Zviratidzo, MRI, uye Lumbar Kupedza Kuongororwa PML
Progressive multifocal leukoencephalopathy (PML) chirwere chinokonzera utachiona hunokonzerwa neJC virus . Iyi hutachiona inokonzera kusina zviratidzo kana ichibata munhu, pakupedzisira yakarara pasi mukati momuviri wayo. Asi kana hutachiona hwemunhu huchikanganiswa (seAIDS, lupus, kana mamwe makondombera), hutachiona hunogona kuitikazve, hutachiona masero anogadzira myelin (nerve yako yokuvhara) -iyo ye biology iri shure kweMDC.
Kukosha kwePML muSMS ndeyokuti haina rutivi rwemazuva ano humwe hutachiona hwehutano- hunochinja hurapa, kunyanya, Tysabri (natalizumab).
Kunewo vaviri vakarondedzera nyaya dze PML kune vanhu vane MS avo vakatora Gilenya (fingolimod), Tecfidera (dimethyl fumarate), kana Ocrevus (ocrelizumab).
Kuongororwa kwechirwere ichi chinouraya kunoda kuongororwa zvakananga uye nekukurumidza nachiremba kunosanganisira nhoroondo yakajeka uye kuongorora muviri, MRI yeuropi, uye kuputika kwechikwata.
Kuedzwa kweJC Virus muCerebrospinal Fluid
Kuti aongorore PML, chiremba achaita chikwata chekuvhara ropa kuti aongorore cerebrospinal fluid (CSF) yekuvapo kweJC virus. Izvi zvinoitwa kuburikidza nekuita puromerase chain reaction (PCR) muedzo weCSF kuona kana DNA yeJC virus iripo.
Migumisiro yechiratidzo chePCR kutarisa JC muropa mucheperesi yemvura inenge yakabatanidzwa nemakiriniki ekuwana (zviratidzo zve PML) uye MRI zvinoguma kusvika pakuongororwa.
MRI kuti iongorore PML
A magnetic resonance imaging (MRI) scan yeuropi icharairwa. Pamusoro peMRI, PML inowanzoratidzira sevamwe vashoma, vakasiyana - siyana T2-zviremera zvakakomba . Ivo vanogona kugona kubatana kuti vagadzire chironda chimwe chikuru.
Zviratidzo Zvako Zvekuona Dambudziko PML
Chiremba wako achada kuziva zvakajeka kuti wakanzwa sei uye apo zviratidzo zvako zvitsva zvakatanga.
Zvakakosha kunyatsotsanangura uye kutsanangurwa mukutsanangurwa kwako. PML zviratidzo zvinoshanduka asi zvinogona kusanganisira kuchinja mukufunga uye unhu, kurasikirwa kwekubatana, zvinetso zvekuona, kuwedzera kukundikana kwemaoko kana makumbo, kuora musoro, kana kuparara.
Dzimwe nguva zvinogona kuva zvakaoma kusiyanisa zviratidzo zveSMS inodzoka zvakare kubva kune PML. Imwe nyanzvi, maererano nekuongorora kwakaitwa muna 2009 mu Archives of Neurology, ndeyekuti munhu ane MS anodzokorora anowanzova nechiratidzo chekutanga chekutanga, asi vanhu vane PML vanowanzova nezviratidzo zvakawanda.
Uropi Hwakanakira Kuona Dambudziko PML
Kana munhu ari kuTysabri, kuongororwa kunoenderana neJC virusi nePRR CSF, inoratidza zviratidzo zve PML, uye ine MRI scan nekuwana zvakaenderana ne PML, zvichida kuti chiremba achabata PML. Dzimwe nguva, kunyange zvakadaro, huropi hupi hunoitwa.
Uropi hunyengeri ndiko kubviswa kwezvidimbu zviduku zveuuropi zvinoshandiswa mukutsvaga kweMDC. Zvikamu zvezviviri zvinongororwa nekuda kweJC virus.
Uropi hutsananguro ndiyo "yegoridhe" yekutarisa zvirwere zve PML. Zvisinei, inotakura zvinokonzera njodzi, kusanganisira rufu. Mukuwedzera, iyo PML zvikoni zvingave zvisingakwanisi kusvika kusvika kuwana bhiopsy sampuli. Hazvina maturo kutaura, iyi haisi nzira yakakurumbira nevarwere kana vanachiremba, kana imwe inoshandiswa kunze kwekunyanya kukanganisa kwemamiriro ezvinhu, kuitira kutonga dzimwe zvirwere.
Munyaya yemunhu ane MS uyo ari kuTysabri, izvi hazviitiki pane munhu ane HIV / AIDS, sezvo nhamba yezvirwere zvinogona kutevedzera PML (toxoplasmosis, cryptococcal meningitis, kana sangano reAIDS). zvichida.
Shoko Rinobva
Kana iwe uchitanga kuva nechiratidzo chipi zvacho chisingawanzoiti kana chichikuvadza paTysabri (kana kumwe kumwe kurapwa kwechirwere cheMMS) taura nechiremba wako pakarepo. Usafungidzira kuti "kungofanana neSMS zvakare" kana kuti zviratidzo zveparoxysmal. Tsvaga kunze nokukurumidza. Nokukurumidza kurapwa kwePPL kwakatanga, zviri nani mikana yako yekupona.
> Sources:
> Boster A et al. Progressive multifocal leukoencephalopathy nekudzokazve-kurega multiple sclerosis: kuenzanisa. Arch Neurol. 2009 May; 66 (5): 593-9.
> Clifford DB et al. Natalizumab-inofambidzana inowedzera maitiro eukoukoencephapathy kune varwere vane multiple sclerosis: zvidzidzo kubva kumatambudziko makumi mana. Lancet Neurol . 2010 Apr; 9 (4): 438-46.
> National MS Society (2015). Nyaya yePPL Yakapiwa muMunhu Kugamuchira Gilenya: UPDATED. uye > Nyaya yePML Yakapiwa Munhu Kuchengeta Tecfidera.
> National MS Society (2017). Nyaya yePPL Yakapiwa muMunhu Kuwana Ocrevus Kubata MS.
> PML Consortium. Vatano Vehutano: Chii chinonzi PML?