Kodi tikudziwa chiyani za kugwirizana pakati pa lupus ndi lymphoma? Chabwino, tikudziwa zambiri kuposa momwe tinachitira zaka 20 zapitazo, koma yankho likhoza kukhala "losakwanira," malinga ndi nkhani ya Boddu ndi anzake ogwira ntchito pa Intaneti mu nkhani ya March 2017 ya "Case Reports in Rheumatology."
Lupus, kapena Lupus Erythematosus Yowonongeka (SLE)
Lupus , kapena systemic lupus erythematosus (SLE), ndi matenda ovuta kwambiri omwe angabwere ndi chiwerengero chilichonse cha zizindikiro zosiyana siyana ndipo angaphatikizepo ziwalo zambiri m'thupi.
Anthu awiri omwe ali ndi lupus akhoza kukhala ndi zizindikiro zosiyana, koma izi ndizofala:
- Ululu umodzi, kuuma ndi kutupa
- Kutopa ndi malungo
- Kuthamanga kumaso pamasaya ndi mlatho wa mphuno, kumakhala ngati mawonekedwe a butterfly, ndi mphuno ngati thupi ndi masaya ngati mapiko a gulugufe. Kuthamanga kungakhale kofiira, kungakhale kotentha, kapena kotentha.
- Matenda ena a khungu omwe amawoneka kuti akuipiraipira ndi dzuwa
- Zalako ndi zala zakumaso zikuwoneka kuti zimasokonezeka, zimasanduka zoyera kapena za buluu m'nyengo yozizira kapena nthawi yovuta-imeneyi imatchedwa Raynaud's phenomenon
- Zizindikiro zosiyana siyana; kupuma pang'ono, kupweteka pachifuwa, maso owuma
- Mutu, chisokonezo, ndi kukumbukira kukumbukira
Lymphoma, Khansa ya White Blood Cells
Lymphoma ndi khansa ya maselo oyera, makamaka maselo oyera a magazi omwe amadziwika kuti lymphocytes . Magulu awiri a lymphoma ndi Hodgkin lymphoma ndipo si a Hodgkin lymphoma , kapena NHL. Lymphoma imayamba m'ziwalo zam'mimba, koma imatha kukhala ndi ziwalo zosiyana, ndipo imatha kuchitika m'magulu osiyanasiyana ndi thupi, osati maselo okhaokha.
Mofanana ndi lupus, zizindikiro za lymphoma ndi osiyanasiyana ndipo anthu osiyanasiyana ali ndi zizindikiro zosiyana siyana za lymphoma. Nthawi zina, chizindikiro chokhacho ndi kutupa kwa mitsempha yotupa:
- Kutupa kopweteka kwa ma lymph nodes m'khosi mwanu, kutupa, kapena kubuula
- Kutopa ndi malungo
- Kutseka usiku kukuwombera
- Kutaya njala, kulemera kosawerengeka-pafupifupi 10 peresenti kapena kulemera kwa thupi lanu
- Khungu lachitsulo
- Kupweteka kwa chifuwa kapena chifuwa, kupweteka kwa m'mimba kapena chidzalo, misampha, ndi khungu la khungu
Kodi Zinthu Ziwirizi Zimagwirizana Ziti?
Eya, nthawi zina zizindikiro zingagwirizane, chifukwa chimodzi. Ndipo matenda onsewa akuphatikizapo chitetezo cha mthupi: Lymphocytes ndi maselo ofunikira ku chitetezo cha mthupi, ndipo chitetezo cha mthupi ndi chovuta mu SLE. Lymphocytes ndi maselo ovuta mu lymphoma.
Koma palinso izi: kafukufuku wochuluka apeza kuti anthu omwe ali ndi SLE ali ndi chiwerengero chokwanira cha lymphoma poyerekezera ndi anthu onse. Chimodzi mwa ziphunzitso zambiri ndi chakuti, mu chitetezo cha chitetezo cha m'thupi (chomwe chili ndi wina yemwe ali ndi SLE), kugwiritsa ntchito mankhwala opatsirana pogonana kuti athetse lupus kungachititse kuti chiwerengero cha lymphoma chiwonjezeke mu SLE. Komabe, maphunziro ambiri apangidwa pa nkhaniyi, ndi zovuta kutsutsana, ndipo izi sizikuwoneka ngati nkhani yonse.
Boddu ndi anzake akugwiritsanso ntchito zida zina kuchokera ku ndondomeko yawo ya zachipatala kuti adziwe zambiri za anthu omwe ali ndi SLE omwe amapanga lymphoma. Zowopsa za chitukuko cha lymphoma mwa anthu omwe ali ndi SLE sizowonekera bwino. Anthu omwe ali ndi matenda opatsirana kwambiri omwe amawoneka ngati ali ndi chiwopsezo chachikulu cha lymphoma, ndipo ena amaopsezedwa kuti angagwiritsidwe ntchito ndi cyclophosphamide komanso kutchuka kwa steroid.
Ngakhale kuti nthawi zina panali maphunziro ochepa omwe amayambira-ndipo nthawi zambiri chiwerengero cha anthu omwe ali ndi SLE ndi lymphoma anali ochepa mu maphunziro awa-Boddu ndi ochita kafukufuku anagwiritsa ntchito zomwe angapeze kuti apange nsanja yoyamba yopitilira maphunziro. Zina mwazidziwitso zovuta kuchokera ku maphunziro ndi Odwala SLE omwe adapanga lymphoma.
Anthu omwe ali ndi SLE omwe adapanga lymphoma:
- Ambiri anali akazi
- Mtengo wa zaka unali pakati pa zaka 57 ndi 61
- Pafupipafupi, iwo akanakhala ali ndi zaka 18 asanakwane lymphoma
- Mavuto a Lymphoma kwa anthu omwe ali ndi SLE anali apamwamba kuposa mitundu yonse
- Zizindikiro, zofufuza ndi ma laboni oyambirira a masitepe a lymphoma adagwedezeka pang'ono ndi zomwe zimawoneka mu SLE.
- Lymph node kutupa, nthawizina chizindikiro chokha cha lymphoma, chimakhalanso chofala kwa anthu omwe ali ndi SLE, omwe amapezeka mpaka 67 peresenti.
Maselo amphamvu omwe amayamba mwa anthu omwe ali ndi SLE:
- Mtundu wa NHL wochuluka kwambiri kwa anthu omwe ali ndi SLE unali kufalitsa kwambiri B-cell lymphoma (DLBCL), yomwe ndi yomwe imapezeka ndi NHL mtundu wonsewo.
- Mankhwala a DLBCL mwa iwo omwe ali ndi SLE amawoneka mochuluka mu gulu lomwe liri ndi vuto loipa kwambiri-losalimba B-cell-like DLBCLs.
- NHL mu SLE, monga ndi NHL mwa anthu ambiri, kawirikawiri imachokera kumatenda am'mimba, komabe ziwalo zam'mimba zomwe zimayambira kunja kwa maselo am'mimba zimakhalanso ndi anthu ambiri komanso omwe ali ndi SLE.
Anthu amene ataya nthawi zambiri amachizidwa ndi glucocorticoids, okha kapena ophatikizidwa ndi mankhwala enaake omwe amachititsa kuti thupi lawo lisagwiritsidwe ntchito ndi mankhwalawa, methotrexate, cyclophosphamide, ndi azathioprine. Kafukufuku wambiri adayesa kudziwa ngati mawonekedwe a immunosuppressive amachulukitsa chiopsezo cha lymphoma kwa anthu omwe ali ndi SLE, koma kawirikawiri zotsatira za phunziro limodzi zimatsutsana ndi zotsatirazi.
Pali zifukwa zambiri zokhudzana ndi chifukwa chake anthu omwe ali ndi SLE akhoza kukhala ndi chiopsezo chachikulu cha khansa yambiri, komanso lymphoma makamaka:
- Chiphunzitso chimodzicho chimakhudza kutupa kosatha. DLBCL yochokera ku lymphocyte yowonjezera ndi yowonjezeka kwambiri ya NHL subtype yomwe imapezeka mu SLE, kotero lingaliro ndilokuti kutupa kosatha kungayambitse matenda a lymphoma mu matenda omwe amadzimadzimadzimodzi monga SLE.
- Lingaliro lina ndilofanana koma lili ndi maziko ambiri a chibadwa. Lingaliro ndilokuti kudziletsa kwa SLE kumawongolera kachilombo ka chitetezo cha mthupi kuyambitsa lymphocytes, maselo a lymphoma, kugawa ndi kufalikira.
- Chiphunzitso china chimaphatikizapo kachilombo ka Epstein-Bar, kapena EBV. Iyi ndiyo kachilombo komwe kamayambitsa matenda otchedwa mononucleosis, kapena mono, matenda opsompsona. Lingaliro ndilo kuti mwina matenda a EBV omwe amapitirira, omwe amatha kupititsa patsogolo chitetezo cha mthupi mwa njira zabwino, ndi gawo la njira yamba ya matenda kwa SLE ndi B-cell lymphomas.
SLE, Lymphoma, ndi Cancer Zina
Zikuwoneka kuti pali chiopsezo chowonjezeka cha Hodgkin ndi osakhala Hodgkin lymphoma mwa anthu omwe ali ndi SLE. Malingana ndi deta yosindikizidwa mu 2015, pali mgwirizano pakati pa SLE ndi malignancy, osati kusonyeza NHL, Hodgkin lymphoma, khansa ya m'magazi, ndi khansa zina zopanda magazi, komanso kuphatikizapo laryngeal, mapapo, chiwindi, ukazi / vulv, ndi chithokomiro cha chithokomiro- ndipo pangakhalenso kuchepa kwa khungu la khansa ya khungu. Khansara ya m'mimba, khansara yamapapo ndi khansara ya chiberekero, komanso khansara ya endometrial zonse zimawoneka ngati zikuyendera ndi SLE kuposa zomwe anthu ambiri angayembekezere.
Anthu omwe ali ndi matenda a Sjögren , omwe ndi ofanana kwambiri ndi anthu omwe ali ndi SLE, amakhala ndi chiopsezo chachikulu cha lymphoma, kotero kuti pangakhale chinthu choyambitsa matenda omwe ali okhudzana ndi matendawa komanso makamaka lymphoma.
Ngakhale kuti mawonekedwe a immunosuppressive akuoneka kuti ali otetezeka kwa anthu omwe ali ndi SLE kuchokera pa maphunziro ambiri, pali zochitika zowonetsera m'mabuku-kuti chachikulu cha CNS lymphoma (PCNSL) ndi mtundu wochepa wa NHL umene umachitika mkatikatikati mwa mitsempha yopanda umboni popanda umboni la lymphoma kwinakwake m'thupi. Pafupifupi milandu yonse ya PCSNL yolembedwa kwa anthu omwe ali ndi SLE amagwiritsidwa ntchito ndi othandizira ma immunosuppressive, ndipo mycophenolate makamaka.
> Zotsatira:
> Boddu P, Mohammed AS, Annem C, Sequeira W. SLE ndi omwe si a Hodgkin's lymphoma: mndandanda wa zochitika ndi kubwereza zolembazo. Nkhani Rep Rheumatol. 2017: 1658473.
> Cao L, Tong H, Xu G, et al. Lupus Erythematous yowonongeka ndi ngozi ya Malignancy: Meta-Analysis. Scheurer M, ed. PLoS ONE. 2015; 10 (4): e0122964.