Matenda a Antiphospholipid - APS

Matenda a Antiphospholipid (APS) ndimatenda amthupi omwe amakhala ndimatenda amwazi pafupipafupi (thromboses).Mukakhala ndi vutoli, chitetezo cha mthupi lanu chimapanga mapuloteni osazolowereka omwe amalimbana ndi maselo am'magazi komanso zotchingira mitsempha. Kupezeka kwa ma antibodies amtunduwu kumatha kubweretsa mavuto pakuyenda kwa magazi ndikubweretsa kuundana m'mitsempha yamagazi mthupi lonse.

Zomwe zimayambitsa APS sizikudziwika. Zosintha zina za majini ndi zina (monga matenda) zingayambitse vuto.

Nthawi zambiri amapezeka mwa anthu omwe ali ndi matenda ena amthupi okha, monga systemic lupus erythematosus (SLE). Vutoli ndilofala kwambiri kuposa azibambo, Amakonda kupezeka mwa azimayi omwe amakhala ndi mbiri yosokonekera mobwerezabwereza.

Anthu ena amakhala ndi ma antibodies omwe atchulidwa pamwambapa, koma alibe APS. Zoyambitsa zina zitha kupangitsa anthuwa kukhala ndi magazi, kuphatikiza:

• Kusuta
• Kupuma kwa nthawi yayitali
• Mimba
• Thandizo la mahomoni kapena mapiritsi oletsa kubereka
• Khansa
• Matenda a impso

Simungakhale ndi zizindikiro zilizonse, ngakhale muli ndi ma antibodies. Zizindikiro zomwe zingachitike ndi monga:

• Magazi amatundikira m'miyendo, mikono kapena mapapo. Mitsempha imatha kukhala mumitsempha kapena m'mitsempha.
• Kupita padera kapena kubadwa.
• Rash, mwa anthu ena.

Nthawi zambiri, kuundana kumatulukira mwadzidzidzi mumitsempha yambiri kwamasiku angapo. Izi zimatchedwa matenda oopsa a anti-phospholipid (CAPS). Zitha kubweretsa sitiroko komanso kuundana kwa impso, chiwindi, ndi ziwalo zina mthupi lonse, ndi zilonda zamiyendo.

Kuyesedwa kwa ma lupus anticoagulant ndi antiphospholipid antibodies kumatha kuchitika:

• Magazi osayembekezereka amapezeka, monga achinyamata kapena omwe alibe zoopsa zilizonse zomwe zimayambitsa magazi.
• Mzimayi amakhala ndi mbiri yakubalidwa mobwerezabwereza.

Mayeso a lupus anticoagulant amayesa kuunditsa magazi. Ma antibodies a antiphospholipid (aPL) amachititsa kuti mayeserowo akhale achilendo mu labotale.

Mitundu yoyeserera yoyeserera ikhoza kuphatikiza:

• Nthawi yokhazikika ya thromboplastin (aPTT)
• Nthawi ya njoka ya Russell njoka
• Mayeso oletsedwa a Thromboplastin

Kuyesedwa kwa ma anti-phospholipid antibodies (aPL) kudzachitikanso. Zikuphatikizapo:

• Mayeso a Anticardiolipin antibody
• Ma antibodies ku beta-2-glypoprotein I (Beta2-GPI)

Wothandizira zaumoyo wanu adzazindikira kuti muli ndi antiphospholipid antibody syndrome (APS) ngati mutayesa mayeso aPL kapena lupus anticoagulant, ndi chimodzi kapena zingapo izi:

• Magazi oundana
• Kupita padera mobwerezabwereza

Mayeso abwino akuyenera kutsimikiziridwa pakatha milungu 12. Ngati muli ndi mayeso abwino popanda zina za matendawa, simudzapezeka ndi APS.

Chithandizo cha APS chimayang'aniridwa poletsa zovuta kuchokera kumagazi atsopano omwe amapanga kapena kuundana komwe kulipo kukulira. Muyenera kumwa mtundu wina wa mankhwala ochepetsa magazi. Ngati inunso muli ndi matenda omwe amadzichotsera okha, monga lupus, muyenera kuyesetsanso vutoli.

Chithandizo chenicheni chimadalira kukula kwa matenda anu komanso zovuta zomwe zikuyambitsa.

ANTIPHOSPHOLIPID ANTIBODY SYNDROME (APS)

Mwambiri, mufunika chithandizo chokhala ndi magazi ochepetsa magazi kwa nthawi yayitali ngati muli ndi APS. Chithandizo choyamba chingakhale heparin. Mankhwalawa amaperekedwa ndi jakisoni.

Nthawi zambiri, warfarin (Coumadin), yomwe imaperekedwa pakamwa, imayambika. Ndikofunikira kuwunika pafupipafupi kuchuluka kwa anticoagulation. Izi zimachitika nthawi zambiri pogwiritsa ntchito mayeso a INR.

Ngati muli ndi APS ndikukhala ndi pakati, muyenera kutsatira mosamalitsa ndi omwe amakupatsani mwayi wodziwa izi. Simudzatenga warfarin panthawi yapakati, koma mudzapatsidwa ma heparin kuwombera m'malo mwake.

Ngati muli ndi SLE ndi APS, omwe akukuthandizani adzakulimbikitsaninso kuti mutenge hydroxychloroquine.

Pakadali pano, mitundu ina ya mankhwala ochepetsa magazi sakuvomerezeka.

CATASTROPHIC ANTIPHOSPHOLIPID SYNDROME (CAPS) YAM'MBUYO YOTSATIRA

Chithandizo cha CAPS chomwe chimaphatikizapo kuphatikiza ma anticoagulation, kuchuluka kwa corticosteroids, komanso kusinthana kwa plasma kwakhala kothandiza kwa anthu ambiri. Nthawi zina IVIG, rituximab kapena eculizumab imagwiritsidwanso ntchito pamavuto akulu.

KUYESA KWABWINO KWA LUPUS ANTICOAGULANT OR APL

Simusowa chithandizo ngati mulibe zizindikilo, kutaya mimba, kapena ngati simunakhalepo ndi magazi.

Chitani izi kuti muteteze magazi kuundana kuti asapangidwe:

• Pewani mapiritsi ambiri oletsa kubereka kapena mankhwala a mahomoni potha msinkhu (azimayi).
• Osasuta kapena kugwiritsa ntchito mankhwala ena a fodya.
• Dzukani ndikuyenda paulendo waulendo wautali kapena nthawi zina mukakhala kapena kugona kwa nthawi yayitali.
• Sungani ma bondo anu mmwamba ndi pansi pomwe simungathe kuyendayenda.

Mudzapatsidwa mankhwala ochepetsa magazi (monga heparin ndi warfarin) othandiza kupewa magazi.

• Pambuyo pa opaleshoni
• Pambuyo pakuthyola fupa
• Ndi khansa yogwira
• Mukafunika kukhala pansi kapena kugona kwa nthawi yayitali, monga nthawi yogonera kuchipatala kapena kuchira kwanu

Muyeneranso kumwa ochepetsa magazi kwa milungu itatu kapena inayi mutachitidwa opaleshoni kuti muchepetse magazi.

Popanda chithandizo, anthu omwe ali ndi APS adzabwereranso kutseka magazi. Nthawi zambiri, zotsatira zake zimakhala zabwino ndi chithandizo choyenera, chomwe chimaphatikizapo mankhwala a antiticoagulation a nthawi yayitali. Anthu ena atha kukhala ndi magazi oundana ovuta kuwongolera ngakhale atalandira chithandizo chamankhwala. Izi zitha kubweretsa ku CAPS, zomwe zitha kupha moyo.

Itanani omwe akukuthandizani mukawona kuti magazi ali ndi magazi, monga:

• Kutupa kapena kufiira mwendo
• Kupuma pang'ono
• Kupweteka, dzanzi, ndi khungu loyera pamanja kapena mwendo

Komanso lankhulani ndi omwe amakupatsani ngati mwataya mimba mobwerezabwereza (kupita padera).

Mankhwala a Anticardiolipin; Matenda a Hughes

• Ziphuphu zotupa za lupus erythematosus pamaso
• Kuundana kwamagazi

Amigo MC, Khamashta MA. Matenda a Antiphospholipid: pathogenesis, diagnostic, and management. Mu: Hochberg MC, Gravallese EM, Silman AJ, Smolen JS, Weinblatt ME, Weisman MH, olemba. Zamatsenga. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier; 2019: mutu 148.

Cervera R, Rodríguez-Pintó I, Colafrancesco S, ndi al. Msonkhano wapadziko lonse wa 14th wa Antiphospholipid Antibodies Task Force lipoti la zoopsa za antiphospholipid. Pangani Auto Rev. 2014; 13 (7): 699-707. PMID: 24657970 www.ncbi.nlm.nih.gov/pubmed/24657970. (Adasankhidwa)

Dufrost V, Risse J, Wahl D, Zuily S. Direct antiticoagulants ntchito mu antiphospholipid syndrome: kodi mankhwalawa ndi othandiza komanso otetezeka m'malo mwa warfarin? Kuwunika mwatsatanetsatane kwa zolembedwazo: yankho kuyankha. Wotsutsa Rheumatol Rep. 2017; 19 (8): 52. PMID: 28741234 www.ncbi.nlm.nih.gov/pubmed/28741234.

Erkan D, Salmon JE, Lockshin MD. Matenda a anti-phospholipid. 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 82.

Webusaiti ya National Heart, Lung, ndi Blood Institute. Matenda a Antiphospholipid antibody. www.nhlbi.nih.gov/health-topics/antiphospholipid-antibody-syndrome. Inapezeka pa June 5, 2019.