Ciwon vasculitis

Necrotizing vasculitis wani rukuni ne na cuta wanda ya ƙunshi kumburi na bangon jijiyoyin jini. Girman jijiyoyin da abin ya shafa na taimakawa wajen tantance sunayen waɗannan yanayin da yadda rikicewar take haifar da cuta.

Necrotizing vasculitis na iya zama ainihin yanayin kamar polyarteritis nodosa ko granulomatosis tare da polyangiitis (wanda ake kira Wegener granulomatosis). A wasu lokuta, cutar vasculitis na iya faruwa a matsayin wani ɓangare na wata cuta, kamar tsarin lupus erythematosus ko hepatitis C.

Ba a san dalilin kumburin ba. Wataƙila yana da alaƙa da dalilai na atomatik. Bangon jirgin jini na iya yin rauni da kauri ko ya mutu (ya zama mai lalacewa). Jigon jini na iya rufewa, yana dakatar da gudan jini zuwa kyallen takarda da yake bayarwa. Rashin kwararar jini zai sa kyallen takarda su mutu. Wani lokaci jijiyoyin jini na iya karyewa su zubar da jini (fashewa).

Necrotizing vasculitis na iya shafar jijiyoyin jini a kowane ɓangare na jiki. Sabili da haka, yana iya haifar da matsala a cikin fata, kwakwalwa, huhu, hanji, koda, kwakwalwa, haɗin gwiwa ko wani ɓangaren jikin.

Zazzaɓi, sanyi, gajiya, amosanin gabbai, ko rage nauyi na iya zama alamun kawai a farko. Koyaya, bayyanar cututtuka na iya kasancewa kusan kowane ɓangare na jiki.

Fata:

• Orututtuka masu launin ja ko shunayya a ƙafafu, hannaye ko wasu sassan jiki
• Launin Bluish zuwa yatsu da yatsun kafa
• Alamomin mutuwar nama saboda rashin isashshen oxygen kamar ciwo, redness, da ulcers waɗanda basa warkewa

Tsokoki da haɗin gwiwa:

• Hadin gwiwa
• Jin zafi a kafa
• Raunin jijiyoyi

Brain da tsarin juyayi:

• Jin zafi, dushewa, kunci a hannu, ƙafa, ko wani wurin jiki
• Raunin hannu, ƙafa, ko wani wurin jiki
• Thatan makaranta masu girma dabam
• Fatar ido na faduwa
• Hadiyar wahala
• Lalacewar magana
• Matsalar motsi

Huhu da numfashi:

• Tari
• Rashin numfashi
• Cunkoson Sinus da zafi
• Cutar jini ko zubar jini ta hanci

Sauran cututtukan sun hada da:

• Ciwon ciki
• Jini a cikin fitsari ko bayan gida
• Sandarewa ko sauya murya
• Jin zafi daga lalacewar jijiyoyin da ke ba da zuciya (jijiyoyin jijiyoyin jini)

Mai ba da sabis na kiwon lafiya zai yi cikakken gwajin jiki. Nazarin tsarin juyayi (na jijiyoyin jiki) na iya nuna alamun lalacewar jijiya.

Gwajin da za a iya yi sun hada da:

• Cikakken lissafin jini, cikakken kimiyyar sinadarai, da binciken fitsari
• Kirjin x-ray
• Gwajin furotin C-mai amsawa
• Yawan kujeru
• Hepatitis gwajin jini
• Gwajin jini don ƙwayoyin cuta akan ƙwayoyin cuta (ANCA antibodies) ko antigens na nukiliya (ANA)
• Gwajin jini don cryoglobulins
• Gwajin jini don matakan haɓaka
  
• Nazarin hotunan hoto kamar angiogram, duban dan tayi, ƙididdigar hoto (CT), ko hoton haɓakar maganadisu (MRI)
• Kwayar halittar fata, tsoka, kayan gabobin jiki, ko jijiya

Ana ba da kwayar Corticosteroids a mafi yawan lokuta. Yanayin zai dogara ne akan irin mummunan yanayin da yanayin yake.

Sauran kwayoyi da suke dankwafar da garkuwar jiki na iya rage kumburin jijiyoyin jini. Wadannan sun hada da azathioprine, methotrexate, da mycophenolate. Ana amfani da waɗannan magungunan sau da yawa tare da corticosteroids. Wannan haɗin yana ba da damar sarrafa cutar tare da ƙananan ƙwayar corticosteroids.

Don cuta mai tsanani, an yi amfani da cyclophosphamide (Cytoxan) tsawon shekaru. Koyaya, rituximab (Rituxan) yana da tasiri daidai kuma yana da ƙaran guba.

Kwanan nan, tocilizumab (Actemra) ya nuna yana da tasiri ga katuwar kwayar halitta don haka ana iya rage adadin corticosteroids.

Necrotizing vasculitis na iya zama mummunan cuta da barazanar rai. Sakamakon ya dogara da wurin da cutar vasculitis take da kuma tsananin lalacewar nama. Matsaloli na iya faruwa daga cutar da kuma magunguna. Yawancin nau'ikan cutar necrotizing vasculitis suna buƙatar bin dogon lokaci da magani.

Matsaloli na iya haɗawa da:

• Lalacewa na dindindin ga tsari ko aikin yankin da abin ya shafa
• Cututtuka na biyu na ƙwayoyin necrotic
• Hanyoyi masu illa daga magunguna da aka yi amfani da su

Kirawo mai bayarwa idan kana da alamun cutar necrotizing vasculitis.

Alamun gaggawa sun haɗa da:

• Matsaloli a cikin ɓangarorin jiki fiye da ɗaya kamar bugun jini, amosanin gabbai, tsananin kumburin fata, ciwon ciki ko tari na jini
• Canje-canje a cikin girman ɗalibi
• Rashin aiki na hannu, kafa, ko wani sashin jiki
• Matsalar magana
• Hadiyar wahala
• Rashin ƙarfi
• Tsananin ciwon ciki
  

Babu wata hanyar da aka sani don hana wannan cuta.

• Tsarin jini

Jennette JC, Falk RJ. Koda da kuma tsarin vasculitis. A cikin: Feehally J, Floege J, Tonelli M, Johnson RJ, eds. M Clinical Nephrology. Na 6 ed. Philadelphia, PA: Elsevier; 2019: sura 25.

Jennette JC, Weimer ET, Kidd J. Vasculitis. A cikin: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Hanyoyin Laboratory. 23 ed. St Louis, MO: Elsevier; 2017: babi na 53.

Rhee RL, Hogan SL, Poulton CJ, et al. Hanyoyin da ke faruwa a cikin lokaci mai tsawo tsakanin marasa lafiya tare da cututtukan antineutrophil cytoplasmic antibody da ke haɗuwa da cutar vasculitis tare da cutar koda. Arthritis Rheumatol. 2016; 68 (7): 1711-1720. PMID: 26814428 www.ncbi.nlm.nih.gov/pubmed/26814428.

Magana U, Merkel PA, Seo P, et al. Inganci na tsarin karɓar gafara don haɗuwa da cutar vasculitis. N Engl J Med. 2013; 369 (5): 417-427. PMID: 23902481 www.ncbi.nlm.nih.gov/pubmed/23902481.

Stone JH, Klearman M, Collinson N. Gwajin tocilizumab a cikin kwayar halitta mai girman jini. N Engl J Med. 2017; 377 (15): 1494-1495. PMID: 29020600 www.ncbi.nlm.nih.gov/pubmed/29020600.