ʻO Polyarteritis nodosa

ʻO Polyarteritis nodosa kahi maʻi maʻi koko koʻikoʻi. Pehu a ʻino hoʻi nā aʻa liʻiliʻi a me waena.

ʻO nā aʻa ke kīʻaha koko e lawe i ke koko waiwai i oxygen i nā ʻōpala a me nā ʻano. ʻAʻole i ʻike ʻia ke kumu o ka polyarteritis nodosa. Kū ke kūlana i ka wā e hoʻouka ai kekahi o nā hunaola i nā aʻa i loʻohia. ʻAʻohe o nā aʻa i hānai ʻia e nā aʻa ʻeha i loaʻa ka oxygen a me ka meaʻai e pono ai. Loaʻa ka pohō ma muli o kahi hopena.

ʻOi aku nā mākua ma mua o nā keiki i kēia maʻi.

ʻO ka poʻe me ka hepatitis B a i ʻole hepatitis C paha e hoʻomohala i kēia maʻi.

Hoʻokumu ʻia nā ʻōuli e ka hōʻino ʻana i nā mea ola i hoʻopili ʻia. Hoʻopili pinepine ʻia ka ʻili, nā hono, nā mākala, nā ʻōpū o ka ʻōpū, ka naʻau, nā puʻupaʻa, a me nā ʻōnaehana.

ʻO nā hōʻailona me:

• Abdominal eha
• Hoʻoemi i ka makemake
• Ka luhi
• Fiva
• ʻEha pū
• ʻEha ka ʻili
• Ka hoʻohaʻahaʻa kaumaha ʻole
• Nawaliwali

Inā pili nā aʻalolo, loaʻa paha iā ʻoe ka helu, ʻeha, ʻā ʻana, a nāwaliwali hoʻi. ʻO ka hōʻino ʻana i ka ʻōnaehana hopohopo e hoʻoulu ai i nā hahau a i ʻole ka hopu ʻana i ka maʻi.

ʻAʻole hiki i nā hoʻokolohua hoʻokolohua kikoʻī ke loaʻa e ʻike pono i ka polyarteritis nodosa. Aia kekahi mau maʻi i loaʻa nā hiʻohiʻona e like me ka polyarthritis nodosa. Ua ʻike ʻia kēia mau mea ma ke ʻano he "mimics."

E loaʻa iā ʻoe kahi hōʻike kino holoʻokoʻa.

Nā hoʻokolohua lab i hiki ke kōkua i ka hana ʻana i ke kuhi a kāpae i nā mimike e komo pū me:

• Helu piha ke koko (CBC) me ka ʻokoʻa, nā mea haku, nā hoʻāʻo no ka maʻi hepitis B a me C, a me ka urinalysis
• Ka helu sedimentation ʻErythrocyte (ESR) a i ʻole protein C-reactive (CRP)
• ʻO nā electrophoresis protein protein, cryoglobulins
• Nā pae kākoʻo Serum
• Arteriogram
• ʻO ka biopsy kope
• E hana ʻia nā hoʻokolohua koko ʻē aʻe e kāpae i nā kūlana like, e like me ka systemus lupus erythematosus (ANA) a i ʻole granulomatosis me polyangiitis (ANCA)
• Hōʻike no ka maʻi HIV
• ʻO Cryoglobulins
• Nā anti-phospholipid antibodies
• Nā moʻomeheu koko

Hoʻopili ka mālama ʻana i nā lāʻau e kāohi i ka mumū a me ka ʻōnaehana pale. Hoʻopili paha kēia i nā steroid, e like me prednisone. ʻO nā lāʻau like, e like me azathioprine, methotrexate a i ʻole mycophenolate e ʻae ai no ka hōʻemi ʻana i ka lāʻau o nā steroid e hoʻohana pinepine ʻia pū kekahi. Hoʻohana ʻia ʻo Cyclophosphamide i nā hihia koʻikoʻi.

No ka polyarteritis nodosa e pili ana i ka hepatitis, hiki i ka mālama ʻana ke hoʻopili i ka plasmapheresis a me nā lāʻau antiviral.

ʻO nā mālama ʻana i kēia manawa me nā steroid a me nā lāʻau ʻē aʻe e kāohi i ka ʻōnaehana pale (e like me azathioprine a i ʻole cyclophosphamide) hiki ke hoʻomaikaʻi i nā hōʻailona a me ka manawa o ke ola lōʻihi.

ʻO nā pilikia koʻikoʻi loa e hoʻopili pinepine i nā puʻupaʻa a me nā ʻōpū o ka gastrointestinal.

Me ka mālama ʻole ʻia, maikaʻi ʻole ka nānā.

Komo pū nā pilikia:

• Maʻi hohola
• ʻO ka nerosis āpau a me ka perforation
• Hewa ʻole nā ​​hakuʻala
• Hahau

Kāhea i kāu lawelawe mālama ola inā hoʻomohala ʻoe i nā ʻōuli o kēia maʻi. ʻO ka hōʻailona mua a me ka mālama ʻana e hoʻomaikaʻi paha i ka manawa o kahi hopena maikaʻi.

ʻAʻohe pale e ʻike ʻia. Eia nō naʻe, hiki i ka mālama mua ʻana ke pale i kekahi mau hōʻino a me nā ʻōuli.

Periarteritis nodosa; PAN; ʻŌnaehana necrotizing ʻōnaehana

• ʻO ka polyarteritis microscopic 2
• ʻŌnaehana puni

Luqmani R, Awisat A. Polyarteritis nodosa a me nā maʻi e pili pū ana. I: Firestein GS, Budd RC, Gabriel SE, Koretzky GA, McInnes IB, O'Dell JR, hua. ʻO Firestein & Kelley's Textbook of Rheumatology. 11th hua. Piladelapia, PA: Elsevier; 2021: chap 95.

Puéchal X, Pagnoux C, Baron G, et al. Ke hoʻohui nei i ka azathioprine i ka glucocorticoids hoʻoiho-hoʻoiho no ka granulomatosis eosinophilic me ka polyangiitis (Churg-Strauss), microscopic polyangiitis, a i ʻole polyarteritis nodosa me ka loaʻa ʻole o nā kumu wānana maikaʻi ʻole: kahi hoʻokolohua i hoʻokolokolo ʻia. Rumatika rumitis. 2017; 69 (11): 2175-2186. PMID: 28678392 www.pubmed.ncbi.nlm.nih.gov/28678392/.

Shanmugam VK. ʻO Vasculitis a me nā arteriopathies ʻē aʻe ʻole. I: Sidawy AN, Perler BA, hua. ʻO Rutherford's Vascular Surgery a me Endotherapy Therapy. 9th ed. Piladelapia, PA: Elsevier; 2019: chap 137.

Pohaku JH. Nā vasculitides ʻōnaehana. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier; 2020: chap 254.