Sjögren syndrome

Cudurka 'Sjögren Syndrome' waa cillad isdifaac ku ah jirka oo qanjidhada soo saara ilmada iyo candhuufta la baabi'iyo. Tani waxay keentaa af qalalan iyo indho qallalan. Xaaladda ayaa laga yaabaa inay ku dhacdo qaybaha kale ee jirka, oo ay ku jiraan kelyaha iyo sambabbada.

Sababta cudurka Sjögren syndrome lama yaqaan. Waa cillad isdifaac ah. Tan macnaheedu waa jidhku si qalad ah ayuu u weeraraa unugyada caafimaadka qaba. Cilladda cillad-xanuunku badanaa waxay ku dhacdaa haweenka jira 40 illaa 50. Waa ku yar tahay carruurta.

Cudurka 'Primary Sjögren syndrome' waxaa lagu qeexaa inuu yahay indho qallalan iyo af qalalan oo aan lahayn cudur kale oo isdifaaca jirka.

Secondary Sjögren syndrome wuxuu la yimaadaa cudur kale oo isdifaaca jirka, sida:

• Rheumatoid arthritis (RA)
• Nidaamka lupus erythematosus
• Scleroderma
• Polymyositis
• Cagaarshowga C wuxuu saameyn ku yeelan karaa qanjidhada candhuufta wuxuuna umuuqdaa Sjögren syndrome
• Cudurka IgG4 wuxuu umuuqan karaa Sjogren syndrome waana in laga fiirsadaa

Indhaha qalalan iyo afka qalalan ayaa ah astaamaha ugu caansan ee cilladan.

Calaamadaha indhaha:

• Indho cuncun
• Isagoo dareemaya inay wax isha ku jiraan

Calaamadaha afka iyo cunaha:

• Dhibaato liqidda ama cunidda cunnooyinka qallalan
• Lumida dareenka dhadhanka
• Dhibaatooyinka hadalka
• Candhuuf adag ama xadhig leh
• Af xanuun ama xanuun
• Ilkaha suuska iyo cirridka oo barara
• Cabaadis

Calaamadaha kale waxaa ka mid noqon kara:

• Daal
• Qandho
• Isbeddel ku yimaada midabka gacmaha ama cagaha oo leh soo-gaadhis qabow (ifafaalaha Raynaud)
• Xanuun wadajir ah ama barar wadajir ah
• Qanjirrada oo barara
• Finan maqaarka ah
• Kabuubyo iyo xanuun ay ugu wacan tahay neuropathy
• Qufac iyo neef gaabis cudurka sambabka awgiis
• Wadne garaac aan caadi ahayn
• Lalabbo iyo laab xanuun
• Qalitaanka xubinta taranka haweenka ama kaadi xanuun

Baadhitaan jireed oo dhameystiran ayaa la sameyn doonaa. Imtixaanku wuxuu muujinayaa indho qallalan iyo af qalalan. Waxaa jiri kara nabarro afka ah, ilko qurmay ama barar xanjo ah. Tani waxay dhacdaa sababtoo ah qallaylka afka. Bixiyaha xanaanada caafimaadkaaga ayaa afkaaga ka fiirin doona infekshanka fungus (candida). Maqaarka ayaa laga yaabaa inuu muujiyo firiiric, baaritaanka sambabka wuxuu noqon karaa mid aan caadi ahayn, caloosha ayaa loo garaacayaa beerka si uu u weynaado. Kala-goysyada waxaa laga baari doonaa arthritis-ka. Imtixaanka neuro wuxuu eegi doonaa cilladaha.

Waxaa laga yaabaa in lagugu sameeyo baaritaanadan soo socda:

• Kiimikada dhiigga oo dhameystiran leh enzymes-ka beerka
• Tirinta dhiigga oo dhammaystiran oo kaladuwan
• Kaadida
• Tijaabinta unugyada difaaca jirka ee loo yaqaan Antinuclear antibodies (ANA)
• Anti-Ro / SSA iyo anti-La / SSB difaaca jirka
• Cudurka rheumatoid
• Tijaabi cryoglobulins
• Heerarka dhammaystirka
• Electrophoresis-ka borotiinka
• Tijaabada cagaarshowga C iyo HIV (haddii ay halis ku jiraan)
• Tijaabooyinka qanjirka 'thyroid'
• Tijaabada Schirmer ee wax soo saarka ilmada
• Sawirka qanjirka candhuufta: ultrasound ama MRI
• Cad ka-qaadista qanjidhada salivary
• Cad ka-qaadista maqaarka haddii finanku jiraan
• Baadhitaanka indhaha ee dhakhtarka indhaha
• Raajo xabadka ah

Hadafku waa in la yareeyo astaamaha.

• Indhaha qallalan waxaa lagu daaweyn karaa ilmo macmal ah, boomaato indhaha ku shubta, ama dareeraha cyclosporine.
• Haddii Candida ay jirto, waxaa lagu daaweyn karaa miconazole oo aan sonkor lahayn ama nystatin.
• Fiilooyin yaryar ayaa lagu ridi karaa marinnada dheecaanka ilmada si looga caawiyo ilmada inay ku sii nagaato dusha sare ee isha.

Daawooyinka antiirheumatic (DMARDs) ee wax ka beddelka cudurada ee la mid ah kuwa loo isticmaalo RA ayaa hagaajin kara calaamadaha cudurka Sjögren syndrome. Kuwaas waxaa ka mid ah qodobka burooyinka necrosis (TNF) ee xakameynaya daawooyinka sida Enbrel, Humira ama Remicaide.

Waxyaabaha qaarkood ee aad sameyn kartid si aad u fududeysid astaamaha waxaa ka mid ah:

• Sipi biyo maalintii oo dhan
• Xanjo aan sonkor lahayn xanjo
• Ka fogow daawooyinka sababi kara qallaylka afka, sida daawooyinka xasaasiyadda ee sunta sunta ka baxda iyo kuwa sunta dila
• Ka fogow aalkolada

Kala hadal dhakhtarkaaga ilkaha wixii ku saabsan:

• Afku wuu dhaqaa si uu u beddelo macdanta ku jirta ilkahaaga
• Bedelka candhuufta
• Daawooyinka caawiya qanjidhada dhareerka ayaa sameeya candhuuf badan

Si looga hortago suuska ilkaha ee ay keento qallaylka afku:

• Caday oo nadiifi ilkahaaga badanaa
• Booqo dhakhtarka ilkaha si baaritaano joogto ah iyo nadiifin loogu sameeyo

Cudurku badiyaa ma aha mid nafta halis geliya. Natiijadu waxay kuxirantahay cudurada kale ee aad qabtid.

Khatar sare ayaa ugu jirta lymphoma iyo geerida hore marka Sjögren syndrome uu aad u firfircoonaa muddo dheer, iyo sidoo kale dadka qaba vaskulitis, dhammaystir hoose, iyo cryoglobulins.

Dhibaatooyinka waxaa ka mid noqon kara:

• Dhaawaca isha
• Godadka ilkaha
• Kelyaha hawlgab (naadir)
• Lymphoma
• Cudurka sambabka
• Vasculitis (dhif)
• Neuropathy
• Caabuq kaadiheysta

Wac takhtarkaaga haddii aad isku aragto astaamaha Sjögren syndrome.

Xerostomia - Sjögren syndrome; Keratoconjunctivitis sicca - Sjögren; Sicca syndrome

• Antibodies

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Mariette X. Sjögren cillad. Gudaha: Goldman L, Schafer AI, eds. Daawada Goldman-Cecil. 25aad. Philadelphia, PA: Elsevier Saunders; 2016: cutubka 268.

Seror R, Bootsma H, Saraux A, et al. Qeexida dhaqdhaqaaqa cudurku wuxuu sheegaa iyo horumarin macno leh oo caafimaad ee aasaasiga ah ee Sjögren's syndrome oo leh EULAR aasaasiga ah ee cudurka Sjögren's syndrome (ESSDAI) iyo tusmooyinka bukaan-socodka la soo sheegay (ESSPRI). Ann Rheum Dis. 2016; 75 (2): 382-389. PMID: 25480887 www.ncbi.nlm.nih.gov/pubmed/25480887.

Singh AG, Singh S, Matteson EL. Heerka, sababaha halista ah iyo sababaha dhimashada bukaannada qaba cudurka Sjögren’s syndrome: dib u eegis nidaamsan iyo falanqeyn meta ah oo ku saabsan daraasadaha kooxda. Rheumatology (Oxford). 2016; 55 (3): 450-460. PMID: 26412810 www.ncbi.nlm.nih.gov/pubmed/26412810.

Turner MD. Muujinta afka ee cudurada nidaamka. Gudaha: Flint PW, Haughey BH, Lund V, et al, eds. Cummings Otolaryngology. 6aad ed. Philadelphia, PA: Elsevier Saunders; 2015: cutubka 14.