I-allergies iyona kuphela yezizathu ezininzi ezinokwenzeka
I-angioedema ukuvuvukala kwe-tissue engaphantsi nje kwesikhumba okanye kwiimbrane ezinamaqabunga. Ukuvuvukala kunokuchaphazela ubuso, ulwimi, imilomo, umqala, iingalo, nemilenze kodwa ingaba yingozi kwaye isongela ubomi xa ivela emqaleni, emaphaphu, okanye emathunjini. I-Angioedema ivame ukubangelwa yi-allergies kodwa nayo ingabangela ukuphendulwa kweziyobisi ezingahambiyo, isifo, umhlaza, i-genetics, kunye noxinzelelo.
Unyango luxhomekeke kwisizathu esisisiseko, kodwa singabandakanya ama-antihistamines, i-steroids, kunye nokuphepha kwezinto ezivelayo.
Iimpawu
Ngelixa i-angioedema ihambelana kakhulu nemifuno (i- urticaria ) ekubambeni igalelo elifanayo, iimpawu ziyahluka.
I-Angioedema ivela kwiisishu zangaphantsi ngaphantsi kweengqimba zangaphandle zesikhumba (ebizwa ngokuthi i-dermis ne-epidermis). Ngaloo ndlela, kubangela ukukhukhumeza okujule, okuqhelekileyo okuhlala kudala kunemihlathi. Ngokwahlukileyo, i-urticaria ibandakanya i-epidermis kunye ne-dermis kwaye ibonakala ngamavili aphakanyisiweyo nemida ecacileyo ecacileyo.
Nge-angioedema, ukuvuvukala kungaqala ngaphakathi kwemizuzu okanye kuphuhlise kwixesha leeyure. Indawo evuvukileyo yesikhumba ayisoloko iyinhlamba (ngaphandle kokuba ihambisane ne-urticaria) kodwa inokuthi ikwazi ukuvutha, ukutshitshisa, okanye ukuphazamiseka. Ukuvuvukala kunokuhlala ixesha elide okanye iintsuku. Xa ukuvuvukala kugqiba ngokugqibeleleyo, ulusu luya kubonakala luqhelekileyo ngaphandle kokukhwabanisa, ukukhangela, ukusila, okanye ukubetha.
Ezinye iindidi ze-angioedema zingaba zibi kakhulu, ingakumbi ukuba zihamba ngaphaya kwemida, ubuso okanye i-trunk. Phakathi kweengxaki:
- I-angioedema yesigca esiswini sinokubangela ukuhlanza okunobundlobongela, ubuhlungu obukhulu phakathi kwe-middlesection, kunye nokuphelelwa umdaka (ngenxa yokungakwazi ukugcina umbane).
- I-Angioedem yemiphunga ingabangela ukuvuthwa, ukuphefumula okufutshane, kunye nokuvinjelwa kwamanzi.
- I-Angioedema ye-larynx (ibhokisi yezwi) inokukhokelela ekufakeni i-asphyxiation nokufa.
Izizathu
Ukususela kumbono obanzi, i- angioedema ibangelwa yimpendulo engavumelekanga yendlela yokuzivikela emzimbeni apho amachiza aziwa ngokuba yi-histamine okanye i-bradykinins akhululwa kwigazi.
I-Histamine , eyenza inxalenye yokhuseleko lomzimba, idala ukukhutshwa kwemithambo yegazi ukwenzela ukuba amangqamuzana omzimba angasondeza kwisiza sokulimala. I-Bradykinins yenza ukuba imivenge yegazi ihluthe, kodwa yenza njalo ukulawula imisebenzi yomzimba njengengcinezelo yegazi kunye nokuphefumula. Xa sikhululwe ngokungavumelekanga, mhlawumbi ngokwabo okanye ngokubambisana, la maqumrhu angenza ukuvuvukala sikuqaphele njenge-angioedema.
I-Angioedema ngokuqhelekileyo ibekwa ngamaqela amabini:
Angioedema efunyenweyo
I-angioedema efumanekayo (AAE) ingabangelwa yi-immunologic (enxulumene nesistim somzimba) kunye nezizathu ezingezizo zokuzibulala. Ziquka:
- Isisombululo sokwenyuka kumachiza , ukutya , izilwanyana , okanye ukudibanisa nezinto ezifana ne- latex okanye i- nickel
- Iziganeko ezingekho phantsi kwezilwanyana, ezinjengalezo ezibandakanya ama-opiates (ngokukodwa i-codeine kunye ne-morphine) kunye nezidakamizwa ezichasayo ezingekho komzimba, ii-NSAID (ikakhulukazi i-aspirin)
- Izinto ezibangelwa ngumzimba ezifana nokufudumala, ukubandayo, ukunyamezela , ukunyakaza , ukukhanya kwelanga, kunye nokuxinzezeleka kwengqondo
- Izifo ezenza ngokuzenzekelayo njenge- lupus ne- Hashimoto's thyroiditis
- Unomdlavuza njenge- lymphoma kunye ne- myeloma
- Izifo ezinentsholongwane ezifana ne-hepatitis, i-HIV, i- cytomegalovirus ne-Epstein-Barr
Kuya kubakho na matyala awaziwayo. Ezi zibizwa ngokuba yi-idiopathic angioedema.
I-angioedema ye-idiopathic engapheliyo yimeko echaphazela abafazi ngaphezu kwamadoda. Abanye baye baxhomekeka ukuba kuhambelana nomjikelezo wokuya esikhathini, apho kuphuma khona i- estrogen kudla ngokuhambisana nokunyuka kwama-bradykinins.
I-Angeliedema yaseHereditary
I-angereded angioedema (HAE) i- autosomal disorder disorder , oku kuthetha ukuba ungayifumana ilifa leengxaki ezivela kumzali omnye kuphela. Ukuguqulwa kwezityalo kubangelwa ukugqithiswa kwee-bradykinins kwaye kunokuchaphazela zonke iinkqubo zesebe, kuquka isikhumba, imiphunga, intliziyo kunye nesondlo sesisu.
Nangona i-HAE inokubangela ukucinezeleka okanye ukulimala, ezininzi izihlaselo azikho isizathu esaziwayo. Ukuphindaphinda kuqhelekileyo kwaye kunokuhlala kwimizuzu emibili ukuya kwemihlanu. I-ACE inhibitors kunye nokukhulelwa kwe-estrogen-based , kokubili oku kunokuchaphazela amazinga e-bradykinin, ayaziwa ukwandisa ubukhulu kunye nobukhulu bokuhlaselwa.
KUNYE kunqabile, kubangelwa ngabantu abangama-50,000 kuphela, kwaye ixakeka kakhulu xa i-antihistamines okanye i-corticosteroids ihluleka ukunika uncedo lweempawu.
Ukuxilongwa
I-Angioedema inokuthi ixilongwe ngokusekelwe ekubonakaleni kwayo kweklinikhi kunye nokuhlaziywa kwimbali yakho yezonyango kunye neempawu ezihambayo.
Ukuba unobungozi obunokubakholelwa, ugqirha wakho unokubonisa ukuba unokuhlolwa kweengxaki zokufumana ulwalamano ukufumanisa i-causal trigger (allergen). Oku kungabandakanya uvavanyo lwe- skin prick (apho inani elincinci lokukhankanya i-allergen lijojowe phantsi kwesikhumba), uvavanyo lwe-patch (usebenzisa iqhosha lokubamba iqhosha elichaphazela i-allergen), okanye iimvavanyo zegazi ukuhlola ukuba i-antigenic antibodies egazini lakho .
Iimvavanyo zegazi zingasetyenziselwa ukuxilonga i-HAE. Ukuba zonke ezinye izizathu ze-angioedema zikhutshiwe, ugqirha wakho unokugqiba isigqibo sokuba ahlole izinga lento ebizwa ngokuba yi- C1 esterase inhibitor , elawula i-bradykinins , egazini lakho. Abo bane-HAE abanako ukuvelisa le protheni, ngoko iqondo eliphantsi le-C1 esterase inhibitor lithathwa njengoluphawu olunamandla lwalo hlobo lwe-angioedema.
Unyango
Phakathi kweyona ndlela efanelekileyo yokukhusela ukuhlaselwa kwangomso kukugwema nayiphi na into eyaziwayo. Ukuba le nto ayifinyeleleki, unyango luya kugxininisa ekukhuseleni iimpendulo zokuzivikela komzimba ukunciphisa amanqanaba e-histamine okanye i-bradykinins egazini lakho.
Phakathi kwezi ndlela:
- Ama-antihistamine omlomo aqhelekileyo anikezelwe ukuphatha i-angioedema echaphazelekayo. I-Zyrtec (i-cetirizine) isebenza ngokukodwa ekuhlaseleni okuthethekileyo kodwa inokuthi ithathwe njengento ephantsi, i-nightly for relief relief.
- Ukuba ukuvavanya ukunyamezela kuqinisekisile ukuba u-hypersensitive certainergens, i- shorteristic shots ingaqulunqwa ukuba unciphise ngokuthe ngcembe ukuqonda kwakho.
- Iziganeko ezingapheliyo ziyakwazi ukuphendula kakuhle kwi- corticosteroids yesistim ehanjiswe yi-injection injection. I-Prednisone yenye yeendlela eziqhelekileyo ezikhethiweyo kodwa isetyenziselwa ukuphululwa kwexesha elifutshane ngenxa yengozi yemiphumo emibi .
- I-HAE ingaphathwa ngamachiza Kalbitor (ecallantide) okanye Firazyr (icatibant). I-Kalibor ikhusela i-enzymes ekhuthaza ukuveliswa kwe-bradykinins, ngoxa i-Firazyr ivimbela i-bradykinins ukuba ixhomekeke kwiimfomfini kwiiseli ezijoliswe kuyo. Ukukhathazeka, ukukhathala, intloko yesifo, kunye nesifo sohudo ziyimiphumo emibi.
- Abantu abane-HAE banokufumana uxolo ngokuthatha i-androgens (i-hormone yamadoda) njenge-methyltestosterone kunye ne-danazol. Oku kusebenza ngokunciphisa amanqanaba ama-bradykinins ajikeleza egazini. Ukusetyenziswa kwexesha elide kunokudala imiphumo yobuninzi kubasetyhini (kubandakanywa umthambo wesimo somntu kunye neenwele zobuso) kunye nokwandiswa kwebele (gynecomastia) kumadoda.
- I-angioedema ephezulu ye-larynx kufuneka iphathwe ngengozi yxamnye ne-epinephrine (adrenaline). Abantu abanolwazi olunzima kakhulu bahlala befuna ukuphatha i-epinephrine injector, ebizwa ngokuba ngu- EpiPen , xa kwenzeka ukuhlaselwa.
ILizwi
I-angioedema inokubandezeleka, ingakumbi ukuba ukuvuvukala kunzima okanye kukuphindaphindiweyo. Nangona kungekho zibonakaliso ezibonakalayo, kufuneka ubone ugqirha ukuba ukuvuvukala kuqhubekeka ngaphezu kweentsuku ezimbalwa.
Ukuba i-angioedema ikholelwa ukuba inxulumene ne-allergies kodwa ungayazi imbangela, gcina idayari ukurekhoda nayiphi na ukutya oye wadla okanye izilwanyana ezingqongileyo oye wavelelwa kuyo. Ukwenza oko kunokunceda ukunciphisa ukukhangela kunye nokukunceda ukuba ugweme izinto ezibangelwa ingxaki.
Ngakolunye uhlangothi, ukuba ukhula ukuqhuma komqala ohamba kunye nokuphefumla ubunzima beyiphi na into, fowuna u-911 okanye ube nomntu ekukhawuleza egumbini lezongxamisekileyo elisondeleyo.
> Umthombo:
> Bernstein, J .; Cremonesi, P .; Hoffmann, T, et al. I-Angioedema kwisebe eliphuthumayo: isikhokelo esicwangcisekileyo sokuxilonga nokuhlukana kolawulo. Int J Emerg Med. 2017; 10 (1): 15. INGXELO: 10.1186 / s12245-017-0141-z.
> Bernstein, J .; I-Lang, D .; Khan, D. et al. Ukuxilongwa kunye nokulawulwa kwe-urticaria enesifo esingapheliyo: ukuhlaziywa kuka-2014. J Allergy Clin Immunol. 2014; 133 (5): 1270-7.