Dermatomyositis

Dermatomyositis ndi matenda aminyewa omwe amakhudzana ndi kutupa komanso zotupa pakhungu. Polymyositis imakhalanso yotupa, yomwe imaphatikizaponso kufooka kwa minofu, kutupa, kufatsa, ndi kuwonongeka kwa minofu koma osachita khungu. Onsewa ndi gawo lalikulu la matenda omwe amatchedwa myopathy yotupa.

Chifukwa cha dermatomyositis sichidziwika. Akatswiri akuganiza kuti mwina ndi chifukwa cha matenda omwe amapezeka m'minyewa kapena vuto la chitetezo chamthupi. Zitha kukhalanso mwa anthu omwe ali ndi khansa m'mimba, m'mapapo, kapena mbali zina za thupi.

Aliyense akhoza kukhala ndi vutoli. Nthawi zambiri zimapezeka mwa ana azaka 5 mpaka 15 ndipo akulu azaka 40 mpaka 60. Zimakhudza azimayi pafupipafupi kuposa amuna.

Zizindikiro zimaphatikizapo:

• Kufooka kwa minofu, kuuma, kapena kupweteka
• Mavuto kumeza
• Mtundu wonyezimira m'maso mwake
• Kutupa kofiira kofiira
• Kupuma pang'ono

Kufooka kwa minofu kumatha kubwera modzidzimutsa kapena kukula pang'onopang'ono pakadutsa milungu kapena miyezi. Mutha kukhala ndi zovuta kukweza manja anu pamutu panu, kunyamuka pomwe mwakhala, ndikukwera masitepe.

Kutupa kumatha kuoneka pankhope panu, zikwapu, khosi, mapewa, chifuwa chapamwamba, ndi msana.

Wothandizira zaumoyo adzayesa. Mayeso atha kuphatikiza:

• Kuyesa magazi kuti muwone kuchuluka kwa michere ya minofu yotchedwa creatine phosphokinase ndi aldolase
• Kuyezetsa magazi kwa matenda amthupi okha
• ECG
• Electromyography (EMG)
• Kujambula kwa maginito (MRI)
• Kutulutsa minofu
• Khungu lakhungu
• Kuyesedwa kwina kwa khansa
• X-ray ndi chifuwa cha CT pachifuwa
• Kuyesa kwa mapapo
• Kumeza kuphunzira
• Myositis yeniyeni komanso yogwirizana ndi autoantibodies

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. Mutha kukhala 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.

Mankhwala omwe angayesedwe ngati matenda omwe amakhalabe ogwira ntchito ngakhale atakhala awa ndi awa:

• Mitsempha yotchedwa gamma globulin
• Mankhwala osokoneza bongo

Minofu yanu ikamalimba, wokuthandizani angakuuzeni kuti muchepetse pang'ono mlingo wanu. Anthu ambiri omwe ali ndi vutoli ayenera kumwa mankhwala otchedwa prednisone kwa moyo wawo wonse.

Ngati khansa ikuyambitsa vutoli, kufooka kwa minyewa ndi zotupa zimatha kukhala bwino pakachotsedwa chotupacho.

Zizindikiro zimatha kutha mwa anthu ena, monga ana.

Vutoli limatha kupha akuluakulu chifukwa cha:

• Kufooka kwakukulu kwa minofu
• Kusowa zakudya m'thupi
• Chibayo
• Kulephera kwa mapapo

Zomwe zimayambitsa kufa ndi matendawa ndi khansa komanso matenda am'mapapo.

Anthu omwe ali ndi matenda am'mapapo omwe ali ndi anti-MDA-5 antibody ali ndi vuto lakuchepa ngakhale atalandira chithandizo chamakono.

Zovuta zingaphatikizepo:

• Matenda am'mapapo
• Kulephera kwakukulu kwa impso
• Khansa (zilonda)
• Kutupa kwa mtima
• Ululu wophatikizana

Itanani omwe akukuthandizani ngati muli ndi kufooka kwa minofu kapena zizindikiro zina za vutoli.

• Dermatomyositis - Gottron papule
• Dermatomyositis - ma papuleti a Gottron padzanja
• Dermatomyositis - zikope za heliotrope
• Dermatomyositis pa miyendo
• Dermatomyositis - Gottron papule
• Paronychia - osankhidwa
• Dermatomyositis - zotupa za heliotrope pamaso

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.

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.

Tsamba la National Organisation for Rare Disways. Dermatomyositis. rarediseases.org/rare-diseases/dermatomyositis/. Idapezeka pa Epulo 1, 2019.