Necrotizing vasculitis

Necrotizing vasculitis o se vaega o faʻaletonu e aofia ai pupuga o le toto toto pa. Ole lapoʻa ole alatoto na afaina e fesoasoani e faʻailoa igoa o nei tulaga ma faʻafefea ona tupu le faʻamaʻi ile faʻamaʻi.

Necrotizing vasculitis atonu o le tulaga muamua e pei o polyarteritis nodosa po granulomatosis ma polyangiitis (na taʻua muamua Wegener granulomatosis). I isi tulaga, o le vasculitis ono tupu o se vaega o le isi faʻaletonu, pei o systemic lupus erythematosus poʻo le hepatitis C.

E leʻo iloa le mafuaʻaga o le fulafula. E ono fesoʻotaʻi ma mea taua o le autoimmune. O le puipui o le alatoto toto mafai ona maʻila ma mafiafia pe oti (avea ai ma necrotic). E mafai ona tapuni le alatoto, ma faʻalavelave i le tafe o le toto i masini na te sapalaiina. O le le lava o le tafe o le toto o le a mafua ai ona mamate sela. O nisi taimi o le alatoto toto e ono malepe ma toto (malepe).

Necrotizing vasculitis e ono afaina ai le toto i soʻo se vaega o le tino. O le mea lea, e mafai ona mafua ai faʻafitauli i le paʻu, faiʻai, mama, manava, fatugaʻo, faiʻai, sooga poʻo se isi lava totoga.

Fiva, malulu, lelava, gugu, pe paʻu pauna atonu na o le pau ia o faʻailoga i le taimi muamua. Peitaʻi, o faʻailoga e ono i ai i soʻo se itu o le tino.

Paʻu:

• O mūmū poʻo le pāuli lanu paʻu i vae, lima poʻo isi vaega o le tino
• Lanumoana lanu i tamatamailima ma tamatamaivae
• Faailoga o le oti oti ona o le leai o se okesene e pei o tiga, mumu, ma papala e le malolo

Maso ma sooga:

• Tiga soʻoga
• Tiga vae
• Vaivaiga maso

Faiʻai ma neula:

• Tiga, leai se mea, magumagu i se lima, vae poʻo seisi itu tino
• Vaivaiga o le lima, vae, poʻo seisi itu tino
• Tagata aʻoga e 'eseʻese tele
• Ua magaugau ifo le mata
• Totoina faigata
• Le lelei tautalaga
• Faigamalaga faigata

Lamu ma ala manava:

• Mama
• Manava le mānava
• Sinus pologa ma tiga
• Faʻalu le toto pe tafetoto mai le isu

Isi faʻailoga aofia ai:

• Tiga o le manava
• Toto i le miaga poʻo faʻataʻavalevale
• Le malu poʻo le suia leo
• Paʻu o le fatafata mai le faʻaleagaina o alatoto e maua ai le fatu (alatoto o le fatu)

O le a faia e le tausi soifua maloloina se faʻaiʻuga atoa o le tino. O le neula (neula) suʻega ono faʻaalia ai faʻailoga o neula leaga.

O suʻega e mafai ona faia e aofia ai:

• Faitau atoa le toto, vaega atoa o kemisi, ma urinalysis
• Fatafata x-ray
• C-toe faʻataʻitaʻia porotini
• Totogi fua
• Tofotofoga toto Hepatitis
• Toto faʻataʻitaʻiga mo vailaʻau faʻasaga i neutrophil (ANCA antibodies) poʻo antigens faaniukilia (ANA)
• Tofotofoga toto mo cryoglobulins
• Toto faʻataʻitaʻiga mo vaega atoatoa
  
• Suʻesuʻega faʻataʻitaʻiga e pei ole angiogram, ultrasound, compute tomography (CT) scan, poʻo le magnetic resonance imaging (MRI)
• Biopsy o le paʻu, maso, totoga o le okeni, poʻo neula

O le tele o tulaga e maua ai Corticosteroids. O le fualaʻau o le a faʻamoemoe i le leaga o le tulaga o.

O isi vailaʻau e taofiofia le puipuiga e mafai ona faʻaititia ai le fulafula o alatoto. E aofia ai azathioprine, methotrexate, ma mycophenolate. O nei vailaʻau e masani ona faʻaaogaina faʻatasi ma le corticosteroids. O lenei tuʻufaʻatasia e mafai ai ona taofiofia le faʻamaʻi ma le paʻu maualalo o le corticosteroids.

Mo faʻamaʻi tuga, cyclophosphamide (Cytoxan) na faʻaaoga mo le tele o tausaga. Peitaʻi, o le rituximab (Rituxan) e tutusa lona aoga ma e laʻitiiti foʻi.

Talu ai nei, tocilizumab (Actemra) na faʻaalia e aoga mo tele sela arteritis ina ia mafai ona faʻaititia le inumaga corticosteroids.

Necrotizing vasculitis mafai ona ogaoga ma lamatia ola. O le taunuʻuga e faʻamoemoe i le tulaga o le vasculitis ma le ogaoga o le tino faʻaleagaina. Faʻafitauli e ono aliaʻe mai le faʻamaʻi ma mai vailaʻau. Tele o ituaiga o necrotizing vasculitis manaʻomia taimi umi-tulitatao ma togafitiga.

Faʻafitauli e ono aofia ai:

• Faʻaleagaina tumau i le fausaga poʻo le gaioiga o le aʻafia vaega
• Maualuga faʻamaʻi o neulaʻa
• Aʻafiaga mai vailaʻau faʻaogaina

Valaʻau lau tautua peʻa iai ni faʻailoga o le necrotizing vasculitis.

Faʻalavelave faʻafuaseʻi e aofia ai:

• Faʻafitauli i sili atu ma le tasi vaega o le tino e pei o le faʻamaʻi, gugu, manava tiga o le paʻu, manava tiga poʻo tale le toto
• Suiga i tamaiti aʻoga lapoʻa
• Leiloa o le aoga o se lima, vae, poʻo seisi tino vaega
• Faʻafitauli tautalaga
• Totoina faigata
• Vaivaiga
• Paʻu tiga o le manava
  

E leai se auala iloa e puipuia ai lenei faʻamaʻi.

• Faiga faʻasolosolo

Jennette JC, Falk RJ. Vasculitis o le fatugaʻo ma le tino. I le: Feehally J, Floege J, Tonelli M, Johnson RJ, eds. Faʻamatalaga auʻiliʻi. 6th ed. Filatelefia, PA: Elsevier; 2019: chap 25.

Jennette JC, Weimer ET, Kidd J. Vasculitis. I totonu: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management e le Laboratory Metotia. 23th lomiga. St Louis, MO: Elsevier; 2017: mata 53.

Rhee RL, Hogan SL, Poulton CJ, et al. Faʻataʻitaʻiga i ni taimi umi iuga i tagata mamaʻi ma antineutrophil cytoplasmic antibody-fesoʻotaʻi vasculitis ma faʻamaʻi fatu. Gugu Rheumatol. 2016; 68 (7): 1711-1720. PMID: 26814428 www.ncbi.nlm.nih.gov/pubmed/26814428.

Faʻamatalaga U, Merkel PA, Seo P, et al. Le aoga o le faʻamamaina-faʻatosina tulafono mo ANCA-fesoʻotaʻi 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. Faʻataʻitaʻiga o le tocilizumab i le lapoʻa-sela arteritis. N Engl J Med. 2017; 377 (15): 1494-1495. PMID: 29020600 www.ncbi.nlm.nih.gov/pubmed/29020600.