Cryoglobulinemia

ʻO Cryoglobulinemia ke kū ʻana o nā protein āpau i ke koko. Mānoanoa kēia mau protein i ke anuanu.

ʻO nā Cryoglobulins he mau antibodies. ʻAʻole i ʻike ʻia ke kumu e lilo ai lākou i mea paʻa a i ʻole gel-like i nā mahana haʻahaʻa ma ka hale hana. I loko o ke kino, hiki i kēia mau antibodies ke hana i nā ʻaoʻao pale pale e hiki ai ke hoʻoulu a ālai i nā kīʻaha koko. Kapa ʻia kēia ʻo cryoglobulinemic vasculitis. Hiki i kēia ke alakaʻi i nā pilikia e pili ana i ka huehue o ka ʻili a i ʻole ke kōkole ʻole.

ʻO Cryoglobulinemia kahi ʻāpana o kahi hui o nā maʻi e kumu i ka hōʻino a me ka mumū o nā kīʻaha koko ma loko o ke kino (vasculitis). ʻEkolu ʻano nui o kēia ʻano. Hoʻohui ʻia lākou e pili ana i ke ʻano o ka antibody i hua ʻia:

• ʻAno I
• ʻAno II
• ʻAno III

ʻO nā ʻano II a me III kekahi i kapa ʻia he cryoglobulinemia i kāwili ʻia.

ʻO ka ʻano I cryoglobulinemia pili pinepine i ka maʻi ʻaʻai o ke koko a i ʻole nā ​​ʻōnaehana pale.

ʻIke ʻia nā ʻano II a me III i ka poʻe i loaʻa kahi maʻi lōlō (lōkahi) mau loa, e like me ka maʻi autoimmune a i ʻole he hepatitis C. ʻO ka hapanui o ka poʻe me ke ʻano II o cryoglobulinemia he maʻi hepatitis C mau.

ʻO nā kūlana ʻē aʻe e pili ana i ka cryoglobulinemia pū kekahi:

• Leukemia
• Myeloma lehulehu
• Macroglobulinemia kumu
• Rheumatoid arthritis
• ʻO ka lupus erythematosus ʻōnaehana

E loli nā ʻōuli, kaukaʻi ʻia i ke ʻano o ka maʻi i loaʻa iā ʻoe a me nā ʻokena i pili. Pākuʻi ʻia paha nā ʻōuli:

• Nā pilikia hanu
• Ka luhi
• Glomerulonephritis
• ʻEha hui
• ʻEha ʻeha
• Puʻuloa
• Hanana Raynaud
• Ka make ʻana o ka ʻili
• Ulcer ʻili

E hana ka mea mālama ola i kahi hoʻokolohua kino. E nānā ʻia ʻoe no nā ʻōuli o ke akepaʻa a me ka ʻōpala.

ʻO nā hoʻāʻo no ka cryoglobulinemia pū kekahi:

• Helu piha ke koko (CBC).
• ʻImi hoʻoliʻiliʻi - e haʻahaʻa nā helu.
• Hōʻike ʻo Cryoglobulin - hōʻike paha i ke alo o nā cryoglobulins. (He ʻōnaehana keʻena paʻakikī kēia e pili ana i nā ʻanuʻu he nui. He mea nui ka maʻa o ka lab e hana nei i ka hoʻokolohua me ka hana.)
• Nā hoʻāʻo o ka hana ate - kiʻekiʻe paha inā aia ka maʻi hepatitis C.
• Rheumatoid factor - maikaʻi ma nā ʻano II a me III.
• ʻO ka biopsy o ka ʻili - hōʻike paha i ka huhū i loko o nā kīʻaha koko, vasculitis.
• Protein electrophoresis - koko - hiki ke hōʻike i kahi protein antibody abnormal.
• Urinalysis - hōʻike paha i ke koko i ka mimi inā hoʻopili ʻia nā puʻupaʻa.

Hiki i nā hoʻokolohua ʻē aʻe ke:

• Angiogram
• Pākuʻi x-ray
• ESR
• Hepatitis C hōʻike
• Nā hoʻokolohua conduction nerve, inā nāwaliwali ke kanaka i nā lima a me nā wāwae

MIXED CRYOGLOBULINEMIA (TYPES II AND III)

Hiki ke mālama pinepine ʻia i ke ʻano akahai a kaulike paha o ka cryoglobulinemia e ka lawe ʻana i nā ʻanuʻu e hana ai i ke kumu kumu.

ʻO nā lāʻau kū pololei i kēia manawa no ka hepatitis C hoʻopau i ka maʻi ma aneane o nā kānaka āpau. Ke hele nei ka maʻi hepitis C, e nalowale nā ​​cryoglobulins ma kahi o hoʻokahi hapalua o nā poʻe āpau i nā mahina he 12 e hiki mai ana. E hoʻomau kāu mea lawelawe i ka nānā ʻana i nā cryoglobulins ma hope o ka mālama ʻana.

ʻO ka cryoglobulinemia vasculitis nui e pili ana i nā mea ola a i ʻole nā ​​wahi nui o ka ʻili. Mālama ʻia ia me nā corticosteroids a me nā lāʻau ʻē aʻe e kaomi i ka ʻōnaehana pale.

• He lāʻau lapaʻau maikaʻi ʻo Rituximab a ʻoi aku ka nui o nā makaʻu ma mua o nā lāʻau ʻē aʻe.
• Hoʻohana ʻia ʻo Cyclophosphamide i nā kūlana hoʻoweliweli ola kahi e hana nei a loaʻa ʻole ai ʻo rituximab. Hoʻohana pinepine ʻia kēia lāʻau i ka wā i hala.
• Hoʻohana ʻia kahi lapaʻau i kapa ʻia plasmapheresis. I kēia kaʻina hana, lawe ʻia ka plasma toto mai ke kahe o ke koko a hoʻoneʻe ʻia nā protein antibody cryoglobulin abnormal. Ua panai ʻia ka plasma e ka wai, protein, a i hāʻawi ʻia i ka plasma.

ʻAno I CRYOGLOBULINEMIA

ʻO kēia maʻi ma muli o kahi maʻi ʻaʻai o ke koko a i ʻole ʻōnaehana pale e like me ka myeloma maha. Hoʻonohonoho ʻia ka mālama ʻana e kūʻē i nā hunaola maʻi ʻaʻai maʻamau e hana i ka cryoglobulin.

ʻO ka hapa nui o ka manawa, cryoglobulinemia kāwili ʻia ʻaʻole alakaʻi i ka make. Hiki i ka Outlook ke ʻilihune inā pili nā puʻupaʻa.

Komo pū nā pilikia:

• Kahe i ka digestive tract (kakaikahi)
• Nā maʻi puʻuwai (rare)
• Nā maʻi o ka ulcer
• Hewa ʻole nā ​​hakuʻala
• Hoka kōpaʻa
• Ka make ʻana o ka ʻili
• Make

Kāhea i kāu mea hāʻawi inā:

• Hoʻolālā ʻoe i nā ʻōuli o cryoglobulinemia.
• Loaʻa iā ʻoe ka maʻi hepitis C a hoʻomōhala i nā ʻōuli o cryoglobulinemia.
• Loaʻa iā ʻoe ka cryoglobulinemia a hoʻomohala i nā hōʻailona hou a i ʻole worsening paha.

ʻAʻohe pale e ʻike ʻia no kēia ʻano.

• Ke pale aku nei i nā anu anuanu e pale i kekahi mau ʻōuli.
• ʻO ka hoʻāʻo ʻana a me ka mālama ʻana no ka maʻi hepatitis C e hōʻemi ai i kou makaʻi.

• ʻO Cryoglobulinemia o nā manamana lima
• Cryoglobulinemia - nā manamana lima
• Nā pūnaewele koko

ʻO Patterson ER, Winters JL. Hemapheresis. I: McPherson RA, Pincus MR, hua. ʻO kā Henry's Clinical Diagnosis a me Management e nā Laboratory Methods. 23rd Ed. St Louis, MO: Elsevier; 2017: chap 37.

Roccatello D, Saadoun D, ​​Ramos-Casals M, et al. Cryoglobulinaemia. ʻO Nat Rev Dis Primers. 2018; 4 (1): 11. PMID: 30072738 pubmed.ncbi.nlm.nih.gov/30072738/.

Pohaku JH. ʻO vasculitis liʻiliʻi liʻiliʻi i hoʻopili ʻia me ka maʻi Immune. 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 91.