Vakuru Zvichiri hosha

Chirwere cheVakuru Zvichiri (ASD) chirwere chisingawanzoite chinokonzera kupisa kwakanyanya, mapundu, uye kurwadziwa kwemajoini. Inogona kutungamira kune yenguva refu (isingagumi) arthritis.

Chirwere cheVakuru Zvichiri chakakomba vhezheni yevechidiki idiopathic arthritis (JIA), inoitika muvana. Vakuru vanogona kuve nemamiriro akafanana, kunyangwe zviri zvishoma zvakajairika. Izvo zvinodaidzwawo kuti vakuru-kutanga Zvichiri chirwere (AOSD).

Vashoma pane munhu mumwe pavanhu zviuru zana vanogadzira ASD gore rega rega. Inobata vakadzi kakawanda kupfuura varume.

Chikonzero chevakuru Chirwere hachizivikanwe. Hapana zvinhu zvine njodzi zvechirwere zvakaonekwa.

Vanenge vese vanhu vane chirwere vanozove nefivha, kurwadza kwemajoini, huro, uye mapundu.

• Marwadzo akabatana, kudziya, uye kuzvimba zvakajairika. Kazhinji kazhinji, majoini akati wandei anobatanidzwa panguva imwe chete. Kazhinji, vanhu vane mamiriro acho vane kuomarara kwemangwanani kwemajoini anogara kwemaawa akati wandei.
• Fivha inouya nekukurumidza kamwe pazuva, kazhinji masikati kana manheru.
• Iko kumhanyisa kweganda kunowanzo salmon-pink pink uye inouya ichienda nefivha.

Zvimwe zviratidzo zvinosanganisira:

• Kutambudzika kwepamuviri uye kuzvimba
• Marwadzo paunotora mweya wakadzika (pleurisy)
• Huro inorwadza
• Kuzvimba lymph nodes (glands)
• Kuonda

Iyo spleen kana chiropa inogona kuzvimba. Mapapu uye moyo kuzvimba kunogona kuitika.

AOSD inogona kuongororwa chete mushure mezvimwe zvirwere zvakawanda (zvakadai sehutachiona uye gomarara) zvinodzorwa kunze. Unogona kuda kuongororwa kwakawanda kwachiremba usati waonekwa.

Kuongorora kwepanyama kunogona kuratidza fivha, kuputika, uye arthritis. Anopa hutano anoshandisa stethoscope kuteerera shanduko mukunzwika kwemoyo wako kana mapapu.

Kuongororwa kweropa kunotevera kunogona kubatsira pakuongorora vanhu vakuru Chirwere:

• Yakazara kuverenga kweropa (CBC), inogona kuratidza huwandu hwakawanda hwesero chena reropa (granulocytes) uye yakaderedzwa nhamba yemasero matsvuku eropa.
• C-inoshanda mapuroteni (CRP), chiyero chekuzvimba, ichave yakakwira kupfuura zvakajairwa.
• ESR (sedimentation rate), chiyero chekuzvimba, ichave yakakwira kupfuura zvakajairwa.
• Chikamu cheFerritin chichava chakakwira kwazvo.
• Chikamu cheFibrinogen chichava chakakwirira.
• Chiropa chebasa bvunzo chinoratidza yakakwira nhanho yeASST uye ALT
• Rheumatoid factor uye ANA bvunzo ichave isina kunaka.
• Tsika dzeropa uye zvidzidzo zvehutachiona zvichave zvisina kunaka.

Mimwe bvunzo inogona kudikanwa kuti utarise kuzvimba kwemajoini, chipfuva, chiropa, uye spleen:

• Abdominal ultrasound
• CT scan yemudumbu
• X-rays emajoini, chifuva, kana dumbu nzvimbo (dumbu)

Chinangwa chekurapa munhu mukuru Chirwere ndechekudzivirira zviratidzo zveArthritis. Aspirin uye mamwe asiri -steroidal anti-anogumbura (NSAIDs), senge ibuprofen, anonyanya kushandiswa kutanga.

Prednisone inogona kushandiswa kumatambudziko akaipisisa.

Kana chirwere ichi chakanyanya kana kuti chichienderera kwenguva yakareba (chikagara chisingaperi), mishonga inodzvinyirira immune system ingangodiwa. Mishonga yakadaro inosanganisira:

• Methotrexate
• Anakinra (interleukin-1 receptor agonist)
• Tocilizumab (interleukin 6 inhibitor)
• Tumor necrosis factor (TNF) vanopikisa senge etanercept (Enbrel)

Muvanhu vazhinji, zviratidzo zvinogona kudzoka kakawanda pamusoro pemakore mashoma anotevera.

Zviratidzo zvinopfuurira kwenguva yakareba (zvisingaperi) mune chinenge chetatu chevanhu vane munhu mukuru Chirwere.

Chimiro chisingawanzoitika chechirwere, chinonzi macrophage activation syndrome, chinogona kuve chakakomba zvakanyanya nefivha yakanyanya, chirwere chakakomba uye mashoma masero eropa. Iyo pfupa yemongo inobatanidzwa uye biopsy inodiwa kuti kuongororwa.

Zvimwe zvinonetsa zvinogona kusanganisira:

• Arthritis muzvikamu zvakati wandei
• Chiropa chirwere
• Pericarditis
• Kubwinya kwepleural
• Kuwedzera kwepleen

Fonera mupiki wako kana iwe uine zviratidzo zvevakuru Zvichiri chirwere.

Kana iwe watoonekwa kuti une chirwere ichi, unofanirwa kufonera mupiki wako kana uine chikosoro kana kunetseka kufema.

Iko hakuna kunozivikanwa kudzivirira.

Zvichiri hosha - mukuru; Yevakuru-kutanga Zvichiri chirwere; AOSD; Wissler-Fanconi chirwere

Alonso ER, Marques AO. Kukura kwevanhu vakuru kuchiri chirwere. Mu: Hochberg MC, Gravallese EM, Silman AJ, Smolen JS, Weinblatt ME, Weisman MH, eds. Rheumatology. 7th ed. Philadelphia, PA: Elsevier; 2019: chitsiko 173.

Gerfaud-Valentin M, Maucort-Boulch D, Kupisa A, et al. Kukura kwevanhu vakuru kuchiri chirwere: kuratidzwa, kurapwa, mhedzisiro, uye zvekufungidzira zvinhu mune 57 varwere. Mushonga (Baltimore). 2014; 93 (2): 91-99. PMID: 24646465 www.ncbi.nlm.nih.gov/pubmed/24646465.

Kaneko Y, Kameda H, Ikeda K, et al. Tocilizumab mune varwere vane vanhu vakuru-kutanga kuchine chirwere chinoratidzira kurapwa kweglucocorticoid: yakasarudzika, yakapofomara-bofu, inodzora-placebo-inodzorwa chikamu chechitatu kutongwa. Ann Rheum Dis. 2018; 77 (12): 1720-1729. PMID: 30279267 www.ncbi.nlm.nih.gov/pubmed/30279267.

National Sangano reRare Disorders webhusaiti. Zvirwere zvisingawanzoitika.org. Kutanga kwevakuru Chirwere. rarediseases.org/rare-diseases/adult-onset-stills-disease/. Yakasvika March 30, 2019.

Ortiz-Sanjuán F, Blanco R, Riancho-Zarrabeitia L, et al. Kubudirira kweananakinra mune inokonzeresa yevakuru-kutanga Chirwere chirwere: multicenter kudzidza kwevarwere makumi mana nevana uye kuongorora mabhuku. Mushonga (Baltimore). 2015; 94 (39): e1554. PMID: 26426623 www.ncbi.nlm.nih.gov/pubmed/26426623.