collagen - immunopathological process is accompanied by the development of degenerative diseases, mainly affecting the connective tissue, characterized by progressive course and a wide range of clinical manifestations.
diagnosis collagenosis flowing in any clinical types, usually require clinical thinking on the part of the treating specialist and a sufficient level of equipment of medical institutions.The complex of diagnostic measures based on the use of various types of laboratory techniques, however, absolute certainty in this situation has a needle biopsy followed by histological and cytological analysis of punctate.
In the treatment of collagenosis, the principle of individual approach, continuity and appropriateness of the appointment of a component of drug therapy.All clinical types of collagenosis united by a common pathologic and etiopathogenetic mechanisms of its development.
connective tissue structure in more or less a proportion of part of all organs and structures
large group of connective tissue are so-called genetically determinate variations, which are caused by congenital disorders in the structure of collagen and related systemic metabolic disorders.As evidence of the priority role of hereditary factors in the development of connective tissue disease indicates the fact of registration of diffuse systemic disease in representatives who have first-degree kinship.
In establishing the conclusion of "acquired collagen" is practically impossible to determine the causative factor for its occurrence, and therefore, the majority of experts in the field reject the theory of acquired origin of this disease.However, there are many factors that are provocateurs debut clinical manifestations of congenital connective tissue disease, which include: adverse effects of environmental factors, infection of the body and hormonal imbalance status.
currently under huge number of randomized trials confirming the correlation of collagenosis infectious and viral agents.
provoking factor in the development of debut collagenosis is a violation of hormonal regulation, which occurs during pregnancy, puberty and menopause in women.Trigger mechanism, provokes manifestations collagenosis is excessive psycho-emotional stress, and collagen in children can develop even after vaccination.
With all the clinical and pathogenetic variants collagenosis mechanism of pathological changes in the structure of connective tissue takes place on the same principle and is gradually changing immunoproliferative changes.Under the influence of provoking factors, or triggers a bacterial-infectious sensitization is started the formation of pathogenic immune complexes deposited on the membranes of the vascular walls and serous membranes, which develops nonspecific allergic inflammation.These processes entail the development and autoallergens autosensibilization to the tissues of its own body, which is accompanied by violation immunogenesis cellular and humoral type and overproduction of antibodies to the cellular structure of collagen, vascular endothelial and muscle fibers.
result distortions of immune mechanisms, as well as existing inflammatory changes is pathological disorganization of the connective tissue, which flows slowly in the form of a change of pathological processes (mucoid swelling, fibrinoid necrosis type cell proliferation and sclerosis).
various pathological variants are accompanied by connective tissue disease patterns of a particular location in the greater or lesser extent.For example, nodular periarteritis more characteristic lesion of the connective tissue of blood vessels, and in scleroderma marked predominant involvement of connective tissue localization in the internal organs and subcutaneous fat.The most wide spectrum of lesions has systemic lupus erythematosus, which is an undifferentiated connective tissue.
etiopathogenetic classification is based on the principle of origin of connective tissue degenerative connective tissue.Accordingly, isolated congenital and acquired form of the disease.Innate degenerative connective tissue disease are rare and their diagnosis is extremely difficult (mucopolysaccharidosis, elastic pseudoxanthoma, Marfan syndrome and others).
Acquired collagen presents a wide range of variants of the pathology, and therefore the international classification divides them into "large collagen" in the form of dermatomyositis, systemic lupus erythematosus, periarteritis nodosa, and scleroderma, severe and differing nedeferrentsiruemym approach to the defeat of the connective tissue.Other forms of collagenosis are "small", which are characterized by a latent within and no serious complications.
most severe in relation to the prognosis for the patient's health option collagenosis is a mixed connective tissue disease, which combines the pathogenesis and clinical features of the various forms of diffuse connective tissue disorders.
Each of the variants pathological tissue disease characterized by specificity of clinical manifestations, but there are common features characteristic of all forms of this disease (intermmitiruyuschee for mandatory presence of periods of relapse and remission while the full progression of pathological changes).
period of exacerbation, usually accompanied by an active febrile syndrome, which is characterized by a significant increase in body temperature above 38 ° C, with episodes of fever and profuse sweating.The main "companion" fever when collagen is asthenia syndrome, manifestations of which is nemotiviruemaya progressive weakness, inability to perform usual physical activity and depressed mood.
characteristic manifestations of connective tissue disease, allowing an experienced suspect the presence of this disease in the patient is symptom-muscle-joint lesions in the form of various localization progressive myalgia, aching pain in the joints with a concomitant violation of their motor function.In some situations, musculo-articular syndrome combined with lesions of the skin with the formation of non-specific lesions in the form of subcutaneous nodules, erythema and petechiae.
Due to the fact that the connective tissue is present in the development of all internal organs, collagen inevitably progresses defeat these structures to the development of degenerative irreversible changes (cardiosclerosis, myocardial, pulmonary fibrosis, renal amyloidosis with chronic renal failure).Non-specific symptoms of collagenosis is a defeat of the gastrointestinal tract pretend for other diseases in the form of functional dyspepsia, gastrointestinal bleeding and abdominal pain.Periods of exacerbations are usually stimulated by the presence of infectious diseases, excessive sun exposure, hypothermia or exposure to stress factors.
Unfortunately, most of the clinical criteria collagenosis no different specificity, so the presence of symptoms and complaints of the patient is not a determinant factor in establishing a definite diagnosis.In this situation, a good tool is a laboratory diagnostic manipulations, allowing to identify the specific and nonspecific markers collagenosis.
nonspecific inflammatory criteria is the detection of elevated levels in the blood globulin fraction of protein, erythrocyte sedimentation rate and C-reactive protein, the discovery of which has not determined the exact form of histopathology collagenosis, but the evidence in favor of changes in diffuse connective tissue inflammatory genesis.To determine the pathogenic variant collagenosis currently applies a range of laboratory techniques, but 100% certainty has only a histological analysis of punctate withdrawn from the affected area.
After the definite diagnosis "collagen" flowing in a particular histological variant, the initial task of the physician is to the patient's belief in the need for lifelong treatment with a whole range of therapeutic and preventive measures.The patient should follow the rules of work and supply with periods of compulsory avoidance of excessive hypothermia or giperinsolyatsii, which are the main provocateurs exacerbation collagenosis.
When first detected in a patient signs of any option collagenosis is a prerequisite hospitalization rheumatological Profile in order to select individual schemes medication.After the relief of acute symptoms of the disease the patient is being treated on an outpatient basis, and with the advent of complete remission necessarily need to continue rehabilitation therapy in the sanatorium specific profile.
Drug treatment is only part of the complex therapy of connective tissue disease, and applying it occurs most often in the period of activity of the inflammatory process.In various embodiments, the pathological connective tissue developed individual methods and correction of anti-drug scheme.The drugs of choice with a high efficiency of evidence is a group of nonsteroidal antiinflammatory drugs (brufen maximum daily dose of 2.4 g).
In a situation where the patient has symptoms of high activity, rapid progression of pathological changes and clinical manifestations, severe visceral failure, a necessary condition is the appointment of an adequate scheme of glucocorticosteroid therapy (prednisolone at a maximum daily dose of 15 mg).And only in the case of adverse reactions in response to receiving corticosteroids acceptable purpose cytostatic therapy (cyclophosphamide in a daily dose of 0.1 grams, Azathioprine maximum dose of 5 mg).
Episodes systemic sclerosis and rheumatoid arthritis respond well to treatment with D-penicillamine in a daily dose rate of 250 mg for at least two months, followed by gradual titration to a level of 750 mg (every 30 days in the 250 mg dose is increased).
good performance in terms of relief of acute clinical manifestations collagenosis have extracorporeal blood correction methods as plasmapheresis, and hemosorption cascade plasma filtration.
Rehabilitation complex of measures consists of applying various kinds of physiotherapy techniques as iontophoresis, phonophoresis, magnetic therapy in sanatorium specific profile.As a preventive treatment of collagenosis considered rehabilitation of chronic foci of infection.