Felty sika Syndrome: Izimpawu, Sifo

Ngaphansi Felty Syndrome libhekisela kwetintfo ka-rheumatoid arthritis, okuyinto eyenzeka ngo-% 1 kuphela azo zonke iziguli nalesi sifo. Fever, imisipha yoma, lesikhumba futhi ezifweni yezifo ezithathelwanayo nemvelo - zonke lezi zici ngokuvamile ezihambisana Felty Syndrome. Pathology Sifo kusekelwe umlando rheumatoid arthritis, i-kubalulekile fanele imingcele laboratory. Ukwelashwa kuhilela edonsa corticosteroids, splenectomy. Kwaphela isikhathi eside i-pathology libhekene imvelo engaqinisekile futhi isithombe emtholampilo. Ngo-1929, AP Felty echazwe lesi sifo. Selokhu lesi sifo ukuthi umahluko njengenhlangano nosology ezimele.

Felty syndrome: kuyini?

Lesi sifo kuchazwe khona pathologies ezintathu kanyekanye: i-rheumatoid arthritis, i -ubende lakhulisiwe futhi leucopenia (ongaphakeme amangqamuzana amhlophe egazi). Lesi sifo ngokuvamile kutholakala abantu abaneminyaka engama-40, ngokuvamile kwabobulili fair.

Ochwepheshe basikisela ukuthi ngesisekelo lesi sifo inqubo sokuhlasela kwamasosha omzimba. It uyaqhubeka ne kokuzibandakanya kwezicubu lymph kanye kumiswa alandelayo izakhiwo mzimba kanye omzimba athile. Pathology obonakala njengenhlangano neutropenia nge ukunciphisa amandla in ukumelana nezifo eziningi, futhi lapho kwenzeka - nzima. Ngakho namuhla splenectomy (ukususwa ubende) saziwa kuphela indlela ephumelelayo yokwelapha.

Felty Syndrome libhekene ukwehluka okukhulu, ngokuvamile atypical. Nokugula kungase sibandulele iminyaka eminingana (5 kuya kweyi-10) izifo okuthiwa polyarthritis samathambo ne ukuzibandakanya kanyekanye e sokugembula inqubo interphalangeal amalunga omzimba, nge ntshashintshe of kobukhulu.

Ngakolunye uhlangothi, iningi leziguli nale Ihlahlubo zinqunywa ukubonakaliswa ejwayelekile zezicubu zezinzwa. Lokhu kungaba imfiva, ukwakheka ngamaqhubu ongama, myocarditis, ukulahlekelwa isisindo, poliserozita.

Izizathu eziyinhloko

Etiology lesi sifo akwaziwa. Akubona bonke iziguli kwathiwa unesifo "samathambo 'ethuthuka lokhu egunjini lokuhlolwa kwezifo. Esikhathini umnkantsha umuntu onempilo ngokuqhubekayo ezivezwa amangqamuzana amhlophe egazi. Iziguli yilesi sifo, yize kunyatheliswa iphansana, leukocyte nazo kwakhiwa. Zingase buthelela esiningi ngokweqile e ubende.

Yini izimpawu ephelezelwa Felty Syndrome e abadala?

• Articular syndrome (isifo sokuqaqamba kwamalunga amalunga omzimba elincane).
• Ukwandisa Usayizi isibindi.
• lymphadenopathy generalized (kutholakala 50% amacala).
• Ukwanda okuqhubekayo ngobukhulu ubende (njengoba kunqunywa palpation).
• Polyneuropathy.
• Lesikhumba esikhumbeni, izilonda shins.
• Ekubhebhetselisa cystic yamaphaphu.
• Izigaxana samathambo.

Zonke izici ezingenhla enze kube nokwenzeka ukuba ukuxilonga Felty Syndrome. Izimpawu zazo zonke iziguli ziboniswa ngendlela ehlukile. Ngokwesibonelo, ngezinye izikhathi kweNdikimba ubende siyenzeka kuphela izigaba kamuva yentuthuko isifo.

uphethwe

Isisekelo isiqinisekiso sokugcina uphethwe basemtholampilo inhlanganisela ngesikhathi esisodwa splenomegaly ne-rheumatoid arthritis. Igazi ukuhlolwa libhekene kwegazi, leukopenia, neutropenia. I immunoassay ngokuvamile kuthola RF titers high, CEC, khona amasosha omzimba antinuclear. Ngokusho imiphumela myelogram myeloid umnkantsha Hyperplasia sekutholakele ukuthi sine- shift ngase izakhi yeselula abonisa ukungavuthwa. izindlela Instrumental yophenyo (MRI, CT, ultrasound emalungeni) cishe ukunikeza ulwazi oluncane. Felty Syndrome kubaluleke kakhulu ukuhlukanisa nge isifo sokusha futhi sarcoidosis.

izimiso eziyisisekelo ukwelashwa

Ukwelashwa, kulesi simo kuhilela indlela olunzulu. rheumatoid arthritis iphathwa njengoba standard. Ukwelashwa okuvela izifo, kanye arthritis kuhlanganise nezidakamizwa ezisiza rheumatism ( "Azathioprine", "MTX").

Iziguli yizifo eziyingozi kunconywa ukwenza imijovo seviki isici, ekhuthaza granulocyte ikoloni. It kwandisa amangqamuzana amhlophe egazi.

izidakamizwa Basic kunganciphisa symptomatology okuyinto ezihambisana samathambo, Felty syndrome ngqo. zihlanganisa Lezi zihlanganisa: "Methotrexate", "Penicillamine".

Glucocorticoids kuphumelela kuphela imithamo ephezulu. Uma kungenjalo, liyakhula amathuba kokushelela. Ngakolunye uhlangothi, ukusetshenziswa isikhathi eside ka glucocorticoids kungaholela ukuthuthukiswa izifo intercurrent.

Indlela ukusebenza yokwelapha:

• Ukwandisa inani granulocytes 2000 / mm.
• Ukuncishiswa kwezehlakalo yezinkinga esithathelanayo nemvelo.
• Ukuncishiswa ukuhlaselwa imfiva.
• Ukuncishiswa izilonda ku ukubonakaliswa isikhumba.

Lapho ukuhlinzwa Kunconywa?

enye Ungakunqoba kanjani Felty Syndrome? Ukwelashwa nge ukuhlinzwa Kunconywa uma ukwelashwa kwaba ayizwakali noma ngenxa yanoma yisiphi isizathu, it is contraindicated. Kulokhu, ngokuvamile kuba umbuzo splenectomy. Kubalulekile ukukhumbula ukuthi 25% amacala neutropenia ivela ngemva kwalokhu nqubo.

Ngaphansi splenectomy kusho ukuhlinzwa, phakathi kwesikhathi lapho udokotela nhlobo noma ingxenye kususa ubende. Namuhla, kunamabandla amabili amathuba ukwenza inqubo enjalo: splenectomy laparoscopic futhi evulekile.

Laparoscopy wenziwa usebenzisa izinzwa. Kulokhu, ukusebenza ukusebenza insimbi mncane ngekhamera ku ukuphela, lapho ibizwa ngokuthi laparoscope. Udokotela ohlinzayo kwenza eziningana sebeziqhumbuza ezincane esiswini ngokusebenzisa eyethula namathuluzi manipulations okwalandela. Isikhathi yokutakula, njengoba umthetho, akudingi isikhathi esiningi.

Vula splenectomy kuhilela imbobo enkulu ngezansi izimbambo, lapho udokotela omkhulu ohlinzayo kususa ubende. Ngemva ukususwa emzimbeni ekhonweni lomzimba lokukwazi ukuhlunga lamagciwane egazini abahlukene encishisiwe.

yezinkinga kungenzeka

Izinkinga kukhona isifo ezingavamile kakhulu futhi zingase ukuzibonakalisa ngesimo a ubende ezambiwa, ukuthuthukiswa nomfutho wegazi ophezulu okuthiwa portal, emathunjini ukopha kakhulu ezenzeka zifo.

isiphetho

Felty Syndrome - isifo ayeyivelakancane, kodwa kunalokho isimo lonke iqembu pathologies okuyinto namuhla uxilongwe akuvamile. Lokhu akusho ukuthi singakwazi sidebeselele ayokwelashwa hhayi ukufuna usizo kumuntu ofanelekayo kudokotela elifanele. izimpawu Primary kufanele wazise wonke umuntu futhi babe isizathu ufuna iseluleko onguchwepheshe. Uma kungenjalo, liyakhula amathuba Ukuwohloka isimo jikelele kanye nokuthuthukiswa ngokwanele yingozi izinkinga zempilo, ezihlanganisa ukudabuka we ubende uqobo. Okuwukuphela ngempumelelo kukho ukwelashwa manje kuqashelwa njengesenzo splenectomy.

Sithemba ukuthi lonke ulwazi oluhlinzekwe kule sihloko ngesihloko kungaba wusizo ngempela kuwe. Hlala uphilile!