Dermatomyositis

Dermatomyositis ke lefu la mesifa le amanang le ho ruruha le lekhopho la letlalo. Polymyositis ke boemo bo ts'oanang ba ho ruruha, bo kenyeletsang bofokoli ba mesifa, ho ruruha, bonolo le tšenyo ea lisele empa ho se na lekhopho la letlalo. Ka bobeli ke karolo ea sehlopha se seholo sa lefu le bitsoang ho ruruha myopathy.

Lebaka la dermatomyositis ha le tsejoe. Litsebi li nahana hore e kanna ea ba ka lebaka la tšoaetso ea vaerase ea mesifa kapa bothata ba boits'ireletso ba mmele. E kanna ea etsahala le ho batho ba nang le mofetše ka mpeng, matšoafong kapa likarolong tse ling tsa 'mele.

Mang kapa mang a ka hlaolela boemo bona. Hangata e hlaha ho bana ba lilemo li 5 ho isa ho 15 le batho ba baholo ba lilemo li 40 ho isa ho 60. E ama basali khafetsa ho feta banna.

Matšoao a ka kenyelletsa:

• Bofokoli ba mesifa, ho satalla kapa ho opeloa
• Mathata a ho metsa
• Mmala o pherese ho ea lintšing tse kaholimo
• Ho phatloha ha letlalo le khubelu
• Phefumoloho e khutšoanyane

Bofokoli ba mesifa bo ka hlaha ka tšohanyetso kapa ba hola butle ho feta libeke kapa likhoeli. U kanna oa ba le bothata ba ho phahamisa matsoho holim'a hlooho ea hau, ho phahama setulong, le ho hloa litepisi.

Lehare le ka hlaha sefahlehong sa hau, likoteng, molaleng, mahetleng, sefubeng se kaholimo le mokokotlong.

Mofani oa tlhokomelo ea bophelo o tla etsa tlhahlobo ea 'mele. Liteko li ka kenyelletsa:

• Teko ea mali ho lekola maemo a li-enzyme tsa mesifa tse bitsoang creatine phosphokinase le aldolase
• Liteko tsa mali bakeng sa maloetse a ikemetseng
• ECG
• Electromyography (EMG)
• Litšoantšo tsa Magnetic resonance (MRI)
• Biopsy ea mesifa
• Letlalo biopsy
• Liteko tse ling tsa tlhahlobo ea mofets'e
• X-ray le sefuba sa CT sefubeng
• Liteko tsa mosebetsi oa matšoafo
• Ho koenya thuto
• Myositis e ikhethileng le li-autoantibodies tse amanang

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 kanna oa lula lethal dose 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.

Kalafo e ka lekiloeng ha lefu le lulang le sebetsa ho sa natsoe meriana ena ke:

• Gamma globulin e kenang ka har'a methapo
• Lithethefatsi tsa biologic

Ha mesifa ea hau e matlafala, mofani oa hau a ka u joetsa hore o fokotse butle butle. Batho ba bangata ba nang le boemo bona ba tlameha ho noa moriana o bitsoang prednisone bophelo bohle ba bona.

Haeba mofetše o baka boemo, bofokoli ba mesifa le lekhopho li ka ntlafala ha hlahala e tlosoa.

Matšoao a ka fella ka ho felletseng ho batho ba bang, joalo ka bana.

Boemo bo ka bolaea batho ba baholo ka lebaka la:

• Bofokoli bo matla ba mesifa
• Khaello ea phepo e nepahetseng
• Nyomonea
• Ho hloleha ha mapafu

Lisosa tse kholo tsa lefu le boemo bona ke mofetše le lefu la matšoafo.

Batho ba nang le lefu la matšoafo ba nang le lesole la anti-MDA-5 ba na le tšoaetso e mpe ho sa tsotelehe kalafo ea hajoale.

Mathata a ka kenyelletsa:

• Boloetse ba sefuba
• Ho hloleha ho matla ha renal
• Kankere (malignancy)
• Ho ruruha ha pelo
• Bohloko bo kopaneng

Bitsa mofani oa hau haeba u na le bofokoli ba mesifa kapa matšoao a mang a boemo bona.

• Dermatomyositis - Gottron papule
• Dermatomyositis - Li-papules tsa Gottron letsohong
• Dermatomyositis - lintsu tsa heliotrope
• Dermatomyositis maotong
• Dermatomyositis - Gottron papule
• Paronychia - ea boemeli
• Dermatomyositis - heliotrope lekhopho sefahlehong

Aggarwal R, Mopalami LG, Ruperto N, et al. 2016 American College of Rheumatology / European League Against Rheumatism Criteria bakeng sa Karabelo e Nyane, e Mahareng le e Meholo ea Bongaka ho Batho ba baholo Dermatomyositis le Polymyositis: Tlhahlobo ea Machabeng ea Tekolo ea Myositis le Clinical Study Group / Pediatric Rheumatology International Trials Organisation Initiative. Ramatiki Rheumatol. 2017; 69 (5): 898-910. PMID: 28382787 www.ncbi.nlm.nih.gov/pubmed/28382787.

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

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.

Mokhatlo oa Naha oa Mathata a Rare. Dermatomyositis. rarediseases.org/rare-diseases/dermatomyositis/. E fihlile ka la 1 Mmesa, 2019.