Takayasu arteritis

ʻO Takayasu arteritis kahi mumū o nā aʻa nui e like me ke aorta a me nā lālā nui. ʻO ke aorta ka aʻa e lawe i ke koko mai ka puʻuwai a i ke koena o ke kino.

ʻAʻole ʻike ʻia ke kumu o Takayasu arteritis. Kū ka maʻi i nā keiki a me nā wahine ma waena o nā makahiki 20 a 40. ʻOi aku ka nui o nā poʻe o ko East Asia, ko India a ko Mekiko paha. Eia nō naʻe, ke ʻike pinepine ʻia nei ma nā wahi ʻē aʻe o ka honua. Ua loaʻa koke kekahi mau genes e hoʻonui i ka manawa kūpono e loaʻa kēia pilikia.

ʻO ke ʻano o Takayasu arteritis kahi ʻano autoimmune. ʻO ke kumu o ka hōʻeha hewa ʻana o ka ʻōnaehana pale o ke kino i nā mea olakino oloko o ka pā o ke kīʻaha koko. Pili pū paha ke ʻano i nā ʻōnaehana ʻē aʻe.

ʻO kēia ʻano he nui nā hiʻohiʻona e like me ka arteritis cell nunui a i ʻole arteritis kūlohelohe i ka poʻe ʻelemakule.

Pākuʻi ʻia paha nā ʻōuli:

• ʻO ka nāwaliwali a ʻeha paha me ka hoʻohana
• ʻEha ʻeha
• Puʻupuʻu
• Ka luhi
• Fiva
• ʻĀlohilohi
• Ka ʻeha a ʻeha pū paha
• ʻ Skinhū ʻili
• Hoʻoulu ka pō
• Hoʻololi ka hihiʻo
• Kaumaha emi
• Hoʻoemi i nā puʻupuʻu radial (ma ka pūlima)
• Kaʻokoʻa i ke kahe o ke koko ma waena o nā lima ʻelua
• Ke koko kiʻekiʻe (hypertension)

Aia kekahi mau hōʻailona o ka mumū (pericarditis a i ʻole pleuritis).

ʻAʻole loaʻa kahi hoʻokolohua koko e hana i kahi hōʻoia kikoʻī. Hana ʻia ka hōʻailona inā loaʻa i kahi kanaka nā ʻōuli a me nā hōʻike kiʻi e hōʻike i nā kino kīnā ʻole o ke kīʻaha koko e hōʻike ana i ka puhū.

ʻO nā hoʻokolohua hiki ke hoʻopili ʻia:

• Angiogram, me ka angiography coronary
• Helu piha koko (CBC)
• C-reactive protein (CRP)
• Electrocardiogram (ECG)
• Ka helu sedimentation ʻErythrocyte (ESR)
• Mākēneki resonance angiography (MRA)
• Mākēneki resonance kiʻi (MRI)
• Angiography tomography i helu ʻia (CTA)
• ʻO ka tomography emission Positron (PET)
• Kukuna ultrasound
• X-ray o ka umauma

He paʻakikī ka mālama ʻana iā Takayasu arteritis. Eia nō naʻe, hiki i ka poʻe i loaʻa ka lāʻau kūpono ke hoʻomaikaʻi. He mea nui e ʻike i ke ʻano i ke kakahiaka. Mālama pinepine ka maʻi, e koi ana i ka hoʻohana wā lōʻihi o nā lāʻau anti-inflammatory.

NA LAAU LAPAAU

ʻO ka hapa nui o ka poʻe e mālama mua ʻia me nā koina kiʻekiʻe o nā corticosteroids e like me prednisone. E like me ka mālama ʻana o ka maʻi i hoʻemi ʻia ka mahele o prednisone.

I ka aneane o nā hihia āpau, hoʻohui ʻia nā lāʻau hoʻomākino e hoʻoliʻiliʻi i ka pono no ka hoʻohana wā lōʻihi o ka prednisone a hoʻomau i ka mālama ʻana i ka maʻi.

Pākuʻi pinepine ʻia nā mea pale pale pale maʻamau e like me methotrexate, azathioprine, mycophenolate, cyclophosphamide, a i ʻole leflunomide.

Maikaʻi paha nā meaola biologic. Hoʻopili kēia i nā mea kāohi TNF e like me infliximab, etanercept, a me tocilizumab.

NA MEA HANA

Hiki ke hoʻohana i ke ʻoki kino a i ʻole angioplasty e wehe i nā aʻa ʻololī e hāʻawi i ke koko a wehe paha i ka constriction.

Pono paha e pani pani pani hakahaka i kekahi mau hihia.

Hiki i kēia maʻi ke make me ka mālama ʻole ʻia. Eia nō naʻe, ua hōʻemi ʻia ka nui o ka make i kahi ʻano hana i hoʻohui ʻia me ka hoʻohana ʻana i nā lāʻau. Loaʻa i ka poʻe mākua ka manawa kūpono o ke ola ma mua o nā keiki.

Komo pū nā pilikia:

• Pūʻulu koko
• Maʻi hohola
• Hewa puʻuwai
• Pericarditis
• Ka lawa ʻole o ke kiwikā Aortic
• Pleuritis
• Hahau
• ʻO ke kahe Gastrointestinal a i ʻole ʻeha mai ka paʻa ʻana o nā kīʻaha koko

Kāhea i kāu mea mālama ola inā loaʻa nā ʻōuli o kēia ʻano. Pono ka mālama koke inā loaʻa iā ʻoe:

• Pulse nāwaliwali
• ʻEha ʻeha
• Pilikia hanu

Maʻi pulseless, vasculitis moku-nui

• Puʻuwai - ʻāpana ma waena o ka waena
• ʻO nā valves puʻuwai - ʻike mua
• Nā valves puʻuwai - ʻike kiʻekiʻe

Alomari I, Patel PM. Takayasu arteritis. I: Ferri FF, hoʻoponopono. ʻO Ferri's Clinical Advisor 2020. Piladelapia, PA: Elsevier; 2020: 1342.e4-1342.e7.

Barra L, Yang G, Pagnoux C; Pūnaewele Vasculitis Kanada (CanVasc). Nā lāʻau non-glucocorticoid no ka mālama ʻana i ka arteritis o Takayasu: He loiloi ʻōnaehana a me nā meta-analysis. ʻO Autoimmun Rev.. 2018; 17 (7): 683-693. PMID: 29729444 pubmed.ncbi.nlm.nih.gov/29729444/.

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 pubmed.ncbi.nlm.nih.gov/29358285/.

Ehlert BA, Abularrage CJ. Maʻi Takayasu. I: Sidawy AN, Perler BA, hua. ʻO Rutherford's Vascular Surgery a me Endotherapy Therapy. 9th ed. Piladelapia, PA: Elsevier; 2019: chap 139.

Serra R, Butrico L, Fugetto F, et al. ʻO nā mea hou i ka pathophysiology, ʻike a me ka hoʻokele o Takayasu arteritis. ʻO Ann Vasc Surg. 2016; 35: 210-225. PMID: 27238990 pubmed.ncbi.nlm.nih.gov/27238990/.