Vasculitele grup heterogen de maladii, caracterizată de leziuni inflamatorii şi necrotizante ale peretelui vaselor



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Cyclophosphamide:

  • Cyclophosphamide:

  • 2 mg/kg 1 dată în zi, p/o de obicei nu mai puţin de 3 luni, sau pînă la obţinerea ameliorării.

  • Monitorizarea riguroasă a leucocitelor şi ajustarea dozei în caz de leucopenie. (L trebuie menţinute pînă la > 3500/µL.)

  • Doza cumulativă IV - 0.75 - 1 g/m2 lunar. Dzele se reduc în insuficienţa renală.





Anticorpi monoclonali anti TNF α –himerici (Infleximab,)

  • Anticorpi monoclonali anti TNF α –himerici (Infleximab,)

  • Anticorpi monoclonali anti TNFα umanizaţi, obţinuţi prin inginerie genetică, - CDP 571.

  • Etanercept (receptori anti TNF α umanizaţi, obţinuţi prin inginerie genetică)













In 2005, two other recombinant medications were reported Certolizumab is a Fab fragment of a humanized anti-TNF alpha monoclonal antibody that is attached to polyethylene glycol to increase its half-life in circulation.

  • In 2005, two other recombinant medications were reported Certolizumab is a Fab fragment of a humanized anti-TNF alpha monoclonal antibody that is attached to polyethylene glycol to increase its half-life in circulation.

  • Natalizumab is an anti-integrin monoclonal antibody. However, it has been associated with progressive multifocal leukoencephalopathy, a usually fatal viral infection of the brain, that may limit its use.



There have been concerns about the side effects of monoclonal antibodies, and specifically of infliximab, but these are rare. Early side effects include the risk of allergic reactions (including anaphylaxis which may be life-threatening), and reactions to the infusion. These are often treated with medications given before treatment. Infliximab also carries a risk of worsening infection, and can cause reactivation of old infections, like tuberculosis. Over time, there is the risk of serum sickness, which is a delayed hypersensitivity response to the medication. Later complications may include multiple sclerosis and lymphoma.

  • There have been concerns about the side effects of monoclonal antibodies, and specifically of infliximab, but these are rare. Early side effects include the risk of allergic reactions (including anaphylaxis which may be life-threatening), and reactions to the infusion. These are often treated with medications given before treatment. Infliximab also carries a risk of worsening infection, and can cause reactivation of old infections, like tuberculosis. Over time, there is the risk of serum sickness, which is a delayed hypersensitivity response to the medication. Later complications may include multiple sclerosis and lymphoma.

  • Finally, the medication is quite expensive, with treatment costs ranging from US$3000 to $8000 per infusion.



Le rituximab (commercialisé sous les noms Rituxan et MabThera) est un anticorps monoclonal chimérique dirigé contre la molécule de surface CD20 (présente sur la plupart des cellules B). Il permet de diminuer de façon substantielle le nombre de lymphocytes B par un effet toxique direct sur ces cellules[1].

  • Le rituximab (commercialisé sous les noms Rituxan et MabThera) est un anticorps monoclonal chimérique dirigé contre la molécule de surface CD20 (présente sur la plupart des cellules B). Il permet de diminuer de façon substantielle le nombre de lymphocytes B par un effet toxique direct sur ces cellules[1].





FORMELE NOSOLOGICE ALE VASCULITELOR SISTEMICE

  • FORMELE NOSOLOGICE ALE VASCULITELOR SISTEMICE





Este o vasculită granulomatoasă ce se caracterizează prin inflamaţia peretelui arterelor mari şi medii, avind o predilecţie pentru arcul aortei şi emergenţa vaselor mari, carotide şi subclavii.

  • Este o vasculită granulomatoasă ce se caracterizează prin inflamaţia peretelui arterelor mari şi medii, avind o predilecţie pentru arcul aortei şi emergenţa vaselor mari, carotide şi subclavii.





- inflamație granulomatoasa ocluziva a aortei și a ramurilor sale principale, care apare cu predilecție la femei tinere (raport intre sexe 9:1).

  • - inflamație granulomatoasa ocluziva a aortei și a ramurilor sale principale, care apare cu predilecție la femei tinere (raport intre sexe 9:1).

  • Incidența anuală in Statele Unite este de 2,6/1 milion, fiind ceva mai mare la populația orientală.



Boala are o etiologie necunoscută, probabil multifactorială.

  • Boala are o etiologie necunoscută, probabil multifactorială.

  • S-au descris asocieri cu tuberculoza, sifilisul, antigenele streptococice, unele mycoplasme,citomegalo- adeno- și parvovirusuri, infecții parazitare etc.



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