So wunim Whipple Yare no? Momma yɛnka ɔyare mmoawa a wɔntaa nhu yi ho asɛm wɔ nsɛm a ɛnyɛ den mu!

So ɛtɔ da bi a wote nka sɛ wo nipadua ayɛ mmerɛw kɛse, wo yafunu mu haw, wo nkwaa mu yɛ wo yaw, nanso wuntumi nhu nea enti a ɛte saa? Ebia eyi yɛ yare a nnipa pii ntee ho asɛm, nanso ɛho hia sɛ wohu. Ɛnnɛ yɛrebɛka yareɛ a ɛte saa a ɛntaa nsi, nanso sɛ wɔsa no yie a, ɛtumi sa ho asɛm. Ɛno ne Whipple Yare no.

Dɛn ne Whipple Yare no?

Sɛ yɛbɛka no tiawa a, Whipple yare no yɛ ɔyare mmoawa a wɔntaa nhu a ɛba wo dwensɔtwaa ketewaa mu . Eyi fi aduan a wudi no a ɛnyam yiye na aduannuru a ehia no ntumi nkɔ wo nipadua mu (wɔfrɛ eyi malabsorption''). Susuw ho hwɛ, yedi aduan na ama yɛanya ahoɔden ne aduannuru ama yɛn nipadua. Enti sɛ wɔannye no yiye a, ɔhaw pii betumi aba. Saa yareɛ yi ba berɛ a mmoawa bi a wɔfrɛ no Tropheryma whipplei'' hyɛn nipadua no mu. Mpɛn pii no, wohu saa mmoawa yi wɔ asase mu, kyerɛ sɛ, asase mu. Nanso asɛmpa no ne sɛ, sɛ wɔde nnuru a ekum ɔyare mmoawa'' a ɛfata di dwuma a, wobetumi ayi saa mmoawa yi afi nipadua no mu, atew sɛnkyerɛnne ahorow so, na wɔasa no koraa .

Whipple yare no abu so dɛn?

Ade a ɛho hia ni. Ɛwom sɛ mmoawa a wɔde yare yi ba ((Tropheryma whipplei)) dɔɔso wɔ nneɛma a atwa yɛn ho ahyia mu, titiriw wɔ asase mu de, nanso Whipple yare no yɛ tebea a ɛntaa nsi koraa . Sɛnea nnuruyɛ mu nhwehwɛmufo kyerɛ no, wɔ ɔman te sɛ Amerika mpo mu no, wobu akontaa sɛ nnipa ɔpepem biako biara mu bɛyɛ akron na wonya bi. Eyi kyerɛ sɛ ɛnyɛ obiara a ɔyare mmoawa yi ka no na onya saa yare yi. Wɔda so ara nnim nea ɛde ba ankasa.

Dɛn ne Whipple yare no ho sɛnkyerɛnne?

Whipple yare no ho sɛnkyerɛnne no nna adi mpofirim. Wɔnyin nkakrankakra wɔ akwan pii so .

Nsɛnkyerɛnne a ɛwɔ ɔfã a edi kan no mu (Prodromal Phase) .

Ɛde nkwaa mu yaw a emu yɛ den na efi ase . Saa ɛyaw yi betumi aba na akɔ. Ɛka wo nkwaa akɛse titiriw – wo nansoaa, wo nsateaa, wo asen, wo nkotodwe, ne wo mmati . Ɛtɔ da bi a nnuruyɛfo frɛ saa mfiase yi prodromal phase.'' Eyi betumi adi mfe ason anaa awotwe , na afei sɛnkyerɛnne afoforo fi ase da adi. Susuw sɛnea ɛyɛ den sɛ obi benya nkwaa mu yaw mfe pii a wunhu nea ɛde ba no ho hwɛ.

Akyiri yi sɛnkyerɛnne ahorow

Bere bi akyi no, sɛnkyerɛnne ahorow a edidi so yi nso betumi ada adi:

• Yafunu mu yaw: Ɛnyɛ yafunu a ɛyɛ yaw daa kɛkɛ, ebetumi ayɛ ɛyaw a emu yɛ den bere a wɔadi awie anaasɛ ɛkɔ so tra hɔ.
• Diarrhea (nsuo a ɛwɔ nsuo mu): Nsuo a ɛba mpɛn pii da biara. Eyi betumi ama nsu ho atɔ no kɛse na aduannuru a ɛwɔ nipadua no mu no ayera.
• Ɔhonhon (Edema): Ebia wubehu sɛ ɛho ahonhon, titiriw wɔ nan ne anansoaa mu. Sɛ ɛte sɛ nea ɛyɛ abon bere a wode wo nsateaa mia so a, ebetumi ayɛ edema.
• Ɔbrɛ a ɛtaa ba:Ɛmfa ho sɛnea wobɛda no, wo nipadua te nka sɛ nkwa nni mu na wonte nka sɛ wobɛyɛ biribiara.
• Atiridii: Ɔte nka sɛ ne ho yɛ hyew a ntease biara nnim.
• Honam ani kɔla a ɛsakra: Mmeae bi, titiriw nea owia bɔ no, betumi ayɛ tuntum asen sɛnea ɛte daa.
• Ntini a ɛho ahonhon: Ntini nketenkete a ɛwɔ mmeae te sɛ kɔn, abasa, ne asen.
• Mu duru a wɔtew so a wontumi nkyerɛkyerɛ mu: Mu duru a wɔtew a wonni adidi anaa apɔw-mu-teɛteɛ.

Central Nervous System Nsɛm a Ɛfa Ntini Ho

Nnipa a wɔwɔ Whipple yare no mu 20% kosi 40% nya ntini mu ntini mu haw ahorow . Eyi yɛ tebea a emu yɛ den kɛse. Ebia sɛnkyerɛnne ahorow no bi ne:

• Ɔhaw ahorow a ɛfa sɛnea wobɛkari pɛ ho: Wote nka sɛ wuntumi nnyina bere a wonam no na wuntumi nnyina hɔ tẽẽ.
• Adwene a ɛyɛ basaa: Baabi a wowɔ, bere, ne nnipa a wunim wɔn mpo a wunhu.
• Ɛyɛ den sɛ wobɛmene: Sɛ woremene aduan anaa anonne a, wobɛte nka sɛ woremene wo.
• Nkae a ɛyera: Nsɛm a esisii nnansa yi mpo a wo werɛ fi.
• Nipasu mu nsakrae: Wote nka sɛ wonyɛ onipa a na woyɛ kan no, wo bo fuw ntɛm, na wo ho yeraw wo.
• Akisikuru: Nhumu a ɛyera mpofirim na ne ho popo.
• Ɔkasa mu akwanside: Nsɛmfua a wɔka no basabasa, wontumi nkasa pefee.

Dɛn na ɛde Whipple yare no ba?

Sɛnea nnuruyɛfo nim no, mmoawa pɔtee bi (Tropheryma whipplei) a abu so wɔ asase mu na ɛde yare no ba . Obiara a obenya ɔyare mmoawa yi wɔ asiane mu sɛ obenya ɔyare no. Nanso, sɛnea yɛadi kan aka no, Whipple yare no ho yɛ na koraa. Enti, ɛda so ara ntumi nna hɔ nea enti a nnipa binom nkutoo na wonya bi .

Nanso, nhwehwɛmu ada no adi sɛ nneɛma a edidi so yi betumi ama asiane a ɛwɔ hɔ sɛ obi benya yare no ayɛ kɛse :

• Mfe a wɔadi: Wɔada no adi sɛ Whipple yare no taa ka nnipa a wɔadi fi mfe 65-84 , nanso ebetumi aba nnipa a wonnii saa nso so.
• Asase anaa mmoayɛn a wɔde wɔn ho hyɛ mu: Nhwehwɛmu kyerɛ sɛ nnipa a wɔde dɔte anaa mmoayɛn yɛ adwuma no wɔ asiane kɛse mu sɛ wobenya saa yare yi. Ne titiriw no, ebia nnipa a wɔyɛ kua, wɔyɛ turo, anaa wɔne mmoa yɛ adwuma no wɔ asiane kɛse mu. Ebia mpo wubehyia saa mmoawa yi bere a wudua biribi ketewaa bi wɔ wo fie turo mu no.
• Awosu mu nkwaadɔm mu nsakrae:Abusuabɔ bi wɔ Whipple yare no ne awosu mu abɔde a ɛma protein (IFR4) no ntam. Saa protein yi boa yɛn nipadua mu nkwammoaa a ɛko tia nyarewa, te sɛ (B nkwammoaa) ne (T nkwammoaa) ma nyin. Wɔahu nso sɛ ɛne nkwaadɔm mu nsakrae bi a ɛwɔ awosu mu nkwaadɔm (HLA-B27) mu wɔ abusuabɔ. Eyinom mu dɔ kakra, nanso sɛ yɛbɛka no tiawa a, nsakrae ahorow bi a ɛba yɛn awosu mu nkwaadɔm mu no betumi ama yɛayɛ eyi.
• Nkwammoaa a ɛko tia nyarewa a ɛyɛ mmerɛw: Sɛ wowɔ yare bi a ɛka wo nipadua mu tumi a ɛko tia nyarewa (te sɛ HIV), anaa sɛ wofa nnuru a ɛma nipadua no tumi ko tia nyarewa (wɔde eyinom ma nyarewa bi, ɛtɔ mmere bi a wɔde ma nneɛma te sɛ ntini mu yare, anaa bere a wɔde akwaa foforo ama wo akyi) a, asiane kɛse nso wɔ hɔ sɛ wubenya saa yare yi.

Dɛn ne nsɛnnennen a ebetumi afi Whipple yare no mu aba?

Sɛnea yɛadi kan aka no, Whipple yare no fi nipadua no a entumi nnye srade, carbohydrates, vitamins, ne aduannuru afoforo mfi aduan a ɛfa wo dwensɔtwaa ketewaa mu no mu yiye . Ɛyɛ yare a ɛkɔ so nkakrankakra a bere kɔ so no ɛyɛ kɛse . Eyi kyerɛ sɛ sɛ wɔansa a, akwahosan ho haw foforo a emu yɛ den betumi aba.

Nsɛnnennen te sɛ eyinom betumi aba:

• Mogya a ɛtɔ mogya (mogya mu nkwammoaa kɔkɔɔ dodow a ɛba fam): Eyi betumi ama obi abrɛ, wayɛ mmerɛw, na ne ho ayɛ fitaa bere nyinaa.
• Dementia (nkae ne adwene mu dwumadi a ɛyera): Eyi betumi aba sɛ ntini a ɛma nipadua no yɛ adwuma no ka obi a.
• Koma mu nwiinwii: Wotumi te eyi bere a oduruyɛfo de afiri a wɔde tie asɛm hwehwɛ wo mu no.
• Oculomasticatory myorhythmia: Eyi yɛ sɛnkyerɛnne pɔtee bi, baabi a ɛte sɛ nea aniwa ne anom reyɛ biako .
• Pleural effusion: Eyi betumi ama ayɛ den sɛ ɔbɛhome.
• Uveitis: Nsɛnkyerɛnne no betumi ayɛ kɔkɔɔ, ɛyaw, ne aniwa a ɛyɛ mmerɛw.

Nea ɛho hia sen biara no, sɛ Whipple yare no ka wo ntini a ɛwɔ mfinimfini no a, ebetumi akum wo. Enti ɛho hia sɛ wokɔ oduruyɛfo nkyɛn ntɛm ara sɛ wowɔ sɛnkyerɛnne ahorow a.

Ɔkwan bɛn so na nnuruyɛfo hu Whipple yare no?

Sɛ wokɔ oduruyɛfo nkyɛn a, obedi kan ayɛ wo nipadua mu nhwehwɛmu . Afei, wobebisa w’ayaresa ho abakɔsɛm , a akwahosan ho haw biara a wowɔ mprempren anaa bere bi a atwam ka ho. Wobetumi nso abisa nnuru biara a wonom ne sɛ ebia obi wɔ w’abusua mu anya saa tebea horow yi bi anaa. Nea ɛka ho no, wobetumi ayɛ sɔhwɛ ahorow a edidi so yi:

• Complete Blood Count (CBC) : Eyi hwɛ sɛnea nipadua no mogya mu nkwammoaa te, sɛ mogya a ɛtɔ kɔ nipadua no mu, ne sɛ ebia sɛnkyerɛnne ahorow bi wɔ hɔ a ɛkyerɛ sɛ ɔyare mmoawa no wɔ hɔ anaa.
• Atifi endoscopy a wɔde yɛ dwensɔtwaa ketewaa no: Wɔ eyi mu no, wɔde afiri bi a mfoninitwa afiri ketewaa bi wom fa ano no mu na wɔhwɛ dwensɔtwaa ketewa no mu. Saa kwan yi so no, wobetumi ahwɛ nsakrae biara a ɛba hɔ, ɔyare mmoawa ho sɛnkyerɛnne. Wɔde wo bɛda ansa na wɔayɛ eyi, enti worente ɛyaw biara.
• Polymerase Chain Reaction (PCR) sɔhwɛ : Eyi yɛ sɔhwɛ titiriw a ebetumi aboa ma wɔahu sɛ mmoawa (T. whipplei) no wɔ hɔ anaa. Wobetumi ayɛ no wɔ ntini bi a wɔafa afi nipadua mu nhwehwɛmu mu anaasɛ ebia wɔde ayɛ nipadua mu nsu foforo so.
• Small intestin biopsy : Bere a wɔreyɛ endoscopy no, woyi ntini ketewaa bi fi dwensɔtwaa ketewa no mu na wɔde afiri a wɔde hwɛ nneɛma nketenkete hwehwɛ mu. Wɔtaa de eyi di dwuma de si Whipple yare no so dua. Ebetumi ahwehwɛ nsakrae pɔtee bi a ɛba dwensɔtwaa mu ntini a mmoawa no de ba no mu.

Ɔkwan bɛn so na wɔsa Whipple yare no?

Egye bere kakra ansa na wɔayi mmoawa a wɔde Whipple yare ba no afi nipadua no mu koraa. Enti, ayaresa no kyɛ kakra. Nanso sɛ wotɔ wo bo ase a, wubetumi anya nneɛma pa.

Eyinom ne nneɛma atitiriw a wɔyɛ sɛ ayaresa:

• Nnuru a ekum ɔyare mmoawa : Mpɛn pii no wɔde nnuru a ekum ɔyare mmoawa a wɔde fa ntini mu (IV) na efi ayaresa ase adapɛn abien kosi anan . Wɔtaa yɛ eyi wɔ ayaresabea. Ɛno akyi no, anyɛ yiye koraa no, ebehia sɛ wonom nnuru a ekum ɔyare mmoawa a wɔnom asram 12 a edi hɔ no . Ɛtɔ da bi a, ebia ɛho behia sɛ wofa wɔn kyɛ, kosi mfe abien. Ɛho hia yiye sɛ wobɛnom aduru no sɛnea wo duruyɛfo akyerɛ wo no pɛpɛɛpɛ.
• Nsuo a wɔde besi ananmu : Sɛ nsuo ho tew wo esiane atiridiinini nti a, wobetumi ama wo nsu a wɔde fa IV mu na aboa ma asiw ano. Anaasɛ, ebia wɔbɛka akyerɛ wo sɛ nom anonne a anyinam ahoɔden wom (te sɛ Jeevani) mfa nsi nsu ne nkyene a ayera ananmu.
• Vitamins ne aduannuru a wɔde ma : Ebia wo duruyɛfo bɛkamfo akyerɛ sɛ fa nnuru a wɔde ma a ɛbɛma vitamin (te sɛ vitamin D, B12, ne iron) ne aduannuru a wo dwensɔtwaa ntumi nnye no yiye. Ɛtaa ba sɛ aduannuru a enni nipadua mu ba wɔ saa yare yi mu.

So ayaresa no mu nsunsuanso bɔne bi wɔ hɔ?

Yiw, nsunsuanso bɔne bi betumi aba, titiriw wɔ nnuru a ekum ɔyare mmoawa ho. Nanso eyinom to obiara, na sɛ ɛba mpo a, mpɛn pii no ɛnyɛ aniberesɛm.

• Ɔyare a ɛma obi dwensɔ (yafunu mu yaw) .
• Adwene a ɛyɛ basaa
• Akisikuru ne ɔfe
• Wora a ɛyɛ mmerɛw
• Mmɔkaw mu yare (titiriw wɔ mmea awotwaa mu) .

Sɛ biribi te sɛ eyi si a, ɛho hia sɛ woka kyerɛ wo duruyɛfo . Ebia wobetumi asesa aduru no anaasɛ wɔama wo biribi foforo de atew nea efi mu ba no so.

Dɛn na obi a ɔwɔ Whipple yare no hyia?

Te sɛ nnipa pii no, wo nsoSɛ wufi ase sa yare wie a, wubefi ase ate ahotɔ nka ntɛm. Yafunu mu yaw ne nkwaa mu yaw bɛbrɛ ase nkakrankakra. Nanso, ebetumi adi mfe abien ansa na wo dwensɔtwaa ketewa no asa koraa. Enti, ɛho hia sɛ yenya abotare wɔ ayaresa ho.

Mpɛn pii no , wɔde ayaresa sa Whipple yare no koraa . Nanso, ɛtɔ mmere bi a, yare no tumi san ba bere a wɔasa yare no awie no. Ɛno nti na nnuruyɛfo bɛkɔ so ahwɛ wo.

Wo duruyɛfo bɛka akyerɛ wo sɛ bra mu nkɔyɛ nhwehwɛmu a wɔde di akyi daa wɔ bere tenten mu. Sɛ nhwɛso no, ebia wɔbɛka akyerɛ wo sɛ wɔnyɛ upper endoscopy:

• Asram asia biara wɔ afe a edi kan a wɔde sa yare no mu.
• Pɛnkoro afe biara wɔ mfe abiɛsa a edi hɔ no mu .
• Afei pɛnkoro wɔ mfe abiɛsa biara mu wɔ wo nkwa nna a aka nyinaa mu .

Wɔyɛ eyi de hwɛ sɛ yare no asan aba bio anaa. Enti, mma nsrahwɛ a wɔde di akyi no nmpa wo ti so sɛnea oduruyɛfo no kamfo kyerɛ no.

So wobetumi asiw Whipple yare no ano?

Ɛno yɛ den kakra sɛ yɛbɛka. Efisɛ ɛkame ayɛ sɛ mmoawa a wɔde Whipple yare ba no wɔ baabiara wɔ yɛn nneɛma a atwa yɛn ho ahyia no mu, titiriw wɔ asase mu . Nanso, ɛnyɛ obiara a ɔde ne ho hyɛ mu no na onya Whipple yare no.

Nanso, nnipa a wɔn nipadua mu tumi a ɛko tia nyarewa no ayɛ mmerɛw anaa wɔn a wɔnom nnuru a ɛma nipadua no tumi ko tia nyarewa no wɔ asiane kɛse mu sɛ wobenya yare no. Sɛ woyɛ saa nnipa yi mu biako a, ɛbɛyɛ papa sɛ wobɛhyɛ nsateaa bere biara a wode dɔte anaa atɛkyɛ bɛyɛ adwuma, na woahohoro wo nsa yiye bere a woawie adwuma . Hwɛ yiye titiriw sɛ woreyɛ turo anaasɛ wo ne mmoa reyɛ adwuma a.

Mɛyɛ dɛn ahwɛ me ho?

Ade a ɛho hia sen biara ne sɛ wobɛnom nnuru a ekum ɔyare mmoawa no sɛnea oduruyɛfo no akyerɛ no pɛpɛɛpɛ, bere tenten no nyinaa . Mma da koro nmpa wo ti so, na nom aduru no bere tenten a oduruyɛfo no akyerɛw ama wo no nyinaa. Anyɛ yiye koraa no, ebehia sɛ nnipa dodow no ara nom nnuru a ekum ɔyare mmoawa afe biako bere a wɔahu sɛ wɔanya bi no. Ebia ɛho behia sɛ nnipa binom nom nnuru a ekum ɔyare mmoawa wɔn nkwa nna nyinaa. Ɛno yɛ oduruyɛfo no na ɛsɛ sɛ osi ho gyinae.

Sɛ wowɔ Whipple yare a, ebia wo nipadua rehwere aduannuru a ɛho hia pii . Sɛ wunya ahotɔ wɔ ayaresa mu mpo a, ɛda so ara yɛ papa sɛ wobɛkɔ akɔhwɛ aduan ho ɔbenfo bi akyerɛ nea ɛsɛ sɛ wudi na wonom . Eyi bɛboa wo ma woanya aduan pa na woakura mu duru a ɛfata.

Bere bɛn na ɛsɛ sɛ mesan kɔ oduruyɛfo nkyɛn bio?

Sɛ wokɔ so nya Whipple yare no ho sɛnkyerɛnne bere a woafi ayaresa ase akyi, anaasɛ sɛ sɛnkyerɛnne no san ba bere a wɔawie ayaresa no akyi bere tiaa bi (sɛ nhwɛso no, sɛ wo yafunu yɛ wo yaw anaa wo nkwaa mu yaw a), hwɛ hu sɛ wobɛkɔ wo duruyɛfo nkyɛn. Ntwentwɛn wo nan ase. Eyi betumi akyerɛ sɛ yare no asan aba, anaasɛ ebia ɔhaw foforo bi wɔ hɔ.

Adɛn nti na wɔfrɛ saa yare yi "Whipples disease"?

Eyi yɛ papa sɛ wubehu. Wɔde George H. Whipple, ɔyare ho ɔbenfo bi a odii kan kaa sɛnkyerɛnne ahorow no ho asɛm wɔ 1907. Mfe 80 akyi ansa na nhwehwɛmufo huu mmoawa a wɔde ba no din. Wɔtoo mmoawa no din Tropheryma whipplei. Edin no yɛ Hela nsɛmfua abien a wɔaka abom, "trophe" a ɛkyerɛ aduan pa ne "eryma" a ɛkyerɛ akwanside . Ɛkyerɛ sɛ ɛde malabsorption ba . So ɛnyɛ edin a ɛfata?

Mmoawa wɔ baabiara a atwa yɛn ho ahyia (ne yɛn nipadua mu). Mpɛn pii no, mmoawa a yehyia wɔn da biara da no nhaw yɛn. Nanso ɔyare mmoawa a wɔntaa nhu yi, Whipple yare no, yɛ soronko kakra. Ɛyɛ mmoawa bi a wɔtaa hu wɔ asase mu a wɔfrɛ no Tropheryma whipplei.

Wubetumi anya saa mmoawa yi (T. whipplei) wɔ adwumam anaa bere a woreyɛ turo no. Nanso, ɛnyɛ obiara a obenya bi no na obenya Whipple yare no. Nea eye ne sɛ, mpɛn pii no, sɛ wohu tebea no ntɛm na wɔsa no yiye a, wobetumi asa.

Nneɛma a ɛho hia paa a ɛsɛ sɛ wokae

Whipple Yare no yɛ ɔyare mmoawa a wɔntaa nhu , nanso sɛ wɔsa no yiye a .

• Sɛ sɛnkyerɛnne ahorow te sɛ nkwaa mu yaw, yafunu a ɛyɛ yaw, akisikuru, ne mu duru a ɛso tew kɔ so a, hwɛ hu sɛ wobɛkɔ oduruyɛfo nkyɛn. Mma w’ani ngu eyinom so.
• Nea ɛka ayaresa ho ne sɛ wɔbɛnom nnuru a ekum ɔyare mmoawa bere tenten . Ɛho hia paa sɛ wudi wɔn akyi pɛpɛɛpɛ.
• Sɛ wode dɔte reyɛ adwuma, titiriw sɛ wo nipadua no mu tumi a ɛko tia nyarewa no ayɛ mmerɛw a, hohoro wo nsa yiye na fa nsateaa di dwuma .
• Sɛ yareɛ no sa mpo a, ɛho hia sɛ wɔkɔ kɔhwɛ wɔn daa (follow-up) sɛdeɛ oduruyɛfoɔ no kyerɛ no.

Nsuro saa yare yi. Ɛho hia sɛ wɔbɔ wo amanneɛ na wohwehwɛ aduruyɛ mu afotu. Ɛnyɛ wo nko ara, na nnuruyɛfo bi wɔ hɔ a wobetumi aboa wo wɔ ɔhaw biara ho. Sɛ w’adwene mu yɛ wo naa a, ntwentwɛn wo nan ase sɛ wo ne oduruyɛfo bɛkasa.