Takayasu arteritis

I-Takayasu arteritis ukuvuvukala kwemithambo emikhulu efana ne-aorta namagatsha ayo amakhulu. I-aorta ingumthambo ohambisa igazi lisuke enhliziyweni liye kuwo wonke umzimba.

Isizathu se-Takayasu arteritis asaziwa. Lesi sifo sivela ikakhulu ezinganeni nakwabesifazane abaphakathi kweminyaka engama-20 kuya kwengama-40. Sitholakala kakhulu kubantu baseMpumalanga Asia, eNdiya noma eMexico. Kodwa-ke manje sekubonakala kaningi kwezinye izingxenye zomhlaba. Izakhi zofuzo eziningana ezandisa amathuba okuba nale nkinga zisanda kutholakala.

I-Takayasu arteritis ibonakala njengesimo sokuzimela. Lokhu kusho ukuthi amasosha omzimba ahlasela ngephutha izicubu ezinempilo odongeni lwemithambo yegazi. Isimo singabandakanya nezinye izinhlelo zezitho.

Lesi simo sinezici eziningi ezifana ne-giant cell arteritis noma i-temporal arteritis kubantu asebekhulile.

Izimpawu zingafaka:

• Ubuthakathaka bengalo noma ubuhlungu ngokusetshenziswa
• Ubuhlungu besifuba
• Isiyezi
• Ukukhathala
• Imfiva
• Ubumhlophe
• Ubuhlungu bemisipha noma bamalunga
• Ukuqhuma kwesikhumba
• Ukujuluka ebusuku
• Umbono uyashintsha
• Ukwehla kwesisindo
• Ukwehla kwamapulisi e-radial (esihlakaleni)
• Umehluko kumfutho wegazi phakathi kwezingalo zombili
• Umfutho wegazi ophezulu (umfutho wegazi ophakeme)

Kungase kube nezimpawu zokuvuvukala (i-pericarditis noma i-pleuritis).

Akukho ukuhlolwa kwegazi okutholakalayo ukwenza ukuxilongwa okuqondile. Ukuxilongwa kwenziwa lapho umuntu enezimpawu nokuhlolwa kwe-imaging kukhombisa ukungajwayelekile kwesitsha segazi okuphakamisa ukuvuvukala.

Ukuhlolwa okungenzeka kufaka:

• I-Angiogram, kufaka phakathi i-angiography yenhliziyo
• Qedela ukubalwa kwegazi (CBC)
• Amaprotheni asebenza ngoku-C (CRP)
• I-Electrocardiogram (ECG)
• Izinga le-sedimentation ye-Erythrocyte (ESR)
• I-Magnetic resonance angiography (MRA)
• Ukucabanga kwe-Magnetic resonance (MRI)
• I-computed tomography angiography (CTA)
• IPositron emission tomography (PET)
• I-Ultrasound
• I-X-ray yesifuba

Ukwelashwa kwe-Takayasu arteritis kunzima. Kodwa-ke, abantu abanokwelashwa okulungile bangathuthuka. Kubalulekile ukukhomba isimo kusenesikhathi. Lesi sifo sihlala singamahlalakhona, sidinga ukusetshenziswa kwesikhathi eside kwemithi elwa nokuvuvukala.

IMITHI

Iningi labantu liphathwa kuqala ngemithamo ephezulu yama-corticosteroids afana ne-prednisone. Njengoba lesi sifo silawulwa umthamo we-prednisone uyehla.

Cishe kuzo zonke izimo, kunezelwa imishanguzo yokuvikela ukuzivikela ukunciphisa isidingo sokusetshenziswa kwesikhathi eside kwe-prednisone kepha nokulawula isifo.

Ama-ejenti we-immunosuppressive ajwayelekile njenge-methotrexate, azathioprine, mycophenolate, cyclophosphamide, noma i-leflunomide avame ukungezwa.

Ama-biologic agents nawo angasebenza. Lokhu kufaka phakathi i-TNF inhibitors efana ne-infliximab, etanercept, ne-tocilizumab.

UKUHLINZA

Ukuhlinzwa noma i-angioplasty kungasetshenziselwa ukuvula imithambo emincane yokunikezela ngegazi noma ukuvula umbandela.

Ukushintshwa kwe-aortic valve kungadingeka kwezinye izimo.

Lesi sifo singabulala ngaphandle kokwelashwa. Kodwa-ke, indlela yokwelashwa ehlanganisiwe esebenzisa imithi nokuhlinzwa kwehlise amazinga okufa. Abantu abadala banethuba elingcono lokusinda kunezingane.

Izinkinga zingafaka:

• Ihluli
• Isifo senhliziyo
• Ukwehluleka kwenhliziyo
• I-Pericarditis
• Ukunganele kwe-valve ye-aortic
• I-Pleuritis
• Unhlangothi
• Ukopha emathunjini noma ubuhlungu bokuvaleka kwemithambo yegazi yamathumbu

Shayela umhlinzeki wakho wezokunakekelwa kwezempilo uma unezimpawu zalesi simo. Ukunakekelwa okusheshayo kuyadingeka uma une:

• I-pulse ebuthakathaka
• Ubuhlungu besifuba
• Ubunzima bokuphefumula

Isifo esinga-pulseless, Isitsha esikhulu se-vasculitis

• Inhliziyo - isigaba phakathi nendawo
• Ama-valve enhliziyo - ukubuka kwangaphakathi
• Ama-valve enhliziyo - ukubuka okuphakeme

U-Alomari I, uPatel PM. Takayasu arteritis. Ku: Ferri FF, ed. Umeluleki Wemitholampilo kaFerri 2020. IPhiladelphia, PA: Elsevier; 2020: 1342.e4-1342.e7.

UBarra L, uYang G, uPagnoux C; Inethiwekhi yaseCanada Vasculitis (CanVasc). Izidakamizwa ezingezona i-glucocorticoid zokwelashwa kwe-Takayasu's arteritis: Ukubuyekezwa okuhlelekile nokuhlaziywa kwemeta. Gwema ngokuzenzakalela uMfu. 2018; 17 (7): 683-693. I-PMID: 29729444 pubmed.ncbi.nlm.nih.gov/29729444/.

UDejaco C, uRamiro S, uDuftner C, et al. Izincomo ze-EULAR zokusetshenziswa kwezithombe emithanjeni enkulu ye-vasculitis ekwenziweni kwemitholampilo. U-Ann Rheum Dis. 2018; 77 (5): 636-643. I-PMID: 29358285 pubmed.ncbi.nlm.nih.gov/29358285/.

I-Ehlert BA, i-Abularrage CJ. Isifo se-Takayasu. Ku: Sidawy AN, Perler BA, ama-eds. Rutherford’s Vascular Surgery and Endovascular Therapy. Umhlaka 9. IPhiladelphia, PA: Elsevier; 2019: isahluko 139.

USerra R, uButrico L, uFugetto F, et al. Ukuvuselelwa kwe-pathophysiology, ukuxilongwa nokuphathwa kwe-Takayasu arteritis. U-Ann Vasc Ukuhlinzwa. 2016; 35: 210-225. I-PMID: 27238990 pubmed.ncbi.nlm.nih.gov/27238990/.