Malakoplakia (मालाकोप्लाकिया) एक rare inflammatory disease है जिसमें bacterial infection के कारण tissue में chronic granulomatous inflammation होता है।
- यह condition urinary tract (किडनी और मूत्राशय) में सबसे common है, लेकिन colon, lungs, skin और other organs में भी हो सकता है।
- नाम “Malakoplakia” ग्रीक शब्दों से आया है: malakos (soft) और plakos (plaque), जिसका अर्थ है soft plaque-like lesion।
- First described by Michael von Malakoplak in 1902।
Malakoplakia क्या है (What is Malakoplakia)
- Chronic granulomatous inflammatory disorder
- Characterized by Michaelis-Gutmann bodies (intracellular calcified inclusions)
- Often associated with immunocompromised conditions (diabetes, HIV, transplant patients)
- Commonly affects urinary bladder, kidneys, retroperitoneum
Malakoplakia कारण (Causes of Malakoplakia)
1. Bacterial Infection
- Most commonly Escherichia coli (E. coli)
- Other Gram-negative bacteria: Proteus, Klebsiella
2. Immune Dysfunction
- Impaired macrophage lysosomal function
- Seen in diabetes, HIV, transplant, chronic steroid therapy
3. Chronic Disease / Predisposing Factors
- Chronic urinary tract infections
- Immunosuppressive medications
Malakoplakia लक्षण (Symptoms of Malakoplakia)
Symptoms depend on organ involved:
Urinary Tract Involvement
- Hematuria (blood in urine)
- Dysuria (painful urination)
- Recurrent urinary tract infections
- Flank pain
Other Organ Involvement
- Gastrointestinal: abdominal pain, diarrhea, bleeding
- Skin: nodules, plaques, ulcerations
- Rare: systemic fever, malaise
Symptoms often nonspecific, diagnosis delayed।
Malakoplakia कैसे पहचाने (Diagnosis of Malakoplakia)
- Urinalysis / Urine Culture – bacterial infection detection
- Imaging – Ultrasound / CT scan to detect masses or lesions
- Biopsy & Histopathology – confirms Michaelis-Gutmann bodies
- Blood Tests – assess kidney function and immune status
- Cystoscopy – for bladder lesions
Histopathology is gold standard for diagnosis।
Malakoplakia इलाज (Treatment of Malakoplakia)
1. Antibiotic Therapy
- Long-term antibiotics effective against Gram-negative bacteria
- Common drugs: Ciprofloxacin, Trimethoprim-sulfamethoxazole
- Treatment duration: 6–12 weeks or longer
2. Immunomodulation / Supportive Therapy
- Vitamin C, bethanechol to improve macrophage function
- Address underlying immunosuppression
3. Surgical Intervention
- Rarely required
- Excision of localized lesions if obstruction or mass effect
4. Monitoring
- Regular urine culture, imaging
- Monitor kidney function in urinary tract involvement
Early treatment prevents organ damage and recurrence।
रोकथाम (Prevention)
- Prompt treatment of urinary tract infections
- Manage diabetes, immunosuppression, chronic diseases
- Regular follow-up in high-risk patients
- Good hygiene to prevent recurrent infections
सावधानियाँ (Precautions)
- Do not ignore persistent urinary symptoms
- Complete the entire course of antibiotics
- Monitor for kidney function and recurrent infections
- Immunocompromised patients need closer surveillance
FAQs (अक्सर पूछे जाने वाले प्रश्न)
Q1. Malakoplakia contagious है?
नहीं, यह disease व्यक्तिगत immune dysfunction और bacterial infection के कारण होती है।
Q2. क्या यह cancer है?
नहीं, यह benign inflammatory disorder है, लेकिन untreated lesions organ damage कर सकते हैं।
Q3. कितनी जल्दी recover होता है?
Antibiotic therapy के बाद weeks to months में improvement।
Q4. कौन high risk में है?
Immunocompromised patients: diabetes, HIV, transplant, chronic steroid use।
निष्कर्ष (Conclusion)
Malakoplakia (मालाकोप्लाकिया) एक rare inflammatory disorder है, जो mostly urinary tract में होता है।
Early diagnosis, long-term antibiotic therapy, underlying immunosuppression management और regular monitoring से organ damage और complications prevent किए जा सकते हैं।
अगर किसी को recurrent urinary infections, hematuria या abdominal pain हो, तो तुरंत urologist या physician से consultation जरूरी है।