Sarcoidosis

I-Sarcoidosis ithinta izigidi zabantu emhlabeni wonke, nokho abaningi abakaze bezwe ngalesi sifo sokuvuvukala. Lesi simo senzeka lapho amaqoqo amangqamuzana avuvukalayo akha ezithweni ezahlukene emzimbeni wonke. Nakuba abanye bengase bakhathazeke ngokuthi i-sarcoidosis ingumdlavuza, empeleni uhlobo oluhlukile lwesimo oludinga indlela ethile yokwelapha. Lo mhlahlandlela ophelele uchaza i-sarcoidosis, okuhlanganisa izimpawu zayo, izimbangela, ukuxilongwa, kanye nezinketho zokwelashwa. 

Iyini i-Sarcoidosis?

I-Sarcoidosis yisifo esiyinkimbinkimbi sokuvuvukala lapho amasosha omzimba enza amaqoqo amancane amaseli abizwa ngokuthi ama-granulomas ezithweni ezihlukahlukene. Lawa ma-granulomas ayimpendulo yokuzivikela yomzimba, edala izigaxa zamangqamuzana ezivuvukalayo ezingakhula kunoma iyiphi ingxenye yomzimba.

Ngenkathi i-sarcoidosis ingathinta izitho eziningi ngesikhathi esisodwa, ivame ukuvela ku:

• Amaphaphu nesifuba lymph nodes
• Isikhumba namehlo
• Inhliziyo nezinye izitho
• Imisipha namalunga
• Isibindi nobende

Izimpawu ze-Sarcoidosis

Izimpawu ze-sarcoidosis ziyahlukahluka kuye ngokuthi yiziphi izitho ezithinta ama-granulomas kanye nobukhulu be-granulomas.

• Izimpawu ze-General Sarcoidosis:
  • Ukukhathala okuqhubekayo
  • Ukulahlekelwa kwesisindo esingachaziwe
  • Izimbali ezivuvukala ze-lymph
  • ubuhlungu Joint nokuvuvukala
  • Izithukuthuku ebusuku
  • Ubuthakathaka bemisipha
• Izimpawu zamaphaphu: Uma i-sarcoidosis yamaphaphu ibonakala, ingabangela okulandelayo:
  • Ukukhwehlela Komile Okuphikelelayo
  • Ukuphelelwa umoya
  • Ukungakhululeki kwesifuba
  • Ukushisa, ikakhulukazi phakathi nokuzivocavoca umzimba
• Izimpawu Zesikhumba: 
  • Amaqhubu abomvu-nsomi ezinqeni noma emaqakaleni
  • Ukuphazamisa izilonda emakhaleni, ezihlathini, noma ezindlebeni
  • Amabala amnyama noma alula esikhumbeni 
• Izimpawu Zamehlo: Izinkinga zamehlo zingakhula ngaphandle kwezimpawu zokuqala, okwenza ukuhlolwa kwamehlo okuvamile kubaluleke kakhulu. Lapho kuvela izimpawu, ngokuvamile zihlanganisa: 
  • Umbono ophundlekile
  • Ubuhlungu bamehlo
  • Ukwanda kokuzwela ekukhanyeni
  • Ukuvutha noma ukulunywa kanye nokubabomvu okunzima
• Izimpawu ezihlobene nenhliziyo: 
  • Izinhliziyo ezingavamile
  • ubuhlungu besifuba
  • Ukuphelelwa umoya
  • Iziphonso zokuquleka noma ukushaya kwenhliziyo
  • Ukuvuvukala kwemilenze, okuwumphumela wokugcinwa koketshezi 

Izinkinga ze-Sarcoidosis 

Lesi sifo siqala lapho isimiso somzimba sokuzivikela ezifweni sisabela ngendlela engavamile ezinhlangeni ezithile, okubangela ukuvuvukala kudlule ithrekhi.

Ukuthuthukiswa kwe-sarcoidosis kubangelwa isiphepho esiphelele sezinto ezihlukahlukene. Lapho izimbangela ezithile zemvelo zihlangabezana nezakhi zofuzo zomuntu, amasosha omzimba angasabela ngokweqile, akhe ama-granulomas ezithweni ezahlukene.

Nazi ezinye zezizathu ezivamile ze-sarcoidosis:

• Ukuvezwa Kwemvelo: Ukuthintana nezibulala-zinambuzane, isikhunta, noma izinto zasembonini, ikakhulukazi ezithinta abasebenzi bezempilo, abasebenza embonini yezimoto, kanye nabacimi bomlilo.
• Ama-ejenti Athelelanayo: Ukuchayeka kumabhaktheriya athile noma amagciwane
• Izakhi zofuzo: Ukuba nezakhi zofuzo ezithile ezithinta izimpendulo zamasosha omzimba
• Izingozi Zomsebenzi: Ukusebenza ezindaweni ezinokuchayeka othulini, amakhemikhali, noma ezinye izinto ezivuvukalayo
• Ukwelashwa Kwezokwelapha: Imithi ethile ye-HIV kanye nemithi ethile yokwelapha umdlavuza

Izici ezibalulekile zobungozi bokuthuthukisa i-sarcoidosis zifaka:

• Ubudala: Izimo eziningi zenzeka phakathi kweminyaka engama-20 nengama-60, nengozi eyengeziwe ngemuva kweminyaka engama-55
• Ubulili: Abesifazane bakhombisa ukuthinteka kancane kunabesilisa
• Ubuhlanga nobuzwe: Abantu bozalo lwase-Afrika kanye namagugu aseNyakatho Yurophu (ikakhulukazi iScandinavia) babhekene nezingozi ezinkulu

Izinkinga zeSarcoidosis

Izinkinga ezimbi kakhulu zingathinta izitho ezihlukahlukene:

• Amaphaphu: I-sarcoidosis yamaphaphu engalashwa ingabangela izibazi ezingapheli (i-pulmonary fibrosis), kwenze ukuphefumula kube nzima. Lesi sibazi singase sibangele umfutho wegazi ophakeme wamaphaphu, kuphoqe inhliziyo ukuthi isebenze kanzima ukuze inikeze igazi ngemithambo yamaphaphu eyonakele.
• Amehlo: Ukuvuvukala kungalimaza i-retina futhi kubangele ubumpumputhe. Ezinye iziguli ziba ne-cataract noma i-glaucoma, edinga ukungenelela kwezokwelapha ngokushesha.
• Izinso: Lesi sifo singaphazamisa ukuphatha i-calcium emzimbeni, okuholela ekutheni kube namatshe ezinso nokuncipha kokusebenza kwezinso. Ezimweni ezimbi kakhulu, lokhu kungase kuqhubekele ekuhlulekeni kwezinso.
• Inhliziyo: I-cardiac i-sarcoidosis idala ama-granulomas ezicutshini zenhliziyo ezingaphazamisa isigqi senhliziyo esivamile nokugeleza kwegazi. Le nkinga enzima idinga ukuqapha ngokucophelela njengoba ingaba yingozi empilweni.
• Uhlelo Lwezinzwa: Lapho ama-granulomas ekhula ebuchosheni nasemgogodleni, iziguli zingase zibe nokukhubazeka kobuso, ukuquleka, noma izimpawu ezifana ne-multiple sclerosis.

Sifo

• Ukuhlolwa Komzimba: Okokuqala, odokotela bahlola izimpawu futhi balalelisise inhliziyo namaphaphu esiguli. Odokotela baphinde bahlole ama-lymph nodes avuvukele futhi bahlole noma yiziphi izilonda esikhumbeni okungenzeka zikhona.

Ukuqinisekisa ukuxilongwa kwe-sarcoidosis, odokotela bathembele kumathuluzi amaningana abalulekile okuxilonga:

• Ukuhlolwa Kwezithombe:
  • Ama-X-ray esifuba ukuhlola amaphaphu nenhliziyo
  • Ama-CT scans ukuze ahlole isitho esinemininingwane
  • I-MRI ihlola ukubandakanyeka kwenhliziyo noma isimiso sezinzwa
  • I-PET ihlola ukuze ithole ukuvuvukala
• Isidumbu: Ukuqinisekiswa kwezicubu nge-biopsy kuhlala kubalulekile, ikakhulukazi uma ukwelashwa kudingekile. Kuye ngezitho ezithintekile, Odokotela bangathola amasampula ezicubu ngezindlela ezihlukahlukene. Indlela ejwayeleke kakhulu i-bronchoscopy, evumela odokotela ukuba bahlole futhi bathathe amasampula emaphashini nasesifubeni.
• Izinqubo Ezengeziwe Zokuxilonga: 
  • Ukuhlolwa kokusebenza kwamaphaphu ukukala umthamo wamaphaphu
  • Ukuhlolwa kwegazi ukuhlola ukusebenza kwesitho
  • Ukuhlolwa kwamehlo okukhethekile ukuze kutholwe izinkinga ezihlobene neso
  • I-Electrocardiogram (ECG) ukuqapha umsebenzi wenhliziyo

Ukwelashwa kwe-Sarcoidosis

Odokotela bavamise ukusebenzisa indlela "yokulinda nokulinda" ezimweni ezithambile, njengoba isimo sivamise ukuzixazulula ngokuzenzakalelayo.

Lapho ukwelashwa kudingekile, odokotela bagxila emigomweni emithathu eyinhloko: ukunciphisa ukuvuvukala, ukuvimbela ukulimala kwezitho, nokuthuthukisa izinga lokuphila. 

Imithi evame ukunikezwa i-sarcoidosis ihlanganisa:

• I-Corticosteroids: Lezi zidakamizwa ezinamandla zokulwa nokuvuvukala zisebenza njengomugqa wokuqala wokwelapha
• Ama-Immunosuppressants: Le mithi yokuvimbela ukwenqaba isiza ukulawula ukusabela kwamasosha omzimba
• Izidakamizwa ezilwa nomalaleveva: IHydroxychloroquine ifakazela ukuthi isebenza kahle kakhulu esikhumbeni nezimpawu zamalunga
• I-TNF-alpha Inhibitors: Le mithi ethuthukisiwe iqondise kumakhemikhali athile amasosha omzimba
• Ukwelashwa Kokusiza: Ngokwezimpawu noma izinkinga, odokotela bangase banikeze ukwelashwa okwengeziwe, okuhlanganisa:
  • Ukwelapha ngokomzimba ukunciphisa ukukhathala nokuthuthukisa amandla emisipha
  • Ukuvuselelwa kwamaphaphu ukunciphisa izimpawu zokuphefumula
  • I-Pacemaker yenhliziyo noma i-defibrillator ye-arrhythmias yenhliziyo

Uzoyibona Nini Udokotela

Ukuqaphela ukuthi kufanele usithathe nini iseluleko ekunakekelweni kwezokwelapha kubalulekile ekulawuleni i-sarcoidosis ngempumelelo. Iziguli kufanele zikhulume nodokotela bazo abelaphayo ngokushesha uma zithola izimpawu ezintsha noma eziba nzima, ikakhulukazi izinguquko ekuphefumuleni, izinkinga zokubona, noma ukushaya kwenhliziyo okungajwayelekile.

Isiphetho

I-Sarcoidosis isalokhu iyisimo esiyinkimbinkimbi sokuvuvukala esithinta izinkulungwane zabantu emhlabeni jikelele. Isayensi yezokwelapha yenze intuthuko enkulu ekuqondeni nasekwelapheni lesi sifo, nakuba imbangela yaso yangempela iqhubeka ibadida abacwaningi. Iziguli ezithola ukuxilongwa kusenesikhathi nokwelashwa okufanele zivame ukuthola imiphumela engcono kanye nezinga lempilo.

Uhambo olune-sarcoidosis lubukeka luhlukile kumuntu ngamunye. Ezinye iziguli zilulama ngokuphelele phakathi neminyaka embalwa (iminyaka engu-2-3), kuyilapho ezinye zidinga ukunakekelwa kwezokwelapha nokuqapha isikhathi eside. Ukuhlolwa njalo, ukuguqulwa kwendlela yokuphila, kanye nokulandela izinhlelo zokwelashwa ezinqunyiwe kusiza iziguli zilawule izimpawu zazo ngempumelelo.

Imibuzo Evame Ukubuzwa

1. I-sarcoidosis ithinta bani?

I-Sarcoidosis ivamise ukuphatha abantu abadala abaphakathi kweminyaka engama-20 nengama-60. Lesi simo sibonisa ukusabalala okuphezulu kwabesifazane futhi kwenzeka kakhulu kubantu bamagugu ase-Afrika naseNyakatho Yurophu. Abasebenzi bezokunakekelwa kwempilo, abalimi, kanye nabacimi bomlilo babhekene nengozi eyengeziwe ngenxa yokuchayeka kwemvelo.

2. Yiziphi izigaba ze-sarcoidosis yamaphaphu?

I-sarcoidosis yamaphaphu ihlukaniswa ngezigaba ezinhlanu ezihlukene:

• Isiteji 0: I-X-ray yesifuba evamile engenazo izimpawu ezibonakalayo
• Isiteji 1: Ama-lymph nodes akhulisiwe kuphela
• Isiteji 2: Ama-lymph nodes akhulisiwe kanye nokubandakanyeka kwamaphaphu
• Isiteji 3: Ukubandakanyeka kwamaphaphu kuphela
• Isiteji 4: I-pulmonary fibrosis (izibazi ezingapheli)

3. Ngiyozizwa ngingcono ngokushesha kangakanani ngemva kokwelashwa?

Ukuthuthukiswa kwenzeka emasontweni ambalwa kuya ezinyangeni ngemva kokuqala ukwelashwa. Umugqa wesikhathi oqondile uyahlukahluka kuye ngobulukhuni besifo kanye nokusabela komuntu ngamunye emithini. Ukuqapha njalo kusiza odokotela balungise izinhlelo zokwelashwa ukuze bathole imiphumela emihle.

4. Yikuphi ukudla okufanele kugwenywe nge-sarcoidosis?

Iziguli kufanele zinciphise ukudla okucolisisiwe, ushukela, i-pasta emhlophe, nokudla okunamafutha amaningi. Ukuphuza utshwala kufanele kuncishiswe noma kugwenywe ngokuphelele, njengoba kungase kuhlanganyele nemithi futhi kuthinte ukusebenza kwesibindi.

5. Ingabe kukhona ukuhlolwa kwegazi kwe-sarcoidosis?

Intuthuko yakamuva iholele ekuhlolweni kwegazi okuthembisayo ukuze kutholakale i-sarcoidosis. Nakuba lezi zivivinyo zibonisa amandla okuxilongwa ngokushesha, ziyahambisana esikhundleni sokuthatha indawo yezindlela zokuxilonga ezivamile ezifana nama-biopsies.

6. Ingabe i-sarcoidosis yisimo esibucayi?

Nakuba izimo eziningi zixazulula phakathi neminyaka engu-2-3, i-sarcoidosis ingaba yingozi. Cishe i-10-20% yeziguli ziba nokulimala okungapheli kwesitho. Isimo sidinga ukuqapha ngokucophelela kanye nokwelashwa okufanele ukuvimbela izinkinga.

7. Yikuphi ukudla okungcono kakhulu kwe-sarcoidosis?

Ukudla okulinganiselayo, okuvimbela ukuvuvukala kusebenza kangcono ekulawuleni i-sarcoidosis. Lokhu kudla kuhlanganisa:

• Inala yezithelo, imifino, nokusanhlamvu
• Amaprotheni anomzimba namafutha anempilo
• Ukudla okucebile kuma-antioxidants nama-omega-3 fatty acids

UDkt. Sandeep Kharkar

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

Ukuze Ubhukhe Isikhathi, shayela:

+ 91 40-68106529

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