Okuqukethwe
I-Vasculitis yama-capillaries amancane
I-Vasculitis yama-capillaries amancane
Leli qembu elikhulu le-vasculitis odongeni lwe-arterioles, ama-venules noma ama-capillaries, ukubikezela okuguquguqukayo kakhulu kuye ngokuthi kuhlanzekile noma ku-systemic cutaneous vasculitis.
Isici somtholampilo esivame kakhulu i-purpura (izindawo ezinsomi ezingabuni lapho zicindezelwa) eziqhumayo futhi zingene ngaphakathi, ikakhulukazi ezithweni ezingezansi, ezibhebhethekiswa ukuma, ezingathatha izinhlobo eziningana (petechial ne-ecchymotic, necrotic, pustular…) noma i-liveo, ukwakha uhlobo lwe-purplish mesh (livedo reticularis) noma i-mottling (livedo racemosa) emilenzeni. Singakwazi futhi ukubona isenzakalo sikaRaynaud (iminwe embalwa iba mhlophe emakhazeni).
I-Purpura ne-liveo ingase ihlotshaniswe nezinye izilonda esikhumbeni (ama-papules, ama-nodules, izilonda ze-necrotic, ama-bubbles wopha), i-urticaria ehleliwe engalunywa.
Ukuba khona kwezibonakaliso ngaphandle kwesikhumba kuyingxenye ye-gravity, ebonisa ukuba khona kokubandakanyeka kwe-vascular ezitho:
- ubuhlungu bamalunga,
- ubuhlungu besisu, indle emnyama, ukuphazamiseka kokuhamba,
- peripheral neuropathy
- i-edema yemilenze engezansi,
- I-Hyper Blood Pressure,
- ubunzima bokuphefumula, isifuba somoya, ukukhwehlela igazi ...
Udokotela ubeka izivivinyo okuhloswe ngazo ukubheka imbangela nezimpawu zobucayi: ukuhlolwa kwegazi ngesibalo samangqamuzana egazi, ukucinga ukuvuvukala, ukuhlolwa kwesibindi nezinso, njll., ukucinga igazi esitokisini kanye nama-x-ray ngokusho kwamaphuzu ocingo ( i-x-ray yamaphaphu uma kwenzeka kuba nobunzima bokuphefumula, njll.).
I-Vasculitis ebangelwa ukutheleleka:
- amagciwane: streptococcus, gram-negative cocci (gonococcus kanye meningococcus)
- igciwane: i-hepatitis, i-mononucleosis esithathelwanayo, i-HIV, njll.
- i-parasitic: umalaleveva ...
- fungal: Candida albicans ...
I-Vasculitis ehambisana nokungajwayelekile kwe-immunological
- Uhlobo II (i-monoclonal exubile) kanye ne-III (i-polyclonal ehlanganisiwe) i-cryoglobulinemia, ehambisana nesifo sokuzivikela komzimba, ukutheleleka (ikakhulukazi i-hepatitis C) noma isifo segazi
- I-Hypocomplementémie (i-Mac Duffie's urticarienne vascularite)
- I-Hyperglobulinémie (Waldenström's hyperglobulinémique purple)
- I-Connectivitis: i-lupus, i-Gougerot-Sjögren syndrome, i-rheumatoid arthritis ...
- I-Vasculitis yezifo zegazi kanye nezifo ezimbi
- I-leukemia, i-lymphoma, i-myeloma, umdlavuza
- I-Vasculitis ehlotshaniswa ne-ANCA (anti-neutrophil cytoplasmic antibodies)
I-Micro Poly Angéite noma i-MPA
I-Micropolyangiitis (MPA) i-systemic necrotizing angeitis izimpawu zayo zomtholampilo zifana kakhulu nalezo ze-PAN.
I-MPA ihlotshaniswa ne-ANCA yohlobo lwe-anti-myeloperoxidase (anti-MPO) futhi ngokuvamile ibangela i-glomerulonephritis ethuthukayo kanye nokubandakanyeka kwamaphaphu okungekho ku-PAN.
Ukwelashwa kwe-MPA njenge-PAN kuqala ngokwelashwa kwe-corticosteroid, ngezinye izikhathi kuhlanganiswe nama-immunosuppressants (ikakhulukazi i-cyclophosphamide)
Isifo sika-Wegener
I-Wegener's granulomatosis i-vasculitis, ukuqala kwayo ngokuvamile okuphawulwa yi-ENT noma izimpawu zokuphefumula (i-sinusitis, i-pneumopathy, njll.) ukumelana nemithi elwa namagciwane.
Ngokwejwayelekile, ukusabalalisa kwe-ENT (i-pansinusitis ebhubhisayo), i-pulmonary (parenchymal nodules) kanye ne-renal (crescent pauci-immune necrotizing glomerulonephritis) kukhiqiza u-triad wakudala we-granulomatosis ka-Wegener.
Ulwelwesi lwamafinyila esikhumbeni luthinta cishe ama-50% eziguli: i-purpura (izindawo ezinsomi ezingashabalali lapho zicindezelwa) eziqhumayo futhi zingene ngaphakathi, ama-papules, amaqhuqhuva angaphansi kwesikhumba, izilonda zesikhumba, ama-pustules, ama-vesicles, i-hyperplastic gingivitis ...
I-ANCA iwukuhlolwa kokuxilonga nokuguquguqukayo kwe-granulomatosis ye-Wegener, ene-cytoplasmic fluorescence (c-ANCA), i-granular encane enokuthuthukiswa kwe-perinuclear kanye / noma i-perinuclear fluorescence (p-ANCA).
Ukuphathwa kwe-granulomatosis ye-Wegener, okungenzeka ngezinye izikhathi kubhekwe njengesimo esiphuthumayo sezokwelapha, kufanele kwenziwe endaweni ekhethekile esibhedlela, ngenhlanganisela ye-cortisone ne-oral cyclophosphamide.
Isifo se-Churg ne-Strauss
Isifuba somoya siwumgomo omkhulu futhi wakuqala walesi vasculitis, esandulela ngokwesilinganiso ngeminyaka eyi-8 ngaphambi kwezimpawu zokuqala ze-vasculitis (i-neuropathy, ukuphazamiseka kwe-sinus, njll.) futhi eqhubekayo ngemva kwalokho.
Ukuhlolwa kwegazi kubonisa ikakhulukazi ukwanda okucacile kwamangqamuzana egazi amhlophe e-eosinophilic polynuclear
Ukwelashwa kwe-Churg and Strauss disease kuqala ngokwelashwa kwe-corticosteroid, ngezinye izikhathi kuhlanganiswe nama-immunosuppressants (ikakhulukazi i-cyclophosphamide)
Umbono kadokotela wethu
I-purpura engenile (i-purplish, iziqephu eziwugqinsi ezingabuni ngokucindezela komunwe) kuwuphawu oluyinhloko lwe-vasculitis. Ngeshwa, lolu phawu aluhlali lukhona futhi ukuhlukahluka kwezimpawu zomtholampilo ezingaqondile ngokuvamile kwenza ukuxilongwa kube nzima kodokotela. Ngokufanayo, kuvame ukuba nzima ukuthola imbangela yokwelapha emkhunjini omncane we-vasculitis, okuyicala elibaluleke kakhulu elihlangene nomkhuba wamanje uma kuqhathaniswa ne-vasculitis yomkhumbi ophakathi nendawo omkhulu: cishe ingxenye ye-vasculitis encane yomkhumbi. imikhumbi ayinaso isizathu esitholakala ngesikhathi sokuhlolwa kwezinto eziphilayo kanye ne-radiological eyenziwa udokotela ukuze afune i-etiology. Sivame ukukhuluma "nge-allergic vasculitis" noma "hypersensitivity vasculitis" noma kunalokho "i-cutaneous vasculitis yemikhumbi emincane ye-idiopathic caliber". UDkt Ludovic Rousseau, udokotela wesikhumba |
iziNdawo
Iqembu le-French Vasculitis Study: www.vascularites.org
I-Dermatonet.com, indawo yolwazi esikhunjeni, izinwele kanye nobuhle ngudokotela wesikhumba
MedicineNet : http://www.medicinenet.com/vasculitis/article.htm