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Vasculitis yemadiki capillaries
Vasculitis yemadiki capillaries
Iri iboka rakakura revasculitis yemadziro eArterioles, venule kana capillaries, kufungidzira kwacho kwakasiyana zvakanyanya zvichienderana nekuti yakachena here kana kuti systemic cutaneous vasculitis.
Chirwere chemakiriniki chinowanzoitika ndechekuti purura (nzvimbo dzinopenya dzisingadzimiki kana dzakamanikidzwa) kubhururuka nekupinda, kunyanya mumakumbo ezasi, zvinowedzerwa nekumira, zvinogona kutora mafomu akati wandei (petechial uye ecchymotic, necrotic, pustular…) kana livedo, kuumba mhando yepepuru mesh (livedo reticularis) kana mottling (livedo racemosa) pamakumbo. Isu tinogona zvakare kucherechedza chiitiko chaRaynaud (minwe mishoma inoshanduka kuva chena muchando).
Purpura uye livedo inogona kuve yakabatana nemamwe maronda paganda (mapuru, ma nodule, maronda ecrotic, kubuda ropa mabhuru), yakagadziriswa urticaria isinga rukure.
Kuvapo kwekuratidzwa kunze kweganda kunoumba giravhiti, kuratidza kuvepo kwekubatanidzwa kwevascular munhengo:
- kurwadza kwemajoini,
- kurwadziwa mudumbu, zvituru zvitema, kutama kusagadzikana,
- peripheral neuropathy
- edema yemakumbo epasi,
- Hyper Ropa Kudzvinyirira,
- kutadza kufema, asima, kukosora ropa…
Chiremba anonyora bvunzo dzakanangana nekutsvaga chikonzero uye zviratidzo zvekukomba: kuongororwa kweropa neropa masero kuverenga, kutsvaga kuzvimba, kuongororwa kwechiropa uye itsvo, nezvimwewo, kutsvaga ropa muzvituru uye ma-x-ray maererano nenzvimbo dzekufona ( mapapu x-ray mune chiitiko chekufema kunetseka, nezvimwewo).
Vasculitis inokonzerwa nehutachiona:
- bhakitiriya: streptococcus, gram-negative cocci (gonococcus uye meningococcus)
- hutachiona: hepatitis, inotapukira mononucleosis, HIV, nezvimwe.
- chisvetasimba: marariya…
- fungal: Candida albicans…
Vasculitis inosangana nehutachiona husina kujairika
- Type II (yakavhenganiswa monoclonal) uye III (yakavhenganiswa polyclonal) cryoglobulinemia, inosangana ne autoimmune chirwere, hutachiona (kunyanya hepatitis C) kana chirwere cheropa.
- Hypocomplementémie (Mac Duffie's urticarienne vascularite)
- Hyperglobulinémie (Waldenström's hyperglobulinémique yepepuru)
- Connectivitis: lupus, Gougerot-Sjögren syndrome, rheumatoid arthritis…
- Vasculitis yezvirwere zveropa uye malignancies
- Leukemia, lymphoma, myeloma, gomarara
- Vasculitis inosangana neANCA (anti-neutrophil cytoplasmic antibodies)
Micro Poly Angéite kana MPA
Micropolyangiitis (MPA) ndeye systemic necrotizing angeitis ine kiriniki zviratidzo zvakafanana neiyo yePAN.
MPA inosanganisirwa neANCA yema anti-myeloperoxidase (anti-MPO) mhando uye inowanzo kupa kumwe kukurumidza kufambira mberi glomerulonephritis nekubatana kwemapapu kusipo muPAN.
Kurapa kweMPA sePAN kunotanga necorticosteroid therapy, dzimwe nguva inosanganiswa nemunosuppressants (cyclophosphamide kunyanya)
Wegener chirwere
Wegener's granulomatosis ndeye vasculitis kutanga kwayo kunowanzo kuverengerwa neET kana zviratidzo zvekufema (sinusitis, pneumopathy, nezvimwewo) zvinopesana nemishonga inorwisa mabhakitiriya.
Zvekare, zvinopararira ENT (inoparadza paninusitis), pulmonary (parenchymal nodules) uye renal (crescent pauci-immune necrotizing glomerulonephritis) kubatanidzwa kunogadzira iyo yechitatu triad ye Wegener's granulomatosis.
Iyo inocheka-mucous membrane inokanganisa angangoita 50% yevarwere: purpura (purplish mavara asingatsakatika kana akatsimbirirwa) kubhururuka uye kupinda, mapuru, subcutaneous nodules, maronda eganda, pustules, vesicles, hyperplastic gingivitis…
ANCA kuongororwa uye kushanduka kweiyo Wegener's granulomatosis, ine cytoplasmic fluorescence inopararira (c-ANCA), yakanyatsoita granular ine peinuclear yekuvandudza uye / kana chete perinuclear fluorescence (p-ANCA).
Iwo manejimendi eWegener's granulomatosis, ayo anogona dzimwe nguva kutariswa seanokurumidzira ekurapa, anofanirwa kuitirwa munzvimbo yakasarudzika yechipatara, nekubatanidzwa kwecortisone nemuromo cyclophosphamide.
Churg uye Strauss chirwere
Asima ndiyo yakakosha uye yekutanga nzira yeiyi vasculitis, iyo inotangira paavhareji nemakore masere pamberi pezviratidzo zvekutanga zvevasculitis (neuropathy, sinus disorders, nezvimwewo) uye izvo zvinoramba zvichitevera.
Kuongororwa kweropa kunoratidza kunyanya kuwedzera kwakajeka kwemasero eropa eosinophilic polynuclear machena
Kurapa kweChurg uye Strauss chirwere kunotanga nekorticosteroid therapy, dzimwe nguva inosanganisirwa nema immunosuppressants (kunyanya cyclophosphamide)
Maonero echiremba wedu
Yakapindirwa purpura (purplish, yakati wandei makwapa makobvu asinga peri nemunwe kudzvinyirira) ndiyo kiyi chiratidzo chevasculitis. Nehurombo, chiratidzo ichi hachiwanzo kuve chiripo uye misiyano yezvisingazivikanwe zviratidzo zvemakiriniki zvinowanzoita kuti kuongororwa kuomere vanachiremba. Saizvozvowo, zvinowanzoomera kuwana chikonzero chekurapa mune diki mudziyo vasculitis, inova ndiyo inonyanya kukosha kesi inosangana mune yazvino maitiro ichienzaniswa neyepakati uye hombe mudziyo vasculitis: inenge hafu yediki diki vasculitis. ngarava hadzina chikonzero chinowanikwa panguva yekuongorora uye kweredhiyo kunoitwa nachiremba kutsvaga etiology. Isu tinowanzo taura nezve "allergic vasculitis" kana "hypersensitivity vasculitis" kana kuti pane "cutaneous vasculitis yemidziyo midiki yeidiopathic caliber". Dr. Ludovic Rousseau, dermatologist |
varipo
French Vasculitis Yekudzidza Boka: www.vascularites.org
Dermatonet.com, saiti yeruzivo paganda, bvudzi uye runako nedermatologist
MedicineNet: http://www.medicinenet.com/vasculitis/article.htm