simo ngokuphumelelayo futhi babambezele ukuqhubeka kwaso ngezindlela ezihlukahlukene zokwelashwa. Ubude besikhathi sokuphila buncike ohlotsheni lwe-amyloidosis, izitho ezithintekile, nokuthi ukwelashwa kusenesikhathi kuqala kanjani. 

2. Yikuphi ukudla okungalungile nge-amyloidosis? 

Nakuba ukudla kungabangeli ngokuqondile i-amyloidosis, ukudla okuthile kungase kube nezimpawu ezimbi kakhulu. Ngokuvamile iziguli kufanele zigweme: 

• Ukudla okugayiwe okuphezulu kwe-sodium 
• Ukudla okubabayo & okune-acidic okungase kucasule uhlelo lokugaya ukudla 
• Ukudla okunamafutha amaningi 

3. Ubani osengozini enkulu ye-amyloidosis? 

Lesi simo singakhula kunoma ubani, amaqembu athile abhekene nezingozi eziphakeme. Amadoda abhekana ne-amyloidosis kaningi kunabesifazane, ikakhulukazi labo abangaphezu kweminyaka engama-50 ubudala. Abantu abanezimo zokuvuvukala okungapheli noma labo abaphila isikhathi eside dialysis futhi ubhekane nezingozi ezikhulayo. 

4. I-amyloidosis iqala eminyakeni emingaki? 

Izimo eziningi ze-amyloidosis zikhula phakathi kweminyaka engama-50 nengama-65. Nokho, amafomu ofuzo angavela ngaphambi kwesikhathi, ngokuvamile phakathi kweminyaka engama-40 nengama-65. Iminyaka yokuqala iyahlukahluka futhi incike ohlotsheni oluthile lwe-amyloidosis kanye nezici zofuzo eziwumsuka. 

5. Iyini imbangela ye-amyloidosis? 

I-Amyloidosis iqala lapho amaprotheni emzimbeni eshintsha isimo futhi akhe amadiphozithi ayingozi. Kunezici ezimbalwa ezingabangela le nqubo: 

• Izinkinga ze-plasma cell 
• Izimo ezingapheli zokuvuvukala 
• Ukuguqulwa kofuzo 
• Izinguquko zamaprotheni ezihlobene nobudala

UDkt. Sandeep Kharkar

MBBS, MD (Int Med),PGCC (Rheumatology)
I-Ganga CARE Hospital Limited, eNagpur

Ukuze Ubhukhe Isikhathi, shayela:

+ 91 40-68106529