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Vasculitis na ƙananan capillaries
Vasculitis na ƙananan capillaries
Wannan babban rukuni ne na vasculitis na bango na arterioles, venules ko capillaries, wanda tsinkayensa ya bambanta sosai dangane da ko yana da tsabta ko tsarin vasculitis cutaneous.
Mafi na kowa al'amari na asibiti shi ne purpura (purplish spots cewa ba su shude lokacin da aka danna) bulging da infiltrated, musamman a cikin ƙananan gaɓoɓi, tsananta ta tsaye, wanda zai iya daukar da dama siffofin (petechial da ecchymotic, necrotic , pustular ...) ko livedo. samar da wani nau'in raga na purplish (livedo reticularis) ko mottling (livedo racemosa) akan kafafu. Hakanan zamu iya lura da abin da ya faru na Raynaud ('yan yatsu sun zama fari a cikin sanyi).
Purpura da livedo na iya haɗawa da wasu raunuka a kan fata (papules, nodules, ciwon necrotic, kumfa mai zubar da jini), ƙayyadaddun urticaria wanda ba ya ƙura.
Kasancewar bayyanar cututtuka a waje da fata ya zama wani abu na nauyi, yana nuna kasancewar shigar da jijiyoyin jini a cikin gabobin:
- ciwon haɗin gwiwa,
- ciwon ciki, baki stools, matsalar wucewa,
- neuropathy na jiki
- edema na ƙananan gabbai,
- Hawan jini,
- wahalar numfashi, asma, tari sama da jini…
Likitan ya rubuta gwaje-gwaje da nufin neman dalili da alamun mahimmanci: gwajin jini tare da ƙididdigar ƙwayoyin jini, bincika kumburi, gwajin hanta da koda, da sauransu, bincika jini a cikin stool da x-ray bisa ga wuraren kira ( huhu x-ray a yayin da wahalar numfashi, da sauransu).
Vasculitis yana haifar da kamuwa da cuta:
- Kwayoyin: streptococcus, gram-korau cocci (gonococcus da meningococcus)
- viral: hepatitis, kamuwa da cuta mononucleosis, HIV, da dai sauransu.
- parasitic: zazzabin cizon sauro…
- fungal: Candida albicans…
Vasculitis da ke hade da cututtuka na rigakafi
- Nau'in II (mixed monoclonal) da na III (mixed polyclonal) cryoglobulinemia, hade da cututtuka na autoimmune, kamuwa da cuta (musamman hepatitis C) ko cutar jini.
- Hypocomplementémie (Mac Duffie's urticarienne vascularite)
- Hyperglobulinémie (Waldenström's hyperglobulinémique purple)
- Connectivitis: Lupus, Gougerot-Sjögren ciwo, rheumatoid amosanin gabbai ...
- Vasculitis na cututtuka na jini da kuma malignancies
- Ciwon daji, lymphoma, myeloma, ciwon daji
- Vasculitis hade da ANCA (anti-neutrophil cytoplasmic antibodies)
Micro Poly Angéite ko MPA
Micropolyangiitis (MPA) wani tsarin necrotizing angeitis wanda alamun asibiti yayi kama da na PAN.
MPA yana da alaƙa da ANCA na nau'in anti-myeloperoxidase (anti-MPO) kuma yawanci yana haifar da glomerulonephritis mai saurin ci gaba da shiga cikin huhu wanda ba ya nan a cikin PAN.
Maganin MPA na PAN yana farawa da corticosteroid far, wani lokacin haɗe tare da immunosuppressants (cyclophosphamide musamman)
Cutar Wegener
Wegener's granulomatosis shine vasculitis farkon wanda gabaɗaya alama ce ta ENT ko alamun numfashi (sinusitis, pneumopathy, da sauransu) masu jure maganin ƙwayoyin cuta.
A al'ada, yaduwa ENT (na lalata pansinusitis), na huhu (parenchymal nodules) da na koda (crescent pauci-immune necrotizing glomerulonephritis) yana haifar da babban triad na granulomatosis na Wegener.
Maɓallin fata-mucous yana rinjayar kusan kashi 50% na marasa lafiya: purpura (tabo masu launin shuɗi waɗanda ba sa ɓacewa lokacin da aka danna su) bulging da infiltrated, papules, nodules subcutaneous, ulceration fata, pustules, vesicles, hyperplastic gingivitis ...
ANCA gwajin gwaji ne da juyin halitta don Wegener's granulomatosis, tare da yaduwa cytoplasmic fluorescence (c-ANCA), finely granular tare da haɓakawa na perinuclear da / ko zalla perinuclear fluorescence (p-ANCA).
Gudanar da granulomatosis na Wegener, wanda wani lokaci ana iya la'akari da shi a matsayin gaggawa na likita, ya kamata a gudanar da shi a wani wuri na musamman na asibiti, ta hanyar haɗin cortisone da cyclophosphamide na baka.
Churg da Strauss cuta
Asthma shine babban kuma farkon ma'auni na wannan vasculitis, wanda ya riga ya wuce shekaru 8 kafin alamun farko na vasculitis (neuropathy, sinus disorders, da dai sauransu) kuma yana ci gaba daga baya.
Gwaje-gwajen jini sun nuna musamman a sarari karuwa a cikin eosinophilic polynuclear farin sel
Jiyya na cutar Churg da Strauss yana farawa tare da maganin corticosteroid, wani lokacin hade tare da immunosuppressants (musamman cyclophosphamide)
Ra'ayin likitan mu
Infiltrated purpura (purplish, ɗan kauri faci waɗanda ba su shuɗe da matsa lamba) shine mabuɗin alamar vasculitis. Abin baƙin ciki shine, wannan alamar ba koyaushe take ba kuma bambancin alamun asibiti marasa ƙayyadaddun lokuta yakan sa ganewar asali da wuya ga likitoci. Hakazalika, sau da yawa yana da wuya a sami dalilin da za a bi da shi a cikin ƙananan vasculitis na jirgin ruwa, wanda shine mafi mahimmancin shari'ar da aka fuskanta a halin yanzu idan aka kwatanta da matsakaici da babban vasculitis: kusan rabin ƙananan vasculitis. Tasoshin ba su da wani dalili da aka samo a lokacin binciken nazarin halittu da na rediyo da likita ke yi don neman ilimin etiology. Mu sau da yawa magana game da "rashin lafiyan vasculitis" ko "hypersensitivity vasculitis" ko kuma "cutaneous vasculitis na kananan tasoshin na idiopathic caliber". Dokta Ludovic Rousseau, likitan fata |
wuri
Rukunin Nazarin Vasculitis na Faransa: www.vascularites.org
Dermatonet.com, shafin bayanai akan fata, gashi da kyawu ta likitan fata
MedicineNet: http://www.medicinenet.com/vasculitis/article.htm