kaunis syndrome

kaunis syndromenu allergy praticharya ledhaa aushadham ledhaa itara padaardhaalaku balamaina roganirodhaka pratispandana valla kalige teevramaina coronary syndrome (gundeku rakta pravaham taggadaaniki sambandhinchina chaatii noppi vanti lakshanaalu) gaa nirvachinchaaru. nirvachinchaaru sameekshinchinatlugaa, 130 mandhi purushulu mariyu 45 mandhi mahilalalo praamaanikamaina kesulu namodaina arudaina syndrome idhi; ayithe, eee rugmata saadhaaranamgaa nirlakshyam cheyabadindani, anduvalla marinta prabalamgaa undani anumaanistunnaaru. maast sell activation mariyu reaction nundi inflammatory cytokins alaage itara inflammatory agentla vidudala dhamanula timmiriki daariteestundi, idhi gunde kandaraalaku daariteestundi ledhaa phalakam vichchinnam kakunda mariyu aaa dhamanulalo okati ledhaa anthakante ekkuva addukuntundi.
kaunis syndrome anedi coronary artary sposmes mariyu lakshanaalaku sambandhinchina maroe rendu kaaranaala nundi vaeru cheyabadindi.chaalaa saadhaaranamaina, allergy kaani syndrome, pringemetal anjina mariyu isinophilic coronary periorterities, idhi adventicia mariyu periadventia yokka vistrutamaina isinophilic chorabatla valla kalige chaalaa arudaina rugmata.ii. coronary dhamanula chuttoo unna mruduvaina kanajaalaalu.
epidemiology.
vividha kesula pariseelana dwara, kaunis syndrome aneka vibhina jaatulu mariyu bhougolika praantaalalo gurtinchabadindi. ayithe, turkey, grease, italii mariyu speyinlatho sahaa dakshina airopalo chaalaa kesulu kanugonabaddayi. 2 nundi 90 samvatsaraala vayassu gala pillala rogula nundi vruddhula varaku vistruta vayassu paridhi gamaninchabadutundi. saadhaaranamgaa kanipinche comorbiditylalo hyperlipidemia, diabetes, dhumapanam, adhika raktapotu mariyu mundastu allergy praticharyalu untaayi. eee roganirdhaarana tappipoyina ledhaa takkuva roganirdhaarana cheyabadinanduna khachitamaina prabalyanni gurtinchadam kashtam. atyavasara vibhagam moolyaankanam taruvaata cherchukunna rogulandarikee bhinnamaina e148q mutation undani oka adhyayanam nivedinchinanduna janyu-paryaavarana paraspara charyalaku avakaasam undhi.
etiology.
mandulu, vividha aarogya paristhitulu, aaharam mariyu paryaavarana bahirgatam vanti eee syndromenu prerepinchadaaniki aneka kaaranaalu kanugonabaddayi. ige antibody utpattiki kaaranamayye eee avakshepa karakallo edainaa eee syndromeku dohadam chestundi. gatamlo kanugonabadina aushadhaalalo aspirin mariyu dipyrone vanti analgesics, anaesthetics, bahula antibiatics, heparin mariyu lepirudin vanti anticogulants, tpa vanti thrombolitics, clopidogrel, anty neoplastics, glucocarticoids, naan steroid anty inflammatory drugs, protan pump inhibitors mariyu skin krimisamhaaraka mandulu vanti anty platelet therapy unnaayi. adanamgaa, saanubhooti, valume expanderlu, anty fungals, antivirals mariyu noti garbhanirodhakaalu kooda eee syndromenu prerepistaayi. itara nirdishta saadhaarana mandulalo allopurinol, analypril, losarton, insulin mariyu marenno unnaayi. kaunis syndromenu neraropana chese paristhitulalo branchial ubbasam, churg-strass syndrome, seeram sickness, scambroid syndrome, angiodema, hay feavour, anaphyloxis (vyayamam prerita ledhaa idiopathic) mariyu anisakiasis unnaayi. coronary artary vyaadhi rogulalo upayoginche saadhaarana prakriya ayina coronary stenting kooda oka kaaranam anie kanugonabadindi. poison iv, gaddi, rabbaru mariyu nikotinlaku paryaavarana bahirgatam dohadapadutundani kanugonabadindi. kaunis syndromenu avakshepinchagala jeevula kaatu salepurugulu, pamulu, teellu, agni cheemalu mariyu jellie fishlu. vividha triggerlalo contrast media unnaayi. allergy mariyu inflammatory pratispandananu kaliginche vividha aahaaraalaku pratispandanalu teevramaina coronary syndromeku daariteestaayi.
sankethaalu mariyu lakshanaalu.
allergy acs anedi rendu bhaagaalato kuudina syndrome. roganirodhaka madhyavartitvam anedi oka bhaagam, dheeni phalitamgaa adhika sunnitatvam, allergy mariyu anaphylactic ledhaa anaphylactoid praticharya erpadataayi. rendava bhaagamlo acute coronary syndrome (acs) thoo kanipinche cardiac sankethaalu mariyu lakshanaalu untaayi. roogi yea rakamaina vaividhyamtho badhapaduthunnado batti hridaya lakshanaalu maarutuu untaayi. acute coronary syndrome saadhaaranamgaa chaatiiloo sankocham noppitho mudipadi untundi, idhi meda ledhaa edama chetiki radiationtho untundi mariyu tarachugaa noppulu, chemata pattadam, vikaram mariyu swaasa teesukovadamlo ibbandi thoo mudipadi untundi. pareekshalo gunde sankethaalu jalubu, broadycardia, tachycardia, hypotension, cardio respiratory arrest ledhaa aakasmika maranam kooda untaayi. allergy praticharyalo telikapati mariyu sthaanikeekarinchina praticharya nundi vistrutamgaa mariyu praanaantakamaina vatiki maaravacchu, allergy esi yokka allergy bhaagam adhe vidhamgaa untundi. allergy esi laloe mukham mariyu naaluka vaapu, swaasalo guraka, daddurlu mariyu chaalaa takkuva raktapotu (anaphylactic shock) vanti antarleena allergy praticharyaku sambandhinchina nirdishta lakshanaalu kooda undavacchu. adanapu phalitaalalo stridor, magata, syncope, kadupu noppi, virechanaalu, vaantulu mariyu teevramaina pulmonary edema vantivi undavacchu.
myocardial inforction, teevramaina cardiac failure mariyu aakasmika cardiac deth kooda chudavachu. 13 saatam varaku vayojanula aakasmika hridaya maranaalu maast sell degranulationtho kalisi untaayi, kaunis syndromelo nissabda allergy praticharya undavacchani nirdhaaristundi.
pathophysiology.
alergylo, maast kanaalu histamine, neutral proteages, arachidonic assid derivatives, platelet activating phyaaktar mariyu vividha rakaala saitokinlu mariyu chemokinlu vanti inflammatory padaarthaalanu vidudala chestaayi. eee madhyavartulu coronary artary spaajamnu vegavantam cheyavachu mariyu coronary aartareela atheromatus phalakaala cheelikanu vegavantam cheyavachu. idhi gunde kandaraalaku rakta pravaahaaniki aatamkam kaligistundi mariyu asthira anjina nundi vaeru cheyaleni lakshanaalanu kaligistundi.
alerjeeki pratyaksha aadharalu laeni vyaktulalo kooda, allergy pratispandana teevramaina coronary syndromelo paatra poeshinchae avakaasam undih acs unnavaarilo maast sell activation gurtulu kanipistaayi.
rooga nirdhaarana.
kaunis syndrome tarachugaa tappipotundi ledhaa takkuvagaa nirdhaarana cheyabadutundi kabatti vyaadhi prakriyanu mariyu clinical presentationnu ardham chesukovadam, samasyapai adhika anumanam kaligi undatam tappanisari.  trigger exposure mariyu lakshanaalu praarambhamayye madhya vyavadhipai drushti pettadam mukhyam. chaalaa varaku kesulu oka ganta kante takkuva vyavadhi kaligi undagaa, konni 6 gantala vyavadhi kaligi unnaayi. myocardial ischemia ledhaa inforction anumanam unte eKG, chaatii ex-rae, ekhocardiography mariyu angiography avasaram.
clinical, electrocardiography, angiographic, echocardiographic mariyu acute myocardial ischemia yokka prayogasaala phalitaalato sambandham unna daihika allergy praticharyalu unna rogulaku kaunis syndrome unnatlu nirdhaarana cheyali. eee keey zii maarpulu saadhaaranamgaa takkuva sthaayi seesaalu, ischemia, sinus broadycardia ledhaa tachycardia, haart block, karnika dada, ventricular dada, ventricular ectopic beats, qrs mariyu cuty podigimpu mariyu degoxin vishapuuritatvam vanti phalitaalalo infractionku anugunamgaa untaayi. ekhocardiography atherosclerotic stenosis mariyu thrombosisnu kanugonadamlo sahaayapadutundi.
seeram tryptase, histamine, immunoglobulins (ige), cardiac enjaimlu, cardiac troponins rooga nirdhaarananu nirdhaarinchadaaniki sahaayapadataayi. kaunis syndromelo, thalium-201 single-photan emission computer tomography (spect) mariyu 125i-15-(p-iodophenyl)-3-(r, s) methyl pentadecanoic assid (bmipp) spect vanti kotta paddhatulu teevramaina myocardial ischemianu velladinchagaa, coronary angiography saadhaarana coronary dhamanulanu choopinchindi. inca, cardiac magnetic resonance imaging (mri) thoo, aalasyamaina contrast-merugaina chitraalu kaunis syndrome type I roopaantaram unna rogulalo subendocardial gaayam praantamloo saadhaarana vaashavutnu chuuputaayi.
takotsubo mariyu hypersensitivity myocarditis vanti itara saaruupya pradarsanalu kooda unnaayi.
vargeekarana.
kaunis syndrome yokka moodu rakalu gurtinchabaddaayih
nirvahana.
eee rogula nirvahana vaidyulaku savaluga undavacchu. beata blackerlu esi laloe prayojanakaramgaa unnappatikee, avi kaunis syndromelo viruddhamgaa untaayi. allergy esi laloe, epinephrine (anaphyloxis chikitsaku aadharam) istuu beata grahakalanu nirodhinchadam anedi α-adrenergic graahakaala ekagreeva kaaryakalaapaaniki daariteestundi, idhi coronary timmirini teevrataram chestundi. chaatii noppi nundi upasamanam kaliginche opioids kooda, bhaarii maast sell degranulation prerepinchavacchu, idhi anaphyloxisnu marinta digajaarchutundi. anduvalla atuvanti rogulaku vaatini jagrattagaa ivvali.
type I roopaantaram.
type I roopaantaram daani clinical pradarsana mariyu allergy praticharya entha teevramgaa untundane daani aadhaaramgaa chikitsa cheyabadutundi. idhi telikapati praticharya ayithe, antihistaminelu mariyu carticosteroids lakshanaalanu niyantrinchadamlo sahaayapadataayi. roogi yokka pradarsanalo anaphyloxis unte, intramuscular adrenaline ivvali.
allergy sanghatanaku matrame chikitsa type I vaividhyaanni raddu cheyagaladu. nitroglyzerine ledhaa calcium chaanal blockers vanti vasodilatorlanu ivvadam sifaarsu cheyabadindi. paryavasanalalo hypotension mariyu anaphyloxis yokka teevrataram. antihistamine mariyu maast sell stabilizers e.zii. chromoglicate ledhaa nedochromilnu kooda pariganinchavacchu.
rakam II roopaantaram.
teevramaina coronary eevent protocol vartinchabadutundi mariyu cardiac symptum controll kosam type II kii type I maadirigaane chikitsa cheyavachu. deerghakaalika beata-blackersnu mundugaane upayoginchina rogulalo teevramaina anaphyloxis kosam adrenaline kante glucagon merugaina empika kaavacchu. adanamgaa, beata-blackerlu coronary vasospasum mariyu ischemianu penchutaayi. opiates nuu jagrattagaa upayoginchaali.
rakam III roopaantaram.
acute coronary syndrome protocol yokka anuvartanamtho paatu, thrumbus aspiration mariyu kotta stent unchadam avasaram. steroidlu mariyu antihistaminela sahakaaramtho maast sell stabilizerla vadakam sifaarsu cheyabadindi. aspirated material yokka hystological pareeksha mariyu isinophils mariyu maast kanaala kosam marakatho paatu intrastant thrumbusnu kose panini chepattaali. stent implantation tarvaata allergy lakshanaalu unnappudu, desensitization charyalanu vartimpajeyaali.
charitra.
vaidyaparamgaa, allergy mariyu gundeku padanirmaana hridaya praticharyalu, teevramaina cardities ledhaa rheumatic cardities yokka praathamika lakshanaalatoo kuudina gayalu vanti paerlatoe anubandhinche aneka paatha nivedikalu unnappatikee, allergy-madhyavartitva teevramaina coronary syndrome yokka modati puurti vivarana greeku cardiologist nicolus kaunis kuu aapaadinchabadindi, athanu athanu coronary artary spazam (ippudu, type I roopaantaram) kesulalo allergy yokka paatra gurinchi nivedinchaadu. eee timmiri madhyavartitvam dwara allergy prerita coronary artary aakluushannu brownwald gurtinchaadu. kaunis syndrome yokka moodu rakalu kanugonabaddayi mariyu oka adhyayanam type 1 roopaantaram saadhaaranamgaa kanipistundani, taruvaata varusaga type 2 mariyu 3 anie nirdhaarinchindi.

