Polymyositis - wamkulu

Polymyositis ndi dermatomyositis ndi matenda osachedwa kutupa. (Vutoli limatchedwa dermatomyositis pomwe limakhudza khungu.) Matendawa amatsogolera kufooka kwa minofu, kutupa, kufatsa, komanso kuwonongeka kwa minofu. Amakhala m'gulu lalikulu la matenda otchedwa myopathies.

Polymyositis amakhudza chigoba minofu. Amadziwikanso kuti idiopathic yotupa myopathy. Chifukwa chenichenicho sichikudziwika, koma chitha kukhala chokhudzana ndi zomwe zimachitika chifukwa cha autoimmune kapena matenda.

Polymyositis imatha kukhudza anthu azaka zilizonse. Amakonda kwambiri achikulire azaka zapakati pa 50 ndi 60, komanso mwa ana okulirapo. Zimakhudza azimayi kawiri kuposa amuna. Ndizofala kwambiri ku Africa America kuposa azungu.

Polymyositis ndi matenda amachitidwe. Izi zikutanthauza kuti zimakhudza thupi lonse. Kufooka kwa minofu ndi kufatsa kumatha kukhala zizindikilo za polymyositis. Ziphuphu ndi chizindikiro cha matenda ofanana, dermatomyositis.

Zizindikiro zodziwika ndizo:

• Kufooka kwa minofu m'mapewa ndi m'chiuno. Izi zitha kupangitsa kuti kukhale kosavuta kukweza mikono pamutu, kudzuka pamalo pomwe mwakhala, kapena kukwera masitepe.
• Zovuta kumeza.
• Kupweteka kwa minofu.
• Mavuto ndi liwu (loyambitsidwa ndi minofu ya khosi lofooka).
• Kupuma pang'ono.

Muthanso kukhala ndi:

• Kutopa
• Malungo
• Ululu wophatikizana
• Kutaya njala
• Kuuma kwa m'mawa
• Kuchepetsa thupi
• Kutupa pakhungu kumbuyo kwa zala, zikope, kapena pankhope

Mayeso atha kuphatikiza:

• Yoteteza ma antibodies ndi mayeso a kutupa
• CPK
• Seramu aldolase
• Zojambulajambula
• MRI ya minofu yomwe yakhudzidwa
• Kutulutsa minofu
• Myoglobin mkodzo
• ECG
• X-ray ndi chifuwa cha CT pachifuwa
• Mayeso a ntchito yamapapo
• Esophageal kumeza kuphunzira
• Myositis yeniyeni komanso yogwirizana ndi autoantibodies

Anthu omwe ali ndi vutoli amayeneranso kuyang'aniridwa mosamala ngati ali ndi khansa.

Chithandizo chachikulu ndikugwiritsa ntchito mankhwala a corticosteroid. Mlingo wa mankhwala umachotsedwa pang'onopang'ono mphamvu ya minofu ikukula. Izi zimatenga pafupifupi milungu 4 mpaka 6. Mudzakhala pamlingo wochepa wa mankhwala a corticosteroid pambuyo pake.

Mankhwala opondereza chitetezo cha mthupi atha kugwiritsidwa ntchito m'malo mwa corticosteroids. Mankhwalawa atha kuphatikiza azathioprine, methotrexate kapena mycophenolate.

Matenda omwe amakhalabe otanganidwa mosasamala kanthu za corticosteroids, intravenous gamma globulin yayesedwa ndi zotsatira zosakanikirana. Mankhwala osokoneza bongo amathanso kugwiritsidwa ntchito. Rituximab ikuwoneka kuti ndi yolonjeza kwambiri. Ndikofunika kuthetsa zikhalidwe zina mwa anthu omwe samvera chithandizo. Kuphatikizanso mobwerezabwereza kwa minofu kungafunike kuti izi zidziwike.

Ngati vutoli limalumikizidwa ndi chotupa, chitha kusintha ngati chotupacho chichotsedwa.

Kuyankha kwa mankhwala kumasiyana, kutengera zovuta. Pafupifupi munthu m'modzi mwa anthu asanu amatha kumwalira pasanathe zaka 5 atadwala.

Anthu ambiri, makamaka ana, amachira ndipo samasowa chithandizo chamankhwala. Kwa achikulire ambiri, komabe, amafunikira mankhwala osokoneza bongo kuti athane ndi matendawa.

Maganizo a anthu omwe ali ndi matenda am'mapapo omwe ali ndi anti-MDA-5 antibody siabwino ngakhale atalandira chithandizo chamakono.

Kwa akuluakulu, imfa imatha kubwera chifukwa cha:

• Kusowa zakudya m'thupi
• Chibayo
• Kulephera kupuma
• Kufooka kwakukulu, kwakanthawi

Zomwe zimayambitsa kufa ndi khansa komanso matenda am'mapapo.

Zovuta zingaphatikizepo:

• Calcium imayikidwa mu minofu yomwe yakhudzidwa, makamaka kwa ana omwe ali ndi matendawa
• Khansa
• Matenda a mtima, matenda am'mapapo, kapena zovuta m'mimba

Itanani omwe akukuthandizani ngati muli ndi zodabwitsazi. Funani chithandizo chadzidzidzi ngati muli ndi mpweya wochepa komanso mukumeza.

• Minofu yakunja yakunja

Aggarwal R, Wokwera LG, Ruperto N, et al. 2016 American College of Rheumatology / European League Against Rheumatism Criteria for Minimal, Moderate, and Major Clinical Response in Adult Dermatomyositis and Polymyositis: An International Myositis Assessment and Clinical Study Group / Pediatric Rheumatology International Trials Organisation Collaborative Initiative. Nyamakazi Rheumatol. 2017; 69 (5): 898-910. PMID: 28382787 www.ncbi.nlm.nih.gov/pubmed/28382787. (Adasankhidwa)

Dalakas MC. Matenda otupa minofu. N Engl J Med. 2015; 373 (4): 393-394. PMID: 26200989 www.ncbi.nlm.nih.gov/pubmed/26200989.

Greenberg SA. Matenda otupa a myopathies. Mu: Goldman L, Schafer AI, olemba. Mankhwala a Goldman-Cecil. Wolemba 25. Philadelphia, PA: Elsevier Saunders; 2016: chap 269.

Nagaraju K, Gladue HS, Lundberg IE.Matenda otupa a minofu ndi myopathies ena. 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: mutu 85.

Yoshida N, Okamoto M, Kaieda S, et al. Mgwirizano wa anti-aminoacyl-transfer RNA synthetase antibody and anti-melanoma-associated-gene 5 antibody ndi chithandizo chamankhwala a polymyositis / dermatomyositis-related interstitial lung disease. Kafukufuku Wofufuza. 2017; 55 (1): 24-32. (Adasankhidwa) PMID: 28012490 www.ncbi.nlm.nih.gov/pubmed/28012490. (Adasankhidwa)