Polyarteritis nodosa

Polyarteritis nodosa ndi nthenda yoopsa yamagazi. Mitsempha yaying'ono komanso yaying'ono imayamba kutupa ndikuwonongeka.

Mitsempha ndiyo mitsempha yamagazi yomwe imanyamula magazi olemera okosijeni kuma ziwalo ndi minofu. Zomwe zimayambitsa polyarteritis nodosa sizikudziwika. Chikhalidwe chimachitika pamene maselo ena amthupi amateteza mitsempha yomwe yakhudzidwa. Minyewa yomwe imadyetsedwa ndi mitsempha yomwe imakhudzidwa samalandira mpweya komanso chakudya chomwe amafunikira. Kuwonongeka kumachitika chifukwa.

Akuluakulu ambiri kuposa ana amatenga matendawa.

Anthu omwe ali ndi chiwindi cha hepatitis B kapena hepatitis C amatha kudwala matendawa.

Zizindikiro zimayamba chifukwa cha kuwonongeka kwa ziwalo zomwe zakhudzidwa. Khungu, mafupa, minofu, m'mimba, mtima, impso, ndi dongosolo lamanjenje nthawi zambiri zimakhudzidwa.

Zizindikiro zake ndi izi:

• Kupweteka m'mimba
• Kuchepetsa chilakolako
• Kutopa
• Malungo
• Kupweteka kofanana
• Kupweteka kwa minofu
• Kuchepetsa mwangozi
• Kufooka

Ngati mitsempha imakhudzidwa, mutha kukhala ndi dzanzi, kupweteka, kutentha, ndi kufooka. Kuwonongeka kwamanjenje kumatha kuyambitsa zilonda kapena khunyu.

Palibe mayeso apadera a labu omwe amapezeka kuti apeze polyarteritis nodosa. Pali zovuta zingapo zomwe zimakhala ndi zofanana ndi polyarthritis nodosa. Izi zimadziwika kuti "mimics."

Muyesedwa kwathunthu.

Mayeso a labu omwe angathandize kuti matendawa athetsedwe ndikuphatikizapo:

• Kuwerengera kwathunthu kwamagazi (CBC) okhala ndi kusiyanasiyana, creatinine, mayeso a hepatitis B ndi C, ndikuyeza kwamkodzo
• Mlingo wa sedimentation wa Erythrocyte (ESR) kapena C-reactive protein (CRP)
• Seramu mapuloteni electrophoresis, cryoglobulins
• Maselo owonjezera a Seramu
• Zovuta
• Zolemba zamatenda
• Kuyezetsa magazi kwina kudzachitika kuti zitheke, monga systemic lupus erythematosus (ANA) kapena granulomatosis yokhala ndi polyangiitis (ANCA)
• Kuyezetsa HIV
• Cryoglobulins
• Ma anti-phospholipid antibodies
• Zikhalidwe zamagazi

Chithandizo chake chimaphatikizapo mankhwala opondereza kutupa komanso chitetezo chamthupi. Izi zitha kuphatikizira ma steroids, monga prednisone. Mankhwala ofanana, monga azathioprine, methotrexate kapena mycophenolate omwe amalola kuti muchepetse mankhwala a steroids amagwiritsidwanso ntchito. Cyclophosphamide ntchito kwambiri milandu.

Kwa polyarteritis nodosa yokhudzana ndi matenda a chiwindi, chithandizo chitha kuphatikizira plasmapheresis ndi mankhwala oletsa ma virus.

Mankhwala apano ndi ma steroids ndi mankhwala ena omwe amalepheretsa chitetezo cha mthupi (monga azathioprine kapena cyclophosphamide) amatha kusintha zizindikilo komanso mwayi wokhala ndi moyo kwakanthawi.

Zovuta kwambiri nthawi zambiri zimakhudza impso ndi mundawo m'mimba.

Popanda chithandizo, malingaliro ake ndiabwino.

Zovuta zingaphatikizepo:

• Matenda amtima
• Matenda a m'mimba necrosis
• Impso kulephera
• Sitiroko

Itanani omwe akukuthandizani mukakhala ndi zodwala. Kuzindikira koyambirira ndi chithandizo kumathandizira kuti pakhale zotsatira zabwino.

Palibe njira yodziwika yopewera. Komabe, chithandizo cham'mbuyomu chitha kupewa kuwonongeka ndi zizindikilo zina.

Periarteritis nodosa; PAN; Njira zothetsera necrotizing vasculitis

• Microscopic polyarteritis 2
• Njira yoyendera

Luqmani R, Awisat A. Polyarteritis nodosa ndi zovuta zina. Mu: Firestein GS, Budd RC, Gabriel SE, Koretzky GA, McInnes IB, O'Dell JR, olemba. Buku la Firestein & Kelley la Rheumatology. 11th ed. Philadelphia, PA: Elsevier; 2021: mutu 95.

Puéchal X, Pagnoux C, Baron G, ndi al. Kuphatikiza azathioprine ku chikhululukiro-cholanditsa glucocorticoids ya eosinophilic granulomatosis ndi polyangiitis (Churg-Strauss), microscopic polyangiitis, kapena polyarteritis nodosa popanda zinthu zolakwika: kuyesedwa kosasinthika. Nyamakazi Rheumatol. 2017; 69 (11): 2175-2186. PMID: 28678392 www.pubmed.ncbi.nlm.nih.gov/28678392/.

Chikhali Mukasa VK. Vasculitis ndi ma arteriopathies ena achilendo. Mu: Sidawy AN, Perler BA, olemba. Rutherford Opaleshoni ya Mitsempha ndi Endovascular Therapy. 9th ed. Philadelphia, PA: Elsevier; 2019: mutu 137.

Mwala JH. Mawonekedwe a vasculitides. Mu: Goldman L, Schafer AI, olemba. Mankhwala a Goldman-Cecil. 26 wa. Philadelphia, PA: Elsevier; 2020: chap 254.