Cudurka Stevens-Johnson (SJS) waxaa badanaa loo arkaa inuu yahay nooc ka mid ah noocyada kala duwan ee "erythema multiforme", kaas oo laftiisa ah nooc ka mid ah dareen-celin-xumada daawada, oo ay ka mid yihiin daawooyinka la iska iibsado ama infekshanka, sida herpes ama pneumonia oo ah ay sababtay Mycoplasma pneumoniae .
Khabiiro kale waxay u maleynayaan in cudurka Stevens-Johnson uu yahay xaalad gooni ah oo ka soo baxaysa noocyada kala duwan ee loo yaqaan 'erythema multiforme', taas oo ay u kala qaybiyaan noocyo kala duwan oo yar yar iyo noocyo badan oo kala duwan oo loo yaqaan 'erythema multiforme'.
Si aad wax uga qabato xitaa jaahwareerka, waxaa sidoo kale jira nooc ka mid ah nooca 'Stevens-Johnson syndrome': 'Toxic Epidermal Necrolysis (TEN), oo sidoo kale loo yaqaan' Lyell's Syndrome.
Stevens-Johnson Syndrome
Laba dhakhtar caruur ah, Albert Mason Stevens iyo Frank Chambliss Johnson, waxay soo arkeen cudurka cagaarshowga Stevens-Johnson ee 1922-kii. Stevens-Johnson syndrome waxay noqon kartaa mid naf-hurin ah waxayna sababi kartaa calaamado halis ah, sida maqaarka maqaarka weyn iyo daadinta maqaarka ilmaha.
Cudurka Stevens-Johnson wuxuu dhacaa dhacdooyinka qiyaastii 1.5 illaa 2 xaaladood halkii milyan halkii sanadba, sidaas daraadeed waa wax dhif ah. Nasiib darro, qiyaastii boqolkiiba 5 dadka qaba Stevens-Johnson syndrome iyo boqolkiiba 30 ayaa qaba sunta sunta ah ee Epidermal Necrolysis waxay leeyihiin calaamado daran oo aan dib u soo kabsan.
Caruurta da 'kasta iyo dadka waawaynba waxaa saameyn kara Stevens-Johnson syndrome, inkasta oo dadka la tallaalay, sida HIV-ga , ay u badan tahay inay halis ugu jiraan.
Astaamaha Astaamaha Stevens-Johnson Syndrome
Astaamaha Stevens-Johnson guud ahaan waxay ka bilaabmaan calaamadaha hargabka , sida qandho, dhuun xanuun, iyo qufac. Marka xigta, 1 illaa 3 maalmood kadib, cunug qaba Stevens-Johnson syndrome wuxuu horumarin doonaa:
- dareen gubasho leh oo ku yaalla bushimaha, gudaha gudaha dhabannada (bukaanshaha buccal), iyo indho
- firiiric casaan, kaas oo laga yaabo inuu leeyahay xarumo mugdi ah, ama uu ku yeesho finan yaryar
- barar wejiga, indhaha, iyo / ama carrabka
- casaan, indhaha oo dhiig ah
- Dareenka iftiinka (sawir-qaadid)
- boogaha xanuunka ama nabarrada afka, sanka, indhaha, iyo xajmiga xubinta taranka, taas oo keeni karta inay qaboojiso
Dhibaatooyinka Stevens-Johnson syndrome-ka waxaa ku jiri kara boog-kicin iyo indho la'aan, pneumonitis, miyokarditis, cagaarsheet, hematuria, kalyaha oo aan shaqeyn, iyo sepsis.
Calaamad muujinaysa Nikolsky, kaas oo lakabka sare ee maqaarka ilmaha ka soo baxo marka la suuxay, waa calaamad muujinaysa calaamadaha daran ee Stevens-Johnson ama in uu ku soo baxo Qalaladda Xanuunka Epidermal Necrolysis.
Ilmo waxaa sidoo kale loo aqoonsan yahay inuu haysto Epidermal Necrolysis Toxic haddii ay qabaan wax ka badan 30 boqolkiiba epidermal (maqaarka).
Sababaha loo yaqaan Stevens-Johnson Syndrome
In kastoo in ka badan 200 daawo ay sababi karaan ama kicin karaan cudurka "Stevens-Johnson syndrome", waxa ugu badan waxaa ka mid ah:
- anticonvulsants (suuxdinta ama daaweynta suuxdinta), oo ay ku jiraan Tegretol (Carbamazepine), Dilantin (Phenytoin), Phenobarbital, Depakote (Valproic Acid), iyo Lamictal (Lamotrigine)
- sulfonamide antibiotics, sida Bactrim (Trimethoprim / Sulfamethoxazole), oo badanaa loo isticmaalo daaweynta UTIs iyo MRSA
- antibiyootikada beta-lactam, oo ay ku jiraan penicillins iyo cephalosporins
- daawooyinka aan anti-inflammatory ahayn, gaar ahaan nooca oxicam, sida Feldene (Piroxicam) (badanaa laguma qoro carruurta)
- Zyloprim (allopurinol), oo sida caadiga ah loo isticmaalo daaweynta gout
Cudurka Stevens-Johnson waxaa badanaa la aaminsan yahay in uu keeno fal-celinta daroogada, laakiin infekshannada laga yaabo inay sidoo kale la xiriirto waxaa ka mid ah kuwa ay sababaan:
- herpes virus virus
- Bakteeriyada Mycoplasma pneumoniae (kudhaca pneumonia)
- Cagaarshowga C
- Histoplasma capsulatum fungus (Histoplasmosis)
- Epstein-Barr virus ( mono )
- Adenovirus
Daaweyn loogu talagalay daaweynta Stevens-Johnson Syndrome
Daawooyinka loo yaqaan Stevens-Johnson syndrome caadi ahaan waxay bilaabaan inay joojiyaan wixii daroogo ah ee keeni kara dareen-celinta ka dibna daryeeli karo ilaa inta bukaanku soo kabsado qiyaastii 4 asbuuc.
Bukaankan badanaa waxay u baahan yihiin daryeel ka tirsan Unugga Daryeelka Khaaska ah, oo leh daaweyn kuwaas oo ay ka mid yihiin:
- Dareerayaasha IV
- dheeraadka ah nafaqada
- antibiyootiko si loo daaweeyo caabuqyada labaad
- daawooyinka xanuunka
- daryeelka dhaawaca
- steroids iyo immunoglobulin (IVIG) xidid, inkastoo isticmaalkooda uu weli muran ka jiro
Daaweynta Stevens-Johnson syndrome ayaa inta badan la isku daraa habka kooxeed, dhakhtarka ICU, dhakhtarka maqaarka, dhakhtarka indhaha, dheef-shiid kiimikaad, iyo dhakhtarka gaasta.
Waalidiintu waa inay raadsadaan daaweyn isla markiiba haddii ay u maleynayaan in ilmahoodu uu yeelan karo cudurka Stevens-Johnson.
Ilaha:
Habif: Dermatologiyada Daryeelka Caafimaadka, 5th ed.
Kliegman: Nelson Textbook of Pediatrics, 18th ed.
Koh MJ. Stevens-Johnson syndrome iyo sunta sunta ah ee sunta cayayaanka ee carruurta Asia. J Am Acad Dermatol - 01-JAN-2010; 62 (1): 54-60.
Mandell: Mandell, Douglas, iyo Bennett Mabaadii'da iyo Tababarka Cudurrada Cudurrada ah, 7aad ed.
Natacha Levi, PharmD. Daawooyinka sida Cudurka Halista ah ee Stevens-Johnson Syndrome iyo Cadaadiska Nalalka Esterida ee Carruurta: Falanqaynta Burburka. Pediatrics, Feb 2009; 123: e297 - e304.