Cutar cutar ta atomatik tana haifar da kumburi na jini
Granulomatosis tare da polyangiitis (GPA), wanda aka fi sani da ciwon gine-ginen Wegener, wani cuta ne wanda ke haifar da ƙananan jini a sassa daban-daban na jiki.
Dalilin
Kamar yadda yake tare da duk wani mummunar cuta ta jiki, GPA yana nuna cewa tsarin rashin lafiya ya ɓace. Don dalilan da ba a sani ba, jiki zai kuskuren gano nama na al'ada a cikin jini kamar yadda yake baƙi.
Don ya ƙunshi barazanar da aka sani, ƙwayoyin jiki ba za su kewaye kwayoyin halitta ba kuma su samar da ƙwayar da aka sani da sunan granuloma .
Samun granulomas zai iya haifar da cigaban ciwon kumburi a cikin jini (wanda aka sani da vascularitis ). Yawancin lokaci, wannan zai iya rushe tasoshin kuma ya sa su fashe, yawanci a shafin yanar gizon girma. Hakanan zai iya haifar da jinin da zai kunsa da kunkuntar, yankan jinin jini zuwa sassa na jiki.
GPA yafi rinjayar kananan jini. Yayin da sashin jiki na numfashi, ƙwayoyin cuta, da kodan sune manyan hare-haren kai hare-haren, GPA na iya haifar da lalacewa ga fata, ɗigogi, da kuma tsarin jin tsoro. Zuciya, kwakwalwa, da kuma gastrointestinal tract suna da wuya a shafar su.
GPA tana shafar maza da mata daidai, da farko a tsakanin shekaru 40 zuwa 60. An dauke shi da rashin lafiya wanda ba a sani ba tare da yanayin shekara-shekara na kimanin 10 zuwa 20 na mutane miliyan daya.
Alamomin farko da cututtukan cututtuka
Sakamakon bayyanar GPA ya bambanta da wurin wurin ƙwayar jikin jini. A farkon cutar, cututtuka na iya zama sau da yawa kuma basu da takamaiman irin su hanci mai zafi, zafi na hanci, sneezing, da kuma ƙananan ƙananan yara.
Duk da haka, yayin da cutar ta ci gaba, wasu, mafi tsanani bayyanar cututtuka na iya bunkasa, ciki har da:
- Asarar nauyi
- Wulo
- Rashin ci
- Fever
- Hanci na Hanci
- Chest ciwo (tare da ko ba tare da shortness na numfashi)
- Muryar kunnen bakin ciki
Sakamakon bambancin irin wadannan bayyanar cututtuka na iya sauƙaƙa gane mahimmanci. Ba abin mamaki ba ne, alal misali, don GPA za a ɓoye shi kuma a bi da shi azaman kamuwa da numfashi. Abin sani kawai idan likitoci ba su iya samun shaida akan kwayar cutar ko kwayar cutar da za a iya yin bincike ba, musamman idan akwai shaida na vasculitis.
Kwayoyin cututtuka na jiki
A matsayin kwayar cutar, GPA na iya haifar da rauni daya ko saurin tsarin kwayoyin lokaci daya. Yayinda wuri na bayyanar cututtuka na iya bambanta, dalilin da ya haifar (vascularitis) zai iya nunawa likita a cikin jagorancin ganewar asibiti idan ɓangarori masu yawa sun haɗa.
Tsarin tsarin GPA na iya hada da:
- Rushewar gada mai zurfi ta hanyar tsaka-tsakin septum (wanda aka fi sani da "saddle nose" deformity kama da abin da aka gani tare da dogon lokaci amfani da cocaine)
- Rashin hasara a sakamakon mummunar lalacewa
- Sanarwar ƙwaƙwalwar jijiyar jiki ta haifar da lalacewar kunnen ciki
- A ci gaba da girma granulomatous a sassa na ido
- Canji na murya saboda ƙuntatawar trachea
- Blood a cikin fitsari ( hematuria )
- Rushewar asarar aikin koda zai haifar da gazawar koda
- Wani tari tare da jini mai laushi saboda ciwon jigilar cutar ta jiki da cavities a cikin huhu
- Arthritis (sau da yawa an bincikar da shi azaman rheumatoid arthritis )
- Girman ja ko launi mai laushi a fata ( purpura )
- Ƙuntatawa, tingling, ko ƙonawa da ke cikin lalacewa ( cutar neuropathy )
Hanyar ganewar asali
Binciken da aka gano na GPA shine yawanci ne kawai aka sanya bayan da yawa, alamu ba tare da alaƙa ba zasu iya wucewa ba don dogon lokaci. Duk da yake akwai gwaje-gwaje na jini don gano ƙayyadaddun maganganun da ke tattare da cutar, rashin kasancewa (ko rashin) na kwayar cutar bai isa ba don tabbatar (ko ƙin yarda) wani ganewar asali.
Maimakon haka, an gano magungunan ta hanyar haɗuwa da bayyanar cututtuka, gwaje-gwajen gwaji, hasken rana, da kuma sakamakon binciken jiki.
Wasu kayan aiki zasu iya buƙatar don tallafawa ganewar asali, ciki har da biopsy na nama mai cutar. Tsarin kwayar halitta ne mafi kyawun wuri don farawa ko da kuwa babu alamar cututtuka. Halitta na fili na numfashi na sama, da bambanci, ya kasance mafi mahimmanci tun lokacin da kashi 50 ba zai nuna alamun granulomas ko lalacewar nama ba.
Bugu da ƙari, nau'i na X-ray ko CT scan zai iya bayyana saurin mahaukaci a cikin mutanen da ke aiki tare da aikin huhu.
Tare, haɗuwa da gwaje-gwajen da bayyanar cututtuka na iya zama isa don tallafawa ganewar GPA.
Jiyya na yanzu
Kafin shekarun 1970s, yawancin kwayoyin cutar Wegener an dauke su kusan mutuwa a duniya, mafi yawancin saboda rashin lafiya na numfashi ko cututtuka (wani yanayin da ke ɗauke da matsala mara kyau a cikin jini).
A cikin 'yan shekarun nan, haɗuwa da ƙwayar cuta mai tsayi da kuma magance kwayoyin cututtuka sun tabbatar da samun gafara a cikin kashi 75 cikin dari.
Ta hanyar rage rayuka ƙin kumburi tare da corticosteroids da kuma saurin maganin mota tare da kwayoyi masu gujewa kamar cyclophosphamide, mutane da yawa da GPA zasu iya rayuwa, tsawon rayuwarsu kuma sun kasance a cikin gafara shekaru 20 ko fiye.
Bayan jiyya na farko, yawancin maganin da ake amfani da su a cikin ƙwayoyin cuta na yawanci sukan rage yayin da aka kawo cutar a ƙarƙashin iko. A wasu lokuta, ana iya dakatar da kwayoyi gaba daya.
Cyclophosphamide, wanda ya bambanta, yawanci an umarce shi har zuwa watanni uku zuwa watanni shida sa'an nan kuma ya canza zuwa wani, ba tare da yaduwar cutar ba. Tsawancin farfadowa na farfadowa zai iya bambanta amma yawanci na tsawon shekara daya ko biyu kafin a yi la'akari da canje-canje.
A cikin mutanen da ke fama da cutar mai tsanani, wasu, za a iya buƙatar karin haɗin gwiwar, ciki har da:
- Mafi girma a cikin maganin intravenous
- Ciniki na Plasma (inda aka raba jini don cire autoantibodies)
- Koda dashi
Faɗakarwa
Duk da yawan tsabar kudi, kashi 50 cikin dari na mutanen da ake bi da su zasu fuskanci sake dawowa. Bugu da ƙari, mutane da GPA suna da haɗari ga rikice-rikice na tsawon lokaci, ciki har da rashin gazawar koda, jijiyar sauraro, da kuma kururuwa. Hanya mafi kyau don kauce wa wadannan shi ne tsara jimillar yau da kullum tare da likitanka da jini na yau da kullum da kuma gwajin hoto.
Tare da magance wannan cuta ta dace, kashi 80 cikin dari na waɗanda aka samu nasarar magance marasa lafiya za su rayu na kimanin shekaru takwas. Sabon sababbin hanyoyin maganin rigakafi da kuma abin da ake kira penicillin mai suna CellCept (mycophenolate mofetil) na iya kara inganta sakamakon nan a cikin shekaru masu zuwa.
> Sources:
> Almouhawis, H. Leao, J. Fedele, S. da Porter, S. "Cibiyar granulomatosis na Wegener: nazari akan siffofin asibiti da kuma sabuntawa a cikin ganewar asali da magani." Hanyar Magana ta Maganin Magunguna. 2013; 42: 507-516.
> Fortin, P .; Tejani, A; Bassett, K .; da kuma Musini, V. "Cutar immunoglobulin mai tsanani ciki har da maganin cike da lafiya ga granulomatosis na Wegener." Cochrane Data Syst Rev 2013; 1: DOI: 10.1002 / 14651858.CD007057.pub3
> Silva, S .; Specks, U .; Kaira, S. et al. "" Ƙararren Labaran Na'urar Mafetil don Nunawa da Kula da Saukewa a cikin Polyangiitis Microscopic tare da Ƙarƙashin Ƙarƙashin Ƙarƙashin Ƙarƙashin Ƙaƙwalwar Renal-Wani Tsarin Gwaji, Binciken Jarrabawa na Label. " Clin J Am Soc Nasrol. 2010; 5 (3): 445-453.