Ho rumatoid vasculitis ke tlhaloso e sa tloaelehang, e tebileng ea ramatiki ea ramatiki e ka 'nang ea beha bophelo kotsing. Ho rumatoid vasculitis, ho ruruha ho ata ho methapo ea mali e nyenyane kapa e bohareng ba 'meleng. Hangata, methapo ea meriana e ameha, empa methapo e ka ba joalo. Likotopo tse kholo tsa mali ha li amehe ka seoelo.
Mabota a methapo ea mali e chesang e matlafala 'me ha lesela la sejana se nang le mali se senyeha, se ka' na sa thibeloa.
Mali a fanang ka setho a ka 'na a sekisetsoa, haeba a sa thibeloa. Ho ruruha ha masculitis ho ka 'na ha akarelletsa litho tse ngata, ho akarelletsa le letlalo, mahlo, methapo, pelo, matšoafo, boko, liphio, kapa pampiri. Empa, ho na le litaba tse ntle hape. Matšoao a fokolang a ramatiki a bakoang ke lefu la masapo a ntse a e-na le lefu la masumine la vasculitis, mohlomong ka lebaka la lithethefatsi tse atlehang tse ileng tsa ntlafatsoa le ho rekisoa lilemong tse leshome tse fetileng (e leng, lithethefatsi tsa biologic ).
Ho ata le Kotsi ea Rheumatoid Vasculitis
Le hoja ho ata ha mesifa ea masumine e mengata ho bonahala e fokotseha, ho hakanyetsoa hore palo ea batho ba nang le lefu la ramatiki ea tlase ho karolo ea 5 ho isa ho e 5 e hlahisa lefu la masculitis. Leha ho le joalo, lithuto tsa autopsy li tlalehile 15-31%. Litefiso tsa ho bolaoa ke lefu le ho shoa ho amanang le lefu la ho ruruha ha masculitis ke tsa bohlokoa ka selemo sa lilemo tse 5 ho shoa ha batho ba 30-50% ka litekanyetso tse ngata tse fokolang tse amanang le mathata a lefu kapa kalafo ea kalafo.
Lintlha tse latelang li eketsa menyetla ea ho ba le mesifa ea lefuba la masumine:
- E ntle bakeng sa ntlha ea rheumatoid
- E ntle bakeng sa anti-CCP
- Banna (banna ba 1 ho ba 9 ba nang le ramatiki ea lefuba ba na le lefuba la masculitis)
- Ho tsuba
- Ho ba le li-nodule tsa rheumatoid
- Motho ea tsofetseng ha a qala ho kula kapa nako e telele ea ramatiki ea mali (lilemo tse fetang 10)
Matšoao le Lipontšo tsa Rheumatoid Vasculitis
Setho leha e le sefe sa 'mele se ka angoa ke lefu la mesifa ea vasculitis. Hangata letlalo le methapo ea meriana li ameha haholo. Le hoja ho ameha ha setho se seholo ho nkoa e le ntho e sa tloaelehang, e amahanngoa le ho kula le ho shoa ha bohlokoa.
Ho kenyelletsa letlalo ho ka kenyelletsa purpura, li-nodules, ulcers le necrosis ea likhaolo, haholo-holo menoana. Livedo reticularis ke mokhoa o tloaelehileng oa ho fumana. Ho kenya letsoho ha letlalo ho hloka hore ho batloe lipatlisiso tse ling tsa karolo ea 'mele. Scleritis , pleuritis , kapa pericarditis ke mehlala ea se ka hlahang. Haeba letlalo le kenngoa ntle le ts'ebetsong e meng ea tsamaiso, lipoleloana li molemo.
Le tsamaiso ea methapo ea methapo ea methapo ea mafu , lisele tsa methapo ea mafu li ka 'na tsa hlaha, tse kang distal symmetric sensory polyneuropathy, distal motor kapa neuropathy e kopantsoeng, kapa multiplex ea mononeuritis. Ha vasculitis e senya methapo. ho ka 'na ha e-ba le ho fokolloa, ho sisinyeha, ho lahleheloa ke maikutlo, bofokoli le tahlehelo ea mesebetsi matsohong kapa maotong. Matšoao a mangata a eketsehileng a ka boela a hlaha, joalo ka feberu, ho lahleheloa ke boima ba 'mele, tahlehelo ea takatso ea lijo le tahlehelo ea matla.
Tlhahlobo ea Rheumatoid Vasculitis
Le hoja mokhoa oa matšoao o ka 'na oa etsa hore ngaka e belaelle hore lefu la rumatoid la vasculitis le liteko tsa laboratori li ka' na tsa fana ka bopaki bo tšehetsang hore ho ka etsahala hore motho a fumane lefu lena, ho hlokahala hore ho be le bothata ba ho hlahlojoa.
Letlalo le amehang le ka 'na la e-ba le lintho tse ngata, hammoho le mesifa kapa methapo sebakeng se amehileng, kapa setho se amehileng.
Le hoja tlhahlobo ea mali ea lefu la rhumatoid le anti-CCP e atisa ho phahama ka ho ruruha ha masumitis, liphello ha li totobetse. Li-antibodies tse peli li atile haholo le ramatiki ea lefu la masapo ntle le vasculitis. Li-anti-neutrophil cytoplasmic antibodies (ANCA) le li-anti-myeloperoxidase le li-anti-proteinase-3 li-antibodies hangata ha li na matla a vasculitis ea lefuba.
Phekolo ea Rheumatoid Vasculitis
Phekolo ea lefu la rumatoid vasculitis e ikemiselitse haholo hore na litho li ameha hokae.
Hape, ramatiki ea lefu la rumatoid e lokela ho tšoaroa ka katleho ho sebelisa DMARD kapa lithethefatsi tsa biologic, tse kang TNF blockers . Ho laola ho ruruha likarolong tse peli le meleng ea mali hoa hlokahala.
Mokha oa pele oa phekolo ea lefu la rhumatoid vasculitis e akarelletsa tšebeliso ea corticosteroids (hangata prednisone ). Prednisone e ka kopanngoa le methotrexate kapa azathioprine. Ka matšoao a tsoetseng pele le ho ameha ha litho tse matla, boiteko bo matla bo feteletseng ba ho itšireletsa mafung bo ka 'na ba akarelletsa cyclophosphamide hammoho le tekanyo e phahameng ea prednisone. Rituxan (rituximab) e hlahella e le phekolo ea pele ea lefu la masculitis. Ho ea ka tlaleho ea Arthritis Care and Research (2012), ho hlahlojoa ha boitsebiso bo tsoang ho Autoimmunity le Rituximab registry ho senoletse hore ho fokotsoa ho finyelitsoe ho 12 ho ea 17 lefu la masumine la vasculitis bakuli ba tšoaroang ka rituximab. Bakuli ba boetse ba khona ho fokotsa lebelo la bona la prednisone.
Lisebelisoa:
Rheumatoid Vasculitis. Johns Hopkins Vasculitis Center.
http://www.hopkinsvasculitis.org/types-vasculitis/rheumatoid-vasculitis/
Rheumatoid Vasculitis. Cleveland Clinic.
http://my.clevelandclinic.org/services/orthopaedics-rheumatology/diseases-conditions/hic-rheumatoid-vasculitis
Rheumatoid Vasculitis. Vasculitis Foundation. September 2012.
http://www.vasculitisfoundation.org/education/forms/rheumatoid-vasculitis/
Ho rumatoid Vasculitis: Ho felloa ke Tšenyo kapa Keletso ea Meriana e Mecha? Bartels le Bridges. Litlaleho tsa Rheumatology tsa hona joale. December 2010.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2950222/
Rituximab therapy bakeng sa vasculitis ea tsamaiso e amanang le ramatiki ea ramatiki: Litholoana tse tsoang ho Autoimmunity le Rituximab Registry. Puechal X et al. Tlhokomelo ea Ramatiki le Lipatlisiso. March 2012.
http://www.ncbi.nlm.nih.gov/pubmed/22076726