Takayasu arteritis

I-Takayasu arteritis kukudumba kwemithambo emikhulu efana ne-aorta kunye namasebe ayo aphambili. I-aorta ngumthambo ophethe igazi lisuka entliziyweni liye kuwo wonke umzimba.

Unobangela we-Takayasu arteritis awaziwa. Esi sifo sivela ikakhulu ebantwaneni nakubantu basetyhini abaphakathi kweminyaka engama-20 ukuya kuma-40. Siqheleke kakhulu kubantu baseMpuma Asiya, baseIndiya okanye baseMexico. Nangona kunjalo, ngoku ibonakala ngokufuthi kwezinye iindawo zehlabathi. Iintlobo zemfuza ezininzi ezonyusa ithuba lokuba nale ngxaki zifunyenwe kutshanje.

I-Takayasu arteritis ibonakala iyimeko yokuzimela. Oku kuthetha ukuba amajoni omzimba ahlasela ngempazamo izicwili ezisempilweni kudonga lwemithambo yegazi. Imeko inokuthi ibandakanye nezinye iinkqubo zamalungu.

Le meko inezinto ezininzi ezifanayo ne-arteritis enkulu yeseli okanye i-tempter arteritis kubantu abadala.

Iimpawu zingabandakanya:

• Ubuthathaka bengalo okanye iintlungu ngokusetyenziswa
• Iintlungu zesifuba
• Ukuba nesiyezi
• Ukudinwa
• Ifiva
• Ubumhlophe
• Intlungu yezihlunu okanye edibeneyo
• Ukudumba kolusu
• Ukubila ebusuku
• Umbono utshintsha
• Ukuhla ukusinda
• Ukunciphisa ukubola kwe-radial (esihlahleni)
• Umahluko kuxinzelelo lwegazi phakathi kweengalo zombini
• Uxinzelelo lwegazi (uxinzelelo lwegazi)

Kunokubakho iimpawu zokudumba (i-pericarditis okanye i-pleuritis).

Uvavanyo olunokwenzeka lubandakanya:

• I-Angiogram, kubandakanya i-coronary angiography
• Gcwalisa ubalo lwegazi (CBC)
• Iprotheni esebenzayo yeC (CRP)
• I-Electrocardiogram (ECG)
• Izinga le-sedimentation ye-Erythrocyte (ESR)
• Imagnetic resonance angiography (MRA)
• Imagnetic resonance imaging (iMRI)
• Ikhompyuter ye-tomography angiography (CTA)
• Ipositron emission tomography (iPET)
• I-Ultrasound
• X-ray esifubeni

Unyango lwe-Takayasu arteritis kunzima. Nangona kunjalo, abantu abanonyango olufanelekileyo banokuphucula. Kubalulekile ukuchonga imeko kwangethuba. Esi sifo sihlala singanyangeki, sifuna ukusetyenziswa kwexesha elide kwamayeza alwa nokudumba.

AMAYEZA

Uninzi lwabantu luphathwa kuqala ngeedosi eziphezulu ze-corticosteroids ezinje nge-prednisone. Njengoko isifo silawulwa idosi ye-prednisone iyancipha.

Phantse kuzo zonke iimeko, iziyobisi ezisebenza ngokuchasene nomzimba ziyongezwa ukunciphisa isidingo sokusetyenziswa kwe-prednisone ixesha elide kwaye sigcine isifo.

Iiarhente eziqhelekileyo zokuzikhusela emzimbeni ezinje nge-methotrexate, azathioprine, mycophenolate, cyclophosphamide, okanye leflunomide zihlala zongezwa.

Iiarhente zebhayoloji zinokusebenza. Oku kubandakanya i-TNF inhibitors enjenge-infliximab, etanercept, kunye ne-tocilizumab.

UKUGQIBELA

Utyando okanye i-angioplasty inokusetyenziselwa ukuvula imithambo encinci yokuhambisa igazi okanye yokuvula inyanzeliso.

Ukutshintshwa kwesivalo seAortic kunokufuneka kwezinye iimeko.

Esi sifo sinokubulala ngaphandle kwonyango. Nangona kunjalo, indlela yonyango edibeneyo yokusebenzisa amayeza kunye notyando kunciphisile amazinga okufa. Abantu abadala banethuba elingcono lokusinda kunabantwana.

Iingxaki zinokubandakanya:

• Ihlwili legazi
• Ukuhlaselwa yintliziyo
• Ukumelwa yintliziyo
• Pericarditis
• Ukungoneliseki kwevalvu yeAortic
• Ipleuritis
• Ukubetha
• Ukopha emathunjini okanye iintlungu ekuvaleni kwemithambo yegazi

Fowunela umboneleli wakho wezempilo ukuba uneempawu zale meko. Unonophelo olukhawulezileyo luyafuneka ukuba:

• Ukubetha okubuthathaka
• Iintlungu zesifuba
• Ukuphefumla ubunzima

Isifo esingapheliyo, inqanawa enkulu ye-vasculitis

• Icandelo lentliziyo phakathi embindini
• Ivaluva zentliziyo - umbono ongaphandle
• Iipavali zentliziyo-umbono ogqwesileyo

UAlomari I, uPatel PM. Takayasu arteritis. Ku: Ferri FF, ed. Umcebisi weKlinikhi kaFerri 2020. IPhiladelphia, PA: Elsevier; 2020: 1342.e4-1342.e7.

UBarra L, uYang G, uPagnoux C; Inethiwekhi yeCanada Vasculitis (CanVasc). Amachiza angenayo i-glucocorticoid kunyango lwe-Takayasu's arteritis: Ukuphononongwa ngokuchanekileyo kunye nokuhlaziywa kwemeta. Ukuzikhusela ngokuzenzekelayo Rev. 2018; 17 (7): 683-693. IINKCUKACHA: 29729444 pubmed.ncbi.nlm.nih.gov/29729444/.

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

I-Ehlert BA, i-Abularrage CJ kunye ne-CJ. Isifo seTakayasu. Ku: Sidawy AN, Perler BA, ii-eds. Utshintsho lukaRutherford lweeVascular and Therapy ze-Endovascular Therapy. Umhla we-9. IPhiladelphia, PA: Elsevier; I-2019: isahluko 139.

USerra R, uButrico L, uFugetto F, et al. Uhlaziyo kwi-pathophysiology, isifo kunye nolawulo lwe-Takayasu arteritis. U-Ann Vasc Uvavanyo. Ngo-2016; 35: 210-225. IINKCUKACHA: 27238990 pubmed.ncbi.nlm.nih.gov/27238990/.