So wo nso wote nka mpofirim sɛ woyare? Dɛn ne yare a ɛba kwa yi? (Mast Cell Activation Syndrome) .

So ɛtɔ mmere bi a wote nka sɛ woyare paa mpofirim? Ɛte sɛ nea wowɔ akisikuru a emu yɛ den. Ebia wo nipadua nyinaa bɛdan kɔkɔɔ, ayɛ wo yaw, ɛho ahonhon, wo yafunu mu ayɛ wo yaw, wobɛfe, anaasɛ wo ho bɛkyere wo. Nanso ɛnyɛ sɛ wodii biribi anaa wode wo nsa kaa biribi nti na saa nneɛma yi nsi. Sɛ saa nneɛma yi si a ntease biara nni mu a, ebetumi ayɛ tebea bi a wɔfrɛ no `Mast Cell Activation Syndrome (MCAS).` Momma yɛnka eyi ho asɛm nkɔ akyiri nnɛ.

Dɛn ne ``Mast Cell Activation Syndrome (MCAS)''?

Sɛ yɛbɛka no tiawa a, MCAS yɛ tebea a ɛma nkwammoaa bi a ɛwɔ yɛn nipadua mu a wɔfrɛ no ``mast cells'' yɛ adwuma boro so a ntease biara nni mu, na ɛde sɛnkyerɛnne ahorow a emu yɛ den ba. Afei ebia woresusuw sɛ, "Ɛno ne nea allergy yɛ." Yiw, allergy nso hwehwɛ sɛ ``mast cells'' yɛ adwuma Nanso mpɛn pii no allergy wɔ nea ɛde ba pefee . Sɛ nhwɛso no, nnipa binom ho yɛ wɔn hyew wɔ shrimp, peanuts, anaa dust mites ho. Nanso wɔ MCAS mu no, ɛyɛ den sɛ wubehu biribi pɔtee bi a ɛde ba. Saa sɛnkyerɛnne ahorow yi da adi mpofirim.

Wɔ tebea horow bi mu no, sɛ saa mast cells yi yɛ adwuma a, ebetumi ama obi anya akisikuru a emu yɛ den yiye a ɛde nkwa to asiane mu a wɔfrɛ no anaphylaxis. Eyi betumi ama ahome ayɛ den na mogya mmoroso akɔ fam wɔ ɔkwan a ɛyɛ hu so. Sɛ wunya anaphylaxis a emu yɛ den a, ɛsɛ sɛ wofrɛ 911 anaa wokɔ dan a ɛbɛn wo a wɔhwɛ wɔn a wɔwɔ yare a egye ntɛmpɛ mu ntɛm ara.

Mast cells te sɛ asraafo a wɔwɔ yɛn nipadua mu ahoɔden a ɛko tia nyarewa no mu. Wɔboa ma wɔko tia nyarewa. Enti, ɛyɛ ade a ɛfata sɛ wobɛte ehu nka bere a wowɔ saa sɛnkyerɛnne ahorow a wonhuu bi yi. Nanso ɛyɛ ade a ɛfata sɛ mast cells no bɛyɛ adwuma. Sɛ nhwɛso no, mast cells yɛ adwuma wɔ tebea horow te sɛ akisikuru a ɛma obi ho yɛ no hyew, ayamtu, nnuru anaa nnuan ho akisikuru, ne mastocytosis mu. Eyi na ɛma yenya saa sɛnkyerɛnne ahorow a ɛhyɛ abufuw, na ɛtɔ mmere bi a asiane wom yi.

Nanso, ``Mast Cell Activation Syndrome (MCAS)`` yɛ tebea a ɛntaa nsi koraa . Nnuruyɛfo hu MCAS sɛ nneɛma a edidi so yi wɔ hɔ a:

• Sɛ wowɔ sɛnkyerɛnne ahorow a ɛsan ba a wususuw sɛ ebetumi ayɛ anaphylaxis a ntease biara nnim a.
• Sɛ saa sɛnkyerɛnne ahorow yi ka wo nipadua nhyehyɛe bɛboro biako bere koro mu a (sɛ nhwɛso no, honam ani ne dwensɔtwaa nyinaa).
• Sɛ sɔhwɛ ahorow kyerɛ adanse a ɛkyerɛ sɛ mast cells reyɛ adwuma a.
• Sɛ nnuru a ɛde n’ani si mast cells so na ɛtew wo sɛnkyerɛnne ahorow so a.

Mast cells ne dwuma a wodi

Mast cells yɛ yɛn nipadua mu ahoɔden a ɛko tia nyarewa no nkwammoaa .Ɔfa. Wɔn adwuma a wɔtaa yɛ ne sɛ wɔbɛbɔ yɛn nipadua ho ban afi ɔyare mmoawa (e.g. mmoawa a wɔsɛe nnɔbae, mmoawa) anaa nneɛma afoforo a epira a ɛkɔ yɛn nipadua mu no ho. Nkwammoaa yi tra yɛn ntini mu, na sɛ wohu biribi a wosusuw sɛ epira a, woyi nnuru te sɛ histamine a ɛma nipadua no mu tumi a ɛko tia nyarewa no yɛ adwuma na ɛbɔ mmɔden sɛ ɛbɛko atia nea ɔtow hyɛ yɛn so no.

Ɛtɔ da bi a, wɔyɛ wɔn ade wɔ nneɛma a ɛnsɛ sɛ wɔyɛ ho biribi ho. Ɛno ne bere a yenya akisikuru . Nanso mpɛn pii no, akisikuru de sɛnkyerɛnne nketenkete te sɛ aniwa a ɛyɛ yaw ne hwene a ɛretu ba. Nea ɛkɔ so wɔ MCAS mu ne sɛ sɛnkyerɛnne ahorow a emu yɛ den kɛse wɔ hɔ a ntease biara nni mu.

``Mast Cell Activation Syndrome (MCAS)'' yɛ aniberesɛm dɛn?

Sɛnea MCAS mu yɛ den no gyina sɛnkyerɛnne ahorow a wuhu no so. Ebia nnipa binom benya yare no ho sɛnkyerɛnne a emu nyɛ den koraa, na honam ani yare no nkutoo na ɛwɔ hɔ. Ebia afoforo nso behyia tebea horow a emu yɛ den kɛse, te sɛ anaphylaxis. Anaphylaxis betumi akum obi sɛ wɔansa no yiye a. Nanso, nneyɛe a ɛde nkwa to asiane mu wɔ MCAS ho no ho yɛ na koraa .

Dɛn ne `Mast Cell Activation Syndrome (MCAS)` ho sɛnkyerɛnne?

MCAS betumi ama woanya yare no ho sɛnkyerɛnne a emu yɛ den a ɛsan ba bio wɔ wo nipadua no afã horow. Ebia saa sɛnkyerɛnne ahorow yi bi ne:

• Mogya mmoroso a ɛba fam.
• Wora a ɛbɛyɛ kɔkɔɔ, pink, na ɛyɛ hyew (`Flushing`).
• Wora a ɛyɛ wo yaw.
• Anom a ɛyɛ mmerɛw.
• Nsuo - titire no anim, anofafa, aniwa, tɛkrɛma anaa menewa (`Angioedema`).
• Akisikuru anaa akisikuru (ebia ɛsesa abien no).
• Yafunu mu yaw.
• Ɔhome a ɛyɛ den.
• Mmerewa anaasɛ obi a ɔtotɔ piti.
• Nkae a ɛyera anaasɛ ɛyɛ den sɛ obesusuw nneɛma ho (amemene mu sum).
• Nnipa a wɔyɛ mmerɛw.
• Nkwaa mu yaw.
• Anaphylaxis (akisikuru a emu yɛ den a ɛwɔ atifi hɔ sɛnkyerɛnne no mu biako anaa nea ɛboro saa).

Sɛ wubesusuw sɛ wowɔ MCAS a, anyɛ yiye koraa no, ɛsɛ sɛ saa sɛnkyerɛnne ahorow yi ka wo nipadua nhyehyɛe abien. Ɛyɛ:

• Ntini ahorow (amemene ne ntini ahorow).
• Ɔhome nhyehyɛe (ahurututu ne mframa kwan).
• Koma ne ntini nhyehyɛe (koma ne mogya ntini).
• Digestive system (yafunu ne dwensɔtwaa).

Sɛ mast cells no yɛ adwuma mpofirim a, ɛte dɛn?

Sɛ woanya akisikuru pɛn a, ebia wunim sɛnea ɛte bere a mast cells no yɛ adwuma no. Nanso wɔ nnipa a wɔwɔ MCAS fam no, tebea no mu yɛ den sen akisikuru a ɛtaa ba, na ɛka nipadua no afã horow pii. Wo honam ani betumi ahonhon, ayɛ kɔkɔɔ, afi ase ayɛ wo yaw, anaa mogya mpo atu. Ebia wubenya dwensɔtwaa ne ɔfe. Sɛ emu yɛ den a, w’anim ne wo menewa betumi ahonhon, na wo mogya so atew. Kae sɛ, sɛ wuhu saa sɛnkyerɛnne ahorow a emu yɛ den yi a, ɛsɛ sɛ wofrɛ 911 anaa wokɔ ayaresabea a ɛbɛn wo ntɛm ara.

Dɛn ne nneɛma a ɛde `Mast Cell Activation Syndrome (MCAS)` ba?

MCAS fi wo mast cells a ɛyɛ wɔn ade bere a ɛnsɛ sɛ wɔyɛ saa no. Mast cells no susuw sɛ biribi a epira ahyɛn nipadua no mu ma enti ɛsɛ sɛ wɔbɔ ho ban. Ɛno ne bere a woyi protein ahorow a ɛde sɛnkyerɛnne ahorow no ba no fi adi. Wɔ allergy mu no, yebetumi ahu nea ɛma nipadua no yɛ n’ade boro so. Nanso wɔ MCAS mu no, ɛyɛ den sɛ wubehu ntease a emu da hɔ a enti mast nkwammoaa no gyae protein ahorow yi.

Nokwarem no, obiara da so ara nnim nea enti a mast cells te nka saa wɔ nneɛma a wɔmpɛ ho no ankasa.

Dɛn ne nneɛma a ebetumi ama mast cell ayɛ adwuma?

Ɛwom sɛ nneɛma pii te sɛ nnuan ne pollen betumi ama mast cells ayɛ adwuma na ayi histamine afi mu de, nanso ɛrentumi nyɛ yiye sɛ yɛbɛka sɛ MCAS ho sɛnkyerɛnne a emu yɛ den no fi ade pɔtee bi a ɛma obi ho yɛ no yaw. Nanso, ebia wubehu sɛ saa sɛnkyerɛnne ahorow yi mu yɛ den kɛse bere a nsakrae ba w’asetra anaa nneɛma a atwa wo ho ahyia mu, sɛ nhwɛso no, wɔ mmere a adwennwen kɛse wom anaa bere a wim tebea sesa no. Sɛ wo yare no ho sɛnkyerɛnne no ba bere a wode wo ho ahyɛ ade pɔtee bi mu akyi nkutoo a, ka kyerɛ wo duruyɛfo. Sɛ ɛba saa a, ebia wunni MCAS, na mmom wowɔ allergy.

Ɔkwan bɛn so na wohu Mast Cell Activation Syndrome (MCAS) no?

Ebia oduruyɛfo bi besusuw sɛ wowɔ MCAS bere a wahwɛ wo mu, aka wo sɛnkyerɛnne ahorow ho asɛm, ne w’ayaresa ho abakɔsɛm awie no. Nnuruyɛfo bɛkyerɛ sɛ wowɔ MCAS sɛ wodi tebea horow a edidi so yi so a:

• Sɛ wowɔ sɛnkyerɛnne ahorow a ɛkyerɛ sɛ mast cell no yɛ adwuma a.
• Sɛ woyɛ w’ade yiye wɔ ayaresa ahorow a wɔde ma mast cell activation ho a.
• Sɛ sɔhwɛ ahorow kyerɛ sɛ mast cell no ayɛ adwuma a.
• Sɛ wowɔ mast cells dodow a ɛfata wɔ wo nipadua mu (mast cells pii a wowɔ no kyerɛ sɛ ebia wowɔ mast cell yare foforo te sɛ mastocytosis).

MCAS sɔhwɛ

Sɛ wopɛ sɛ wohwɛ sɛ MCAS wɔ hɔ a, wo duruyɛfoɔ bɛtumi ayɛ mogya mu nhwehwɛmu de ahwɛ sɛ nnuru bi a wɔfrɛ no ``tryptase'' wɔ wo mogya mu anaa. ``tryptase'' yɛ biribi a ɛkɔ soro bere a wɔde ``mast cells'' ayɛ adwuma no. Ɛho behia sɛ wɔyɛ sɔhwɛ yi mpɛn pii – bere a wo ho atɔ wo ne bere a wowɔ sɛnkyerɛnne a emu yɛ den nyinaa. Nanso kae sɛ, ``tryptase'' nso betumi akɔ soro wɔ ayaresa tebea afoforo mu. Enti ``tryptase'' levels nko ara ntumi nkyerɛ sɛ wowɔ MCAS anaa. Ebia nnipa binom benya ``tryptase'' dodow a ɛkɔ soro sen sɛnea wɔhwɛɛ kwan mpo a wonni sɛnkyerɛnne biara.

Wo duruyɛfo nso betumi ayɛ honam ani nhwehwɛmu a ɛma obi ho yɛ no hyew anaasɛ mogya mu nhwehwɛmu a ɛma obi ho yɛ no yaw de hwɛ sɛ ebia nneɛma afoforo de ba anaa.

Nea ɛho hia: Sɛ histamine mogya mu nhwehwɛmu kyerɛ sɛ histamine dɔɔso mpo a, nnuruyɛfo nkyerɛ sɛ wowɔ MCAS.

Ɔkwan bɛn so na wɔsa Mast Cell Activation Syndrome (MCAS) no yare?

Nnuruyɛfo de ayaresa ahorow di dwuma de hu MCAS na ɛtew wo sɛnkyerɛnne ahorow so. Sɛ nnuru a ɛde n’ani si mast cells so no ho antɔ wo a, ebia wunni MCAS.

Ɛdenam wo yare no ho sɛnkyerɛnne so no, wo duruyɛfo betumi akyerɛw wo nnuru te sɛ eyinom:

• Histamine type 1 receptor blockers (Antihistamines) : Eyinom yɛ nnuru a wɔde sa akisikuru ho sɛnkyerɛnne. Nhwɛso ahorow: Loratadine, Cetirizine, Fexofenadine.
• Histamine type 2 receptor blockers (antihistamines a ɛtew yafunu mu acid so) : Wɔde eyinom ma ma akisikuru ne yafunu mu yaw. Nhwɛso ahorow: Ranitidine anaa Famotidine.
• Aspirin : Wobetumi ama aspirin de atew nsu a ɛho tew so.
• Leukotriene modifiers : Eyinom boa ma ahomegye yɛ mmerɛw. Nhwɛso ahorow: Montelukast, Zafirlukast.
• Omalizumab (XOLAIR®) : Eyi betumi atew asiane a ɛwɔ hɔ sɛ obi benya anaphylaxis no so.
• Epinephrine : Nnuruyɛfo de epinephrine di dwuma de gyae anaphylaxis. Wubetumi de epinephrine injector (EpiPen®, Auvi-Q®) ahyɛ wo nsa sɛ ebia wubenya anaphylaxis a.
• Mast cell stabilizers : Nnuru te sɛ cromolyn sodium siw nnuru a efi mast cells mu no ano (degranulation).
• Corticosteroids : Eyinom brɛ ɔfe ase, ebue mframa kwan, na ɛtew nsu a ɛwɔ ntini ahorow mu no so. Nanso, esiane asiane a ɛwɔ hɔ sɛ ebefi mu aba nti, nnuruyɛfo ntaa nkyerɛw nnuru a wɔde yɛ steroid mma MCAS.

So wɔbɛsa Mast Cell Activation Syndrome (MCAS) no koraa da bi?

Dabi, aduru biara nni hɔ a wɔde sa MCAS. Sɛ wowɔ MCAS a, ɛho behia sɛ wode nnuru di ho dwuma.

Dɛn ne obi a ɔwɔ MCAS nkwa nna?

Nnuruyɛfo hwɛ kwan sɛ nnipa dodow no ara a wɔwɔ MCAS no bɛtra ase akyɛ te sɛ obi a onni bi. Nanso esiane sɛ eyi yɛ tebea a wɔahu foforo nti, yentumi nka sɛnea ɛbɛka nkwa nna no yiye.

Mɛyɛ dɛn ahwɛ me ho?

Akwan bi a wobɛfa so ahwɛ wo ho wɔ MCAS ho ni:

• Yɛ wo yare no ho sɛnkyerɛnne ahorow ho kyerɛwtohɔ da biara da. Kyerɛw nea na wo yare no ho sɛnkyerɛnne te, nea wudii ne nea wonom saa bere no, ne nneɛma biara a woda no adi. Susuw nea na ɛyɛ soronko wɔ saa mmere yi mu bere a na worennya yare no ho sɛnkyerɛnne no ho. Sɛ wuhu nhwɛso ahorow bi a, ka kyerɛ wo duruyɛfo.
• Ka sɛnea wobɛyɛ w’ade wɔ tebea yi mu, ne baabi a wo epinephrine injector anaa nnuru foforo a egye ntɛmpɛ no wɔ kyerɛ wo nnamfo a wɔbɛn wo paa, abusuafo, anaa nnipa a wotaa ne wɔn bɔ fekuw.

Bere bɛn na ɛsɛ sɛ mekɔ Emergency Department (ETU) ?

Ɛwom sɛ MCAS ho nneyɛe a emu yɛ den ntaa mma de, nanso sɛ wuhu sɛnkyerɛnne ahorow a ɛkyerɛ sɛ wo ho yɛ wo hyew kɛse anaasɛ anaphylaxis a, fa epinephrine injector di dwuma sɛ wowɔ bi a. Afei frɛ 911 anaa kɔ baabi a ɛbɛn hɔ a wɔhwɛ wɔn a wɔwɔ ayaresa a egye ntɛmpɛ mu ntɛm ara. Nsɛnkyerɛnne a ɛkyerɛ sɛ obi anya anaphylaxis no bi ne:

• Anim, ano, tɛkrɛma, anaa menewa a ɛho ahonhon.
• Ɛyɛ den sɛ wobɛhome anaasɛ wobɛmene.
• Koma a ɛbɔ denneennen.
• Mogya mmoroso a ɛba fam.

Nsɛm bɛn na ɛsɛ sɛ mibisa me duruyɛfo?

Ebia ɛbɛyɛ nea mfaso wɔ so sɛ wubebisa wo duruyɛfo nsɛm te sɛ eyinom:

• Sɛ tebea yi mu yɛ den/ɛyɛ kɛse mpofirim ma me a, dɛn na ɛsɛ sɛ meyɛ?
• Ɔkwan bɛn so na ɛsɛ sɛ menom m’aduru?
• Ɔkwan bɛn so na bere bɛn na ɛsɛ sɛ mede me epinephrine injector no di dwuma?
• Bere bɛn na ɛsɛ sɛ mekɔ baabi a wɔhwɛ wɔn a egye ntɛmpɛ?
• Bere bɛn na ɛsɛ sɛ meba bɛhwɛ wo bio?

So ``Mast cell activation'' yɛ yare a nipadua no tumi ko tia nyarewa?

Dabi, MCAS nyɛ ɔyare a nipadua no tumi ko tia nyarewa.

Fa no sɛ siren bi wɔ hɔ. Ahobammɔ asraafo no reba. Wo ``mast cells`` no ahu asiane bi na wɔrefrɛ mmoa. Nanso... asiane biara nni hɔ ankasa. Te sɛ aseresɛm a ɛhaw adwene no, wo ``mast cells`` no rebɔ alarm dɔn no ara kwa a ntɛmpɛ biara nni mu. Sɛ́ anka wɔbɛbɔ wo ho ban afi nyarewa ho no, wɔn na wɔma woyare.

Ɛwom sɛ yennim nea enti a nnipa binom mast cells yɛ adwuma boro so ankasa de, nanso akwan bi wɔ hɔ a wɔfa so di MCAS ho dwuma. Hu sɛnkyerɛnne ahorow a ɛkyerɛ sɛ obi yɛ ade ntɛm. Sɛ wote nka sɛ wo yare no ho sɛnkyerɛnne no refi wo nsam a, wo ne wo duruyɛfo nkasa. Ade a ɛho hia sen biara ne sɛ wode epinephrine injector bɛkɔ bere nyinaa na woahu sɛnea wode bedi dwuma ne bere a wode bedi dwuma. Ebia wunhia da, nanso sɛ wusiesie wo ho ma adeyɛ a wonhwɛ kwan a, ebetumi ama woanya asomdwoe.

Nneɛma a ɛsɛ sɛ wuhu (Take-Home Message) .

• Mast cell activation syndrome (MCAS) yɛ tebea a ɛntaa nsi a ɛde akisikuru ho sɛnkyerɛnne a emu yɛ den ba a ɛnyɛ nea ɛda adi pefee sɛ ɛde ba.
• Eyi betumi aka nipadua no nhyehyɛe ahorow pii prɛko pɛ.
• Tebea horow a ɛde nkwa to asiane mu te sɛ `Anaphylaxis` betumi aba, enti hwehwɛ aduruyɛ mu afotu ntɛm ara sɛ sɛnkyerɛnne a emu yɛ den ba a.
• Ɛwom sɛ wontumi nsa MCAS koraa de, nanso wobetumi de nnuru adi sɛnkyerɛnne ahorow no so.
• Hu wo yare no ho sɛnkyerɛnne, fa epinephrine injector si wo nsam na wode adi dwuma ntɛm, na ka ho asɛm kyerɛ w’abusua.
• Sɛ wowɔ nsɛmmisa bi fa MCAS ho a, nsuro sɛ wobɛbisa wo duruyɛfoɔ.

` Mast nkwammoaa, MCAS, akisikuru, anaphylaxis, histamine, tryptase, nipadua mu ahoɔden a ɛko tia nyarewa