Takayasu arteritis

Takayasu arteritis ndikutupa kwamitsempha yayikulu monga aorta ndi nthambi zake zazikulu. Aorta ndi mtsempha wamagazi womwe umanyamula magazi kuchokera pamtima kupita ku thupi lonse.

Zomwe zimayambitsa Takayasu arteritis sizikudziwika. Matendawa amapezeka makamaka mwa ana ndi akazi azaka zapakati pa 20 mpaka 40. Amagwidwa kwambiri ndi anthu ochokera kum'mawa kwa Asia, India kapena Mexico. Komabe, tsopano ikuwonekera kambiri kumadera ena padziko lapansi. Mitundu yambiri yomwe imawonjezera mwayi wokhala ndi vutoli idapezeka posachedwa.

Takayasu arteritis imawoneka ngati yokhayokha. Izi zikutanthauza kuti chitetezo cha mthupi molakwika chimagunda minyewa yathanzi mumtambo wamagazi. Vutoli litha kuphatikizanso ziwalo zina zamagulu.

Vutoli lili ndi zinthu zambiri zomwe zikufanana ndi chimphona cha arteritis kapena temporical arteritis mwa anthu okalamba.

Zizindikiro zimaphatikizapo:

• Kufooka kwa mkono kapena kupweteka pogwiritsa ntchito
• Kupweteka pachifuwa
• Chizungulire
• Kutopa
• Malungo
• Mitu yopepuka
• Kupweteka kwa minofu kapena molumikizana
• Ziphuphu pakhungu
• Kutuluka thukuta usiku
• Masomphenya akusintha
• Kuchepetsa thupi
• Kuchepetsa kozungulira kozungulira (padzanja)
• Kusiyana kwa kuthamanga kwa magazi pakati pa mikono iwiri
• Kuthamanga kwa magazi (matenda oopsa)

Pakhoza kukhalanso zizindikilo za kutupa (pericarditis kapena pleuritis).

Mayeso omwe angakhalepo ndi awa:

• Angiogram, kuphatikiza coronary angiography
• Kuwerengera kwathunthu kwa magazi (CBC)
• Mapuloteni othandizira C (CRP)
• Electrocardiogram (ECG)
• Mlingo wa sedimentation wa erythrocyte (ESR)
• Magnetic resonance angiography (MRA)
• Kujambula kwa maginito (MRI)
• Kuwerengera tomography angiography (CTA)
• Positron umuna tomography (PET)
• Ultrasound
• X-ray ya chifuwa

Chithandizo cha Takayasu arteritis ndi chovuta. Komabe, anthu omwe ali ndi chithandizo choyenera amatha kusintha. Ndikofunika kuzindikira vutoli msanga. Matendawa amakhala osachiritsika, omwe amafuna kugwiritsa ntchito mankhwala osokoneza bongo kwa nthawi yayitali.

MANKHWALA

Anthu ambiri amathandizidwa koyamba ndi milingo yayikulu ya corticosteroids monga prednisone. Popeza matendawa amalamulidwa mlingo wa prednisone umachepa.

Pafupifupi nthawi zonse, mankhwala opatsirana pogonana amawonjezeredwa kuti achepetse kufunika kogwiritsa ntchito prednisone kwakanthawi komabe ndikuwongolera matendawa.

Mankhwala ochiritsira osachiritsika monga methotrexate, azathioprine, mycophenolate, cyclophosphamide, kapena leflunomide nthawi zambiri amawonjezeredwa.

Ma biologic agents nawonso angakhale othandiza. Izi zikuphatikizapo TNF inhibitors monga infliximab, etanercept, ndi tocilizumab.

KUGWIDWA

Opaleshoni kapena angioplasty itha kugwiritsidwa ntchito kutsegula mitsempha yocheperako kuti ipereke magazi kapena kutsegula kwa kukakamira.

Kusintha kwa valavu ya aortic kungafune nthawi zina.

Matendawa amatha kupha popanda chithandizo. Komabe, njira imodzi yothandizira pogwiritsa ntchito mankhwala ndi opaleshoni yachepetsa imfa. Akuluakulu amakhala ndi mwayi wopulumuka kuposa ana.

Zovuta zingaphatikizepo:

• Kuundana kwamagazi
• Matenda amtima
• Mtima kulephera
• Matenda a m'mapapo
• Kuperewera kwa valavu ya aortic
• Pleuritis
• Sitiroko
• Kutuluka m'mimba kapena kupweteka kwamitsempha yamitsempha yotseka

Itanani omwe akukuthandizani ngati muli ndi zodabwitsazi. Kusamalira mwachangu kumafunika ngati muli:

• Kugunda kofooka
• Kupweteka pachifuwa
• Kupuma kovuta

Matenda osapindika, Matenda akulu-akulu vasculitis

• Mtima - gawo kupyola pakati
• Mavavu amtima - mawonekedwe akunja
• Mavavu amtima - mawonekedwe apamwamba

Alomari I, Patel PM. Takayasu arteritis. Mu: Ferri FF, Mkonzi. Mlangizi Wachipatala wa Ferri 2020. Philadelphia, PA: Elsevier; 2020: 1342.e4-1342.e7.

Barra L, Yang G, Pagnoux C; Canada Vasculitis Network (CanVasc). Mankhwala osagwiritsa ntchito glucocorticoid pochiza Takayasu's arteritis: Kuwunika mwatsatanetsatane ndikuwunika meta. Pangani Auto Rev. 2018; 17 (7): 683-693. PMID: 29729444 pubed.ncbi.nlm.nih.gov/29729444/.

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 pubed.ncbi.nlm.nih.gov/29358285/.

Ehlert BA, Abularrage CJ. Matenda a Takayasu. Mu: Sidawy AN, Perler BA, olemba. Rutherford Opaleshoni ya Mitsempha ndi Endovascular Therapy. 9th ed. Philadelphia, PA: Elsevier; 2019: mutu 139.

Serra R, Butrico L, Fugetto F, ndi al. Zosintha mu pathophysiology, diagnostic and management of Takayasu arteritis. Ann Vasc Opaleshoni. 2016; 35: 210-225. PMID: 27238990 adatulutsidwa.ncbi.nlm.nih.gov/27238990/.