Cudurka lupus erythematosus ee daroogada

Cudurka lupus erythematosus ee daroogada ku dhaca waa cillad isdifaac ah oo isdaba joog ah oo kicisa falcelinta daawada.

Cudurka lupus erythematosus ee daroogadu keento ayaa la mid ah laakiin aan la mid ahayn nidaamka lupus erythematosus (SLE). Waa cillad isdifaac ah. Tani waxay ka dhigan tahay in jirkaaga uu si qalad ah u weeraro unugyada caafimaadka qaba. Waxaa sababa falcelinta daawada. Xaaladaha la xiriira ayaa ah lupus-ka daroogada keena iyo daawada ay keento daawada 'ANCA vasculitis'.

Daawooyinka ugu caansan ee loo yaqaan inay sababaan lupus erythematosus ee daroogada keena waa:

• Isoniazid
• Hydralazine
• Procainamide
• Tumor-necrosis factor (TNF) alfa inhibitors (sida etanercept, infliximab iyo adalimumab)
• Minocycline
• Quinidine

Daawooyinka kale ee aan caadiga ahayn ayaa waliba sababi kara xaaladda. Kuwaas waxaa ka mid noqon kara:

• Daawooyinka ka-hortagga qalalaasaha
• Capoten
• Chlorpromazine
• Methyldopa
• Sulfasalazine
• Levamisole, sida caadiga ah sumowga kookaha

Daawooyinka difaaca jirka ee kansarka sida pembrolizumab ayaa sidoo kale sababi kara fal-celinno kala duwan oo isdifaaca jirka ah oo ay ku jiraan lupus daroogo laaluush ah.

Astaamaha lupus-ka ay daroogada sababto waxay u egtahay inay dhacaan ka dib qaadashada dawada ugu yaraan 3 ilaa 6 bilood.

Calaamadaha waxaa ka mid noqon kara:

• Qandho
• Dareen guud (xanuun)
• Xanuun wadajir ah
• Barar wadajir ah
• Cunto xumo
• Xanuun laab laabta
• Finan maqaarka ah oo ku yaal meelaha u nugul qorraxda

Bixiyaha xanaanada caafimaadka wuxuu sameyn doonaa baaritaan jireed wuxuuna ku dhageysan doonaa laabtaada stethoscope. Bixiyaha ayaa laga yaabaa inuu maqlo dhawaq loo yaqaan qashin-xoqidda wadnaha ama xoqidda qallalka murqaha.

Baadhitaanka maqaarku wuxuu muujinayaa finan.

Isku-xidhka ayaa barari kara oo jilicsan.

Tijaabooyinka la qaadi karo waxaa ka mid ah:

• Antihistone antibody
• Guddi ka hortagga Antinuclear antibody (ANA)
• Antineutrophil cytoplasmic antibody (ANCA) guddiga
  
• Tirinta dhiigga oo dhameystiran (CBC) oo leh kala duwanaansho
• Guddi kiimiko oo dhameystiran
• Kaadida

Raajada feeraha ayaa laga yaabaa inay muujiso calaamadaha xanuunka 'pleuritis' ama 'pericarditis' (caabuq ku dhaca dahaadhka sanbabada ama wadnaha). ECG ayaa laga yaabaa inay muujiso in wadnuhu waxyeelleeyey.

Inta badan, astaamuhu waxay ku baaba'aan dhowr maalmood illaa toddobaadyo gudahood ka dib markay joojiyaan dawada xaaladda keentay.

Daaweynta waxaa ka mid noqon kara:

• Daawooyinka neerfaha ee ka hortagga bararka (NSAIDs) si loogu daaweeyo arthritis iyo pleurisy
• Kiriimyada 'Corticosteroid cream' si loo daaweeyo finanka maqaarka
• Dawooyinka duumada (hydroxychloroquine) si loogu daaweeyo astaamaha maqaarka iyo arthritis

Haddii xaaladdu saamaynayso wadnahaaga, kilyaha, ama habdhiska dareenka, waxaa laguu qori karaa qadar sare oo ah corticosteroids (prednisone, methylprednisolone) iyo xakamaynta nidaamka difaaca jirka (azathioprine ama cyclophosphamide). Tani waa dhif iyo naadir.

Markuu cudurku firfircoon yahay, waa inaad xirataa dhar difaaca iyo muraayadaha indhaha si aad uga ilaaliso qorraxda badan.

Waqtiga intiisa badan, lupus erythematosus oo ay daroogo keento uma daran sida SLE. Astaamuhu badanaa waxay ku baaba'aan dhawr maalmood gudahood ilaa toddobaadyo markay joojiyaan dawada aad qaadanaysay. Marar dhif ah, caabuqa kelyaha (nephritis) wuxuu ku horumari karaa lupus daroogada sababa oo ay sababaan xakameeyayaasha TNF ama lafa-beelka 'ANCA vasculitis' sababtoo ah hydralazine ama levamisole. Cudurka neerfaha wuxuu u baahan karaa daaweyn loogu talagalay daawada loo yaqaan 'prednisone' iyo 'immunosuppressive drugs'.

Ka fogow qaadashada daroogada sababtay falcelinta mustaqbalka. Astaamuhu waxay u egyihiin inay soo noqdaan hadaad saas sameyso.

Dhibaatooyinka waxaa ka mid noqon kara:

• Caabuq
• Thrombocytopenia purpura - dhiigbax ku dhow maqaarka dusha sare ee maqaarka, taas oo ka dhalanaysa tiro yar oo ka mid ah dhiig-barooyinka dhiigga ku jira
• Dhiig yaraanta Hemolytic
• Myocarditis
• Cudurka 'Pericarditis'
• Xanuun qoorta

Wac adeeg bixiyahaaga haddii:

• Waxaad isku arkeysaa calaamado cusub markaad qaadanayso mid ka mid ah daawooyinka kor ku xusan.
• Calaamadahaagu ma fiicnaanayaan ka dib markaad joojiso qaadashada dawada xaaladda keentay.

Ka taxaddar calaamadaha fal-celinta haddii aad qaadanayso mid ka mid ah daroogooyinka dhibaatadan sababi kara.

Lupus - daroogo ayaa keentay

• Lupus, discoid - oo ah aragtida nabarrada laabta
• Antibodies

Benfaremo D, Manfredi L, Luchetti MM, Gabrielli A. Musculoskeletal iyo cudurada rheumatic ee ay keeneen kuwa xakameynaya isbaarada difaaca: dib u eegista suugaanta. Curr Drug Saf. 2018; 13 (3): 150-164. PMID: 29745339 www.ncbi.nlm.nih.gov/pubmed/29745339.

Dooley MA. Lupus-daroogada ay keento Gudaha: Tsokos GC, ed. Nidaamka Lupus Erythematosus. Cambridge, MA: Saxaafadda Tacliinta Sare ee Elsevier; 2016: cutubka 54.

Radhakrishnan J, Perazella MA. Cudurka glomerular ee daroogada ay sababto: fiiro gaar ah ayaa loo baahan yahay! Clin J Am Soc Nephrol. 2015; 10 (7): 1287-1290. PMID: 25876771 www.ncbi.nlm.nih.gov/pubmed/25876771.

Richardson BC. Lupus-daroogada ay keento Gudaha: Hochberg MC, Gravallese EM, Silman AJ, Smolen JS, Weinblatt ME, Weisman MH, eds. Rheumatology. 7aad ed. Philadelphia, PA: Elsevier; 2019: cutubka 141.

Rubin RL. Lupus-daroogada ay keento Khabiirka Opin Drug Saf. 2015; 14 (3): 361-378. PMID: 25554102 www.ncbi.nlm.nih.gov/pubmed/25554102.

Vaglio A, Grayson PC, Fenaroli P, iyo al. Lupus-daroogada ay keento: fikradaha dhaqanka iyo cusub. Autoimmun Rev.. 2018; 17 (9): 912-918. PMID: 30005854 www.ncbi.nlm.nih.gov/pubmed/30005854.