Puas Yog Tubulointerstitial Nephritis-uveitis Syndrome kuaj tau li cas?

Hauv kev kho mob, muaj ntau yam kab mob uas tsis paub txog etiology, uas yog cov kab mob intractable uas cov kws kho mob muaj teeb meem los ntawm. Qhov ua rau ntawm tus kab mob txiav txim seb tus kab mob tshwm sim li cas thiab tso cai rau cov kws kho mob kuaj nws. Yog li ntawd, kom paub yuav ua li cas kho tubulointerstitial nephritis uveitis syndrome, peb yuav tsum nrhiav qhov ua rau. Tsis muaj cov txheej txheem kuaj pom zoo rau tubulointerstitial nephritis thiab uveitis syndrome. Mandeville et al. tsim cov txheej txheem kuaj mob uas txhais cov txheej txheem kuaj mob rau tus mob interstitial nephritis thiab cov yam ntxwv ntawm uveitis.

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Raws li qhov tsis muaj kev kuaj mob, nws raug txiav txim raws li qhov tseeb tubulointerstitial nephritis uveitis syndrome, xav tias tubulointerstitial nephritis uveitis syndrome, thiab pseudo tubulointerstitial nephritis uveitis syndrome. hom. Vim tias tus qauv no yog cumbersome, cov ntsiab lus kuaj mob ntawm tus mob no tau teev tseg hauv Table 3 rau kev siv tshuaj kho mob. Nws yog feem ntau ntseeg hais tias qhov kev kuaj mob tuaj yeem ua raws li qhov tshwm sim ntawm qhov tshwm simraumkev puas tsuajthiab ob sab uas tsis yog granulomatous anterior uveitis, tab sis qee zaum uveitis hauv cov neeg mob tuaj yeem tshwm sim ua ntej lossis ntau hli tom qab.raumkev puas tsuaj. Qhov no coj qee qhov nyuaj rau kev kuaj mob. Yog li ntawd, tsis yog tsuas yog cov ncauj lus kom ntxaws txog kev kho mob tab sis kuj yuav tsum tau ua raws li kev soj ntsuam xyuas kom paub meej tias qhov kev kuaj mob.

Txij li thaum muaj ntau tus neeg mob muaj qhov tshwm sim tsis meej xws li kub taub hau, qaug zog, xeev siab thiab ntuav, poob phaus, thiab mob plab, kev kuaj ntshav thiab zis yuav tsum tau ua rau cov neeg mob uas tsis yog-granulomatous anterior uveitis hauv ob lub qhov muag kom tsis txhob ncua kev kuaj mob. Txawm li cas los xij, thaum tus neeg mob muaj tubulointerstitial nephritis-uveitis syndrome, cov tsos mob ntawm tus mob nephritis yuav tshwm sim, thiab kev kuaj mob tsis zoo yog qhov yooj yim heev rau lub sijhawm no. Tom qab kev nkag siab, txhua tus muaj kev nkag siab ua ntej ntawm tubulointerstitial nephritis thiab uveitis syndrome, thiab nws yog ib qho tsim nyog yuav tsum tau ntxiv dag zog rau lawv lub cev kom tiv thaiv qhov tshwm sim ntawm tus kab mob.

Yuav kho thiab kho li cas rau tubulointerstitial nephritis thiab uveitis syndrome

Thaum kho tus mob tubulointerstitial nephritis-uveitis syndrome, ob feem ntawm lub cev raug kho cais. Yog li ntawd, cov txheej txheem kho mob kuj nyuaj dua, thiab tib neeg nyiam tsis quav ntsej qee cov ntsiab lus thaum kho, ua rau muaj kev tawm tsam ntawm tus kab mob. Yog li ntawd, nws yog ib qho tsim nyog yuav tsum paub txog kev kho mob tshwj xeeb thiab kho mob ntawm tubulointerstitial nephritis uveitis syndrome. Kev kho mob ntawm idiopathic mob tubulointerstitial nephritis feem ntau yog kev txhawb nqa kev kho mob thiab kev tiv thaiv kab mob. Nws feem ntau ntseeg tias txawm tias qee cov neeg mob hnyavmob hnyavraumua tsis tiavxav tau kev hloov kho kev txhawb nqa, feem ntau cov neeg mob uas muaj idiopathic AIN muajraumua tsis tiavspontaneously daws tom qab txhawb kev kho mob, thiab cov prognosis feem ntau yog zoo, tshwj xeeb tshaj yog rau cov me nyuam.

Raws li kev pom ntawm pathogenesis thiab cov yam ntxwv kho mob ntawm hom mob tubulointerstitial nephritis, nws tau pom tias kev tiv thaiv kab mob cuam tshuam nrog, thiab kev kho mob glucocorticoid feem ntau tau muab kho. Kev kho mob hauv zos glucocorticoid feem ntau tuaj yeem txo uveitis, thiab dexamethasone qhov muag tee tuaj yeem muab rau lub qhov muag ib teev ib teev, thiab tom qab ntawd qhov zaus ntawm qhov muag tee yuav maj mam txo raws li kev tswj ntawm qhov mob. Yog hais tias qhov muag tee kev kho mob ua rau muaj zog intraocular siab, zaus ntawm lub qhov muag installation tuaj yeem hloov kho lossis glucocorticoids nrog cov kev mob tshwm sim tsawg dua tuaj yeem siv, thiab cov tshuaj tiv thaiv kab mob glaucoma tuaj yeem kho qhov muag. Tom qab ntawd, raws li qhov mob txo qis, qhov zaus ntawm cov tshuaj pleev qhov muag tau maj mam txo. Koj tuaj yeem xaiv cov tshuaj uas tsis yog-steroidal anti-inflammatory tshuaj qhov muag tee rau kev kho qhov muag. Txawm li cas los xij, kev saib xyuas yuav tsum tau them rau kom txo qis cov tshuaj tiv thaiv kom tsis txhob rov muaj dua, thiab kev kho mob hauv zos tseem tuaj yeem ua tau zoo rau cov neeg mob rov qab los.

Rau feem ntau cov neeg mob uas muaj tubulointerstitial nephritis thiab uveitis syndrome, kev kho mob glucocorticoid tsis tuaj yeem tsuas yogtxhim khoraummuaj nuj nqitab sis kuj tiv thaiv kev loj hlob ntawmrauminterstitialfibrosis. Tam sim no, nws ntseeg tau tias kev kho mob me me steroid yuav tsum tau siv thaum ntxov rau cov neeg mob uas muaj kab mob hnyav thiab idiopathic mob tubulointerstitial nephritis nrog granuloma, thiab kev kho mem tes nrog methylprednisolone tuaj yeem txiav txim siab yog tias tsim nyog. Yog tias nws tsis muaj txiaj ntsig lossis rov ua haujlwm dua tom qab tshem tawm cov tshuaj, lwm cov tshuaj tiv thaiv kab mob (xws li cyclophosphamide lossis cyclosporine, thiab lwm yam) tuaj yeem txiav txim siab rau kev kho mob, thiab cov txiaj ntsig zoo tseem tuaj yeem tau txais, tab sis kev saib xyuas tshwj xeeb yuav tsum tau them rau kev saib xyuas cov kev mob tshwm sim ntawm cov tshuaj no. tshuaj. Qee tus neeg laus cov neeg mob tsis teb zoo rau kev kho hormonal, lossis TINU syndrome rov tshwm sim dua, ua rau ntau theem ntawm lub raum puas, tab sis tsuas yog tsawg heev (<5%) progress="" to="" end-stage="" renal="">

Tsis zoo li ibraumkab mob, uveitis yog nquag rov ua dua, thiab rov ua dua ntawm uveitis anterior tuaj yeem tshwm sim txawm tias thaum lub sijhawm kho glucocorticoid. Txawm li cas los xij, nyob rau hauv feem coob ntawm cov neeg mob, qhov mob tsuas yog txwv rau ntu ntu thiab nkag siab rau kev kho mob hauv zos glucocorticoid, yog li nws feem ntau tsis ua rau muaj qhov tshwm sim loj. Cov teeb meem xws li glaucoma cuam tshuam qhov pom kev pom ntawm cov neeg mob. Rau kev kho mob ntawm tubulointerstitial nephritis-uveitis syndrome, yuav tsum tau them nyiaj mloog mus rau qhov kev tshwm sim ntawm nephritis thiab tiv thaiv kev rov tshwm sim ntawm nephritis. Rau uveitis, nws yog ib qho tsim nyog yuav tsum tau them sai sai rau nws txoj kev kho mob kom tsis txhob muaj teeb meem tsis tsim nyog los ntawm txoj kev kho tsis tsim nyog. Cov neeg mob yuav tsum koom tes nrog tus kws kho mob thaum tau txais kev kho mob.

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