Ukungezwani komzimba kungenye yezizathu eziningi ezikhona
I-angioedema ukuvuvukala kwezingxenyana ezingaphansi kwesikhumba noma ngaphansi kwesikhumba. Ukuvuvukala kakhulu kuthinta ubuso, ulimi, izindebe, umphimbo, izingalo, nemilenze kodwa kungabi sína futhi kungasongela ukuphila uma kwenzeka emphethweni, emaphashini, noma emathunjini. I-Angioedema ivame ukubangelwa ukungezwani komzimba kodwa futhi ingabangelwa ukusabela okungahambi kahle kwezidakamizwa, ukutheleleka, umdlavuza, izakhi zofuzo kanye nokucindezeleka.
Ukwelashwa kuxhomeke ekubangela imbangela, kepha kungafaka ama-antihistamine, i-steroids, nokugwema izimbangela eziziwa.
Izimpawu
Nakuba i-angioedema isondelene kakhulu nama-hives (i- urticaria ) ngokuthi bayabelana ngezimbangela ezifanayo, izimpawu ziyahlukahluka.
I-Angioedema ivela emathanjeni angaphansi kwesikhumba ngaphansi kwezingxenye zangaphandle zesikhumba (okuthiwa i-dermis ne-epidermis). Njengalokhu, kubangela ukuvuvukala okujulile, okujwayelekile okuvame ukuhlala isikhathi eside kunemihlathi. Ngokuphambene, i-urticaria ihilela i-epidermis ne-dermis futhi ibonakala ngamagundane aphakanyisiwe ngemingcele ecacisiwe.
Nge-angioedema, ukuvuvukala kungaqala phakathi namaminithi noma kuthuthuke ngokuhamba kwesikhathi. Indawo evuvukile yesikhumba ngokuvamile ayiyona into enhle (uma ihambisane ne-urticaria) kodwa ingaba nokuzwa okuvuthayo, ukugubha, noma kunzima. Ukuvuvukala kungahlala amahora ambalwa noma izinsuku. Lapho ukuvuvukala ekugcineni kuxazulula, isikhumba sizovame ukubonakala singavamile, kungekho ukukhwabanisa noma ukulimaza.
Izinhlobo ezithile ze-angioedema zingaba kakhulu kakhulu, ikakhulukazi uma zidlulisa ngaphesheya kwemiphetho, ubuso noma isiqu. Phakathi kwezinkinga:
- I-angioedema yepheshana lamathumbu ingabangela ukuhlanza okunonya, ubuhlungu obukhulu emaphakathi, nokuphelelwa amandla kwamanzi (ngenxa yokuhluleka ukugcina uketshezi phansi).
- I-Angioedema yamapayipi ingabangela ukuvuthwa, ukuphefumula, nokuvimbela umoya.
- I-angioedema ye-larynx (ibhokisi lezwi) lingabangela ukuphefumula nokufa.
Izimbangela
Ngombono obanzi, i- angioedema ibangelwa impendulo engavamile yesistimu yomzimba omzimba lapho amakhemikhali abizwa ngokuthi i-histamine noma i-bradykinins akhishwa egazini.
I-Histamine , eyingxenye yokuzivikela komzimba, idala ukuthungulwa kwemithambo yegazi ukuze amangqamuzana omzimba angasondelana nesayithi lokulimala. I-Bradykinins nayo ibangela ukuthi imithwalo yegazi ihlaziye, kodwa yenza kanjalo ukulawula imisebenzi yomzimba njengengcindezi yegazi nokuphefumula. Uma sikhululwe ngokungavamile, kungaba ngokwabo noma ndawonye, lezi zinhlanganisela zingabangela ukuvuvukala esikuqaphela njenge-angioedema.
I-Angioedema ngokuvamile ihlukaniswa ibe yinye lamaqembu amabili:
Angioedema eyatholakala
I-angioedema etholakalayo (AAE) ingabangelwa i-immunologic (ehlobene nesistimu yomzimba) kanye nezimbangela ezingezona izifo. Zihlanganisa:
- Ukusabela okubangelwa ukwelapha kwemithi , ukudla , izimbongolo ezinambuzane , noma ukuxhumana nezinto ezifana ne- latex noma i- nickel
- Ukusabela kwezidakamizwa okungezona okweqile, njengalabo ababandakanya ama-opiate (ikakhulukazi i-codeine ne-morphine) nezidakamizwa ezingezona ukuvuvukala, ama-NSAID (ikakhulukazi i-aspirin)
- Izimbangela ezibonakalayo ezifana nokushisa, ukubandayo, ukuzivocavoca okunzima, ukudlidliza , ukukhanya kwelanga, ngisho nokucindezeleka ngokomzwelo
- Zenza izifo ezizenzakalelayo njenge- lupus ne- Hashimoto's thyroiditis
- Amanqamu afana ne- lymphoma ne- myeloma
- Izifo ezithathelwanayo njenge-hepatitis, i-HIV, i- cytomegalovirus ne-Epstein-Barr virus
Kuzophinde kube namacala angenayo imbangela eyaziwayo. Lezi zibizwa ngokuthi i-angiedema idiopathic.
I-angioedema ye-idiopathic engapheli yisimo esithinta abesifazane ngaphezu kwamadoda. Abanye baye bacabanga ukuthi kuhlobene nomjikelezo wokuya esikhathini, lapho kuphakama khona i- estrogen ngokuvamile kuvame ukuhambisana nokuphakama kwama-bradykinins.
I-Angeliedema ye-Hereditary
I-angerede ye-Hereditary (HAE) i- disosomal disorder enkulu , okusho ukuthi ungayithola ifa lofuzo oluyinkimbinkimbi kusuka kumzali oyedwa kuphela. Izakhi zofuzo ezithinta izakhi zivame ukungena ngokweqile kwe-bradykinins futhi zingathinta zonke izinhlaka zensikimba, kufaka phakathi isikhumba, amaphaphu, inhliziyo, kanye namathumbu emathunjini.
Ngenkathi i-HAE ingabangela ukucindezeleka noma ukulimala, ukuhlaselwa okuningi akubanga imbangela eyaziwayo. Ukuphindaphindiwe kuvamile futhi kungadlulela kuphi kusukela ezinsukwini ezimbili ukuya ezinhlanu. I-ACE inhibitors nesisu sokubeletha esise-estrogen , kokubili okungathinta amazinga e-bradykinin, ayaziwa ukwandisa ukuvama nokuqina kokuhlaselwa.
I-HAE ayinqamuli, eyenzeka kubantu abangu-50 000 kuphela, futhi ngokuvamile ikhonjiswa uma ama-antihistamine noma i-corticosteroids ehluleka ukunikeza ukukhululeka kwezimpawu.
Ukuxilongwa
I-Angioedema ingase itholakale njalo ngokususelwa ekubukeni kwayo komtholampilo nokubuyekeza komlando wakho wezokwelapha kanye nezimpawu ezihambisanayo.
Uma kunomdlavuza, udokotela wakho angase akhombise ukuthi uhlolwe ukuhlolwa kwamagciwane ukuze ubone ukuthi i-causal trigger (i-allergen). Lokhu kungabandakanya ukuhlolwa okuphambene nesikhumba (lapho inani elincane le-allergen elisolwayo lijova ngaphansi kwesikhumba), ukuhlolwa kwe-patch (usebenzisa i-patch yokunamathisela ehambisana ne-allergen), noma ukuhlolwa kwegazi ukuhlola ukuthi ngabe i-antibodies ye-allergen egazini lakho .
Ukuhlolwa kwegazi kungasetshenziselwa ukuxilonga i-HAE. Uma zonke ezinye izimbangela ze-angioedema zikhishwe, udokotela wakho anganquma ukuhlola izinga lezinto ezibizwa ngokuthi i- C1 esterase inhibitor , elawula i-bradykinins , egazini lakho. Labo abane-HAE abakwazi ukukhiqiza le phrotheni, ngakho izinga elincane le-inhibitor ye-C1 libhekwa njengesibonakaliso esinamandla salolu hlobo lwe-angioedema.
Ukwelapha
Phakathi kwendlela engcono kakhulu yokuvimbela ukuhlaselwa kwesikhathi esizayo ukugwema noma iyiphi i-trigger eyaziwayo. Uma lokhu kungafinyeleleki, ukwelashwa kuzogxila ekwenzeni ukuphendula kwegciwane lokuzivikela ekunciphiseni amazinga we-histamine noma ama-bradykinins egazini lakho.
Phakathi kokukhethwa kukho:
- Ama-antihistamine omlomo ajwayelekile ukuba ahlinzeke nge-angioedema ehlotshaniswa ne-allergies. I-Zyrtec (i-cetirizine) isebenza ngokukhethekile ekuhlaselweni okunamandla kodwa ingathathwa njengendlela ephansi, ephansi ebusuku yokuphumula okuqhubekayo.
- Uma ukuhlolwa kokunciphisa umzimba kuqinisekisa ukuthi uthola izifo ezithile, izibhamu zokunciphisa umzimba zingase zibekwe ukuze unciphise kancane kancane ukuzwela kwakho.
- Amacala angapheli angase aphendule kahle kwi- corticosteroids ehleliwe ehlinzekwa ngejozi lomjovo. I-Prednisone ingenye yezinketho ezivame ukwedlula kodwa isetshenziselwa kuphela ukuphumula okwesikhashana ngenxa yobungozi bemiphumela emibi .
- I-HAE ingaphathwa ngezidakamizwa ze-Kalbitor (ecacisiwe) noma i-Firazyr (icatibant). I-Kalibor ivimbela ama-enzyme avuselela ukukhiqizwa kwama-bradykinins, kanti u-Firazyr uvimbela i-bradykinins ekuxhumaneni nama-receptors kumaseli ahlosiwe. Ukukhathazeka, ukukhathala, ikhanda lokukhwabanisa, kanye nokuhuda yizinto ezivamile zemihelo.
- Abantu abane-HAE bangathola nokuphumula ngokuthatha ama-androgens (ama-hormone wesilisa) afana ne-methyltestosterone ne-danazol. Lokhu kusebenza ngokucindezela amazinga ama-bradykinins ajikeleza egazini. Ukusetshenziswa kwesikhathi eside kungabangela imiphumela yamasimini kwabesifazane (kubandakanya ukuguqa kwesimo sezinsikazi kanye nezinwele zobuso) nokukhuliswa kwesifuba (gynecomastia) emadodeni.
- I-angioedema ephawulekayo ye-larynx kufanele ilashwe ngomjovo ophuthumayo we-epinephrine (adrenaline). Abantu abanezifo ezinzima ezivame ukwelashwa ngokuvamile badinga ukuthwala i-epinephrine injector, ebizwa nge- EpiPen , uma kwenzeka kuhlaselwa.
Izwi elivela
I-angioedema ingabangela ukucindezeleka, ikakhulukazi uma ukuvuvukala kunzima noma kuphindaphindiwe. Ngisho noma kungekho ezinye izimpawu ezibonakalayo, kufanele ubone udokotela uma ukuvuvukala kuqhubeka isikhathi esingaphezu kwezinsuku ezimbalwa.
Uma i-angioedema ikholelwa ukuthi ihlobene nokungahambisani nemithi kodwa ungazi imbangela, gcina idayari ukurekhoda noma yikuphi ukudla okudlile noma izilonda ezingokwemvelo ongase uzibonise kuzo. Ukwenza kanjalo kungasiza ekunciphiseni ukusesha futhi kukusize ugweme izinkinga eziyinkimbinkimbi.
Ngakolunye uhlangothi, uma uhlakulela ukuvuvukala komphimbo ohambisana nokuphefumula kunoma yiluphi uhlobo, shayela u-911 noma omunye umuntu akugijime ekamelweni eliphuthumayo eliseduzane.
> Umthombo:
> Bernstein, J .; Cremonesi, P .; U-Hoffmann, T, no-al. I-Angioedema emnyangweni ophuthumayo: isiqondiso esiwusizo sokuhlonza ukuhlukana nokuphathwa. Int J Emerg Med. 2017; 10 (1): 15. I-DOI: 10.1186 / s12245-017-0141-z.
> Bernstein, J .; I-Lang, D .; Khan, D. et al. Ukuxilongwa nokuphathwa kwe-urticaria ephuthumayo futhi engapheli: isibuyekezo se-2014. J Allergy Clin Immunol. 2014; 133 (5): 1270-7.