ʻāneʻane Nui O Ka'Ā'Ī

ʻO ka arteritis cell nui ka mumū ʻana o ka papa o kou mau arteries. ʻO ka hapa nui, hoʻopili ia i nā arteries i loko o kou poʻo, ʻoi aku hoʻi nā mea i loko o kou mau luakini. No kēia kumu, ua kapa ʻia ʻo ka arteritis cell nui i kekahi manawa he temporal arteritis.

Hoʻokumu pinepine ka arteritis cell nui i nā headaches, nā ʻeha poʻo, ka ʻeha i ka ihu, a me nā pilikia ʻike. Inā ʻaʻohe mālama, hiki ke alakaʻi i ka makapō.

ʻO ka mālama koke me nā lāʻau corticosteroid e hoʻomaha mau i nā hōʻailona o ka arteritis cell nui a hiki ke pale aku i ka nalowale o ka ʻike. E ʻike paha ʻoe i ka maikaʻi ʻana i loko o nā lā o ka hoʻomaka ʻana o ka mālama. Akā ʻoiai me ka mālama, he mea maʻamau nā relapses.

Pono ʻoe e kipa aku i kāu kauka maʻamau no nā nānā a me ka mālama ʻana i nā hopena ʻaoʻao mai ka lawe ʻana i nā corticosteroids.

ʻO nā hōʻailona maʻamau loa o ka arteritis cell nui ka ʻeha poʻo a me ka palupalu - pinepine loa - e pili pinepine ana i nā luakini ʻelua. Hiki i ka ʻeha poʻo ke hoʻonui i ka ʻino, hele mai a hele aku, a i ʻole e emi iki. Ma ke ʻano holoʻokoʻa, ʻo nā hōʻailona a me nā hōʻailona o ka arteritis cell nui e komo pū ana: ʻEha poʻo mau, nui, maʻamau ma kou wahi luakini Palupalu poʻo ʻEha i ka ihu ke nahu ʻoe a wehe nui i kou waha Fever Luhi Pau ke kaumaha me ka manaʻo ʻole Nānalo ʻana o ka ʻike a i ʻole ka ʻike pālua, ʻoi aku ka poʻe i loaʻa pū kekahi i ka ʻeha ihu Nānalo koke, mau o ka ʻike i hoʻokahi maka ʻO ka ʻeha a me ka paʻakikī i ka ʻāʻī, nā poʻohiwi a i ʻole nā ​​hipu he mau hōʻailona maʻamau ia o kahi maʻi pili, polymyalgia rheumatica. Ma kahi o 50 pakeneka o nā kānaka me ka arteritis cell nui loaʻa pū kekahi i ka polymyalgia rheumatica. Inā loaʻa iā ʻoe kahi poʻo ʻeha hou, mau a i ʻole kekahi o nā hōʻailona a me nā hōʻailona i helu ʻia ma luna nei, e ʻike i kāu kauka me ka hoʻokaʻulua ʻole. Inā ʻike ʻia ʻoe me ka arteritis cell nui, hiki i ka hoʻomaka ʻana o ka mālama ʻana i ka hiki ke kōkua i ka pale ʻana i ka nalowale ʻana o ka ʻike.

Inā loaʻa iā ʻoe kahi ʻeha poʻo hou, mau loa a i ʻole kekahi o nā hōʻailona a me nā ʻōuli i helu ʻia ma luna nei, e ʻike koke i kāu kauka. Inā ʻike ʻia ʻoe me ka giant cell arteritis, ʻo ka hoʻomaka ʻana i ka mālama ʻana i ka wā hiki ke kōkua pinepine i ka pale ʻana i ka nalowale ʻana o ka maka.

Ma ka giant cell arteritis, ʻāpala ka papa o nā arteries, e hoʻoulu ai i ka pehu. Hoʻemi kēia pehu i kou mau kīʻaha koko, e hoʻemi ana i ka nui o ke koko—a no laila, ka oxygen a me nā meaʻai nui—e hiki ai i nā pūnaewele o kou kino. Hiki ke hoʻopilikia ʻia nā arteries nui a waena paha, akā ʻo ka pehu pinepine loa ma nā arteries ma nā luakini. Aia kēia ma mua o kou mau pepeiao a hoʻomau i luna i kou poʻo. ʻAʻole maopopo ke kumu o ka ʻāpala ʻana o kēia mau arteries, akā manaʻo ʻia he pili ia i nā hoʻouka kūpono ʻole i nā paia artery e ka ʻōnaehana pale. Hiki i kekahi mau gene a me nā kumu kūlohelohe ke hoʻonui i kou hiki ke loaʻa i ke kūlana.

He mau kumu e hiki ai ke hoʻonui i kou pilikia o ka loaʻa ʻana o ka giant cell arteritis, me kēia mau mea:

• Makahiki. Hoʻopili wale ka giant cell arteritis i nā mākua, a he mea maʻamau ʻole ia i nā poʻe ma lalo o 50. ʻO ka hapanui o nā kānaka me kēia maʻi e loaʻa ana nā hōʻailona a me nā ʻōuli ma waena o 70 a me 80 mau makahiki.
• Wahine kāne. ʻOi aku ka nui o ka loaʻa ʻana o ka maʻi i nā wāhine ma mua o nā kāne ma kahi o ʻelua mau manawa.
• Lāhui a me ka ʻāina āpau. ʻOi aku ka nui o ka giant cell arteritis i waena o nā kānaka keʻokeʻo ma nā heluna kanaka ʻEulopa ʻĀkau a i ʻole nā ​​mea i hele mai mai Scandinavia.
• Polymyalgia rheumatica. ʻO ka loaʻa ʻana o ka polymyalgia rheumatica e hoʻonui i kou pilikia o ka loaʻa ʻana o ka giant cell arteritis.
• Mōʻaukala ʻohana. I kekahi manawa, e holo ana ka maʻi i loko o nā ʻohana.

Hiki i ka arteritis cell nui ke hoʻokumu i nā pilikia nui, me kēia mau mea:

• Makapo. Hiki i ka emi ʻana o ke kahe koko i kou mau maka ke hoʻokumu i ka nalowale koke ʻana o ka ʻike, ʻaʻohe ʻeha, ma kekahi maka, a i ʻole, ma nā maka ʻelua. ʻO ka nalowale ʻana o ka ʻike, ʻo ka mea maʻamau, he mau loa.
• Aortic aneurysm. He ʻāʻī ka aneurysm, he puʻupuʻu e ulu ana ma ka ipu koko nāwaliwali, ma ka mea nui e holo ana ma waenakonu o kou umauma a me kou ʻōpū (aorta). Hiki i ka aortic aneurysm ke pahū, e hoʻokumu ana i ke kahe koko kūloko e hoʻoweliweli ana i ke ola.

No ka mea hiki i kēia pilikia ke loaʻa ma hope o nā makahiki mai ka ʻike ʻana o ka arteritis cell nui, hiki i kāu kauka ke nānā i kou aorta me nā X-ray umauma makahiki a i ʻole nā hoʻokolohua kiʻi ʻē aʻe, e like me ka ultrasound a me ka CT.

• Stroke. He pilikia maʻamau ʻole kēia o ka arteritis cell nui.

Aortic aneurysm. He ʻāʻī ka aneurysm, he puʻupuʻu e ulu ana ma ka ipu koko nāwaliwali, ma ka mea nui e holo ana ma waenakonu o kou umauma a me kou ʻōpū (aorta). Hiki i ka aortic aneurysm ke pahū, e hoʻokumu ana i ke kahe koko kūloko e hoʻoweliweli ana i ke ola.

No ka mea hiki i kēia pilikia ke loaʻa ma hope o nā makahiki mai ka ʻike ʻana o ka arteritis cell nui, hiki i kāu kauka ke nānā i kou aorta me nā X-ray umauma makahiki a i ʻole nā hoʻokolohua kiʻi ʻē aʻe, e like me ka ultrasound a me ka CT.

Hiki ke paʻakikī ka ʻike ʻana i ka arteritis cell nui no ka mea ua like nā hōʻailona mua me nā hōʻailona o nā kūlana maʻamau ʻē aʻe. No kēia kumu, e ho'āʻo kāu kauka e kāpae i nā kumu ʻē aʻe o kāu pilikia.

Ma waho aʻe o ka nīnau ʻana e pili ana i kāu mau hōʻailona a me ka mōʻaukala lapaʻau, ua nui ka manawa e hana ai kāu kauka i kahi hoʻokolokolo kino piha, e hoʻolohe nui ana i kāu mau arteries temporal. I ka manawa pinepine, he palupalu kekahi a i ʻole nā ​​arteries ʻelua, me ka emi ʻana o ka pulse a me ka paʻakikī, cordlike manaʻo a me ke ʻano.

Hiki paha i kāu kauka ke ʻōlelo aku i kekahi mau hoʻokolohua.

Hiki ke hoʻohana ʻia nā hoʻokolohua aʻe e kōkua i ka ʻike ʻana i kou kūlana a me ka hahai ʻana i kou holomua i ka wā o ka mālama ʻana.

• Ka nui o ka erythrocyte sedimentation. I kapa pinepine ʻia ʻo ka sed rate, ke ana nei kēia hoʻokolohua i ka wikiwiki o ka hāʻule ʻana o nā cell ʻulaʻula i lalo o kahi tube o ke koko. ʻO nā cell ʻulaʻula e hāʻule koke ana paha e hōʻike ana i ka mumū i loko o kou kino.
• C-reactive protein (CRP). Ke ana nei kēia i kahi mea e hana ai kāu ate i ka wā e loaʻa ai ka mumū.

Hiki ke hoʻohana ʻia kēia mau mea e ʻike i ka arteritis cell nui a e nānā i kāu pane i ka mālama ʻana. Hiki ke komo nā hoʻokolohua:

• Doppler ultrasound. Ke hoʻohana nei kēia hoʻokolohua i nā nalu kani e hana i nā kiʻi o ke koko e kahe ana ma o kāu mau kīʻaha koko.
• Magnetic resonance angiography (MRA). Ke hoʻohui nei kēia hoʻokolohua i kahi MRI me ka hoʻohana ʻana i kahi mea hoʻohālikelike e hana i nā kiʻi kikoʻī o kāu mau kīʻaha koko. E haʻi aku i kāu kauka ma mua o ka manawa inā ʻaʻole ʻoluʻolu ʻoe i ka paʻa ʻana i kahi wahi liʻiliʻi no ka mea ua hana ʻia ka hoʻokolohua i loko o kahi mīkini ʻano tube.
• Positron emission tomography (PET). Inā manaʻo kāu kauka ua loaʻa paha iā ʻoe ka arteritis cell nui i nā arteries nui, e like me kāu aorta, hiki iā ia ke ʻōlelo aku i ka PET. Ke hoʻohana nei kēia hoʻokolohua i kahi hopena tracer intravenous e loaʻa ana i kahi liʻiliʻi o ka mea radioactive. Hiki i kahi PET scan ke hana i nā kiʻi kikoʻī o kāu mau kīʻaha koko nui a e hōʻike i nā wahi o ka mumū.

ʻO ke ala maikaʻi loa e hōʻoia ai i ka ʻike ʻana i ka arteritis cell nui ma o ka lawe ʻana i kahi laʻana liʻiliʻi (biopsy) o ka artery temporal. Aia kēia artery kokoke i ka ʻili ma mua o kou mau pepeiao a hoʻomau a hiki i kou poʻo. Hana ʻia ke kaʻina hana ma kahi outpatient me ka hoʻohana ʻana i ka anesthesia kūloko, maʻamau me ka liʻiliʻi o ka ʻoluʻolu ʻole a i ʻole ka ʻeha. Nānā ʻia ka laʻana ma lalo o ka microscope i loko o kahi lapaʻau.

Inā loaʻa iā ʻoe ka arteritis cell nui, e hōʻike pinepine ka artery i ka mumū e komo pū ana i nā cell nui ʻole, i kapa ʻia ʻo nā cell nui, ka mea e hāʻawi ai i ka maʻi i kona inoa. He mea hiki ke loaʻa iā ʻoe ka arteritis cell nui a loaʻa kahi hopena biopsy maikaʻi ʻole.

Inā ʻaʻole maopopo nā hopena, hiki i kāu kauka ke ʻōlelo aku i kahi biopsy temporal artery ʻē aʻe ma ka ʻaoʻao ʻē aʻe o kou poʻo.

ʻO ka lāʻau nui no ka arteritis cell nui ka hoʻohana ʻana i nā nui o ka lāʻau corticosteroid e like me ka prednisone. Ma muli o ka pono o ka lāʻau koke e pale aku ai i ka nalowale ʻana o ka ʻike, e hoʻomaka paha kāu kauka i ka lāʻau ma mua o ka hōʻoia ʻana i ka maʻi me ka biopsy. E ʻoi aku paha kou maikaʻi i loko o kekahi mau lā ma hope o ka hoʻomaka ʻana o ka lāʻau. Inā loaʻa iā ʻoe ka nalowale ʻana o ka ʻike ma mua o ka hoʻomaka ʻana o ka lāʻau me nā corticosteroids, ʻaʻole paha e hoʻomaikaʻi kou ʻike. Eia naʻe, hiki paha i kou maka ʻaʻole i pilikia ke hoʻopihapiha i kekahi o nā loli ʻike. Pono paha ʻoe e hoʻomau i ka lawe ʻana i ka lāʻau no hoʻokahi a ʻelua paha makahiki a ʻoi aku paha. Ma hope o ka mahina mua, hiki paha i kāu kauka ke hoʻomaka mālie e hoʻemi i ka nui a hiki i ka nui haʻahaʻa loa o nā corticosteroids e pono ai e kaohi i ka mumū. Hiki ke hoʻi mai kekahi mau hōʻailona, ʻo nā poʻo ʻeha ke kumu nui, i kēia manawa tapering. ʻO kēia kahi i hoʻomohala ai nā kānaka he nui i nā hōʻailona o ka polymyalgia rheumatica. Hiki ke mālama ʻia kēlā mau ʻāpana me ka hoʻonui iki ʻana i ka nui o ka corticosteroid. Hiki paha i kāu kauka ke manaʻo i ka lāʻau immune-suppressing i kapa ʻia ʻo methotrexate (Trexall). Hiki i nā Corticosteroids ke alakaʻi i nā hopena ʻaoʻao koʻikoʻi, e like me ka osteoporosis, ke koko kiʻekiʻe a me ka nāwaliwali o nā ʻiʻo. No ka pale ʻana i nā hopena ʻaoʻao, e nānā paha kāu kauka i kou nui o ka iwi a hāʻawi paha i nā mea hoʻohui calcium a me ka vitamina D a i ʻole nā ​​lāʻau ʻē aʻe e kōkua i ka pale ʻana i ka nalowale ʻana o ka iwi. Ua ʻae ʻia ʻo tocilizumab (Actemra) e ka Food and Drug Administration i kēia manawa e mālama i ka arteritis cell nui. Hāʻawi ʻia ia ma ke ʻano he inikini ma lalo o kou ʻili. ʻO nā hopena ʻaoʻao e komo pū me ka hoʻonui ʻana i kou pilikia i nā maʻi. Pono hou ka noiʻi. Noi i kahi manawa

Ke aʻo ʻana i nā mea a pau āu e hiki ai ke aʻo e pili ana i ka arteritis cell nui a me kāna mālama ʻana e kōkua iā ʻoe e manaʻo hou aku i ka mana o kou kūlana. Hiki i kāu hui mālama ola ke pane i kāu mau nīnau, a hiki paha i nā hui kākoʻo pūnaewele ke kōkua pū. E ʻike i nā hopena ʻaoʻao o nā lāʻau āu e lawe ai, a e hōʻike i nā loli i kou olakino i kāu kauka.