Pemphigoid Gestationis Pakati pa Mimba

Zamkati

• Zithunzi za pemphigoid gestationis
• Zizindikiro za Pemphigoid gestation
• Pemphigoid gestationis amayambitsa
• Pemphigoid gestationis vs. PUPPP
• Pemphigoid gestationis matenda
• Pemphigoid gestationis chithandizo
• Zithandizo zapakhomo
• Milandu yowopsa kwambiri
• Pemphigoid gestationis zovuta
• Maganizo ake

Chidule

Pemphigoid gestationis (PG) ndimaphulika osowa khungu, omwe nthawi zambiri amapezeka m'chigawo chachiwiri kapena chachitatu cha mimba. Nthawi zambiri zimayamba ndikuwoneka kwamatumba ofiira ofiira pamimba ndi thunthu, ngakhale atha kuwonekera mbali zina za thupi lanu.

PG imayambitsidwa ndi chitetezo chanu chamthupi molakwika khungu lanu. Nthawi zambiri zimangopita zokha m'masiku kapena milungu ingapo kuchokera kubereka. Nthawi zambiri, zimatha kukhala kwakanthawi.

PG ikuyembekezeka kuchitika pa 1 mwa 40,000 mpaka 50,000 apakati.

Pemphigoid gestationis amadziwika kuti herpes gestationis, koma tsopano zimamveka kuti zilibe mgwirizano ndi herpes virus. Palinso mitundu ina ya kuphulika kwa khungu kwa pemphigus kapena pemphigoid, kosagwirizana ndi mimba.

Pemphigus amatanthauza chithuza kapena pustule, ndipo maliro amatanthauza "kutenga pakati" m'Chilatini.

Zithunzi za pemphigoid gestationis

Zizindikiro za Pemphigoid gestation

Ndi PG, mabampu ofiira amawoneka mozungulira batani la m'mimba ndikufalikira mbali zina za thupi m'masiku kapena milungu ingapo. Nkhope yanu, khungu, zikhatho, ndi phazi lanu sizimakhudzidwa.

Pakatha milungu iwiri kapena inayi, ziphuphu zimasanduka matuza akuluakulu, ofiira komanso odzaza madzi. Mabampu awa amathanso kutchedwa bulla. Atha kukhala omangika kwambiri.

M'malo mwa matuza kapena bulla, anthu ena amakhala ndi zigamba zofiira zomwe zimatchedwa zikwangwani.

Matuza a PG amatha kuchepa kapena kutha okha kumapeto kwa mimba yanu, koma azimayi 75 mpaka 80% azimayi omwe ali ndi PG amakumana ndi zovuta nthawi yobereka.

PG imatha kubwereranso msambo kapena pakubereka pambuyo pake. Kugwiritsanso ntchito njira zakulera pakamwa kumayambitsanso kuukira kwina.

Nthawi zina - za - PG zitha kuwoneka mwa ana obadwa kumene.

Pemphigoid gestationis amayambitsa

Pemphigoid gestationis tsopano amadziwika kuti ndi matenda omwe amangodziyimira pawokha. Izi zikutanthauza kuti chitetezo chamthupi chanu chimayamba kuwononga ziwalo za thupi lanu. Mu PG, maselo omwe amaukiridwa ndi omwe amadzala.

Minyewa yamkati imakhala ndi maselo ochokera kwa makolo onse. Maselo omwe achokera kwa bambo amakhala ndi mamolekyulu omwe amadziwika kuti ndi achilendo ndi chitetezo cha mayi. Izi zimapangitsa chitetezo cha mthupi cha amayi kuti chiziwatsutsana nawo.

Maselo a abambo amapezeka pamimba iliyonse, koma matenda omwe amadzichitira okha ngati PG amapezeka nthawi zina. Sizikumveka bwino chifukwa chake chitetezo chamthupi cha amayi chimagwira motere nthawi zina, osati mwa ena.

Koma mamolekyu ena omwe amadziwika kuti MHC II omwe nthawi zambiri sapezeka mu placenta amapezeka mwa amayi omwe ali ndi PG. Chitetezo cha mthupi la amayi apakati chikazindikira ma molekyuluwa, chimayambitsa.

Mamolekyu a MHC II omwe amachititsa kuti thupi lanu likhale limodzi. Chitetezo cha mthupi mwanu chikayamba kuwaukira, zimatha kubweretsa matuza ndi zolengeza zomwe ndi chizindikiro chachikulu cha PG.

Chimodzi mwazomwe zimachitika ndikudzipangitsa kukhalapo kwa protein yomwe tsopano imadziwika kuti Collagen XVII (yomwe kale inkatchedwa BP180).

Pemphigoid gestationis vs. PUPPP

Kuphulika kwina kwa khungu kotchedwa PUPPP (pruritic urticarial papules ndi zikwangwani za mimba) kumatha kufanana ndi pemphigoid gestationis. Monga momwe dzinalo likusonyezera, PUPPP ndiyovuta (pruritic) komanso ngati mng'oma (urticarial).

PUPPP imachitika nthawi zambiri mu trimester yachitatu, yomwe ndi nthawi yodziwika kuti PG iwonekere. Ndipo monga PG, imawonekera koyamba pamimba ngati zotupa zoyera kapena zikwangwani.

Koma PUPPP nthawi zambiri sichimapita m'matuza akulu, odzaza madzi ngati PG. Ndipo mosiyana ndi PG, nthawi zambiri imafalikira mpaka kumiyendo ndipo nthawi zina kumamenyedwa pansi.

PUPPP imathandizidwa ndi mafuta odzola, komanso nthawi zina ndi mapiritsi a antihistamine. Ziphuphu nthawi zambiri zimasowa zokha pakadutsa milungu isanu ndi umodzi mutabereka.

PUPPP imachitika pafupifupi 1 pa mimba 150 zilizonse, zomwe zimapangitsa kuti zikhale zofala kwambiri kuposa PG. PUPPP imadziwikanso kwambiri mukakhala ndi pakati, komanso mwa amayi omwe amakhala ndi mapasa, atatu, kapena ochulukirapo.

Pemphigoid gestationis matenda

Ngati dokotala akukayikira PG, atha kukutumizirani kwa dermatologist kukayezetsa khungu. Izi zimaphatikizapo kupaka mankhwala oletsa kupweteka m'dera lanu pakhungu laling'ono ndikudula kachidutswa kakang'ono koti katumizidwe ku labotale.

Ngati labu ipeza zizindikiro za pemphigoid pansi pa microscope, ayesanso mayeso omwe amadziwika kuti kusanthula kwa immunofluorescence komwe kungatsimikizire PG.

Dokotala wanu amatenganso zitsanzo zamagazi kuti adziwe kuchuluka kwa antigen ya pemphigoid Collagen XVII / BP180 m'magazi. Izi zingawathandize kuwunika matendawa.

Pemphigoid gestationis chithandizo

Ngati zizindikiro zanu ndizofatsa, dokotala wanu akhoza kukupatsani mankhwala odana ndi itch otchedwa topical corticosteroids. Izi zimakhazikitsa khungu pochepetsa kuchuluka kwa chitetezo chamthupi pamalo omwe ali ndi matuza.

Mankhwala osokoneza bongo (antihistamines) amathanso kuthandizira. Izi ndizophatikiza zomwe sizikugona:

• cetirizine (Zyrtec)
• fexofenadine (Allegra)
• loratadine (Claritin)

Diphenhydramine (Benadryl) imayambitsa kugona ndipo imamwedwa bwino usiku. Imagwira ngati tulo tothandizira kuphatikiza pazazinthu zake ngati zotchinga.

Zonsezi zimapezeka pa kauntala. Mitundu ya generic ndiyofanana pochita ndi mayina amtunduwu, ndipo nthawi zambiri imakhala yotsika mtengo kwambiri.

Nthawi zonse lankhulani ndi dokotala musanamwe mankhwala aliwonse, ngakhale ogulitsira, mukakhala ndi pakati.

Zithandizo zapakhomo

Dokotala wanu amathanso kunena zithandizo zapakhomo kuti athane ndi kuyabwa komanso kusapeza bwino kwa PG. Izi zingaphatikizepo:

• kusunga khungu ozizira ndi ayezi kapena compresses ozizira
• kukhala m'malo ozizira kapena oziziritsa mpweya
• kusamba mu Epsom mchere kapena kukonzekera oatmeal
• kuvala zovala zabwino za thonje

Milandu yowopsa kwambiri

Pamene kuyabwa ndi kukwiya kuli kovuta kwambiri, dokotala wanu angapereke mankhwala a corticosteroids. Pamene mankhwalawa amachepetsa kuchepa kwa chitetezo cha mthupi, mulingo woyenera wofunikira nthawi zonse uyenera kugwiritsidwa ntchito.

Dokotala wanu azikumbukira zomwe zingakhudze inuyo ndi mwana wanu, komanso musachepetse kuchuluka kwa mankhwala ndi nthawi yake.

Mankhwala osokoneza bongo monga azathioprine kapena cyclosporine atha kugwiritsidwanso ntchito kuthandizira kuchepetsa kuyabwa komanso kusapeza bwino. Kuwunika mosamala zotsatira zoyipa kumafunika. Izi zingaphatikizepo:

• kuwunika kuthamanga kwa magazi kamodzi kapena kawiri pamlungu mwezi woyamba kugwiritsa ntchito
• kuyang'anira ntchito ya impso ndi kuyesa magazi ndi mkodzo
• kuwunika momwe chiwindi chimagwirira ntchito, uric acid, komanso kusala kwa lipid

Pemphigoid gestationis zovuta

Kafukufuku wa 2009 adapeza kuti kuphulika kwa matuza a PG mu trimester yoyamba kapena yachiwiri kumatha kubweretsa zovuta pathupi.

Kafukufukuyu adawunika zolemba za azimayi 61 apakati omwe ali ndi PG ochokera ku United Kingdom ndi Taiwan. Zotsatira zoyipa zomwe zimapezeka mwa amayi omwe amayamba koyambirira (trimester yoyamba kapena yachiwiri) PG adaphatikizapo:

• asanabadwe asanabadwe
• kulemera kochepa kubadwa
• yaying'ono msinkhu wobereka

Ndizofala kwambiri kuti PG iwonekere pambuyo pake. Zikachitika m'gawo loyamba kapena lachiwiri, olemba kafukufuku amalimbikitsa kuti azichita ngati mimba yomwe ili pachiwopsezo chachikulu ndikuwunika mosamala.

Pazifukwa zabwino, phunziroli linapezanso kuti chithandizo cha systemic (oral) corticosteroids sichimakhudza kwambiri zotsatira za mimba.

Maganizo ake

Pemphigoid gestationis ndikutuluka kosowa khungu komwe kumachitika nthawi yayitali mochedwa. Ndizovuta komanso zosasangalatsa, koma osati zowopsa kwa inu kapena mwana wanu.

Pomwe zimachitika koyambirira kwa mimba pamakhala kuwonjezeka pang'ono pamwayi wakubadwa msanga kapena mwana wochepa kwambiri. Kuwunika kwambiri dokotala wanu wa OB-GYN ndikuthandizira chithandizo ndi dermatologist ndikulimbikitsidwa.

Mungafune kulumikizana ndi International Pemphigus ndi Pemphigoid Foundation, yomwe ili ndi magulu azokambirana ndi makochi azinzanu a anthu omwe ali ndi PG.