Vasculitis ee xididada yaryar

Vasculitis ee xididada yaryar

Vasculitis ee xididada yaryar  

Tani waa koox weyn oo ah vasculitis ee darbiga arterioles, venules ama capillaries, saadaasha taas oo ah mid aad u kala duwan iyadoo ku xiran haddii ay tahay mid saafi ah ama habaysan vasculitis maqaarka.

Midka ugu caansan ee daaweynta waa purpura (dhibcaha dhogorta leh ee aan libdhin marka la cadaadiyo) barar iyo dhexgal, gaar ahaan lugaha hoose, oo ay ka sii daraan joogsiga, taas oo qaadan karta qaabab badan (petechial iyo ecchymotic, necrotic , pustular ...) ama livedo, samaynta nooc ka mid ah mesh guduudan (livedo reticularis) ama mottling (livedo racemosa) ee lugaha. Waxaan sidoo kale u fiirsan karnaa ifafaale Raynaud (far yar oo qabow ayaa cadaan doona).

Purpura iyo livedo waxaa laga yaabaa inay la xiriiraan nabarada kale ee maqaarka (papules, nodules, lesions necrotic, xumbo dhiigbaxa), urtikaria go'an oo aan cuncun.

Joogitaanka muuqaalada ka baxsan maqaarka ayaa ka dhigan cunsur cufan, taasoo muujinaysa joogitaanka ku lug lahaanshaha xididdada dhiigga ee xubnaha:

  • kalagoysyo xanuun,
  • calool xanuun, saxaro madow, cillad ku-meel-gaar ah,
  • neuropathy peripheral
  • bararka lugaha hoose,
  • Dhiig karka,
  • neefsashada oo ku adkaata, neefta, qufaca dhiiga…

Dhaqtarku wuxuu qoraa baaritaanno loogu talagalay in lagu raadiyo sababta iyo calaamadaha halista: baaritaanka dhiigga oo leh tirada unugyada dhiigga, raadinta caabuqa, baaritaanka beerka iyo kelyaha, iwm., ka raadi dhiigga saxarada iyo raajada iyadoo loo eegayo qodobbada wacitaanka ( raajo sambabada haddii ay dhacdo dhibaato neefsasho, iwm.).

Vasculitis oo uu keeno caabuqa:

  • bakteeriyada: streptococcus, cocci garaam-negative (gonococcus iyo meningococcus)
  • viral: cagaarshow, mononucleosis infekshanka, HIV, iwm.
  • dulin: duumada…
  • fungal: Candida albicans

Vasculitis oo la xiriirta cilladaha difaaca jirka

  • Nooca II (monoclonal isku dhafan) iyo III (polyclonal isku dhafan) cryoglobulinemia, oo la xidhiidha cudurrada difaaca jirka, caabuqa (gaar ahaan cagaarshow C) ama cudurka dhiigga
  • Hypocomplementémie (Mac Duffie's urticarienne vascularite)
  • Hyperglobulinémie (Waldenström's hyperglobulinémique guduud)
  • Connectivitis: lupus, Gougerot-Sjögren syndrome, rheumatoid arthritis-ka
  • Vasculitis ee cudurrada dhiigga iyo malignancies
  • Leukemia, lymphoma, myeloma, kansarka
  • Vasculitis la xiriirta ANCA (anti-neutrophil cytoplasmic antibodies)   

Micro Poly Angéite ama MPA

Micropolyangiitis (MPA) waa necrotizing angeitis oo calamadaha caafimaadku ay aad ula mid yihiin kuwa PAN.

MPA waxay la xiriirtaa ANCA ee nooca anti-myeloperoxidase (anti-MPO) waxayna sida caadiga ah keentaa glomerulonephritis oo si degdeg ah u socda iyo ka qayb qaadashada sambabada oo ka maqan PAN.

Daawaynta MPA ee PAN waxay ku bilaabataa daawaynta corticosteroid, mararka qaarkoodna lagu daro immunosuppressants (gaar ahaan cyclophosphamide)

Cudurka Wegener

Wegener's granulomatosis waa vasculitis bilawga ah kaas oo guud ahaan lagu calaamadiyo ENT ama calaamadaha neefsashada (sinusitis, pneumopathy, iwm.) oo u adkaysta daaweynta antibiyootiga.

Sida caadiga ah, ku lug lahaanshaha ENT (pansinusitis burburiya), sambabada (nodules parenchymal) iyo kelyaha (crescent pauci-immune necrotizing glomerulonephritis) waxay soo saartaa saddex-geesoodka caadiga ah ee granulomatosis Wegener.

Xuubka maqaarka-xuubka-xuubka ah waxa uu saameeyaa qiyaastii 50% bukaannada: purpura (dhibcaha dhogorta leh ee aan baaba'anayn marka la cadaadiyo) barar iyo faleebo, papules, nodules subcutaneous, boogaha maqaarka, malax, vesicles, cirridka hyperplastic ...

ANCA waa baaritaan ogaanshaha iyo korriinka ee Wegener's granulomatosis, oo leh fayloorescence cytoplasmic firdhisan (c-ANCA), si quruxsan granular leh kobcinta perinuclear iyo / ama kaliya fluorescence perinuclear (p-ANCA).

Maareynta granulomatosis ee Wegener, oo mararka qaarkood loo tixgelin karo xaalad degdeg ah, waa in lagu sameeyaa goob isbitaal oo gaar ah, iyada oo la isku daray cortisone iyo cyclophosphamide afka.

Churg iyo Strauss cudurka

Neeftu waa halbeeg weyn iyo mid hore oo lagu garto vasculitis-ka, kaas oo celcelis ahaan ka horreeya 8 sano ka hor calaamadaha ugu horreeya ee vasculitis (neuropathy, sinus disorders, iwm.) oo sii socota ka dib.

Tijaabooyinku waxay muujinayaan gaar ahaan koror cad oo ah unugyada dhiiga cad ee polynuclear eosinophilic

Daawaynta cudurka Churg iyo Strauss waxay ku bilaabataa daawaynta corticosteroid, mararka qaarkoodna lagu daro difaac difaac (gaar ahaan cyclophosphamide)

Fikirka dhakhtarkayaga    

Purpura la dhex galiyay (purplish, dhogor dhumuc yar leh oo aan ku baabba'in cadaadiska farta) waa calaamada ugu muhiimsan ee xididdada dhiigga.

Nasiib darro, calaamadani had iyo jeer ma jirto oo kala duwanaanshaha calaamadaha caafimaad ee aan la cayimin waxay inta badan ka dhigtaa ogaanshaha mid adag dhakhaatiirta.

Sidoo kale, inta badan way adag tahay in la helo sabab lagu daweeyo vasculitis maraakiibta yaryar, taas oo ilaa hadda ah kiiska ugu muhiimsan ee la kulma dhaqanka hadda jira marka la barbardhigo xididdada dhexdhexaadka ah iyo kuwa waaweyn: qiyaastii kala badh vasculitis yar yar. maraakiibta wax sabab ah looma helin inta lagu jiro sahaminta bayooloji iyo shucaaca ee uu takhtarku sameeyo si uu u raadiyo etiology. Waxaan inta badan ka hadalnaa "xasaasiyadda vasculitis" ama "vasculitis hypersensitivity" ama halkii "vasculitis xuubka ah ee maraakiibta yaryar ee caliber idiopathic".

Dr. Ludovic Rousseau, dhakhtarka maqaarka

 

Bartilmaameedyo

Kooxda Daraasada Vasculitis-ka Faransiiska: www.vascularites.org

Dermatonet.com, goobta macluumaadka ee maqaarka, timaha iyo quruxda dhakhtarka maqaarka

MedicineNet: http://www.medicinenet.com/vasculitis/article.htm

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