Vasculitis ee xididdada dhexe

Peri Arteritis Nodosa ama PAN

Periarteritis nodosa (PAN) waa necrotizing angeitis oo aad dhif u ah oo saameyn kara xubno badan, taas oo aan si fiican loo ogeyn sababta (qaababka qaarkood ayaa la rumeysan yahay inay xiriir la leeyihiin fayraska cagaarshow B).

Bukaan-socodka ayaa inta badan ku dhaca xaaladdooda guud oo ka sii daraysa miisaan lumis, qandho, iwm.

Xanuunka murqaha ayaa ku jira kala badh kiisaska. Aad bay u daran yihiin, u kala firdhisan yihiin, lama filaan ah ama cadaadis uu kiciyo, kaas oo ciddi kara bukaanka sariirta sababtoo ah xanuunka iyo xanuunka murqaha oo luminaya.

Xanuunka wadajirka ah wuxuu ku badan yahay kala-goysyada durugsan ee waaweyn: jilbaha, anqawyada, xusullada iyo curcurada.

Dhaawaca dareemayaasha loo yaqaan 'multineuritis' ayaa badanaa la arkaa, oo saameeya dhowr neerfo sida sciatica, popliteal dibadda ama gudaha, radial, ulnar ama dareemaha dhexdhexaadka ah waxaana badanaa lala xiriiriyaa bararka qaybta fog. Neuritis-ka aan la daweyn ayaa aakhirka u horseeda atrophy murqaha oo ay galaan dareemaha saameeya.

Vasculitis waxa kale oo uu si dhif ah u saameeyaa maskaxda, taas oo keeni karta suuxdin, hemiplegia, istaroog, ischemia ama dhiigbax.

Calaamadaha soo jeedinaya ee heerka maqaarka ayaa ah purpura (dhibcaha dhogorta leh ee aan libdhin marka la cadaadiyo) bararka iyo gudaha gudaha, gaar ahaan xubnaha hoose ama kuwa nool, samaynta noocyo meshes ah (livedo reticularis) ama mottles (livedo racemosa) oo nadiif ah lugaha. Waxaan sidoo kale arki karnaa ifafaalaha Raynaud (far yar oo qabow ayaa cadaan doona), ama xitaa faraha ama gangrene.

Orchitis (bararka xiniinyaha) waa mid ka mid ah calaamadaha caadiga ah ee PAN, oo uu keeno vasculitis ee halbowlaha xiniinyaha taasoo keeni karta necrosis xiniinyaha.

Xanuunka caabuqa bayoolojiga ayaa ku jira badi bukaanada qaba PAN (kordhinta heerka sedimentation in ka badan 60 mm saacadii ugu horeysay, ee C Reactive Protein, iwm), hyper eosinophilia weyn (kordhinta eosinophilic polynuclear unugyada dhiigga cad).

Caabuqa cagaarshow B wuxuu keenaa joogitaanka antigen-ka HBs qiyaastii ¼ ilaa 1/3 bukaanada

Angiography ayaa daaha ka qaadaya microaneurysms iyo stenosis (hoos u dhaca muuqaalka ama muuqaalka) ee maraakiibta caliber dhexdhexaad ah.

Daawaynta PAN waxay ku bilaabataa daawaynta corticosteroid, oo mararka qaarkood lagu daro difaac difaac (gaar ahaan cyclophosphamide)

Biotherapies waxay ka dhacdaa maamulka PAN, gaar ahaan rituximab (anti-CD20).

Buerger cudurka

Cudurka Buerger ama thromboangiitis obliterans waa angiitis saameeya qaybaha halbowlayaasha yaryar iyo kuwa dhexe iyo xididdada addimada hoose iyo sare, taasoo keenta xinjirowga dhiigga iyo dib u soo kabashada xididdada ay saameeyeen. Cudurkani wuxuu aad ugu badan yahay Aasiya iyo Yuhuuda Ashkenazi.

Waxay ku dhacdaa bukaanka da'da yar (in ka yar 45 sano), inta badan sigaar cabba, kuwaas oo bilaabay inuu soo bandhigo calaamadaha arteritis horaantii nolosha (ischemia faraha ama suulasha, claudication intermittent, boogaha arterial ischaemic ama gangrene lugaha, iwm.)

Arteriography wuxuu muujinayaa dhaawaca xididada fog.

Daawadu waxay ku lug leedahay joojinta sigaarka guud ahaan, taas oo ah kicinta iyo sii xumeynta cudurka.

Dhaqtarku wuxuu u qoraa vasodilators iyo dawooyinka ka hortagga platelet sida aspirin

Waxaa laga yaabaa in loo baahdo qalliin dib-u-qaadis.

Cudurka Kawasaki

Cudurka Kawasaki ama "adeno-cutaneous-mucous syndrome" waa vasculitis si wax ku ool ah u saameeya dhulka halbowlayaasha wadnaha ee ka mas'uulka ah gaar ahaan halbowlayaasha halbowlaha ah kaas oo noqon kara isha dhimashada, gaar ahaan carruurta da'doodu u dhaxayso 6 bilood iyo 5 sano oo leh inta jeer ee ugu sarreysa. da'da 18 bilood.

Cudurku wuxuu ku dhacaa saddex waji dhowr toddobaad gudahood

Marxaladda ba'an (oo socota 7 ilaa 14 maalmood): qandho leh finan iyo muuqaal "bishimaha cherry", "carrab strawberry", "indhaha lagu duro" conjunctivitis laba geesood ah, "ilmo aan raaxaysan karin", barar iyo casaan gacmaha iyo cagaha. Sida habboon, daawaynta waa in la bilaabo marxaladan si loo xaddido khatarta soo noqnoqota wadnaha

Marxaladda hoose (14 ilaa 28 maalmood) taasoo keentay in la dilo saxarka faraha iyo suulasha oo ka bilaabmaya agagaarka ciddiyaha. Waa marxaladdan marka xididdada halbowlayaasha ay sameeyaan

Marxaladda Convalescent, inta badan calaamado ma laha, laakiin inta lagu jiro taas oo ay dhici karto dhibaatooyinka degdega ah ee wadnaha sababtoo ah samaynta aneurysms halbowlaha ah ee wajigii hore.

Calaamadaha kale waxaa ka mid ah finanka xafaayadda, casaan dhalaalaysa oo leh xuubka xuubka, calamadaha wadnaha iyo xididdada dhiigga (xanuunnada wadnaha, qulqulka wadnaha, cilladda wadnaha ee wadnaha, pericarditis, myocarditis ...), dheef-shiid kiimikaad (shuban, matag, calool xanuun ...), Neurological ( meningitis aseptic, gariir , curyaannimo), kaadi malax (malax kaadida, urethritis), polyarthritis.

Caabuqa weyn ee dhiiga waxa lagu muujiyaa Heerka Sedimentation ka badan 100mm saacadii ugu horaysay iyo borotiinka C-reactive oo aad u sarreeya, korodhka muuqda ee unugyada dhiiga cad ee polynuclear oo ka weyn 20 curiye / mm000, iyo korodhka platelet.

Daaweyntu waxay ku salaysan tahay immunoglobulins la isku duro xididka (IV Ig) sida ugu dhaqsaha badan ee suurtogalka ah si loo xaddido halista halbowlaha wadnaha. Haddii IVIG aysan waxtar lahayn, dhakhaatiirtu waxay isticmaalaan cortisone xididka ama aspirin.