Necrotizing vasculitis

Necrotizing vasculitis iboka rematambudziko anosanganisira kuzvimba kwemidziyo yeropa. Kukura kwemitsipa yeropa yakakanganiswa kunobatsira kuona mazita emamiriro aya uye kuti chirwere ichi chinokonzera sei chirwere.

Necrotizing vasculitis inogona kunge iri yekutanga mamiriro senge polyarteritis nodosa kana granulomatosis ine polyangiitis (yaimbonzi Wegener granulomatosis). Mune zvimwe zviitiko, iyo vasculitis inogona kuitika sechikamu cheimwe hosha, senge systemic lupus erythematosus kana hepatitis C.

Chikonzero chekuzvimba hachizivikanwe. Izvo zvinogona kunge zvine chekuita ne autoimmune zvinhu. Rusvingo rwemutsipa weropa runogona kuvava uye kuita gohwo kana kufa (kuva necrotic). Mudziyo weropa unogona kuvhara, uchikanganisa kuyerera kweropa kumatishu aanopa. Kushaikwa kweropa kuyerera kunokonzera kuti nyama dzife. Dzimwe nguva mutsipa weropa unogona kutyoka nekubuda ropa (kutsemuka).

Necrotizing vasculitis inogona kukanganisa mitsipa yeropa mune chero chikamu chemuviri. Naizvozvo, zvinogona kukonzera matambudziko paganda, huropi, mapapu, ura, itsvo, huropi, majoini kana chero imwe nhengo.

Fivha, kutonhora, kuneta, arthritis, kana kurasikirwa uremu zvinogona kunge zviri izvo chete zviratidzo pakutanga. Zvisinei, zviratidzo zvinogona kunge zviri munenge chero chikamu chemuviri.

Ganda:

• Akatsvuka kana epepuru ane mavara ane makumbo, maoko kana zvimwe zvikamu zvemuviri
• Bhuruu bhuruu kuminwe nezvigunwe
• Zviratidzo zverufu kufa nekuda kwekushayikwa kweoksijeni senge kurwadziwa, kutsvuka, uye maronda asingarape

Tsandanyama uye majoini:

• Joint kurwadziwa
• Kurwadziwa kwegumbo
• Tsvina kushaya simba

Ubongo uye huta hurongwa:

• Marwadzo, chiveve, kurira neruoko, gumbo, kana imwe nzvimbo yemuviri
• Kuneta kweruoko, gumbo, kana imwe nzvimbo yemuviri
• Vadzidzi vakaenzana saizi
• Eyelid ichinyura
• Kumedza kuoma
• Kukanganisa kutaura
• Kufambisa kunetseka

Mapapu uye nzira yekufema:

• Kukosora
• Kufema kwekufema
• Sinus kuzara uye kurwadziwa
• Kukosora ropa kana kubuda ropa mumhino

Zvimwe zviratidzo zvinosanganisira:

• Marwadzo emudumbu
• Ropa mune weti kana zvigaro
• Hoarseness kana kuchinja izwi
• Kurwadziwa pachifuva kubva mukukuvara kwetsinga dzinopa moyo (coronary arteries)

Anopa hutano anozoongorora bvunzo. A nervous system (neurological) bvunzo inogona kuratidza zviratidzo zvekukuvara kwetsinga.

Miedzo inogona kuitwa inosanganisira:

• Yakazara kuverenga kweropa, yakazara kemisitiri pani, uye urinalysis
• Chest x-ray
• C-inoshanda mapuroteni bvunzo
• Sedimentation mwero
• Hepatitis ropa bvunzo
• Ropa bvunzo yezvirwere zvinopesana neutrophils (ANCA antibodies) kana nyukiliya maantigen (ANA)
• Ropa bvunzo ye cryoglobulins
• Ropa bvunzo yekuwedzera mazinga
  
• Kufungidzira zvidzidzo zvakadai seangiogram, ultrasound, computed tomography (CT) scan, kana magnetic resonance imaging (MRI)
• Biopsy yeganda, mhasuru, nhengo yemuviri, kana tsinga

Corticosteroids inopihwa kazhinji. Muyero unoenderana nekuti mamiriro acho akaipa sei.

Mimwe mishonga inodzvinyirira immune immune inogona kudzora kuzvimba kwemitsipa yeropa. Izvi zvinosanganisira azathioprine, methotrexate, uye mycophenolate. Iyi mishonga inowanzo shandiswa pamwe necorticosteroids. Iko kusanganiswa kunoita kuti zvikwanise kudzora chirwere ichi nedosi yakaderera yecorticosteroids.

Kune chirwere chakakomba, cyclophosphamide (Cytoxan) yanga ichishandiswa kwemakore mazhinji. Zvisinei, rituximab (Rituxan) inoshanda zvakaenzana uye haina chepfu.

Munguva pfupi yapfuura, tocilizumab (Actemra) yakaratidzirwa kuve inoshanda kune hofori cell arteritis saka iyo muyero corticosteroids inogona kuderedzwa.

Necrotizing vasculitis inogona kuve yakakomba uye inotyisidzira hupenyu. Mhedzisiro yacho inoenderana nenzvimbo yevasculitis uye kuomarara kwekukuvara kwenyama. Matambudziko anogona kuitika kubva kuchirwere uye kubva kumishonga. Mazhinji mafomu e necrotizing vasculitis anoda kwenguva refu yekutevera uye kurapwa.

Zvinetso zvinogona kusanganisira:

• Kukuvadza kusingaperi kune chimiro kana mashandiro enzvimbo yakakanganiswa
• Matambudziko echipiri encrotic tishu
• Zvimwe zvinokanganisa kubva kumishonga inoshandiswa

Fonera mupi wako kana iwe uine zviratidzo zve necrotizing vasculitis.

Emergency zviratidzo zvinosanganisira:

• Matambudziko muzvikamu zvinopfuura chimwe chemuviri senge sitiroko, arthritis, kuputika kwakakomba kweganda, kurwadziwa mudumbu kana kukosora ropa.
• Shanduko muhukuru hwemudzidzi
• Kurasikirwa kwekushanda kweruoko, gumbo, kana imwe nhengo yemuviri
• Zvinetso zvekutaura
• Kumedza kuoma
• Kushaya simba
• Kutambudzika kwakanyanya kwepamuviri
  

Iko hakuna inozivikanwa nzira yekudzivirira iyi kusagadzikana.

• Kutenderera system

Jennette JC, Falk RJ. Renal uye systemic vasculitis. Muna: Feehally J, Floege J, Tonelli M, Johnson RJ, eds. Yakakwana Kliniki Nephrology. 6th ed. Philadelphia, PA: Elsevier; 2019: chitsiko 25.

Jennette JC, Weimer ET, Kidd J. Vasculitis. Mune: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis uye Management nemaLabhoritari Maitiro. 23 ed. St Louis, MO: Elsevier; 2017: chits. 53.

Rhee RL, Hogan SL, Poulton CJ, et al. Maitiro emhedzisiro yenguva refu pakati pevarwere vane antineutrophil cytoplasmic antibody-inosanganisirwa vasculitis ine chirwere chetsvo. Arthritis Rheumatol. 2016; 68 (7): 1711-1720. PMID: 26814428 www.ncbi.nlm.nih.gov/pubmed/26814428.

Anotsanangura U, Merkel PA, Seo P, et al. Kubudirira kwekuregererwa-induction regimens yeANCA-inosangana vasculitis. N Engl J Med. 2013; 369 (5): 417-427. PMID: 23902481 www.ncbi.nlm.nih.gov/pubmed/23902481.

Dombo JH, Klearman M, Collinson N. Kuedzwa kwe tocilizumab mu giant-cell arteritis. N Engl J Med. 2017; 377 (15): 1494-1495. PMID: 29020600 www.ncbi.nlm.nih.gov/pubmed/29020600.