Izifo ezazibizwa ngokuba yi-pauciarticular juvenile idiopathic arthritis
I-oligoarticalular juvenile idiopathic arthritis (eyayibizwa ngokuba yi-pauciarticular juvenile idiopathic arthritis okanye i-pauciarthritis) yincinci ye- juvenile idiopathic arthritis ebandakanya amancinane angama-5. I-oligoarticalular juvenile idiopathic arthritis yona nto ixhaphakileyo yintsholongwane ye-idiopathic arthritis subtype. Iquka u-30% ukuya kwi-60% yazo zonke izigulane ze-idiopathic arthritis kwi-North America naseYurophu.
I-subtype ye-oligoarticular juvenile idiopathic arthritis iphinda yahlula phakathi:
- I-oligoarthritis eqhubekayo - Akukho nto inokubandakanyeka ngokubambisana ngaphandle kweenyanga ezi-6 zokugula kunye neempawu.
- I-oligoarthritis eyongeziweyo - Ukubandakanyeka ngokubandakanyekileyo okongezelelweyo kwenzeka emva kweenyanga ezi-6 zokugula kwaye ekugqibeleni kunamaqela angama-4 abandakanyekayo.
Phantse isiqingatha sabantwana abane-oligoarticalular juvenile idiopathic arthritis bahlakulele uhlobo olongezelelweyo lwe-4 ukuya kwe-6 kwiminyaka emva kokugula. Nangona kungekho ndlela eqinileyo yokuchazela ukuba yeyiphi na abantwana abaya kuqhubeka nokwandisa uhlobo olwandisiweyo, zikhona iimpawu zesifo esibonakalayo zandisa ukwenzeka, kuquka ukubandakanyeka ngokubambisana, ukubandakanyeka kwe-ankle okanye i-wrist (okanye zombini isandla kunye nesandla), kunye Isantya se- erythrocyte sophakamileyo kwiinyanga ezintandathu zokuqala.
Uhlobo lweMpawu kunye neMpawu
Ubuncinane bokuqala kwe-oligoarticular juvenile idiopathic arthritis uneminyaka engama-2 kuya kwe-4 ubudala kwi-Caucasian abantwana base-United States naseYurophu.
Amantombazana athatyathwa kakhulu kubafana (3 ukuya ku-1). Ukuqala kwe-oligoarticular juvenile idiopathic arthritis ayifana kakhulu nabantwana abangaphezu kweminyaka emi-5 ubudala kunye nokuqala kubunqabile kubantwana abaneminyaka eli-10 ubudala okanye ngaphezulu.
Ngokuqhelekileyo, ngokuqala kwe-oligoarticalular juvenile idiopathic arthritis, kukho ukubandakanyeka okubandakanyekayo okuchaphazelekayo okuchaphazela omnye okanye amaninzi amakhulu.
Amadolo ayona nto iqhelekileyo. I-ankle, isandla, kunye neenombolo zizahlulo eziqhelekileyo ezibandakanyekayo. Izimpawu zesistim (umz., Umkhuhlane, ukukhawuleza) akunqabile, njengokubandakanyeka kwe-hip kunye nomva. Ukuba umntwana unokubandakanyeka kwenkqubo okanye ukubandakanyeka kwe-hip okanye emuva, ukuhlaziywa kwakhona kwakhona kuboniswa kwaye kuhlolwe kwakhona ukuxilongwa.
Ngelixa unokuba ulindele ukuba intlungu ibe yona nto ibonakaliswe ngayo impawu ze-oligoarticalular juvenile idiopathic arthritis, ngokuqhelekileyo iqala ukuqonda. Umzali angaqaphela ukuba umntwana wabo unesiphako, ukungafuni ukuhamba okanye ukugijima, okanye ukuvuvukala okudibanayo.
I-70% ukuya kwi-80% yabantwana abane-arthritis ye-idiopathic yenkwenkwezi ye-oligoarticular kunye ne-80% ukuya kuma-95% kunye ne-oligoarticalular childhood idiopathic arthritis ene- ANA . Iimpawu ze-ANA ziphantsi ukuya kuthotyelwa. Kwi-ANA izigulane ezintle ezine-oligoarticalular juvenile idiopathic arthritis, kukho umngcipheko omkhulu wokuphuhlisa i- uveitis . Kwakhona, uninzi lwabantwana abane-oligoarticular juvenile idiopathic arthritis bane- CRP eqhelekileyo okanye ephakamileyo, kunye ne-sedimentation rate, i-white normal cell cell counts, kunye ne- anemia (i-mildem).
Ngokubhekisele kwi-uveitis, kukho iimvavanyo zelabhoratri ezikunceda ukuqikelela ubunzima be-uveitis yangaphakathi kubantwana abane-oligoarticular juvenile idiopathic arthritis.
Iimvavanyo aziqikeleli ukuqala, nangona kunjalo. Iimvavanyo zingabandakanya i-a2-globulin level kwi-serum, kunye ne-HLA antigen (HLA-A19, HLA-B22, HLA-DR9).
Unyango lwe-Oligoarticular Juvenile Idiopathic Arthritis
Ukunyanga kwe-oligoarticalular juvenile idiopathic arthritis kufana nesimo se-rheumatoid esichaphazelekayo okanye i-rheumatoid factor negative polyarticular juvenile idiopathic arthritis. Ukufana kwonyango kubangelwa ukubandakanyeka kwepolyarticular .
Ukuqhubeka kwe-oligoarticular juvenile idiopathic arthritis, indlela yokunyathela isetyenziswa ngokuqhelekileyo:
- Unyango nge- NSAID (kunye okanye ngaphandle kwe-intra-articular injection steroid)
- I-Methotrexate iyalingwa xa impendulo kwi-intra-articular injini ye-steroid ayinelanga
- I-TNF inhibitor ingafakwa, kunye okanye ngaphandle kwe-methotrexate, ukuba i-methotrexate yedwa ayaneleyo
I-Azulfidine (i-sulfasalazine) kunye ne- Plaquenil (i-hydroxychloroquine) ingasetyenzisiswa kunye njengesicwangciso esinye. Ukuxolelwa (nokuba yinxalenye okanye iphelele) ye-oligoarticular ye-juvenile idiopathic arthritis inokufunyanwa kwi-60-70% yezigulane ezongeziweyo zezilwanyana ze-idiopathic arthritis izigulane ezinokusetyenziswa kwe-methotrexate.
Imithombo:
I-Kelley's Bookbook yeRheumatology. Elsevier. I-ninth edition. Isahluko 107. unyango lwe-Juvenile Idiopathic Arthritis. Hsu, Lee, Sandborg.
I-Oligoarticalular juvenile idiopathic arthritis. Isemgangathweno. UM Pamela F. Weiss MD. 12/09/15.
http://www.uptodate.com/contents/oligoarticular-juvenile-idiopathic-arthritis
OrthoInfo. Umntwana weArthritis. Septemba 2013.
http://orthoinfo.aaos.org/topic.cfm?topic=a00075
Ukuqwalasela kwangaphambili kwindlela enzima ye-uveitis kwi-oligoarticalular juvenile idiopathic arthritis. Zulian E. et al. Journal of Rheumatology. Novemba 2002.
http://www.ncbi.nlm.nih.gov/pubmed/12415607