ʻO Sarcoidosis

ʻO Sarcoidosis kahi maʻi kahi e loaʻa ai ka mumū i nā lymph node, nā mumū, ke ake, nā maka, ka ʻili, a me / a i ʻole nā ​​mea ʻē aʻe.

ʻAʻole ʻike ʻia ke kumu kūpono o ka sarcoidosis. ʻO ka mea i ʻike ʻia inā loaʻa ka maʻi i kekahi kanaka, kū nā puʻupuʻu liʻiliʻi o nā kiko ʻole (granulomas) i kekahi mau lālā o ke kino. ʻO nā Granulomas nā huhui o nā hunaola pale.

Hiki i ka maʻi ke hoʻopili i nā mea ola āpau. Hoʻohui pinepine ia i nā akemāmā.

Manaʻo nā kauka ʻo ka loaʻa ʻana o kekahi mau gen i mea e ulu ai ke kanaka i ka sarcoidosis. ʻO nā mea e hoʻonāukiuki i ka maʻi e hoʻopili pū me nā maʻi me nā koʻohune a i ʻole nā ​​virus. ʻO ka launa pū ʻana me ka lepo a me nā kemika paha kahi mea e hoʻomaka ai.

ʻOi aku ka maʻi ma nā ʻAmelika ʻApelika a me ka poʻe keʻokeʻo o ka hoʻoilina Scandinavian. ʻOi aku nā wahine ma mua o nā kāne i ka maʻi.

Hoʻomaka pinepine ka maʻi ma waena o 20 a 40 mau makahiki. Sarcoidosis laha ʻole i nā keiki ʻōpio.

ʻO ke kanaka me kahi pili koko pili loa i loaʻa ka sarcoidosis kokoke i 5 mau manawa e hoʻomohala i kēia ʻano.

ʻAʻohe paha ʻōuli. Ke hiki mai nā ʻōuli, hiki iā lākou ke hoʻopili i kēlā me kēia ʻāpana o ke kino a i ʻole ka ʻola.

Loaʻa i nā poʻe āpau e hoʻopili ʻia e sarcoidosis ka maʻi a me nā ʻōpū o ka umauma:

• ʻO ka ʻeha o ka umauma (ʻo ka manawa pinepine ma hope o ka iwi umauma)
• Mū maloo
• Pokole o ka hanu
• ʻApu ʻana i ke koko (laha ʻole, akā koʻikoʻi)
  

Pākuʻi ʻia paha nā ʻōuli o ka hōʻoluʻolu maʻamau:

• Ka luhi
• Fiva
• ʻEha ʻeha a ʻeha paha (arthralgia)
• Kaumaha emi

Pākuʻi ʻia paha nā ʻōuli o ka ʻili:

• Lilo ka lauoho
• Hoʻonui ʻia, ʻulaʻula, ʻili ʻili (erythema nodosum), ʻaneʻane mau i ka ʻaoʻao mua o nā wāwae lalo
• Rash
• Nā scars e hoʻokiʻekiʻe a i ʻole hoʻāhu

Pākuʻi ʻia paha nā ʻōnaehana nervous:

• ʻEha poʻo
• Ka hopu ʻana i nā maʻi
• Nāwaliwali ma kekahi ʻaoʻao o ka maka

Pākuʻi ʻia nā ʻōuli o ka maka me:

• Hoʻā ʻana
• Hoʻokuʻu mai ka maka
• Nā maka maloʻo
• Kāwili
• ʻEha
• Lilo hihio

ʻO nā ʻōuli ʻē aʻe o kēia maʻi e komo pū paha:

• Waha maloo
• Pākuʻi hoʻomaloka, inā pili ka puʻuwai
• Nosebleed
• ʻO ka pehu ʻana ma ka ʻaoʻao luna o ka ʻōpū
• Maʻi maʻi ate
• ʻO ka pehu ʻana o nā wāwae inā pili ka naʻau a me ka māmā
• Rhythm puʻuwai maʻamau inā pili ka puʻuwai

E hana ka mea mālama ola i kahi hoʻokolokolo kino a nīnau e pili ana i nā hōʻailona.

Hiki i nā hoʻokolohua kiʻi ʻokoʻa ke kōkua i ka diagnose sarcoidosis:

• ʻIke i ka x-ray e ʻike inā pili ka nāhāhā a hoʻonui ʻia paha nā lymph
• CT scan o ka umauma
• ʻO ka loiloi gallium lung (hana ʻole ʻia i kēia manawa)
• Nā hoʻokolohua kiʻi o ka lolo a me ke ake
• ʻO Echocardiogram a i ʻole MRI o ka puʻuwai

No ke kuhi ʻana i kēia ʻano, koi ʻia kahi biopsy. Hana pinepine ʻia ka Biopsy o ka māmā me ka hoʻohana ʻana i ka bronchoscopy. Hiki ke hana ʻia nā biopsies o nā kino o ke kino.

E hana ʻia paha nā hoʻokolohua lab penei:

• Nā pae pālolo (mimi, ionized, koko)
• CBC
• Immunoelectrophoresis
• Nā hoʻāʻo hana ate
• Nā immunoglobulins nui
• Pākuʻi
• ʻO ka Angiotensin hoʻololi i ka enzyme (ACE)

ʻOi aku ka maikaʻi o nā hōʻailona Sarcoidosis me ka ʻole o ka lāʻau.

Inā pili ka maka, puʻuwai, ʻōnaehana, a i ʻole nā ​​akemāmā, kuhikuhi pinepine ʻia nā corticosteroids. Pono e lawe i kēia lāʻau no 1 a 2 mau makahiki.

ʻO nā lāʻau e kāohi i ka ʻōnaehana pale e pono ai i kekahi manawa.

I nā hihia maʻamau, hiki i ka poʻe me ka puʻuwai nui a i ʻole nā ​​ʻāpana māmā (ka hopena hope loa) pono i kahi transplant organ.

Me ka sarcoidosis e hoʻopili i ka puʻuwai, pono paha kahi cardioverter-defibrillator implantable (ICD) e pono e mālama i nā pilikia o ka puʻuwai puʻuwai.

ʻAʻole maʻi ka poʻe he nui me ka sarcoidosis, a ʻoi aku ka maikaʻi me ka ʻole o ka lāʻau. ʻOi aku i ka hapalua o nā poʻe āpau me ka maʻi i ʻoi aku ka maikaʻi i loko o 3 mau makahiki me ka ʻole o ka lāʻau. Hiki i nā kānaka i pā i ka hanu ke hoʻomāhuahua i ka māmā.

Ma lalo o 5% ka helu make mai sarcoidosis. Nā kumu o ka make pū:

• Kahe ʻana mai kaʻiʻo māmā
• Poino ka puʻuwai, alakaʻi i ka puʻuwai puʻuwai a me nā ʻano puʻuwai maikaʻi ʻole
• Lā scarring (pulmonary fibrosis)

Hiki i ka Sarcoidosis ke alakaʻi i kēia mau pilikia olakino:

• Fungal lung maʻiʻaʻai (aspergillosis)
• Glaucoma a me ka makapō mai uveitis (laha ʻole)
• Nā pōhaku hakuʻala mai nā kiʻekiʻe o ke kalipuna i ke koko a i ʻole ka mimi
• ʻO Osteoporosis a me nā pilikia ʻē aʻe o ka lawe ʻana i nā corticosteroids no nā wā lōʻihi
• ʻO ke koko kiʻekiʻe i nā aʻa o nā akemā (hypertension pulmonary)

Kāhea koke i kāu mea hāʻawi inā loaʻa iā ʻoe:

• Hanu paʻakikī
• Paʻi kuʻi ʻole
• Hoʻololi ka hihiʻo
• Nā ʻōuli ʻē aʻe o kēia maʻi

• Maʻi maʻi Interstitial lung - makua - hoʻokuʻu

• Sarcoid, kahua I - umauma x-ray
• Sarcoid, kahua II - umauma x-ray
• Sarcoid, kahua IV - umauma x-ray
• Sarcoid - pili kokoke i nā lehelehe o ka ʻili
• Pili ʻia ʻo Erythema nodosum me sarcoidosis
• Sarcoidosis - kokoke loa
• Sarcoidosis ma ka kuʻe lima
• Sarcoidosis ma ka ihu a me ka lae
• ʻŌnaehana hanu

ʻO Iannuzzi MC. ʻO Sarcoidosis. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier; 2020: chap 89.

Judson MA, Morgenthau AS, Baughman RP. ʻO Sarcoidosis. I: Broaddus VC, Mason RJ, Ernst JD, et al, eds. ʻO Murray a me Nadel's Textbook of Respiratory Medicine. ʻElua huaʻōlelo Piladelapia, PA: Elsevier Saunders; 2016: chap 66.

ʻO Soto-Gomez N, Peters JI, Nambiar AM. ʻIke a me ka hoʻokele o sarcoidosis. He Kauka Lapaʻau. 2016; 93 (10): 840-848. PMID: 27175719 www.ncbi.nlm.nih.gov/pubmed/27175719.