Takayasu arteritis

Takayasu arteritis ke ho ruruha ha methapo e meholo e kang aorta le makala a eona a maholo. Aorta ke mothapo o tsamaisang mali ho tloha pelong ho ea 'meleng kaofela.

Lebaka la Takayasu arteritis ha le tsejoe. Lefu lena le hlaha haholo ho bana le basali ba pakeng tsa lilemo tse 20 ho isa ho tse 40. Le atile haholo bathong ba Asia Bochabela, India kapa Mexico. Leha ho le joalo, hona joale e bonoa khafetsa libakeng tse ling tsa lefats'e. Liphatsa tsa lefutso tse 'maloa tse eketsang menyetla ea ho ba le bothata bona li sa tsoa fumanoa.

Takayasu arteritis e bonahala e le boemo bo ikemetseng. Sena se bolela hore boits'ireletso ba mmele ka phoso bo hlasela lisele tse phetseng hantle leboteng la methapo ea mali. Boemo bona bo kanna ba kenyelletsa litsamaiso tse ling tsa setho.

Boemo bona bo na le likarolo tse ngata tse ts'oanang le giant cell arteritis kapa temporal arteritis ho batho ba baholo.

Matšoao a ka kenyelletsa:

• Bofokoli ba letsoho kapa bohloko ka ts'ebeliso
• Bohloko ba sefuba
• Botsoa
• Mokhathala
• Feberu
• Hlooho e bobebe
• Bohloko ba mesifa kapa manonyeletso
• Ho phatloha ha letlalo
• Mofufutso oa bosiu
• Pono ea fetoha
• Ho fokotsa boima ba 'mele
• Ho fokotseha ha maqhubu a radial (letsohong)
• Phapang ea khatello ea mali lipakeng tsa matsoho a mabeli
• Khatello ea mali e phahameng (hypertension)

Ho kanna ha ba le matšoao a ho ruruha (pericarditis kapa pleuritis).

Ha ho na tlhahlobo ea mali e fumanehang ho netefatsa hore na o na le eng. Ho hlahlojoa ho etsoa ha motho a e-na le matšoao le liteko tsa ho nka litšoantšo a bontša sejana sa mali se sa tloaelehang se bontšang ho ruruha.

Liteko tse ka bang teng li kenyelletsa:

• Angiogram, ho kenyelletsa le angiography ea coronary
• Palo e felletseng ea mali (CBC)
• Protheine ea C-reactive (CRP)
• Electrocardiogram (ECG)
• Sekhahla sa sedimentation sa Erythrocyte (ESR)
• Ts'ebetso ea Magnetic resonance angiography (MRA)
• Litšoantšo tsa Magnetic resonance (MRI)
• Khomphutha ea tomography angiography (CTA)
• Positron tlhahiso ea tomography (PET)
• Ultrasound
• X-ray ea sefuba

Kalafo ea Takayasu arteritis e thata. Leha ho le joalo, batho ba nang le kalafo e nepahetseng ba ka ntlafala. Ho bohlokoa ho khetholla boemo kapele. Lefu lena le atisa ho ba le sa foleng, le hlokang tšebeliso ea nako e telele ea meriana e thibelang ho ruruha.

MERIANA

Batho ba bangata ba qala ho phekoloa ka litekanyetso tse phahameng tsa corticosteroids tse kang prednisone. Ha lefu lena le laoloa, tekanyo ea prednisone ea fokotseha.

Hoo e batlang e le maemong ohle, litlhare tse thibelang khatello ea mmele li eketsoa ho fokotsa tlhoko ea ts'ebeliso ea nako e telele ea prednisone empa leha ho le joalo e boloka taolo ea lefu lena.

Mekhoa e tloaelehileng ea ho itšireletsa mafung e kang methotrexate, azathioprine, mycophenolate, cyclophosphamide kapa leflunomide hangata li eketsoa.

Likokoana-hloko tsa biologic le tsona li ka sebetsa. Tsena li kenyelletsa TNF inhibitors joalo ka infliximab, etanercept le tocilizumab.

HO SEBETSA

Phekolo kapa angioplasty e ka sebelisoa ho bula methapo e patisaneng ho fana ka mali kapa ho bula thibelo.

Phetolo ea valve ea aortic e ka hlokahala maemong a mang.

Lefu lena le ka bolaea ntle le kalafo. Leha ho le joalo, mokhoa o kopaneng oa kalafo o sebelisang meriana le opereishene o fokolitse sekhahla sa lefu. Batho ba baholo ba na le monyetla o motle oa ho phela ho feta bana.

Mathata a ka kenyelletsa:

• Ho koala mali
• Lefu la pelo
• Ho hloleha ha pelo
• Pericarditis
• Ho haella ha valve ea aortic
• Pleuritis
• Leqeba
• Ho tsoa mali mpeng kapa bohloko ba ho koaloa ha methapo ea mali

Bitsa mofani oa hao oa tlhokomelo ea bophelo haeba u e-na le matšoao a boemo bona. Tlhokomelo ea hanghang ea hlokahala haeba u na le:

• Pelo e fokolang
• Bohloko ba sefuba
• Bothata ba ho hema

Boloetse bo sa foleng, Sesosa se seholo sa vasculitis

• Pelo - karolo ho ea bohareng
• Li-valve tsa pelo - pono e ka pele
• Li-valve tsa pelo - pono e phahameng

Alomari I, Tonakholo ea Patel. Takayasu arteritis. Ka: Ferri FF, e hlophisitsoeng. Moeletsi oa Bongaka oa Ferri oa 2020. Philadelphia, PA: Elsevier; 2019: 1342.e4-1342.e7.

Barra L, Yang G, Pagnoux C; Mokhatlo oa Canada Vasculitis Network (CanVasc). Lithethefatsi tse se nang glucocorticoid bakeng sa kalafo ea Takayasu's arteritis: Tlhahlobo e hlophisitsoeng le tlhahlobo ea litlhahlobo. Iketsetse Auto Rev. 2018; 17 (7): 683-693. PMID: 29729444 e fetotsoe.ncbi.nlm.nih.gov/29729444/.

Dejaco C, Ramiro S, Duftner C, le al. Litlhahiso tsa EULAR mabapi le ts'ebeliso ea litšoantšo setsing se seholo sa vasculitis ts'ebetsong ea bongaka. Ann Rheum Dis. 2018; 77 (5): 636-643. PMID: 29358285 pubmed.ncbi.nlm.nih.gov/29358285/.

Ehlert BA, Abularrage CJ. Lefu la Takayasu. Ka: Sidawy AN, Perler BA, bahlophisi. Rutherford's Vasculry and Endovascular Therapy. La 9th. Philadelphia, PA: Elsevier; 2019: khaolo ea 139.

Serra R, Butrico L, Fugetto F, le al. Lintlafatso ho pathophysiology, diagnostic le management ea Takayasu arteritis. Ann Vasc Phekolo. 2016; 35: 210-225. PMID: 27238990 phatlalalitsoe.ncbi.nlm.nih.gov/27238990/.