Yintoni isifo samathambo?

Imfundo yezeMpilo

Isifo samathambo kukukrala nokuqina kwamalungu. Xa uninzi lwabantu lucinga ngesifo samathambo, bahlala becinga ngabantu abadala. Kodwa, inyani iphantse ibe ngama-300,000 abantwana kunye nolutsha oluneminyaka engaphantsi kwe-16 ubudala e-United States bahlala nohlobo oluthile lwei-juvenile idiopathic arthritis (ekwabizwa ngokuba yi-juvenile rheumatoid arthritis).

Yintoni isifo samathambo?

Uninzi lweentlobo ze-juvenile idiopathic arthritis (JIA) zizifo ezizimeleyo, aphoamajoni omzimba ahlasela ngempazamo izicwili zawo kunye namalungu, kule meko, amalungu.Akukho sizathu saziwayo salo meko kodwa kukho iingcinga ezibonisa ukuba ufuzo, izifo ezosulelayo kunye nokusingqongileyo kunokubandakanyeka, utsho. IMagdalena Cadet, MD , ugqirha wamathambo waseNew York kunye nabahlobo abaya kwiZiko Lonyango le-NYU Langone.

Kuphela yipesenti encinci yamatyala abantwana abanesifo samathambo esichazwe ukuba sibaleka kwiintsapho, kodwa aumntakwabo womntu onale meko unayo malunga namaxesha ali-12 umngcipheko oqikelelweyo yokuphuhlisa isifo samathambo kulutsha kunoluntu ngokubanzi. Abasetyhini nabo basemngciphekweni omkhulu zokuphuhlisaulutsha lwe-idiopathic arthritis, njengoko zinjalo nezinye iimeko zamathambo.

Ziintoni iimpawu zesifo samathambo kulutsha?

Iimpawu ze-juvenile idiopathic arthritis ziqala ngaphambi kweminyaka eyi-16, zinganyangeki, kwaye zinokubandakanya:

• Ukudumba ngokudibeneyo, iintlungu kunye nokuqina: Ukuqina ngokudibeneyo kunokubonakala ngakumbi kusasa, okanye emva kwamaxesha okungasebenzi. Unokuphinda uqaphele umntwana wakho eqhwalela.
• Umkhuhlane oqhubekayo
• Ukukhawuleza: Ukuqaqamba kolusu olupinki kunokuvela ngokudibeneyo nomkhuhlane.
• I-lymph nodes ezidumbileyo
• Iingxaki zamehlo: Oku kunokubandakanyauveitis (ukudumba kwamehlo) okanye umbono ongacacanga.

Ukufumana uxilongo lwe-JIA / JRA lokwenyani kugqirha, isigulana siya kufuna ukufumana iintlungu eziphindaphindayo kwaye sibonakalise iimpawu zokudumba ngokudibeneyo okungenani iiveki ezi-6, utsho U-Lawrence Barnard , DO, ibhodi eqinisekisiweyo ye-neuromusculoskeletal specialist esebenza kwi-MAXIM ReGen. NgokukaGqr.Barnard, eli xesha libalulekile kuba uninzi lwabantwana nolutsha banamava okukhula kwiintlungu zokufikisa ezibuhlungu kwaye eziphazamisayo kodwa ayilulo uhlobo lwesifo samathambo. Ukuba kurhanelwa isifo samathambo solutsha, ugqirha wabantwana okanye ugqirha jikelele angathumela isigulana kwi-rheumatologist yabantwana emva kokujonga izinto ezinje ngembali yosapho.

Zithini iintlobo zentsholongwane yesifo samathambo?

Kukho iindidi ezahlukeneyo zeJIA ezinokusekwa kwizinto ezininzi ezinje ngenani yamalungu adibeneyo, ubudala bokuqala, ubukho beempawu zokumakishwa komzimba (into elungileyo okanye engalunganga ye-rheumatoid factor okanye i-antinuclear antibody), okanye ezinye izinto ezinxulumene neklinikhi ezinje ngomkhuhlane, okanye ukubandakanyeka kwamehlo, uGqr.

Kukho ii-subtypes ezintandathu ze-juvenile idiopathic arthritis:

1. Oligoarthritis (olona hlobo luqhelekileyo): Le fomu ichaphazela amalungu angaphantsi kwesihlanu kwiinyanga ezintandathu zokuqala zesi sifo. KubangelaUkudumba kwamehlo okanye i-uveitis / iritis kwaye ixhaphake kakhulu kumantombazana.
2. IPolyarthritis: Le fomu ichaphazela amalunga amahlanu okanye nangaphezulu kumacala omabini omzimba, iyafana nesifo samathambo esidala, kwaye ixhaphake kakhulu kumantombazana.
3. Inkqubo yeArthritis: Olu hlobo lwe-arthritis lunokuchaphazela wonke umzimba kubandakanya amalungu angaphakathi kunye neenkqubo zomzimba. Ihlala ibangela ukwanda kweemfiva, irhashalala kunye nokwandiswa kwe-lymph node.
4. Inxulumene ne-Enthesitis: Le fomu ibangela ukudumba apho imisipha incamathele khona emathanjeni (entheses) kunye neminwe kunye neenzwane. Ichaphazela amakhwenkwe amadala.
5. Ulutsha lwepsoriatic arthritis: Le fomu ibangelabomvu kunye namaqebengwana anamaxolo esikhumbeni. Umqolo obuhlungu, iintlungu ezidibeneyo, kunye nokungaqheleki kwenzipho njengokukhonkwane kwezikhonkwane kunokuba khona.
6. Ukungafani: Olu luhlelo lwezigulana ezingalinganiyo kwezinye iindidi, okanye ngubanizalisekisa iikhrayitheriya zodidi olunye.

Isifo samathambo esikwishumi elivisayo sifunyaniswa njani?

I-juvenile idiopathic arthritis kunokuba nzima ukuyichonga kwaye yahluke kwezinye iimeko. Akukho luvavanyo luchanekileyo lwe-JIA, ke oogqirha bafumanisa imeko ngokusekelwe kwimbali yezonyango, uvavanyo olupheleleyo lomzimba, kunye nokulawula ezinye iimeko. Banokuyalela ezi mvavanyo zilandelayo zokuqonda isifo.

• Uvavanyo lweRheumatoid factor: Uvavanyo lobukho be-antibody eveliswe ngamajoni omzimba anokubonisa ubukho besifo samathambo.
• Uvavanyo lweprotein olusebenzayo kunye / okanye inqanaba le-sedimentation sedimentation (ESR): Ezi mvavanyo zilinganisa ukudumba emzimbeni.
• Uvavanyo lwe-HLA-B27: Amanyathelo okuvavanywa kwemakishi yemfuza kwi-JIA enxulumene ne-enthesitis.
• Uvavanyo lwe-antibody yenyukliya: Olu vavanyo lunceda ukubonisa ubukho bokuzimela.
• I-MRI kunye / okanye i-X-ray: Ezi skeni zinceda ukulawula ezinye iimeko.

Uninzi lwezi mvavanyo zikhankanywe apha ngasentla zinokuba yinto entle kumntwana oqhelekileyo, kungoko iziphumo kufuneka zitolikwe ngugqirha ukuze enze uxilongo lokugqibela.

Ukuhlolwa kwamehlo kuyacetyiswa kwezinye iintlobo zentsholongwane yesifo samathambo, kwaye ndingacebisa ukuba wonke umntwana ekurhanelwa ukuba unale meko kufuneka athunyelwe kugqirha wamehlo, utshilo uGqirha Cadet. Uthi kubalulekile ukuba kuvavanywe ngokucokisekileyo kubantwana ngaphambi kokuba kwenziwe isifo se-arthritis yabantwana ukuba bangabandakanyi ezinye iimeko zonyango ezifana nesifo seLyme, i-lupus, ukuphazamiseka kwethambo, i-fibromyalgia, usulelo kunye nomhlaza.

Sinyangwa njani isifo samathambo esencinci?

Unyango lwe-arthritis yolutsha lwe-idiopathic isekwe kuluphi uhlobo lwe-arthritis umntwana anayo, kwaye kubandakanya indibaniselwano yamayeza kunye nokuzilolonga.Injongo yonyango kukunciphisa iintlungu kunye nokudumba, ukuthintela ukonzakala ngokudibeneyo, kunye nokunyusa ukuhamba ngokudibeneyo, utshilo uGqirha Cadet. Ukwaphawula ukuba ngamanye amaxesha aba bantwana bayakhula ngaphandle kweempawu kwaye baye kuxolelo kunyango, kodwa abanye bangaqhubela phambili kwaye baqhubeke nokukhulisa isifo samathambo sabantu abadala.

Utshintsho kwindlela yokuphila

Ezinye iindlela zokuphila ezinokuba luncedo kwisifo samathambo sabantwana zibandakanya:

• Zilolonge
• Ukutya okusempilweni
• Ulungiso lwenyama
• Unyango lobushushu

UGqirha Barnard uthi ubushushu bunokunceda ukudumba kunye nentlungu. Ukuhlamba okufudumeleyo kunokuba yinto eyonwabisayo ebantwaneni (yiza nje nezinto zabo zokudlala abazithandayo kwaye wenze umcimbi ngazo!), Utsho, okanye usebenzise Irayisi ye-DIY sock bunnies unyango lobushushu.

Amayeza

Amayeza anokunceda imeko ngeendlela ezintathu eziphambili: ukulawula iintlungu, ukuthintela ukuqhubela phambili kwemeko, kunye nokuphepha iingxaki zokukhula. Izinketho ezikhoyo zibandakanya:

• Iziyobisi ezichasayo ezingasebenziyo ( ibuprofen , iqeqsha ): Ii-NSAID zimiselwe ukunyanga iintlungu. Abazali mabajongisise isicaphucaphu, iintlungu zesisu, ukutyumka, kunye nokonyuka koxinzelelo lwegazi okanye iingxaki zezintso ngeliyeza, utshilo uGqirha Cadet.
• Iimpawu zokuguqula izifo ( ihydroxychloroquine , imethotrexate , isulfasalazine ): La mayeza ajolise kwimichiza ethile emzimbeni ebangela ukudumba. Iziphumo ebezingalindelekanga zala mayeza zinokuba nzima, ke kubalulekile ukuba uwathathe njengoko kuyalelwe ngumboneleli wezempilo.
• Inaliti ye-Biologic ( Humira , Ungenelelo , Yiza kwakhona , ICosentyx , Ocrevus ): La mayeza avela kwizinto eziphilayo kwaye avimba iindlela zokuzikhusela kwizisele.

Ngokucacileyo, ukhetho lokuqala kwaye 'olulula' luthatha i-anti-inflammatory, enje nge-ibuprofen, ukubona ukuba oko kuyabunciphisa na ubuzaza bentlungu kunye nokudumba, utshilo uGqirha Barnard. Ukuba oko akuncedi… umntwana uya kukhuthazeka ukuba atyelele ugqirha osebenza emzimbeni okanye emsebenzini ukuze akwazi ukuhamba nokuqina.

Ezona zicwangciso zonyango zilungileyo zi-multimodal. Ukudibanisa amayeza kunye nokuhamba okukhuselekileyo kodwa okungaguqukiyo kunokunceda ukukhulula la malungu, ngakumbi ukuba ubhangqiwe kunye nokuzivocavoca ekujolise kuko okunyangwa ngumzimba wakho njengomzimba 'njengomsebenzi wasekhaya' phakathi kweeseshoni, uGqirha uBarnard uyacacisa.

Unyango

Ukuphila nesifo samathambo kunokuba nzima emntwaneni. Ukusebenza nonyango okanye iqela lenkxaso kunokunceda ekunciphiseni iziphumo zengqondo zesifo esinganyangekiyo.

Kubalulekile ukuba abazali kunye noogqirha bajongane nefuthe leemvakalelo nakwintlalo yesi sifo, utshilo uGqirha Cadet, kunye nokufumana inkxaso kubantwana ngokucebisa ngokwengqondo okanye imibutho efana neArthritis Foundation ekhuthaza abantwana abaphila nesi sifo singanyangekiyo.

Ngaba i-arthritis yabantwana iyahamba?

Akukho lunyango lwe-arthritis yabantwana, kodwa iArthritis Foundation ithi ukuba ngoxilongo kwangoko kunye nonyango olundlongondlongo, uxolelo lunokwenzeka. Bacebisa isicwangciso esijikelezwe kakuhle esibandakanya amayeza, umsebenzi womzimba, unyango olongezelelweyo, kunye nokutya okusempilweni ukunyanga kunye nokuthintela ukuqhuma.