Polymyositis - qof weyn

Polymyositis iyo dermatomyositis waa cuduro barar ah oo naadir ah. (Xaaladda waxaa lagu magacaabaa dermatomyositis markay ku lug leedahay maqaarka.) Cudurradan waxay keenaan daciifnimo muruq, barar, danqasho, iyo dhaawaca unugyada. Waxay qayb ka yihiin koox weyn oo cuduro ah oo loo yaqaan 'myopathies'.

Polymyositis wuxuu saameeyaa muruqyada muruqyada. Waxaa sidoo kale loo yaqaan 'idiopathic inflammatory myopathy'. Sababta saxda ah lama garanayo, laakiin waxaa laga yaabaa inay la xiriirto fal-celinta jirka ama infekshan.

Polymyositis wuxuu ku dhici karaa dadka da 'kasta. Wuxuu ku badan yahay dadka waaweyn ee da'doodu u dhaxayso 50 ilaa 60, iyo carruurta waaweyn. Wuxuu ku dhacaa dumarka laba jeer ka badan inta ragga. Waxay ku badan tahay Afrikaanka Mareykanka marka loo eego dadka caddaanka ah.

Polymyositis waa cudur nidaamsan. Tan macnaheedu waa inay saameyso jirka oo dhan. Murqaha daciifnimada iyo jilicsanaantu waxay noqon karaan calaamadaha polymyositis. Finanku waa calaamad muujinaysa xaalad la xiriirta, dermatomyositis.

Calaamadaha caadiga ah waxaa ka mid ah:

• Murqaha oo daciifa garbaha iyo miskaha. Tani waxay adkeyneysaa in gacmaha kor loo qaado madaxa, laga kaco fadhiga, ama jaranjarada la fuulo.
• Dhibaato liqitaan.
• Murqo xanuun.
• Dhibaatooyinka xagga codka (waxaa sababa muruqyada hunguriga oo daciifa).
• Neefta oo kugu yaraata.

Waxaad sidoo kale yeelan kartaa:

• Daal
• Qandho
• Xanuun wadajir ah
• Cunto xumo
• Madax adayg subax
• Miisaanka oo yaraada
• Finan maqaarka ah oo ku yaal dhabarka faraha, daboolka indhaha, ama wajiga

Tijaabooyinka waxaa ka mid noqon kara:

• Unugyada difaaca jirka iyo baaritaanka caabuqa
• CPK
• Serum aldolase
• Electromyography
• MRI ee muruqyada ay saameysay
• Cad ka-qaadista murqaha
• Myoglobin kaadida
• ECG
• Raajo laabta ah iyo baaritaanka CT ee laabta
• Imtixaanada shaqada ee sambabada
• Daraasada liqitaanka hunguriga
• Myositis gaar ah oo laxiriira autoantibodies

Dadka qaba xaaladan sidoo kale waa in si taxaddar leh looga ilaaliyaa calaamadaha kansarka.

Daaweynta ugu weyn waa isticmaalka dawooyinka loo yaqaan 'corticosteroid'. Qiyaasta daawadu si tartiib tartiib ah ayey u duubantahay iyadoo muruqyada ay soo fiicnaanayaan. Tani waxay qaadataa qiyaastii 4 ilaa 6 toddobaad. Waxaad kusii nagaan doontaa qadar hoose oo ah daawada 'kortikosteroid' intaas ka dib.

Daawooyinka lagu xakameynayo nidaamka difaaca jirka ayaa loo isticmaali karaa in lagu beddelo corticosteroids. Daawooyinkan waxaa ka mid noqon kara azathioprine, methotrexate ama mycophenolate.

Cudurka weli firfircoon in kasta oo loo yaqaan 'corticosteroids', xididka gamma globulin ayaa lagu tijaabiyay natiijooyin isku dhafan. Daawooyinka nafleyda sidoo kale waa la isticmaali karaa. Rituximab waxay umuuqataa tan ugu rajada badan. Waa muhiim in meesha laga saaro xaaladaha kale ee dadka aan ka jawaabin daaweynta. Soo-noqoshada muruqyada ee soo noqnoqda ayaa loo baahan karaa si loo sameeyo baaritaankaan.

Haddii xaaladdu la xiriirto buro, way fiicnaan kartaa haddii burada laga saaro.

Jawaabta daaweynta way kala duwan tahay, iyadoo ku saleysan dhibaatooyinka jira. Ilaa 1 qof 5tii qofood ayaa laga yaabaa inay u dhintaan 5 sano gudahood markay xaaladdu ku dhacdo.

Dad badan, gaar ahaan carruurta, way ka bogsadaan jirrada umana baahna daaweyn socota. Dadka waaweyn badankood, si kastaba ha noqotee, daawooyinka difaaca jirka ayaa loo baahan yahay si loo xakameeyo cudurka.

Aragtida dadka qaba cudurka sambabka ee anti-MDA-5 antibody waa liidataa inkasta oo daaweyn hadda socota.

Dadka waaweyn, dhimashadu waxay ka dhalan kartaa:

• Nafaqo darrada
• Burunkiito
• Neefsashada oo xumaata
• Daciifnimo, daciifnimo muruq-dheer

Sababaha ugu waaweyn ee dhimashada waa kansarka iyo cudurka sambabka.

Dhibaatooyinka waxaa ka mid noqon kara:

• Kalshiyaamtu waxay dhigtaa muruqyada ay dhibaatadu saameysey, gaar ahaan carruurta qaba cudurka
• Kansarka
• Wadne xanuun, cudurada sambabka, ama dhibaatooyinka caloosha

Wac daryeel caafimaad bixiyahaaga haddii aad leedahay astaamo cilladan. Raadso daaweyn degdeg ah haddii neefta kugu gaabiyo iyo wax liqidda oo dhib kugu ah.

• Muruqyada hore ee dusha sare

Aggarwal R, Rider LG, Ruperto N, et al. 2016 American College of Rheumatology / European League Against Rheumatism Shureria for Minimal, Moderate, and Major Clinical Response in Adult Dermatomyositis and Polymyositis: International Myositis Assessment and Clinical Studies Group / Dhakhaatiirta Caafimaadka Rheumatology International Trials Organization Iskaashiga Hindisaha. Arthritis Rheumatol. 2017; 69 (5): 898-910. PMID: 28382787 www.ncbi.nlm.nih.gov/pubmed/28382787.

Dalakas MC. Cudurada muruqyada caabuqa. N Engl J Med. 2015; 373 (4): 393-394. PMID: 26200989 www.ncbi.nlm.nih.gov/pubmed/26200989.

Greenberg SA. Myopathies caabuq leh. Gudaha: Goldman L, Schafer AI, eds. Daawada Goldman-Cecil. 25aad. Philadelphia, PA: Elsevier Saunders; 2016: cutubka 269.

Nagaraju K, Gladue HS, Lundberg IE.Cudurrada caabuqa ee muruqyada iyo myopathies kale. Gudaha: Firestein GS, Budd RC, Gabriel SE, McInnes IB, O'Dell JR, eds. Kelley iyo Firestein's Buugga Buugga Rheumatology. 10aad ed. Philadelphia, PA: Elsevier; 2017: cutubka 85.

Yoshida N, Okamoto M, Kaieda S, iyo al. Ururka anti-aminoacyl-transfer RNA synthetase antibody iyo anti-melanoma kala-soocida la xidhiidha hiddo-wadaha 5 antibody oo leh jawaabta daweynta ee polymyositis / dermatomyositis-la xiriirta cudurka sanbabada. Jawaabta Respir. 2017; 55 (1): 24-32. PMID: 28012490 www.ncbi.nlm.nih.gov/pubmed/28012490.