Izifo ezazibizwa ngokuthi i-pauciarticular i-idiopathic arthritis
I-oligoarticular i-juvenile idiopathic arthritis (eyayibizwa ngokuthi i-pauciarticular i-idiopathic arthritis noma i-pauciarthritis) iyinhlangano engaphansi kwe- juvenile idiopathic arthritis efaka amalungu angaphansi kwama-5. I-Oligoarticular i-juvenile idiopathic arthritis yilapho i-juvenile idiopathic arthritis subtype evame kakhulu. I-30% kuya ku-60% yazo zonke iziguli ze-juvenile idiopathic arthritis eNyakatho Melika naseYurophu.
I-subtype ye-oligoarticular i-iveniopathic arthritis ibuye ibe phakathi:
- I-oligoarthritis eqhubekayo - Akukho ukubandakanyeka okuhlangene okungeziwe ngaphezu kwezinyanga eziyisithupha zokuqala zokugula nezimpawu.
- I-oligoarthritis enwetshiwe - Ukubandakanyeka okuhlangene okungeziwe kwenzeka ngemuva kwezinyanga eziyisithupha zokugula futhi ekugcineni kunezihlanganisi ezingaphezu kwezingu-4 ezihilelekile.
Cishe isigamu sezingane ezine-arthritis ye-oligoarticular i-idiopathic arthritis ithuthukisa uhlobo olwandisiwe eminyakeni engu-4 kuya kweyisithupha emva kokugula. Nakuba kungekho ndlela eqinile yokubikezela ukuthi yiziphi izingane ezizoqhubeka nokuthuthukisa uhlobo olwandisiwe, kunezici zezifo ezibonakala zikhulisa amathuba, kufaka phakathi ukubandakanyeka okuhlangene komlinganiso, ukubandakanya kwe-ankle noma isibindi (noma kokubili isikhumba nesandla), futhi isilinganiso se-erythrocyte se-sedimentation ezinyangeni ezingu-6 zokuqala.
Ukufaniswa Okuvamile Nezimpawu
Isikhathi esiphezulu sokuqala kwe-oligoarticular ye-arthritis ye-idiopathic isifo seminyaka engu-2 kuya kwengama-4 e-Caucasian e-United States naseYurophu.
Amantombazane avame ukuthinteka kakhulu kunabantwana (3 kuya ku-1). Ukuqala kwe-oligoarticular youngly idiopathic arthritis akuyona into evamile kakhulu ezinganeni ezineminyaka engaphezu kwengu-5 ubudala futhi kuqala kungavamile ezinganeni ezineminyaka engu-10 noma ngaphezulu.
Ngokujwayelekile, lapho kuqala i-oligoarticular i-young veicidal arthritis, kunomthelela ohlangene wokubambisana okuthinta amajoyina amabili noma amabili.
Ibhande lingumjoqo ovamile kakhulu othintekayo. I-ankle, isibindi, namadijithi yizingxenye ezilandelayo ezivame ukubandakanya. Izimpawu zesistimu (isib., Umkhuhlane, ukushayeka) akuvamile, njengokubandakanya kwe-hip nangemuva. Uma ingane ine-systemic ukubandakanyeka noma ukubandakanyeka kwe-hip noma emuva, ukuhlolwa kabusha kukhonjisiwe futhi kubuyisisa kabusha ukuxilongwa.
Ngenkathi ungase ulindele ukuthi ubuhlungu bube uphawu oluqala kakhulu lwe-oligoarticular ye-arthritis ye-juvenile idiopathic, ngokuvamile iqala ukucabangela. Umzali angaqaphela ukuthi ingane yakhe inesibindi, ukungafuni ukuhamba noma ukugijima, noma ukuvuvukala kokuhlangene okuthintekile.
Cishe ngo-70% kuya ku-80% wezingane ezine-arthritis ye-oligoarticular ye-idiopathic i-oligoarticular futhi i-80% kuya ku-95% ene-oligoarticular ye-juvenile idiopathic arthritis ene- ANA . Iziqu ze-ANA ngokuvamile ziphansi ukuze zilinganiswe. Ku-ANA iziguli ezinhle ezine-oligoarticular ze-idiopathic arthritis, kukhona ingozi enkulu yokukhula kwe- uveitis . Futhi, iningi lezingane ezine-oligoarticular i-idiopathic arthritis ine- CRP ejwayelekile noma ephakanyisiwe kanye ne-sedimentation rate, izibalo ezijwayelekile ze-cell white, ne- anemia (emnene).
Ngokuphathelene ne-uveitis, kunezivivinyo zama-laboratory ezisiza ukubikezela ubunzima bokuthi u-uveitis wangaphakathi unabantwana abane-oligoarticular ye-idiopathic arthritis.
Ukuhlolwa akubikezeli ukuqala, noma kunjalo. Ukuhlolwa kungabandakanya izinga le-a2-globulin ku-serum, kanye nama-anti-HLA (HLA-A19, HLA-B22, HLA-DR9).
Ukwelashwa kwe-Oligoarticular Juvenile Idiopathic Arthritis
Ukwelashwa kwe-oligoarticular juvenile idiopathic arthritis kufana nalokho okwenziwa yi- rheumatoid factor positive noma i-rheumatoid factor negative polyarticular yezingane ezincane ze-idiopathic arthritis. Ukufaniswa kokwelashwa kungenxa yokubandakanyeka kwepolyarticular .
Ukuze i-oligoarticular i-juvenile idiopathic arthritis iphikelele, indlela yokuhamba isetshenziswa ngokuvamile:
- Ukwelashwa nge- NSAID (noma ngaphandle kokujola kwe-intra-articular steroid)
- I-Methotrexate ivivinywa uma impendulo ye-intra-articular injection ye-steroid ayanele
- I-TNF inhibitor inganezelwa, noma ngaphandle kwe-methotrexate, uma i-methotrexate yodwa isanele
I-Azulfidine (sulfasalazine) ne- Plaquenil (i-hydroxychloroquine) ingasetshenziswa ndawonye njengenye indlela ehlukile. Ukukhululwa (noma okuyingxenye noma okuphelele) ye-oligoarticular i-youngveni idiopathic arthritis ingafinyelelwa ku-60-70% yeziguli ezinwetshiwe ze-oligoarticular ze-idiopathic arthritis ezinokusetshenziswa kwe-methotrexate.
Imithombo:
I-Kelley's Bookbook of Rheumatology. Elsevier. Umagazini wesishiyagalolunye. Isahluko 107. Ukwelashwa kwe-Juvenile Idiopathic Arthritis. Hsu, Lee, Sandborg.
I-Oligoarticular i-youngest idiopathic arthritis. Kusesikhathini. Pamela F. Weiss MD. 12/09/15.
http://www.uptodate.com/contents/oligoarticular-juvenile-idiopathic-arthritis
I-OrthoInfo. I-Arthritis yamaJuni. September 2013.
http://orthoinfo.aaos.org/topic.cfm?topic=a00075
Ukuqagela kokuqala kwenkambo enzima ye-uveitis ku-oligoarticular ye-young idiopathic arthritis. U-Zulian E. et al. Journal of Rheumatology. Novemba 2002.
http://www.ncbi.nlm.nih.gov/pubmed/12415607