Tagata matua Filemu faamaʻi

Matutua e Toʻatasi lava le faʻamaʻi (ASD) o se maʻi seasea mafua ai maualuga fiva, mageso, ma soʻoga soʻoga. E mafai ona taitai atu ai i le tumau (tumau) gugu.

Tagata matua Maʻi faamaʻi o se ogaoga lomiga o tamaiti laiti idiopathic gugu (JIA), lea e tupu i tamaiti. Tagata matutua mafai ona maua le tutusa tulaga, e ui lava e sili atu le laʻititi masani. E taʻua foi ole tagata matua, onset Still disease (AOSD).

Itiiti ifo ile tasi mai le 100,000 tagata e atiaʻe ASD i tausaga taʻitasi. E masani ona aʻafia ai fafine nai lo aliʻi.

Le mafuaʻaga o tagata matutua Ae o faʻamaʻi e leʻo iloa. Leai se tulaga lamatia mo le faamai ua faailoaina.

Toetoe lava o tagata uma e maua i le maʻi o le a maua i le fiva, tiga soʻoga, tiga o le faʻaʻi, ma le mageso.

• E masani ona tiga soʻoga, mafanafana, ma fulafula. Tele o taimi, e tele soʻoga e aʻafia ile taimi e tasi. E masani a, o tagata e maua ile maʻi ei ai le malō o soʻoga ile taeao e tumau ile tele o itula.
• O le fiva e sau vave i le tasi i le aso, masani lava i le aoauli po o le afiafi.
• O le paʻu o le paʻu e masani ona lanu samasama-piniki ma sau ma alu ma le fiva.

Faʻailoga faʻaopopo aofia ai:

• Manava manava ma fulafula
• Paʻu pe a manava loloa (pleurisy)
• Tiga faʻaʻi
• Fula fulafula nodes (glands)
• Paʻu pauna

E mafai ona fulafula le gutu poʻo le ate. E mafai foi ona tupu le pupuga ole fatu ma le fatu.

E faʻatoa iloa le AOSD pe a maeʻa le tele o isi faʻamaʻi (pei o faʻamaʻi ma kanesa) ua faʻateʻaina. Atonu e te manaʻomia le tele o suʻesuʻega faʻafomaʻi ae leʻi faia se faʻamaoniga mulimuli.

O se suʻega faʻaletino atonu e faʻaalia ai le fiva, mageso, ma le gugu. O le tausi soifua maloloina o le a faʻaaogaina se stethoscope e faʻalogo ai mo suiga i le leo o lou fatu poʻo mama.

O suʻesuʻega o le toto e mafai ona fesoasoani ile faʻailoaina o faʻamaʻi o le tagata matua.

• Faitau atoa le toto (CBC), ono faʻaalia ai le maualuga o sela papaʻe (granulosit) ma faʻaititia le aofaʻi o toto mumu.
• C-reactive protein (CRP), o le fuataga o le fulafula, o le a maualuga atu nai lo le masani ai.
• ESR (sedimentation rate), o le fuataga o le fulafula, o le a maualuga atu nai lo le masani ai.
• Ferritin maualuga o le a maualuga maualuga.
• Fibrinogen tulaga o le a maualuga.
• Ole suʻega ole gaioiga ole ate ole a faʻaalia ai le maualuga ole AST ma le ALT.
• Rheumatoid vaega ma le ANA faʻataʻitaʻiga o le a le lelei.
• Toto aganuu ma viral suesuega o le a le lelei.

O isi suʻega atonu e manaʻomia e siaki ai le fulafula o soʻoga, pusa, ate, ma le alatoto:

• Laʻititi ultrasound
• CT faʻataʻitaʻi le manava
• X-ave o soʻoga, fatafata, poʻo le manava vaega (manava)

O le sini o togafitiga mo tagata matutua Maʻi faamaʻi o le taofiofia o faʻailoga o le gugu. O le Aspirin ma isi vailaʻau e le faʻaaoga e teteʻe ai i le mafaufau (NSAIDs), pei ole ibuprofen, e masani ona faʻaaoga muamua.

Prednisone mafai ona faʻaaogaina mo sili atu matuia mataupu.

Afai o le faʻamaʻi e ogaoga pe tumau mo se taimi umi (avea tumau), vailaʻau e taofiofia le puipuia faiga ono ono manaʻomia. O vailaʻau e aofia ai:

• Methotrexate
• Anakinra (interleukin-1 receptor agonist)
• Tocilizumab (interleukin 6 taofi)
• Tumor nekrosis factor (TNF) tagata tetee e pei o le etanercept (Enbrel)

I le tele o tagata, auga e ono toe foi mai tele taimi i isi tausaga.

Faʻailoga faʻaauau mo se taimi umi (tumau) i le tusa o le tasi vaetolu o tagata ma tagata matutua Maʻi faʻamaʻi.

O se ituaiga seasea o le faʻamaʻi, ua taʻua o le macrophage activation syndrome, e mafai ona ogaoga tele i le maualuga o le fiva, ogaoga o maʻi ma le maualalo o le toto sela. O le ponaivi ponaivi e aofia ai ma biopsy e manaʻomia e faia ai le faʻamaoniga.

Isi faʻalavelave e ono aofia ai:

• Gugu i le tele sooga
• Maʻi ole ate
• Pericarditis
• Faʻamalosi tino
• Faʻalautelega

Valaʻau lau tautua peʻa iai ni faʻailoga o le tagata matua Maʻi pea.

Afai ua uma ona faʻamaonia oe i le maʻi, oe tatau ona valaʻau lau tautua pe a fai oe maua se tale pe faigata ona manava.

E leai se iloa puipuia.

Maʻi pea - matua; Tagata matua-onset Taʻi Maʻi; AOSD; Wissler-Fanconi syndrome

Alonso ER, Marques AO. Tagata matua-amataina lava faamaʻi. I: Hochberg MC, Gravallese EM, Silman AJ, Smolen JS, Weinblatt ME, Weisman MH, eds. Rheumatology. 7th ed. Filatelefia, PA: Elsevier; 2019: chap 173.

Gerfaud-Valentin M, Maucort-Boulch D, Hot A, et al. Tagata matua-onset pea faʻamaʻi: faʻaaliga, togafitiga, taunuʻuga, ma vavalo mea i 57 tagata mamaʻi. Vailaau (Baltimore). 2014; 93 (2): 91-99. PMID: 24646465 www.ncbi.nlm.nih.gov/pubmed/24646465.

Kaneko Y, Kameda H, Ikeda K, et al. Tocilizumab i tagata mamaʻi ma tagata matutua-onset o loʻo tumau pea faʻamaʻi refactory i togafitiga glucocorticoid: o se randomized, faʻalua-tauaso, placebo-pulea vaega III faʻamasinoga. Ann Rheum Dis. 2018; 77 (12): 1720-1729. PMID: 30279267 www.ncbi.nlm.nih.gov/pubmed/30279267.

'Upega Tafaʻilagi a le Atunuʻu mo le Rare Disorder website. Maʻi seasea.org. Amataina e tagata matua le Maʻi o le. rarediseases.org/rare-diseases/adult-onset-stills-disease/. Avanoa ia Mati 30, 2019.

Ortiz-Sanjuán F, Blanco R, Riancho-Zarrabeitia L, et al. Malosiaga o anakinra i refactory matutua-onset Maʻi o le maʻi: multicenter suesuega o 41 tagata mamaʻi ma tusitusiga toe iloiloina. Vailaau (Baltimore). 2015; 94 (39): e1554. PMID: 26426623 www.ncbi.nlm.nih.gov/pubmed/26426623.