Arteritis pūnana nui

ʻO ka arteritis cell nunui ka mumū a me ka hōʻino ʻana i nā kīʻaha koko e hāʻawi i ke koko i ke poʻo, ka ʻāʻī, ke kino o luna a me nā lima. Kapa ʻia ia hoʻi he arteritis kūlohelohe.

Hoʻopili ka arteritis cell nui i nā aʻa waena-a-nui. Mālama ia i ka mumū, ka pehu ʻana, ka palupalu, a me ka hōʻino ʻana i nā kīʻaha koko e hāʻawi i ke koko i ke poʻo, ka ʻāʻī, ke kino o luna, a me nā lima. Kū pinepine ia i nā aʻa e pili ana i nā heiau (nā aʻa kūlohelohe). Kūleʻa kēia mau aʻa mai ke aʻa carotid i ka ʻāʻī. I kekahi mau hihia, hiki i ke ʻano ke hana i nā aʻa waena-i-nui i nā wahi ʻē aʻe o ke kino pū kekahi.

ʻAʻole ʻike ʻia ke kumu o kēia ʻano. Manaʻo ʻia ma muli o kekahi hapa o ka pane pale pale hala. Ua hoʻopili ʻia ka maʻi i kekahi mau maʻi a i kekahi mau ʻāpana.

ʻOi aku ka maʻamau o ka arteritis cell Giant i ka poʻe me kekahi maʻi ʻino ʻē aʻe i ʻike ʻia ʻo polymyalgia rheumatica. ʻO ka arteritis cell Giant kokoke mau i nā poʻe ma mua o 50 mau makahiki. ʻO ka mea maʻamau i nā poʻe o ka ʻohana ʻEulopa ʻākau. E holo paha ke ʻano i loko o nā ʻohana.

ʻO kekahi mau hōʻailona maʻamau o kēia pilikia:

• ʻO ka ʻeha hou o ka ʻeha ma kekahi ʻaoʻao o ke poʻo a i ʻole ke kua o ke poʻo
• Ka palupalu ke pili i ka ʻili

Hiki i nā ʻōuli ʻē aʻe ke:

• ʻEha ʻeha i ka wā e nau ana
• ʻEha ma ka lima ma hope o ka hoʻohana ʻana
• ʻEha ka ʻili
• ʻO kaʻeha a me ka ʻoʻoleʻa i ka ʻāʻī, nā lima kiʻekiʻe, nā poʻohiwi, a me nā hiʻupuʻu (polymyalgia rheumatica)
• Nawaliwali, luhi nui
• Fiva
• Manaʻo maʻi laulā

Kū paha nā pilikia me ka maka maka, a i kekahi manawa hoʻomaka koke paha. Aia kēia mau pilikia i:

• ʻIke makapō
• Hōʻike pālua
• ʻImi hōʻemi ʻia ka hihiʻo (makapō i hoʻokahi a i ʻole nā ​​maka ʻelua)

E nānā ka mea mālama ola i kou poʻo.

• Hoʻomaʻamaʻa pinepine ke poʻo i ka hoʻopā.
• Aia paha he aʻa mānoanoa, mānoanoa ma kekahi ʻaoʻao o ke poʻo, pinepine ma luna o hoʻokahi a i ʻole nā ​​luakini ʻelua.

Pili pū paha nā hoʻokolohua koko:

• Hemoglobin a i ʻole hematocrit
• Nā hoʻāʻo hana ate
• Ka helu sedimentation (ESR) a me ka protein C-reactive

ʻAʻole hiki i nā hōʻike koko wale nō ke hāʻawi i kahi kuhi. Pono ʻoe i kahi biopsy o ke aʻa kino. He hana ʻoki kēia e hiki ke hana ʻia ma ke ʻano he mea maʻi.

Loaʻa paha iā ʻoe kekahi mau hoʻokolohua ʻē aʻe, e like me:

• ʻO ke ultrasound Doppler kala o nā aʻa kino. Lawe paha kēia i kahi biopsy artery temporal inā hana ʻia e kekahi mea ʻike me ka hana.
• MRI.
• Scanner PET.

Hiki i ke kōkua koke ʻana ke pale aku i nā pilikia koʻikoʻi e like me ka makapō.

Ke kānalua ʻia ka arteritis cell nunui, e loaʻa iā ʻoe nā corticosteroids, e like me prednisone, e ka waha. Hoʻomaka pinepine ʻia kēia mau lāʻau i mua o ka hana ʻia ʻana o kahi biopsy. E haʻi ʻia paha ʻoe e lawe i ka aspirin.

Hoʻomaka ka hapa nui o ka poʻe e ʻoi aku ka maikaʻi i loko o kekahi mau lā ma hope o ka hoʻomaka ʻana o ka lāʻau. ʻO ka mahele o nā corticosteroids e ʻoki mālie ʻia. Eia nō naʻe, pono ʻoe e ʻai i ka lāʻau no 1 a 2 mau makahiki.

Inā kuhi ʻia ka arteritis cell nunui, i ka hapanui o ka poʻe e hoʻohui ʻia kahi lāʻau biologic i kapa ʻia ʻo tocilizumab. Hoʻoemi kēia lāʻau i ka nui o nā corticosteroids e pono ai e kaohi i ka maʻi.

Hiki i ka mālama wā lōʻihi me nā corticosteroids ke lahilahi nā iwi a hoʻonui i kou manawa o ka haki. Pono ʻoe e hana i kēia mau hana e pale ai i ka ikaika o kou iwi.

• Hōʻalo i ka puhī ʻana a me ka ʻai nui ʻana i ka waiʻona.
• E lawe i ka calcium hou a me ka huaola D (ma muli o ka ʻōlelo aʻoaʻo a kāu mea hāʻawi).
• E hoʻomaka i ka hele wāwae a i ʻole nā ​​ʻano hana ʻē aʻe o ka hoʻoikaika kino.
• E nānā i kou mau iwi me ka hoʻāʻo Mineral iwi (BMD) a i ʻole DEXA scan.
• E lawe i kahi lāʻau bisphosphonate, e like me alendronate (Fosamax), e like me ka mea i kauoha ʻia e kāu mea hāʻawi.

ʻO ka hapa nui o ka poʻe e hoʻōla hou, akā pono paha ka lāʻau no 1 a 2 mau makahiki a ʻoi paha.E hoʻi paha ke ʻano i kekahi lā ma hope.

ʻO ka hōʻino i nā kīʻaha koko ʻē aʻe i ke kino, e like me nā aneurysms (ballooning o nā kīʻaha koko), hiki paha. Hiki i kēia hōʻino ke alakaʻi i kahi hahau i ka wā e hiki mai ana.

Kāhea i kāu mea hāʻawi inā loaʻa iā ʻoe:

• Pākuʻi i ka ʻehaʻeha ʻaʻole hele
• Lilo o ka hihiʻo
• Nā ʻōuli ʻē aʻe o ka arteritis kūlohelohe

E kuhikuhi ʻia ʻoe i kahi loea e mālama i ka arteritis kūlohelohe.

ʻAʻohe pale e ʻike ʻia.

Arteritis - kūlohelohe; Cranial arteritis; Arteritis pūnana nui

• ʻAtomy anatomy carotid

Dejaco C, Ramiro S, Duftner C, et al. Nā ʻōlelo EULAR no ka hoʻohana ʻana i ke kiʻi ʻana i ka vasculitis moku nui i ka hana lapaʻau. ʻO Ann Rheum Dis. 2018; 77 (5): 636-643. PMID: 29358285 www.ncbi.nlm.nih.gov/pubmed/29358285.

James WD, Elston DM, Hana iā JR, Rosenbach MA, Neuhaus IM. Nā maʻi maʻi vaskular. I: James WD, Elston DM, mālama iā JR, Rosenbach MA, Neuhaus IM, eds. Nā maʻi o Andrews 'o ka ʻili: Dermatology Haumāna. 13th ed. Piladelapia, PA: Elsevier; 2020: chap 35.

ʻO Koster MJ, Matteson EL, Warrington KJ. ʻO ka arteritis pūnaewele nunui-moku nui: ʻike, nānā a me ka hoʻokele. Rheumatology (Oxford). 2018; 57 (suppl_2): ii32-ii42. PMID: 29982778 www.ncbi.nlm.nih.gov/pubmed/29982778.

Pōhaku JH, Tuckwell K, Dimonaco S, et al. ʻO ka hoʻāʻo o tocilizumab i ka arteritis cell-cell. N Engl J Med. 2017; 377 (4): 317-328. PMID: 28745999 www.ncbi.nlm.nih.gov/pubmed/28745999.

Tamaki H, Hajj-Ali RA. ʻO Tocilizumab no ka arteritis cell nunui-kahi anuu nunui hou i kahi maʻi kahiko. JAMA Neurol. 2018; 75 (2): 145-146. PMID: 29255889 www.ncbi.nlm.nih.gov/pubmed/29255889.