Vasculitis wa capillaries ang'onoang'ono

Vasculitis wa capillaries ang'onoang'ono

Vasculitis wa capillaries ang'onoang'ono  

Ichi ndi gulu lalikulu la vasculitis khoma la arterioles, venules kapena capillaries, zomwe zimadziwika kuti ndizosiyana kwambiri malinga ndi momwe zilili zoyera kapena zamtundu uliwonse za vasculitis.

Mbali yodziwika bwino yazachipatala ndi purpura (mawanga ofiirira omwe sazimiririka akakanikizidwa) otukumula ndikulowa, makamaka m'miyendo yakumunsi, yokulirapo chifukwa choyimirira, yomwe imatha kutenga mitundu ingapo (petechial ndi ecchymotic, necrotic, pustular…) kupanga mtundu wa mauna a purplish (livedo reticularis) kapena mottling (livedo racemosa) pamiyendo. Titha kuwonanso zochitika za Raynaud (zala zingapo zimasanduka zoyera pakazizira).

Purpura ndi liveo zitha kulumikizidwa ndi zotupa zina pakhungu (zotupa, tinatake tozungulira, zotupa za necrotic, thovu lokha magazi), urticaria yosasunthika yomwe simayaka.

Kukhalapo kwa mawonetseredwe kunja kwa khungu kumapanga chinthu chokoka, kusonyeza kukhalapo kwa mitsempha yokhudzana ndi ziwalo:

  • kupweteka kwa mafupa,
  • kupweteka kwam'mimba, chimbudzi chakuda, kusokonezeka kwamayendedwe,
  • peripheral neuropathy
  • edema ya m'munsi mwa miyendo,
  • Hyper Blood Pressure,
  • kupuma movutikira, mphumu, kutsokomola magazi ...

Dokotala amalemba mayeso omwe cholinga chake ndikuyang'ana chomwe chimayambitsa komanso zisonyezo zakuzama: kuyezetsa magazi ndi kuchuluka kwa maselo a magazi, kusaka kutupa, kuyesa kwa chiwindi ndi impso, ndi zina zambiri, fufuzani magazi mu chopondapo ndi ma x-ray malinga ndi malo oyitanitsa ( x-ray m'mapapo pakachitika vuto la kupuma, etc.).

Vasculitis yoyambitsidwa ndi matenda:

  • bakiteriya: streptococcus, gram-negative cocci (gonococcus ndi meningococcus)
  • tizilombo: chiwindi, matenda mononucleosis, HIV, etc.
  • parasitic: malungo…
  • mafangasi: Candida albicans ...

Vasculitis yokhudzana ndi matenda a immunological

  • Type II (mixed monoclonal) ndi III (mixed polyclonal) cryoglobulinemia, yokhudzana ndi matenda a autoimmune, matenda (makamaka hepatitis C) kapena matenda amagazi.
  • Hypocomplementémie (Mac Duffie's urticarienne vascularite)
  • Hyperglobulinémie (Waldenström's hyperglobulinémique purple)
  • Connectivitis: lupus, Gougerot-Sjögren syndrome, nyamakazi ya nyamakazi ...
  • Vasculitis wa matenda a magazi ndi malignancies
  • Leukemia, lymphoma, myeloma, khansa
  • Vasculitis yokhudzana ndi ANCA (anti-neutrophil cytoplasmic antibodies)   

Micro Poly Angéite kapena MPA

Micropolyangiitis (MPA) ndi systemic necrotizing angeitis yomwe zizindikiro zake zimakhala zofanana kwambiri ndi za PAN.

MPA imalumikizidwa ndi ANCA yamtundu wa anti-myeloperoxidase (anti-MPO) ndipo nthawi zambiri imayambitsa glomerulonephritis yomwe imapita patsogolo mwachangu komanso kulowerera m'mapapo komwe kulibe mu PAN.

Chithandizo cha MPA monga PAN chimayamba ndi chithandizo cha corticosteroid, nthawi zina kuphatikiza ndi ma immunosuppressants (makamaka cyclophosphamide).

Matenda a Wegener

Wegener's granulomatosis ndi vasculitis yomwe imayamba ndi zizindikiro za ENT kapena kupuma (sinusitis, pneumopathy, etc.) kugonjetsedwa ndi maantibayotiki.

M'mbuyomu, kuphatikizika kwa ENT (zowononga pansinusitis), pulmonary (parenchymal nodules) ndi aimpso (crescent pauci-immune necrotizing glomerulonephritis) kumapanga utatu wapamwamba wa Wegener's granulomatosis.

Kakhungu kakang'ono kakang'ono kamene kamakhudza pafupifupi 50% ya odwala: purpura (mawanga ofiirira omwe satha akakanikizidwa) otupa ndi kulowa, ma papules, tinthu tating'onoting'ono tating'onoting'ono, zilonda zapakhungu, pustules, vesicles, hyperplastic gingivitis ...

ANCA ndi mayeso ozindikira komanso osinthika a Wegener's granulomatosis, okhala ndi cytoplasmic fluorescence (c-ANCA), granular granuclear ndi / kapena perinuclear fluorescence (p-ANCA).

Kuwongolera kwa Wegener's granulomatosis, komwe nthawi zina kumatha kuonedwa ngati ngozi yachipatala, kuyenera kuchitika m'chipatala chapadera, kuphatikiza cortisone ndi oral cyclophosphamide.

Matenda a Churg ndi Strauss

Chifuwa chachikulu ndi oyambirira muyeso wa vasculitis izi, amene patsogolo pafupifupi ndi zaka 8 pamaso zizindikiro zoyamba vasculitis (neuropathy, nkusani matenda, etc.) ndi amene amapitiriza pambuyo pake.

Kuyeza magazi kumasonyeza makamaka kuwonjezeka kwa maselo oyera a eosinophilic polynuclear

Chithandizo cha matenda a Churg ndi Strauss chimayamba ndi chithandizo cha corticosteroid, nthawi zina kuphatikiza ma immunosuppressants (makamaka cyclophosphamide)

Lingaliro la dokotala wathu    

Kulowetsedwa kwa purpura (zofiirira, zigamba zokhuthala zomwe sizizimiririka ndi kukakamiza kwa chala) ndiye chizindikiro chachikulu cha vasculitis.

Tsoka ilo, chizindikirochi sichipezeka nthawi zonse ndipo kusiyanasiyana kwa zizindikiro zachipatala zosadziwika nthawi zambiri kumapangitsa kuti madokotala akhale ovuta.

Momwemonso, nthawi zambiri zimakhala zovuta kupeza chifukwa chochizira mu chotengera chaching'ono vasculitis, chomwe chili chofunikira kwambiri chomwe chimachitika pano poyerekezera ndi vasculitis yapakatikati ndi yayikulu: pafupifupi theka la vasculitis yaing'ono yotengera. ziwiya alibe chifukwa chopezeka pa zamoyo ndi radiological kufufuza kuti adokotala amachita kufunafuna etiology. Nthawi zambiri timalankhula za "matupi a vasculitis" kapena "hypersensitivity vasculitis" kapena "cutaneous vasculitis ya ziwiya zazing'ono zamtundu wa idiopathic caliber".

Dr. Ludovic Rousseau, dermatologist

 

zikhomo

Gulu Lophunzira la French Vasculitis: www.vascularites.org

Dermatonet.com, tsamba lazidziwitso pakhungu, tsitsi ndi kukongola ndi dermatologist

MedicineNet: http://www.medicinenet.com/vasculitis/article.htm

Siyani Mumakonda