Chirwere

Yakakwana Lupus Management

Systemic Lupus Erythematosus (SLE) chirwere chisingaperi che autoimmune chinokanganisa masystem akawanda enhengo, kusanganisira ganda, majoini, itsvo, moyo, uye central nerve system. SLE inozivikanwa nekusiyana kwayo kwekiriniki kuratidzwa, sezvo inogona kuratidza nezviratidzo zvakasiyana uye zvirwere muvarwere vakasiyana.

Taura nesu

Etiology

Chikonzero chaicho cheSLE hachina kujeka, asi kusangana pakati pemajini uye zvakatipoteredza zvinhu zvinotendwa kuita basa rakakosha. Abnormal activation ye immune system inotungamira mukurwiswa kwe autoimmune, zvichikonzera kukuvadzwa kwematishu uye nhengo dzemuviri.

Genetic Factors: SLE inowanzomhanya mumhuri, uye hama dzevarwere dzine chiitiko chepamusoro zvakanyanya zvichienzaniswa nehuwandu hwevanhu. Chiitiko mumapatya akafanana chakanyanya kukwirira kupfuura mumapatya ehama, zvichiratidza hukama pakati peSLE uye genetic factor.

Environmental Factors:
Chiedza chezuva: Varwere veSLE vanowanzoona zvirwere zvinopisa mushure mekubuda kwezuva, zvichida nekuda kweultraviolet-induced cell apoptosis inotungamira kune antigen exposure.

Zvinodhaka uye Chemical Agents: Ekunze maantigen anogona kumisa immune system, zvichikonzera kugadzirwa kwe autoantibody uye kukuvara kwetishu. Zvinodhaka zvakadai seprocainamide, hydralazine, quinidine, nezvimwe zvinogona kukonzera SLE.
Zvirwere: Pathogenic microorganisms (yakadai se cytomegalovirus, hepatitis C virus, Epstein-Barr virus, nezvimwewo) inoita zvakafanana nemishonga, inowanzokonzera kugadzirwa kweautoantibodies nemasimba ekudzivirira.

Estrogen: Mhando dzakawanda dzeSLE dzinowanzoonekwa muvakadzi vezera rekubereka. Kubata pamuviri uye kushandiswa kweestrogen-ine zvinodhaka (zvakadai sekudzivirira pamuviri) zvinogona kuwedzera chirwere chacho. Kuedza kwemhuka kwakaratidza kuti estrogen inowedzera lupus mumhuka dzakakanganiswa, nepo testosterone inoderedza zviratidzo, zvichiratidza kuwirirana kwepedyo pakati peesrogen mazinga uye kutanga kweSLE.

Clinical Manifestations

Makiriniki ekuratidzwa kweSLE akasiyana uye anosanganisira, asi haana kugumira kune:

Zviratidzo zveGanda: Rashes, shavi-shavi-shavi kumeso (malar rash), photosensitivity, nezvimwe.

Joint Symptom: Arthritis, kurwadza kwemajoini, kuzvimba kwemajoini.

Renal Zviratidzo: Proteinuria, hematuria, izvo zvinogona kukonzera nephritis.

Cardiac Zviratidzo: Pericarditis, valvular mwoyo kukuvara.

Central Nervous System Zviratidzo: Musoro, kugumburwa, kukanganisa kwekuziva.

Examination

Kuongororwa kweSLE kunosanganisira matanho akati wandei:

Kuonana: Chiremba anobvunza nezve zviratidzo zvikuru, zviratidzo zvine hukama, nguva, kuongororwa kwakapfuura, marapirwo, nhoroondo yemhuri, nezvimwe.

Kuongorora Kwemuviri: Kuongorora kwakadzama uye kuongororwa kwemuviri, kusanganisira ganda, bvudzi, muromo wemuromo, uye majoini, pakati pevamwe.

Miedzo Yakakodzera: Kuongororwa kweropa, kuongorora weti, zvidzidzo zvekufungidzira, itsvo biopsies, etc. Tsvodzo dzeitsvo dzinosanganisira chirongwa chidiki chekuvhiya apo chidimbu chidiki cheitsvo chinowanikwa pasi peanesthesia yemunharaunda yekuongororwa kwepathological uye immunopathological.

Kuongororwa

Kunze kwezvakajairwa zvironda zveganda, histopathological kuongororwa uye kuongororwa ropa kunoshanda seuchapupu hwekuongorora. Immunopathological examination inokosha zvikuru mukuongororwa. Positive serum autoantibodies, senge anti-nuclear antibodies (ANA), anti-dsDNA antibodies, anti-Sm antibodies, nezvimwewo, maitiro. Shanduko mune antibody titers inogona kuratidza chiitiko chechirwere, uye vanoshingaira SLE varwere vanowanzoratidza kuwedzera erythrocyte sedimentation rate. Urinalysis inogona kuratidza proteinuria, tsvuku/chena masero eropa, uye cellular casts.