Ukungezwani komzimba, imvelo, kanye nezakhi zofuzo kungase kudlale ingxenye
I-Angioedema, ukuvuvukala kwesisindo samathambo ngokushesha ngaphansi kwesikhumba, kungabangelwa ukungezwani komzimba, ukusabela kwezidakamizwa, imvelo yomuntu, noma ukucindezeleka. Kungase futhi kube yifa, ukuguqulwa kwezakhi zofuzo ezihlobene emndenini. Izindlela ezisemqoka kuzo zonke izimo ukukhubazeka kwamasosha omzimba lapho amakhemikhali abizwa ngokuthi i-histamine noma i-bradykinins akhululwa ngokwemvelo egazini.
Indawo yomzimba ethintekile-ubuso, ulimi, umphimbo, izingalo, noma imilenze-ingahlinzeka ngokubangela, kodwa hhayi ngaso sonke isikhathi.
Izimbangela ezivamile
I- angioedema etholakalayo (AAE) ingaba ne-immunologic (ehlobene nokungalingani), okungewona-immunologic (okubangelwa yizimbangela ezingezona izifo), noma idiopathic (yomsuka ongaziwa). Ngokungafani ne-angioedema enezizathu ezenzelwe izakhi zofuzo (bheka ngezansi), ezinye zezici ezihilelekile kulezi zinhlobo zingashintsha.
Immunologic
Ukungezwani komzimba yiyona imbangela evamile kakhulu ye-angioedema, okubangelwa ukusabela kwemithi , ukudla , izibungu ezinambuzane , noma ezinye izinto ezifana ne- latex . Isizathu sibhekwa njenge-immunologic ngoba kuhilela impendulo engavamile yesistimu yomzimba.
Ngenxa yezizathu ezingaziwa, umzimba ngezinye izikhathi uzophutha into engeyona ingozi engozini futhi ihlakaze inqwaba ye- histamine egazini njengendlela yokuzivikela.
Nakuba i-histamines isetshenziselwa ukunciphisa imithwalo yegazi ukuze amangqamuzana egazi amhlophe angasondelana nesayithi lokulimala, lapho ekhishwa ngokungabikho kokulimala, angabangela izimpawu ezimbi, kufaka phakathi imfiva ye-hay (i- rhinitis ye-allergen ), imifantu (i- urticaria ), ne- asthma ye-allergen .
Nokho, ngokungafani nanoma yikuphi kwalokhu kuphendula, i-angioedema ivela ezinxenyeni ezingaphansi kwesigcawu esingaphansi kwesikhumba noma i-membrane yamangqamuzana. Ukuvuvukala ngeke kube okubomvu noma okubomvu futhi kungapheli amahora amaningana noma izinsuku. Lapho ukuvuvukala ekugcineni sekuyeka, isikhumba sivame ukubonakala sijwayelekile ngaphandle kokushayeka, ukucubungula noma ukulimaza.
Okungeyona-Immunologic
Nge-immunologic angioedema, amangqamuzana anesibopho sokugqugquzela ukuhlaselwa ayaziwa njengamamitha amangqamuzana . Amangqamuzana amancane aqukethe ama-granules acebile ku-histamine futhi, uma eyala isimiso somzimba sokuzivikela, uzokwenza inqubo ebizwa nge-degranulation ukukhulula i-histamine ohlelweni.
Nge-non-immunologic angioedema, amasosha omzimba akwenzi lutho ngokukhululwa. Esikhundleni salokho, amakhemikhali athile noma izinqubo zomzimba kungenza ukuba amangqamuzana amancane asebenze. Ukuphendula kuzovame ukuvela kubantu abanesifo esibucayi se-mast cell disorder, njenge- mastocytosis .
Imithi evame ukuhlotshaniswa nalokhu ihlanganisa:
- Ama-opiates, ikakhulukazi i-codeine ne-morphine
- Izidakamizwa eziphikisana nezidakamizwa (ama-NSAID), ikakhulukazi i-aspirin
- Intravenous vancomycin , i-antibiotic enamandla
- Idayi yama-radiocontrast engeyona ionic esetshenziselwa ukuthuthukisa izithombe ze-X ray
Ezinye izimbangela ezingekho-immunologic zifaka ukumpontshelwa ngegazi, amakhemikhali afana ne- lymphoma , izifo ezizimele njenge- lupus , nezifo ezithile ezifana nesifo sofuba, i-HIV, i- cytomegalovirus ne-Epstein-Barr.
Izinto ezithile ezenziwa ngokomzimba ezifana nokushisa, ukubandayo, ukuzivocavoca ngokweqile, ukudlidliza , ukwehla kwelanga, ngisho nokucindezeleka ngokomzwelo kuye kwaziwa ngenxa ye-angioedema.
Idiopathic
Nge-idiopathic angioedema, ngeke kube khona imbangela noma incazelo eyaziwayo yokuvuvukala okungazelelwe.
Okwenza isimo sibe nzima kangaka ukuthi labo abathintekayo bajwayele ukuphindaphindiwe, ngezinye izikhathi kunzima.
Ngokusho kocwaningo oluvela eNyuvesi yaseWisconsin School of Medicine, abangaphezu kwesigamu sabangu-99 abantu abathintekayo abane-idiopathic angioedema bahlangabezana neziqephu eziphindaphindiwe ezingaphezu konyaka. Ubuso, umlomo nolimi kwakuyizindawo ezivame ukuthinteka kakhulu. Ngokuvamile, amaphesenti angu-55 awo abike ukuthi athola okungenani enye ye- corticosteroids ephezulu-dose ukunciphisa ukuvuvukala. Ngokuphathelene nalokho kwakungenxa yokuthi amaphesenti angu-52 adinga okungenani ukuvakashelwa okulodwa ekamelweni lokuphuthumayo.
I-Genetics
I-angerede ye-Hereditary (HAE) ibhekwa njenge- autosomal disorder enkulu , okusho ukuthi ungayithola ifa lofuzo oluyinkimbinkimbi kusuka kumzali oyedwa kuphela.
Kunezinhlobo ezimbili ze-HAE ezihlobene nokuguqulwa kwesigamu se-SERPING1 futhi okwesithathu okubangelwa ukuguqulwa kwesakhi se-F1.
Zonke izinhlobo ezintathu zidala ukusebenza okungajwayelekile kwesistimu yomzimba futhi kungabangela ukuvuvukala kuzo zonke izingxenye zomzimba. Lapho i-HAE ihlukile e-AAE yukuthi imboni eyinhloko ayiyona i-histamine. Esikhundleni salokho, ukuhlaselwa kuyokwenziwa ngenye inhlanganisela eyenziwa ngokwemvelo eyaziwa ngokuthi i-bradykinin.
I-Bradykinin, njenge-histamine, ibangela ukuxoshwa kwemithambo yegazi kodwa yenza kanjalo njengendlela yokulawula imisebenzi yomzimba. Isibonelo, umzimba uzokhipha ama-bradykinins ukunciphisa ukucindezelwa kwegazi noma ukulawula umsebenzi wokuphefumula noma wezinso.
Ukukhululwa okungavamile kwama-bradykinins kungabangela i-angioedema, kaningi emilenzeni, izingalo, izitho zangasese, ubuso, izindebe, i-larynx, noma umthamo wamathumbu (GI). Ukulimala okuncane noma isiqephu sokucindezeleka ngokomzwelo kungabangela ukuhlaselwa, kodwa kuningi kwenzeka ngaphandle kwesizathu esaziwayo.
I-angioedema yepheshana le-GI ingaba nzima, ehlanza ukuhlukunyezwa okukhulu, ubuhlungu obukhulu, nokuphelelwa amandla kwamanzi ngenxa yokungakwazi ukugcina amanzi. Uma ukuvuvukala kwenzeka emphinjeni, kungasongela ukuphila.
Ngenxa yokuthi i- ACE inhibitors (esetshenziselwa ukuphatha izinga eliphezulu legazi) isebenza ngokusekela amazinga e-bradykinin, ziyingxenye ejwayelekile kunazo zonke yezi-angioedema ezibangelwa izidakamizwa (nakuba kunezifo ezahlukene zesifo kunama-opiates noma i-aspirin).
I-HAE ibhekwa njengeyingavamile, ivela kunomunye wabantu abangu-50,000, futhi ngokuvamile ikhonjelwa uma othile ono-angioedema engaphenduli kuma-antihistamine. I-HAE ingavame ukuqinisekiswa ngezivivinyo ezintathu zegazi ezihlola impendulo yomzimba.
Izingozi Zezingozi
Ayikho indlela yokuchaza ukuthi kungani abanye bathola i-angioedema kanye nabanye abanezimo zempilo ezifanayo noma izindlela zokuphila. Uma kuthiwa, ungase ube engozini ephakeme uma uke wabhekana nanoma yikuphi okulandelayo:
- Ukusabela kwezidakamizwa okubandakanya ukuqhuma noma izihlahla
- Amagciwane ahlanganisa imifantu
- Umlando we-angioedema
- Umlando womndeni wama-hives noma i-angioedema
- Izifo ezizenzakalelayo ezifana ne-lupus noma i- Hashimoto's thyroiditis , okungukuthi i-angioedema yimuphi uphawu olungenzeka
Uma wena noma othandekayo uye wabhekana nezinkinga eziningi ze-angioedema, ungazuza ezithombeni ezingasiza ekuvikeleni ukuhlaselwa okuzayo. Izinketho zibandakanya umthamo webusuku we-antihistamine iZyrtec (i-cetirizine) , uma imbangela ingelahleki, noma izidakamizwa eziguqula imithi ezifana ne-Kalbitor (ecallantide) noma i-Firazyr (icatibant).
> Umthombo:
> Bernstein, J .; I-Lang, D .; Khan, D. et al. "Ukuxilongwa nokuphathwa kwe-urticaria eyingozi futhi engapheli: isibuyekezo se-2014." J Allergy Clin Immunol. 2014; 133 (5): 1270-7.
> Inomata, M. "Ukuthuthuka Kwamuva Ku-Angioedema Yezidakamizwa." I- Allerg Int. 2012; 61 (4): 545-57. I-DOI: 10.2332 / i-alergolint.12-RAI-0493.
> Rosenberg, D .; UMathur, uS .; kanye noVevathanathan, R. "Izimpawu zomtholampilo ze-Angioedema ye-Idiopathic." J Allergy Clin Immunol. 2017; 139 (2): AB235. I-DOI: 10.1016 / j.jaci.2016.12.757.