Matenda a achinyamata a nyamakazi

Juvenile idiopathic arthritis (JIA) ndi mawu omwe amagwiritsidwa ntchito pofotokoza gulu la zovuta mwa ana zomwe zimaphatikizapo nyamakazi. Matendawa ndiotenga nthawi yayitali (omwe amapangitsa kulumikizana ndi kutupa). Mayina omwe amafotokoza za mikhalidwe imeneyi asintha mzaka makumi angapo zapitazi popeza zambiri zikuphunziridwa za vutoli.

Zomwe zimayambitsa JIA sizikudziwika. Amaganiziridwa kuti ndimatenda okhaokha. Izi zikutanthauza kuti thupi limagunda ndikuwononga minofu yathanzi mwangozi.

JIA nthawi zambiri imayamba asanakwanitse zaka 16. Zizindikiro zimatha kuyambira miyezi isanu ndi umodzi.

International League of Associations for Rheumatology (ILAR) yatulutsa njira zotsatirazi zokhazikitsira mtundu wamatenda amwanawu:

• Kuyamba kwadongosolo JIA. Zimaphatikizapo kutupa molumikizana kapena kupweteka, malungo, ndi zotupa. Ndiwo mtundu wofala kwambiri koma ukhoza kukhala woopsa kwambiri. Zikuwoneka kuti ndizosiyana ndi mitundu ina ya JIA ndipo ndizofanana ndi Matenda a Adult Onset Stills.
• Matenda a m'minyewa. Zimaphatikizapo ziwalo zambiri. Fomu iyi ya JIA itha kukhala nyamakazi ya nyamakazi. Itha kukhala yophatikizira 5 kapena kupitilira apo yayikulu komanso yaying'ono yolumikizira miyendo ndi mikono, komanso nsagwada ndi khosi. Rheumatoid factor atha kupezeka.
• Oligoarthritis (yolimbikira komanso yowonjezera). Amakhudza 1 mpaka 4 mfundo, nthawi zambiri pamanja, kapena mawondo. Zimakhudzanso maso.
• Matenda a nyamakazi. Chimaimira spondyloarthritis mwa akulu ndipo nthawi zambiri chimakhudza mgwirizano wa sacroiliac.
• Matenda a Psoriatic. Odwala omwe amapezeka ndi ana omwe ali ndi nyamakazi ndi psoriasis kapena matenda amisomali, kapena amakhala ndi achibale apafupi ndi psoriasis.

Zizindikiro za JIA zitha kuphatikiza:

• Kutupa, kofiira, kapena kutentha
• Kuchita ziwalo kapena mavuto pogwiritsa ntchito chiwalo
• Kutentha kwakukulu mwadzidzidzi, komwe kumatha kubwerera
• Kutupa (pamtengo ndi kumapeto) komwe kumabwera ndikupita ndi malungo
• Kuuma, kupweteka, ndi kuyenda kochepa kophatikizana
• Kupweteka kwakumbuyo komwe sikumatha
• Zizindikiro za thupi lonse monga khungu lotumbululuka, kutupa kwa lymph gland, komanso mawonekedwe odwala

JIA amathanso kuyambitsa mavuto amaso otchedwa uveitis, iridocyclitis, kapena iritis. Sipangakhale zizindikiro. Zizindikiro zamaso zikachitika, zimatha kuphatikiza:

• Maso ofiira
• Kupweteka kwa diso, komwe kumatha kukulirakulira mukayang'ana kuwala (photophobia)
• Masomphenya akusintha

Kuyezetsa thupi kumatha kuwonetsa kutupa, kutentha, komanso mafupa omwe amapweteka kuti asunthe. Mwanayo akhoza kukhala ndi zotupa. Zizindikiro zina ndizo:

• Kutupa chiwindi
• Kutupa nthenda
• Kutupa ma lymph node

Kuyezetsa magazi kungaphatikizepo:

• Chifuwa cha nyamakazi
• Mlingo wa sedimentation wa erythrocyte (ESR)
• Antinuclear antibody (ANA)
• Kuwerengera kwathunthu kwa magazi (CBC)
• HLA-B27

Mayeso aliwonse kapena mayesedwe amwazi awa akhoza kukhala abwinobwino kwa ana omwe ali ndi JIA.

Wothandizira zaumoyo amatha kuyika singano yaying'ono palimodzi yotupa kuti achotse madzi. Izi zitha kuthandiza kupeza chomwe chimayambitsa nyamakazi. Zingathandizenso kuchepetsa ululu. Wothandizirayo atha kubaya ma steroids palimodzi kuti athandize kuchepetsa kutupa.

Mayesero ena omwe angachitike ndi awa:

• X-ray yolumikizana
• Kujambula mafupa
• X-ray ya chifuwa
• ECG
• Kuyesedwa kwamaso kwamaso ndi dokotala wa maso - Izi ziyenera kuchitidwa ngakhale palibe zisonyezo zamaso.

Mankhwala osagwiritsidwa ntchito poletsa kutupa (NSAIDs) monga ibuprofen kapena naproxen akhoza kukhala okwanira kuwongolera zizindikiritso zikangokhala ziwalo zochepa.

Corticosteroids itha kugwiritsidwa ntchito pophulika kwambiri kuti athetse matenda. Chifukwa cha kawopsedwe kawo, kugwiritsa ntchito mankhwalawa kwa nthawi yayitali kuyenera kupewedwa mwa ana.

Ana omwe ali ndi nyamakazi m'malo ambiri, kapena omwe ali ndi malungo, zotupa, ndi zilonda zotupa angafunikire mankhwala ena. Izi zimatchedwa mankhwala osintha matenda (DMARDs). Amatha kuthandiza kuchepetsa kutupa pamalumikizidwe kapena thupi. Ma DMARD ndi awa:

• Methotrexate
• Mankhwala a biologic, monga etanercept (Enbrel), infliximab (Remicade), ndi mankhwala ena ofanana nawo

Ana omwe ali ndi systemic JIA adzafunika biologic inhibitors a IL-1 kapena IL-6 monga anakinra kapena tocilizumab.

Ana omwe ali ndi JIA ayenera kukhalabe achangu.

Kuchita masewera olimbitsa thupi kumathandiza kuti minofu ndi ziwalo zawo zikhale zolimba komanso zoyenda.

• Kuyenda, njinga, ndi kusambira zingakhale zochitika zabwino.
• Ana ayenera kuphunzira kutentha asanayambe kuchita masewera olimbitsa thupi.
• Lankhulani ndi dokotala kapena wothandizira zakuthupi za zochitika zomwe mungachite pamene mwana wanu akumva ululu.

Ana omwe ali achisoni kapena okwiya chifukwa cha nyamakazi yawo angafunikire kuthandizidwa.

Ana ena omwe ali ndi JIA angafunike kuchitidwa opaleshoni, kuphatikiza olowa m'malo.

Ana omwe ali ndi ziwalo zochepa zomwe zakhudzidwa sangakhale ndi zizindikiro kwa nthawi yayitali.

Kwa ana ambiri, matendawa satha kugwira ntchito ndipo amawononga pang'ono.

Kukula kwa matendawa kumadalira kuchuluka kwa ziwalo zomwe zakhudzidwa. Sizingatheke kuti zizindikiro zidzatha pazochitikazi. Ana awa nthawi zambiri amakhala ndi zowawa zazitali (zopweteka), olumala, komanso mavuto kusukulu. Ana ena amatha kupitiliza kudwala nyamakazi akamakula.

Zovuta zingaphatikizepo:

• Kuvala kapena kuwonongeka kwa mafupa (kumatha kuchitika kwa anthu omwe ali ndi JIA ovuta kwambiri)
• Kukula pang'onopang'ono
• Kukula kofanana kwa mkono kapena mwendo
• Kutaya masomphenya kapena kuchepa kwa masomphenya kuchokera ku uveitis (vutoli limatha kukhala lalikulu, ngakhale nyamakazi siyolimba)
• Kuchepa kwa magazi m'thupi
• Kutupa mozungulira mtima (pericarditis)
• Kupweteka kwakanthawi (kosatha), kusayenda bwino kusukulu
• Macrophage activation syndrome, matenda akulu omwe amatha kukhala ndi systemic JIA

Itanani omwe akukuthandizani ngati:

• Inu, kapena mwana wanu, muzindikira zizindikiro za JIA
• Zizindikiro zimaipiraipira kapena sizikusintha ndi mankhwala
• Zizindikiro zatsopano zimayamba

Palibe chitetezo chodziwika cha JIA.

Matenda a nyamakazi a achinyamata (JRA); Matenda osachiritsika a ana; Matenda akadali; Achinyamata spondyloarthritis

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