| Abstract | Primarni vaskulitisi predstavljaju skupinu bolesti obilježenu upalnim
promjenama i oštećenjem stijenke krvnih žila. Najčešći vaskulitis dječje dobi je IgA
vaskulitis koji pripada skupini vaskulitisa malih krvnih žila. Iako je bolest poznata još
od 19. stoljeća kao Henoch-Schönleinova purpura, njezina etiopatogeneza još uvijek
nije u potpunosti jasna. Klinički se prezentira razvojem kožnih promjena uglavnom
tipičnih obilježja i rasporeda, uz pojavu jednog ili više dodatnih simptoma: artritisa /
artralgija, bolova u trbuhu i nefritisa, te rijetko simptoma zahvaćanja drugih organa i
organskih sustava. Dijagnoza bolesti se u većine bolesnika postavlja na temelju
kliničke slike, u pojedinih bolesnika nadopunjene patološkim laboratorijskim nalazom
urina u smislu hematurije i/ili proteinurije. U slučaju nejasne kliničke prezentacije ili
izraženog nefritisa dijagnoza se potvrđuje nalazom depozita IgA u bioptatu kože ili
bubrega. IgA vaskulitis je u pravilu samoograničavajuća bolest čiji simptomi spontano
regrediraju u periodu od nekoliko tjedana. Iako rijetko, moguć je i razvoj komplikacija,
među kojima je najteža kronični nefritis. Većinu bolesnika moguće je liječiti i pratiti u
ambulantnim uvjetima, dok manji broj djece zahtijeva hospitalizaciju. Liječenje se
najčešće sastoji od provođenja potpornih mjera (adekvatna hidracija, analgezija), a po
potrebi se upotrebljavaju i različiti lijekovi te rijetko kirurške procedure.
Medicinska sestra, kao neizostavni dio tima, ima značajnu ulogu u zbrinjavanju
djeteta oboljelog od IgA vaskulitisa u ambulantnim te posebno u bolničkim uvjetima.
Zato uz osnove patogeneze, mora dobro poznavati sve elemente kliničke slike i
liječenja te ovisno o njima, uz konstantnu procjenu stanja djeteta, usmjeriti svoju skrb
k zajedničkom cilju što kraćeg liječenja i bržeg ozdravljenja djece oboljele od IgA
vaskulitisa. |
| Abstract (english) | Primary vasculitis is a group of diseases characterized by inflammatory changes
and damage of blood vessels wall. The most common vasculitis of childhood is IgA
vasculitis which belongs to the group of vasculitis of small blood vessels. Although the
disease has been known since the 19th century as Henoch-Schönlein purpura, its
etiopathogenesis is still not completely clear. It is clinically presented by the
development of skin changes, mostly typical features, and arrangements, with the
appearance of at least one or more additional symptoms: arthritis / arthralgia,
abdominal pain, and nephritis, and rarely symptoms of other organs and organ systems
involvement. The diagnosis of the disease in most patients is made based on the
clinical picture, in some patients supplemented by pathological laboratory findings of
urine in terms of haematuria and / or proteinuria. In case of unclear clinical presentation
or pronounced nephritis, the diagnosis is confirmed by the finding of IgA deposits in
the skin or kidney biopsy. IgA vasculitis is typically a self-limiting disease whose
symptoms spontaneously regress over a period of several weeks. Although rare,
complications may develop, the most severe of which is chronic nephritis. Most
patients can be treated and monitored in an outpatient setting, while a smaller number
of children require hospitalization. Treatment usually consists of supportive measures
(adequate hydration, analgesia), and if necessary, various drugs and rarely surgical
procedures.
The nurse, as an indispensable part of the team, has a significant role in caring
for a child with IgA vasculitis in an outpatient setting and especially in a hospital setting.
Therefore, in addition to the basics of pathogenesis, he/she must be well acquainted
with all elements of the clinical picture and treatment and depending on them, with
constant assessment of the child's condition, focus his/her care on the common goal
of short-term treatment and faster recovery of children with IgA vasculitis. |
