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ʻO Vasculitis o nā capillaries liʻiliʻi
ʻO Vasculitis o nā capillaries liʻiliʻi
He pūʻulu nui kēia o nā vasculitis o ka paia o nā arterioles, venules a i ʻole capillaries, ʻo ka prognosis e loli loa ma muli o ka maʻemaʻe a i ʻole systemic cutaneous vasculitis.
ʻO ka hiʻohiʻona maʻamau maʻamau ʻo ka purpura (ʻeleʻele ʻulaʻula ʻaʻole e mae i ka wā e kaomi ʻia) e hoʻopuʻi ana a hoʻokomo ʻia, ʻoi aku hoʻi i nā lālā haʻahaʻa, i hoʻonui ʻia i ke kū ʻana, hiki ke lawe i nā ʻano he nui (petechial a me ecchymotic, necrotic, pustular…) a i ʻole livedo, ka hana ʻana i kahi ʻano ʻōniʻoniʻo (livedo reticularis) a i ʻole mottling (livedo racemosa) ma nā wāwae. Hiki iā mākou ke nānā i kahi hanana o Raynaud (ua keʻokeʻo kekahi mau manamana lima i ke anuanu).
Hiki ke hui pū ʻia ka Purpura a me ka livedo me nā maʻi ʻē aʻe ma ka ʻili (papules, nodules, necrotic lesions, bleeding bubbles), urticaria paʻa ʻaʻole ʻona.
ʻO ka hele ʻana o nā hōʻike ma waho o ka ʻili he kumu ia o ka gravity, e hōʻike ana i ke komo ʻana o ka vascular i loko o nā kino:
- ʻeha pū,
- ʻeha ʻōpū, ʻeleʻele ʻeleʻele, maʻi hele,
- peripheral neuropathy
- edema o nā lālā lalo,
- ʻO ke koko Hyper,
- pilikia hanu, hānō, ʻaʻa koko…
Ke kuhikuhi nei ke kauka i nā hoʻokolohua e pili ana i ka ʻimi ʻana i ke kumu a me nā hōʻailona o ke koʻikoʻi: ka hoʻāʻo ʻana i ke koko me ka helu o ke koko, ʻimi i ka ʻāʻī, nā hoʻāʻo ʻana o ka ate a me nā puʻupaʻa, etc. lung x-ray inā pilikia ka hanu, etc.).
ʻO Vasculitis i hoʻokumu ʻia e ka maʻi:
- bacteria: streptococcus, gram-negative cocci (gonococcus a me meningococcus)
- viral: maʻi hepatitis, mononucleosis infectious, HIV, etc.
- malaria: malaria…
- mea ʻala: Candida albicans…
ʻO ka Vasculitis e pili ana me nā maʻi kūlohelohe
- ʻAno II (mixed monoclonal) a me III (mixed polyclonal) cryoglobulinemia, pili me ka maʻi autoimmune, ka maʻi (ʻoi aku ka hepatitis C) a i ʻole ka maʻi koko.
- Hypocomplementémie (Mac Duffie's urticarienne vascularite)
- Hyperglobulinémie (ʻulaʻula ʻulaʻula o Waldenström)
- Connectivitis: lupus, Gougerot-Sjögren syndrome, rheumatoid arthritis…
- ʻO Vasculitis o nā maʻi koko a me nā maʻi ʻino
- Leukemia, lymphoma, myeloma, kanesa
- ʻO Vasculitis pili me ANCA (anti-neutrophil cytoplasmic antibodies)
Micro Poly Angéite a i ʻole MPA
ʻO ka Micropolyangiitis (MPA) kahi ʻōnaehana necrotizing angeitis nona nā hōʻailona maʻi e like loa me ka PAN.
Hoʻopili ʻia ka MPA me ANCA o ke ʻano anti-myeloperoxidase (anti-MPO) a ʻo ia ka mea maʻamau e hoʻāla ai i ka glomerulonephritis holomua wikiwiki a me ke komo ʻana o ka pulmonary i loaʻa ʻole i ka PAN.
Hoʻomaka ka mālama ʻana i ka MPA e like me ka PAN me ka corticosteroid therapy, i kekahi manawa i hui pū ʻia me nā immunosuppressants (cyclophosphamide i ka nui)
Maʻi ʻo Wegener
ʻO ka granulomatosis o Wegener he vasculitis ka mea i hoʻomaka ʻia e ka ENT a i ʻole nā hōʻailona hanu (sinusitis, pneumopathy, a me nā mea ʻē aʻe) kū i ka lāʻau antibiotic.
ʻO ka maʻamau, ʻo ka diffuse ENT (destructive pansinusitis), pulmonary (parenchymal nodules) a me ka renal (crescent pauci-immune necrotizing glomerulonephritis) e hoʻopuka i ka triad maʻamau o ka granulomatosis a Wegener.
Hoʻopilikia ka ʻili-mucous membrane ma kahi o 50% o nā maʻi: purpura (nā wahi ʻulaʻula ʻaʻole nalo i ka wā e kaomi ʻia) bulging a infiltrated, papules, subcutaneous nodules, ulcerations ʻili, pustules, vesicles, hyperplastic gingivitis ...
ʻO ANCA kahi hōʻike diagnostic a me ka hoʻomohala ʻana no ka granulomatosis o Wegener, me ka diffuse cytoplasmic fluorescence (c-ANCA), granular maikaʻi me ka hoʻonui perinuclear a / a i ʻole ka fluorescence perinuclear (p-ANCA).
ʻO ka mālama ʻana i ka granulomatosis o Wegener, i hiki ke manaʻo ʻia i kekahi manawa he lāʻau ulia pōpilikia, pono e hana ʻia i loko o kahi halemai kūikawā, ma o ka hui pū ʻana o cortisone a me ka cyclophosphamide waha.
ʻO ka maʻi Churg a me Strauss
ʻO ka hānō kahi hōʻailona nui a mua o kēia vasculitis, a ma mua o ka awelika e 8 mau makahiki ma mua o nā hōʻailona mua o ka vasculitis (neuropathy, sinus disorders, etc.) a hoʻomau ma hope.
Hōʻike nā hoʻāʻo koko i ka piʻi ʻana o ka eosinophilic polynuclear white blood cell
Hoʻomaka ka mālama ʻana i ka maʻi Churg a me Strauss me ka corticosteroid therapy, i kekahi manawa hui pū me nā immunosuppressants (ʻoi aku ka cyclophosphamide)
Ka manaʻo o kā mākou kauka
ʻO ka purpura infiltrated (ʻulaʻula, ʻano mānoanoa ʻaʻole e mae me ke kaomi manamana lima) ka hōʻailona nui o ka vasculitis. ʻO ka mea pōʻino, ʻaʻole i loaʻa kēia hōʻailona i nā manawa a pau a ʻo ka loli ʻana o nā hōʻailona lapaʻau ʻike ʻole e paʻakikī i nā kauka. Pēlā nō, paʻakikī pinepine ka loaʻa ʻana o ke kumu e mālama ai i ka vasculitis moku liʻiliʻi, ʻo ia ka hihia koʻikoʻi i loaʻa i ka hana o kēia manawa ke hoʻohālikelike ʻia me ka vasculitis moku waena a me ka moku nui: ma kahi o ka hapalua o ka vasculitis moku liʻiliʻi. ʻAʻohe kumu i loaʻa i nā moku i ka wā o ka ʻimi ʻana o ke kino a me ka radiological a ke kauka e hana ai e ʻimi i kahi etiology. 'Ōlelo pinepine mākou no ka "allergic vasculitis" a i ʻole "hypersensitivity vasculitis" a i ʻole "cutaneous vasculitis o nā moku liʻiliʻi o ka idiopathic caliber". ʻO Kauka Ludovic Rousseau, dermatologist |
palena'āina
Pūʻulu Haʻawina Vasculitis Farani: www.vascularites.org
Dermatonet.com, kahua ʻike ma ka ʻili, ka lauoho a me ka nani e kahi dermatologist
MedicineNet : http://www.medicinenet.com/vasculitis/article.htm