antargarbhacha mutrapindshoth

interstitial nephrietis, jyala tubulienterstial nephrietis asehi mhanatat, haah mutrapindachya tyaa bhagacha daah aahe jyala mootrapind interstitium mhanatat, jyamadhye peshi, bahya koshikeey matricks aanee mutrapindachya nalikanchya sabhovatalacha drav yancha sangrah asato. yala aatadyansambandhi nephrietis asehi mhanatat kaaran vaidyakeey chitrat tivra pyelonephritischya kahee prakarananmadhye (mukhytah aine. ess. aii. dii. chya vaparamule) macentaric lymphadenitischa samavesh asoo shakato. adhik visheshtah, varanvar varanvar mutramargachya sansargachya babatit, duyyam sansarg shejarchya aatadyat pasaru shakato. nalikanchya sanrachanesathi farshicha aadhar pradan karnyavyatirikt, interstitium mutrapindachya drav aanee electrolyte vinimay tasech antahsravi karyanmadhye sahbhagi asalyache disun aale aahe.
aushadhashastriy, paryavaraniy, sansargjanya aanee pranaligat rog yogdankartyansaha, mutrapindachya antargrahanamadhye dahak prakriyela uttejan denare vividh dnyat ghatak aahet. rogachya prasarachi vyapti tivra prakriyepasoon teey pragatishil nalika peshi nuksan aanee mutrapindatil apkriya asalelya junat sthitiparyant asoo shakate.
chinhe aanee lakshane.
antargarbhacha mutrapindshoth vividh chinhe aanee lakshanansah disu shakato, yapaiki anek anirdisht aahet. 30-50% rugnanmadhye, visheshtah aushadh-prerit antargarbhachya nephrietis asalelya rugnanmadhye honara taap haah sarvat samanya aahe. aahe varanvartesaha varanvartesaha itar samanya lakshananmadhye malmal, ulatya, thakwa, bhook naan lagane aanee vajan qamee hone yancha samavesh hoto. parshvadukhi, laghvibarobar vedna aanee mutrat disanare rakt, tasech uchch raktadabasarkhi chinhe yasarkhi adhik vishisht lakshane nidanasathi shanka vadhavinyat madat karoo shakatat. suruvatichya dastaivajikaran kelelya prakarananmadhye nondavalelya lakshanancha "abhijat" trikutamadhye pural, sandhedukhi aanee raktatil vadhalelya eosinophilcha samavesh hota; tathapi, alikadil mahamarishastra asey suchavate qee lakshanancha haah gut keval rugnanchya chhotya alpasankhyakanmadhye (5-10%) hoto. sadhyachya prakarananpaiki 70 teey 90 takke prakarananmadhye aadhunik aushadhanmule, sadarikaranat badal honyachi shakyata aahe.
karane.
samanya karananmadhye sansarg kinwa vedanshamak, dahak-virodhi kinwa methicillin (meticillin) sarkhya pratijaivikansarkhya aushadhanna pratikriya yancha samavesh hoto. aushadhanchya pratikriyemule 71 teey 92 takke prakarane udbhavtat.
aushadhe.
haah rog mutrapindala haanee haanee itar roganmule aanee vishari padarthanmulehi hoto. tivra aanee junat tubulointerstial nephrietis donhi mutrapindatil jivanu sansargamule houu shakatat jyala pyelonephritis mhanatat, parantu sarvat samanya kaaran aushadhanchya pratikool pratikriyemule aahe. yaa prakarchya pratikriyesathi jee aushadhe dnyat aahet tee mhanje penisilinsarkhya beeta-lactum pratijaivik
aanee sephalexin aanee nonsteroidal dahak aushadhe (espirin itaranpeksha qamee varanvar), tasech proton-pump avarodhak, refampicin, salfa aushadhe, fluoroquinolones, mutravardhak, allopurinol, mesalemine aanee phenitoin. aushadhachya samparkat yene aanee tivra tubulienterstial nephraitisachya vikasatil vel 5 divasanpasun 5 mahinyanparyant (phenoprophen-prerit) asoo shakato.
nidan.
hii sthitee lakshananshivay disu shakate. jevha teey upasthit asatat tevha teey mothya pramanat vaividhyapurn disu shakatat aanee vegane kinwa haloohaloo houu shakatat. 
jevha ellergychya pratikriyemule udbhavate, tevha tivra tubulienterstial nephrietischi lakshane mhanje taap (27 takke rugna), pural (15 takke rugna) aanee vadhaleli mutrapinde. kahee lokanna dsouria aanee pathdukhicha anubhav yeto. 
junat tubulienterstial nephraitismadhye rugnala malmal, ulatya, thakwa aanee vajan qamee hone yasarkhi lakshane disu shakatat. vikasit houu houu itar paristhitinmadhye raktatil potassiumche uchch praman, chayapachay aamlata aanee mootrapind nikami hone yancha samavesh hoto.
rakt chachanya.
sumare 23 takke rugnanmadhye raktatil eosinophilschi patali jaast asate.
mootra nishkarsh.
mootra nishkarshanmadhye khaleel goshtincha samavesh hotoh
pathology.
aakramak nasalele rugna moolyankan (sharirik tapasani, rakt aanee mootra chachani, imaging abhyas) soochak asoo shakate, tarr mutrapindachya bayopsidware prapt kelelya uutinchya nidanane interstitial nephrietische nishchitpane nidan karnyacha ekmev marg aahe. pathologic tapasanimule neutrophils, eosynophils aanee lymphocytes vividh vividh raktpeshinmadhil antarmukh sooj aanee dahak ghuskhorichi upasthiti disun yeil. samanyatah, raktavahinya aanee glomeruli prabhavit hott naheet. electron sukshmadarshakiyadvare nalika upakala peshinmadhil mitochondrial nuksan, peshidravyatil riktika aanee vistarit endoplasmic reticulum darshavile jaate.
gallium scan.
asamanya gallium scanchi sanvedansheelata 60 takkyanpasoon 100% paryant asalyache nondavale gele aahe. 76 rugnanmadhye gallium scanchya abhyasat [aay. aine. saha 23, biopsy-siddha aay. aine. saha 8] 0.75 chee aii. yuu. see. darshavili gelee.
naveen biomarkers.
vaidyakeey vaishishtyancha abhav aanee vidyaman chachanyanchya achookatechya abhavamule aay. aine. chya vaidyakeey nidanatil aavhane lakshat gheta, yaa rogasathi gair-aakramak biomarker olakhanyat lakshaniy swarasya aahe. eka abhyasat asey disun aale aahe qee monocyte chemotactic prathine-1 (kemokin see. see. ell.-2) aanee neutrophil gelatinageshy sambandhit lipocallin (aine. jee. ell.) heey aay. aine. asalelya rugnanmadhye niyantranat asalelya (yaa prakaranat nirogi sahbhagi) rugnanpeksha jaast hote. eka alikadil abhyasat asey disun aale aahe qee mootra cytokines interleukin-9 aanee tumour necrosis factor-α heey aayan nasalelya rugnanmadhye aayan nasalelya niyantranapeksha jaast hote, jyanni tivra mutrapindachya dukhapatichya mulyankanasathi biopsy kelee aanee 0.79 chee auc darshavili. yaa abhyasat asehi disun aale qee biomarkersmadhye doctoranchya aayanchya purv-biopsy chhapapeksha auc jaast hote aanee jevha clinical chalanchya modelmadhye jodale gele tevha auc 0.84 darshavile gele. tyanantarchya abhyasat, interleukin-9 dekhil corticosteroid therapila pratisad denyachi shakyata asalelya rugnanna olakhanyasathi darshavile gele.
upchar.
upcharanmadhye, aaksheparh aushadh kadhoon takane yasarkhe kaaran hatalane samavisht asate. corticosteroids madat karatat yacha konatahi spasht purava nahee.
poshan upcharpaddhatimadhye purese dravpadarth sevan asate, jyasathi anek litter atirikt dravpadarthanchi aavashyakta asoo shakate.
purvasoochana.
mootrapind hii ekmev shareer pranali aahe jee tubulienterstial nephrietisne thet prabhavit hote. mutrapindache karya sahasa qamee hote; mutrapinde thodishi nishkriy asoo shakatat kinwa purnapane ayashasvi houu shakatat.
dirghakalin tubulienterstial nephraitismadhye, mootrapind nikami hone haah sarvat gambhir dirghakalin parinam asato. jevha nikatvarti nalee jakhami hote, tevha soodiyam, potassium, bicarbonate, euric acid aanee phosphateche punarshoshan qamee kinwa badalale jaau shakate, parinami qamee bicarbonate, jyala metabolic acidosis mhanatat, qamee potassium, qamee euric acid jyala hyporisemia mhanatat aanee qamee phosphet jyala hypophosphatemia mhanatat. durvarchya nalikela jhalelya hanimule mootra-kendrit karanyachi kshamata aanee polyuria qamee houu shakate.
tivra tubulienterstial nephraitisachya bahutansh prakarananmadhye, hanikarak aushadh bund jhalyanantar kinwa jevha antarnihit rog upcharadvare barah hoto tevha mutrapindache karya parat yeil. 
jarr haah aajaar allergychya pratikriyemule jhaala asel, tarr corticosteroid punarprapti mutrapindachya karyala gatee deu shakato; tathapi, asey sahasa hott nahee.
junat tubulienterstial nephrayatisavar konatahi upchar nahee. kahee rugnanna dialysischi aavashyakta asoo shakate. akheris, mootrapind pratyaropanachi aavashyakta bhasu shakate.
mahamarishastra.
konatyahi lakshananshivay rugnanmadhye interstitial nephrietis haah asamanya (<1 takke ghatana) aahe parantu adnyat karanamule mutrapindala tivra dukhapat jhalelya rugnalayat dakhal jhalelya sumare 10-15% rugnanmadhye hoto. jaree heey serve vayogatatil rugnanmadhye houu shakate, taree kadachit aushadhanchya vadhatya samparkat yene aanee itar uttejak karananmule vruddha rugnanmadhye heey adhik samanya aahe.

