Sjögren lefu

Sjögren syndrome ke boloetse bo ikemetseng boo ho lona litšoelesa tse hlahisang meokho le mathe li senngoang. Sena se baka molomo o omileng le mahlo a omileng. Boemo bona bo ka ama likarolo tse ling tsa 'mele, ho kenyeletsoa liphio le matšoafo.

Lebaka la Sjögren syndrome ha le tsejoe. Ke boloetse bo ikemetseng. Sena se bolela hore 'mele o hlasela lisele tse phetseng hantle ka phoso. Lefu lena le hlaha khafetsa ho basali ba lilemo tse 40 ho isa ho tse 50. Ke ka seoelo ho bana.

Matšoao a mantlha a Sjögren a hlalosoa e le mahlo a omileng le molomo o omileng ntle le bothata bo bong bo ikemetseng.

Matšoao a Sjögren a mahareng a hlaha le bothata bo bong bo ikemetseng bo kang:

• Ramatiki ea ramatiki (RA)
• Sesebelisoa sa lupus erythematosus
• Scleroderma
• Polymyositis
• Hepatitis C e ka ama litšoelesa tsa mathe mme ea shebahala joalo ka Sjögren syndrome
• Lefu la IgG4 le ka shebahala joalo ka Sjogren syndrome mme le lokela ho tsotelloa

Mahlo a omileng le molomo o omileng ke matšoao a atileng haholo a lefu lena.

Matšoao a mahlo:

• Ho hlohlona mahlo
• Ho utloa hore ho na le ntho e ka leihlong

Matšoao a molomo le 'metso:

• Ho ba thata ho koenya kapa ho ja lijo tse ommeng
• Ho lahleheloa ke kutlo ea tatso
• Mathata ho bua
• Mate a matenya kapa a khoele
• Liso tsa molomo kapa bohloko
• Ho bola ha meno le ho ruruha ha marenene
• Ho thothofala

Matšoao a mang a kenyeletsa:

• Mokhathala
• Feberu
• Fetola 'mala oa matsoho kapa maoto ka ho pepesehela serame (ts'ebetso ea Raynaud)
• Bohloko bo kopaneng kapa ho ruruha ho kopaneng
• Litšoelesa tse ruruhileng
• Ho phatloha ha letlalo
• Ho ba shoohlo le bohloko ka lebaka la lefu la methapo
• Khohlela le phefumoloho e khuts'oane ka lebaka la lefu la matšoafo
• Ho otla ha pelo ka tsela e sa tloaelehang
• Ho nyekeloa le pelo
• Ho oma ka bosaling kapa ho rota ho bohloko

Ho tla etsoa tlhahlobo e felletseng ea 'mele. Teko e senola mahlo a omileng le molomo o omileng. Ho ka ba le liso tsa molomo, meno a bolileng kapa ho ruruha ha marenene. Sena se etsahala ka lebaka la ho omella ha molomo. Mofani oa hao oa tlhokomelo ea bophelo o tla sheba molomong oa hau bakeng sa tšoaetso ea fungus (candida). Letlalo le ka bonts'a lekhopho, tlhatlhobo ea matšoafo e kanna ea ba e sa tloaelehang, mpa e tla palpated bakeng sa ho holisa sebete. Manonyeletso a tla hlahlojoa bakeng sa ramatiki. Tlhahlobo ea neuro e tla sheba likhaello.

U kanna oa etsoa liteko tse latelang:

• K'hemistri e felletseng ea mali e nang le li-enzyme tsa sebete
• Palo e felletseng ea mali ka phapang
• Ho hlahloba urinal
• Teko ea li-antibodies tsa nyutlelie (ANA)
• Anti-Ro / SSA le lithibela-mafu tse khahlanong le La / SSB
• Lebaka la ramatiki
• Teko ea li-cryoglobulins
• Tlatsa maemo
• Protheine electrophoresis
• Teko ea hepatitis C le HIV (haeba e le kotsing)
• Liteko tsa qoqotho
• Teko ea Schirmer ea tlhahiso ea meokho
• Ho nahana ka tšoelesa ea salivary: ka ultrasound kapa ka MRI
• Sefuba sa salivary biopsy
• Letlalo la biopsy haeba ho na le lekhopho
• Ho hlahloba mahlo ke ngaka ea mahlo
• X-ray sefubeng

Morero ke ho fokotsa matšoao.

• Mahlo a omileng a ka phekoloa ka meokho ea maiketsetso, mafura a tlotsang mahlo, kapa mokelikeli oa cyclosporine.
• Haeba Candida e le teng, e ka alafshoa ka litokisetso tse se nang tsoekere tsa miconazole kapa litokisetso tsa nystatin.
• Ho ka kenngoa lipolaka tse nyane mekoting ea likhoerekhoere ho thusa meokho hore e lule holim'a leihlo.

Lithethefatsi tse fetolang lefu lena (DMARD) tse tšoanang le tse sebelisetsoang RA li ka ntlafatsa matšoao a Sjögren syndrome. Tsena li kenyelletsa tumor necrosis factor (TNF) e thibelang lithethefatsi tse kang Enbrel, Humira kapa Remicaide.

Lintho tse ling tseo u ka li etsang ho fokotsa matšoao li kenyelletsa:

• Sip metsi ho pholletsa le letsatsi
• Hlafuna chepisi e se nang tsoekere
• Qoba meriana e ka etsang hore molomo o ome, joalo ka li-antihistamine le li-decongestant
• Qoba joala

Bua le ngaka ea meno ka:

• Ho hlatsoa molomo ho nka liminerale sebakeng sa meno a hau
• Baemeli ba mathe
• Lithethefatsi tse thusang litšoelesa tsa hau tsa mathe li etsa mathe a mangata

Ho thibela ho bola ha meno ho bakoang ke ho oma ha molomo:

• Hlatsoa 'me u phunye meno hangata
• Etela ngaka ea meno bakeng sa ho hlahlojoa khafetsa le ho hloekisoa

Hangata lefu lena ha le kotsing ea bophelo. Sephetho se ipapisitse le mafu a mang ao u nang le ona.

Ho na le kotsi e kholo ea "lymphoma" le "lefu la pele" ha lefu la Sjögren le sebelitse nako e telele haholo, le ho batho ba nang le vasculitis, complements e tlase le li-cryoglobulins.

Mathata a ka kenyelletsa:

• Tšenyo ho leihlo
• Meno a meno
• Ho hloleha ha liphio (seoelo)
• Lymphoma
• Lefu la pulmonary
• Vasculitis (e sa tloaelehang)
• Phekolo ea methapo
• Ho ruruha ha senya

Bitsa mofani oa hau haeba u ba le matšoao a Sjögren syndrome.

Xerostomia - lefu la Sjögren; Keratoconjunctivitis sicca - Sjögren; Lefu la Sicca

• Masole a mmele

Lefu la Baer AN, Alevizos I. Sjögren. Ho: Hochberg MC, Gravallese EM, Silman AJ, Smolen JS, Weinblatt ME, Weisman MH, bahlophisi. Rheumatology. La 7th. Philadelphia, PA: Elsevier; 2019: khaolo ea 147.

Lefu la Mariette X. Sjögren. Ka: Goldman L, Schafer AI, li-eds. Phekolo ea Goldman-Cecil. La 25th ed. Philadelphia, PA: Elsevier Saunders; 2016: khaolo ea 268.

Seror R, Bootsma H, Saraux A, le al. Ho hlalosa liketsahalo tsa maloetse le ntlafatso e nang le moelelo ea bongaka setsing sa mantlha sa Sjögren's se nang le EULAR primary Sjögren's syndrome disease disease (ESSDAI) le li-index tse tlalehiloeng ke bakuli (ESSPRI). Ann Rheum Dis. 2016; 75 (2): 382-389. PMID: 25480887 www.ncbi.nlm.nih.gov/pubmed/25480887.

Singh AG, Singh S, Matteson EL. Sekhahla, lisosa tsa kotsi le lisosa tsa lefu ho bakuli ba nang le lefu la Sjögren's: tlhahlobo e hlophisehileng le tlhahlobo ea litlhahlobo tsa lithuto tsa sehlopha. Rheumatology (Oxford). 2016; 55 (3): 450-460. PMID: 26412810 www.ncbi.nlm.nih.gov/pubmed/26412810.

Turner MD. Lipontšo tsa molomo tsa mafu a tsamaiso. Ka: Flint PW, Haughey BH, Lund V, et al, eds. Cummings Otolaryngology. La 6th. Philadelphia, PA: Elsevier Saunders; 2015: khaolo ea 14.