I-vasculitis ye-Rheumatoid yinto engabonakaliyo, engathandabuzekiyo ye- rheumatoid arthritis engasongela ubomi. Kwi-rumatoid vasculitis, ukuvuvukala kusasazeka kwimithambo yegazi encinci okanye ephakathi emzimbeni. Ngokuqhelekileyo, iireyriyiti zibandakanyeka, kodwa imithanjeni ingaba nayo. Iimitha ezinkulu zegazi azibandakanyekanga.
Iindonga zemithambo yegazi echithweyo iyancipha kwaye njengoko i-lumen yesitya esichaphazelekayo segazi iyancipha, ingaba ivalwe.
Ukunikezelwa kwegazi kwilungu kunokuthi kutyeshelwe, ukuba kungenakuphazamiseka. I-vasculitis ye-rumatoid inokubandakanya izitho ezininzi, kuquka isikhumba, amehlo, iintliziyo, intliziyo, imiphunga, ingqondo, izintso, okanye isisu. Kodwa, kukho iindaba ezilungileyo kunye. Izigulana ezincinci ze-rheumatoid arthritis ziphuhlisa i-vasculitis ye-rhumatoid, mhlawumbi ngenxa yeziyobisi ezinobungakanani eziye zaphuhliswa kwaye zithengiswa kwiminyaka elishumi edlulileyo (oko kukuthi, iziyobisi ze-biologic ).
Ubuninzi kunye nobungozi beRumatoid Vasculitis
Ngoxa i-vasculitis ye-rheumatoid ibonakala iyancipha, kuqikelelwa ukuba ngaphantsi kwe-5 ukuya kwi-5% yesigulane se-rheumatoid arthritis isigulane senza i-vasculitis ye-rheumatoid. Nangona kunjalo, izifundo ze-autopsy ziye zabika i-15-31%. Amanani okufa kunye nokufa okuhambisana ne-vasculitis ye-rhumatoid kubaluleke kakhulu kwi-5% yokufa kwabangama-30 ukuya kuma-50% kunye namazinga amaninzi okuxhatshazwa okubangelwa zizifo ezinobungozi okanye utywala.
Ezi zinto zilandelayo zandisa ingozi yokuphuhlisa i-vasculitis ye-rheumatoid:
- Efanelekileyo kwi- rheumatoid factor
- Efanelekileyo kwi- anti-CCP
- Abesilisa (1 kwaba-9 abesilisa abane-rheumatoid arthritis bahlakulela i-vasculitis ye-rhumatoid)
- Ukutshaya
- Ubuninzi bee- nodules ze-rheumatoid
- Umdala kwisifo esiqalayo okanye ixesha elide le-rheumatoid arthritis (ngaphezu kweminyaka eyi-10)
Iimpawu kunye nokubonakaliswa kwe-Rumatoid Vasculitis
Naliphi na iqumrhu lomzimba linokuchaphazeleka yi-vasculitis ye-rhumatoid. Ikhumba kunye neentsholongwane zomhlaba zihlala zibandakanyeka. Nangona ukubandakanyeka kwequmrhu elibalulekileyo kuthathwa njengento exhaphakileyo kakhulu, kudibaniswa nokuphazamiseka okukhulu nokufa.
Ukubandakanya isikhumba kunokubandakanya i-purpura, iigununu, izilonda, ne-necrosis yamadijithi, ngokukodwa i-fingertips. ULivedo reticularis uyifumana ngokuqhelekileyo. Ukubandakanya isikhumba kufuna ukuba uphando olongezelelweyo lwenye iqhaza lombutho. I-Scleritis , i- pleuritis , okanye i- pericarditis yimizekelo yezinto ezinokuphuhliswa. Ukuba ulusu lubandakanyeka ngaphandle kokubandakanyeka kwesinye inkqubo, ukuxela kwangcono.
Ngendlela yesistim yomnxeba, i- neuropathies ye-périphher iyakhula , njenge-distal symmetric sensory polyneuropathy, i-distal motor okanye i-neuropathy ehlangeneyo, okanye i-mononeuritis multiplex. Xa i-vasculitis yonakalisa amaninzi. kukho ukuphazamiseka, ukubetha, ukulahleka kweentlungu, ubuthathaka kunye nokulahleka komsebenzi ezandleni okanye ezinyaweni. Iimpawu ezingaphezulu kwezinto eziqhelekileyo zinokuthi zenzeke, ezinjengomkhuhlane, ukulahleka kwesisindo, ukulahleka kwesidlo, nokulahleka kwamandla.
Ukuxilongwa kwe-Rheumatoid Vasculitis
Ngoxa iprogram yezimpawu zenza ugqirha ukuba usongele i-vasculitis ye-rheumatoid kunye neemvavanyo zelabhoratri zinokunika ubungqina obuxhasayo malunga nokuxilongwa okubonakalayo, i-biopsy iyadingeka ukuba ihlolwe ngokucacileyo.
Ikhumba elibandakanyekayo linokuthi litshintshwe, kunye ne-muscle okanye intshontsho kwindawo echaphazelekayo, okanye iqumrhu elichaphazelekayo.
Nangona ukuhlolwa kwegazi kwi-rheumatoid factor kunye ne-anti-CCP ngokuqhelekileyo kuphakanyiswe kwi-vasculitis ye-rheumatoid, iziphumo azizodwa. Amanqindi amabini anesifo esiphambili kwi-rheumatoid arthritis ngaphandle kwe-vasculitis. I-anti-neutrophil cytoplasmic antibodies (i-ANCA) kunye ne-anti-myeloperoxidase kunye ne-anti-proteinase-3 antibodies ayinayo i-vasculitis ye-rheumatoid.
Unyango lwe-Rheumatoid Vasculitis
Unyango lwe-vasculitis ye-rheumatoid ngokubanzi luzimisele ukuba yiziphi izitho ezibandakanyekayo.
Kwakhona, isifo se-rheumatoid arthritis kufuneka siphathwe kakuhle nge- DMARD okanye iziyobisi ze-biologic, ezifana ne- TNF blockers . Ukulawula ukuvuvukala kwiimbini zombini kunye nemida yegazi kubalulekile.
Umgca wokuqala wonyango lwe-vasculitis ye-rhumatoid iquka ukusebenzisa i- corticosteroids (ngokuqhelekileyo i- prednisone ). I-Prednisone ingadibana ne methotrexate okanye i-azathioprin. Ngeempawu eziphambili kunye nokubandakanyeka komzimba okunzima, umzamo okhuselekileyo wokunyuswa kwe-immunosuppression ungabandakanya i-cyclophosphamide kunye namazinga aphezulu e-prednisone. I-Rituxan (rituximab) ikhulayo njengendlela yokuqala yonyango kwi-vasculitis ye-rheumatoid. Ngokombiko we-Arthritis Care and Research (2012), uhlalutyo lwedatha ukusuka kwi-Autoimmunity kunye neRituximab registry lubonise ukuba ukuxolelwa kwafezekiswa kwi-12 ye-17 ye-rumatoid vasculitis izigulane eziphathwe nge-rituximab. Izigulane nazo zakwazi ukunciphisa umthamo wazo we-prednisone.
Imithombo:
I-Rumatoid Vasculitis. Johns Hopkins Vasculitis Centre.
http://www.hopkinsvasculitis.org/types-vasculitis/rheumatoid-vasculitis/
I-Rumatoid Vasculitis. Kliniki yaseCleveland.
http://my.clevelandclinic.org/services/orthopaedics-rheumatology/diseases-conditions/hic-rheumatoid-vasculitis
I-Rumatoid Vasculitis. IVasculitis Foundation. Septemba 2012.
http://www.vasculitisfoundation.org/education/forms/rheumatoid-vasculitis/
I-Rumatoid Vasculitis: Ukuphazamiseka Kwempembelelo okanye Ukujoliswa Kwezonyango Ezintsha? Bartels kunye neeBridges. IiNgxelo zeRheumatology zangoku. Disemba 2010.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2950222/
I-Rituximab unyango lwe-vasculitis yesistim ehambisana ne-rheumatoid arthritis: Iziphumo ezivela kwi-Autoimmunity and Rituximab Registry. Puechal X et al. Ukunyamekela kweArthritis noPhando. Matshi 2012.
http://www.ncbi.nlm.nih.gov/pubmed/22076726