Giant cell arteritis

Giant cell arteritis ndikutupa komanso kuwonongeka kwa mitsempha yamagazi yomwe imapereka magazi kumutu, m'khosi, kumtunda ndi mikono. Amatchedwanso temporical arteritis.

Giant cell arteritis imakhudza mitsempha yayikulu mpaka yayikulu. Zimayambitsa kutupa, kutupa, kufatsa, komanso kuwonongeka kwa mitsempha yamagazi yomwe imapereka magazi kumutu, m'khosi, kumtunda, ndi mikono. Nthawi zambiri zimachitika m'mitsempha yozungulira akachisi (mitsempha yanthawi yayitali). Mitsempha imeneyi imachokera kumtunda wa carotid m'khosi. Nthawi zina, vutoli limatha kuchitika m'mitsempha yayikulu mpaka kwina m'malo ena m'thupi.

Zomwe zimayambitsa vutoli sizikudziwika. Amakhulupirira kuti mwina chifukwa chakulakwitsa kwa chitetezo chamthupi. Vutoli limalumikizidwa ndi matenda ena komanso majini ena.

Giant cell arteritis imafala kwambiri mwa anthu omwe ali ndi vuto lina lotupa lotchedwa polymyalgia rheumatica. Giant cell arteritis nthawi zambiri imapezeka mwa anthu azaka zopitilira 50. Imafala kwambiri pakati pa anthu ochokera kumpoto kwa Europe. Vutoli limatha kuyenda m'mabanja.

Zizindikiro zina zavutoli ndi izi:

• Mutu watsopano wopweteka kumbali imodzi ya mutu kapena kumbuyo kwa mutu
• Chifundo mukakhudza khungu

Zizindikiro zina zitha kuphatikiza:

• Nsagwada zomwe zimachitika mukamafuna
• Kupweteka kwa mkono mutagwiritsa ntchito
• Kupweteka kwa minofu
• Ululu ndi kuuma kwa khosi, mikono yakumtunda, phewa, ndi chiuno (polymyalgia rheumatica)
• Kufooka, kutopa kwambiri
• Malungo
• Kumva kudandaula

Mavuto a maso amatha, ndipo nthawi zina amayamba mwadzidzidzi. Mavutowa akuphatikizapo:

• Masomphenya olakwika
• Masomphenya awiri
• Maso achepetsa mwadzidzidzi (khungu m'maso amodzi kapena m'maso onse awiri)

Wopereka chithandizo chazaumoyo awunika mutu wanu.

• Khungu lakumutu limakonda kumva kukhudza.
• Pakhoza kukhala mtsempha wamafuta, wonenepa mbali imodzi yamutu, nthawi zambiri pamatchalitchi amodzi kapena onse awiri.

Kuyezetsa magazi kungaphatikizepo:

• Hemoglobin kapena hematocrit
• Kuyesa kwa chiwindi
• Mlingo wa sedimentation (ESR) ndi mapuloteni othandizira C

Kuyezetsa magazi kokha sikungapeze matenda. Muyenera kukhala ndi biopsy yamitsempha yakanthawi. Iyi ndi njira yochitira opaleshoni yomwe imatha kuchitidwa ngati wodwala akuchipatala.

Muthanso kukhala ndi mayeso ena, kuphatikiza:

• Mtundu Doppler ultrasound wa mitsempha yosakhalitsa. Izi zitha kutenga malo a mtsempha wamagazi osakhalitsa ngati angachitike ndi wina wodziwa njirayi.
• MRI.
• Kusanthula PET.

Kulandila chithandizo mwachangu kumathandiza kupewa mavuto akulu monga khungu.

Mukakayikira kuti cell cell arteritis, mudzalandira corticosteroids, monga prednisone, pakamwa. Mankhwalawa amayamba nthawi zambiri asanachitike. Muthanso kuuzidwa kuti mutenge aspirin.

Anthu ambiri amayamba kumva bwino m'masiku ochepa atayamba kulandira chithandizo. Mlingo wa corticosteroids amachepetsedwa pang'onopang'ono. Komabe, muyenera kumwa mankhwala kwa 1 mpaka 2 zaka.

Ngati matenda a giant cell arteritis apangidwa, mwa anthu ambiri mankhwala a biologic otchedwa tocilizumab adzawonjezeredwa. Mankhwalawa amachepetsa kuchuluka kwa ma corticosteroids omwe amafunikira kuti athane ndi matendawa.

Kuchiza kwa nthawi yayitali ndi corticosteroids kumatha kupangitsa mafupa kukhala owonda ndikuwonjezera mwayi wanu wophulika. Muyenera kuchita izi kuti muteteze mafupa anu.

• Pewani kusuta ndi kumwa mowa mopitirira muyeso.
• Tengani calcium ndi vitamini D yowonjezera (kutengera upangiri wa omwe akukupatsani).
• Yambani kuyenda kapena mitundu ina yazolimbitsa thupi.
• Fufuzani mafupa anu ndi mayeso a mineral mineral (BMD) kapena DEXA scan.
• Tengani mankhwala a bisphosphonate, monga alendronate (Fosamax), malinga ndi zomwe amakupatsani.

Anthu ambiri amachira kwathunthu, koma chithandizo chitha kukhala chofunikira kwa zaka 1 kapena 2 kapena kupitilira apo.Vutoli limatha kubwerera mtsogolo.

Kuwonongeka kwa mitsempha ina yamagazi mthupi, monga ma aneurysms (kubaluni kwa mitsempha yamagazi), kumatha kuchitika. Kuwonongeka kumeneku kumatha kubweretsa sitiroko mtsogolo.

Itanani omwe akukuthandizani ngati muli ndi:

• Mutu wopweteka womwe sutha
• Kutaya masomphenya
• Zizindikiro zina za temporitis arteritis

Mutha kutumizidwa kwa katswiri yemwe amachiza arteritis wosakhalitsa.

Palibe njira yodziwika yopewera.

Arteritis - kwakanthawi; Cranial arteritis; Giant cell arteritis

• Matenda a Carotid

Dejaco C, Ramiro S, Duftner C, ndi al. Zoyeserera za EULAR zogwiritsa ntchito kulingalira mu chotengera chachikulu cha vasculitis pakuchipatala. Ann Rheum Dis. 2018; 77 (5): 636-643. (Adasankhidwa) PMID: 29358285 www.ncbi.nlm.nih.gov/pubmed/29358285.

James WD, Elston DM, Chitani JR, Rosenbach MA, Neuhaus IM. Matenda osakanikirana. Mu: James WD, Elston DM, Tsatirani JR, Rosenbach MA, Neuhaus IM, eds. Matenda a Andrews a Khungu: Clinical Dermatology. Wolemba 13. Philadelphia, PA: Elsevier; 2020: chap 35.

Koster MJ, Matteson EL, Warrington KJ. Makina akulu-akulu cell arteritis: kuzindikira, kuwunika ndi kuwongolera. Rheumatology (Oxford). 2018; 57 (suppl_2): ii32-ii42. PMID: 29982778 www.ncbi.nlm.nih.gov/pubmed/29982778. (Adasankhidwa)

Mwala JH, Tuckwell K, Dimonaco S, et al. Kuyesedwa kwa tocilizumab mu chimphona-cell arteritis. N Engl J Med. 2017; 377 (4): 317-328. (Adasankhidwa) PMID: 28745999 www.ncbi.nlm.nih.gov/pubmed/28745999. (Adasankhidwa)

Tamaki H, Hajj-Ali RA. Tocilizumab ya chimphona cha arteritis - sitepe yatsopano mu matenda akale. JAMA Neurol. 2018; 75 (2): 145-146. PMID: 29255889 www.ncbi.nlm.nih.gov/pubmed/29255889. (Adasankhidwa)