Maxaan ka ogaannaa xidhiidhka ka dhexeeya lupus iyo lymphoma? Waa hagaag, waxaan ognahay in ka badan 20 sanno ka hor, laakiin jawaabtu waxay weli noqon kartaa "kuma filna", sida ay qoreen Boddu iyo jaaliyadaha ay soo daabaceen internetka bishii March 2017 "Case Reports in Rheumatology."
Lupus, ama Systemic Lupus Erythematosus (SLE)
Lupus , ama nidaamka lupus erythematosus (SLE), waa cudur aad u kakooban oodhan oo ku dhici kara calaamado kala duwan oo kala duwan waxayna ku lug yeelan karaan nidaamyada unugyada jirka dhexdiisa.
Labo qof oo leh lupus waxay yeelan karaan calaamado gebi ahaanba kala duwan, laakiin halkan waa kuwo caadi ah:
- Xanuun wadajir ah, qallaf iyo barar
- Daal iyo qandho
- Finanku wejiga ku yaallo dhabannada iyo buunshaha sanka, ayaa sheegay in loo yaqaan 'butterfly-shape', oo sanka ah sida jirka iyo dhabannada oo ah baalalka balastiga. Finanku waxay noqon karaan qaro, cuncun, ama kulul.
- Dhibaatooyinka kale ee maqaarka ee u muuqda inay ka sii xumaanayaan qorraxda
- Faraha iyo suulasha ayaa u muuqda in ay lumayaan wareegga, u rogista caddaan ama buluug ah qabow ama muddooyinka walaaca-waxaa loo yaqaan 'Raynaud' phenomenon
- Astaamaha laga helo hababka kala duwan ee xubnaha; neefta gaaban, xanuunka feeraha, indhaha qallalan
- Madax-xanuun, jahawareer, iyo xusuus-darro
Lymphoma, Kansar ah Unugyada Dhiigga Cad (White Blood Cells)
Lymphoma waa kansar ku dhaca unugyada dhiiga cad, gaar ahaan unugyada dhiiga cad ee loo yaqaanno lymphocytes . Labada qaybood ee asaasiga ah ee lymfoma waa Hodgkin lymphoma iyo non-Hodgkin lymphoma , ama NHL. Lymphoma caadi ahaan waxay ku bilaabataa qanjidhada nudaha, laakiin sidoo kale waxay ku jiri karaan xubnaha kala duwan, waxayna ku dhici kartaa unugyo kala duwan iyo qaababka jidhka, ma aha oo keliya qanjirada nudaha.
Sida lupus, astaamaha lymphoma way kala duwan yihiin, dadkuna waxay leeyihiin astaamo kala duwan oo lymfoma ah. Marmarka qaarkood, calaamadaha kaliya ayaa ah qanjidhada qanjidhada oo barara:
- Barar xummad la'aan ah oo ku dhaca qanjidhada qoorta, qoorta, ama gumaarka
- Daal iyo qandho
- Dhidid dhidid habeenkii
- Lumitaanka cuntada oo luma, miisaan lumis la'aan ah-ilaa boqolkiiba 10 ama ka badan miisaanka jidhkaaga
- Maqaarka cuncunka
- Qufac ama xabad xanuun, xanuunka caloosha ama buuxda, finan, iyo maqaarka maqaarka
Maxay Labadaan Shuruudood Leedahay?
Waa hagaag, marmarka qaarkood waxay astaamuhu isku rogi karaan, mid ahaan. Labada cudurba waxay ku lug leeyihiin nidaamka difaaca: Lymphocytes waa unugyada muhiimka ah ee habka difaaca jirka, habka difaaca jidhkuna waa waxa laga helo SLE. Lymphocytes sidoo kale waa unugyada dhibaatada ee lymphoma.
Laakiin waxaa kale oo jira sidan: tiro daraasado ah ayaa ogaaday in dadka SLE ay leeyihiin dhacdooyinka sare ee lymfoma marka la barbar dhigo dadweynaha guud. Mid ka mid ah fikradaha badani waa, nidaamka difaaca ee aan haysan nidaam habboon (sida qof leh SLE), isticmaalka daweynta difaaca jirka ee lagu daaweynayo lupus waxay sababi kartaa dhacdooyinka sii kordhaya ee lymphoma ee SLE. Hase yeeshee, daraasado badan ayaa lagu sameeyay mawduucaan, oo leh natiijooyin iska hor imanaya, taasina uma muuqato sheeko dhan.
Boddu iyo colleagues ayaa dhowaan soo xaadiray isbeddellada qaar ka yimid dib u eegista suugaanta caafimaadka wixii macluumaad ah ee ku saabsan dadka qaba SLE ee hormarta lymfoma. Cunsurrada khatarta ah ee horumarinta lymfoma ee dadka leh SLE ma aha mid gebi ahaanba cad. Dadka qaba cudurrada SLE ama firfircoon ee SLE waxay u muuqatay in ay halis weyn u tahay lymphoma, waxaana dhici karta in qaar ka mid ah khatarta ay la xidhiidhaan isticmaalka siklofosphamide iyo isku dhafka sare ee kudhaca steroids.
Inkastoo mararka qaarkood ay jiri lahaayeen daraasado si loo soo qaato-badanaana tirada dadka SLE iyo lymfoma labaduba way yar yahiin daraasaddan - Boddu iyo cilmi-baarayaashu waxay adeegsadeen waxa ay ka heli karaan inay dhisaan barmaamijka bilawga ah ee daraasad dheeraad ah. Qaar ka mid ah indho-indheyn-darro oo ka yimaada daraasado lala yeeshay bukaannada SLE oo ay sameeyeen lymphoma ayaa raacday
Dadka qaba SLE oo sameeya lymphoma:
- Inta badan dumarka
- Xadka da'da wuxuu ahaa inta u dhaxaysa 57 iyo 61 sano
- Celcelis ahaan, waxay lahaayeen SLE ilaa 18 sano kahor lenfoma
- Khatarta lenfoma ee dadka SLE waxay ka sarreeyeen dhammaan jinsiyada
- Calaamadaha, natiijooyinka iyo baaritaanada shaybaadhka ee lymphoma-ka hore ayaa si xad dhaaf ah u qulqulaya waxa laga arkay SLE.
- Bararka lenf bararka, mararka qaarkood calaamad keliya oo lymfoma ah, ayaa sidoo kale aad ugu badan dadka qaba SLE, oo ku dhacaya ilaa 67 boqolkiiba.
Lymphomas oo ku horumariya dadka leh SLE:
- Nooca ugu caansan ee NHL ee dadka SLE waxay ku faafeen B-cell Lymphoma (DLBCL), oo ah nooca NHL ee ugu badan ee dadweynaha guud.
- Qeybaha DLBCL ee kuwa leh SLE waxay u muuqatay in ay badanaa ku jirtaa qayb ka mid ah natiijada ka sii dareysa - xarunta non-germinal B-cell sida DLBCLs.
- NHL ee SLE, sida NHL ee dadweynaha guud ahaan, badanaa waxay ka yimaadaan qanjidhada nudaha, si kastaba ha ahaatee, lymphomas oo ka bilawda dibedda qanjidhada ayaa sidoo kale suuragal ah in dadweynaha iyo kuwa SLE-ga.
Dadka qaba SLE waxaa badanaa lagu daaweeyaa glucocorticoids, kali ahaan ama lagu daro daawooyinka kale ee difaaca jirka ama cytotoxic oo ay ku jiraan methotrexate, cyclophosphamide, iyo azathioprine si loo daaweeyo kaqaybgalka xubnaha ama calaamadaha aan ka jawaabeynin daaweynta hore ee loo isticmaalo. Daraasado badan ayaa isku dayay in ay go'aamiyaan haddii wakiilada difaaca jirka ay kordhiyaan halista lenfoma ee dadka leh SLE, hase yeeshee mararka qaarkood natiijooyinka hal daraasad ayaa ka hor imaanaysa xiga.
Waxaa jira fikrado dhowr ah oo ku saabsan sababta dadka SLE loo yaqaana ay halis weyn u yihiin kansarka guud ahaan, iyo sidoo kale lymphoma, gaar ahaan:
- Mid ka mid ah aragtidaas waxaa ka mid ah bararka dabaysha. DLBCL asal ahaan ka yimaadda lymphocytes firfircoon ayaa ah noocyada ugu caansan ee NHL ee ka soo baxa SLE, sidaas fikradu waxay tahay in caabuq dabadheeraad ah uu sare u kici karo khatarta lenfoma ee cudurrada autoimmune sida SLE.
- Qormo kale ayaa la mid ah, laakiin wuxuu leeyahay waxyaabo badan oo ka mid ah hiddaha. Fikradda ayaa ah in habdhaqanka SLE-du dib u rogayo nidaamka difaaca si uu u keeno lymphocytes, unugyada lymphoma, si loo qaybiyo loona badiyo.
- Wali aragti kale oo ku lug leh fayraska Epstein-Bar, ama EBV. Tani waa fayruus isku mid ah oo keena mononucleosis infekshanka, ama mono, cudurka dhunkashada. Fikradda waa in laga yaabo in cudurka infakshanka EBV in uu yahay mid joogto ah, kaas oo xoojiya nidaamka habka saxda ah ee habka saxda ah, waa qayb ka mid ah wadada caadiga ah ee jirrada SLE iyo B-cell lymphomas labadaba.
SLE, Lymphoma, iyo Kansarrada Kale
Waxay u muuqataa inay halis dheeraad ah u tahay Hodgkin iyo non-Hodgkin lymphoma ee dadka SLE. Sida laga soo xigtay xogta la daabacay sannadkii 2015, waxaa jira ururo ka dhexeeya SLE iyo malignancy, maaha oo keliya muujinta NHL, Hodgkin lymphoma, leukemia, iyo qaar ka mid ah kansarrada aan dhiigga lahayn, laakiin sidoo kale ay ku jiraan lugaha, sambabada, beerka, xubinta taranka haweenka iyo qanjirka ' waxaana dhici karta inay sidoo kale jirto khatar hoos u dhaca melaniga maqaarka. Kansarka naasaha, kansarka sanbabada iyo kansarka ilma-mareenka, iyo kansarka endometrial dhammaantood waxay u muuqdaan inay la socdaan SLE in ka badan waxa laga filaayo guud ahaan dadweynaha.
Dadka qaba cudurrada Sjögren , xaalad caadi ah oo dadka SLE qaba, waxay la kulmaan halis dheeraad ah ee lymphoma, sidaas awgeed waxaa jiri kara waxyaabo ay ka mid yihiin cudurrada SLE ee ku xiran kansarka iyo gaar ahaan lymphoma.
Inkastoo wakiillada difaaca jirka ay u muuqdaan kuwo badbaado u leh dadka SLE oo ku salaysan baadhitaano badan, waxaa jira digniin taxadar leh oo ku saabsan suugaanta - oo ah midka ugu horreeya ee CNS lymfoma (PCNSL) waa nooc naadir ah NHL kaas oo ka dhacaya habka dhexdhexaadinta habdhiska dareenka iyada oo aan caddayn ee lymphoma meelo kale oo jirka ah. Ku dhowaad dhammaan kiisaska PCSNL ee ku soo waramey dadka SLE waxay la xiriiraan wakiilo difaac ah, iyo gaar ahaan mycophenolate.
> Ilo:
> Boddu P, Mohammed AS, Annem C, Sequeira W. SLE iyo non-Hodgkin's lymphoma: taxane kiis iyo dib u eegista suugaanta. Kiis Rep Rep Röumatol. 2017: 1658473.
> Cao L, Tong H, Xu G, iyo al. Khatarta Nidaamka Lupus Jilicsanaanta iyo Halista Xoogga: Qalabka Meta-Analysis. Scheurer M, ed. KA HELI KARO. 2015; 10 (4): e0122964.