Tiyɛ ne aniwa mu haw ahorow a ɛba bere a onyin mu: Momma yensua Giant Cell Arteritis (GCA) anaa Temporal Arteritis ho ade?

So obi a ne mfe akɔ anim wɔ w’abusua mu, ebia wo maame, wo papa, anaa wo nanabea, taa nwiinwii wɔ tiyɛ ho? So ɛte sɛ nea w’aniwa yɛ mmerɛw kakra bere koro no ara mu? Afei eyi yɛ biribi a ebia ɛho hia wo. Ɛnnɛ yɛreka yare bi a wɔfrɛ no Giant Cell Arteritis (GCA) , a kan no na wɔfrɛ no Temporal Arteritis , a ɛtaa ka mpanyimfo ho asɛm. Biribiara nni hɔ a ɛsɛ sɛ wosuro, nea ɛho hia sen biara ne sɛ wobɛma wohu eyi.

Dɛn ne GCA? Dɛn nti na ebetumi ayɛ nea asiane wom?

Sɛ yɛbɛka no tiawa a, Giant Cell Arteritis (GCA) yɛ tebea a ɛma mogya ntini akɛse a ɛwɔ wo nipadua mu (titiriw nea ɛwɔ wo ti, wo kɔn, ne wo nsa mu) no hohoro. Nnuruyɛfo nso frɛ no ``vasculitis.'' Sɛ mogya ntini ahonhon saa kwan yi so a, wɔn afasu yɛ den, na ɛma ɔkwan a wɔfa so kɔ mogya mu no yɛ teateaa. Fa no sɛ nsu paipu a asiw kwan sɛ ɛnsen. Sɛ wɔsɛe mogya no wɔ saa kwan yi so a, ebetumi asɛe akwaa ne ntini a ɛho hia a saa mogya ntini no de mogya ma no.

Bere mu ntini a ɛwɔ wo moma so no afã abien no nyinaa de mogya kɔ wo ti nhwi, wo hwene ntini, ne aniwa ntini a ɛyɛ ntini a ɛma wuhu ade no mu. Sɛ GCA ka ntini a ɛwɔ nipadua no mu yi a, ebetumi de nsɛnnennen a emu yɛ den te sɛ anifurae aba . GCA betumi aka aorta, mogya ntini a ɛsõ sen biara wɔ nipadua no mu, ne ne nkorabata nso. Wɔfrɛ saa ahurututu no mu ahonhon yi aortitis, na ebetumi de akwahosan ho haw a emu yɛ den aba.

GCA betumi ne yare foforo a ɛma obi ho hyehye no, Polymyalgia Rheumatica, anaa PMR . Yɛbɛka PMR ho asɛm pii akyiri yi.

So GCA yɛ tebea a emu yɛ den ankasa?

Yiw, GCA yɛ tebea a sɛ wɔanhu na wɔansa ntɛm a, ebetumi ayɛ aniberesɛm . Eyi te saa efisɛ:

• Ebia w'ani betumi asɛe . Ebia w’ani bɛyera mpofirim, anaasɛ w’ani biako anaa abien no nyinaa befura.
• Wo mogya ntini betumi asɛe . Sɛ nhwɛso no, tebea bi a wɔfrɛ no aneurysm, a ɛyɛ mogya ntini a ɛpae te sɛ balloon na ɛpae no ma asiane a ɛwɔ hɔ sɛ ɛbɛpae no yɛ kɛse.
• Tebea afoforo te sɛ akisikuru anaa bere tiaa mu ischemic ntua (a wɔsan frɛ no "mini-strokes"), betumi aba.

Ɛno nti na ɛho hia paa sɛ wohu saa sɛnkyerɛnne ahorow yi.

GCA abu so dɛn?

Ɛwom sɛ GCA yɛ ntini mu yare ahorow a abu so no mu biako de, nanso ne nyinaa mu no, ɛyɛ yare a ɛntaa nsi koraa . Sɛnea akontaabu a ɛwɔ United States kyerɛ no, nnipa 100,000 biara mu 19-23 pɛ na wɔyare saa yare yi. Ɛwom sɛ akontaabu pɔtee biara nni Sri Lanka de, nanso eye sɛ yɛbɛhaw yɛn ho wɔ eyi ho bere a nnipa a wɔn mfe akɔ anim redɔɔso no.

Dɛn ne GCA (Temporal Arteritis) ho sɛnkyerɛnne ahorow?

GCA ho sɛnkyerɛnne titiriw ne nea ɛtaa ba ne tiyɛ a emu yɛ den a ɛkɔ so tra hɔ a ɛte sɛ ɛyaw a ɛbɔ wɔ ti no fã biako anaa abien no nyinaa.Nanso eyi akyi no, sɛnkyerɛnne afoforo betumi ada adi:

• Ɛyɛ mmerɛw bere a wode wo nsa to ti nhwi so anaa moma so afã abien no nyinaa (aso atifi).
• Jaw pain , titiriw bere a woredi anaa worewe.
• Anisoadehu ho haw : Anisoadehu mmɔho abien, aniwa a ɛyɛ kusuu, anaasɛ aniwa a ɛyera mpofirim bere tiaa bi.
• Ɔbrɛ .
• Huraeɛ .
• Aduan ho akɔnnɔ a ɛyera anaasɛ ne mu duru a ɛso tew .
• Ntini mu yaw : Ɛyaw wɔ mmati, abasa atifi, asen, asen atifi, akyi, ne akyi.

Wokae bere a mekaa tebea foforo a ɛtaa ka GCA ho, Polymyalgia Rheumatica (PMR) ho asɛm no? Eyi nso yɛ tebea a ɛma ɔfe. PMR ma ɛyaw a emu yɛ den na ɛyɛ den , titiriw wɔ mmati ne asen mu. PMR nso betumi aba n’ankasa (ɛtaa ba sɛ PMR ankasa ba sen GCA). Nanso, nnipa a wɔwɔ GCA no mu bɛyɛ 40-60% nso bɛnya PMR. Afei nso, nnipa a wɔwɔ PMR nkutoo no mu 10-20% benya GCA akyiri yi wɔ wɔn asetra mu.

Dɛn na ɛde GCA ba?

Nhwehwɛmufo da so ara nnim nea ɛde GCA ba ankasa , nanso nnipa pii gye di sɛ ɛyɛ yare a nipadua no tumi ko tia nyarewa anaa nea ɛma nipadua no yɛ hyew. Sɛ yɛbɛka no tiawa a, ɛyɛ bere a wo nipadua no ankasa nipadua mu ahoɔden a ɛko tia nyarewa no di mfomso tow hyɛ wo mogya ntini a ɛte apɔw no so no .

Saa yare yi abu so wɔ nnipa a wɔn mfe akɔ anim mu, enti nnipa binom susuw sɛ ɛne onyin wɔ abusuabɔ. Wosusuw nso sɛ awosu mu nneɛma ne nneɛma a atwa yɛn ho ahyia (te sɛ ɔyare mmoawa a ɛka nipadua no mu tumi a ɛko tia nyarewa) na ɛde ba.

Henanom na GCA ka wɔn kɛse?

Ɛwom sɛ obiara betumi anya GCA de, nanso nnipa a wodi so yi na asiane wom kɛse:

• Nkwakoraa ne mmerewa : Ɛkame ayɛ sɛ bere nyinaa na GCA ka nnipa a wɔadi boro mfe 50. Asiane a ɛwɔ hɔ sɛ wobenya yare no kɔ soro bere a obi nyin no. Ɛtaa ba nnipa a wɔadi fi mfe 70 kosi 80 so kɛse.
• Mmea : Saa yare yi abu so wɔ mmea so sen mmarima. Nanso, mmarima wɔ asiane kɛse mu sɛ wobenya anifurae esiane yare yi nti.
• Aborɔfo : Nhwehwɛmu ada no adi sɛ GCA ka aborɔfo a wofi Europa Atifi fam mpɛn pii sen mmusuakuw afoforo. Nanso, eyi nkyerɛ sɛ mmusuakuw afoforo ntumi nnya bi.

Ɔkwan bɛn so na wohu GCA?

Sɛ wowɔ GCA ho sɛnkyerɛnne a, wo duruyɛfo bedi kan abisa wo w’ayaresa ho abakɔsɛm na afei wayɛ nipadua mu nhwehwɛmu. Wɔbɛhwɛ sɛ wo nsa ne wo nan mu ntini yɛ mmerɛw anaa. Wɔbɛhwehwɛ wo ti nso mu ahwɛ sɛ ebia wo tirim yɛ wo yaw bi, na sɛ ntini a ɛwɔ wo moma so no afã abien no nyinaa ahonhon anaa.

Nhwehwɛmu bɛn na wɔde hu GCA?

Oduruyɛfo no bedi kan ahyɛ sɛ wɔnyɛ mogya mu nhwehwɛmu pii na ama wɔahu sɛnea ɔfe no te wɔ wo nipadua mu. Nhwɛsoɔ:

• (Erythrocyte Nsuo a Ɛkɔ Nsuo Mu) (ESR) .
• `(C-Protein a Ɛyɛ Adwuma)` (CRP) .

Saa nhwehwɛmu ahorow yi betumi ama woanya sɛnea ɔfe no te wɔ wo nipadua mu no ho adwene. Wobetumi asusuw hemoglobin dodow a ɛwɔ wo mogya mu nkwammoaa kɔkɔɔ no fã a ɛkura mframa pa no nso de ahwɛ sɛ mogya atɔ wo anaa.

Sɛ wo duruyɛfo susuw sɛ GCA (Temporal Arteritis) a, ebia ɔbɛkra sɛ wɔnyɛ temporal artery ultrasound, ntini a ɛwɔ wo moma so no mu ultrasound. Anaasɛ, wobetumi ahyɛ sɛ wɔnyɛ temporal artery biopsy . Eyi hwehwɛ sɛ oduruyɛfo a wɔatete no bɛfa ntini ketewaa bi a ɛwɔ wo moma so na ɔde akɔma ɔyaresafo bi ma wakɔhwɛ wɔ afiri a wɔde hwɛ nneɛma nketenkete mu. Eyi bɛhwɛ sɛ ebia sɛnkyerɛnne ahorow a ɛkyerɛ sɛ ɔfe (vasculitis) wɔ ntini no mu anaa. Eyi ne sɔhwɛ titiriw a wɔde si GCA so dua.

Ɛtɔ mmere bi a, ebia sɔhwɛ ahorow yi nso ho behia:

• ``(Computed Tomography)`` anaa ``(CT)`` scan sɔhwɛ
• Magnetic Resonance Imaging (MRI) a wɔde hwɛ nneɛma so
• Ultrasound a wɔde yɛ ntini akɛse no
• `(Positron Emission Tomography)` anaa `(PET)` scan sɔhwɛ

Dɛn ne ayaresa ahorow a wɔde sa GCA (Temporal Arteritis)?

Ɛsɛ sɛ wofi ase sa GCA ntɛm ara sɛnea wobetumi, titiriw sɛnea ɛbɛyɛ a wɔrenhu ade yiye .

Ayaresa titiriw ne aduru bi a wɔfrɛ no ``glucocorticoid''. Aduru a wɔtaa de di dwuma ne ``prednisone.'' Wode miligram 40 kosi 60 (mg) na efi ase da biara (wɔ ano) na wode nkakrankakra tew dodow no so. Sɛ wowɔ aniwa mu haw dedaw anaasɛ wo nhu ade yiye a, wo duruyɛfo betumi ama wo ``glucocorticoids'' dodow a ɛkɔ soro denam kankyee a wɔde ahyɛ ntini bi mu (``(IV)'') so.

Nea ɛho hia: Glucocorticoids yɛ aduru a ɛho hia yiye a wɔde siw GCA ano. Nanso, nnuru yi betumi de ɔhaw ahorow bi aba, enti wo duruyɛfo bɛhwɛ wo yiye.

Glucocorticoids ma wo nipadua mu tumi a ɛko tia nyarewa no yɛ mmerɛw, na ebetumi ama woanya ɔyare mmoawa na ama ayɛ den kɛse . Wobetumi nso ayɛ wo nnompe a ɛyɛ mmerɛw , na ama asiane a ɛwɔ hɔ sɛ wobɛbubu no ayɛ kɛse.

Nneɛma afoforo a ebetumi afi mu aba ne:

• Aniwa a ɛyɛ mmerɛw
• Mogya mmoroso
• Asikre a ɛwɔ mogya mu a ɛkɔ soro
• Asoroben
• Adwene mu nsakrae
• Ntini mu mmerɛwyɛ ne ɔsɛe, titiriw wɔ nan mu
• Ɛhohoro, titiriw wɔ anim ne anan mu
• Mu duru a ɛkɔ soro

Bere a worenom glucocorticoids no, ebia wo duruyɛfo bɛhwɛ sɛnea wo nnompe mu yɛ den. Ebia ɔbɛkamfo apɔw-mu-teɛteɛ, calcium ne vitamin D a wɔde ma, ne ebia nnuru a wɔde besiw nnompe mu yare (nnompe a ɛyera) ano na ama wo nnompe ayɛ den nso akyerɛ.

Wɔ afe 2017 mu no, U.S. Aduan ne Nnuru Dwumadibea no penee aduru foforo a wɔde yɛ abɔde a nkwa wom a wɔfrɛ no tocilizumab (Actemra®) a wɔde sa GCA so. Wɔde saa aduru yi ma sɛ aduru a wɔde twitwiw honam ani anaasɛ wɔde ma IV. Ebetumi aboa ma glucocorticoids a ɛho hia no so atew. Nanso, tocilizumab wɔ n’ankasa nsunsuanso bɔne, na wo duruyɛfo bɛkyerɛkyerɛ mu akyerɛ wo.

Bere bɛn na ɛsɛ sɛ mekɔ oduruyɛfo nkyɛn?

Sɛ wowɔ GCA ho sɛnkyerɛnne, wowɔ ɔyare mmoawa ho sɛnkyerɛnne, anaa sɛnkyerɛnne foforo biara a, kɔ wo duruyɛfo nkyɛn ntɛm ara . Wo duruyɛfoɔ nkyɛn a wobɛkɔ daa na woayɛ mogya mu nhwehwɛmu ne scans no bɛtumi aboa ama woahunu sɛ ɔyareɛ no asan aba bio (`resan yareɛ`) ntɛm.

Nsɛm bɛn na ɛsɛ sɛ mibisa oduruyɛfo no?

Wubetumi abisa wo duruyɛfo nsɛm te sɛ:

• Ayaresa ahorow bɛn na wokamfo kyerɛ?
• Nneɛma bɔne bɛn na ɛsɛ sɛ mehwɛ bere a wɔreyɛ ayaresa no?
• Dɛn na metumi ayɛ de atew ayaresa a ɛde ba no so?
• Dɛn ne nsɛnnennen a ebetumi afi tebea yi mu aba?
• Mɛyɛ dɛn ahwɛ me tebea no so?
• Dɛn ne sɛnkyerɛnne ahorow a ɛkyerɛ sɛ obi asan anya yare no?
• Nsɛnkyerɛnne bɛn na ɛsɛ sɛ me ne wo di nkitaho hwehwɛ?

Dɛn ne obi a ɔwɔ GCA nkwa nna?

Wɔnhunuu sɛ GCA a obi wɔ no ma nkwa nna yɛ tiaa, nanso nneɛma ahorow betumi aka eyi. Sɛ wohu yare no na wɔsa no ntɛm a, nea efi mu ba no ye paa , na yare no ho sɛnkyerɛnne fi ase tu mpɔn wɔ nna kakraa bi mu.

Nanso, sɛ wɔansa GCA ntɛm ara a, ebetumi de nsɛnnennen a ɛde nkwa to asiane mu te sɛ aniwa a ɛyera daa, ntini a ɛyɛ den, ne obubuafo aba. Enti, ɛho hia yiye sɛ wobɛkɔ oduruyɛfo nkyɛn ntɛm ara sɛ wowɔ sɛnkyerɛnne ahorow a ɛfa GCA ho a.

Sɛ wofi ase sa yare wie a, asiane titiriw a wuhyia ne ayaresa no mu nsunsuanso bɔne . Afei nso, sɛ mfiase no wɔde ayaresa a edi mu sa GCA mpo a, ɛtɔ mmere bi a ebetumi asan aba (`san a ɛsan ba`) . Nhwehwɛmufo nnya nhuu nea enti a eyi ba.

Mɛyɛ dɛn ahwɛ me ho bere a me ne GCA te no?

GCA a wobɛtra ase no betumi ayɛ den. Sɛ wobɛhwɛ wo tebea no so na woadi glucocorticoids nsunsuanso bɔne so a, sɔ nneɛma yi hwɛ:

• Di aduan pa a ahoɔden wom : nneɛma te sɛ nam a ɛnyɛ den, atoko, aburow a wɔayam, nnuaba ne nhabannuru a wɔayɛ no foforo.
• Nya vitamin D ne calcium a ɛdɔɔso a ɛbɛbɔ wo nnompe ho ban.
• Fa wo ho hyɛ apɔw-mu-teɛteɛ bi mu anyɛ yiye koraa no simma 30 da biara.
• Anyɛ yiye koraa no, da yiye nnɔnhwerew ason kosi awotwe anadwo biara.
• Nom aduru a wɔakyerɛw ama wo no wɔ bere ano .
• Kɔ wo duruyɛfo nkyɛn daa .
• Fa nneɛma bi bɔ wo ho ban fi nyarewa ho .

Nneɛma bɛn na ɛsɛ sɛ mekwati bere a mewɔ GCA no?

Sɛ wowɔ GCA a, ɛyɛ papa sɛ wobɛkwati saa nneɛma yi:

• Nneɛma a ɛma asiane a ɛwɔ hɔ sɛ wobɛyare no yɛ kɛse : Esiane sɛ nnuru a wɔde sa GCA no ma wo nipadua mu tumi a ɛko tia nyarewa no yɛ mmerɛw nti, ɛda adi sɛ wubenya nyarewa. Bisa wo duruyɛfo no akwan foforo a wobɛfa so atew asiane a ɛwɔ hɔ sɛ wubenya ɔyare no so, te sɛ yare a wobɛkwati, wo nsa a wobɛhohoro mpɛn pii, ne nnipa a wɔyare a wobɛtwe wo ho afi ho.
• Sigaretnom : Sigaretnom betumi ama asiane a ɛwɔ hɔ sɛ wubenya GCA no ayɛ kɛse. Wo mogya ntini no akwahosan bɛtu mpɔn bere a woagyae sigaretnom ara pɛ, na ɛno bɛboa wo wo nkwa nna nyinaa.
• Nsã a wɔnom : Nsã betumi aka wo koma ne wo mogya ntini akwahosan wɔ ɔkwan a enye so. Ebetumi nso ama nnompe asɛe ntɛmntɛm na ɛne nnuru a wonom ma wo tebea no adi nkitaho.

Nsɛm bi a ɛho hia paa (Take-Home Message) .

Giant Cell Arteritis (kan no na wɔfrɛ no Temporal Arteritis) betumi ayɛ tebea a emu yɛ den. Nanso, sɛ wohu wo yare no ntɛm na wokɔ oduruyɛfo a ɔfata kɔhwɛ wo daa a, wubetumi anya nea eye sen biara . Nsɛnkyerɛnne ne nea efi ayaresa no mu ba no betumi aka w’adwene, w’adwuma, ne w’asetra mu nneɛma pii. Nanso ɛnyɛ wo nko ara. Bisa wo duruyɛfo no sɛ ɔmmoa wo mma wunnya mmoa kuw a nnipa a wɔafa nneɛma a ɛte saa ara mu ka ho. Wo suahu ne afotu a wobɛka akyerɛ afoforo no betumi ayɛ awerɛkyekye fibea.

Kae sɛ, sɛ wowɔ sɛnkyerɛnne bi a ɛyɛ soronko te sɛ tiyɛ, anom yaw, anaa aniwa mu haw (titiriw sɛ woadi boro mfe 50 a) a, mmu w’ani ngu so na hwehwɛ aduruyɛfo afotu ntɛm ara. Ayaresa a wɔyɛ no ntɛm betumi asiw nsɛnnennen a emu yɛ den ano.

` Nkwammoaa Kɛse Ntini Mu Ntini, Bere mu Ntini, GCA, Tiyɛ, Aniwa a Wohu, Mogya Ntini a Ɛhonhon, Nkwakoraa ne mmerewa Akwahosan, Polymyalgia Rheumatica, Prednisone, Vasculitis