Viêm màng bồ đào
Mô tả: Màng mạch nho (uveal tract) bao gồm Sự bắt chước phân tử (molecular mong mắt, thé mi và màng mạch. Khi vùng mimicry) và kích thích kháng nguyên nay bị viêm và tay đỏ, nó được diễn tả là không đặc hiệu của đáp ứng miễn dịch việm màng bổ đảo (viêm màng mạch nho). là hai cơ chế gây viêm mang bỏ đảo Nếu chỉ có móng mắt bị viêm, nó chi đơn khi nhiễm trùng.” „ giản là viêm mồng mắt. Trong cơ chế “bat chước phân tử”, tự ki. kháng nguyên có phản ứng chéo với mắm.
Nguyên nhân: one ws chống lại tự kháng nguyên, nghĩ rang nó là Thuong gap „ “vat lạ”, tạo nên quá trình viêm. $ Chân thương mat Hệ miễn dich bẩm sinh được cho là có „ ° Nhiễm trùng thể nhận diện các sản phẩm do vi khuẩn lruập —- tiết ra như nội độc tố, ligand và RNA. Nếu. + Bệnh viêm một (IBD) các chat nay nằm ở trong mắt, chúng sẽ + Viêm mạch kích thích gây viêm.
Cơ chế: Nhiing hiểu biết về cơ chế bệnh sinh của ệnh viêm ruột (IBD) viêm màng bé đào vẫn còn nghèo nàn. Không có cơ chề rõ rằng „ Chan thương Có khả năng biểu hiện viêm mang bồ + Ban đầu, cơ chế trong chắn thương đào trong bệnh viêm ruột phụ thuộc vio, được cho là do các kháng nguyên ngoại Dâm chat di truyện và đáp ứng miễn dịch bat lai bị cô lập nằm trong mang bồ đào. thường gây huy hoại các mô tương ứng.” + Gan đây, có đề xuất cho rằng nhiễm ban Nhiều nghiên cứu” đã tìm ra được moi liên vi sinh (di cùng với chân thương) và các hệ giữa viêm màng bồ đào và HLA-B27, - kháng thé ngoại lai và các chất hoại tử B58 và -DRB1*0103. Tai sao, và cái gì đã đây mạnh các quá trình viêm lâm đỏ kích hoạt quá trình viêm thực sự, vẫn dang mat" được nghiên cứu. — HÌNH 6.54 Viêm p7” mảng bb do tước A ... nặng liên quan đến. pA A a - - HLA-B27 Nguồn: YanofF M, “3 £ < Duiker JS, số Ophthalmology, 3rd 4 8 « ‘edn, St Louis: Mosby, 2008: Fig 7-32. aN £ ; “7. Bx, c4 ; cee bề ” sà đài Tham khảo. 501 Tham khảo 1 Sherlock S, Shaldon S. The aetiology and pathologic thalamo-motor-cortical coupling, management of ascites in patients with Neurology 2003; 61(5): 689-692. hepatic cirrhosis: a review. Gut 1963; 4 16 Gokula RM, Khasnis A. Asterixis. J Postgrad 95-105, Med 2003; 49(3); 272-275. 2 eberman No Denison EK, Reynolds bị 17 Hardison WG, Lee FI. Prognosis in acute Zhe relationship of plasma volume, portal liver disease of the alcoholic patient. N Engl ypertension, ascites, and renal sodium Med 1966; 275: 61-66. retention in cirrhosis: the overllow theory of yg ne dJR, Ditchburn J, De Dombal FT. ascites ormation. Ann NY Acad Sci 1970; Clinical presentation of acute abdomen: ae study of 600 patients. BMJ 1972; 3: 3 Schrier RW. Pathogenesis of sodium and bì U water retention in high-output and low-output cardiac failure, nephrotic 19 Eskanderi MK, Kalff JC. Billing TR etal, syndrome, cirrhosis, and pregnancy: first of Lipopolysaccharide activates the muscularis cro parts’ N Enel Med £086 318 macrophage network and suppresses circular 0611 ma ist J Me ủ smooth muscle activity. Am J Physiol 1997; 273: G727-G734. TT ee 20 KalffJC, Schraut WH, Simmons RL, Bauer nw output cardiac felure, nephrotic AJ. Surgical manipulation of the gut elicits syndrome, cirrhosis, and pregnancy: second Tan ee Mog it pomiyie eee ann ov wo paris: N Engl J Med 1988; 319 Surg 1998; 228: 625-653. 5 Chiprut RO, Knudsen KB, Liebermann TR et — 2Ì Schwarz NT, Simmons RL, Bauer AJ. Minor SL Myxedema ascites. Am: Digest Dis 1976, intraabdominal injury followed by low dose 3i, 807-308, * LPS administration act synergistically to 6 De Castro E Bonacini M, Walden JM et al induce ileus. Neurogastroenterol Motil 2000; astro F, Bona , Walder a 110): 288. Myxedema ascites: report of two cases and review of the literature Clin Gastroenterol 22 Wood J. Chapter 26: Neurogastroenterology TOOL 1d Let Lt and gastrointestinal motility. In: Rhoades RA, TWAS Hà KQ Ma «of ascites, Ch Tanner GA (eds). Medical Physiology: 2nd WAS Hu KQ. Management of ascites Clin edn, Philadelphia: Lippincott Williams & ` ~ Wilkins, 2003. 8 Pockros PJ, Esrason KT, Nguyen C et al 23 Kirton CA, Assessing bowel sounds, Nursing Mobilization of malignant ascites with 1997, 27G): 64 diuretics is dependent on ascitic fluid othe abd characteristics, Gastroenterology 1992; 103: 24 Epstein O. The abdomen. In: Epstein O, 1302 1306 Perkin GD, Cookson J et al (eds). Clinical 9 Brown MW, Burk RE Development of Bee eae an. Edinburgh: Mesby intractable ascites following upper Sevier abdominal surgery in patients with cirrhosis, 29. van der Waal RI, Schulten EA, van de Scheur ‘Am J Med 1986; 80: 879-883 MR, Wauters IM, Starink TM, van der Waal ‹ 7 1. Cheilitis granulomatosa. J Eur Acad 10 ÁN Can: nen cenplode AE et Dermatol Venereol 2001; 15(6): 519-523. retroperitoneal lymphadenectomy for testis 26 Palmer K, Management of haematemesis and tumors: management with peritoneovenous melaena. Postgrad Med J 2004; 80: 399-404. shunting, J Urol 1978; 120: 377-382. 27 Courvoisier LJ. Casuistisch-statistische 11 Bichler T, Dudley DA. Nephrogenous ascites. Beitrage zur Pathologic and Chirurgie der Am J Gastroenterol 1983; 77: 73-74. Gallenweger, Leipzig: Vogel, 1890, 12 Han SHB, Reynolds TB, Fong TL. 28 Chung RS. Pathogenesis of the ‘Courvoisier Nephrogenic ascites: analysis of 16 cases and Gallbladder’. Dig Dis Sei 1983; 26(1): 33-38. review of the literature. Medicine 1998; 77: 29 Harris S, Harris HV. Cullen’s sign revisited. 233-245. Am J Med 2008; 121(8): 682-683. 13 McGee S. Evidence Based Physical Diagnosis. 30 Dickson AP, Imrie CW. The incidence and 2nd edn. St Louis: Elsevier, 2007 prognosis of body wall ecchymosis in acute 14 Timmermann L, Gross J, Kircheis G, pancreatitis. Surg Gynecol Obstet 1984; 159: Haussinger D, Schnitzler A. Cortical origin 343-347, of mini-asterixis in hepatic encephalopathy, 31 Requena L, Sanchez E. Erythema nodosum. Neurology 2002; 58(2): 295-298, Dermatol Clin 2008; 26: 524-538. 15 Timmermann L, Gross J, Butz M, Kircheis G, 32 Kunz M, Beutel S, Brocker E. Leucocyte Haussinger D, Schnitzler A. Mini-asterixis in activation in erythema nodosum. Clin Exp hepatic encephalopathy induced by Dermatol 1999; 24: 396-401 502 Tham khảo 33 Winkelmann RK, Fostrom L. New 50 Bannayan GA, Hajdu SI. Gynecomastia: observations in the histopathology of clinicopathological study of 351 cases. Am J erythema nodosum. J Invest Dermatol 1975; Clin Pathol 1972; 57: 431 65: 441-446, 51 Eroglu Y, Byrne WJ. Hepatic encephalopathy. 34 Jones JV, Cumming RH, Asplin CM. Emergency Medicine Clin N Am 2009; Evidence for circulating immune complexes 401-414 in erythema nodosum and early sarcoidosis. 52 Jalan R, Shawcross D, Davies N. The Ann NY Acad Sci 1976; 278: 212-219, molecular pathogenesis of hepatic 35 Ryan TJ. Cutaneous vasculitis. In: Champion encephalopathy. Int J Biochem Cell Biol RH, Burton JL, Burns DA et al (eds) 2003; (35): 1175-1181 Textbook of Dermatology. 6th edn. Oxford: 53 Odeh M, Pathogenesis of hepatic Blackwell Scientific Publications; 1998: encephalopathy: the tumour necrosis 2155-2225. factor-a theory. Eur J Clin Invest 2007; 37: 36 Farhi D, Cosnes J, Zizi N et al. Significance 291-304. of erythema nodosum and pyoderma 54 Mullen K, Dasarathy S. Hepatic gangrenosum in inflammatory bowel encephalopathy. In: Schiff ER, Sorrell ME, diseases. Medicine 2008; 87(5): 281-293. Maddrey WC (eds). Schiff’s Diseases of the 37 Bem J, Bradley EL 3rd. Subcutaneous Liver. 8th edn, Philadelphia: Lippincott- manifestations of severe acute pancreatitis. Raven; 1999: 545-581 Pancreas 1998; 16: 551-555. 55. Poordad FE Review article: the burden of 38 Lucas LM, Kumar KL, Smith DL. hepatic encephalopathy. Aliment Pharmacol Gynecomastia. A worrisome problem for the Ther 2006; 25(1): 3-9. patient. Postgrad Med 1987; 82: 73-81 56 Vaquero J, Polson J, Chung C et al. Infection 39 Nuttall FQ. Gynecomastia as a physical and the progression of hepatic finding in normal men. J Clin Endocrinol encephalopathy in acute liver failure Metab 1979; 48: 338-340, Gastroenterology 2003; 125: 755-764. 40 Niewoehner CB, Nuttall FQ. Gynecomastia 57 Bernal W, Hall C, Karvellas CJ et al. Arterial in a hospitalized male population. Am J Med ammonia and clinical risk factors for 1984; 77: 633-638. encephalopathy and intracranial 41 Olivo J, Gordon GG, Rafi E Southren AL. hypertension in acute liver failure. Estrogen metabolism in hyperthyroidism and Hepatology 2007; 46(6): 1844-1852. in cirthosis of the liver. Steroids 1975; 26 58 Sandhir S, Weber FL Jr. Portal-systemic 41 encephalopathy. Curr Practice Med 1999; 2 42 Southren A, Olivo J, Gordon GG et al. The 103-108. conversion of androgens to estrogens in 59 Talley NJ, O'Connor S. Clinical Examination: hyperthyroidism. J Clin Endocrinol Metab A Systematic Guide to Physical Diagnosis. 1974; 38(2): 207-214. Sth edn, Sydney: Churchill Livingstone 43 Eckman A, Dobs A. Drug induced Elsevier, 2006. gynecomastia. Expert Opin Drug Saf 2008; 60 Sapira JD, Williamson DL. How big is the 7(6): 691-702 normai liver? Arch Intern Med 1979; 139: 44 Gordon GG, Olivo J, Rafi F Southren AL. 971-973. Conversion of androgens to estrogens in 61 Rajnish J, Amandeep S, Namita J et al cirrhosis of the liver. Clin Endocrinol Accuracy and reliability of palpation and Metab 1975; 40: 1018. percussion in detecting hepatomegaly: a 45 Schmitt GW, Shehadeh I, Sawin CT. tural based study. Indian J Gastroenterol Transient gynecomastia in chronic renal 2004; 23: 171-174, failure during chronic intermittent 62 Ariel IM, Briceno M. The disparity of the hemodialysis. Ann Int Med 1968; 69: 73-79. size of the liver as determined by physical 46 Morley JE, Melmed S. Gonadal dysfunction examination and by hepatic gamma scanning in systemic disorders. Metabolism 1979; 28: in 504 patients. Med Ped Oncology 1976; 2: 1051-1073. 69-73. 47 Gabrilove JL, Nicolis GL, Mitty HA, Sohval 63 Aoki T. Genetic disorders of copper AR. Fetninising interstitial cell tumour of transport — diagnosis and new treatment for the testis: personal observations and a the patients of Wilson's disease. No To review of the literature. Cancer 1975; 35: Hattatsu 2005; 37(2): 99-109. 1184-1202. 64 Innes JR, Strachan IM, Triger DR. Unilateral 48 Tseng A, Horning SJ, Freiha FS, Resser KJ, Kayser-Fleischer rings. Br J Ophthalmol Hannigen JE Torti FM. Gynecomastia in 1986; 70: 469-470. testicular cancer patients. Cancer 1985; 56: 65. Cairns JE, Walshe JM. The Kayser-Fleischer 2534-2538. ring, Trans Ophthalmol Soc UK 1970; 40: 49 Nydick M, Bustos J, Dale JH, Rawson RW. 187-190. Gynecomastia in adolescent boys. JAMA 66 Tso MOM, Fine BS, Thorpe HE. Kayser 1961; 178: 109-114. Fleischer ring and associated cataract and Tham khảo — 505 Wilson's disease. Am J Ophthalmol 1975; 79: 83 Trowbridge RL, Rutkowski NK, Shojania KG. 479-488. Does this patient have acute cholecystitis? 67 Ellis PP Ocular deposition of copper in JAMA 2001; 289(1): 80, hypercupremia. Am J Ophthalmol 1969; 68: 8# Berry J, Malt RA. Appendicitis near its 423-427. centenary. Ann Surg 1984; 200: 567-575. 68 Tauber JJ. Pseudo-Kayser-Fleischer ring of 85 Perera GA. A note on palmar erythema the cornea associated with non-Wilsonian (so-called liver palms). JAMA 1942; 119 liver disease. A case report and literature (17): 1417-1418. review. Cornea 1903; 12(1): 74. 86 Bean W. Acquired palmar erythema and 69 Kasper D, Braunwald E, Fauci A, Hauser S, cutaneous vascular ‘spiders’. Am Heart J Longo D, Jameson J. Harrisonš Principles of 1943; 25: 463-477. Internal Medicine. 16th edn. New York: 87 Serao R, Zirwas M, English JC. Palmar McGraw-Hill, 2005: Vol 2, Ch 339. erythema, Am Clin Dermatol 2007; 8(6) 70 Kates SL, Harris GD, Nagle DJ. Leukonychia 347-356. totalis. J Hand Surg 1986; 11B(3): 465-466. 88 Nadeem M, Yousof MA, Zakaria M et al. 71 Grossman M, Scher RK. Leukonychia. The value of clinical signs in diagnosis Review and classification. Int J Dermatol of cirrhosis. Pak J Med Sei 2005; 21(2): 1990; 29(8): 535-541. 121-124. 72 Tosti A, lorizzo M, Piraccini BM, Starace M. 89 Leonardo G, Arpaia MR, Del Guercio R, The nail in systemic diseases. Dermatol Clin Coltorti M. Local deterioration of the 2006; 243): 341-347, cutaneous venoarterial reflex of the hand in 73 Lingyong J, Bing E Lina H, Chao W. Calcium cirthosis. Scand J Gastroenterol 1992; 27 regulating the polarity: a new pathogenesis 326-332. of aphthous ulcer. Med Hypotheses 2009; 90 Bland JH, O'Brien R, Bouchard RE. Palmar T3: 933-934. erythema and spider angiomata in 74 Rhee SH, Kim YB, Lee ES. Comparison of rheumatoid arthritis. Ann Intern Med 1958; Behcet's disease and recurrent aphthous ulcer 48 G): 1026-1031. according to characteristics of 91 Saario R, Kalliomaki JL. Palmar erythema in gastrointestinal symptoms. J Korean Med Sci theumatoid arthritis. Clin Rheumatol 1985; 2005; 20: 971-976. 4(4): 449-451 75 Jurge S, Kuffer R, Scully C, Porter SR. 92 Chopra J, Abraham GE, Chopra U et al Mucosal disease series number VI. Recurrent Alterations in circulating estradiol-17 in aphthous stomatitis. Oral Dis 2006; 12: 1-21 male patients with Graves disease. N Engl J 76 Baran R, Tosti A. Nails. In: Freedberg IM, Med 1972; 286(3): 124-129. Eisen AZ, Wolff K et al. Dermatology in 93 Etter L, Myers S. Pruritus in systemic General Medicine. 5th edn. New York: disease: mechanisms and management. McGraw-Hill, 1999: 752-768. Dermatol Clin 2002; (20): 459-472. 77 Unamuno P, Fernandez-Lopez E, Santos C 94 Kranjik M, Zylicz Z. Understanding pruritus Leukonychia due to cytostatic agents. Clin in systemic disease. J Pain Symptom Manage Exp Dermatol 1992; 17: 273-274. 2001; 21(2): 151-168. 78 Bianchi L, Iraci S, Tomassoli M, Carrozzo 95 Kremer AE, Beuers U, Oude Elferink RPJ, AM, Ninni G. Coexistence of apparent Pusl T. Pathogenesis and treatment of transverse leukonychia (Muehrcke’ lines pruritus in cholestasis. Drugs 2008; 68(15): type) and longitudinal melanonychia after 2163-2187. 5-fluorouraciladriamycincyclophosphamide 96 Kremer AE et al. Lysophosphatidic acid is a chemotherapy. Dermatology 1992; 185: potential mediator of cholestatic pruritus. 216-217. Gastroenterology 2010; 139: 1008. 79 Schwartz RA, Vickerman CE, Muehrcke’s 97 Fjellner B, Hagermark O. Pruritus in lines of the fingernails (abstract). Arch polycythaemia vera: treatment with aspirin Intern Med 1979; 139: 242. and possibility of platelet involvement. Acta 80 Adedji OA, McAdam WAE Murphy’ sign, Dermatovenerol 1979; 59: 505-512. acute cholecystitis and elderly people. J R 98 Albert HS, Warner RR, Wasserman LR. A Coll Surg Engl 1996; 28: 88-89. study of histamine in myeloproliferative 81 Singer AJ, McCracken G, Henry MC et al. disease. Blood 1966; 28: 796-806. Correlation of clinical laboratory and 99 Murphy M, Carmichael A. Renal itch, Clin hepatobiliary scanning findings in patients Exp Dermatol 2000; 25: 103-106. with suspected cholecystitis. Ann Emerg, 100 Botero E Pruritus as a manifestation of Med 1996; 28: 267-272. systemic disorders. Cutis 1978; 21: 873~ 82 Mills LD, Mills T, Foster B. Association of 880, clinical and laboratory variables with 101 Caravati C, Richardson D, Wood B et al ultrasound findings in right upper quadrant Cutaneous manifestations of abdominal pain. South Med J 2005; 98: hyperthyroidism. South Med J 1969; 62: 155-161 1127-1130. 504 Tham khảo 102 Lober CW. Should the patient with 116 Neiman RS, Orazi A. Disorders of the generalized pruritus be evaluated for Spleen. 2nd edn. Philadelphia: Saunders, malignancy? J Am Acad Dermatol 1988; 19: 1999, 350-352. 117 Pozo AL, Godfrey EM, Bowles KM. 103 Ruocco E, Sangiuliano S, Gravina AG, Splenomegaly: investigation, diagnosis and Miranda A, Nicoletti G. Pyoderma ‘management. Blood Rev 2009; 23(3): gangrenosum: an updated review. JEADV 105-111, 2009; 23: 1008-1017. 118 Stutte HJ, Heusermann U. Splenomegaly and 104 Van den Driesch P Pyoderma gangrenosum: red blood cell destruction: a morphometric a report of 44 cases with follow-up. Br J study on the human spleen. Virchows Arch Dermatol 1997, 137:1000-1005. Abt B Zellpath 1972; 12: 1-21. 105 Ruiz MA, Saab S, Rickman LS. The clinical 119 Pettit JE, Williams ED, Glass HI, Lewis SM, detection of scleral icterus: observations of Szur L, Wicks CJ. Studies of splenic function multiple examiners. Mil Med 1997; 162(8): in the myeloproliferative disorders and 560-563. generalised malignant lymphomas. Br J 106 Bohl L, Merlo C, Carda C, Gomez de Haematol 1971; 20: 575-586. Ferraris ME, Carranza M. Morphometric 120 Lewis SM, Catovsky D, Hows JM, Ardalan B. analysis of the parotid gland affected by Splenic red cell pooling in hairy cell alcoholic sialosis. J Oral Pathol Med 2008; leukaemia. Br J Haematol 1977; 35: 351- 37(8): 499-503. Epub 2008 Feb 19. 357. 107 Mandel L, Hamele-Bena D. Alcoholic parotid 121 Witte CL, Witte MH. Circulatory dynamics sialadenosis. J Am Dent Assoc 1997; of spleen. Lymphology 1983; 16: 60-71. 128(10): 1411-1415. 122 Zhang B, Lewis SM. The splenomegaly of 108 Mandel L, Vakkas J, Sagi A. Alcoholic (beer) myeloproliferative and lymphoproliferative sialosis. J Oral Maxillofac Surg 2005; 63(3): disorders: splenic cellularity and vascularity. 402-405. Eur J Haematol 1989; 43: 63-66. 109 Proctor GB, Shori DK. The effects of ethanol 123 Kogoj E Seitrag zur atiologie und on salivary glands. In: Preedy VR, Watson pathogenese der stria cutis distensae. Arch PR (eds). Alcohol and the Gastrointestinal Dermatol Syphilol 1925; 149: 667. Tract. Boca Raton: CRC Press; 1996: 124 Agache P, Ovide MT, Kienzler JL et al, 111-122 Mechanical factors in striae distensae. In 110 Chen P, Middlebrook MR, Goldman SM, Moretti G, Rebora A (eds). Striae Distensae. Sandler CM. Sister Mary Joseph nodule from Milan: Brocades, 1976: 87-96 metastatic renal cell carcinoma. J Comput 125 Osman H, Rubeiz N, Tamim H et al. Risk Assist Tomogr 1998; 22: 756. factors for the development of striae 111 Dubreuil A, Compmartin A, Barjot P, Louvet gravidarum. Am J Obstet Gynecol 2007; S, Leroy D. Umbilical metastasis or Sister 196; 62.€1-62.€5 Mary Joseph’s nodule. Int J Dermatol 1998; 126 Stevanovic DV. Corticosteroid induced 37:7. atrophy of the skin with telangiectasia: a 112 Khasnis A, Gokula RM. Spider nevus. J clinical and experimental study. Br J Postgrad Med 2002; 48(4): 307-309. Dermatol 1972; 87: 548-556. 113 Li CP, Lee FY, Hwang SJ et al. Role of 127 Gery 1, Chan CC. Chapter 7.2: Mechanisms substance P in the pathogenesis of spider of uveitis. In: Yanoff M, Duker JS (eds) angiomas in patients with nonalcoholic liver Ophthalmology. 3rd edn. St Louis: Mosby, cirthosis. Am J Gastroenterol 1999; 94: 2008. 502-507. 128 Singleton EM, Hutson SE. Anterior uveitis, 114 Pirovino M, Linder R, Boss C, Kochli HP, inflammatory bowel disease, and ankylosing Mahler E Cutaneous spider nevi in liver spondylitis in a HLA-B27-positive woman. cirrhosis: capillary microscopical and South Med J 2006; 99 (5): 531-533. hormonal investigations. Klin Wochenschr 129 Orchard TR, Chua CN, Ahmad T, Cheng H, 1988; 66: 298-302. Welsh KI, Jewell DP. Uveitis and erythema 115 Romagnuolo J, Jhangri GS, Jewall LD, Bain nodosum in inflammatory bowel disease: VG. Predicting the liver histology in chronic clinical features and the role of HLA hepatitis C: how good is the clinician? Am J genes. Gastroenterology 2002; 123(3): Gastroenterol 2001; 96: 3165-3174. 714-718.