Vasculitis na tsakiyar tasoshin

Peri Arteritis Nodosa ko PAN

Periarteritis nodosa (PAN) wani nau'in necrotizing angeitis ne mai wuyar gaske wanda zai iya rinjayar gabobin da yawa, wanda ba a san dalilinsa ba (wasu siffofin suna da alaƙa da cutar hanta na B).

Marasa lafiya sau da yawa suna samun lalacewa a cikin yanayin gaba ɗaya tare da asarar nauyi, zazzabi, da sauransu.

Ciwon tsoka yana cikin rabin lokuta. Suna da ƙarfi, bazuwa, na kaitsaye ko kuma haifar da matsa lamba, wanda zai iya ƙusa majiyyaci akan gado saboda tsananin zafi da ɓarnawar tsoka…

Ciwon haɗin gwiwa ya fi girma a cikin manyan haɗin gwiwa na gefe: gwiwoyi, idon sawu, gwiwar hannu da wuyan hannu.

Lalacewa ga jijiyoyi da ake kira multineuritis sau da yawa ana ganin su, yana shafar jijiyoyi da yawa kamar sciatica, na waje ko na ciki popliteal, radial, ulnar ko tsaka-tsakin jijiya kuma sau da yawa yana hade da edema mai nisa. Neuritis wanda ba a kula da shi ba a ƙarshe yana haifar da atrophy na tsokoki wanda jijiyar da ta shafa ke shiga.

Vasculitis kuma zai iya shafar kwakwalwa da wuya, wanda zai iya haifar da farfadiya, hemiplegia, bugun jini, ischemia ko zubar jini.

Alamar da ke nuna a kan matakin fata shine purpura (guraren da ba sa shuɗewa lokacin da aka danna) ta kumbura da kutsawa, musamman a cikin ƙananan gaɓoɓin ƙafafu ko rayuwa, samar da nau'ikan meshes (livedo reticularis) ko mottles (livedo racemosa) purplish akan kafafu. Hakanan zamu iya ganin lamarin Raynaud ('yan yatsu suna yin fari a cikin sanyi), ko ma yatsa ko gangrene.

Orchitis (kumburi na maniyyi) yana daya daga cikin mafi yawan bayyanar cututtuka na PAN, wanda ke haifar da vasculitis na jijiyar jini wanda zai iya haifar da necrosis na testicular.

Wani ciwo mai kumburi na ilimin halitta yana samuwa a cikin mafi yawan marasa lafiya tare da PAN (ƙara a cikin adadin sedimentation zuwa fiye da 60 mm a cikin sa'a ta farko, a cikin C Reactive Protein, da dai sauransu), manyan eosinophilia (ƙara a cikin eosinophilic polynuclear white blood cells).

Ciwon hanta yana haifar da kasancewar HBs antigen a cikin kusan ¼ zuwa 1/3 na marasa lafiya

Angiography yana bayyana microaneurysms da stenosis (raguwa a cikin caliber ko tapering bayyanar) na matsakaicin caliber tasoshin.

Jiyya na PAN yana farawa da corticosteroid far, wani lokacin hade tare da immunosuppressants (musamman cyclophosphamide)

Biotherapies suna faruwa a cikin gudanar da PAN, musamman rituximab (anti-CD20).

Buerger cuta

Cutar Buerger ko thromboangiitis obliterans wani angiitis ne wanda ke shafar sassan kananan da matsakaitan arteries da veins na ƙananan gaɓɓai da na sama, yana haifar da thrombosis da sake farfadowa na tasoshin da aka shafa. Wannan cuta ta fi yawa a Asiya da kuma tsakanin Yahudawan Ashkenazi.

Yana faruwa a cikin matasa marasa lafiya (kasa da shekaru 45), sau da yawa shan taba, wanda ya fara gabatar da bayyanar cututtuka na arteritis a farkon rayuwa (ischemia na yatsun hannu ko yatsun kafa, claudication intermittent, ischemic arterial ulcers ko gangrene na kafafu, da dai sauransu).

Arteriography yana bayyana lalacewar arteries mai nisa.

Magani ya ƙunshi dakatar da shan taba gaba ɗaya, wanda ke haifar da cutar da cutar.

Likitan ya rubuta magungunan vasodilator da antiplatelet irin su aspirin

Ana iya buƙatar tiyatar sake dawo da jijiyoyin jini.

Cutar Kawasaki

Cutar Kawasaki ko "adeno-cutaneous-mucous syndrome" wani nau'in vasculitis ne wanda ke shafar yankin jijiyoyin jijiyoyin jini da ke da alhakin musamman ga ciwon jini na jijiyoyin jini wanda zai iya zama tushen mace-mace, musamman a yara tsakanin watanni 6 zuwa 5 tare da mafi girma. yana da shekara 18 watanni.

Cutar tana faruwa a matakai uku a cikin makonni da yawa

M lokaci (kwanaki 7 zuwa 14): zazzabi tare da kurji da bayyanar "cherry lebe", "harshen strawberry", "idon allura" ta hanyar conjunctivitis na biyu, "yaro mara jin dadi", edema da ja na hannaye da ƙafafu. Da kyau, yakamata a fara magani a wannan matakin don iyakance haɗarin cututtukan zuciya

Lokaci mai zurfi (kwanaki 14 zuwa 28) yana haifar da bawon yatsu da yatsun kafa da ke farawa kusa da kusoshi. A wannan mataki ne aneurysms na jijiyoyin jini ke tasowa

Lokaci na karewa, yawanci ba shi da wata alama, amma lokacin da kwatsam rikice-rikice na zuciya na iya faruwa saboda samuwar aneurysms na jijiyoyin jini a lokacin da ya gabata.

Sauran alamun su ne kurjin diaper, ja mai haske tare da ɓacin rai, alamun cututtukan zuciya (gurgin zuciya, gallo na zuciya, rashin lafiyar Electro CardioGram, pericarditis, myocarditis…), narkewa (zawo, amai, ciwon ciki…), Neurological (aseptic meningitis, convulsions). , inna), yoyon fitsari (bakararriyar mugun jini a cikin fitsari, urethritis), polyarthritis…

Ana nuna babban kumburi a cikin jini tare da Sedimentation Rate mafi girma fiye da 100mm a cikin sa'a ta farko da kuma babban furotin C-reactive, alamar karuwa a cikin fararen jinin polynuclear fiye da abubuwa 20 / mm000, da karuwa a cikin platelets.

Jiyya ta dogara ne akan immunoglobulins da aka yi musu allurar ta hanyar jijiya (IV Ig) da wuri-wuri don iyakance haɗarin ciwon zuciya. Idan IVIG ba ta da tasiri, likitoci suna amfani da cortisone na ciki ko aspirin.