
eosynophilic gastroenteritis

eosynophilic gastroenteritis (udaa. kinwa ije) hii eka durmil aanee vijatiy sthitee aahe, jee jatharantra (jee. aay.) uutinchya patchy kinwa pasarlelya eosynophilic ghuskhoridvare darshavili jaate, jyache varnan pahilyanda 1937 madhye kaijarne kele hote. sadarikaran sthan tasech aatadyachya bhintitil sahbhagachya kholee aanee vyaptinusar badaloo shakate aanee sahasa dirghakalin punaravartan abhyaskram chalavate. sahbhagachya sakholatechya aadhare tyache shleshmal, snayu aanee serosal prakaranmadhye vargikaran kele jaau shakate. jee. aay. margatil konatyahi bhagavar parinam houu shakato aanee pittmargatil vilag sahbhag dekhil nondavala gela aahe.
pooat haah sarvat jaast prabhavit honara avyav aahe, tyanantar lahan aatade aanee bruhadantra aahe.
chinhe aanee lakshane.
udaharanarth, samanyatah dirghakalin anirdisht jee. aay. lakshananche sanyojan disun yete jyat otipotat dukhane, atisar, adhunmadhun malmal aanee ulatya, vajan qamee hone aanee otipotat vaadh hone yancha samavesh hoto. andaje 80 takke lokanmadhye anek varshe lakshane asatat; nidan sthapit karnyasathi anekada uchch patalivaril vaidyakeey sanshayachi aavashyakta asate, kaaran haah rog atyant durmil aahe. heey achanak yet nahee parantu rugnachya vayanusar vikasit honyas sumare 3-4 varshe lagatat. kadhikadhi, haah rog otipotat tivra adthala kinwa aatadyat adthala mhanoon prakat houu shakato.
pathophysiology.
paridhiy rakt eosynophilia aanee elevated seeram iji heey nehamiche asatat parantu sarvatrik nasatat. jatharantramargachya bhintiche nuksan eosynophilic ghuskhori aanee degranulationmule hote.
yazman sanrakshn yantranecha eka bhag mhanoon, eosynophils samanyatah jatharantra shleshmalamadhye asatat, jaree khol uutinmadhye aadhalane jawaljawal nehmich rogshastriy asate. udaharanarth, asha daat ghuskhorila kaaran kaay heey spasht nahee. heey shakya aahe qee rogachya vegvegalya rogjankiy yantrana rugnanchya anek upasamuhanmadhye samavisht aahet. kahee rugnanmadhye annapadarthanchi allergy aanee annapadarthanna badalnara aay. jee. eae. pratisad disun aala aahe, joou rogjananamadhye atisanvedanshil pratisadachi bhoomika soochit karato. anek rugnanna khartar isab, damaa ii. sarkhya itar atopic sthiticha itihas asato.
dahak uutinmadhye eosinophilchi bharati hii eka guntaguntichi prakriya aahe, jee anek dahak cytokinesdware niyantrit kelee jaate. udaharanarth cytokines il-3, il-5 aanee granulocyte macrophage collany stimulating factor (jee. emm.-see. ess. eff.) heey bharati aanee sakriy karnyamage asoo shakatat. roggrast aatadyanchya bhintimadhye teey rogpratikarak rasayanikdrushtya pahile gele aahet.
yavyatirikt, pooat aanee lahan aatadyachya lamina propriyamadhye eosynophilschya homingche niyaman karnyat eotaxinchi avibhajya bhoomika asalyache disun aale aahe.
rogachya allergic upprakarat, asey manale jaate qee ann allergykarak padarth aatadyansambandhi shleshmal sharirala paar karatat aanee dahak pratisadas chalana detat jyat mast peshiche vighatan aanee eosinophilschi bharati samavisht aahe.
nidan.
tally aanee itar. nidanasathiche 3 nikash suchavale jeey ajunahi mothya pramanat vaparale jaatatah
hyperocenophilia, ellergychya pratisadache vaishishtya, 20 takke rugnanmadhye anupasthit asoo shakate, parantu hypoalbuminemia aanee itar vikrutee, jeey durvaparas soochit karatat, tyaa upasthit asoo shakatat. seaty scanmadhye durchya potatil aanee jawalchya lahan aatadyatil patanchi gaath aanee aniyamit ghattapana disun yeu shakato, parantu heey nishkarsh crone rog aanee lymphoma yasarkhya itar paristhitinmadhye dekhil asoo shakatat.
eosynophilic gastroenteritismadhe endoscopic swaroop anirdisht aahe; tyat erythemates, fryable, nodular aanee adhunmadhun ulcerative badal samavisht aahet.
kadhikadhi pasarlelya jaljalimule viliche sampoorn nuksan hote, anek tharancha samavesh hoto, submucosal edema aanee fibrosis hoto.
nishchit nidanamadhye biopsy slidesmadhye eosynophilic ghuskhoricha uutishastriy purava samavisht asato. sukshmadarshakadvare prati uchch shakti kshetra 20 eosynophils ughad hotat. ghuskhori anekada khadbadit asate, chukavata yete aanee laparoscopic purn jaadi biopsychi aavashyakta asoo shakate.
technitium (99 emm. tii. see.) exametazime-label kelele leukocyte spect vaparoon redio isotope scan rogachya vyaptiche moolyankan karnyasathi aanee upcharanna pratisad denyasathi upayukt tharoo shakate parantu nidanat tyache farse moolya nahee, kaaran scanmule udaharanarth dahachya itar karananpasun vegale honyas madat hott nahee.
jevha itar avyav pranalinchya eosynophilic ghuskhorichya sahkaryane eosynophilic jatharantrashoth disun yeto, tevha idiopathic hyperiocenophilic syndromeche nidan vicharat ghetale pahije.
vyavasthapan.
kahee abhyasanmadhye 90 takke pratisad darasah corticosteroids haah upcharacha mukhya aadhar aahe. steroid upcharacha yogya kalavadhi adnyat aahe aanee punha udbhavalyane anekada dirghakalin upcharanchi aavashyakta bhasate. vividh steroid bachav karnare ghatak udaa.jee. soodiyam chromoglycate (mastakachya peshi patalanche sthirikaran), ketotifen (antihistamine) aanee montelucast (eka nivadak, spardhatmak leukotrin receptor virodhi) prastavit kele gele aahet, jeey mishra parinamansah, allergychya gruhitkavar kendrit aahet. maukhik budesonide (eka maukhik steroid) upcharanmadhye dekhil upayukt tharoo shakate. maryadit sankhyene annapadarthanchya allergychi olakh patali tarr nirmulan aahar yashasvi houu shakato. mulanvar upchar karnyat moolbhut aahar dekhil yashasvi houu shakato.
yadruchchik vaidyakeey chachanit, eosynophilic jatharshoth aanee duodenitis asalelya vyaktinmadhye eosinophilchi sankhya aanee lakshane sudharanyasathi lyrentalimab aadhalun aale.
mahamarishastra.
rogasansargshastra abhyasanmadhye bhinn asoo shakate, kaaran prakarananchi sankhya qamee aahe, sumare 300 prakarane udaharanarth prakashit sahityat nondavali gelee aahet.
udaharanarth, konatyahi vayat aanee serve vanshanmadhye, purushanmadhye kinchit jaast pramanat aadhalu shakate. aadhichya abhyasanmadhye aayushyachya tisya teey pachvya dashakanmadhye adhik ghatana disun aalya.