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Vasculitis ea li-capillaries tse nyane
Vasculitis ea li-capillaries tse nyane
Ena ke sehlopha se seholo sa vasculitis ea lerako la arterioles, li-venules kapa capillaries, seo ho buuoang ka sona ho fapaneng haholo ho itšetlehile ka hore na ke vasculitis e hloekileng kapa ea systemic cutaneous vasculitis.
Karolo e atileng haholo ea kliniki ke purpura (matheba a pherese a sa timeng ha a hatelloa) a phunyeletsa le ho kenella, haholo-holo maotong a tlase, a mpefatsoa ke ho ema, a ka nka mefuta e mengata (petechial le ecchymotic, necrotic, pustular…) ho etsa mofuta wa letlooeng la purplish (livedo reticularis) kapa mottling (livedo racemosa) maotong. Re ka boela ra bona ketsahalo ea Raynaud (menoana e seng mekae e fetoha e tšoeu serame).
Purpura le Liveo li ka amahanngoa le liso tse ling letlalong (li-papules, nodules, liso tsa necrotic, li-bubble tse tsoang mali), urticaria e tsitsitseng e sa hloekang.
Boteng ba lipontšo ka ntle ho letlalo ke karolo ea matla a khoheli, e bontšang ho ba teng ha methapo ea mali lithong tsa 'mele:
- bohloko ba manonyeletso,
- mahlaba ka mpeng, mantle a matšo, bothata ba ho tsamaea,
- peripheral neuropathy
- edema ea maoto le matsoho a tlase,
- Khatello ea mali ea Hyper,
- mathata a ho hema, asthma, ho khohlela mali ...
Ngaka e fana ka litlhahlobo tse reretsoeng ho fumana sesosa le matšoao a ho teba: tlhahlobo ea mali ka palo ea lisele tsa mali, ho batla ho ruruha, liteko tsa sebete le liphio, joalo-joalo, ho batla mali ka setulong le x-ray ho latela lintlha tsa mohala ( X-ray ea matšoafo ha ho hlaha mathata a ho hema, joalo-joalo).
Vasculitis e bakoang ke tšoaetso:
- baktheria: streptococcus, gram-negative cocci (gonococcus le meningococcus)
- kokoana-hloko: lefu la sebete, mononucleosis e tšoaetsanoang, HIV, joalo-joalo.
- parasitic: malaria ...
- fungal: Candida albicans ...
Vasculitis e amanang le ho se tloaelehe ha immunology
- Mofuta oa II (motsoako oa monoclonal) le III (motsoako oa polyclonal) cryoglobulinemia, o amanang le lefu la autoimmune, tšoaetso (haholo-holo lefu la sebete la C) kapa lefu la mali.
- Hypocomplementémie (Mac Duffie's urticarienne vascularite)
- Hyperglobulinémie (Waldenström's hyperglobulinémique pherese)
- Connectivitis: lupus, lefu la Gougerot-Sjögren, ramatiki ea ramatiki ...
- Vasculitis ea mafu a mali le malignancies
- Leukemia, lymphoma, myeloma, kankere
- Vasculitis e amanang le ANCA (anti-neutrophil cytoplasmic antibodies)
Micro Poly Angéite kapa MPA
Micropolyangiitis (MPA) ke systemic necrotizing angeitis eo matšoao a eona a kliniki a tšoanang haholo le a PAN.
MPA e amahanngoa le ANCA ea mofuta oa anti-myeloperoxidase (anti-MPO) 'me hangata e baka glomerulonephritis e tsoelang pele ka potlako le ho kenya letsoho matšoafong a sieo ho PAN.
Kalafo ea MPA ha e le PAN e qala ka phekolo ea corticosteroid, ka linako tse ling e kopantsoe le immunosuppressants (haholo-holo cyclophosphamide)
Lefu la Wegener
Wegener's granulomatosis ke vasculitis eo qaleho ea eona hangata e tšoauoang ke ENT kapa matšoao a ho hema (sinusitis, pneumopathy, joalo-joalo) e hananang le kalafo ea lithibela-mafu.
Hajoale, ho kenella ha ENT (destructive pansinusitis), pulmonary (parenchymal nodules) le renal (crescent pauci-immune necrotizing glomerulonephritis) ho hlahisa triad ea khale ea Wegener's granulomatosis.
Lera la "cutaneous-mucous" le ama hoo e ka bang 50% ea bakuli: purpura (matheba a pherese a sa nyameleng ha a hatelloa) a phunyehile 'me a kenelletse, li-papules, maqhutsu a ka tlas'a letlalo, maqeba a letlalo, pustules, vesicles, hyperplastic gingivitis ...
ANCA ke teko ea tlhahlobo le ea ho iphetola ha lintho bakeng sa granulomatosis ea Wegener, e nang le cytoplasmic fluorescence (c-ANCA), e nang le granular e ntle e nang le ntlafatso ea perinuclear le / kapa perinuclear fluorescence (p-ANCA).
Tsamaiso ea Wegener's granulomatosis, eo ka linako tse ling e ka nkoang e le tšohanyetso ea bongaka, e lokela ho etsoa sebakeng se khethehileng sa sepetlele, ka motsoako oa cortisone le oral cyclophosphamide.
Lefu la Churg le Strauss
Asthma ke criterion e kholo le ea pele ea vasculitis ena, eo e etellang pele ka karolelano ka lilemo tse 8 pele ho matšoao a pele a vasculitis (neuropathy, mafu a sinus, joalo-joalo) le e tsoelang pele ka mor'a moo.
Liteko tsa mali li bontša ka ho khetheha keketseho e hlakileng ea eosinophilic polynuclear lisele tse tšoeu tsa mali
Kalafo ea lefu la Churg le Strauss e qala ka phekolo ea corticosteroid, ka linako tse ling e kopantsoe le li-immunosuppressants (haholo-holo cyclophosphamide)
Maikutlo a ngaka ea rona
Purpura e kentsoeng (e pherese, e batlang e teteaneng e sa timeng ka khatello ea menoana) ke letšoao la mantlha la vasculitis. Ka bomalimabe, letšoao lena ha se kamehla le leng teng, 'me ho fapana ha matšoao a sa tsitsang hangata ho etsa hore ho be thata ho hlahloba lingaka. Ka mokhoa o ts'oanang, hangata ho thata ho fumana sesosa sa ho phekola vasculitis e nyane ea sejana, e leng eona taba ea bohlokoa ka ho fetisisa e kopaneng le ts'ebetso ea hajoale ha e bapisoa le vasculitis ea sejana se mahareng le se seholo: hoo e ka bang halofo ea vasculitis e nyane ea sejana. likepe ha li na lebaka le fumanoang nakong ea lipatlisiso tsa likokoana-hloko le tsa radiological tseo ngaka e li etsang ho batla etiology. Re atisa ho bua ka "allergic vasculitis" kapa "hypersensitivity vasculitis" kapa ho e-na le "cutaneous vasculitis ea lijana tse nyenyane tsa idiopathic caliber". Dr. Ludovic Rousseau, ngaka ea letlalo |
lifika
Sehlopha sa Thuto ea Vasculitis ea Fora: www.vascularites.org
Dermatonet.com, sebaka sa tlhahisoleseling ka letlalo, moriri le botle ka ngaka ea letlalo
MedicineNet: http://www.medicinenet.com/vasculitis/article.htm