Ukubona imbangela eyimbangela ye- urticaria , noma imifuba, noma iyingozi noma engapheliyo, kubalulekile ukusiza ukuphatha izimpawu, ukunciphisa ukuphindaphinda, ukuqondisa izinqumo zokwelapha, futhi okubaluleke kakhulu, ukuvimbela izinkinga ezingenzeka.
Umuntu oyedwa kwabayisihlanu uzothola urticaria okungenani kanye ngesikhathi sokuphila kwakhe. Lesi simo sibhalwe yi-welts ebomvu ebonakalayo engabonakala noma kuphi esikhumbeni.
Lezi zinwele, ezibizwa nangokuthi amasondo, zingahlala imizuzu emahoreni kodwa zingaphenduka emavikini ambalwa.
Esikhathini esiningi, i-urticaria iyakwazi ukuzilinganisa futhi iyinhlonipho. Uma ama-flare-ups ehlala isikhathi eside kunamaviki ayisithupha, lokhu kwaziwa ngokuthi i-urticaria engapheli. Nakuba lezi zinyosi zithinta amaphesenti angu-1 kuphela abantu, zingaba nomthelela omubi kwizinga lokuphila.
Umlando Wezokwelapha
Ezimweni eziningi, imbangela ye-urticaria iyabonakala. Uma ugwetshiwe ngezinyosi bese uphuma emifuba, unempendulo yakho. Ngokufanayo, amacala amaningi atholakele ngokusekelwe emlandweni wakho kanye nezimpawu zomtholampilo.
Ucwaningo olwenziwe kwi- World Allergy Organization Journal lubuyekeze ama-athikili wezokwelapha angu-82 futhi lunconywa uhlu lokuhlola lwe-urticaria kudokotela wakho olufaka okulandelayo:
- Izinsuku, izikhathi, nobude bemifantu
- Ukucindezeleka, ukukhathazeka, noma ukucindezeleka
- Umlando womndeni wamifuba
- I-Dyspepsia noma i- peptic isifo sesilonda (ukutheleleka kwe-H. pylori )
- Ukudla, ikakhulukazi uma uzame okuthile okusha
- Imithi kanye ne-supplement, kokubili umuthi kanye ne-over-the-counter
- Umjikelezo wokuya esikhathini (ifomu eliyinqaba ye-urticaria engapheli-izinsuku ezingu-7 kuya kwezingu-10 ngaphambi kwesikhathi sakho)
- Ukuqeda umzimba (kubanda, ukuzivocavoca, ukushisa, ukukhanya kwelanga)
- Izifo zakamuva (ubanda obuvamile, i-GI bug)
- Ukuvezwa emsebenzini (amakhemikhali)
Ungase ufune ukuletha i-log nalolu lwazi ekuvakasheni kwehhovisi lakho.
Ukuhlolwa Kwemvelo
Ngaphandle kokuba ube nesifuba ngesikhathi sokuvakasha kwehhovisi, ukuhlolwa kwakho ngokomzimba kaningi akusizo ukusiza ukuxilongwa. Yilokho okwenzeka ngaphandle uma une- dermatographism .
I-Dermatographism isisignali esiyinkimbinkimbi ehlotshaniswa ne-urticaria yangokomzimba (ama-hives abangelwa ukuvezwa ngokomzimba) kanye ne- atopic dermatitis . Uma une-dermatographism, ama-wheal amafomu lapho isikhumba sakho sigxiliwe noma sishaywa endaweni ethile. Udokotela wakho uzovusa le mpendulo ngokushaya isikhumba sakho ngento ehlanzekile, eqinile. Isondo lizovela emaminithini ayisithupha kuya kwayisishiyagalombili bese uqala ukuphela amaminithi angu-15 kuya kwangu-30 kamuva.
Ama-Labs nezivivinyo
Ukuhlolwa kwebhu akudingeki njalo ukuxilonga i-urticaria. Zisiza kakhulu uma unempawu ezithile noma izimbangela ezithile.
Ukufuna Ukudla Kokudla
Ukwelashwa kokudla akugcini nje ukwandisa ingozi yakho emathunzini. Kungabangela futhi i- angioedema noma esimweni esibucayi kakhulu, i- anaphylaxis . Kubalulekile ukugwema ukuvezwa kokudla okungabangela ukusabela okusongela ukuphila.
Udokotela wakho angalawula okunye kokuvivinywa okulandelayo uma bebheka ukungahambi kahle kokudla:
- Ukuhlolwa kwe-immunosorbent e-enzyme (i-ELISA) : Ukwenyuka kwamagciwane omzimba we-IgE kuyimbonakaliso yezifo zomzimba. Esivivinyweni se-ELISA, i-antigen ekudleni okuthile isengezwe kwisampula segazi. Uma uthola ukwelashwa kulowokudla, uzoba namagciwane e-IgE egazini lakho ngokumelene nalawo antigens. Bazobopha ndawonye esikhungweni segazi, futhi uzothola imiphumela emihle yokuhlolwa. Ukuhlolwa kwenziwa kalula ebhokisatri futhi kungabizi kakhulu. Kuyindlela enhle kakhulu kumuntu ongakwazi ukubekezelela ukuhlolwa okuphambene nesikhumba.
- Ukuhlolwa kwe-radioallergosorbent (RAST) : Izivivinyo ze-ELISA zishintshe kakhulu i-RAST. I-RAST iphinde ilandele amasosha omzimba we-IgE ngokungeza i-allergen ethile kwisampula segazi. Umehluko omkhulu wukuthi usebenzisa i-anti-ignored IgE antibody ukuze uhumushe imiphumela yokugcina.
- Izivivinyo zokuqwashisa izikhumba: Inani elincane le-antigen lihanjiswe esikhumbeni ngenaliti futhi uhlolwe ukuphendula kwendawo. Uma uvivinyo luhle, uzokwakha ipompo encane ebomvu endaweni, ngokuvamile emaminithini angu-20 kuya kwangu-30. Lokhu kuhlolwa kwenziwa ehhovisi likadokotela wakho uma kwenzeka unempendulo enzima edinga ukwelashwa. Ukuze uthole imiphumela enembile, kubalulekile ukuthi ungathathi ama-antihistamine ngesonto ngaphambi kokuhlolwa kwakho.
Lezi zivivinyo zingasetshenziselwa ukuhlola izidakamizwa kwezinye izimbangela, hhayi nje ukudla.
Ukufuna izifo ezizimele
Amaphesenti angama-40 kuya kwangu-45 amacala angamahlalakhona e-urticaria ahlotshaniswa nezifo ezizimele ezifana nesifo se-celiac , lupus, Sjogren syndrome, isifo se-rheumatoid arthritis , nohlobo lwesifo sikashukela 1. Kuhlotshaniswa kakhulu nakakhulu nezifo ze-autoimmune ezifana ne- Graves 'nesifo sikaHashimoto's thyroiditis , okungenani okungenani amaphesenti angu-10 kulawo mahlakalo.
Uma udokotela wakho esolisa isimo esizimele, angase ahlole ezinye zezivivinyo ezilandelayo zegazi:
- I-anti-nuclear antibody (ANA)
- Iprotheyini esebenzayo e-C
- Isilinganiso se-sedimentation
- I-thyroid evuselela i-hormone (TSH)
Ukuthola okungavamile kulezi zivivinyo kungaholela kwezinye izivivinyo eziqondile ezisekelwe esimweni esicatshangelwayo: amasosha omzimba we-transglutaminase wesifo se-celiac; anti-dsDNA, anti-Smith, futhi uhlanganise lupus ; i-peptide anti-cyclic citrullinated (anti-CCP) ne-rheumatoid factor for arthritis ye-rheumatoid; futhi anti-SSA / Ro noma anti-SSB / La for Sjogren syndrome .
Ngokuvamile akwanele ukuhlola umsebenzi we -roid wedwa. Ezingamaphesenti ayisishiyagalombili amacala, i-urticaria engapheli ibangelwa isifo se-autoimmune kodwa umsebenzi we-thyroid ujwayelekile. Ngenxa yalesi sizathu, udokotela wakho angase ahlole nokuba khona kwama-antibodies we-thyroid, ikakhulukazi i-thyroglobulin antibody (anti-Tg) kanye ne-peroxidase antibody ye-thyroid (anti-TPO).
Ukufuna ukutheleleka
Ucwaningo oluningi lubonise ukuthi i-urticaria ingahlotshaniswa nezifo ezivela kuma-bacterium, amagciwane, nama-parasites. Izifo zingabangela i-urticaria elula noma engapheli. Ezinye izifo ezithathelwanayo ezinganeni, kodwa hhayi abantu abadala, zinengozini enkulu yokwanda kwezinkukhu. Lezi amagciwane zihlanganisa i-adenovirus, i-enterovirus, i- rotavirus , ne- RSV .
| Amabhaktheriya | Ama-parasites | Ama-virus |
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Ngokuthakazelisayo, izifo eziningi zegciwane kanye nemifantu yazo zilinganiselwe. Izifo ezithathelwanayo, noma kunjalo, zingaholela e-urticaria engapheli futhi zidinga ukwelashwa. Ukuhlolwa kwebhu kungahle kudingekile ukuze kutholakale ukuxilongwa.
Ukuhlola i-Lab kuvame ukuqala ngokubala kwegazi okuphelele. Ukubala kwegazi elimhlophe kungase kube uphawu lokutheleleka futhi ukwanda kwama-eosinophil, ikakhulukazi, kungabonisa ukuthi ukutheleleka kwe-parasitic kungukusola. Kulokhu, isampula se-stool kufanele iqoqwe ukuze ihlolwe i-ova nama-parasites.
I-Serology yenza izinyathelo zokulwa namagciwane emzimbeni ngokumelene nezinambuzane ezithile, okubonisa ukuthi usulelekile, noma okungenani ugcizelele kulowo mzimba. Kukhona ukuhlolwa kwegazi kwe-serologic etholakalayo kuma-bacterium amaningi namagciwane ashiwo ngenhla. I-Anti-streptolysin (ASO) ihlola amasosha omzimba ngokumelene ne-Streptococcus.
I-H. pylori ingahlolwa nge-serology kodwa kunezinye izindlela ezimbili zokuyibukela kuzo okungase kube nenembile kakhulu.
- Gwema ukuhlolwa kwe-antigen: H. pylori uhlala esiswini. Ama-antigens avela kuma-bacteria adonswa esitokisini futhi angatholakala esampula esitokisini usebenzisa i-immunoassay.
- Urea ukuhlolwa kokuphefumula: H. pylori uphula urea phansi kwe-carbon dioxide ne-ammonia. Ngemva kokufaka ithebhulethi noma i-urea elandelela inani lamakhemikhali ahlanganisiwe, ucelwa ukuthi uphefumule kwisitsha. Isivivinyo sithola u- H. pylori ngokusekelwe ekuboneni kwe-carbon isotope ekuphumeni kwakho.
Ukufuna izizathu zomzimba
Ama-urticaria ama-akhawunti angama-20 ukuya kwangu-30 amaphesenti azo zonke i-urticaria ezingapheli. Kulesi simo, ukuvezwa kwesimo esithile semvelo kungabangela ukuba ama-hive enze.
Ukuze uthole ukuxilongwa, udokotela wakho angase afune ukulinganisa isimo somzimba endaweni elawulwayo. Angase azame ukusungula ukuthi kungakanani lokho okukhuthazayo ongakubekezelela ngaphambi kokuthuthukisa izimpawu. Lokhu kuzomvumela ukuba anikele ngezeluleko ezisebenzayo zokunciphisa nokuphatha izimpawu.
Lezi zi-physicals ezivame kakhulu zenza udokotela wakho angahlolwa ngokusekelwe emlandweni wakho:
- Amakhaza: I- urticaria yama-cold isimo lapho umoya obandayo, uketshezi, noma izinto ezibangela umswakama. Udokotela wakho angenza ukuhlolwa kwe-cube ye-ice, lapho i-cube ye-ice esikhwameni sepulasitiki isetshenziswa ku-forearm ngaphezu kwemizuzu emihlanu. Ukusabela ngokuvamile kuvame kungakapheli imizuzu eyishumi yokususwa.
- Ukuzivocavoca: Abanye abantu bathuthukisa ama- hives ngokuzivocavoca . Lokhu kungenziwa kusukela ekuzivocavoeni uqobo noma kusukela ekukhuleni komzimba okwenyuka okwenyuka ngokuzivocavoca. Udokotela wakho angase abe nokuzivocavoca ngebhayisikili esiteshini noma ku-treadmill ukuze enze izimpawu.
- Ukushisa: Ukushisa kwendawo kungabangela ukuthi amasondo akhiwe. Ukuhlola ukufutheka kokushisa kwenziwa ngokubeka isilinda esilalini engagcwele amanzi angu-44 ° C noma isilinda sensimbi ku-50 ° C kuya ku-55 ° C ngokumelene nengalo imizuzu emihlanu. I-Hives ithuthuka phakathi nemizuzu embalwa.
- Ukucindezela: Kukhona uhlobo lokubambezeleka kwe-dermatographism lapho ukuvuvukala kwesikhumba kubonakala khona ngemva kwamahora amane kuya kweziyisithupha ngemuva kokucindezelwa , nakuba kungenzeka noma kuphi ukusuka kumaminithi angu-30 kuya kumahora angu-12 kamuva. Kungenzeka noma kuphi emzimbeni lapho izingubo ziqinile khona, emagodini anehlezi isikhathi eside, noma ezinyaweni ngemva kokuhamba okude. Udokotela angafaka isisindo esingamakhilogremu angu-10 engalweni yakho imizuzu engu-20. Uzocelwa ukuba uqaphele ukusabela kwesikhumba emahoreni angu-24 alandelayo.
- Ukukhanya kwelanga: I- urticaria ye-solar ayivamile futhi ikhula esikhumbeni esingakafihliwe ngaphakathi kwemizuzu yokukhanya kwelanga. Ukuhlola ukuhlaselwa kwenziwa ngokuveza izindawo ezincane ezichaziwe zesikhumba kuya ezikhanyeni ze-ultraviolet (UV) ezinezihlungi ze-UV-A ne-UV-B.
Ukuhlola kunembile kakhulu uma ungenalo ukwelashwa kwe-antihistamine ngaleso sikhathi.
I-Skin Biopsy
I-skin biopsy ayidingi isidingo kodwa kungasiza uma kukhona ukukhathazeka nge-vasculitis ye-urticarial. Lokhu akulona uhlobo lwe-urticaria kodwa lungayilingisa ngokubukeka. Umehluko wukuthi izilonda zesikhumba zivame ukuchazwa njengokushisa kunokushisa.
Lesi simo sinzima nakakhulu kunama-classic hives ngoba angathinta izinqubo eziningi zomzimba, kuhlanganise nomgudu wamathumbu, izinso, amaphaphu kanye nemisipha.
Ukuhlonza okuhlukile
I-hives inezimbangela ezihlukahlukene, kusukela emzimbeni wesifo kuya kwesifo esizimele. Ukushisa okubandayo noma okushisayo, ukuvivinya umzimba, ukukhanya kwelanga, ngisho nezingubo eziqinile kungabangela ukuphazamiseka. Izifo ezingapheli, njengeH. i-pylori noma i-hepatitis C, nayo ihlotshaniswe ne-urticaria. Uma kunesifo sokuhlonza, kubalulekile ukuhlukanisa phakathi kwe-hive yeqiniso kanye ne-vasticitis ye-urticarial, engabonakala ifana kodwa ingaba nezinkinga ezinkulu.
> Imithombo:
> Cherrez-Ojeda Mina, Robles-Velasco K, Bedoya- P, et al. Uhlu Lokuhlola Umlando Wezokwelapha Ophelele Wase-Urticaria Odlula: Ithuluzi Elilula. I-World Allergy Organ J. 2017 Okthoba 3; 10 (1): 34. i-doi: 10.1186 / s40413-017-0165-0.
> Kasumagic-Halilovic E, Beslic N, Ovcina-Kurtovic1 N. Ukuzimela Kwelinye I-Thyroid Kwabagulayo abane-Urticaria Engapheli. I-Med Arch. 2017 Feb; 71 (1): 29-31. doi: 10.5455 / medarh.2017.71.29-31.
> I-S.ini Urticaria Yenkinga: Ukubonakaliswa Kwemitholampilo, Ukuxilongwa, I-Pathogenesis, Nemlando Yendalo. Ku: Feldweg AM (ed), UptoDate [Inthanethi] , Waltham, MA. Kubuyekezwe ngo-Juni 29, 2017.
> Schoepke N, Doumoulakis G, Maurer M. Ukuhlolwa kwe-Urticaria. I-Indian J Dermatol . 2013 Meyi-Jun; 58 (3): 211-218. doi: 10.4103 / 0019-5154.110831.
> Wedi B, Raap U, Wieczorek D, Kapp A. Urticaria kanye nezifo. I-allergies Asthma Clin Immunol. 2009; 5 (1): 10. kufanele: 10.1186 / 1710-1492-5-10.