Polymyalgia rheumatica

ʻO Polymyalgia rheumatica (PMR) kahi maʻi hōʻeha. Pili ia i ka ʻeha a me ka ʻoʻoleʻa i nā poʻohiwi a pinepine i nā pūhaka.

Kū pinepine ʻo Polymyalgia rheumatica i ka poʻe ma mua o 50 mau makahiki. ʻAʻole ʻike ʻia ke kumu.

Hiki paha ke PMR ma mua a i ʻole me ka arteritis cell nunui (GCA; i kapa ʻia hoʻi ʻo arteritis temporal). ʻO kēia kahi ʻano e wela ai nā kīʻaha koko e hāʻawi i ke koko i ke poʻo a me ka maka.

Hiki i ka PMR ke paʻakikī ke haʻi aku ma kahi o ka rheumatoid arthritis (RA) i kahi ʻelemakule. Kū kēia i ka wā maikaʻi ʻole nā ​​hoʻāʻo no ka mea rheumatoid a me anti-CCP antibody.

ʻO ka hōʻailona maʻamau ka ʻeha a me ka ʻoʻoleʻa i nā poʻohiwi ʻelua a me ka ʻāʻī. ʻOi aku kaʻeha a me ka ʻoʻoleʻa i ke kakahiaka. Holomua pinepine kēia ʻeha i nā pūhaka.

Luhi pū kekahi. ʻIke ka poʻe me kēia ʻano paʻakikī i ka hele ʻana mai kahi moe a neʻe.

ʻO nā ʻōuli ʻē aʻe e like me:

• ʻO ka nalo leʻaleʻa, kahi e alakaʻi ai i ka pohō kaumaha
• Kaumaha
• Fiva

ʻAʻole hiki i nā hōʻike Lab wale nō ke kuhikuhi i ka PMR. ʻO ka hapa nui o ka poʻe me kēia ʻano he mau māka kiʻekiʻe ko ka mumū, e like me ka sedimentation rate (ESR) a me ka C-reactive protein.

ʻO nā hopena hōʻike ʻē aʻe no kēia ʻano:

• Nā pae kūpono ʻole o nā protein i ke koko
• ʻO ka pae maʻamau o nā hunaola keokeo
• Anemia (helu haʻahaʻa ke koko)

Hoʻohana ʻia paha kēia mau hoʻokolohua e nānā i kāu kūlana.

Eia nō naʻe, ʻaʻole kōkua pinepine nā hoʻokolohua kiʻi e like me nā kukuna x o ka poʻohiwi a i ʻole nā ​​hope. Hōʻike paha kēia mau ho'āʻo i ka hōʻino pū i pili ʻole i nā hōʻailona hou. I nā hihia paʻakikī, hana ʻia paha ke ultrasound a i ʻole MRI o ka poʻohiwi. Hōʻike pinepine kēia mau hoʻokolohua kiʻi ʻana i ka bursitis a i ʻole nā ​​pae haʻahaʻa o ka huʻi pū.

Me ka ʻole o ka lapaʻau ʻana, ʻaʻole maikaʻi ʻo PMR. Eia nō naʻe, hiki i nā lāʻau haʻahaʻa o nā corticosteroids (e like me prednisone, 10 a 20 mg i kēlā me kēia lā) hiki ke hoʻomāmā i nā ʻōuli, pinepine i loko o hoʻokahi lā a ʻelua paha.

• E hoʻemi mālie ʻia ka lāʻau i kahi pae haʻahaʻa loa.
• Pono e hoʻomau i ka mālama ʻana no 1 a 2 mau makahiki. I kekahi poʻe, ʻoi aku ka lōʻihi o ka mālama ʻana me nā kaona haʻahaʻa o prednisone.

Hiki i nā Corticosteroids ke kumu i nā hopena he nui e like me ka loaʻa ʻana o ke kaupaona, hoʻomohala ʻana i ka maʻi ʻaʻa a i ʻole osteoporosis. Pono ʻoe e nānā pono inā ʻoe e lawe i kēia mau lāʻau. Inā pilikia ʻoe i ka osteoporosis, hiki i kāu mea mālama ola ke ʻōlelo iā ʻoe e lawe i nā lāʻau e pale ai i kēia maʻi.

No ka hapanui o ka poʻe, hele aku ka PMR me ka lāʻau lapaʻau ma hope o 1 a 2 mau makahiki. Hiki paha iā ʻoe ke hōʻoki i ka lawe ʻana i nā lāʻau i hope o kēia kiko, akā e nānā mua me kāu mea hāʻawi.

No kekahi poʻe, hoʻi nā ʻōuli ma hope o ka hōʻoki ʻana i ka lawe ʻana i nā corticosteroids. I kēia mau hihia, pono ʻia kahi lāʻau hou e like me methotrexate a i ʻole tocilizumab.

Hiki paha i kahi arteritis cell nunui a i ʻole hiki ke hoʻomohala ma hope. Inā ʻo kēia ka hihia, pono e loiloi i ke aʻa kino.

Hiki i nā hōʻailona ʻoi loa ke paʻakikī iā ʻoe e hana a mālama paha iā ʻoe iho ma ka home.

Kāhea i kāu mea hāʻawi inā loaʻa ʻoe i ka nāwaliwali a paʻakikī paha i kou poʻohiwi a me kou ʻāʻī ʻaʻole e hele. E launa pū me kāu mea hāʻawi inā loaʻa iā ʻoe nā hōʻailona hou e like me ke kuni, ka maʻi poʻo, a me ka ʻeha me ka nau ʻana a i ʻole ka nalo ʻana o ka ʻike. Hiki mai kēia mau ʻōuli mai ka arteritis cell nunui.

ʻAʻohe pale e ʻike ʻia.

PMR

Dejaco C, Singh YP, Perel P, et al. Nā ʻōlelo aʻoaʻo 2015 no ka mālama ʻana i ka polymyalgia rheumatica: a European League Against Rheumatism / American College of Rheumatology kolaborative. Rumatika rumitis. 2015; 67 (10): 2569-2580. PMID: 2635874 www.ncbi.nlm.nih.gov/pubmed/26352874.

Hellmann DB. ʻO ka arteritis cell Giant, polymyalgia rheumatica, a me Takayasu's arteritis. I: Firestein GS, Budd RC, Gabriel SE, McInnes IB, O'Dell JR, nā hua. ʻO Kelley lāua ʻo Firestein's Bookbook of Rheumatology. 10 o ka lā. Piladelapia, PA: Elsevier; 2017: chap 88.

Kermani TA, Warrington KJ. Nā holomua a me nā pilikia i ke kuhi a me ka mālama ʻana i ka polymyalgia rheumatica. Ther Adv Musculoskelet Dis. 2014; 6 (1): 8-19. PMID: 24489611 www.ncbi.nlm.nih.gov/pubmed/24489611.

ʻO Salvarani C, Ciccia F, Pipitone N. Polymyalgia rheumatica a me ka arteritis cell nunui. I: Hochberg MC, Gravallese EM, Silman AJ, Smolen JS, Weinblatt ME, Weisman MH, eds. Rheumatology. ʻEpekema 7 Piladelapia, PA: Elsevier; 2019: chap 166.