Pres European Union Printo

Sonlain-henoxis purpura

ra daavadebaa?
Sonlain-henoxis purpura (Henoch-Schoenlein Purpura - HSP) aris mdgomareoba, romlis drosac aRiniSneba wvrili sisxlZarRvebis (kapilarebis) anTeba. am anTebas vaskuliti ewodeba. Cveulebriv ziandeba kanis, nawlavisa da Tirkmelis sisxlZarRvebi. anTebis mdgomareobaSi myofi sisxlZarRvebidan aRiniSneba sisxldena kanSi, rac iwvevs wiTeli an mewamuli feris gamonayaris gaCenas, romelsac purpura ewodeba. sisxldena SeiZleba aRiniSnos nawlavebsa da TirkmelebSic, rac iwvevs sisxlis gaCenas ganavalsa da SardSi (hematuria).
HSP -s saxeli daerqva eqimebis _ henoxisa da Sonlainis pativsacemad, romlebmac erTmaneTisagan damoukideblad aRweres igi erT saukuneze ufro adre.

ramdenad xSiria?
HSP, romelic marTalia ar aris xSiri bavSvTa asakSi, yvelaze gavrcelebuli sistemuri vaskulitia 5-dan 15 wlamde asakis bavSvebSi. igi ufro xSiria vaJebSi, vidre gogonebSi (2:1).
daavadebis gavrceleba ar aris dakavSirebuli eTnikuri Tu geografiuli faqtorebis moqmedebasTan. evropasa da CrdiloeT naxevarsferoSi SemTxvevaTa umravlesoba aRiniSneba zamTarSi, Tumca zogierTi SemTxveva gazafxulzec gvxvdeba.

ra aris daavadebis gamomwvevi mizezi?
aravin icis Tu ra iwvevs HSP -s.
fiqroben, rom infeqciuri agentebi (rogoricaa virusebi da baqteriebi) daavadebis potenciuri gamomwvevebia, vinaidan HSP xSirad Cndeba respiratoruli traqtis zeda nawilis infeqciis Semdeg. aseve aRwerilia HSP-s SemTxvevebi sxvadasxva medikamentis miRebis, mwerebis kbenis, sicivis zemoqmedebis, qimiuri toqsinebisa da specifikuri kvebiTi alergenebis miRebis Semdeg. amis gamo winad gamoiyeneboda termini `alergiuli purpura”, vinaidan fiqrobdnen, rom HSP iyo alergiuli reaqcia yvela am agentze. zogierT qveyanaSi mas aseve eZaxian `revmatoidul purpuras”, rac saxsarsa da kunTebTan dakavSirebuli simptomebiTaa ganpirobebuli. (ix. qvemoT `ra ZiriTadi simptomebi axasiaTebs?”).
HSP -s dros dazianebul adgilebSi imunuri sistemis specifiuri komponentebis, rogoricaa imunoglobulini A (IgA), depozitebis aRmoCena miuTiTebs imaze, rom imunuri sistemis aranormaluri reaqcia azianebs kanis, saxsrebis, kuW-nawlavis traqtis, Tirkmelebis wvril sisxlZarRvebs; iSviaTad _ centralur nervul sistemasa da sasqeso jirkvlebs; da iwvevs daavadebas.

memkvidreobiT gadadis? gadamdebia? SeiZleba am daavadebis Tavidan acileba?
HSP ar aris memkvidreobiTi daavadeba. igi arc gadamdebia, da verc Tavidan avicilebT.

rogoria ZiriTadi simptomebi?
wamyvani simptomia damaxasiaTebeli gamonayari kanze, romelic aRiniSneba HSP -is mqone yvela pacientSi. Cveulebriv gamonayari iwyeba wvrili nasicxiT an wiTeli laqebiT, romelic droTa ganmavlobaSi molurjo an mewamul elfers iZens. maT `palpirebadi purpura” ewodeba, radgan zedapiridan amoweuli kanis dazianebebi SeiZleba SevigrZnoT. purpura Cveulebriv qveda kidurebsa da dunduloebs azianebs, magram SeiZleba Segvxvdes sxeulis sxva nebismier nawilSic (zeda kidurebi, tani).
pacientTa umravlesobaSi (>65%) aRiniSneba saxsrebis tkivili (arTralgia) an saxsris tkivili da Sesieba moZraobis SezRudvasTan erTad (arTriti), romelic Cveulebriv muxlis an koWis da iSviaTad idayvis, majis da TiTebis saxsrebs azianebs. arTralgiasa da/an arTrits Tan axlavs saRi qsovilebis Sesieba saxsris garSemo da mis maxloblad. saRi qsovilebis Sesieba xelebsa da fexebze, Sublsa da skrotumze aRiniSneba daavadebis dasawyisSi, gansakuTrebiT ki Zalian mcire asakis bavSvebSi.
saxsrovani simptomebi droebiTia da ramodenime dReSi qreba.
rodesac anTeba vrceldeba nawlavis sisxlZarRvebze, 60%-ze met SemTxvevaSi aRiniSneba muclis tkivili da gardamavali tkivili Wipis irgvliv, rasac Tan axlavs zomieri an Zlieri sisxldena muclis RruSi (hemoragia). Zalian iSviaTad SeiZleba aRiniSnos nawlavis maryuJebis specifiuri gadagrexva, invaginacia. igi nawlavis obstruqcuas iwvevs, amis gamo SeiZleba saWiro gaxdes qirurgiuli Careva.
rodesac anTeba Tirkmelebis sisxlZarRvebze gadadis, maTgan SeiZleba sisxldena daiwyos (daaxloebiT pacientTa 20-35%-Si); aRiniSneba zomieri Tu mZime hematuria da proteinuria (proteini SardSi). Cveulebriv Tirkmelebis mxriv problemebi seriozuli ar aris. iSviaT SemTxvevaSi Tirkmlis dazianeba SeiZleba TveobiT an wlobiT grZeldebodes da Tirkmlis ukmarisobaSi gadaizardos (1-5%). aseT SemTxvevebSi pacientis mkurnali eqims esaWiroeba nefrologis (Tirkmelebis specialisti) konsultacia da TanamSromloba.
zemoT aRwerili simptomebi Cveulebriv 4-dan 6 kviramde grZeldeba. iSviaTad isini SeiZleba ramodenime dRiT win uswrebdes kanis gamonayars; SeiZleba erTdroulad da TandaTanobiT gaCndes.
sxva simptomebi, rogoricaa dambla, sisxlCaqcevebi tvinsa an filtvebSi da saTesle jirkvlebis Sesieba, romlebic am organoebis sisxlZarRvebis anTebiTaa gamowveuli, metad iSviaTad gvxvdeba.

daavadeba yvela bavSvSi erTnairad mimdinareobs?
daavadeba met-naklebad erTnairia yvela bavSvSi, Tumca, kanisa da organoebis dazianebis xarisxi pacientTa umravlesobaSi metad gansxvavebulia. SeiZleba aRiniSnos HSP -is mxolod erTi epizodi an gamwvavebis ramodenime SemTxveva.

gansxvavdeba Tu ara daavadeba bavSvebsa da mozrdilebSi?
bavSvebsa da mozrdilebSi daavadeba gansxvavebulad ar mimdinareobs, magram mozrdilebSi igi iSviaTad gvxvdeba.

rogor diagnostirdeba?
HSP -s diagnozi ZiriTadad klinikuria da emyareba klasikuri purpuris (romelic Cveulebriv qveda kidurebsa da dunduloebze aRiniSneba) arsebobas muclis tkivilTan, saxsris dazianebasa da hematuriasTan erTad an maT gareSe. unda gamoiricxos msgavsi klinikuri suraTis mqone sxva daavadebebi.

laboratoriuli da sxva gamokvlevebidan romlis Catarebaa mizanSewonili?
specifiuri gamokvleva, romelic gaadvilebda HSP -s diagnozis dasmas _ ar arsebobs. eriTrocitebis daleqvis siCqare (eds-i) an C-reaqtiuli cila (sistemuri anTebis maCvenebeli) SeiZleba normaluri an momatebuli iyos. ganavalSi SeiZleba aRiniSnos faruli sisxli, rac mcire nawlavuri hemoragiiTaa gamowveuli, daavadebis mimdinareobisas unda gakeTdes Sardis analizi, rac Tirkmelebis dazianebis gansazRvris saSualebas mogvcems. xSiria umniSvnelo hematuria; droTa ganmavlobaSi is qreba. Tirkmlis dazianebis SemTxvevaSi, mimarTaven Tirkmelebis biofsias (Tirkmlis ukmarisobisa an mZime proteinuriis SemTxvevaSi).

ikurneba Tu ara?
pacientTa umravlesoba Tavs mSvenivrad grZnobs da ar saWiroebs medikamentebiT mkurnalobas.
mkurnaloba, Tu is saWiroa, ZiriTadad damxmare xasiaTisaa da gvexmareba tkivili vakontroloT. upiratesad gamoiyeneba martivi analgetikebi (tkivilgamayuCeblebi), rogoricaa paracetamoli; xolo saxsrebis mxriv seriozuli Civilebis arsebobis SemTxvevaSi _ anTebis sawinaaRmdego arasteroiduli preparatebi, magaliTad obuprofeni da naproqsini.
steroidebis (prednizoloni) daniSvna naCvenebia mZime gastrointestinaluri simptomebisa an hemoragiis mqone pacientebSi da iSviaTad sxva organoebis (mag. saTesle jirkvlebis) mZime dazianebis SemTxvevaSi. Tu Tirkmelis dazianeba mZimea, unda Catardes Tirkmelis biofsia da Cvenebisda mixedviT iwyeba kombinirebuli mkurnaloba steroidebiTa da imunosupresiuli medikamentebiT.

rogoria medikamenturi mkurnalobis gverdiTi moqmedeba?
vinaidan HSP -is SemTxvevaTa umravlesobaSi medikamenturi mkurnaloba aucilebeli ar aris an mxolod xanmokle droiT iniSneba, mZime gverdiTi moqmedeba ar aRiniSneba. Tirkmlis mZime dazianebis im iSviaT SemTxvevebSi, rodesac xangrZlivi drois ganmavlobaSi saWiroa prednizolonisa da imunosupresiuli medikamentebis gamoyeneba, SeiZleba maT mier gamowveuli gverdiTi efeqtebi SeiZleba ukve problemas warmoadgendes (ix. mkurnalobis qveTavi).

ramden xans grZeldeba daavadeba?
daavadeba daaxloebiT 4-6 kviras grZeldeba. bavSvebis naxevars 6-kviriani periodis ganmavlobaSi aReniSneba gamwvavebis sul mcire erTi epizodi, romelic Cveulebriv pirvelze xanmoke da msubuqia. iSviaTad recidivi xangrZlivdeba. pacientTa umravlesoba sruliad gamojanmrTeldeba.

ra saxis perioduli kontrolia aucilebeli?
daavadebis mimdinareobisas da mis Semdegac ramodenimejer keTdeba Sardis analizi Tirkmelebis mxriv problemebis gamoricxvis mizniT. zogierT SemTxvevaSi Tirkmlis dazianeba daavadebis dawyebidan ramodenime kviris Semdeg SeiZleba gamovlindes.

rogoria daavadebis grZelvadiani evolucia (prognozi)?
bavSvTa umravlesobaSi daavadeba TavisTavad gaivlis da xangrZliv problemebs ar iwvevs. pacientTa mcire nawilSi, romelTac Tirkmlis mZime da mdgradi dazianeba aReniSnebaT, daavadeba SeiZleba progresirebdes da Tirkmlis ukmarisobaSic ki gadaizardos.

ra SeiZleba iTqvas skolisa da sportis Sesaxeb?
daavadebos mwvave periodis ganmavlobaSi fizikuri aqtiuroba Cveulebriv izRudeba, magram gamojanmrTelebis Semdeg bavSvs kvlav SeuZlia iaros skolaSi da cxovrebis normalur wess misdevdes. vaqcinacia unda gadaidos; Tu ra droiT, amas bavSvis mkurnali eqimi gadawyvets.