Polymyalgia rheumatica

Polymyalgia rheumatica (PMR) ndi vuto lotupa. Zimakhudza kupweteka komanso kuuma m'mapewa ndipo nthawi zambiri mchiuno.

Polymyalgia rheumatica nthawi zambiri imapezeka mwa anthu azaka zopitilira 50. Choyambitsa sichikudziwika.

PMR imatha kuchitika kale kapena ndi cell cell arteritis (GCA; yotchedwanso temporial arteritis). Umu ndi momwe mitsempha yamagazi yomwe imapereka magazi kumutu ndi m'maso imawotchera.

PMR nthawi zina zimakhala zovuta kusiyanitsa ndi nyamakazi (RA) mwa munthu wokalamba. Izi zimachitika mayeso a rheumatoid factor ndi anti-CCP antibody alibe.

Chizindikiro chofala kwambiri ndikumva kupweteka komanso kuuma m'mapewa onse ndi m'khosi. Kupweteka ndi kuuma kwake kumakulirakulira m'mawa. Kupwetekaku kumakonda kupita m'chiuno.

Kutopa kuliponso. Anthu omwe ali ndi vutoli zimawavuta kwambiri kudzuka pabedi ndikuyenda-yenda.

Zizindikiro zina ndizo:

• Kulakalaka kudya, komwe kumabweretsa kuonda
• Matenda okhumudwa
• Malungo

Mayeso a labu okha sangathe kudziwa PMR. Anthu ambiri omwe ali ndi vutoli amakhala ndi zotupa, monga sedimentation rate (ESR) ndi C-reactive protein.

Zotsatira zina zoyesera za matendawa ndi monga:

• Mapuloteni osazolowereka m'magazi
• Mulingo wosazolowereka wama cell oyera
• Kuchepa kwa magazi m'thupi (magazi ochepa)

Mayeserowa amathanso kugwiritsidwa ntchito kuwunika momwe muliri.

Komabe, kuyerekezera zojambula monga x-ray paphewa kapena m'chiuno sizothandiza nthawi zambiri. Mayesowa atha kuwonetsa kuwonongeka kwa olumikizana komwe sikukugwirizana ndi zizindikilo zaposachedwa. Pazovuta, ultrasound kapena MRI ya phewa zitha kuchitidwa. Mayeso ojambula awa nthawi zambiri amawonetsa bursitis kapena kuchepa kwamatenda olumikizana.

Popanda chithandizo, PMR sikhala bwino. Komabe, kuchepa kwa ma corticosteroids (monga prednisone, 10 mpaka 20 mg patsiku) kumatha kuchepetsa zizindikilo, nthawi zambiri mkati mwa tsiku limodzi kapena awiri.

• Mlingowo uyenera kuchepetsedwa pang'onopang'ono mpaka kutsika kwambiri.
• Chithandizo chikuyenera kupitilizidwa kwa zaka 1 mpaka 2. Kwa anthu ena, pamafunika chithandizo chotalikirapo chochepa cha prednisone.

Corticosteroids imatha kuyambitsa zovuta zina monga kunenepa, kukula kwa matenda ashuga kapena kufooka kwa mafupa. Muyenera kuyang'anitsitsa ngati mukumwa mankhwalawa. Ngati muli pachiwopsezo chofooka kwa mafupa, othandizira anu azaumoyo angakulimbikitseni kuti mutenge mankhwala kuti mupewe vutoli.

Kwa anthu ambiri, PMR imachoka ndi chithandizo patatha zaka 1 mpaka 2. Mutha kusiya kumwa mankhwala pambuyo pake, koma kambiranani ndi omwe akukuthandizani kaye.

Kwa anthu ena, zizindikiro zimabweranso atasiya kumwa corticosteroids. Zikatero, pangafunike mankhwala ena monga methotrexate kapena tocilizumab.

Giant cell arteritis itha kukhalaponso kapena itha kubwera pambuyo pake. Ngati ndi choncho, minyewa yakanthawi iyenera kuyesedwa.

Zizindikiro zowopsa kwambiri zimatha kukulepheretsani kugwira ntchito kapena kudzisamalira kunyumba.

Itanani omwe akukuthandizani ngati muli ndi zofooka m'mapewa ndi m'khosi zomwe sizichoka. Lumikizanani ndi omwe amakupatsani ngati muli ndi zizindikilo zatsopano monga kutentha thupi, kupweteka mutu, komanso kupweteka ndikutafuna kapena kusowa masomphenya. Zizindikirozi zimatha kukhala kuchokera ku chimphona cha cell arteritis.

Palibe njira yodziwika yopewera.

PMR

Dejaco C, Singh YP, Perel P, ndi al. Malangizo a 2015 oyendetsera polymyalgia rheumatica: Mgwirizano wa European League Against Rheumatism / American College of Rheumatology. Nyamakazi Rheumatol. 2015; 67 (10): 2569-2580. PMID: 2635874 www.ncbi.nlm.nih.gov/pubmed/26352874.

Hellmann DB. Giant cell arteritis, polymyalgia rheumatica, ndi Takayasu's arteritis. Mu: Firestein GS, Budd RC, Gabriel SE, McInnes IB, O'Dell JR, olemba. Kelley ndi Firestein's Bookbook of Rheumatology. 10th ed. Philadelphia, PA: Elsevier; 2017: chap 88.

Kermani TA, Warrington KJ. Kupita patsogolo ndi zovuta pakuzindikira ndi kuchiza polymyalgia rheumatica. Ther Adv Musculoskelet Dis. 2014; 6 (1): 8-19. PMID: 24489611 www.ncbi.nlm.nih.gov/pubmed/24489611. (Adasankhidwa)

Salvarani C, Ciccia F, Pipitone N. Polymyalgia rheumatica ndi chimphona cha cell arteritis. Mu: Hochberg MC, Gravallese EM, Silman AJ, Smolen JS, Weinblatt ME, Weisman MH, olemba. Zamatsenga. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier; 2019: chap 166.