{"id":107387,"date":"2020-02-21T09:27:04","date_gmt":"2020-02-21T08:27:04","guid":{"rendered":"https:\/\/sdk.mk\/?p=107387"},"modified":"2020-02-21T09:27:04","modified_gmt":"2020-02-21T08:27:04","slug":"ju-njoftojme-me-semundjet-e-rralla-mielofibroza-primare","status":"publish","type":"post","link":"https:\/\/sdk.mk\/index.php\/uncategorized-sq\/ju-njoftojme-me-semundjet-e-rralla-mielofibroza-primare\/","title":{"rendered":"JU NJOFTOJM\u00cb ME S\u00cbMUNDJET E RRALLA: MIELOFIBROZA PRIMARE"},"content":{"rendered":"<div class=\"f52428582a4b906b2d2e2a7d733c7d27\" data-index=\"7\" style=\"float: none; margin:10px 0 10px 0; text-align:center;\">\n<!-- MSP Ads Asynchronous JS Tag - Generated with Revive Adserver v5.4.1 -->\r\n<ins data-revive-zoneid=\"167\" data-revive-id=\"060fdb01f6430ec164d3519234aa4967\"><\/ins>\r\n<script async src=\"\/\/panel.ads.com.mk\/www\/delivery\/asyncjs.php\"><\/script>\n<\/div>\n<p><a href=\"https:\/\/www.youtube.com\/watch?v=76YNCdPStQE&amp;list=PLPGcigDEy-qj0I1um2ByEqy4a1IdVRjzf&amp;index=22&amp;t=0s\" target=\"_blank\" rel=\"noopener noreferrer\"><em><strong>Mielofibroza primare MFP<\/strong><\/em><\/a><\/p>\n<p>MKB: D47.4<\/p>\n<p>Primary myelofibrosis<\/p>\n<p>Mielofibroza \u00ebsht\u00eb nj\u00eb \u00e7rregullim kronik i gjakut q\u00eb shfaqet nj\u00eblloj, si tek meshkujt edhe tek femrat. Mund t\u00eb shfaqet n\u00eb \u00e7do mosh\u00eb, edhe pse \u00ebsht\u00eb m\u00eb e zakonshme tek personat m\u00eb t\u00eb moshuar se 50 vje\u00e7. Mosha e mesme e diagnostifikimit \u00ebsht\u00eb af\u00ebrsisht 65 vje\u00e7. Kjo p\u00ebrb\u00ebn nj\u00eb \u00e7rregullim t\u00eb rrall\u00eb, kur n\u00eb palc\u00ebn e kock\u00ebs krijohen qeliza jonormale gjaku dhe qime.<br \/>\nKy proces ndikon negativisht n\u00eb krijimin e qelizave normale t\u00eb gjakut dhe transmetohet edhe n\u00eb organe t\u00eb tjera, si p\u00ebr shembull tek shpretka dhe m\u00ebl\u00e7ia e zez\u00eb, q\u00eb rriten si pasoj\u00eb e k\u00ebsaj.<br \/>\nP\u00ebr shkak t\u00eb zmadhimit t\u00eb shpretk\u00ebs pacient\u00ebt ndiejn\u00eb shqet\u00ebsime n\u00eb abdomen, si edhe dhimbje tek brinja e majt\u00eb. Presioni i shpretk\u00ebs n\u00eb stomak, krahas dhimbjes, mund t\u00eb shkaktoj\u00eb nj\u00eb lloj mbingopje t\u00eb parakohshme dhe humbjen e oreksit, nd\u00ebrsa presioni mbi zorr\u00eb mund t\u00eb ndikoj\u00eb n\u00eb v\u00ebshtir\u00ebsi tek tretja dhe jasht\u00ebqitja.<\/p>\n<p>Zmadhimi i m\u00ebl\u00e7is\u00eb (hepatomegalia) shfaqet tek m\u00eb shum\u00eb se gjysma e pacient\u00ebve, shpeshher\u00eb n\u00eb fazat m\u00eb t\u00eb avancuara t\u00eb s\u00ebmundjes. Zmadhimi i ngadalsh\u00ebm i nyejve limfatike \u00ebsht\u00eb m\u00eb i rrall\u00eb (prezent tek 10-20 % e pacient\u00ebve).<\/p>\n<p>Qelizat anormale prodhojn\u00eb molekula q\u00eb quhen citokine, q\u00eb shkaktojn\u00eb inflamacion n\u00eb organiz\u00ebm, i cili sjell edhe deri tek simptomat dhe shenjat e tilla, si humbje peshe, djersitje gjat\u00eb nat\u00ebs, lodhje, dhimbje koke, t\u00eb cilat e reduktojn\u00eb duksh\u00ebm cil\u00ebsin\u00eb e jet\u00ebs s\u00eb pacientit. Me kalimin e koh\u00ebs, pacient\u00ebt zhvillojn\u00eb anemi, trombocidopeni dhe jan\u00eb t\u00eb prirur drejt gjakderdhjeve.<\/p>\n<p>Zakonisht, MFP-ja zbulohet me nj\u00eb analiz\u00eb t\u00eb plot\u00eb gjaku, ku shfaqet edhe nj\u00eb nivel tep\u00ebr i ul\u00ebt i qelizave t\u00eb kuqe t\u00eb gjakut, edhe pse jo tek t\u00eb gjith\u00eb pacient\u00ebt shfaqet anemia dhe dukuria e qelizave t\u00eb pamaturuara t\u00eb gjakut, t\u00eb bardha dhe t\u00eb kuqe, e ashtuquajtura reaksioni leukoaritroblastik.<\/p>\n<p>Pacienti me MF \u00ebsht\u00eb pacient i s\u00ebmur\u00eb me t\u00eb pakt\u00ebn disa simptoma, p\u00ebrpara se t\u00eb vizitohet tek specialisti. Simptomat q\u00eb shfaqen m\u00eb shpesh jan\u00eb: dhimbje n\u00eb kocka, djersitje nat\u00ebn, munges\u00eb energjie, lodhje e madhe, dhimbje n\u00eb shpretk\u00eb dhe humbje e pesh\u00ebs trupore.<\/p>\n<p>Shkaku dhe mekanizmi i formimit t\u00eb MFP nuk \u00ebsht\u00eb i njohur t\u00ebr\u00ebsisht.<br \/>\nTek njer\u00ebzit ekspozimi kronik ndaj disa substancave t\u00eb caktuara kimike, si tret\u00ebsit organik\u00eb benzen dhe tulin, lidhet me shfaqjen e MFP.<br \/>\nNdryshimi m\u00eb i madh n\u00eb kuptimin e mekanizmit t\u00eb formimit t\u00eb k\u00ebsaj s\u00ebmundje \u00ebsht\u00eb zbulimi i mutacione t\u00eb vet\u00eb gjenit qelizor \u0408\u0410\u041a-2 (janus \u2013 kinaza ), q\u00eb sjell deri tek aktiviteti i vet i tepruar, po ashtu edhe me aktivitetin e rritur t\u00eb qelizave t\u00eb palc\u00ebs s\u00eb kock\u00ebs, q\u00eb reflektohet n\u00eb shumimin, maturimin dhe rritjen e qelizave t\u00eb palc\u00ebs s\u00eb kock\u00ebs.<br \/>\nQ\u00eb t\u00eb diagnostifikohet s\u00ebmundja \u00ebsht\u00eb e domosdoshme q\u00eb t\u00eb vler\u00ebsohen me kujdes problemet e pacientit, si edhe t\u00eb v\u00ebrehet zmadhimi i shpretk\u00ebs dhe m\u00ebl\u00e7is\u00eb, si edhe ndryshimet tek pasqyra e gjakut. Si pasoj\u00eb, duhet q\u00eb t\u00eb kryhen analizat e duhura t\u00eb palc\u00ebs s\u00eb kock\u00ebs, para s\u00eb gjithash biopsia e palc\u00ebs s\u00eb kock\u00ebs p\u00ebr hulumtime patohistologjike dhe vler\u00ebsimin e shkall\u00ebs s\u00eb fibroz\u00ebs (akumulimi i kordonit n\u00eb mjediset e sfungjerta t\u00eb palc\u00ebs s\u00eb kock\u00ebs). Ky vler\u00ebsim po ashtu mund\u00ebson q\u00eb t\u00eb vler\u00ebsohet edhe serioziteti i vet\u00eb s\u00ebmundjes, q\u00eb luhatet nga 0 deri n\u00eb 3.<\/p>\n<p>Metodat speciale gjenetike nga gjaku i pacientit mund t\u00eb tregojn\u00eb ekzistenc\u00ebn e mutacionit t\u00eb gjenit \u0408\u0410\u041a-2 kinaza (mutacioni specifik i \u0408\u0410\u041a-2 V617F), q\u00eb \u00ebsht\u00eb pozitive tek m\u00eb shum\u00eb se gjysma e pacient\u00ebve. Gjetja e k\u00ebtij mutacioni e v\u00ebrteton ekzistenc\u00ebn e s\u00ebmundjes, por mungesa e tij nuk \u00ebsht\u00eb e domosdoshme p\u00ebr dh\u00ebnien e diagnoz\u00ebs finale.<br \/>\nGrafit\u00eb nga rezonanca magnetike dhe grafit\u00eb nga r\u00ebntgeni mund t\u00eb shfryt\u00ebzohen p\u00ebr vler\u00ebsimin e hepatomegalis\u00eb.<\/p>\n<p>N\u00eb var\u00ebsi nga simptomat e pacientit ekzistojn\u00eb metoda t\u00eb ndryshme n\u00eb dispozicion p\u00ebr kurimin e Mielofibroz\u00ebs. Disa njer\u00ebz me vite nuk mundet q\u00eb t\u00eb shfaqin simptoma. Madje edhe n\u00ebse nuk k\u00ebrkojn\u00eb trajtim urgjent, duhet t\u00eb ndiqen p\u00ebr \u00e7far\u00ebdolloj ndryshimesh q\u00eb tregojn\u00eb n\u00eb keq\u00ebsimin e gjendjes s\u00eb tyre.<\/p>\n<p>\u201eJakavi\u201e (ruksolitinib) \u00ebsht\u00eb medikamenti i par\u00eb i miratuar nga Drejtoria e ushqimit dhe barnave p\u00ebr trajtimin e Mielofibroz\u00ebs mesatare ose me rrezik t\u00eb lart\u00eb.<\/p>\n<p>Ai ndihmon q\u00eb t\u00eb largohen disa prej simptomave t\u00eb lidhura me s\u00ebmundjen, duke p\u00ebrfshir\u00eb edhe zmadhimin e shpretk\u00ebs, djersitjen nat\u00ebn, kruarjen, dob\u00ebsimin dhe ethet.<\/p>\n<p>\u201eHidroksiurea\u201e \u00ebsht\u00eb tradicionalisht i preferuesh\u00ebm dhe shpesh medikamenti m\u00eb i p\u00ebrdorur \u2013 mesatarisht efikas n\u00eb p\u00ebrmir\u00ebsimin e splenomegalis\u00eb, leukocitoz\u00ebs dhe trombocitoz\u00ebs.<br \/>\nDisa pacient\u00eb ndoshta mund t\u00eb trajtohen kirurgjikisht p\u00ebr shpretk\u00ebn (splenektomiaa), sidomos n\u00ebse ajo shkakton komplikime. Trajtime t\u00eb tjera mund t\u00eb p\u00ebrfshijn\u00eb terapin\u00eb me rreze ose transplantimin e palc\u00ebs s\u00eb kock\u00ebs (qeliza stematike).<\/p>\n<p>Prognoza<\/p>\n<p>Q\u00eb t\u00eb gjitha problemet e sip\u00ebrp\u00ebrmendura, t\u00eb tilla si anemia, dhimbjet n\u00eb stomak p\u00ebr shkak t\u00eb zmadhimit t\u00eb m\u00ebl\u00e7is\u00eb dhe shpretk\u00ebs, mund t\u00eb zgjidhen me terapi simptomatike, por jo q\u00eb ta sh\u00ebrojn\u00eb s\u00ebmundjen n\u00eb afat m\u00eb t\u00eb gjat\u00eb. Edhe krahas t\u00eb gjitha masave q\u00eb mund t\u00eb nd\u00ebrmerren, jet\u00ebgjat\u00ebsia e pacient\u00ebve me Mielofibroz\u00eb \u00ebsht\u00eb m\u00eb e shkurt\u00ebr sesa tek s\u00ebmundjet e tjera t\u00eb ngjashme n\u00eb grupin e s\u00ebmundjes kronike mieloproliferative. Mbijetesa mesatare e k\u00ebtyre pacient\u00ebve varet nga nj\u00eb num\u00ebr i madh specifikash dhe luhatet nga 2 deri n\u00eb mbi 10 vjet.<\/p>\n\n<div style=\"font-size: 0px; height: 0px; line-height: 0px; margin: 0; padding: 0; clear: both;\"><\/div>","protected":false},"excerpt":{"rendered":"<p>Mielofibroza primare MFP MKB: D47.4 Primary myelofibrosis Mielofibroza \u00ebsht\u00eb nj\u00eb \u00e7rregullim kronik i gjakut q\u00eb shfaqet nj\u00eblloj, si tek meshkujt [&hellip;]<\/p>\n","protected":false},"author":24,"featured_media":107385,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_mo_disable_npp":"","inline_featured_image":false},"categories":[1794],"tags":[],"imageURL":"https:\/\/sdk.mk\/wp-content\/uploads\/2020\/02\/21-Primary-myelofibrosis-650x366.png","thumbURL":"https:\/\/sdk.mk\/wp-content\/uploads\/2020\/02\/21-Primary-myelofibrosis-250x141.png","categoryNames":["Uncategorized"],"feature_caption":"","subtitle":"","views":"5954","source":"\u0421\u043a\u043e\u043f\u0458\u0435, (\u0421\u0410\u041a\u0410\u041c\u0414\u0410\u041a\u0410\u0416\u0410\u041c.\u041c\u041a)","yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v15.0 - 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