I-Vasculitis yama-capillaries amancane

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

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