I-Giant cell arteritis

IGiant cell arteritis ukuvuvukala nokulimala emithanjeni yegazi ehambisa igazi ekhanda, entanyeni, emzimbeni nasengalweni. Kubizwa nangokuthi i-arteritis yesikhashana.

IGiant cell arteritis ithinta imithambo emaphakathi nkulu. Kubanga ukuvuvukala, ukuvuvukala, isizotha, nokulimala emithanjeni yegazi ehambisa igazi ekhanda, entanyeni, emzimbeni ongaphezulu, nasezingalweni. Ngokuvamile kwenzeka emithanjeni ezungeze amathempeli (imithambo yesikhashana). Le mithambo yegazi isuka emthanjeni we-carotid entanyeni. Kwezinye izimo, lesi simo singenzeka emithanjeni emaphakathi nkulu kuya kwezinye izindawo emzimbeni futhi.

Imbangela yalesi simo ayikaziwa. Kukholakala ukuthi kungenxa yempendulo engafanele yomzimba. Lesi sifo sixhunyaniswe nokutheleleka okuthile kanye nezakhi ezithile zofuzo.

I-Giant cell arteritis ivame kakhulu kubantu abanesinye isifo sokuvuvukala esaziwa njenge-polymyalgia rheumatica. IGiant cell arteritis cishe njalo ivela kubantu abaneminyaka engaphezu kwengama-50. Kuvame kakhulu kubantu abadabuka enyakatho yeYurophu. Isimo singase siqhubeke emindenini.

Ezinye izimpawu ezivamile zale nkinga yilezi:

• Ikhanda elisha lokushaya ikhanda ohlangothini olulodwa lwekhanda noma ngemuva kwekhanda
• Ubumnene lapho uthinta isikhumba sasekhanda

Ezinye izimpawu zingafaka:

• Ubuhlungu bomhlathi obenzeka lapho uhlafuna
• Ubuhlungu engalweni ngemuva kokuyisebenzisa
• Ubuhlungu bemisipha
• Ubuhlungu nokuqina entanyeni, izingalo ezingaphezulu, ihlombe nezinqulu (i-polymyalgia rheumatica)
• Ubuthakathaka, ukukhathala ngokweqile
• Imfiva
• Ukuzizwa okuvamile

Izinkinga zokubona zingenzeka, futhi kwesinye isikhathi zingaqala kungazelelwe. Lezi zinkinga zifaka:

• Ukubona okufiphele
• Umbono ophindwe kabili
• Umbono owehlisiwe ngokungazelelwe (ubumpumputhe kwelinye noma womabili amehlo)

Umhlinzeki wezokunakekelwa kwempilo uzohlola ikhanda lakho.

• Isikhumba sezinwele sivame ukuzwela lapho sithintwa.
• Kungaba khona umthambo wethenda, ojiyile ohlangothini olulodwa lwekhanda, imvamisa ngaphezu kwethempeli elilodwa noma womabili.

Ukuhlolwa kwegazi kungafaka:

• I-hemoglobin noma i-hematocrit
• Ukuhlolwa kokusebenza kwesibindi
• Izinga le-Sedimentation (ESR) ne-C-esebenzayo

Ukuhlolwa kwegazi kukodwa akukwazi ukunikeza ukuxilongwa. Uzodinga ukuthi ube ne-biopsy yomthambo wesikhashana. Le yinqubo yokuhlinza engenziwa njengesiguli esingalaliswayo.

Ungase futhi ube nezinye izivivinyo, kufaka phakathi:

• Umbala we-Doppler ultrasound wemithambo yesikhashana. Lokhu kungathatha indawo ye-biopsy yesikhashana yomthambo uma kwenziwa ngumuntu onolwazi ngenqubo.
• I-MRI.
• Ukuskena kwe-PET.

Ukuthola ukwelashwa ngokushesha kungasiza ekuvikeleni izinkinga ezinzima ezifana nokungaboni.

Lapho kusolwa i-giant cell arteritis, uzothola ama-corticosteroids, afana ne-prednisone, ngomlomo. Le mithi ivame ukuqala ngisho nangaphambi kokuba kwenziwe i-biopsy. Ungatshelwa futhi ukuthi uthathe i-aspirin.

Iningi labantu liqala ukuzizwa lingcono ezinsukwini ezimbalwa ngemuva kokuqala ukwelashwa. Umthamo wama-corticosteroids uzokwehliswa kancane kakhulu. Kodwa-ke, uzodinga ukuthatha umuthi unyaka owodwa kuya kwemibili.

Uma kutholakala ukuxilongwa kwe-giant cell arteritis, kubantu abaningi kuzongezwa umuthi we-biologic obizwa nge-tocilizumab. Lo muthi unciphisa inani lama-corticosteroids adingekayo ukulawula lesi sifo.

Ukwelashwa kwesikhathi eside ngama-corticosteroids kungenza amathambo abe mancane futhi kwandise amathuba okuphuka. Uzodinga ukuthatha izinyathelo ezilandelayo ukuvikela amathambo akho.

• Gwema ukubhema nokuphuza ngokweqile.
• Thatha i-calcium eyengeziwe novithamini D (ngokuya ngezeluleko zomhlinzeki wakho).
• Qala ukuhamba noma ezinye izinhlobo zokuzivocavoca umzimba.
• Yenza amathambo akho ahlolwe ngokuhlolwa kwe-bone mineral density (BMD) noma nge-DEXA scan.
• Thatha umuthi we-bisphosphonate, njenge-alendronate (Fosamax), njengoba kunqunywe ngumhlinzeki wakho.

Abantu abaningi bayalulama ngokugcwele, kepha ukwelashwa kungadingeka unyaka owodwa kuya kwemibili noma ngaphezulu.Isimo singabuya emuva kwesikhathi.

Ukulimala kweminye imithambo yegazi emzimbeni, njengama-aneurysms (ukubhaliswa kwemithambo yegazi), kungenzeka. Lo monakalo ungaholela ekushayweni unhlangothi ngokuzayo.

Shayela umhlinzeki wakho uma une:

• Ukudinwa ikhanda elingapheli
• Ukulahleka kombono
• Ezinye izimpawu ze-arteritis yesikhashana

Ungathunyelwa kuchwepheshe owelapha i-arteritis yesikhashana.

Akukho ukuvimbela okwaziwayo.

I-Arteritis - yesikhashana; I-cranial arteritis; I-Giant cell arteritis

• I-carotid artery anatomy

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UJames WD, u-Elston DM, Phatha i-JR, i-Rosenbach MA, i-IM ye-Neuhaus. Izifo zemithambo yegazi. Ku: James WD, Elston DM, Treat JR, Rosenbach MA, Neuhaus IM, eds. Izifo zika-Andrews 'Zesikhumba: I-Clinical Dermatology. Umhlaka 13. IPhiladelphia, PA: Elsevier; 2020: isahluko 35.

UKoster MJ, uMatteson EL, uWarrington KJ. I-Large-ship giant cell arteritis: ukuxilongwa, ukuqapha kanye nokuphathwa. I-Rheumatology (i-Oxford). I-2018; 57 (suppl_2): ii32-ii42. I-PMID: 29982778 www.ncbi.nlm.nih.gov/pubmed/29982778.

UStone JH, uTuckwell K, uDimonaco S, et al. Ukuhlolwa kwe-tocilizumab ku-giant-cell arteritis. N Engl J Med. 2017; 377 (4): 317-328. I-PMID: 28745999 www.ncbi.nlm.nih.gov/pubmed/28745999.

UTamaki H, Hajj-Ali RA. I-Tocilizumab ye-giant cell arteritis - isinyathelo esisha esikhulu esifo esidala. I-JAMA Neurol. 2018; 75 (2): 145-146. I-PMID: 29255889 www.ncbi.nlm.nih.gov/pubmed/29255889.