Faʻamaʻi o le nephotic
Nephrotic syndrome o se vaega o faʻailoga e aofia ai porotini i le miaga, maualalo le toto polotini tulaga i le toto, maualuga kolisi tulaga, maualuga triglyceride tulaga, faateleina toto maua ai lamatiaga, ma fulafula.
O le nephotic syndrome e mafua mai i eseesega eseese e faaleagaina ai fatugaʻo. O lenei faʻaleagaina e mafua ai le faʻamatuʻu atu o le tele o polotini i le miaga.
O le mafuaʻaga sili ona taatele i tamaiti o le itiiti suia suiga faʻamaʻi. Membranous glomerulonephritis o le sili ona taatele mafuaʻaga i tagata matutua. I faʻamaʻi uma e lua, o le glomeruli i fatugaʻo ua faʻaleagaina. Glomeruli o fausaga ia e fesoasoani e faʻamama lapisi ma otaota.
Lenei tulaga mafai foi ona tupu mai:
- Kanesa
- O faʻamaʻi e pei o le maʻisuka, systemic lupus erythematosus, myeloma e tele, ma le amyloidosis
- Faʻalavelave faʻafitauli
- Faʻamaʻi pipisi
- Faamaʻi (pei o le faʻaʻi o le faʻaʻi, hepatitis, poʻo le mononucleosis)
- Faʻaaogaina o nisi fualaʻau
E mafai ona tupu faʻafitauli i fatugaʻo pei o:
- Fuafua ma vaevaega glomerulosclerosis
- Glomerulonephritis
- Mesangiocapillary glomerulonephritis
E mafai ona aʻafia vaega uma o le nephrotic syndrome. I tamaiti, o le taatele i le va o tausaga 2 ma 6. O lenei faʻamaʻi e tupu soʻo i alii nai lo fafine.
Fula (edema) o le masani masani faʻailoga. E ono tupu:
- I foliga ma faataamilo i mata (fula mata)
- I lima ma vae, aemaise lava i vae ma tapuvae
- I le manava vaega (fulafula manava)
Isi faʻailoga aofia ai:
- Paʻu mago poʻo papala
- Foliga foliga o le miaga
- Le lelei le fiaai
- Weight mauaina (le fuafuaina) mai vai faatumauina
- Faoa faamalosi
E faʻataʻitaʻi e le tausi soifua le suʻega o le tino. O le a faia suʻesuʻega falesuesue e iloa ai le lelei o le galue o fatugaʻo. E aofia ai:
- Suʻega toto ole albumin
- Toto vailaʻau kemisi, pei o le autu metabolic vaega poʻo atoatoa metabolic vaega
- O le urea nitrogen (BUN)
- Creatinine - suʻega toto
- Faʻamamaina o le Creatinine - suʻesuʻega mimi
- Urinalysis
E i ai foʻi gaʻo i le miaga. Toto suka ma tulaga triglyceride ono maualuga.
Atonu e manaʻomia se biopsy o le fatugao e saili ai le mafuaaga o le faaletonu.
Suʻega e faʻateʻa eseʻese ai mafuaʻaga ono aofia ai mea nei:
- Antinuclear antibody
- Cryoglobulins
- Laʻasaga faʻamalieina
- Suʻega ole faʻapalepale ole kulukose
- Hepatitis B ma le C sela
- Suʻega ole HIV
- Rheumatoid vaega
- Serum porotini electrophoresis (SPEP)
- Syphilis serology
- Urine protein electrophoresis (UPEP)
O lenei faʻamaʻi ono mafai foi ona suia iʻuga o suʻesuʻega nei:
- Vitamini D tulaga
- Uʻamea serum
- Faateʻa urinary
O sini o togafitiga o le faʻamamaina o faʻailoga, puipuia faʻafitauli, ma tuai le faʻaleagaina o fatugaʻo. Ia faʻatonutonu nephrotic syndrome, o le faʻamaʻi ua mafua ai e tatau ona togafitia. Oe ono manaʻomia togafitiga mo le ola.
Togafitiga ono aofia ai nisi o mea nei:
- Tausia le toto i lalo pe i lalo ole 130/80 mm Hg e faʻatuai ai le afaina o fatugaʻo. O le inisinia ole Angiotensin-liua (ACE) poloka poʻo le angiotensin receptor blockers (ARBs) o vailaʻau e masani ona faʻaaogaina. ACE inhibitors ma ARBs e mafai foi ona fesoasoani e faʻaititia le aofaʻi o polotini na leiloa i le miaga.
- Corticosteroids ma isi vailaʻau e taofi pe faʻafilemu e le tino puipuia.
- Togafitiga maualuga kolisi e faʻaititia ai le tulaga lamatia mo fatu ma toto ala faʻafitauli - O le maualalo-gaʻo, maualalo-kolisi taumafa e masani ona le lava mo tagata e maua i le nephrotic syndrome. Vailaau e faʻaititia ai le kolesterol ma triglycerides (masani statins) ono manaʻomia.
- O se meaʻai maualalo le sodium e mafai ona fesoasoani ile fulafula i lima ma vae. Pamu vai (diuretics) mafai foi ona fesoasoani i lenei faʻafitauli.
- O meaʻai e maualalo le polotini e ono aoga. E ono fautuaina e lau kamupani se meaʻai lelei ile polotini (1 kalama o polotini ile kilokalama ole mamafa o le tino ile aso).
- Aveina vitamini D faʻaopopo pe a fai o le nephrotic syndrome e umi ma e le tali mai i togafitiga.
- Aveina o fualaʻau manifinifi i le toto e togafitia ai pe puipuia ai le papala toto.
E eseese uma taunuʻuga. Nisi tagata toe malosi mai le tulaga. O isi e atiaʻe i se maʻi fatugaʻo mo se taimi umi ma manaʻomia le faʻamama toto ma iu ai ina tuiina fatugaʻo.
O faʻafitauli tau soifua maloloina e ono aliaʻe mai le nephrotic syndrome e aofia ai:
- Ogaoga fatugao
- Faʻaʻaʻa o alatoto ma faʻamai fatu e fesoʻotaʻi
- Faamai o le fatugao faaumiumi
- Loloto tele o le suavai, faaletonu o le fatu, faʻaputuputuina vai i mama
- Faamaʻi pipisi, e aofia ai ma le niumonia pneumococcal
- Paleni meaai
- Trombosis o le uaua o le fatu
Valaʻau lau tautua pe a fai:
- O oe poʻo lau tama e maua i le faʻamaʻi o le nephrotic syndrome, e aofia ai le fulafula i ona foliga, manava, poʻo lima ma vae, poʻo papala.
- O oe poʻo lau tama o loʻo togafitia mo nephrotic syndrome, ae e le faʻaleleia atili faʻailoga
- O auga fou e tupu, e aofia ai le tale, faʻaititia miti galuega, faʻaletonu i urination, fiva, tiga o le ulu
Alu i le potu faʻafuaseʻi pe valaʻau le numera faʻafuaseʻi i le lotoifale (pei o le 911) pe a fai o oe ni maʻi o le fao.
Togafitiga tulaga e ono mafua ai nephrotic syndrome mafai fesoasoani fesoasoani puipuia ai le syndrome.
Nefosema
- Anatomia fatugaʻo
Erkan E. Nephrotic syndrome. I le: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Tusitusiga o Pediatrics. 21 ed. Filatelefia, PA: Elsevier; 2020: mata 545
Saha MK, Pendergraft WF, Jennette JC, Falk RJ. Muamua glomerular faʻamaʻi. I: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, eds. Brenner ma Rector's Le Fatugaʻo. 11th lomiga. Filatelefia, PA: Elsevier; 2020: mata 31