Ukunyuka kwezilwanyana, imvelo kunye ne-genetics bonke bangaba nendima
I-Angioedema, ukuvuvukala kwimizimba yexubile kwangoko phantsi kwesikhumba, kunokubangelwa yi-allergies, ukusabela kwezidakamizwa, imeko yendawo okanye ukuxinezeleka. Kwakhona ingaba yindlalifa, kunye nokuguquka kwezinto eziphathekayo ezidlulileyo kwiintsapho. Indlela esezantsi kuzo zonke iimeko ziyimpilisi yesistim somzimba apho iikhemikhali ezibizwa ngokuthi i-histamine okanye i-bradykinins zikhutshwa ngokwemvelo kwigazi.
Ummandla womzimba ochaphazelekayo-ubuso, ulwimi, umhombo, iingalo, okanye imilenze-kunokubonelela ngeyona nto, kodwa kungekho rhoqo.
Izizathu eziqhelekileyo
I- angioedema efumanekayo (AAE) ingaba ne-immunologic (enxulumene nokupheliswa komzimba), engeyiyo-immunologic (ebangelwa yimibangela engeyona ingxaki), okanye idiopathic (engaziwayo imvelaphi). Ngokungafani ne-angioedema kunye neyona nto ibangela i-genetic (jonga ngezantsi), ezinye zezinto ezibandakanyekayo kule ntlobo zingaguquleka.
Immunologic
I-allergyism iyona nto ibangele kakhulu ye-angioedem, eyenziwe yindlela yokuphendula kumachiza , ukutya , izilwanyana ezinambuzane , okanye ezinye izinto ezifana ne- latex . Isizathu sithathwa njenge-immunologic kuba iquka impendulo engavumelekanga yenkqubo yokuzivikela.
Ngenxa yezizathu ezingaziwa, umzimba uya kuphutha ngenye into engekho nengozi ngenxa yengozi kwaye usasaze i- histamine enkulu kwigazi njengendlela yokukhusela.
Ngelixa iidamamines zenzelwe ukuphucula imilambo yegazi ukuze iiselungu zegazi ezimhlophe zingasondeza kwindawo yokulimala, xa zikhishwa ngokungabikho konakaliso, zinokubangela izibonakaliso ezinobungozi, kubandakanywa ne-hay fever (i -rhinitis ye-allergen ) imihlathi ( urticaria ), kunye nesifo se-asthma .
Nangona kunjalo, ngokungafani naliphi na leyo mpendulo, i-angioedema iyenzeka kwiisishu zangaphantsi nje ngaphantsi kwesikhumba esiphezulu okanye i-membrane. Ukuvuvukala akuyi kuba yinto ebomvu kwaye ikwazi ukuhlala iiyure eziliqela okanye iintsuku. Xa ukuvuvukala ekugqibeleni uyeke, isikhumba siza kubonakala siqhelekile singabikho ukukhwabanisa, ukuxubha okanye ukubetha.
Non-Immunologic
Nge-immunologic angioedema, iiseli ezinoxanduva lokugqugquzela ukuhlaselwa ziyaziwa njengeemastal cell . Iiseli ezininzi ziqulethe i-granules ezizityebi kwi-histamine kwaye, xa iyalwa ngumzimba wokuzivikela ukuba wenze njalo, iya kuqhuba inkqubo ebizwa ngokuba yi-degranulation ukukhulula i-histamine kwinkqubo.
Ngaphandle kwe-nonio immunologic angioedema, isimiso somzimba sokuzivikela sisenzi lutho ngokukhululwa. Kunoko, iikhemikhali ezithile okanye iinkqubo zomzimba zingenza ukuba isisitye seentsimbi zidibanise. Iimpendulo ziza kwenzeka rhoqo kubantu abanesifo sengxaki yesisitrasi esingaphantsi, njengemastocytosis.
Amachiza aqhelekileyo anxulumene nalokhu kubandakanya:
- Ama-ophiates, ngakumbi i-codeine kunye ne-morphine
- Izidakamizwa ezichasayo ezingabhubhisiyo (i-NSAID), ngakumbi i-aspirin
- Intravenous vancomycin , i-antibiotic enamandla
- Iidayi ze-radiocontrast ezingezona-ioni ezisetyenziselwa ukuphucula imifanekiso ye-X-ray
Ezinye izizathu ezingekho-immunologic zibandakanya ukumpontshelwa igazi, i-cancer efana ne- lymphoma , izifo ezizimelayo njenge- lupus , kunye nezifo ezithile ezifana ne-hepatitis, i-HIV, i- cytomegalovirus ne-Epstein-Barr.
Iimpawu ezithile zomzimba ezifana nokufudumala, ukubandayo, ukuzivocavoca ngokweqile, ukunyakaza , ukutshatyalaliswa kwelanga, kunye noxinzelelo lwengqondo ziye zaziwa ngenxa ye-angioedema.
Idiopathic
Nge-idiopathic angioedema, akukho nto iyaziwa okanye imbangela yokukhukhuma ngokukhawuleza.
Yintoni eyenza loo nto ibe yinto enzima kukuba abo bachaphazelekayo banelungelo lokuphindaphinda, ngamanye amaxesha banzima.
Ngokomphando ovela kwiYunivesithi yaseWisconsin School of Medicine, ngaphezu kwesigamu se-99 abantu abafumene i-idiopathic angioedema abanamava amaninzi aphindaphindiweyo ngonyaka. Ubuso, umlomo kunye nolwimi beyona ndawo ixhaphake kakhulu. Ngokubanzi, iipesenti ezingama-55 zazo zithi zifumana ubuncinane ikhosi eyodwa ye- corticosteroids ephezulu yokunciphisa ukuvuvukala. Okungakumbi malunga noko kwakungenxa yokuba ama-52 ekhulwini afunwa ubuncinane ukutyelela kwelinye igumbi lexakeka.
Genetics
I-angereded angioedema (HAE) ithathwa njenge- autosomal disorder disorder , oku kuthetha ukuba ungayifumana ilifa leengxaki ezivela kumzali omnye.
Kukho iintlobo ezimbini ze-HAE ezihambelana nokuguqulwa kwimizimba ye-SERPING1 kunye neyesithathu ezibangelwa ukuguqulwa kwegciwane le-F1.
Zonke iintlobo zintathu zenza ukusetyenziswa okungavumelekanga kwenkqubo yokuzivikela komzimba kwaye kunokudala ukuvuvukala kuzo zonke iinxalenye zomzimba. Apho i-HAE ihluke kwi-AAE kukuba i-culprit ayiyona nto i-histamine. Kunoko, ukuhlaselwa kuya kubangelwa enye ikomidi eyaziwayo njenge-bradykinin.
I-Bradykinin, njenge-histamine, ibangela ukuxutywa kwemithambo yegazi kodwa yenza njalo njengendlela yokulawula imisebenzi yomzimba. Umzekelo, umzimba uya kukhupha i-bradykinins ukunciphisa uxinzelelo lwegazi okanye ukulawula umsebenzi wokuphefumula okanye wengqondo.
Ukukhululwa okungavumelekanga kwama-bradykinins kunokubangela i-angioedema, ngokuqhelekileyo imilenze, iingalo, izitho zangasese, ubuso, imilomo, i-larynx, okanye isisu somzimba (GI). Ukulimala kancinci okanye isiqhelo sokucinezeleka kwengqondo kunokubangela ukuhlaselwa, kodwa kuninzi kwenzeka ngaphandle kwesizathu esaziwayo.
I-angioedema yephepha le-GI inokuba nzima kakhulu, ibenokuhlanza ubugwenxa, intlungu ekhulu, kunye nokudambisa amanzi ngenxa yokungakwazi ukugcina umbane. Ukuba ukuvuvukala kwenzeka emqaleni, kungasongela ubomi.
Ngenxa yokuba i- ACE inhibitors (esetyenziselwa ukunyanga uxinzelelo lwegazi) isebenza ngokugcina amazinga e-bradykinin, ziphakathi kwezona zinto ziqhelekileyo ezibangelwa yi-angioedema eyenziwa yiziyobisi (kunye neendlela ezahlukeneyo zesifo kune-opiates okanye i-aspirin).
I-HAE ithathwa njengeyinqabileyo, ivela kumntu omnye kuma-50,000 abantu, kwaye ihlala ikhunjulwa xa umntu ono-angioedema engaphenduli kwi-antihistamines. I-HAE iyakwazi ukuqinisekiswa ngeemvavanyo ezintathu zegazi ezivavanya ukuphendula komzimba.
Izinto zobungozi
Ayikho indlela yokucacisa ukuba kutheni abanye abantu bafumana i-angioedema kunye nabanye abaneemeko zempilo okanye iindlela zokuphila ezifanayo. Xa kuthethwa oko, unokuba ngumngcipheko ophezulu xa unayo okanye ufumene naluphi na olu lulandelayo:
- Ukusetyenziswa kwezidakamizwa ezibandakanya ukugqithisa okanye umlingo
- Ubuthakathaka obubandakanya imihlathi
- Imbali ye-angioedema
- Imbali yentsapho yemihlathi okanye i-angioedema
- Izifo ezizenzekelayo ngokufana ne-lupus okanye i- Hashimoto's thyroiditis , apho i-angioedema yinto ebonakalayo
Ukuba wena okanye othandekayo uye wafumana ubunzima obukhulu be-angioedema, unokufumana uncedo kwizonyango ezinokukunceda ukukhusela ukuhlaselwa kwangaphambili. Okukhethwa kukho kubandakanya umthamo webusuku we-antihistamine i- Zyrtec (cetirizine) , ukuba imbangela iyingozi, okanye izidakamizwa eziguqula umzimba ezifana ne-Kalbitor (ecallantide) okanye i-Firazyr (icatibant).
> Umthombo:
> 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.
> Inomata, M. "Uphuhliso olutshanje kwi-Angioedem e-Drug-Impact." I- Allerg Int. 2012; 61 (4): 545-57. INGXELO: 10.2332 / alergolint.12-RAI-0493.
> Rosenberg, D .; Mathur, S; kunye neVisathanathan, R. "Iinkcukacha zeCliniki ze-Idiopathic Angioedema." I- Allergy Clinic Immunol. 2017; 139 (2): AB235. INGXELO: 10.1016 / j.jaci.2016.12.757.