Polymyalgia rheumatica

Polymyalgia rheumatica (PMR) ke lefu la ho ruruha. E kenyelletsa bohloko le ho satalla mahetleng mme hangata lethekeng.

Polymyalgia rheumatica hangata e etsahala ho batho ba fetang lilemo tse 50. Lebaka ha le tsejoe.

PMR e ka hlaha pele kapa ka giant cell arteritis (GCA; eo hape e bitsoang temporal arteritis). Ena ke boemo boo methapo ea mali e fanang ka mali hloohong le mahlong e ka ruruhang.

PMR ka linako tse ling ho ka ba thata ho e tseba ntle le ramatiki ea ramatiki (RA) ho motho ea tsofetseng. Sena se etsahala ha liteko tsa lesole la ramatiki le anti-CCP li le mpe.

Letšoao le tloaelehileng ke bohloko le ho satalla mahetleng ka bobeli le molaleng. Bohloko le ho satalla ho mpefala hoseng. Hangata bohloko bona bo fetela lethekeng.

Mokhathala le ona o teng. Batho ba nang le boemo bona ba thatafalloa ho tsoha betheng le ho tsamaea.

Matšoao a mang a kenyelletsa:

• Takatso ea takatso ea lijo, e lebisang ho boima ba 'mele
• Ho tepella maikutlo
• Feberu

Liteko tsa Lab feela li ke ke tsa tseba PMR. Batho ba bangata ba nang le boemo bona ba na le matšoao a phahameng a ho ruruha, joalo ka sekhahla sa sedimentation (ESR) le C-reactive protein.

Liphetho tse ling tsa liteko tsa boemo bona li kenyelletsa:

• Methati e sa tloaelehang ea liprotheine maling
• Tekanyo e sa tloaelehang ea lisele tse tšoeu tsa mali
• Phokolo ea mali (palo e tlase ea mali)

Liteko tsena li ka sebelisoa ho lekola boemo ba hau.

Leha ho le joalo, liteko tsa ho nka litšoantšo tse kang x-ray mahetleng kapa lethekeng hangata ha li thuse. Liteko tsena li ka senola tšenyo e kopaneng e sa amaneng le matšoao a morao tjena. Maemong a thata, ultrasound kapa MRI ea lehetla e ka etsoa. Liteko tsena tsa ho nka litšoantšo hangata li bonts'a bursitis kapa maemo a tlase a ho ruruha ho kopaneng.

Ntle le kalafo, PMR ha e fole. Leha ho le joalo, litekanyo tse tlase tsa corticosteroids (joalo ka prednisone, 10 ho isa ho 20 mg ka letsatsi) li ka fokotsa matšoao, hangata nakong ea letsatsi kapa a mabeli.

• Moriana o lokela ho fokotsoa butle butle ho fihlela boemong bo tlase haholo.
• Kalafo e hloka ho tsoela pele bakeng sa lilemo tse 1 ho isa ho tse 2. Ho batho ba bang, kalafo e telele ho feta e nang le tekanyetso e tlase ea prednisone ea hlokahala.

Corticosteroids e ka baka litla-morao tse ngata tse kang ho nona, nts'etsopele ea lefu la tsoekere kapa lefu la masapo. U hloka ho shebeloa ka hloko haeba u noa meriana ena. Haeba u le kotsing ea lefu la ho fokola ha masapo, mofani oa tlhokomelo ea bophelo a ka u khothaletsa hore u noe meriana ho thibela boemo bona.

Bakeng sa batho ba bangata, PMR e ea kalafo kamora lilemo tse 1 ho isa ho tse 2. U kanna oa khona ho emisa ho noa meriana kamora ntlha ena, empa sheba le mofani oa hau pele.

Bakeng sa batho ba bang, matšoao a khutla kamora ho emisa ho nka li-corticosteroids. Maemong ana, ho ka hlokahala moriana o mong o kang methotrexate kapa tocilizumab.

Giant cell arteritis le eona e kanna ea ba teng kapa ea hola hamorao. Haeba ho joalo, mothapo oa nakoana o tla hloka ho hlahlojoa.

Matšoao a matla haholo a ka u thatafalletsa ho sebetsa kapa ho itlhokomela lapeng.

Bitsa mofani oa hau haeba o na le bofokoli kapa ho satalla lehetleng le molaleng o sa foleng. Ikopanye le mofani oa hau haeba u na le matšoao a macha a kang feberu, hlooho e opang le bohloko ka ho hlafuna kapa ho felloa ke pono. Matšoao ana a ka hlaha ho seneng cell arteritis.

Ha ho na thibelo e tsebahalang.

PMR

Dejaco C, Singh YP, Perel P, le al. Litlhahiso tsa 2015 bakeng sa taolo ea polymyalgia rheumatica: European League Against Rheumatism / American College of Rheumatology e kopanetsoeng. Ramatiki Rheumatol. 2015; 67 (10): 2569-2580. PMID: 2635874 www.ncbi.nlm.nih.gov/pubmed/26352874.

Hellmann DB. Giant cell arteritis, polymyalgia rheumatica, le Takayasu's arteritis. Ka: Firestein GS, Budd RC, Gabriel SE, McInnes IB, O'Dell JR, bahlophisi. Kelley le Firestein's Bookbook ea Rheumatology. 10th ed. Philadelphia, PA: Elsevier; 2017: khaolo ea 88.

Kermani TA, Warrington KJ. Tsoelo-pele le liphephetso ho fumanoeng le kalafo ea polymyalgia rheumatica. Ther Adv Musculoskelet Dis. 2014; 6 (1): 8-19. PMID: 24489611 www.ncbi.nlm.nih.gov/pubmed/24489611. (Lebokose)

Salvarani C, Ciccia F, Pipitone N. Polymyalgia rheumatica le senema cell arteritis. Ho: Hochberg MC, Gravallese EM, Silman AJ, Smolen JS, Weinblatt ME, Weisman MH, bahlophisi. Rheumatology. La 7th. Philadelphia, PA: Elsevier; 2019: khaolo ea 166.