Ato ho da sɛ woate saa protein ahorow a ɛyɛ nwonwa yi ho asɛm wɔ wo mogya mu? (Cryoglobulinemia) Ma yɛnka ho asɛm!

Ɛtɔ da bi a yɛn nipadua no yɛ nneɛma a yɛnhwɛ kwan, ɛnte saa? Ɛnnɛ yɛrebɛka tebea bi a ɛyɛ nwonwa kakra, nanso ɛho hia paa sɛ yehu ho asɛm. Wɔfrɛ eyi Cryoglobulinemia. Edin no bɛyɛ te sɛ nea ɛyɛ den kakra, nanso nsuro, yɛbɛkyerɛkyerɛ mu nyinaa wɔ kwan a ɛyɛ mmerɛw so.

Dɛn ne Cryoglobulinemia? (Mmerɛw so nkyerɛkyerɛmu)

Sɛ yɛbɛka no mmerɛw a, Cryoglobulinemia yɛ tebea bi a protein ahorow bi a ɛnyɛ nea ɛtaa ba a wɔfrɛ no Cryoglobulins no, wɔn ho kyere wɔn, na ɛyɛ den wɔ wo mogya mu bere a awɔw wɔ hɔ no. Fa no sɛ, sɛ wode ngo gu nsu a ayɛ nwini mu a, ɛyɛ den no, saa pɛpɛɛpɛ na eyi nso te. Nanso, eyi si wɔ yɛn mogya ntini mu.

Saa tebea yi, wɔ nokware mu no, ɛyɛ Vasculitis bi. Vasculitis kyerɛ sɛ wo mogya ntini ahorow no ahon (inflammation). Sɛ mogya ntini ahorow no ahon a, ɛtumi siw mogya a ɛrekɔ nipadua no afã afã no kwan. Dɛn na ebetumi asi? Ebetumi asɛe wo honam ani, wo ntini, wo nnompe ntam, wo nam, ne nea ɛho hia paa ne wo nipadua mu akwaa te sɛ wo saayowa (kidneys). Ɛtɔ da bi a wɔfrɛ eyi Cryoglobulinemic Vasculitis.

Cryoglobulinemia ahorow wɔ hɔ anaa?

Yiw, saa Cryoglobulins a yɛreka ho asɛm yi yɛ Antibodies (nipaduam nkwammoaa a ɛko tia nyarewa) ahorow bi. Egyina antibodies a nipadua no yɛ so no, yebetumi akyekyɛ Cryoglobulinemia mu atitiriw abiɛsa:

• Type I Cryoglobulinemia: Eyi taa fa mogya mu kokoram anaa nipaduam nkwammoaa ho kokoram ahorow bi ho. Ɛnyɛ nea ɛtaa si mprɛn pii, nanso ɛyɛ asɛm a ɛsɛ sɛ yɛde aniberɛ hwɛ.
• Type II ne Type III Cryoglobulinemia: Eyi na ɛtaa si na etumi fa nyarewa a ahon dedaw ho. Sɛ nhwɛso no, nnipa a wɔwɔ Autoimmune diseases (nyarewa a nipadua no ara ko tia ne ho) no, eyi tumi bɔ wɔn. Nea ɛho hia paa ne sɛ, Type II Cryoglobulinemia no taa ne Hepatitis C virus (HCV) a aba nnipa mu no wɔ abusuabɔ. Wɔtaa bom frɛ Type II ne Type III yi Mixed Cryoglobulinemia.

Saa tebea yi taa si anaa?

Nokwasɛm ne sɛ, Cryoglobulinemia yɛ yare a ɛntaa nsi. Nanso, ahwehwɛfo ntumi nka nipadɔm pɔtee a wɔwɔ yare yi, efisɛ nnipa bi wɔ Cryoglobulins no kakraa bi wɔ wɔn mogya mu a enyi yare no ho sɛnkyerɛnne biara nkyerɛ. Wobu akontaa sɛ, nnipa ɔpepem biara mu no, onipa biako pɛ na ebetumi anya saa tebea yi wɔ wiase nyinaa.

Dɛn ne sɛnkyerɛnne ahorow no? Ɛba obiara so anaa?

Dabi, ɛnyɛ obiara a ɔwɔ Cryoglobulinemia na enya sɛnkyerɛnne no. Nnipa bi nte nka biara. Nanso sɛ sɛnkyerɛnne no fi ase ba a, nea wɔtaa hu paa ne nea wɔfrɛ no Purpura. Eyi yɛ honam ani a ɛyɛ kɔkɔɔ anaa purple (te sɛ nea abɔ hɔ) wɔ anan a ase fam. Ɛka ho ne brɛ a wonnya ho kwan, ne nnompe ntam yaw (joint pains).

Sɛnkyerɛnne foforo nso betumi aba. Ebi ne:

• Nsa ne nan mu mogya ntini a ɛyɛ teateaa na ɛdan bruu wɔ awɔw mu. Wɔfrɛ eyi Raynaud's phenomenon. Ɛyɛ yare yi mu nsɛnkyerɛnne a ɛyɛ nwonwa paa.
• Nipadua mu duru a ɛso tew.
• Mogya mmoroso (Hypertension).
• Anan nnompe (ankles) ne anan a ehon (Edema).
• Honam ani akuru (ulcers) a etumi kɔfa nam a awu (Gangrene) ba.
• Brɛbo (Liver) a ɛyɛ kɛse (Hepatomegaly) anaa Splenomegaly (spleen a ɛyɛ kɛse).
• Nsa ne nan a etutu obi, awow, anaa mmerɛwyɛ.
• Saayowa (Kidneys) a asɛe. Eyi yɛ asiane a emu yɛ den paa.

Mma no nyɛ wo sɛ awɔw nti na wo nsa anaa wo nan adan bruu kɛkɛ. Eyi betumi akyerɛ ɔhaw kɛse bi a ɛrekɔ so wɔ wo nipadua no mu. Enti ɛho hia sɛ wode w'adwene si nneɛma a ɛte saa so.

Dɛn na ɛde Cryoglobulinemia ba?

Adɔkotafo ne ahwehwɛfo nnya nhui nea ɛde Cryoglobulinemia ba tẽẽ. Nanso yɛaka sɛ ɛyɛ Vasculitis, kyerɛ sɛ mogya ntini a ahon, a ɛyɛ Autoimmune disease (nipaduam nkwammoaa a ɛko tia ne ho). Nea ɛkyerɛ ne sɛ, nipadua no ankasa immune system (akoa a ɔko bɔ wo ho ban fi nyarewa ho no) na ɔfom tu ahyɛ wo nipadua nkwammoaa pa no so. Nneɛma a ebetumi aka ho na aba no bi ne:

• Abusua mu awosu (Genetics): Sɛ ebi wɔ w'abusua mu a.
• Nnuruyɛ ahorow bi: Ɛnyɛ nnuru nyinaa, nanso ebi betumi aka ho.
• Nkwammoaa bɔne (Infections) ne mmoawa (Viruses): Titiriw virus ahorow bi a etumi asɛe nipadua no ho banbɔ.
• Atwa yɛn ho ahyia tebea: Nneɛma bi a yɛn nipadua no de hyia wɔ afã biara.

Cryoglobulinemia betumi asɔre a enni ntease pɔtee biara (wɔfrɛ no Idiopathic), nanso wɔtaa hu no sɛ ɛne nyarewa foforo na ɛkɔ. Nyarewa no bi ne:

• Hepatitis C yare no: Eyi na ɛtaa wɔ abusuabɔ kɛse paa.
• Mogya mu nkwammoaa mu haw ahorow: Sɛ nhwɛso no, Lymphoma ne Multiple Myeloma a ɛyɛ kokoram ahorow bi.
• Connective tissue diseases: Nea wɔfrɛ no Lupus no yɛ nhwɛso kɛse.

Hena na onyaa asiane yi kɛse?

Wɔahu sɛ Cryoglobulinemia taa ka mmea sen mmarima. Afei nso, nnipa a wɔadi mfe 50 ne nea ɛboro saa no na wotaa hu yare yi wɔ wɔn mu.

Sɛ woannya ayaresa a, ebetumi de ɔhaw ahorow aba anaa?

Yiw, ampa. Sɛ woannya ayaresa pa amma Cryoglobulinemia a, ebetumi asɛe wo honam ani, wo nam ne wo nipadua mu akwaa ahorow ma ayɛ asɛe a wontumi nsa. Ɔhaw akɛse a ebetumi aba no bi ne:

• Honam ani nyarewa anaa akuru a enwu.
• Honam ani nam a ewuwu (Necrosis).
• Saayowa (Kidneys) a etumi gyae adwumayɛ (Kidney failure).
• Brɛbo (Liver) a etumi gyae adwumayɛ (Liver failure).

Eyi yɛ tebea ahorow a asiane wom paa. Eyi nti na ɛho hia sɛ wohu yare no ntɛm na woanya ayaresa no.

Ɔkwan bɛn so na adɔkotafo hu yare yi?

Sɛ wokɔ dɔkota hɔ a, obebisa wo wo yare ho abakɔsɛm, na w'ayɛ wo nipadua ho nhwehwɛmu (physical examination). Ɛno akyi no, ɔbɛkyerɛ sɛ wɔnyɛ wo mogya mu nhwehwɛmu soronko bi na wɔahu sɛ Cryoglobulins wɔ mu anaa. Saa mogya mu nhwehwɛmu yi bɛkyerɛ Cryoglobulinemia pɔtee a wowɔ no. Ebetumi aboa ama wɔahu nea ɛde yare no bae, ne kwan a wɔbɛfa so asa wo yare no.

Wɔ mogya mu nhwehwɛmu yi akyi no, dɔkota no betumi aka sɛ wɔnyɛ nhwehwɛmu foforo bi na wɔde ahyɛ mu den na wɔate tebea no ase:

• Dwensɔ (Urinalysis) nhwehwɛmu.
• Koko mu X-ray (Chest X-ray).
• CT scan a ɛfa nipadua no ho.
• Angiogram (nhwehwɛmu a wɔyɛ de hwɛ mogya ntini mu).
• MRA (magnetic resonance angiogram) anaa CT angiogram nhwehwɛmu ahorow.
• Nerve conduction test (ntini mu nhwehwɛmu).
• Electromyography (EMG) nhwehwɛmu (nea ɛhwɛ ntini a ɛwɔ nam mu no adwumayɛ).
• Biopsy nhwehwɛmu (ɛtɔ da bi a wɔtwa nam kakra anaa saayowa nam de yɛ nhwehwɛmu).

Wɔsa yare yi dɛn?

Kwan a wɔfa so sa Cryoglobulinemia no gyina akwaa bɛn na asɛe, ɛkɔ akyiri dɛn, ne sɛ wowɔ nyarewa foforo bi anaa so. Sɛ wɔresa Cryoglobulinemia no a, ɛho hia paa sɛ wɔsa nyarewa foforo a ɛne no wɔ abusuabɔ (te sɛ Hepatitis C) no nso. Efisɛ, sɛ wɔsa saa nyarewa foforo no a, ɛma Cryoglobulinemia sɛnkyerɛnne no brɛ ase.

Sɛ sɛnkyerɛnne no nyɛ den a, na ɛyɛ mmerɛw a, dɔkota no betumi akyerɛ wo aduru a wobɛtɔ wɔ pharmacy (te sɛ NSAIDs) de adwudwo yaw no, na ɔbɛka akyerɛ wo sɛ ntwe wo ho mfi awɔw tebea mu. Ɛno akyi no, ɔbɛka sɛ bɛyɛ nhwehwɛmu wɔ akyiri yi, sɛnea wobetumi ahwɛ yare no tebea kwan.

Sɛ yare no aso mu anaa emu ayɛ den a, ayaresa akwan no betumi asesa:

• Nnuru a ɛbrɛ nipadua ho banbɔ ase (Immunosuppressive drugs): Eyi ne ayaresa kwan titiriw no. Wɔde Corticosteroids te sɛ Prednisone ne nnuru foforo fra mu ma. Ɛgyina akwaa a asɛe ne asɛe no kɛseyɛ so.
• Antiviral medications (nnuru a ɛko tia mmoawa): Sɛ w'adɔkota no hu sɛ wowɔ Hepatitis C anaa yare foforo bi a, obetumi akyerɛ wo nnuru a ɛko tia mmoawa no. Ɛbɛyɛ a obetumi de wo akɔma dɔkota a ɔhwɛ brɛbo (Hepatologist) so.
• Biologics: Rituximab yɛ biologic aduru a wɔtaa de di dwuma wɔ Cryoglobulinemia ayaresa mu. Biologics yi yɛ protein ahorow a wɔyɛ no wɔ ɔkwan a ɛyɛ den so a egyina nipadua mu nneɛma so. Wɔde boaboa nipadua no immune system fã bi so na adwudwo ntini no ahon (inflammation) no.
• Plasmapheresis: Eyi yɛ ayaresa kwan foforo. Ɛno na ɛtew Cryoglobulins a ɛwɔ wo mogya mu no so. Wɔ nhyehyɛe yi mu no, wɔyi Cryoglobulins no fi wo plasma (mogya mu nsu no) mu. Eyi bɔ wo mogya ntini akɛse (Arteries) a wɔabɔ pɔ no ho ban ma mogya kɔ akwaa ahorow no mu yiye na ansiw mogya kwan.

Ma yɛnhu ayaresa no mu asiane ne ɔhaw a ebetumi afi mu aba

Nnuru a adɔkotafo kyerɛ sɛ wɔmfa nsa Cryoglobulinemia no betumi de ɔhaw a emu yɛ den aba. Nea ɛho hia paa ne nnompe a emu yɛ mmerɛw (Osteoporosis) ne nipadua no ahoɔden a obetumi ako atia nkwammoaa bɔne a ɛso tew. Eyi nti, ɛho hia paa sɛ wobɛkɔ akɔhu w'adɔkota no bere nyinaa de ahyɛ wo ho den. Saa bere no, dɔkota no betumi akyerɛ wo nnuru foforo a ɛbɛboa ma w'adi saa ɔhaw ahorow yi so. Ɛho hia nso sɛ wobɛbɔ wo ho ban afi nkwammoaa bɔne ho. Enti, ka nkwammoaa kum nnuru (Vaccinations) a ebetumi atew asiane no so no ho asɛm kyerɛ w'adɔkota no.

Ɔkwan bi wɔ hɔ a wobɛfa so asi yare yi kwan anaa?

Esiane sɛ wonhuu nea ɛde Cryoglobulinemia ba tẽẽ nti, kwan pɔtee biara nni hɔ a wɔfa so siw ano. Nanso, sɛ wotwe wo ho fi awɔw mu a ebetumi aboa ma w'adi Raynaud's phenomenon ne sɛnkyerɛnne foforo so. Bio nso, ɛho hia paa sɛ wobɛyɛ nhwehwɛmu de ahwɛ sɛ wowɔ Hepatitis C, na sɛ wowɔ a, wanya ayaresa.

Dɛn ne anidaso a wɔn a wɔwɔ yare yi wɔ daakye? (Prognosis)

Wo daakye anidaso no gyina nneɛma bi so:

• Nyarewa foforo a wowɔ a ahunta.
• Nnipadua akwaa a asɛe no kɛseyɛ.
• Sɛnea wogye ayaresa no to mu.

Saa yare yi mu denden nso sesa fi onipa biako so kɔ foforo so. Nnipa bi nnya sɛnkyerɛnne biara, anaa emu nyɛ den a ennhia ayaresa. Wɔn a yare no aso mu anaa emu yɛ den no, sɛ wɔhu no ntɛm na wofi ayaresa no ase a, ebetumi adwudwo sɛnkyerɛnne no na asi daakye haw akɛse no kwan. Sɛ wo nipadua akwaa no nsɛee koraa a, w'anidaso yɛ papa paa.

Mɛyɛ dɛn ahwɛ me ho? Hena na obeboa me?

Nea wobɛyɛ a eye paa ne sɛ wobɛyɛ adwuma abom ne w'adɔkotafo kuw no nyinaa daa. Egyina nipadua akwaa a Cryoglobulinemia aka no so, ebia ebehia sɛ wone dɔkotafo a wɔyɛ ho abenfo ahorow bedi nkitaho. Adɔkotafo a wɔte saa no bi ne:

• Nnompe ne nipadua nam ho adɔkotafo (Rheumatologists).
• Honam ani nyarewa ho adɔkotafo (Dermatologists).
• Mogya ho adɔkotafo (Hematologists).
• Saayowa (Kidney) ho adɔkotafo (Nephrologists).
• Koma ho adɔkotafo (Cardiologists).
• Ntini (Nerve) ho adɔkotafo (Neurologists).
• Brɛbo (Liver) ho adɔkotafo (Hepatologists).

Hu w'adɔkotafo kuw no mufo nyinaa yiye. Kasa ma wo ho. Bisa nsɛm. Sɛ wowɔ haw biara fa w'ayaresa ho a, ka. W'adɔkotafo no wɔ hɔ sɛ wobetie wo, na wɔakyerɛkyerɛ wo nneɛma nyinaa a ɛka w'apɔwmuden ne w'ahwɛso no mu yiye.

Bere bɛn na ɛsɛ sɛ mikohu dɔkota?

Sɛ wunya Cryoglobulinemia sɛnkyerɛnne biara a, hwehwɛ adɔkotafo mmoa ntɛm ara. Sɛ ɛyɛ ahohwim a, frɛ gyigya adwumayɛfo wɔ 112 so na wanya mmoa ntɛm. Sɛ wowɔ Hepatitis C na sɛnkyerɛnne yi bi ba a, kɔhu dɔkota.

Sɛ wunya ayaresa pa mpo a, ɛtɔ da bi a yare no tumi san ba (Relapses). Sɛ wunya sɛnkyerɛnne foforo, sɛ nea wowɔ dedaw no mu yɛ den, anaa sɛ sɛnkyerɛnne no san ba a, kɔhu dɔkota. Nhwehwɛmu a wɔyɛ no daa ne ahwɛso a wɔyɛ no daa no ho hia paa sɛnea wɔbɛhu sɛ yare no asan aba ntɛm na wɔasiw ɔhaw akɛse no kwan.

Nsɛm bɛn na ɛsɛ sɛ mibisa dɔkota no?

Sɛ wokɔhu dɔkota no a, eye sɛ wobebisa nsɛm a edidi so yi:

• Dɛn na ɛmaa minyaa saa tebea yi?
• Ayaresa bɛn na wokyerɛ sɛ memfa nsa me ho?
• Ayaresa no mu nnuru nsunsuanso bɛn na ɛsɛ sɛ mede m'adwene si so?
• Ɔhaw akɛse bɛn na ebetumi afi saa yare yi mu aba?
• Dɛn na metumi ayɛ de asi yare yi kwan sɛ ɛnnsan mma bio?

Nsɛm Titiriw a Ɛsɛ sɛ Wokura Kɔ Fie (Take-Home Message)

Sɛ wubekura Cryoglobulinemia yare yi mu a, ɛtɔ da bi a ebetumi ayɛ den paa. Sɛnkyerɛnne ahorow ne nnuru no nsunsuanso betumi aka w'adwene ne w'apɔwmuden kɛse. Bio nso, ebetumi aka w'abrabɔ mu afã afã pii.

Nanso kae sɛ, ɛnyɛ wo nko ara na worefa mu. Hwehwɛ mmoa fi w'adɔkota hɔ, na hwehwɛ mmoa akuw (Support groups) a nnipa a wɔwɔ saa tebea no mu pɛpɛɛpɛ wom. W'osuahu a wode bɛkyɛ wɔn, ne nneɛma a wonim a wode bɛkyɛ no bɛboa wo ma wode Cryoglobulinemia atena yiye. Bɔ wo ho ban fi awɔw ho, hwehwɛ adɔkota mmoa wɔ bere a ɛsɛ mu, gyae sigaret nom, di aduan a ahoɔden wom, eyinom nyinaa ho hia.

Mewɔ anidaso sɛ saa nsɛm yi bɛboa wo paa. Nya apɔwmuden pa!