IBD Therapy ndi ngozi ya khansa

Matenda opweteka , kapena IBD, amaphatikizapo ulcerative colitis ndi matenda a Crohn. Zonsezi ndizo matenda osachiritsika omwe amatha kupezeka m'matumbo. Onsewa ali ndi mankhwala omwe angachepetse opaleshoni ndi opaleshoni.

Kukhala ndi IBD ndi kupatsidwa mankhwala chifukwa cha matendawa kumakhudzidwa ndi ngozi yowopsa ya lymphoma, ndipo zoopsa zimasiyana ndi zinthu zina pambali pokhapokha chithandizo.

Matenda Opopa Matenda

IBD imayamba chifukwa cha kutupa m'mimba, zomwe zingayambitse magazi, malungo, kukwera kwa maselo oyera a magazi , komanso kutsekula m'mimba komanso kupweteka kwa m'mimba. Zomwe zimachitika mu IBD nthawi zambiri zimakhalapo pamaphunziro ojambula monga CT scan, kapena colonoscopy.

Lymphoma Risk

Anthu omwe ali ndi matenda a IBD omwe amachiritsidwa ndi mankhwala ena monga anti-TNF ndi mawonekedwe oteteza ku chitetezo cha mthupi - ali ndi chiopsezo chowonjezereka kwa khansa zina zomwe zimaphatikizapo maselo oyera a mitsempha ya lymphocyte , malinga ndi maphunziro angapo. Pali kusakayikira podziwa kuti pali ngozi yotani, komabe.

Lymphoma ndi khansa yomwe imayambira mu maselo oyera a magazi, omwe ndi mbali ya chitetezo cha mthupi. Mitundu ikuluikulu ya lymphoma ndi Hodgkin ndipo si Hodgkin lymphoma (NHL) . Pali mitundu yambiri ndi zochepa . Zinawonetseratu kuti NHL imapezeka pamwamba kuposa momwe amayembekezerapo m'magulu osiyanasiyana omwe amafunika kuteteza thupi, monga IBD.

Kuopsa kwa lymphoma sikuli kofanana kwa aliyense amene ali ndi IBD. Mavuto amasiyana malinga ndi zinthu monga zaka, chikhalidwe, ndi zina. Kuwona kuopsa ndi phindu la mankhwala opatsirana pogonana ndi dokotala ndi gawo lofunikira pa chisankho. Kawirikawiri, zimatsimikiziridwa kuti kupindula kwakukulu kwa mankhwalawa kumaposa chiopsezo chochepa chomwe chimachitika.

Matenda a IBD

Kugwiritsira ntchito mankhwala otsutsa-kutupa kwa IBD kuti atulutseni chiweretsedwe ndi kutsata mankhwala opatsirana pogwiritsa ntchito mankhwala opatsirana pogwiritsa ntchito mankhwala omwe akadali opitilirabe. Matenda a thiopurines - monga azathioprine - amagwiritsidwa ntchito kwambiri pochiza matenda opatsirana omwe amatha kutupa.

Kwa odwala omwe ali ndi matenda a IBD omwe amachititsidwa ndi thiopurines, pali chiopsezo chowonjezereka cha mitundu ina ya khansa yamagazi, koma chiwerengero cha khansa chomwe chimayamba chifukwa cha chithandizo chikukhulupiriridwa kukhala chochepa kwambiri. Kwa anthu omwe amapanga ziwalo, NHL yokhudzana ndi chitetezo cha mthupi imatchedwa matenda a post-transplant lymphoproliferative, ndipo zina zomwe zimadziwika ndi vuto la lymphoma zimachokera ku gulu la odwala.

Mapulogalamu apadera a lymphoma awonetsedwa ndi mawothandizidwe oteteza mthupi omwe amagwiritsidwa ntchito mu IBD. Lymphoma pambuyo pa kumuika ndi chimodzi cha izo. N'kutheka kuti mavitamini amatha kukhala ndi mononucleosis, kapena kuti mono, ndipo mawonekedwe ameneŵa amachititsa kuti amuna asanakwane zaka 35 azikhala ndi vutoli. Kawirikawiri, hepatosplenic T-cell lymphoma ikhoza kukhalapo, ndipo imayamba kukula pambuyo pa zaka ziwiri zachipatala pogwiritsa ntchito mankhwala a thiopurines ndi anti-tumor necrosis factor, kapena thiopurines okha.

• Azathioprine anali ndi 2.40 x kuwonjezeka kwa vuto la lymphoma mu kafukufuku wofalitsidwa mu "American Journal of Epidemiology."

• Kuphatikiza kwa azathioprine ndi 6-mercaptopurine ali ndi chiwopsezo chokwanira 4,92 chokwanira cha kukula kwa lymphoma pakati pa anthu omwe ali ndi IBD, malinga ndi kafukufuku wofalitsidwa mu "Clinical Gastroenterology ndi Hepatology."

Zochepa zochepa zimadziwika ndi vuto la methotrexate ndi lymphoma ku IBD. Pogwiritsa ntchito antchito a anti-TNF, kafukufuku wa 2009 anapeza kuti ngozi ya lymphoma ndi anti-TNF + immunomodulator inali yaikulu kuposa immunomodulator yekha.

Pansi

Pali mafunso ambiri osayankhidwa okhudzana ndi zoopsa za lymphoma m'maganizo a IBD mankhwala. Ngati muli ndi IBD ndikusowa chithandizo, ndi bwino kukambirana za mavuto omwe mungakhale nawo ndi dokotala wanu, amene angathandize kuti zinthu ziziwoneka bwino ndikuthandizani kuwona zochitika ndi zochitika zanu.

Popanda chithandizo choyenera, odwala omwe ali ndi Crohn's disease ndi ulcerative colitis akhoza kukhala ndi moyo wochepa kwambiri. Madokotala ena amatsindika mfundo yakuti mwina tili ndi vuto lochepa la odwala ambirimbiri, ndipo zaka zambiri zomwe zimatipangitsa kuganizira za chiopsezo.

Chinthu chimodzi chotsimikizika: kudandaula kwakukulu ndi kupsinjika maganizo kumayenderana ndi matenda amtundu uliwonse, kotero ngati inu ndi adokotala mwasankha kuti mukusowa chithandizo, sizikukuvutitsani.

_Zotsatira:

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_{Kandiel A, Fraser AG, Korelitz BI, Brensinger C, Lewis JD. Kuwonjezeka kwa chiopsezo cha lymphoma pakati pa odwala matenda opatsirana amagazi amachitidwa ndi azathioprine ndi 6-mercaptopurine. Kutha. 2005; 54 (8): 1121-1125.}

_{Askling J, Brandt L, Lapidus A, et al. Kuopsa kwa khansa ya hematopoietic kwa odwala matenda opatsirana. Kutha. 2005; 54 (5): 617-622.}

_{Bhandari BM, Kroser JA, Bloomfeld RS, Lynch SP. Matenda Opopa Matenda. American College of Gastroenterology. 2013.}

_{Siegel CA. Ngozi ya Lymphoma mu Matenda Opatsirana Opatsirana. Gastroenterol Hepatol. 2009; 5 (11): 784-790.}