Membranoproliferative glomerulonephritis

Membranoproliferative glomerulonephritis ndi vuto la impso lomwe limakhudzana ndi kutupa komanso kusintha kwa maselo a impso. Zingayambitse impso kulephera.

Glomerulonephritis ndikutupa kwa glomeruli. Glomeruli wa impso amathandiza kusefa zinyalala ndi madzi am'magazi kuti apange mkodzo.

Membranoproliferative glomerulonephritis (MPGN) ndi mtundu wa glomerulonephritis womwe umayambitsidwa ndi chitetezo chamthupi chachilendo. Malo osungira chitetezo amadzipangira mu gawo la impso lotchedwa glomerular chapansi nembanemba. Kakhungu kameneka kamathandiza kusefa zinyalala ndi madzi ena am'magazi.

Kuwonongeka kwa nembanemba kumakhudza impso kuthekera kopanga mkodzo mwachizolowezi. Itha kulola magazi ndi mapuloteni kutayikira mumkodzo. Ngati mapuloteni okwanira atuluka mkodzo, madzimadzi amatha kutuluka m'mitsempha yamagazi kupita mthupi, ndikupangitsa kutupa (edema). Zinyalala za nayitrogeni zitha kukhalanso m'magazi (azotemia).

Mitundu iwiri ya matendawa ndi MPGN I ndi MPGN II.

Anthu ambiri omwe ali ndi matendawa ali ndi mtundu wa I. MPGN II ndiofala kwambiri. Zimakhalanso zoyipa kwambiri kuposa MPGN I.

Zomwe zimayambitsa MPGN zitha kuphatikiza:

• Matenda osokoneza bongo (systemic lupus erythematosus, scleroderma, Sjögren syndrome, sarcoidosis)
• Khansa (leukemia, lymphoma)
• Matenda (hepatitis B, hepatitis C, endocarditis, malungo)

Zizindikiro zimatha kuphatikizira izi:

• Magazi mkodzo
• Zosintha pamalingaliro monga kuchepa kwa chidwi kapena kuchepa kwa chidwi
• Mkodzo wamvula
• Mkodzo wamdima (utsi, kola, kapena tiyi)
• Kuchepetsa mkodzo voliyumu
• Kutupa kwa gawo lililonse la thupi

Wothandizira zaumoyo adzakufunsani ndikufunsani za matenda anu. Wothandizirayo atha kupeza kuti muli ndi zizindikilo zamadzimadzi ambiri mthupi, monga:

• Kutupa, nthawi zambiri kumapazi
• Kumveka kosazolowereka mukamamvetsera pamtima ndi m'mapapu anu ndi stethoscope
• Mutha kukhala ndi kuthamanga kwa magazi

Mayesero otsatirawa amatsimikizira kuti matendawa ndi awa:

• BUN ndi creatinine kuyesa magazi
• Magulu othandizira magazi
• Kupenda kwamadzi
• Mkodzo mapuloteni
• Impso biopsy (kutsimikizira membranoproliferative GN I kapena II)

Chithandizo chimadalira zizindikiro. Zolinga zamankhwala ndikuchepetsa zizindikilo, kupewa zovuta, ndikuchepetsa kukula kwa matendawa.

Mungafunike kusintha kadyedwe. Izi zitha kuphatikizira kuchepetsa sodium, madzi, kapena mapuloteni othandizira kuti athane ndi kuthamanga kwa magazi, kutupa, komanso kuchuluka kwa zinyalala zamagazi.

Mankhwala omwe angaperekedwe ndi awa:

• Mankhwala a kuthamanga kwa magazi
• Dipyridamole, wokhala ndi aspirin kapena wopanda
• Okodzetsa
• Mankhwala opondereza chitetezo cha mthupi, monga cyclophosphamide
• Steroids

Chithandizo chimagwira ntchito kwambiri kwa ana kuposa akulu. Dialysis kapena kupatsirana kwa impso pamapeto pake kungafunike kuthana ndi vuto la impso.

Vutoli limakula pang'onopang'ono ndipo pamapeto pake limalephera impso.

Hafu ya anthu omwe ali ndi vutoli amakhala ndi kulephera kwa impso kwakanthawi m'zaka 10. Izi ndizotheka kwambiri kwa iwo omwe ali ndi mapuloteni ambiri mumkodzo wawo.

Zovuta zomwe zingachitike chifukwa cha matendawa ndi monga:

• Matenda oopsa a nephritic
• Kulephera kwakukulu kwa impso
• Matenda a impso

Itanani kuti mudzakumane ndi wokuthandizani ngati:

• Muli ndi zizindikiro za vutoli
• Zizindikiro zanu zimaipiraipira kapena sizimatha
• Mumakhala ndi zizindikilo zatsopano, kuphatikizapo kuchepa kwa mkodzo

Kupewa matenda monga chiwindi kapena kusamalira matenda monga lupus kungathandize kupewa MPGN.

Zolemba pamodzi za GN I; Kulembetsa GN II; Mesangiocapillary glomerulonephritis; Membranoproliferative glomerulonephritis; Lobular GN; Glomerulonephritis - membranoproliferative; MPGN mtundu I; MPGN mtundu wachiwiri

• Matenda a impso

Roberts ISD. Matenda a impso. Mu: Cross SS, yokonzedwa. Underwood's Pathology: Njira Yachipatala. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier; 2019: mutu 21.

Saha MK, Pendergraft WF, Jennette JC, Falk RJ (Adasankhidwa) Matenda oyamba a glomerular. Mu: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, olemba. Brenner ndi Rector a Impso. 11th ed. Philadelphia, PA: Elsevier; 2020: chap 31.

Sethi S, De Vriese AS, Fervenza FC. Membranoproliferative glomerulonephritis ndi cryoglobulinemic glomerulonephritis. Mu: Feehally J, Floege J, Tonelli M, Johnson RJ, olemba. Chachikulu Chachipatala Nephrology. Lachisanu ndi chimodzi. Philadelphia, PA: Elsevier; 2019: mutu 21.