Zosokoneza, chilengedwe, ndi majini angakhale ndi gawo
Angioedema, kutupa kwa minofu yomwe imakhala pansi pa khungu, ikhoza kuyambitsidwa ndi zovuta, mankhwala, malo a munthu, kapena nkhawa. Zingakhalenso zaufulu, ndipo zokhudzana ndi gene mutation zikuperekedwa m'mabanja. Zomwe zimayambitsa vutoli ndizovuta kwa chitetezo cha mthupi momwe mankhwala omwe amatchedwa histamine kapena bradykinins amamasulidwa mosavuta m'magazi.
Malo omwe thupi limakhudzidwa-nkhope, lilime, khosi, mikono, kapena miyendo-zimapereka chitsimikizo chothandiza, koma osati nthawi zonse.
Zomwe Zimayambitsa
Odwala angioedema (AAE) amatha kukhala immunologic (okhudzana ndi zovuta), osakhala ndi immunologic (amachititsidwa ndi zosayambitsa zovuta), kapena amodzi (osadziwika kuchokera pachiyambi). Mosiyana ndi angioedemia yokhala ndi zenizeni (onani m'munsimu), zina mwa zinthu zomwe zikukhudzana ndi mitunduyi zingasinthe.
Immunologic
Matendawa ndi omwe amayamba chifukwa cha angioedema, amachititsa chidwi ndi mankhwala , chakudya , tizilombo toyambitsa matenda , kapena zinthu zina monga latex . Cholingacho chimaonedwa kuti ndi chamadzimadzi chifukwa chimapangitsa kuti chitetezo cha mthupi chitengeke mosavuta.
Pazifukwa zosadziwika, thupi nthawi zina limangokhalira kulakwitsa zinthu zopanda pangozi kuti likhale loopsya ndikufalitsa mbiri yambiri ya histamine m'magazi monga njira yotetezera.
Ngakhale kuti mbiri ya histamines imayenera kuchepetsa mitsempha ya magazi kotero kuti maselo oyera a mitsempha akhoza kuyandikira malo a chovulala, atamasulidwa popanda kuvulazidwa, angayambitse zizindikiro zovuta, kuphatikizapo chiwindi ( allergenic rhinitis ), ming†™ oma ( urticaria ), ndi asterma yosautsa .
Komabe, mosiyana ndi zomwe zimachitika, angioedema amapezeka m'magulu ang'onoang'ono pansi pa pamwamba pa khungu kapena mu chipankhu. Kutupa sikungakhale kofiira kapena kofiira ndipo kungathe kukhala maola ambiri kapena masiku angapo. Pamene kutupa kumatha, khungu limakhala labwinobwino popanda kutsekemera, kupukuta kapena kuvulaza.
Non-Immunologic
Ndi immunologic angioedema, maselo omwe amayambitsa chiwembu amadziwika ngati maselo akuluakulu . Maselo ammimba ali ndi granules olemera mu histamine ndipo, ataphunzitsidwa ndi chitetezo cha mthupi kuti achite zimenezo, adzachita ndondomeko yotchedwa degranulation kutulutsa histamine mu dongosolo.
Ndi osakhala ndi immunologic angioedema, chitetezo cha mthupi sichinachite ndi kumasulidwa. Mmalo mwake, mankhwala ena kapena mapangidwe a thupi angapangitse maselo kuti awonongeke. Zomwe zimachitika nthawi zambiri zimachitika kwa anthu omwe ali ndi matenda osokoneza bongo, monga mastocytosis .
Mankhwala omwe amagwirizanitsidwa ndi izi ndi awa:
- Opiates, makamaka codeine ndi morphine
- Mankhwala otsutsana ndi kutupa (nonsteroidal anti-inflammatory drugs (NSAIDs), makamaka aspirin
- Intravenous vancomycin , mankhwala amphamvu kwambiri
- Diso losakhala ndi ionic radiocontrast yomwe imapangidwira zithunzi za X-ray
Zina zomwe sizimayambitsa matenda, zimaphatikizapo kuika magazi, khansa ngati matenda a lymphoma , matenda opatsirana monga lupus , ndi matenda ena monga chiwindi, HIV, cytomegalovirus , ndi Epstein-Barr.
Zovuta zina monga kutentha, kuzizira, kuchita masewera olimbitsa thupi, kuthamanga , kutuluka dzuwa, komanso kupsinjika maganizo kumadziwika chifukwa cha angioedema.
Idiopathic
Ndi mankhwala osokoneza bongo, palibe chomwe chidzadziwitse chifukwa kapena kufotokozera kwa chidziwitso chodzidzimutsa.
Chomwe chimapangitsa kuti vutoli likhale lovuta kwambiri ndi lakuti anthu omwe akukhudzidwawo amawoneka mobwerezabwereza, nthawi zina kwambiri.
Malinga ndi kafukufuku wochokera ku yunivesite ya Wisconsin School of Medicine, anthu opitirira theka la anthu 99 omwe anapezeka ndi matenda a idiopathic angioedema omwe amapezekapo nthawi zambiri kuposa chaka chimodzi. Maonekedwe, pakamwa, ndi malirime ndiwo malo omwe amapezeka kwambiri. Kwawo, 55 peresenti ya iwo adanena kuti amalandira mankhwala osachepera amodzi a corticosteroids kuti achepetse kutupa. Zambiri zokhudzana ndikenso zinalipo kuti 52 peresenti amafunika ulendo umodzi ku chipinda chodzidzimutsa.
Genetics
Angereded angioedema (HAE) imaonedwa ngati vuto lalikulu la vesi , kutanthauza kuti mungathe kulandira jini yovuta kuchokera kwa kholo limodzi.
Pali mitundu iwiri ya HAE yokhudzana ndi kusintha kwa jini la SERPING1 ndi lachitatu lomwe linayambitsa kusintha kwa jini la F1.
Mitundu yonseyi imachititsa kuti thupi liziyenda bwino komanso likhoza kuyambitsa kutupa mbali zonse za thupi. Kumene HAE imasiyana ndi AAE ndikuti vuto lalikulu si mbiri ya histamine. M'malo mwake, chiwonongekocho chidzachitidwa ndi gulu lina lodziwika bwino lomwe limatchedwa bradykinin.
Bradykinin, monga mbiri ya histamine, imayambitsa mitsempha ya mthupi koma imatero ngati njira yothetsera ntchito za thupi. Mwachitsanzo, thupi limasula bradykinins kuti achepetse kuthamanga kwa magazi kapena kuyendetsa ntchito ya kupuma kapena impso.
Kutulutsidwa kosazolowereka kwa bradykinins kungayambitse angioedema, nthawi zambiri miyendo, mikono, ziwalo, nkhope, milomo, larynx, kapena m'mimba (GI). Kuvulaza pang'ono kapena zochitika za kupsinjika maganizo kungayambitse chiwonongeko, koma zimachitika makamaka popanda chifukwa.
Angioedema ya thirakiti la GI ikhoza kukhala yowopsya, kuyambitsa kusanza kwaukali, kupweteka kwambiri, ndi kutaya madzi kwa madzi osakhoza kusunga madzi. Ngati kutupa kumachitika pammero, kungakhale koopsa.
Chifukwa chakuti ACE inhibitors (amagwiritsidwa ntchito pochiza magazi) amagwira ntchito pochirikiza mazinga a bradykinin, ndiwo amodzi omwe amachititsa anthu ambiri kuti azidwala mankhwala osokoneza bongo (ngakhale ali ndi matenda osiyanasiyana kusiyana ndi opiat kapena aspirin).
HAE imawoneka kuti ndi yosawerengeka, ikupezeka mwa mmodzi mwa anthu 50,000, ndipo nthawi zambiri amangoganiza kuti munthu yemwe ali ndi angioedema sakuvomereza antihistamines. HAE ikhoza kutsimikiziridwa ndi mayesero atatu a magazi omwe amawunika momwe akumvera.
Zowopsa
Palibe njira yeniyeni yofotokozera chifukwa chake anthu ena amatenga angioedema ndi ena omwe ali ndi thanzi labwino kapena miyoyo. Pomwe zikunenedwa, mutha kukhala pachiopsezo chachikulu ngati muli ndi zotsatirazi:
- Kugwiritsa ntchito mankhwala osokoneza bongo kumalonda kapena ming'oma
- Zilonda zokhudzana ndi ming'oma
- Mbiri ya angioedema
- Mbiri ya banja la ming'oma kapena angioedema
- Matenda osokoneza bongo monga lupus kapena Hashimoto's thyroiditis , omwe angioedema ndi chizindikiro chotheka
Ngati inu kapena wokondedwa wanu mwakhala mukudwala matenda ambiri a angioedemia, mukhoza kupindula ndi mankhwala omwe angathandize kupewa masoka amtsogolo. Zosankha zimaphatikizapo mlingo wa usiku wa antihistamine Zyrtec (cetirizine) , ngati chifukwa chake sichikakamiza, kapena mankhwala osokoneza thupi monga Kalbitor (osasintha) kapena Firazyr (icatibant).
> Chitsime:
> Bernstein, J ;; Lang, D ;; Khan, D. et al. "Kusanthula ndi kuyang'anira urticaria yovuta komanso yosasintha: 2014." J Zachilombo Zamtundu wa Immunol. 2014; 133 (5): 1270-7.
> Inomata, M. "Zotsatira Zatsopano Zogwiritsa Ntchito Mankhwala Osokoneza Bongo." Allerg Int. 2012; 61 (4): 545-57. DOI: 10.2332 / alergolint.12-RAI-0493.
> Rosenberg, D .; Mathur, S .; ndi Viswanathan, R. "Zochitika zapadera za Idiopathic Angioedema." J Zachilombo Clinic Immunol. 2017; 139 (2): AB235. DOI: 10.1016 / j.jaci.2016.12.757.