Matenda Akuluakulu

Matenda Aanthu Achikulire (ASD) ndimatenda achilendo omwe amayambitsa malungo, zotupa, komanso kupweteka kwamagulu. Zingayambitse matenda a nyamakazi a nthawi yayitali.

Matenda Aanthu Achikulire ndi mtundu woopsa wa ana idiopathic arthritis (JIA), womwe umapezeka mwa ana. Akuluakulu amatha kukhala ndi vuto lomwelo, ngakhale ndizofala kwambiri. Amatchedwanso matenda achikulire-onset Still (AOSD).

Ochepera kuposa munthu m'modzi pa anthu 100,000 amayamba ASD chaka chilichonse. Zimakhudza amayi nthawi zambiri kuposa amuna.

Zomwe zimayambitsa matenda akuluakulu Sitikudziwika. Palibe zifukwa zoopsa za matendawa zomwe zadziwika.

Pafupifupi anthu onse omwe ali ndi matendawa amakhala ndi malungo, kupweteka pamfundo, zilonda zapakhosi, ndi zidzolo.

• Kupweteka pamodzi, kutentha, ndi kutupa ndizofala. Nthawi zambiri, zimfundo zingapo zimakhudzidwa nthawi imodzi. Nthawi zambiri, anthu omwe ali ndi vutoli amakhala ndi ziweto zolimba m'mawa zomwe zimatha maola angapo.
• Malungo amabwera mwachangu kamodzi patsiku, makamaka masana kapena madzulo.
• Kutupa pakhungu nthawi zambiri kumakhala ngati pinki ya saumoni ndipo kumabwera ndikumapita ndi malungo.

Zizindikiro zina ndizo:

• Kupweteka m'mimba ndi kutupa
• Ululu mukamapuma kwambiri (pleurisy)
• Chikhure
• Kutupa ma lymph node (glands)
• Kuchepetsa thupi

Ndulu kapena chiwindi chimatha kutupa. Kutupa kwamatenda ndi mtima kumathanso kuchitika.

AOSD imatha kupezeka pambuyo poti matenda ena ambiri (monga matenda ndi khansa) achotsedwa. Mungafunike mayesero ambiri azachipatala musanapezeke matenda omaliza.

Kuyezetsa thupi kumatha kuwonetsa malungo, zotupa, ndi nyamakazi. Wopereka chithandizo chamankhwala adzagwiritsa ntchito stethoscope kuti amvetsere pakusintha kwakumveka kwa mtima wanu kapena mapapu.

Mayeso amwazi otsatirawa atha kukhala othandiza kudziwa ngati munthu ali ndi matenda akuluakulu:

• Kuwerengera kwathunthu kwamagazi (CBC), kumatha kuwonetsa kuchuluka kwama cell oyera (ma granulocyte) ndikuchepetsa ma cell ofiira.
• C-reactive protein (CRP), muyeso wa kutupa, idzakhala yayikulu kuposa yachibadwa.
• ESR (sedimentation rate), muyeso wa kutupa, idzakhala yokwera kuposa yachibadwa.
• Mulingo wa Ferritin ukhala wokwera kwambiri.
• Mulingo wa Fibrinogen udzakhala wapamwamba.
• Kuyesa kwa chiwindi kudzawonetsa milingo yayikulu ya AST ndi ALT.
• Rheumatoid factor ndi mayeso a ANA sizikhala zabwino.
• Zikhalidwe zamagazi ndi maphunziro a ma virus sizikhala zabwino.

Mayeso ena angafunike kuti muwone kutupa kwa mafupa, chifuwa, chiwindi, ndi ndulu:

• M'mimba ultrasound
• CT scan pamimba
• X-ray ya malo, chifuwa, kapena m'mimba (pamimba)

Cholinga chothandizira munthu wamkulu Matenda akadali ndikuwongolera zizindikilo za nyamakazi. Aspirin ndi mankhwala ena osakanikirana ndi kutupa (NSAIDs), monga ibuprofen, amagwiritsidwa ntchito koyamba.

Prednisone itha kugwiritsidwa ntchito pamavuto akulu kwambiri.

Ngati matendawa ndi oopsa kapena akupitilira kwa nthawi yayitali (amakhala osatha), mankhwala omwe amaletsa chitetezo cha mthupi angafunike. Mankhwala awa ndi awa:

• Methotrexate
• Anakinra (interleukin-1 receptor agonist)
• Tocilizumab (interleukin 6 choletsa)
• Otsutsana ndi tumor necrosis factor (TNF) monga etanercept (Enbrel)

Kwa anthu ambiri, zizindikilo zimatha kubwereranso kangapo pazaka zingapo zikubwerazi.

Zizindikiro zimapitilira kwa nthawi yayitali (yayitali) pafupifupi gawo limodzi mwa atatu mwa anthu omwe ali ndi matenda achikulire.

Matenda osowa, omwe amatchedwa macrophage activation syndrome, amatha kukhala owopsa kwambiri ngati malungo atha, matenda akulu komanso kuchuluka kwama cell ochepa. Pafupipafupi pamafunika mafuta am'mafupa kuti apange matendawa.

Zovuta zina zingaphatikizepo:

• Matenda a nyamakazi m'magulu angapo
• Matenda a chiwindi
• Matenda a m'mapapo
• Kutulutsa kwa Pleural
• Kukulitsa kwa nthata

Itanani omwe akukuthandizani ngati muli ndi zizindikiro za matenda akuluakulu.

Ngati mwapezeka kuti muli ndi vutoli, muyenera kuyimbira omwe akukuthandizani ngati muli ndi chifuwa kapena kupuma movutikira.

Palibe njira yodziwika yopewera.

Matenda a Still - wamkulu; Matenda achikulire Akuyambabe; AOSD; Matenda a Wissler-Fanconi

Alonso ER, Marques AO. Kuyamba kwa achikulire akadali matenda. Mu: Hochberg MC, Gravallese EM, Silman AJ, Smolen JS, Weinblatt ME, Weisman MH, olemba. Zamatsenga. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier; 2019: chap 173.

Gerfaud-Valentin M, Maucort-Boulch D, Wotentha A, et al. Kuyamba kwa achikulire kumakhalabe matenda: mawonetseredwe, chithandizo, zotsatira, ndi zoneneratu mwa odwala 57. Mankhwala (Baltimore). 2014; 93 (2): 91-99. PMID: 24646465 www.ncbi.nlm.nih.gov/pubmed/24646465. (Adasankhidwa)

Kaneko Y, Kameda H, Ikeda K, et al. Tocilizumab mwa odwala omwe ali ndi kachilombo koyambitsa matenda akuluakulu omwe amatsutsa mankhwala a glucocorticoid: mayesero olamulidwa ndi placebo, omwe ndi olamulira awiri, akhungu awiri. Ann Rheum Dis. 2018; 77 (12): 1720-1729. PMID: 30279267 www.ncbi.nlm.nih.gov/pubmed/30279267. (Adasankhidwa)

Tsamba la National Organisation for Rare Disways. Matenda ambiri.org. Matenda achikulire a Still. rarediseases.org/rare-diseases/adult-onset-stills-disease/. Idapezeka pa Marichi 30, 2019.

Ortiz-Sanjuán F, Blanco R, Riancho-Zarrabeitia L, ndi al. Kuchita bwino kwa anakinra mu Refractory wamkulu-oyambitsa Matenda a Still: kuphunzira mosiyanasiyana kwa odwala 41 ndikuwunikanso zolemba. Mankhwala (Baltimore). 2015; 94 (39): e1554. PMID: 26426623 www.ncbi.nlm.nih.gov/pubmed/26426623.