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PRACA PRZEGLĄDOWA
Choroba Takayasu: jak oceniać aktywność zapalną?
 
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Data publikacji online: 29-04-2013
 
 
Reumatologia 2013;51(2):144-150
 
SŁOWA KLUCZOWE
STRESZCZENIE
Choroba Takayasu (TA) jest rzadkim zapaleniem dużych tętnic. Początek choroby jest podstępny, może pozostać niezauważony. Przewlekłe zapalenie prowadzi do nieodwracalnych konsekwencji: powikłań sercowo-naczyniowych, niedrożności naczyń, zaniewidzenia czy przełomu nadciśnieniowego. Z uwagi na układowy charakter schorzenia pacjenci trafiają do specjalistów różnych dziedzin: reumatologów, okulistów, kardiologów i chirurgów naczyniowych. Dostępne metody farmakoterapii wpływają tylko na aktywne zmiany zapalne. Przedłużające się leczenie glikokortykosteroidami ma niekorzystne skutki odległe i nie powinno być nadużywane. Aby określić efekt leczenia, wybrać moment jego modyfikacji, konieczna jest ocena aktywności choroby. Celem prezentowanej pracy jest przedstawienie możliwości oceny aktywności TA.
W diagnostyce znaczącą rolę odgrywają badania obrazowe naczyń: ultrasonografia i rezonans magnetyczny. Prowadzone są prace dotyczące pozytonowej tomografii emisyjnej (positron emission tomography – PET), która jest badaniem czułym, ale trudno dostępnym, kosztownym i wymagającym walidacji. Poszukuje się również biomarkera, którego wartości korelowałyby z aktywnością choroby. Wśród potencjalnych kandydatów na biomarker są interleukiny 6, 12, 18. Aktualnie opracowywane są skale aktywności choroby, np. DEI.Tak (Disease Extent Index-Takayasu). Żadne z tych narzędzi nie jest uniwersalne.
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