So wo nipadua no ankasa ahobammɔ nhyehyɛe redi wo ho agoru? Momma yensua Autoimmune Pancreatitis ho ade wɔ ɔkwan a ɛnyɛ den so!

Yɛwɔ ahobammɔ nhyehyɛe a ɛyɛ nwonwa wɔ yɛn nipadua mu, ɛnte saa? Ɛno ne nea yɛfrɛ no nipadua no mu tumi a ɛko tia nyarewa. Ɛbɔ yɛn ho ban denam mmoawa, mmoawa, ne mmoawa a wɔde nyarewa ba a ɛko tia so. Nanso susuw ho hwɛ, sɛ ɛtɔ mmere bi a yɛn ahobammɔ nhyehyɛe yi ara ne nkwammoaa pa a ɛwɔ yɛn ankasa nipadua mu no frafra na efi ase tow hyɛ wɔn so nso ɛ? Ɛno na ɛba, a wɔfrɛ no ``Autoimmune Pancreatitis''. Sɛ yɛbɛka no tiawa a, w’ankasa nipadua mu ahoɔden a ɛko tia nyarewa no fi ase yɛ adwuma tia wo dwensɔtwaa no.

Dɛn ne ``Autoimmune Pancreatitis''? Sɛ yɛbɛka no tiawa a...

Fa wo nipadua mu tumi a ɛko tia nyarewa no sɛ asraafo dɔm a wɔbɔ ɔman bi ho ban. Asraafo yi adwuma ne sɛ wɔbɛbɔ ɔman no ho ban afi atamfo a wofi abɔnten (te sɛ mmoawa ne mmoawa) ho. Nanso wɔ `(Autoimmune Pancreatitis)` mu no, saa asraafo dɔm yi di mfomso na wɔtow hyɛ wɔn ankasa man mu ɔman mma a wɔn ho nni asɛm (kyerɛ sɛ, nkwammoaa a wɔwɔ apɔwmuden wɔ dwensɔtwaa mu) so a wosusuw sɛ wɔyɛ atamfo. Ne saa nti, dwensɔtwaa no ho hyehye no, epirapira, na ɛnyɛ adwuma yiye. Eyi ne nea yɛfrɛ no autoimmune pancreatitis .

Saa yare yi abu so dɛn?

Nokwarem no, `(Autoimmune Pancreatitis)` yɛ yare a ɛntaa nsi mmom . Ɛtaa ba nnipa bɛyɛ ɔha biara mu biako mu. Sɛ yɛfa bere tenten a ɛyɛ hyew tebea horow a ɛwɔ dwensɔtwaa no mu (`akyi berɛmo mu yare a enni sabea`) a, emu bɛyɛ 2% pɛ na ɛhyɛ saa `(Autoimmune Pancreatitis)` kuw yi mu. Enti, eyi nyɛ yare a ɛka obiara.

So `(Autoimmune Pancreatitis)` ahorow bi wɔ hɔ?

Yiw, `(Autoimmune Pancreatitis)` ahorow abien titiriw na ɛwɔ hɔ. Ma yɛnhwɛ nea wɔyɛ.

1. Ɔkwan a Ɛto so 1 Autoimmune Pancreatitis

Eyi ne ɔkwan a ɛtaa ba . Wɔ eyi mu no, yɛwɔ protein bi a wɔfrɛ no `(Immunoglobulin G4)` anaa `(IgG4)` pii wɔ yɛn nipadua mu. Saa `(IgG4)` yi yɛ antibody bi. Sɛ ɔfe anaa ɔfe wɔ nipadua no mu baabiara a, saa `(IgG4)` yi dodow kɔ soro.

Nanso wɔ saa ɔkwan a edi kan yi mu no, ɛnyɛ dwensɔtwaa no nkutoo na ɔhaw no wɔ. Ebetumi aka yɛn nipadua no akwaa afoforo nso. Nhwɛsoɔ:

• Bile ducts: Eyinom yɛ tube -te sɛ ntini a ɛde bile fi mmerɛbo no mu kɔ dwensɔtwaa ketewa no mu.
• Renal tubes: Nsuo a ɛwɔ asaabo mu.
• Brɛboɔ
• Ahrawa
• Akisikuru a ɛwɔ akisikuru mu
• Ntini a ɛma nnompe mu nsu
• Thyroid ntini a ɛma nipadua no yɛ adwuma

Nhohoro ne nneɛma a asɛe nso betumi aba wɔ mmeae te sɛ eyinom.

2. Ɔkwan a Ɛto so 2 Autoimmune Pancreatitis

Saa ɔkwan yi ka dwensɔtwaa no nkutoo . Nea ɛkɔ so wɔ ha ne sɛ mogya mu nkwammoaa fitaa bi a wɔfrɛ no ``neutrophils`` sɛe dwensɔtwaa ne dwensɔtwaa ntini. Wɔtaa hu saa tebea yi wɔ mmerante ne mmabaa mu.Afei nso, ɛda adi sɛ wobenya dwensɔtwaa mu yare a ɛma obi ho hyehye no (IBD).

Dɛn ne nneɛma a ɛde `(Autoimmune Pancreatitis)` ba? So asiane ahorow bi wɔ hɔ?

Nhwehwɛmufo da so ara rebɔ mmɔden sɛ wobehu nea ɛde ba ankasa , nanso ɛtaa ba nnipa a wɔadi fi mfe 50 kosi 60. Nanso, ebetumi aba ntɛm. Mmarima betumi anya yare no mmɔho abien sen mmea.

Ɛtɔ mmere bi a, wosusuw sɛ ɛyɛ sɛnea nipadua no mu tumi a ɛko tia nyarewa no yɛ wɔ ɔyare mmoawa bi ho. Nea ɛka ho no, nnipa a wɔwɔ yare afoforo a nipadua no tumi ko tia nyarewa no wɔ asiane kɛse mu sɛ wobenya bi. Nhwɛsoɔ:

• (Hashimoto thyroiditis): Eyi ma thyroid ntini no ntumi nyɛ adwuma yiye (hypothyroidism).
• (Inflammatory bowel disease - IBD): Titiriw tebea horow te sɛ `(ulcerative colitis)`.
• (Bliary cholangitis a edi kan) .
• Retroperitoneal fibrosis: Ntini a ɛte sɛ akuru a ɛba yafunu no akyi ntini mu.
• Ntini mu yare: Ntini a ɛyɛ hyew.
• (Sarcoidosis) .
• (Sjögren yare no) .

Sɛ wowɔ autoimmune tebea afoforo te sɛ eyi a, ɛyɛ papa sɛ wobɛhaw wo ho kakra wɔ Autoimmune Pancreatitis nso ho.

Dɛn ne `(Autoimmune Pancreatitis)` ho sɛnkyerɛnne?

Wɔ yare yi mfiase no , ebia na sɛnkyerɛnne biara nni hɔ . Nanso, bere a yare no kɔ so no, dwensɔtwaa no mu ntini no fi ase teateaa, na ɛmma enzymes a dwensɔtwaa no yi fi mu no ntumi mfa mu yiye.

Sɛ obi asiw dwensɔtwaa no mu a, ebetumi ama wanya yare no ho sɛnkyerɛnne te sɛ:

• Yafunu atifi yaw
• Mfinimfini akyi yaw
• Ayamtuo
• Akisikuru/akisikuru
• Mu duru a ɛso tew

Nea ɛho hia: Wobetumi ahu saa sɛnkyerɛnne ahorow yi bi wɔ dwensɔtwaa mu kokoram nso mu. Enti, sɛ wowɔ saa sɛnkyerɛnne ahorow yi a, nyansa wom sɛ woremmɔ hu na wokɔ oduruyɛfo nkyɛn ntɛm ara na woahu nea ɛyɛ ɔhaw no ankasa . Sɛ wowɔ `(Autoimmune Pancreatitis)` a, ɛnkyerɛ sɛ wowɔ kokoram.

Nea ɛka ho no, dwensɔtwaa a nipadua no tumi ko tia nyarewa no betumi ama akisikuru, anyin a ɛnyɛ kokoram, na nsu ahyɛ mu ma wɔ dwensɔtwaa no mu. Sɛ saa ahurututu, akuru, anaa akisikuru yi ba wo dwensɔtwaa ti mu a, ebetumi asiw bile ntini no ano, na ebetumi asiw bile no kwan sɛ ɛbɛsen akɔ dwensɔtwaa ketewa no mu yiye. Bile wɔ aduru bi a wɔfrɛ no bilirubin. Sɛ bilirubin yi boaboa ano wɔ mogya no mu a, ebetumi ama obi anya jaundice.Aniwa honam ani fitaa bɛyɛ kɔkɔɔ (jaundice), na ebia wobɛte ɔbrɛ nka. Sɛ bilirubin kɔ soro wɔ nsu no mu a , nsu no yɛ tuntum . Sɛ wɔyi bilirubin gu dwensɔtwaa no mu a , nsuo no betumi ayɛ kɔla a ɛyɛ mmerɛw .

Dɛn ne nsɛnnennen a ebetumi aba wɔ `(Autoimmune Pancreatitis)` mu?

dwensɔtwaa mu ɔfe a enni sabea betumi ama obi ho ayɛ no yaw, ne mu duru so atew, na wate yaw a ɛkɔ so wɔ yafunu no atifi ne n’akyi. Afei nso, sɛ nkwammoaa a ɛma insulin wɔ dwensɔtwaa mu no sɛe , asikreyare betumi anya.

Ɛnyɛ dwensɔtwaa nko na IgG4 antibodies tumi tow hyɛ so, na mmom akwaa afoforo nso, titiriw wɔ Type 1. Akwaa a ɛtete saa no bi ne:

• Nsu a ɛma mogya tu
• Ntini a ɛma nnompe mu nsu
• Nsu a ɛma nusu
• Ntini a ɛma mogya tu (`Thyroid`) .
• Asaabo a ɛma obi nya asaabo
• Akoma
• Ahurututu ne ahurututu (ahurututu a ɛkata so) .

Ɔkwan bɛn so na wohu sɛ obi anya Autoimmune Pancreatitis?

Sɛnea ɛbɛyɛ na wɔahu yare yi pɛpɛɛpɛ na wɔahwɛ ahu sɛ ɛnyɛ dwensɔtwaa mu kokoram no, ɛho behia sɛ wɔyɛ nhwehwɛmu pii. Ɛho behia sɛ woyɛ sɔhwɛ ahorow te sɛ eyinom:

• Mogya mu nhwehwɛmu: Eyinom hwɛ sɛ ebia IgG4 dɔɔso wɔ ɔkwan a ɛnteɛ so, ne mmerɛbo no dwumadi ne mogya mu nkwammoaa ahorow bi dodow.
• Mfoniniyɛ mu sɔhwɛ ahorow: Eyinom hwɛ sɛnea dwensɔtwaa no kɛse te, sɛ ebia akuru bi wɔ hɔ anaa, anaasɛ ntini no mu teateaa anaa. Saa sɔhwɛ ahorow yi ho nhwɛso ne `(CT scan)` ne `(MRI scan)`.
• Biopsy: Nea ɛka eyi ho ne sɛ wubeyi ntini ketewaa bi afi wo dwensɔtwaa mu na wode afiri a wɔde hwɛ nneɛma nketenkete ahwɛ mu. Wɔtaa fa endoscopic adeyɛ a ɛnyɛ nea wɔde hyɛ nipadua mu a wɔfrɛ no Endoscopic Ultrasound (EUS) so na ɛyɛ eyi. Wɔ saa adeyɛ yi mu no, wo duruyɛfo de afiri tenten bi a ɛyɛ mmerɛw (a kanea ne ultrasound afiri wɔ ano biako) hyɛ wo yafunu ne wo dwensɔtwaa mu de hwɛ wo dwensɔtwaa no. Afei wɔfa wo yafunu anaa wo dwensɔtwaa mu fa biopsy sample. Ɛtɔ mmere bi a, ebia ɛho behia sɛ oduruyɛfo a ɔyɛ oprehyɛn no twa wo honam ani fã ketewaa bi (laparoscopy) na ama wafa biopsy nhwɛsode.
• Corticosteroid sɔhwɛ: Eyi nso boa ma wosi nea wɔahu no so dua. Wɔma wo steroid bere tiaa bi de hwɛ sɛ ebia wo IgG4 dodow so tew na wo mfoniniyɛ mu sɔhwɛ ahorow no tu mpɔn anaa.

Ɔkwan bɛn so na wɔsa `(Autoimmune Pancreatitis)`?

Nea ɛyɛ nwonwa no, wɔ nnipa kakraa bi pɛ fam no, yare yi ankasa sa a wonnya ayaresa biara . Nanso wɔ nnipa pii fam no, ɛho hia sɛ wɔsa yare .

Wɔde corticosteroids titiriw na ɛsa Autoimmune Pancreatitis.Aduru bi a wɔfrɛ no steroid. Sɛ nhwɛso no, aduru bi te sɛ `(prednisone)` anaa `(prednisolone)`. Saa nnuru yi yɛ adwuma denam ɔfe a ɛtew so na ɛma nipadua no mu tumi a ɛko tia nyarewa a ɛyɛ adwuma boro so no dwo no so. Mpɛn pii no, wɔde steroid dodow a ɛdɔɔso na efi ase sa yare. Afei wɔtew dodow no so nkakrankakra (`tapered`).

Sɛ wunni nsɛnnennen bi a, mpɛn pii no wunhia ayaresa foforo biara. Ayaresa a ehia no gyina ɔhaw ko a ɛba no so. Sɛ pancreatic duct no teateaa (`duct narrowing`) a, wobetumi ayɛ ɔkwan bi de abue duct no na wɔde hollow mesh device (`stent`) ahyɛ no den.

So metumi asiw `(Autoimmune Pancreatitis)` a menya no ano?

Nokwarem no, biribiara nni hɔ a wubetumi ayɛ de asiw yare yi ano efisɛ ɛyɛ ɔhaw wɔ yɛn ankasa nipadua mu tumi a ɛko tia nyarewa no ho.

Dɛn ne adwene a ɛwɔ hɔ ma nnipa a wɔwɔ `(Autoimmune Pancreatitis)`?

Nnipa dodow no ara ho tɔ wɔn yiye wɔ corticosteroid ayaresa akyi , na nsɛnnennen biara nni ho. Sɛ wowɔ autoimmune pancreatitis a ennya wo nkwa nna so nkɛntɛnso .

Nanso, `(Autoimmune Pancreatitis)` betumi asan aba bio (asan aba bio) . Eyi taa ba nnipa a wɔwɔ ɔkwan a edi kan (`Type 1`) mu titiriw. Ɛda adi kɛse sɛ yare no bɛsan aba bio wɔ mfe abiɛsa a edi kan wɔ bere a wɔahu sɛ yare no akyi no mu. Obi a yare no san ba no nso taa nya nsɛnnennen.

Sɛ yare no san ba a, dɛn na ɛba?

Sɛ wodi ho dwuma yiye a, wɔn a wɔwɔ yare a ɛsan ba mpo betumi atra ase a ɛyɛ nnam na apɔwmuden .

Ebia ɛho behia sɛ wufi ase de corticosteroids di dwuma bio. Nnipa binom kɔ so sa steroid mfe pii na amma yare no ho sɛnkyerɛnne no nsan mma bio. Nnuruyɛfo betumi asɔ nnuru afoforo a ɛsa nipadua no mu tumi a ɛko tia nyarewa a ɛyɛ adwuma boro so (nnuru a ɛma nipadua no tumi ko tia nyarewa ne nea ɛma nipadua no tumi ko tia nyarewa) nso ahwɛ.

Mɛte nka dɛn bere a wɔreyɛ me ayaresa no?

Nsunsuanso bɔne bi betumi aba bere a wɔde steroid di dwuma no. Sɛ nhwɛso no, yafunu a ɛyɛ yaw, aduan ho akɔnnɔ a ɛkɔ soro, ahomegye, ne nna a ɛyɛ den. Saa nsunsuanso bɔne yi betumi ahaw da biara da asetra kakra, nanso ɛyɛ bere tiaa mu de . Sɛnea ɛbɛyɛ a wubenya wo Autoimmune Pancreatitis ayaresa no so mfaso kɛse no, ɛho hia sɛ wokɔ so nom steroid ahorow no sɛnea wo duruyɛfo akyerɛ wo no .

Sɛ nsunsuanso bɔne no haw dodo sɛ wubegyina ano a, hwɛ hu sɛ wobɛbɔ wo duruyɛfo amanneɛ ansa na woagyae ayaresa. Ebia ɔbɛkyerɛw ayaresa foforo ama wo de aboa wo ma woanya ahotɔ, anaasɛ ɔbɛsesa w’ayaresa nhyehyɛe.

Bere bɛn na metumi asan akɔ dwumadi ahorow a na meyɛ daa mu bere a wɔasa `(Autoimmune Pancreatitis)` aduru awie no?

Steroid ayaresa taa ma ahotɔ fi `(Autoimmune Pancreatitis)` ho sɛnkyerɛnne ahorow mu wɔ adapɛn kakraa bi mu.Nnipa pii san kɔ wɔn dwumadi ahorow a wɔtaa yɛ no so bere a wɔn yare no ho sɛnkyerɛnne no ano abrɛ ase no.

Autoimmune Pancreatitis yɛ ɔyare a ɛntaa nsi a ɛma obi ho hyehye no a ebetumi aka dwensɔtwaa no dwumadi. Sɛ wokɔ oduruyɛfo a onim dwensɔtwaa mu nyarewa a, ebetumi aboa wo ma woanya ɔhwɛ a eye sen biara a wuhia. Nnipa dodow no ara ho tɔ wɔn koraa bere a wɔanom steroid awie no . Ebia nnipa binom behia Autoimmune Pancreatitis ayaresa foforo na ama wɔanya ahotɔ bere tenten.

Awiei koraa no, kae eyi (Take-Home Message) .

• Autoimmune Pancreatitis yɛ tebea a ɛntaa nsi a w’ankasa nipadua no mu tumi a ɛko tia nyarewa no tow hyɛ wo dwensɔtwaa so.
• Sɛ wowɔ sɛnkyerɛnne ahorow te sɛ yafunu mu yaw, wo mu duru a ɛso tew, anaasɛ jaundice , hwɛ hu sɛ wobɛhwehwɛ aduruyɛfo afotu .
• Eyi nyɛ kokoram a ɛwɔ dwensɔtwaa mu, nanso sɛnkyerɛnne ahorow no te sɛ nea ɛwɔ hɔ, enti ɛho hia sɛ wohu yare no yiye .
• Ayaresa titiriw ne corticosteroids.
• Nnipa pii ho tɔ wɔn yiye bere a wɔsa wɔn yare, nanso yare no betumi asan aba bio.
• Ɛho hia yiye sɛ wubedi oduruyɛfo no akwankyerɛ akyi pɛpɛɛpɛ na ama wo ho atɔ wo ntɛmntɛm .

Kae sɛ ɛnyɛ wo nko ara. Ɛyɛ ade a ɛfata sɛ wubenya nsusuwii pii atu mmirika wɔ w’adwene mu wɔ tebea a ɛte sɛɛ mu. Enti, bue w’ani kyerɛ wo duruyɛfo na bisa wo nsɛm. Wɔwɔ ha sɛ wɔrebɛboa wo.

` Ɔyare a ɛko tia nyarewa, Pancreatitis, Autoimmunity, IgG4, Pancreas akwahosan, Pancreatitis Sinhala, Adidi mu akwahosan