Diagnostics.

Bases of A – specifically signs;

- LE cells – ripe neutrophils who phagocyte nuclear protein other cells.

- ANF by highly titer – this is autoantibody against nuclear. 3-5:1000 leucoc.

- Antibody with native DNk. 1:32, 1:64, 1:128.

B –disproteinemia - > a2 and Y globulins (20-60)

- C-reactive protein

- fibrinogen,

- >ESR – erythrocyte sedimentation rate (20-60)

- anemia,

- thrombocytopenia,

- leucopenia,

- lymphopenia.

C- in the urine: - proteinuria, leucocyturia.

D- biopsy of kidney van can seen – free prostrate in the tissue of kidney modification nuclear, turndown immune complex on the membranes. By this change have rapidly development kidneys insufficient.

Treatment.

1. glucocorticoid – by acute form used at once, by subacute and chronically – used from 2-3 form activity. Treatment 3-6 mounts, beginning of the 40-60 mg and decrease till 15-20.

2. cytostatics: cyclosporinum 1-3 mg on the 1 kg masses body used 2-3 mounts. Azathioprinum.

3. immunomodulate – immunoglobulinum, lumbenzarid – inhibits synthesis antibody.

4. pulls-therapy – Methylprednisolone 1000 mg +100mg isotonic solution + 5000 heparin = drip transfusion 3 day.

5. used treatment untiprotozoid drugs: Chingamini, Delagil used o,25 mg twice following 5 day; are used of collagen’s diseases in oral on 1 tab. of the day about 2 mouth with 5 day interruption; Presocil including 0,04 delagil + 0,75 mg Prednisolone + 0,2 acetilsalysil acid, take on the 6 tab ones day.

6. antiagregation drugs – Kurantil 150-200 mg, Trental 400-600mg some mounts.

7. Avoidance of sun: patients should be advised on the avoidance of sun and strong light, the use of broad brim hat and tight woven clothing should be emphasized.

Anscreens to shield out UVB and UVA are required. The sunscreen should have sun protection factor (SPF) >15. More frequent application of sunscreens is necessary at the time of profuse sweating and swimming.

Drugs that potentially aggravate LE should be avoided.

Topical:

Topical steroid: potent topical or intralesional steroid is helpful for localized and mild disease. Mild steroid is sufficient for lesion of NLE. Care should be exercised to avoid side effects induced by prolonged application, the face is most susceptible.

Date: 2014-12-21; view: 922