Pā ʻōpio idiopathic ʻōpio

ʻO Juvenile idiopathic arthritis (JIA) kahi manawa i hoʻohana ʻia e wehewehe i kahi hui o nā maʻi i nā keiki e pili pū ana me ka maʻi kō. ʻO lākou nā maʻi wā lōʻihi (mau) e hōʻeha i ka ʻeha hui a me ka pehu. Ua loli nā inoa e wehewehe nei i kēia pūʻulu kūlana i nā makahiki i hala aku nei i ka ʻike hou aku e pili ana i ke ʻano.

ʻAʻole ʻike ʻia ke kumu o JIA. Manaʻo ʻia he maʻi maʻi autoimmune ia. ʻO ke kumu kēia e hoʻouka a hōʻino ke kino i ke kino o ke kino ma ke kuhihewa.

Hoʻokumu pinepine ʻo JIA ma mua o ka makahiki 16. E hoʻomaka paha nā ʻōuli ma mua o 6 mau makahiki.

Ua hoʻolālā ka International League of Associations for Rheumatology (ILAR) i ke ala aʻe o ka hōʻuluʻulu ʻana i kēia ʻano ʻano maʻi ʻōpio:

• ʻO JIA ka ʻōnaehana. Hoʻopili i ka pehu ami a ʻeha paha, nā fiva, a me ka ʻino. ʻO ia ka ʻano liʻiliʻi liʻiliʻi akā hiki ke ʻoi aku ke koʻikoʻi. ʻIke ʻia he ʻokoʻa ma mua o nā ʻano ʻē aʻe o JIA a ʻano like me ka maʻi ʻo ka hoʻomaka ʻana o nā mākua.
• ʻO Polyarthritis. Hoʻopili i nā ami he nui. Hiki ke hoʻololi i kēia ʻano ʻo JIA i ka rumitis rheumatoid. Pili paha ia i 5 a ʻoi paha nā hui nui a liʻiliʻi o nā wāwae a me nā lima, a ʻo ka ʻāʻī a me ka ʻāʻī. Aia paha ke kumu Rheumatoid.
• Oligoarthritis (hoʻomau a hoʻonui ʻia). Hoʻokomo i ka 1 i ka 4 hui, ka pinepine o nā pulima, a i ʻole nā ​​kuli. Hoʻopili ia i nā maka.
• Pākuʻi pili i ka Enthesitis. Hoʻohālikelike i ka spondyloarthritis i nā mākua a pili pinepine i ka hui sacroiliac.
• Pāleʻa psoriatic. ʻIke ʻia i nā keiki i loaʻa i ka maʻi kōkō a me ka psoriasis a i ʻole ka maʻi kui, a i ʻole he lālā ʻohana kokoke me ka psoriasis.

Pākuʻi ʻia paha nā ʻōuli o JIA:

• Huehue, ʻulaʻula, a i ʻole hui pumehana
• Limping a i ʻole nā ​​pilikia e hoʻohana ana i kahi lālā
• ʻO ke kuni kiʻekiʻe kiʻekiʻe, hoʻi paha ia
• Rash (ma ke kumu a me nā ʻaoʻao) hele mai a hele me ka fiva
• ʻOʻoleʻa, ʻeha, a me ka neʻe palena ʻia o kahi hui
• ʻEha ʻeha haʻahaʻa i hele ʻole
• Nā ʻōuli o ke kino e like me ka ʻili keʻokeʻo, ka pehu lymph gland, a me ka helehelena maʻi

Hiki i ka JIA ke hana i nā pilikia o ka maka i kapa ʻia ʻo uveitis, iridocyclitis, a i ʻole iritis. ʻAʻohe paha ʻōuli. Ke hiki mai nā ʻōuli o ka maka, hiki iā lākou ke hoʻopili:

• Nā maka ʻulaʻula
• ʻEhaʻeha maka, ka mea e ʻoi aku ka maikaʻi ke nānā aku i ka mālamalama (photophobia)
• Hoʻololi ka hihiʻo

Hōʻike ka hoʻokolohua kino i ka pehu, mehana, a me nā hono palupalu e ʻeha e neʻe. Loaʻa paha i ke keiki kahi hū. ʻO nā hōʻailona ʻē aʻe:

• Hū palahalaha
• ʻLepala nunui
• Nā pehu lymph pehu

Pili pū paha nā hoʻokolohua koko:

• ʻLelo Rheumatoid
• Ka helu sedimentation ʻErythrocyte (ESR)
• Antinuclear antibody (ANA)
• Helu piha koko (CBC)
• HLA-B27

ʻO kekahi a i ʻole o kēia mau hoʻokolohua koko he maʻamau i nā keiki me JIA.

Hoʻokomo paha ka mea mālama ola i kahi nila liʻiliʻi i loko o kahi hui pehu e hemo ai ka wai. Hiki i kēia ke kōkua i ka loaʻa ʻana o ke kumu o ka maʻi pākī. Hiki iā ia ke kōkua i ka hōʻoluʻolu i ka ʻeha. Hoʻokomo paha ka mea hāʻawi i nā steroid i loko o ka hui e kōkua i ka hoʻoliʻiliʻi

Nā hoʻokolohua ʻē aʻe i hana ʻia e hoʻopili ʻia:

• X-kukuna o kahi ami
• ʻImi iwi
• X-ray o ka umauma
• ECG
• ʻO ka hoʻokolohua maka maka maʻamau e ka ophthalmologist - pono e hana kēia inā ʻaʻohe ʻōuli o ka maka.

ʻO nā lāʻau anti-inflammatory Nonsteroidal (NSAIDs) e like me ka ibuprofen a i ʻole naproxen paha e lawa ai ka mālama ʻana i nā ʻōuli ke pili wale kekahi hapa liʻiliʻi o nā hono.

Hoʻohana ʻia ʻo Corticosteroids no ka ʻoi aku o ke ahi e kōkua i ke kaohi ʻana i nā ʻōuli. Ma muli o kā lākou kūpikipiki, pono e hōʻalo i ka hoʻohana wā lōʻihi o kēia mau lāʻau i nā keiki.

ʻO nā keiki i loaʻa i ka maʻi kōpaʻa i loko o nā hono he nui, a i ʻole he fiva, pehu, a pehu paha nā gland e pono ai i nā lāʻau ʻē aʻe. Kapa ʻia kēia mau mea he lāʻau antirheumatic (DMARD) e hoʻololi nei i ka maʻi. Hiki iā lākou ke kōkua i ka hōʻemi ʻana i ka pehu i nā hono a i ʻole ke kino. Aia nā DMARD i:

• Methotrexate
• Nā lāʻau biologic, e like me etanercept (Enbrel), infliximab (Remicade), a me nā lāʻau e pili ana

Pono paha nā keiki me ka JIA ʻōnaehana i nā mea kāohi biologic o IL-1 a i ʻole IL-6 e like me anakinra a i ʻole tocilizumab.

Pono nā keiki me JIA e noho mau.

E kōkua ka hoʻoikaika i ka mālama ʻana i ko lākou mau mākala a me nā hono a maʻalahi hoʻi.

• ʻO ka hele wāwae, kaʻa paikikala, a me ka ʻauʻau ʻana he hana maikaʻi paha.
• Pono nā keiki e aʻo e hoʻomehana ma mua o ka hoʻoikaika kino.
• E kamaʻilio me ke kauka a mea hoʻoponopono kino paha e pili ana i nā hana e hana ai ke loaʻa ka ʻeha o kāu keiki.

ʻO nā keiki i loaʻa ke kanikau a huhū paha e pili ana i kā lākou maʻi arthritis pono paha ke kākoʻo hou.

Pono paha kekahi mau keiki me JIA i ke ʻoki, me ke kuapo like.

ʻO nā kamaliʻi me kahi mau līlū e hoʻopili ʻia ʻaʻohe o nā ʻōuli no kahi wā lōʻihi.

I nā keiki he nui, e lilo ka maʻi i mea hana ʻole a hoʻoliʻiliʻi iki i nā hui pū.

Pili ka nui o ka maʻi i ka helu o nā ami i hoʻopili ʻia. Heʻuʻuku paha ka hele ʻana o nā ʻōuli ma kēia mau hihia. Loaʻa pinepine kēia mau keiki i ka ʻeha lōʻihi, mau loa, kīnā ʻole, a me nā pilikia ma ke kula. Hiki i kekahi mau keiki ke hoʻomau i ka loaʻa ʻana i ka maʻi o ke kuamoʻo ma ke ʻano he makua.

Komo pū nā pilikia:

• Ke hele a luku paha i nā hono (hiki i nā poʻe me JIA ʻoi loa ka hewa)
• Lohi mālie o ka ulu ʻana
• Ke ulu pono ʻole ʻana o ka lima a me ka wāwae
• Ka nalowale o ka hihiʻo a hoʻoliʻiliʻi paha i ka ʻike mai uveitis mau loa (hiki i kēia pilikia ke koʻikoʻi, ʻoiai inā ʻaʻole koʻikoʻi loa ka maʻi ʻōpū)
• Anemia
• ʻO ka pehu a puni ka puʻuwai (pericarditis)
• ʻEha wā lōʻihi (mau), hele kino ʻole o ke kula
• ʻO Macrophage activation syndrome, kahi maʻi nui e hoʻomohala pū me JIA ʻōnaehana

Kāhea i kāu mea hāʻawi inā:

• ʻO ʻoe, a i ʻole ʻo kāu keiki, e ʻike i nā hōʻailona o JIA
• Hele a maikaʻi ʻole nā ​​ʻōuli a hoʻomaikaʻi ʻole paha me ka lāʻau
• Hoʻolālā nā ʻōuli hou

ʻAʻohe pale e ʻike ʻia no JIA.

Juvenile rheumatoid arthritis (JRA); ʻO Juarthile mau loa polyarthritis; Maʻi naʻe; Spondyloarthritis ʻōpio

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Schulert GS, Minoia F, Bohnsack J, et al. Ka hopena o ka biologic therapy ma nā hiʻohiʻona a me nā hiʻohiʻona o ka macrophage activation syndrome e pili ana me ka ʻōpio idiopathic arthritis. Hoʻolaha Hoʻolaha Hoʻolaha Hoʻolaha (Hoboken). 2018; 70 (3): 409-419. PMID: 28499329 www.ncbi.nlm.nih.gov/pubmed/28499329.

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