Anti-glomerular lefu le ka tlaase la lera

Maloetse a anti-glomerular kamoreng e ka tlase ea mafu (anti-GBM mafu) ke lefu le sa tloaelehang le ka kenyelletsang ho hloleha ha liphio ka potlako le mafu a matšoafo.

Mefuta e meng ea lefu lena e ama feela matšoafo kapa liphio. Lefu la anti-GBM le ne le tsejoa e le Goodpasture syndrome.

Anti-GBM lefu ke bokuli bo ikemetseng. E etsahala ha sesole sa 'mele se hlasela le ho senya lisele tsa' mele tse phetseng hantle. Batho ba nang le lefu lena ba hlahisa lintho tse hlaselang protheine e bitsoang collagen ka mekotleng e menyenyane ea moea matšoafong le litsing tsa ho sefa (glomeruli) tsa liphio.

Lintho tsena li bitsoa li-antibodies tsa antiglomerular kamoreng e ka tlase. Lera le kamoreng e ka tlase ea glomerular ke karolo ea liphio tse thusang ho sefa litšila le mokelikeli o mong o tsoang maling. Lisireletsi tse loantšang likokoana-hloko tse ka tlas'a lefatše tse loantšang lera lena. Li ka senya lera le ka tlaase, le ka lebisang tšenyo ea liphio.

Ka linako tse ling, bothata bona bo bakoa ke tšoaetso ea vaerase ea ho hema kapa ka ho hema ka har'a solvents ea hydrocarbon. Maemong a joalo, sesole sa 'mele se ka hlasela litho kapa lisele hobane li li fosa bakeng sa livaerase tsena kapa lik'hemik'hale tsa kantle ho naha.

Karabelo e fosahetseng ea sesole sa 'mele e baka ho tsoa mali ka mekotleng ea moea ea matšoafo le ho ruruha litsing tsa ho sefa liphio.

Matšoao a ka hlaha butle butle ho feta likhoeli kapa esita le lilemo, empa hangata a hlaha kapele haholo ho feta matsatsi ho isa ho libeke.

Ho felloa ke takatso ea lijo, mokhathala le bofokoli ke matšoao a tloaelehileng a pele.

Matšoao a matšoafo a kenyeletsa:

• Ho kgohlela madi
• Khohlela e ommeng
• Phefumoloho e khutšoanyane

Liphio le matšoao a mang a kenyelletsa:

• Moroto o nang le madi
• Ho chesa maikutlo ha u ntša metsi
• Ho nyekeloa le ho hlatsa
• Letlalo le putswa
• Ho ruruha (edema) sebakeng sefe kapa sefe sa 'mele, haholo maotong

Tlhahlobo ea 'mele e ka senola matšoao a khatello e phahameng ea mali le mokelikeli o mongata. Mofani oa tlhokomelo ea bophelo a ka utloa melumo e sa tloaelehang ea pelo le ea matšoafo ha a mametse sefuba ka stethoscope.

Liphetho tsa urinalysis hangata ha lia tloaeleha, 'me li bontša mali le protheine morotong. Ho ka bonoa lisele tse khubelu tsa mali tse sa tloaelehang.

Liteko tse latelang le tsona li ka etsoa:

• Teko ea membrane ea kamoreng e ka tlase ea likokoana-hloko
• Khase ea mali ea mali
• BUN
• X-ray sefubeng
• Creatinine (serum)
• Biopsy ea matšoafo
• Liphio biopsy

Morero oa mantlha ke ho tlosa li-antibodies tse kotsi maling. Kalafo e ka kenyelletsa:

• Plasmapheresis, e tlosa li-antibodies tse kotsi ho thusa ho fokotsa ho ruruha liphio le matšoafo.
• Meriana ea Corticosteroid (e kang prednisone) le lithethefatsi tse ling, tse hatellang kapa ho khutsisa sesole sa 'mele.
• Meriana e kang angiotensin-converting enzyme (ACE) inhibitors le angiotensin receptor blockers (ARBs), tse thusang ho laola khatello ea mali.
• Dialysis, e ka etsoang haeba ho hloleha ha liphio ho ke ke ha hlola ho phekoloa.
• Ho kenyelletsa liphio, ho ka etsoang ha liphio tsa hau li se li sa sebetse.

U kanna oa bolelloa hore u lekanyetse ho noa letsoai le maro ho laola ho ruruha. Maemong a mang, ho ka buelloa phepo e nepahetseng ea protheine.

Lisebelisoa tsena li ka fana ka tlhaiso-leseling e batsi ka lefu la anti-GBM:

• Setsi sa Naha sa Lefu la Ts'oaetso le Mafu a Ts'oaetso le a Diphio - www.niddk.nih.gov/health-information/kidney-disease/glomerular-diseases/anti-gbm-goodpastures-disease
• Motheo oa Naha oa Liphio - www.kidney.org/atoz/content/goodpasture
• Mokhatlo oa Naha oa Mathata a Rare - rarediseases.org/rare-diseases/goodpasture-syndrome

Ho hlahlojoa kapele ho bohlokoa haholo. Pono e mpe le ho feta haeba liphio li se li senyehile haholo ha kalafo e qala. Tšenyo ea matšoafo e ka fapana ho tloha boemong bo bonolo ho ea ho bo matla

Batho ba bangata ba tla hloka dialysis kapa ho kenyelletsa liphio.

Ha e sa alafshoe, boemo bona bo ka lebisa ho efe kapa efe ea tse latelang:

• Lefu le sa foleng la liphio
• Boloetse ba liphio qetellong
• Ho hloleha ha mapafu
• Glomerulonephritis e tsoelang pele ka potlako
• Ho tsoa mali ho matla ha pulmonary (ho tsoa mali matšoafong)

Bitsa kopano le mofani oa hau haeba o hlahisa moroto o fokolang, kapa o na le matšoao a mang a lefu la anti-GBM.

Le ka mohla u se ke ua nkha sekhomaretsi kapa peterole ea molomo ka molomo oa hao, e pepesetsang matšoafo ho solvents ea hydrocarbon mme e ka baka lefu lena.

Lefu la Goodpasture; Glomerulonephritis e tsoelang pele ka potlako e nang le tšollo ea mali ea pulmonary; Lefu la renal la pulmonary; Glomerulonephritis - pulmonary hemorrhage

• Phepelo ea mali a liphio
• Glomerulus le nephron

Collard HR, Morena TE, Schwarz MI. Ho tsoa mali ha alveolar le maloetse a sa tloaelehang a kenang. Ka: Broaddus VC, Mason RJ, Ernst JD, et al, li-eds. Buka ea Bongaka ea Phefumoloho ea Murray le Nadel. La 6th. Philadelphia, PA: Elsevier Saunders; 2016: khaolo ea 67.

Phelps RG, Turner AN. Anti-glomerular kamoreng e ka tlaase ea lera le lefu la Goodpasture. Ho: Feehally J, Floege J, Tonelli M, Johnson RJ, bangoli. Kakaretso ea Nephrology ea Kliniki. La 6th. Philadelphia, PA: Elsevier; 2019: khaolo ea 24.

Radhakrishnan J, Appel GB, D'Agati VD. Lefu la bobeli la glomerular. Ka: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, li-eds. Brenner le Rector ea Liphio. 11th ed. Philadelphia, PA: Elsevier; 2020: khaolo ea 32.