Polymyositis - motho e moholo

Polymyositis le dermatomyositis ke maloetse a sa tloaelehang a ho ruruha. (Boemo bona bo bitsoa dermatomyositis ha bo ama letlalo.) Maloetse ana a lebisa bofokoling ba mesifa, ho ruruha, bonolo le ho senyeha ha lisele. Ke karolo ea sehlopha se seholo sa mafu a bitsoang myopathies.

Polymyositis e ama mesifa ea masapo. E boetse e tsejoa e le idiopathic inflammatory myopathy. Lebaka la 'nete ha le tsejoe, empa le kanna la amana le karabelo ea motho a le mong kapa tšoaetso.

Polymyositis e ka ama batho ba lilemo tsohle. E atile haholo ho batho ba baholo ba pakeng tsa lilemo tse 50 le 60, le ho bana ba baholo. E ama basali habeli ho feta banna. E atile haholo ho batho ba Afrika Boroa ho feta makhooa.

Polymyositis ke lefu le tloaelehileng. Sena se bolela hore se ama 'mele oohle. Bofokoli ba mesifa le bonolo e ka ba matšoao a polymyositis. Lehare ke sesupo sa boemo bo amanang, dermatomyositis.

Matšoao a tloaelehileng a kenyelletsa:

• Bofokoli ba mesifa mahetleng le lethekeng. Sena se ka etsa hore ho be thata ho phahamisa matsoho holim'a hlooho, ho phahama setulong, kapa ho hloa litepisi.
• Ho thata ho koenya.
• Bohloko ba mesifa.
• Mathata ka lentsoe (le bakoang ke mesifa e fokolang ea 'metso).
• Phefumoloho e khutšoanyane.

U kanna ua ba le:

• Mokhathala
• Feberu
• Bohloko bo kopaneng
• Ho felloa ke takatso ea lijo
• Ho thatafala ha hoseng
• Ho fokotsa boima ba 'mele
• Ho phatloha ha letlalo mokokotlong oa menoana, lintšing tsa sefahleho kapa sefahlehong

Liteko li ka kenyelletsa:

• Ho itšireletsa mafung le liteko tsa ho ruruha
• CPK
• Serum aldolase
• Electromyography
• MRI ea mesifa e amehileng
• Biopsy ea mesifa
• Myoglobin ka morong
• ECG
• X-ray le sefuba sa CT sefubeng
• Liteko tsa tšebetso ea pulmonary
• Thuto ea ho metsa Esophageal
• Myositis e ikhethileng le li-autoantibodies tse amanang

Batho ba nang le boemo bona le bona ba tlameha ho shebeloa ka hloko bakeng sa matšoao a mofets'e.

Kalafo ea mantlha ke ts'ebeliso ea meriana ea corticosteroid. Tekanyo ea moriana e theoleloa butle-butle ha matla a mesifa a ntse a ntlafala. Sena se nka libeke tse ka bang 4 ho isa ho tse 6. U tla lula tekanyong e tlase ea moriana oa corticosteroid kamora moo.

Meriana e thibelang sesole sa 'mele e ka sebelisoa ho nkela corticosteroids sebaka. Lithethefatsi tsena li ka kenyelletsa azathioprine, methotrexate kapa mycophenolate.

Bakeng sa maloetse a lulang a le teng le ha ho na le li-corticosteroids, gamma globulin e kenang methapong e lekile liphetho tse fapaneng. Lithethefatsi tsa biologic le tsona li ka sebelisoa. Rituximab e bonahala e tšepisa haholo. Ho bohlokoa ho lahla maemo a mang ho batho ba sa arabeleng kalafo. Ho ka 'na ha hlokahala hore ho be le mesifa e pheta-phetang ho etsa sena.

Haeba boemo bo amahanngoa le hlahala, bo ka ntlafala haeba hlahala e tlosoa.

Karabelo ea kalafo ea fapana, ho ipapisitse le mathata. Batho ba bangata ho motho a le mong ho ba bahlano ba ka shoa pele ho lilemo tse 5 ho ba le boemo bona.

Batho ba bangata, haholo-holo bana, baa fola 'me ha ba hloke kalafo e tsoelang pele. Leha ho le joalo, ho batho ba baholo, ho hlokahala lithethefatsi tse itšireletsang mafung ho itšireletsa mafung.

Pono ea batho ba nang le lefu la matšoafo e nang le lesole la anti-MDA-5 e mpe leha e le kalafo ea hajoale.

Ho batho ba baholo, lefu le ka bakoa ke:

• Khaello ea phepo e nepahetseng
• Nyomonea
• Ho hloleha ho phefumoloha
• Bofokoli bo matla, ba nako e telele ba mesifa

Lisosa tse kholo tsa lefu ke lefu la mofetše le mafu.

Mathata a ka kenyelletsa:

• Calcium e kenya mesifa e amehileng, haholo-holo ho bana ba nang le lefu lena
• Kankere
• Lefu la pelo, lefu la matšoafo kapa mathata a mpeng

Bitsa mofani oa tlhokomelo ea bophelo haeba u na le matšoao a lefu lena. Batla kalafo ea maemo a tšohanyetso haeba u hema hampe ebile u na le bothata ba ho koenya.

• Mesifa ea ka ntle e kantle

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Dalakas MC. Maloetse a tšoaetsang mesifa. N Engl J Med. 2015; 373 (4): 393-394. PMID: 26200989 www.ncbi.nlm.nih.gov/pubmed/26200989.

Greenberg SA. Myopathies ea ho ruruha. Ka: Goldman L, Schafer AI, li-eds. Phekolo ea Goldman-Cecil. La 25th ed. Philadelphia, PA: Elsevier Saunders; 2016: khaolo ea 269.

Nagaraju K, Gladue HS, Lundberg IE.Maloetse a ho ruruha a mesifa le tse ling tsa myopathies. 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 85.

Yoshida N, Okamoto M, Kaieda S, le al. Mokhatlo oa anti-aminoacyl-transfer RNA synthetase antibody le anti-melanoma phapang e amanang le liphatsa tsa lefutso tsa 5 le kalafo ea kalafo ea lefu la sefuba le amanang le polymyositis / dermatomyositis. Mofuputsi oa Phefumoloho. 2017; 55 (1): 24-32. PMID: 28012490 www.ncbi.nlm.nih.gov/pubmed/28012490.