I-Myositis

I-Myositis iyiqembu lezimo ezingavamile ze-musculoskeletal ezibangela ukuvuvukala emisipha, okuholela ebuthakathakeni, ubuhlungu, nokukhathala. Lesi sifo sithinta izinkulungwane zabantu emhlabeni wonke, sithinta izimpilo zabo zansuku zonke kanye nezinga lempilo lilonke. Ake sihlole izinhlobo ezahlukene zesifo se-myositis kanye nezimbangela ze-myositis kanye nezici eziyingozi. Icubungula izimpawu, izinkinga ezingaba khona, nezindlela zokuxilonga ezisetshenziselwa ukuhlonza lesi simo. 

Iyini i-Myositis?

I-Myositis yiqembu lezimo ezingavamile ezibonakala ngokuvuvukala kwemisipha. Igama elithi 'myositis' ngokwezwi nezwi lisho ukuvuvukala kwemisipha. Kuwuhlobo lwe-myopathy olubhekisela ezifweni ezithinta izicubu zamathambo ezixhuma emathanjeni. Isifo se-myositis singenzeka kunoma ibuphi ubudala, kuhlanganise nezingane, futhi ngokuvamile sithinta imisipha ezungeze amahlombe, ama-hips, namathanga.

I-Myositis yi-autoimmune disorder lapho umzimba izivikeli mzimba ihlasela ngephutha izicubu zomzimba ezinempilo. Esimisweni sokuzivikela esinempilo, ukuvuvukala kuyimpendulo yokuvikela ekulimaleni noma ekuthelelekeni. Kodwa-ke, ku-myositis, ukuvuvukala okungadingekile kwenzeka, okubangela izinkinga zemisipha.

Izinhlobo ze-Myositis

I-Myositis ihlanganisa izinhlobo eziningana ezihlukene, ngayinye enezici ezihlukile. Lokhu kubandakanya:

• I-Dermatomyositis (DM): I-DM ibangela i-myositis enobuthakathaka bemisipha nokuvuvukala, okuhambisana nokuqubuka kwesikhumba okuhlukile, okuvamise ukubonakala njengokushintsha kombala okunsomi phezu kwamajwabu amehlo. 
• I-Juvenile Dermatomyositis (JDM): Lokhu ukuhluka kwezingane kwe-DM, okuthinta kakhulu amantombazane.
• I-Polymyositis (PM): I-PM iholela ebuthakathakeni bemisipha nokuvuvukala kubantu abadala, ikakhulukazi abesifazane. 
• I-Inclusion Body Myositis (IBM): I-IBM iwukuphazamiseka kwemisipha okuqhubekayo okubonakala ngokuba buthakathaka, ukuvuvukala, nokumoshakala futhi ngokuvamile kuthinta amadoda angaphezu kweminyaka engama-50. Isifo semisipha esitholakala kakhulu kuleli qembu lobudala.
• I-Antisynthetase Syndrome: Kungase kwenzeke njengenkinga kubantu abane-PM noma i-DM. Kubandakanya ukuba khona kwama-autoantibodies athile futhi kunengozi yokuhlangana isifo samaphaphu. 

Izimbangela kanye Nezingozi Zezinkinga ze-Myositis

I-Myositis ibhekwa njengokuphazamiseka kwe-autoimmune, lapho amasosha omzimba ehlasela ngephutha izicubu zemisipha enempilo. Ukuguqulwa kofuzo, ikakhulukazi ku-human leukocyte antigen (HLA), kungase kwenyuse ingozi yomuntu yokuba ne-myositis. Inkimbinkimbi ye-HLA idlala indima ebalulekile ekusizeni amasosha omzimba ahlukanise phakathi kwamaprotheni omzimba kanye nabahlaseli bangaphandle.

Izimbangela zemvelo nazo zinomthelela ekuthuthukisweni kwe-myositis. Lokhu kubandakanya:

• Amagciwane: Ukutheleleka ngegciwane, njengomkhuhlane ovamile, umkhuhlane, ne-HIV
• Imithi: I-Statins ne-alpha-interferon 
• Ezinye izimo ze-Autoimmune: I-Lupus, rheumatoid arthritis, kanye ne-scleroderma kuhlotshaniswa nokwanda kwamathuba okuba ne-myositis. 
• Ukuchayeka ekukhanyeni kwe-Ultraviolet kanye nobuthi: Ziphinde zihlonzwe njengezici eziyingozi ezingaba khona.

Izimpawu ze-Myositis

• Ubuthakathaka Bemisipha: Ivame ukukhula kancane kancane futhi ingaba nobuqili ekuqaleni. Abantu bangase babe nobunzima bokwenza imisebenzi yansuku zonke njengokugibela izitebhisi, ukuxubha izinwele, noma ukungena nokuphuma ezimotweni.
• Ingozi Eyandayo Yokukuwa: Imisipha ezungeze amahlombe, ezinqulwini, namathanga ivame ukuthinteka, okuholela engozini enkulu yokuwa.
• IRash ebomvu noma ephinki: Ku-dermatomyositis, ukuqubuka okuhlukile okubomvu noma okubomvana kungase kuvele kumajwabu amehlo angenhla, ubuso, intamo, nangemuva kwezandla neminwe. 
• Ezinye Izimpawu ze-Myositis: Lezi zihlanganisa: 
  • Ubuhlungu besisu
  • Ukuzwela ukuthinta
  • Ukuvuvukala ngezikhathi ezithile
  • Abanye abantu bangase bazizwe bengaphilile ngokuvamile
  • Ukwehla kwesisindo
  • Izithukuthuku ebusuku
  • Inkinga yokugwinya (dysphagia) 
  • Ukuphefumula kanzima ngenxa yomphimbo obuthakathaka noma imisipha ye-diaphragm 
  • Ukukhathala nobunzima bokusekela imizamo yomzimba 

Izinkinga

I-Myositis ingaholela ezinkingeni ezihlukahlukene ezithinta izinhlelo eziningi zomzimba. 

• I-Interstitial Lung Disease (ILD): Kwenzeka cishe ku-23% wabantu abane-dermatomyositis noma i-polymyositis. I-ILD ingabangela ukuphelelwa umoya, ukukhwehlela okomile, nokuncipha kokusebenza kwamaphaphu. Kwezinye izimo, kungase kuthuthuke ngokushesha, okuholela ekuqaguleni okubi.
• Izinkinga Zenhliziyo: Zibikwa ku-30% weziguli ezine-myositis. Lokhu kungabandakanya i-arrhythmias, ukuhluleka kwenhliziyo, kanye isifo se-artery coronary. 
• Izinkinga Zamathumbu: I-Dysphagia (ubunzima bokugwinya) kanye nokubambezeleka kokukhipha isisu kungase kwenzeke.
• I-Aspiration Pneumonia: I-Myositis ingathinta ukuphefumula nokugwinya imisipha, okungase kuholele ku-aspiration pneumonia.
• Izimo ze-Autoimmune: Abanye abantu abane-myositis bangase bahlakulele izimo ze-autoimmune ezidlulayo, njenge-rheumatoid arthritis, lupus, noma i-scleroderma. 
• I-Calcinosis: Izingane ezine-juvenile dermatomyositis zingase zibe ne-calcinosis, ehlanganisa ukufakwa kwe-calcium ebuhlungu emisipha eyonakele. 
• I-Cancer: Ezimweni ezingavamile, i-myositis iye yahlotshaniswa nengozi eyengeziwe yomdlavuza, ikakhulukazi kubantu abadala abangaphezu kuka-40 abane-dermatomyositis. 

Sifo

• Umlando Wezokwelapha Nokuhlolwa Komzimba: Odokotela babuza ngezimpawu, ukuqala kwazo, nanoma yiziphi izici ezingase zibe zimbi kakhulu noma zithuthuke. Baphinde bahlole amandla emisipha futhi bahlole noma yikuphi ukungahambi kahle kwesikhumba.
• Ukuhlolwa kwegazi: Lezi zivivinyo zikala amazinga ama-enzyme emisipha afana ne-creatine kinase (CK) ne-aldolase, angabonisa ukulimala kwemisipha. Ukuhlolwa kwe-Antinuclear antibody (ANA) kanye namaphaneli e-myositis-specific amasosha omzimba asiza ukukhomba umsebenzi we-autoimmune.
• Izifundo Zokuqhuba Izinzwa kanye ne-Electromyography (EMG): Lezi zivivinyo zihlola ukusebenza kwemisipha nezinzwa.
• Ukufaniswa kwe-Magnetic Resonance (MRI): Bangaveza ukuvuvukala kwemisipha endaweni enkulu. 
• Isidumbu: Odokotela basusa ucezu oluncane lwezicubu zemisipha ukuze bahlaziywe nge-microscopic.

Ukwelashwa kwe-Myositis

Nakuba lingekho ikhambi le-myositis, izindlela zokwelashwa ezihlukahlukene zingalawula izimpawu futhi zithuthukise izinga lokuphila. Lokhu kubandakanya:

• Imithi: I-Corticosteroids ngokuvamile iwumugqa wokuqala wokwelapha we-myositis. Lezi zidakamizwa zinciphisa ukuvuvukala futhi zidambise ubuhlungu bemisipha. 
• Ama-Immunosuppressants: Zivame ukubekwa eceleni kwe-corticosteroids ukusiza ukulawula ukuhlasela kwamasosha omzimba kumathishu emisipha enempilo.
• Ukwelashwa Kwebhayoloji: Ngezinye izikhathi odokotela batusa izidakamizwa zebhayoloji lapho ezinye izindlela zokwelapha zingasebenzi. Le mithi iqondise ezingxenyeni ezithile zamasosha omzimba ukunciphisa ukuvuvukala. 

Uzoyibona Nini Udokotela

Abantu kufanele bavakashele udokotela ngokushesha uma bethola ubuthakathaka obusha bemisipha, ubuhlungu, noma ezinye izimpawu eziqhubekayo ezinsukwini ezimbalwa. Kwezinye izimo, izimpawu zokuqala ze-myositis zingase zihlanganise ukukhwehlela okomile, okungenzeka ngaphambi kokuba kuvele izimpawu zesikhumba nemisipha. Lesi simo samaphaphu sinamandla okuba sibi, okwenza ukwelashwa ngokushesha kubaluleke kakhulu. 

Ukunakekelwa kwezempilo okuphuthumayo kuyadingeka uma umuntu ngokuzumayo elahlekelwa ikhono lokuhambisa ingxenye yomzimba wakhe, enenkinga yokuphefumula, noma enenkinga yokugwinya. 

Prevention

Nakuba ingekho indlela eyaziwayo yokuvimbela i-myositis, abantu ngabanye bangathatha izinyathelo zokulondoloza impilo yonke futhi okungenzeka banciphise umthelela wesimo. Lezi izi:

• Ukuzivocavoca Okujwayelekile kanye Nokwelashwa Komzimba: Ukuzivivinya umzimba kusiza ukugcina imisipha iqinile, kuvimbela i-atrophy, futhi kuthuthukisa izinga lempilo. 
• Ukudla Okunempilo: Ukudla ukudla okulinganiselayo, okulwa nokuvuvukala okucebile ngezithelo eziphilayo, imifino, okusanhlamvu okuphelele, nama-omega-3 fatty acids kungasiza ekunciphiseni ukuvuvukala futhi kusekele inhlalakahle yonke. 
• Ukucatshangelwa Okukhethekile Kwezokudla: Lokhu kungase kuhlanganise ukunciphisa ukudla kukasawoti, ukwandisa ukudla okune-potassium, nokulawula ukusetshenziswa kwama-carbohydrate ukusiza ukulawula amazinga kashukela egazini. 
• Izithako zokudla: I-calcium, i-vitamin D, ne-omega-3 fatty acids ingase izuze abantu abane-myositis.

Isiphetho

I-Myositis yisimo esiyinkimbinkimbi nesiyinselele esinomthelela omkhulu ezimpilweni zalabo abathintekile. Yize lingekho ikhambi le-myositis okwamanje, ucwaningo oluqhubekayo lunikeza ithemba lokwelashwa okungcono esikhathini esizayo. Okwamanje, inhlanganisela yokunakekelwa kwezokwelapha, ukwelapha ngokomzimba, nokuguqulwa kwendlela yokuphila kungasiza abantu abaningi abane-myositis baphile ukuphila okwanelisayo. 

Imibuzo Evame Ukubuzwa

1. Ubani ovame ukuthola i-myositis?

I-Myositis ingathinta abantu babo bonke ubudala, kodwa izinhlobo ezithile zivame kakhulu emaqenjini athile. I-Dermatomyositis iwuhlobo oluvame kakhulu ezinganeni, kuyilapho i-polymyositis ngokuvamile ihlasela abantu abadala abaneminyaka engaphezu kwengama-20, kanti abesifazane yibona abathinteka kakhulu. I-inclusion body myositis ihlasela kakhulu abantu abangaphezu kweminyaka engama-50, amadoda athambekele kakhulu kulolu hlobo.

2. Ungakwazi yini ukwelapha i-myositis?

Alikho ikhambi le-myositis, kodwa ukwelashwa ngokuvamile kungafaka isimo ekuxolelweni. Abantu abaningi abane-myositis banayo impilo yabo yonke. Kodwa-ke, ngokuphathwa ngendlela efanele, iziguli eziningi zingaphila ukuphila okusebenzayo futhi zithole ukukhululeka kwezimpawu ezibalulekile.

3. I-myositis ihlala isikhathi esingakanani?

I-Myositis ngokuvamile iyisimo esingapheli esihlala impilo yonke. Kodwa-ke, ubude nokuqina kwezimpawu kungahluka kakhulu phakathi kwabantu. Abanye bangase babe nenkathi eyodwa kuphela yokugula okuyingozi, kuyilapho abanye bengase babhekane nezimpawu iminyaka.

4. I-myositis iqala iminyaka emingaki?

I-myositis ingakhula kunoma iyiphi iminyaka, kodwa ukuqala kuyahlukahluka futhi kuncike ohlotsheni oluthile lwe-myositis. I-dermatomyositis yezingane ngokuvamile ivela ezinganeni eziphakathi kweminyaka engu-5 no-15 ubudala. I-dermatomyositis eqala kubantu abadala kanye ne-polymyositis ngokuvamile iqala phakathi kweminyaka engama-30 no-50 ubudala. I-inclusion body myositis ivame ukuthinta abantu abangaphezu kweminyaka engama-50. Iminyaka yokuqala ingaba nomthelela enkambweni yesifo nendlela yokwelashwa. Izimo ezisaqala, ikakhulukazi ezinganeni, zingase zibe nokubikezelwa okungcono ngokwelashwa ngokushesha. I-myositis eqala sekwephuzile, ikakhulukazi i-myositis yomzimba efakwayo, ingaba inselele kakhulu ukuyelapha.

UDkt. Sandeep Kharkar

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

Ukuze Ubhukhe Isikhathi, shayela:

+ 91 40-68106529