Anyi la'akari da ciwon sikila Stevens-Johnson (SJS) a matsayin mummunan nau'i na erythema multiforme, wanda shine kanta nau'in hypersensitivity zuwa maganin magani, ciki har da magunguna, ko kamuwa da cuta, kamar herpes ko tafiya mai kwakwalwa wanda shine lalacewa ta hanyar Mycoplasma pneumoniae .
Wasu masana sunyi la'akari da ciwo na Stevens-Johnson a matsayin wani yanayi daban daga erythema multiforme, wanda suke rarraba a cikin ƙananan siffofin erythema multiforme da ƙananan erythema multiforme.
Don yin abin da ya fi rikitarwa, akwai kuma wani mummunan cututtuka na Stevens-Johnson: Toxic Epidermal Necrolysis (TEN), wanda ake kira Lyell's Syndrome.
Stevens-Johnson Syndrome
Kwararrun yara biyu, Albert Mason Stevens da Frank Chambliss Johnson, sun gano ciwo na Stevens-Johnson a shekara ta 1922. Ƙungiyar Stevens-Johnson na iya zama barazanar rayuwa kuma zai iya haifar da mummunan bayyanar cututtuka, irin su manyan fata da zubar da fata.
Cututtuka Stevens-Johnson yana faruwa tare da wani tasiri na kimanin 1.5 zuwa 2 kowace miliyan mutane a kowace shekara, saboda haka yana da kyau sosai. Abin takaici, kimanin kashi 5 cikin dari na mutanen da ke fama da cutar Stevens-Johnson da kuma kashi 30 cikin 100 tare da Toxic Epidermal Necrolysis suna da irin wannan mummunan alamar da basu iya farfado ba.
Yara na kowane zamani da tsofaffi na iya cutar da Stevens-Johnson, kodayake mutanen da ba su da kamuwa da cutar , kamar kamuwa da kwayar cutar HIV , suna iya fuskantar haɗari.
Kwayar cututtuka na Stevens-Johnson Syndrome
Sashin ciwon Stevens-Johnson yana farawa ne tare da kamuwa da cututtuka , irin su zazzaɓi, ciwon makogwaro, da kuma tari. Daga gaba, 1 zuwa 3 bayan kwana uku, yaro da Stevens-Johnson ciwon zai ci gaba:
- wani abin da yake ji daɗi a kan lebe, a cikin kwakwalwarsu (mucosa muccosa), da idanu
- wani raƙuman launin ja, wanda zai iya samun cibiyoyin duhu, ko ci gaba cikin ɓaɓɓuka
- kumburi da fuska, eyelids, da / ko harshe
- ja, idanu jini
- hankali ga hasken (photophobia)
- ƙunƙarar zafi ko yunkuri a cikin baki, hanci, idanu, da kuma mucosa na al'ada, wanda zai haifar da cunkushe
Samun ciwon cututtuka na Stevens-Johnson zai iya haɗawa da ciwon daji da kuma makanta, pneumonitis, myocarditis, hepatitis, hematuria, gazawar koda, da kuma sepsis.
Alamar Nikolsky mai kyau, wanda awancen saman da yaron ya fara a lokacin da aka rubutsa, alama ce mai tsanani na Stevens-Johnson ko kuma ya samo asali a cikin mai guba na Epidermal Necrolysis.
Yarinya kuma an lasafta yana da ciwon ciwon magungunan Epidermal Necrolysis idan suna da fiye da kashi 30 cikin fursunonin epidermal (fata).
Dalili na Stevens-Johnson Syndrome
Kodayake magunguna fiye da 200 na iya haifar ko haifar da ciwo na Stevens-Johnson, mafi yawan sun hada da:
- magunguna (cututtuka ko cututtuka), ciki har da Tegretol (Carbamazepine), Dilantin (Phenytoin), Phenobarbital, Depakote (Valproic Acid), da Lamictal (Lamotrigine)
- sulfonamide maganin rigakafi, kamar Bactrim (Trimethoprim / Sulfamethoxazole), wanda aka sau da yawa amfani da mu bi da UTIs da MRSA
- beta-lactam maganin rigakafi, ciki har da penicillins da cephalosporins
- kwayoyin cutar anti-inflammatory, musamman ma irin nau'in oxicam, irin su Feldene (Piroxicam) (ba a saba wa yara ba)
- Zyloprim (allopurinol), wadda ake amfani dasu don biyan gout
Ana tunanin yawan ciwo na Stevens-Johnson da ake haifar da halayen miyagun ƙwayoyi, amma cututtuka da za a iya haɗuwa da ita zai iya haɗawa da waɗanda aka lalacewa ta hanyar:
- herpes simplex cutar
- Mycoplasma pneumoniae kwayoyin cuta (tafiya mai ciwon huhu)
- hepatitis C
- Tarihin capsulatum tarihi (Histoplasmosis)
- Epstein-Barr cutar ( daya )
- Adenovirus
Jiyya ga Stevens-Johnson Syndrome
Hanyoyin maganin ciwo na Stevens-Johnson yana farawa ta hanyar dakatar da duk wani magani da zai iya haifar da amsawa sannan kuma ya taimakawa har sai mai yin haƙuri zai dawo cikin kusan makonni hudu.
Wadannan marasa lafiya sau da yawa suna buƙatar kulawa a Ƙungiyar Kulawa Mai Kula, tare da jiyya wanda zai iya haɗawa da:
- IV ruwaye
- abubuwan kari
- maganin rigakafi don magance cututtuka na biyu
- magunguna na shan magani
- kulawa da rauni
- magunguna da kuma immunoglobulin intravenous (IVIG), ko da yake yin amfani da su har yanzu yana da rikici
Magungunan cututtuka na Stevens-Johnson kullum suna hadewa a cikin wata ƙungiya, tare da likitan ICU, likitan ilimin lissafi, likitan magunguna, masanin ilimin likitancin mutum, da kuma gastroenterologist.
Dole ne iyaye su nemi magunguna nan da nan idan sunyi tunanin cewa yaro zai iya samun ciwo na Stevens-Johnson.
Sources:
Habif: Clinical Dermatology, 5th ed.
Kliegman: Nelson Rubutun Ilimin Harkokin Yara da Hoto, 18th ed.
Koh MJ. Ƙungiyar Stevens-Johnson da kuma ƙananan ƙwayoyin cuta a cikin yara Asiya. J Am Acad Dermatol - 01-JAN-2010; 62 (1): 54-60.
Mandell: Dokokin Mandell, Douglas, da kuma Bennett da Dokokin Cututtukan Cututtuka, 7th ed.
Natacha Lawi, PharmD. Magunguna kamar yadda ƙananan kwayoyin cutar na Stevens-Johnson Syndrome da Toxic Epidermal Necrolysis a cikin Yara: A Mahimman Bincike. Pediatrics, Feb 2009; 123: e297 - e304.