Iseli enkulu yegazi

Iseli enkulu ye-arteritis kukudumba kunye nomonakalo kwimithambo yegazi ebonelela ngegazi entlokweni, entanyeni, emzimbeni nasengalweni. Ikwabizwa ngokuba yi-tempter arteritis.

Iseli enkulu yearteritis ichaphazela imithambo ephakathi ukuya kwelikhulu. Kubangela ukudumba, ukudumba, ukuthamba, kunye nokonakala kwimithambo yegazi ebonelela ngegazi entlokweni, entanyeni, emzimbeni ephezulu nasezingalweni. Ixhaphake kakhulu kwimithambo ejikeleze iitempile (kwimithambo yexeshana). Ezi zixhobo zemithambo zisuka kwimithambo ye-carotid entanyeni. Ngamanye amaxesha, imeko inokwenzeka nakwiimithambo eziphakathi ukuya kwezikhulu nakwezinye iindawo emzimbeni.

Unobangela wale meko akaziwa. Kukholelwa ukuba kungenxa yempendulo engalunganga yomzimba. Ukuphazamiseka kunxulunyaniswe nosulelo oluthile kunye nakwimfuza ethile.

Iseli enkulu ye-arteritis ixhaphake kakhulu kubantu abanesinye isifo sokudumba esaziwa ngokuba yi-polymyalgia rheumatica. Iseli enkulu ye-arteritis ihlala isenzeka kubantu abangaphezu kweminyaka yobudala engama-50. Ixhaphake kakhulu kubantu abavela kumantla eYurophu. Le meko inokuhamba kwiintsapho.

Ezinye zeempawu eziqhelekileyo zale ngxaki zezi:

• Intloko entsha yokubamba intloko kwelinye icala lentloko okanye ngasemva kwentloko
• Ukuthantamisa xa uchukumisa ulusu

Ezinye iimpawu zingabandakanya:

• Intlungu yomhlathi eyenzeka xa uhlafuna
• Ubuhlungu engalweni emva kokuyisebenzisa
• Ubuhlungu bemisipha
• Ubuhlungu kunye nokuqina entanyeni, ezingalweni eziphezulu, egxalabeni, nasezinqeni (polymyalgia rheumatica)
• Ubuthathaka, ukudinwa kakhulu
• Ifiva
• Imvakalelo yokugula ngokubanzi

Iingxaki zokubona zinokubakho, kwaye ngamanye amaxesha zinokuqala ngesiquphe. Ezi ngxaki zibandakanya:

• Umbono omfiliba
• Umbono kabini
• Ukunciphisa ngokukhawuleza umbono (ukungaboni kwelinye okanye zombini amehlo)

Umboneleli wezempilo uya kukuvavanya intloko.

• Nentloko enesihlwitha yohambayo isoloko inovakalelo ekuchukumisweni.
• Kunokubakho ithenda, umthambo ongqindilili kwicala elinye lentloko, ubukhulu becala ngaphezulu kwetempile enye okanye zombini.

Uvavanyo lwegazi lunokubandakanya:

• IHemoglobin okanye ihemmatocrit
• Uvavanyo lomsebenzi wesibindi
• Ireyithi yokulinganisa (ESR) kunye neprotein esebenzayo yeC

Uvavanyo lwegazi lulodwa alunakho ukubonelela ngoxilongo. Uya kudinga ukuba ube ne-biopsy yomthambo wexeshana. Le yinkqubo yotyando enokwenziwa njengesigulana esingalaliswayo.

Unokuba nolunye uvavanyo, kubandakanya:

• Umbala weDoppler ultrasound yemithambo yexeshana. Oku kungathatha indawo ye-biopsy yomzuzwana wexeshana ukuba yenziwe ngumntu onamava ngenkqubo.
• IMRI.
• Ukuskena iPET.

Ukufumana unyango ngokukhawuleza kunokunceda ukukhusela iingxaki ezinzima ezifana nokungaboni.

Xa kukrokrelwa i-arteritis enkulu yeseli, uya kufumana i-corticosteroids, efana ne-prednisone, ngomlomo. La mayeza ahlala eqala nangaphambi kokuba kwenziwe i-biopsy. Usenokuxelelwa nokuba uthathe iiasprini.

Uninzi lwabantu luqala ukuziva lungcono kwiintsuku ezimbalwa emva kokuqala unyango. Umthamo we-corticosteroids uya kuncitshiswa kancinci kancinci. Nangona kunjalo, kuya kufuneka uthathe amayeza unyaka omnye ukuya kwiminyaka emibini.

Ukuba ukuxilongwa kwe-cell cell arteritis kwenziwa, kubantu abaninzi iyeza le-biologic elibizwa ngokuba yi-tocilizumab liza kongezwa. Eli yeza linciphisa inani le-corticosteroids efunekayo ukulawula isifo.

Unyango lwexesha elide kunye ne-corticosteroids lunokwenza amathambo acekeceke kwaye wandise ithuba lakho lokophuka. Kuya kufuneka uthathe la manyathelo alandelayo ukukhusela amandla akho ethambo.

• Kuphephe ukutshaya kunye nokusela kakhulu.
• Thatha i-calcium eyongezelelweyo kunye ne-vitamin D (ngokusekelwe kwiingcebiso zomboneleli wakho).
• Qalisa ukuhamba okanye ezinye iindlela zokuthwala ubunzima.
• Yenza amathambo akho ahlolwe ngovavanyo lwe-bone mineral density (BMD) okanye uvavanyo lwe-DEXA.
• Thatha iyeza le-bisphosphonate, njengealendronate (Fosamax), njengoko kumiselwe ngumboneleli wakho.

Uninzi lwabantu luyachacha ngokupheleleyo, kodwa unyango lunokufuneka kangangeminyaka emi-1 ukuya kwezi-2 okanye nangaphezulu.Imeko inokubuyela emva komhla.

Ukonakala kweminye imithambo yegazi emzimbeni, njengee-aneurysms (ibhaluni yemithambo yegazi), inokwenzeka. Lo monakalo ungakhokelela kwistroke kwixesha elizayo.

Fowunela umnikezeli wakho ukuba unayo:

• Intloko ebuhlungu engapheliyo
• Ukuphulukana nombono
• Ezinye iimpawu ze-arteritis yokwexeshana

Unokuthunyelwa kwingcali ephatha i-arteritis yokwexeshana.

Akukho sithintelo saziwayo.

Arteritis - okwethutyana; I-cranial arteritis; Iseli enkulu yegazi

• Umzobo weCarotid

UDejaco C, uRamiro S, uDuftner C, et al. Iingcebiso ze-EULAR malunga nokusetyenziswa kwemifanekiso kwi-vasculitis yenqanawa enkulu kunyango. U-Ann Rheum Dis. 2018; 77 (5): 636-643. IINKCUKACHA: 29358285 www.ncbi.nlm.nih.gov/pubmed/29358285.

UJames WD, u-Elston DM, nyanga i-JR, i-Rosenbach MA, i-IM ye-Neuhaus. Izifo zemithambo yegazi. Ku: James WD, Elston DM, Phatha uJR, Rosenbach MA, Neuhaus IM, ii-eds. Izifo zikaAndrews zolusu: Unyango lweKlinikhi. Umhla we-13. IPhiladelphia, PA: Elsevier; 2020: isahluko 35.

UKoster MJ, uMatteson EL, uWarrington KJ. I-arteritis enkulu yenqanawa enkulu: ukuxilongwa, ukubeka iliso kunye nokulawulwa. IRheumatology (iOxford). 2018; 57 (suppl_2): ii32-ii42. IINKCUKACHA: 29982778 www.ncbi.nlm.nih.gov/pubmed/29982778.

Ilitye JH, Tuckwell K, Dimonaco S, et al. Uvavanyo lwe-tocilizumab kwi-giant-cell arteritis. N Engl J Med. Ngo-2017; 377 (4): 317-328. IINKCUKACHA: 28745999 www.ncbi.nlm.nih.gov/pubmed/28745999.

UTamaki H, Hajj-Ali RA. I-Tocilizumab yeseli enkulu ye-arteritis-inyathelo elitsha elikhulu kwisifo esidala. IJAMA Neurol. 2018; 75 (2): 145-146. IINKCUKACHA: 29255889 www.ncbi.nlm.nih.gov/pubmed/29255889.