Systemic vasculitis symptoms
Vasculitis - a group of diseases, the pathogenesis of which is an inflammation of the vascular wall.In several disease affected tissues and organs: organ blood flow is disturbed, constricts blood vessels, which leads to tissue destruction.
When the affected skin with vasculitis, there is a characteristic rash.If the nerves are damaged, the human sensitivity is disturbed to some extent, from the hypersensitivity and ending with its complete loss.Due vasculitis of the kidneys, renal failure may occur.it may be noted weakness and fatigue among the common symptoms of vasculitis, loss of appetite, pallor, increased body temperature, and more.If
constantly observed abdominal pain, mental disorders, muscle pain, weight loss, this is the typical symptoms of nodular vasculitis.Giant cell arteritis can cause symptoms such as very severe headaches, fever, persistent weakness and weight loss, swelling at the temples and some other symptoms.
Inflammation differ in morphological picture, common to the
Clinical manifestations of systemic vasculitis is difficult to identify and verify a clearly-defined syndromes, as often observed transitional forms, or they develop in other diseases (vasculitis in tumors, bowel disease and liver transplant, and others.).
From the perspective of the role of the immunopathological mechanisms, systemic vasculitis is divided into three main groups.
Vasculitis associated with immune complexes.
Hemorrhagic vasculitis (Henoch purpura-Shёnlyayna);
Vasculitis in SLE and rheumatoid arthritis.
Vasculitis associated with organ-specific antibodies.
Goodpasture's Syndrome (antibodies to the basement membrane of kidney glomeruli).
Kawasaki disease (antibodies to endothelium).
Vasculitis associated with neutrophil cytoplasm antibodies to:
microscopic polyarteritis (polyangiitis).
Classic polyarteritis nodosa (rare).
Some medicines vasculitis.
Forms There are two forms of vasculitis: primary and secondary.
Primary vasculitis appears as a distinct disease, the cause of which is not clear to date.Under the secondary vasculitis is meant damage to the blood vessel walls in various diseases.
secondary vasculitis may be a symptom while:
acute and chronic diseases of infectious origin;
genetic predisposition to the emergence of a specific person vasculitis;
individual response to vaccination;
contact with biological poisons, which are part of some drugs, for example, is applied in oncology;
impact on the body serums or chemicals;
strong overheating of the body;
prolonged exposure to low temperatures;
injuries of various localization and origin;
thermal skin lesions, in particular, for sunburn.
role and importance of immune complexes in the development of systemic vasculitis in SLE and rheumatoid arthritis described above
Vasculitis second group closely associated with certain types of antibodies.Antibodies to the basement membrane of the kidney glomeruli have high (over 90%), the diagnostic sensitivity and specificity for Goodpasture's syndrome.In recent years, we received handshake Kawasaki disease with antibodies to the endothelium.
AT to the cytoplasm of neutrophils play an important role in the development of Vasco litas, in the third group.They constitute a set of antibodies to different granulocytic, monocytic, and possibly endothelial cytoplasmic Ar.
By painting fluorescence in determining antibodies to neutrophil cytoplasm, they are divided into two types:
1) AT with classic diffuse fluorescence directed against protein kinase-3 (which account for 85-90% of all antibodies in this group) and protein enhancerbactericidal activity of neutrophils;
2) AT with perinuclear fluorescence directed against myeloperoxidase (anti-IP, they accounted for 90% of all antibodies in this group), elastase, lactoferrin, cathepsin G and other polypeptides.
If the diagnosis of autoimmune liver disease (especially primary sclerosing cholangitis) was sufficient to determine total antibodies of the second type, for the diagnosis of systemic vasculitis and other rheumatic diseases are exploring the entire spectrum of antibodies to neutrophil cytoplasm.For detecting them it can be used as a method of indirect immunofluorescence and ELISA.Initially, it is recommended to conduct a screening test for the detection of total ANCA in patient serum and then, upon receipt of a positive result, to use the test system for a particular individual Az.
Almost all vasculitis are chronic progressive disease, when periods of exacerbation are replaced by remissions, which is achieved only targeted treatment.Currently, the key areas of treatment of vasculitis secrete immunosuppression (immunosuppression) and anti-inflammatory medication that is provided by the joint use of glucocorticoids and / or cytotoxic drugs, allowing to limit or interrupt the process of development of immune inflammation.
The drug of choice is prednisone as quickly able to remove swelling of the vascular wall, which reduces the manifestations of ischemic syndrome.However, prolonged use glyukortikosteroidov maintenance dose allows further prevent stenosis of large vessels.
, however, is not contested that the significant improvement in the prognosis for life due to the use of cytotoxic drugs.Cyclophosphamide - dose of the drug can vary quite widely, usually during the initial dose of marked clinical manifestations of the disease is 2 - 3 mg / Ku per day.With a view to intensification of therapy for severe vasculitis torpid course uses a combination of high-dose methylprednisolone and cyclophosphamide 1000 mg intravenously.
good effect in the treatment, as concomitant therapy, give vasodilators (nicotinic acid, persantin, komplamin) and antithrombotic (Courant trental, agapurin) drugs are prescribed long-term rates.
In recent years, widely used methods of extracorporeal blood correction to improve microcirculatory disturbances (plasmapheresis combined with gemoksigenatsiey and ultraviolet blood irradiation).Also, in order to correct microcirculatory disorders based on their driving mechanism causing the following groups of drugs may be used: anticoagulants (direct and indirect) - heparin fraxiparine;methylxanthines - trental, agapurin;a group of non-steroidal anti-inflammatory drugs (low-dose aspirin - 75 - 125 mg / kg).
The active pathogenetic therapy all over the disease can not only extend the life of patients, but also to return some of them to work.This pathology is not treatable herbal drugs, only drugs that are listed here, have a proven, positive effect.
Considering the causes that trigger the disease, as prevention is possible to recommend the following:
- hardening of the body;
- eliminate the negative impact of environmental pollution;
- exclusion unjustified use of medicines and vaccines destination.