Nemoci imunitn\u00edho syst\u00e9mu jsou u lid\u00ed i zv\u00ed\u0159at jednou z nej\u010dast\u011bj\u0161\u00edch p\u0159\u00ed\u010din onemocn\u011bn\u00ed. Vedle alergick\u00fdch reakc\u00ed k nim rovn\u011b\u017e pat\u0159\u00ed velmi \u010dast\u00e9 autoimunitn\u00ed nemoci. Jsou to choroby imunitn\u00edho syst\u00e9mu, p\u0159i kter\u00fdch jsou imunitn\u00ed reakce organismu zam\u011b\u0159eny proti vlastn\u00edm tk\u00e1n\u00edm a org\u00e1n\u016fm. Za n\u011bkter\u00fdch okolnost\u00ed jsou autoimunitn\u00ed reakce fyziologick\u00e9. Jde nap\u0159\u00edklad o rozpozn\u00e1n\u00ed a odstran\u011bn\u00ed bun\u011bk napaden\u00fdch viry, bakteriemi nebo parazity, bun\u011bk n\u00e1dorov\u011b zm\u011bn\u011bn\u00fdch nebo p\u0159est\u00e1rl\u00fdch. Probl\u00e9m nast\u00e1v\u00e1, pokud dojde k zam\u011b\u0159en\u00ed imunity proti bu\u0148k\u00e1m zdrav\u00fdm. (K tomu m\u016f\u017ee doj\u00edt nap\u0159\u00edklad p\u0159i zm\u011bn\u011b bun\u011b\u010dn\u00fdch antigen\u016f nebo p\u0159i ztr\u00e1t\u011b regula\u010dn\u00edch mechanism\u016f p\u0159i tvorb\u011b protil\u00e1tek.)
\nAutoimunitn\u00ed onemocn\u011bn\u00ed m\u016f\u017eeme rozd\u011blit na ta, kter\u00e1 postihuj\u00ed pouze jeden org\u00e1n nebo tk\u00e1\u0148 (org\u00e1nov\u011b specifick\u00e1 onemocn\u011bn\u00ed) a na ta, kter\u00e1 postihuj\u00ed \u0161irokou \u0161k\u00e1lu org\u00e1n\u016f a tk\u00e1n\u00ed (celkov\u00e1 onemocn\u011bn\u00ed). Jedn\u00edm z org\u00e1nov\u011b specifick\u00fdch onemocn\u011bn\u00ed u ps\u016f jsou nap\u0159\u00edklad autoimunitn\u00ed onemocn\u011bn\u00ed \u017el\u00e1z s vnit\u0159n\u00ed sekrec\u00ed, projevuj\u00edc\u00ed se sn\u00ed\u017eenou tvorbou ur\u010dit\u00fdch hormon\u016f. Pat\u0159\u00ed sem zejm\u00e9na autoimunitn\u00ed z\u00e1n\u011bt \u0161t\u00edtn\u00e9 \u017el\u00e1zy nebo diabetes mellitus (cukrovka). D\u00e1le se setk\u00e1v\u00e1me s autoimunitn\u00edmi z\u00e1n\u011bty nervov\u00e9 tk\u00e1n\u011b. U n\u011bkter\u00fdch loveck\u00fdch plemen ps\u016f m\u016f\u017eeme pozorovat symetrick\u00e9 ochrnut\u00ed kon\u010detin. (Poprv\u00e9 se toto onemocn\u011bn\u00ed objevilo u coonhaund\u016f po pokous\u00e1n\u00ed \u010di \u0161kr\u00e1bnut\u00ed m\u00fdvalem.) V d\u0159\u00edv\u011bj\u0161\u00ed dob\u011b se ojedin\u011ble vyskytoval i z\u00e1n\u011bt mozkov\u00e9 tk\u00e1n\u011b po aplikaci star\u00fdch typ\u016f vakc\u00edn proti vzteklin\u011b.
\nV\u00fdznamnou skupinu tvo\u0159\u00ed autoimunitn\u00ed onemocn\u011bn\u00ed k\u016f\u017ee. Jde o n\u011bkolik typ\u016f ko\u017en\u00edch zm\u011bn ozna\u010dovan\u00fdch jako tzv. pemphigus. U t\u011bchto onemocn\u011bn\u00ed vznikaj\u00ed puch\u00fd\u0159e nej\u010dast\u011bji v okol\u00ed p\u0159echodu sliznice v k\u016f\u017ei (pysky, \u010denich, o\u010dn\u00ed v\u00ed\u010dka, u\u0161i). Tyto puch\u00fd\u0159e snadno praskaj\u00ed a zanech\u00e1vaj\u00ed po sob\u011b obna\u017een\u00e9 mokvav\u00e9 plochy a bol\u00e1ky.
\nVelmi z\u00e1va\u017enou a p\u0159itom pom\u011brn\u011b \u010dastou nemoc\u00ed u ps\u016f je tzv. autoimunitn\u00ed hemolytick\u00e1 an\u00e9mie. P\u0159i t\u00e9to nemoci doch\u00e1z\u00ed k tvorb\u011b protil\u00e1tek proti vlastn\u00edm \u010derven\u00fdm krvink\u00e1m (erytrocyt\u016fm). N\u00e1sledkem nav\u00e1z\u00e1n\u00ed protil\u00e1tek na povrch erytrocyt\u016f je bu\u010f jejich rozpad (hemol\u00fdza) p\u0159\u00edmo v c\u00e9v\u00e1ch, nebo jejich zv\u00fd\u0161en\u00e9 odbour\u00e1v\u00e1n\u00ed ve slezin\u011b \u010di j\u00e1trech. Podobn\u00fdm onemocn\u011bn\u00edm je i tzv. autoimunitn\u00ed trombocytopenie, p\u0159i kter\u00e9 se tvo\u0159\u00ed protil\u00e1tky proti krevn\u00edm desti\u010dk\u00e1m (trombocyt\u016fm). N\u00e1sledkem tohoto onemocn\u011bn\u00ed je v\u00fdskyt drobn\u00fdch krv\u00e1cenin na k\u016f\u017ei, d\u00e1sn\u00edch a spojivk\u00e1ch, \u010dast\u00e9 b\u00fdv\u00e1 krv\u00e1cen\u00ed z nosu, a m\u016f\u017ee se objevit krev v mo\u010di nebo ve stolici.
\nZ org\u00e1nov\u011b specifick\u00fdch onemocn\u011bn\u00ed d\u00e1le m\u016f\u017eeme jmenovat Sj\u00f6gren\u016fv syndrom, p\u0159i kter\u00e9m se u ps\u016f vyv\u00edj\u00ed autoimunita proti slzn\u00fdm a slinn\u00fdm \u017el\u00e1z\u00e1m. Myasthenia gravis je autoimunitn\u00ed choroba zp\u016fsoben\u00e1 po\u0161kozen\u00edm nervosvalov\u00e9 plot\u00e9nky, projevuj\u00edc\u00ed se abnorm\u00e1ln\u00ed \u00fanavou a slabost\u00ed kostern\u00ed svaloviny. Nejen u lid\u00ed, ale i u ps\u016f se vyskytuje tzv. revmatoidn\u00ed artritida (z\u00e1n\u011bt kloub\u016f), zp\u016fsoben\u00e1 ukl\u00e1d\u00e1n\u00edm komplex\u016f protil\u00e1tek v kloubech. Ukl\u00e1d\u00e1n\u00edm imunitn\u00edch komplex\u016f v ledvin\u00e1ch m\u016f\u017ee tak\u00e9 vzniknout autoimunitn\u00ed z\u00e1n\u011bt ledvin .
\nCelkov\u00e9 autoimunitn\u00ed onemocn\u011bn\u00ed, postihuj\u00edc\u00ed \u0159adu org\u00e1nov\u00fdch syst\u00e9m\u016f sou\u010dasn\u011b, se naz\u00fdv\u00e1 syst\u00e9mov\u00fd lupus erytematosus (SLE). Nejcharakteristi\u010dt\u011bj\u0161\u00ed je pro n\u011bj kombinace z\u00e1n\u011btu kloub\u016f, z\u00e1n\u011btu ledvin a ko\u017en\u00edch zm\u011bn. B\u00fdv\u00e1 \u010dasto doprov\u00e1zen hore\u010dkou a chudokrevnost\u00ed. Diagnostika a l\u00e9\u010dba tohoto onemocn\u011bn\u00ed nen\u00ed jednoduch\u00e1, proto\u017ee m\u016f\u017ee b\u00fdt snadno zam\u011bn\u011bno za nejr\u016fzn\u011bj\u0161\u00ed jin\u00e9 choroby.
\nNyn\u00ed se podrobn\u011bji vr\u00e1t\u00edme k z\u00e1va\u017en\u00e9mu onemocn\u011bn\u00ed ps\u016f, kter\u00fdm je autoimunitn\u00ed hemolytick\u00e1 an\u00e9mie (AIHA). Je to nej\u010dast\u011bj\u0161\u00ed p\u0159\u00ed\u010dina chudokrevnosti ps\u016f, zp\u016fsoben\u00e1 rozpadem \u010derven\u00fdch krvinek. Dal\u0161\u00edmi p\u0159\u00ed\u010dinami rozpadu erytrocyt\u016f mohou b\u00fdt krevn\u00ed parazit\u00e9, nap\u0159\u00edklad babesi\u00f3za (obdoba lidsk\u00e9 mal\u00e1rie, vyskytuj\u00edc\u00ed se u ps\u016f v ji\u017en\u00ed Evrop\u011b, ale ojedin\u011ble i u n\u00e1s na B\u0159eclavsku). P\u0159i diagnostice je pot\u0159eba vylou\u010dit tak\u00e9 n\u011bkter\u00e9 otravy (nap\u0159\u00edklad zinek, paracetamol, n\u011bkter\u00e1 antibiotika), metabolick\u00e9 poruchy (nap\u0159\u00edklad p\u0159i cukrovce) nebo n\u00e1dory kr\u00e9vn\u00edch c\u00e9v.
\nPacienti s autoimunitn\u00ed hemolytickou an\u00e9mi\u00ed se vyzna\u010duj\u00ed velmi rychl\u00fdm n\u00e1stupem apatie a slabosti, bledost\u00ed sliznic, n\u011bkdy sou\u010dasn\u011b se \u017elut\u00fdm n\u00e1dechem zp\u016fsoben\u00fdm rozlo\u017een\u00fdm krevn\u00edm barvivem. N\u011bkdy m\u016f\u017eeme zjistit zv\u011bt\u0161en\u00ed sleziny, srde\u010dn\u00ed \u0161elesty, pop\u0159. zvracen\u00ed a bolest b\u0159icha. P\u0159i sou\u010dasn\u00e9m poklesu krevn\u00edch desti\u010dek pozorujeme tak\u00e9 drobn\u00e9 krv\u00e1ceniny na sliznic\u00edch a v podko\u017e\u00ed. P\u0159i k\u00e1pnut\u00ed krve na skl\u00ed\u010dko m\u016f\u017eeme pozorovat tvorbu drobn\u00fdch shluk\u016f \u010derven\u00fdch krvinek (tzv. autoaglutinace). P\u0159i AIHA lze nal\u00e9zt tak\u00e9 n\u011bkter\u00e9 mikroskopick\u00e9 zm\u011bny ve tvaru a slo\u017een\u00ed erytrocyt\u016f. Diagn\u00f3zu potvrzujeme specifick\u00fdm krevn\u00edm testem (tzv. Coombs\u016fv test).
\nL\u00e9\u010dba se prov\u00e1d\u00ed vysok\u00fdmi d\u00e1vkami tzv. kortikosteroid\u016f, co\u017e jsou l\u00e9ky potla\u010duj\u00edc\u00ed imunitn\u00ed reakce. U velk\u00e9ho procenta ps\u016f l\u00e9\u010den\u00fdch kostikosteroidy dojde do 24 a\u017e 96 hodin k v\u00fdrazn\u00e9mu zlep\u0161en\u00ed. U ps\u016f nereaguj\u00edc\u00edch na \u00favodn\u00ed l\u00e9\u010dbu lze pou\u017e\u00edt tak\u00e9 cytostatika. U n\u011bkter\u00fdch pacient\u016f mus\u00edme pou\u017e\u00edt i masivn\u00ed infuzn\u00ed l\u00e9\u010dbu nebo krevn\u00ed transfuzi. U pacient\u016f s AIHA v\u0161ak bez sou\u010dasn\u00e9 dal\u0161\u00ed l\u00e9\u010dby velmi rychle doch\u00e1z\u00ed k rozpadu erytrocyt\u016f darovan\u00e9 krve. Po intenzivn\u00ed \u00favodn\u00ed l\u00e9\u010db\u011b n\u00e1sleduje dlouhodob\u00e1 udr\u017eovac\u00ed terapie. B\u011bhem t\u00e9to doby se sna\u017e\u00edme postupn\u011b sni\u017eovat d\u00e1vky l\u00e9k\u016f za sou\u010dasn\u00e9ho sledov\u00e1n\u00ed zdravotn\u00edho stavu pacienta. U n\u011bkter\u00fdch ps\u016f lze l\u00e9ky po ur\u010dit\u00e9 dob\u011b \u00fapln\u011b vysadit, ale v\u00edce ne\u017e dv\u011b t\u0159etiny ps\u016f s AIHA vy\u017eaduj\u00ed do\u017eivotn\u00ed l\u00e9\u010dbu.
\nProgn\u00f3za autoimunitn\u00ed hemolytick\u00e9 an\u00e9mie u ps\u016f z\u00e1vis\u00ed na mnoha faktorech. Nejd\u016fle\u017eit\u011bj\u0161\u00edm krit\u00e9riem je rychlost n\u00e1stupu a pr\u016fb\u011bh onemocn\u011bn\u00ed, a s t\u00edm souvisej\u00edc\u00ed v\u010dasnost jeho rozpozn\u00e1n\u00ed a zah\u00e1jen\u00ed l\u00e9\u010dby. Mnoho ps\u016f uhyne velmi rychle od objeven\u00ed prvn\u00edch klinick\u00fdch p\u0159\u00edznak\u016f. \u0158adu ps\u016f se v\u0161ak da\u0159\u00ed zachr\u00e1nit spr\u00e1vn\u011b nasazenou l\u00e9\u010dbou.<\/p>\n
MVDr. Martin \u0160ando<\/p>\n","protected":false},"excerpt":{"rendered":"
Nemoci imunitn\u00edho syst\u00e9mu jsou u lid\u00ed i zv\u00ed\u0159at jednou z nej\u010dast\u011bj\u0161\u00edch p\u0159\u00ed\u010din onemocn\u011bn\u00ed. Vedle alergick\u00fdch reakc\u00ed k nim rovn\u011b\u017e pat\u0159\u00ed velmi \u010dast\u00e9 autoimunitn\u00ed nemoci. Jsou to choroby imunitn\u00edho syst\u00e9mu, p\u0159i kter\u00fdch jsou imunitn\u00ed reakce organismu zam\u011b\u0159eny proti vlastn\u00edm tk\u00e1n\u00edm a org\u00e1n\u016fm. Za n\u011bkter\u00fdch okolnost\u00ed jsou autoimunitn\u00ed reakce fyziologick\u00e9. Jde nap\u0159\u00edklad o rozpozn\u00e1n\u00ed a odstran\u011bn\u00ed bun\u011bk
+ Read More<\/a><\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"ngg_post_thumbnail":0},"categories":[4],"tags":[],"_links":{"self":[{"href":"http:\/\/www.veterina-holesov.cz\/index.php?rest_route=\/wp\/v2\/posts\/8"}],"collection":[{"href":"http:\/\/www.veterina-holesov.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/www.veterina-holesov.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/www.veterina-holesov.cz\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"http:\/\/www.veterina-holesov.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=8"}],"version-history":[{"count":0,"href":"http:\/\/www.veterina-holesov.cz\/index.php?rest_route=\/wp\/v2\/posts\/8\/revisions"}],"wp:attachment":[{"href":"http:\/\/www.veterina-holesov.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=8"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/www.veterina-holesov.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=8"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/www.veterina-holesov.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=8"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}