Èse protein wɔnuku sia si le wò ʋu me ŋu nya kpɔa? (Cryoglobulinemia) Mina míaƒo nu tso eŋu!

Ɣeaɖewoɣi la, nanewo dzɔna le míaƒe ŋutilã me siwo míele mɔ kpɔm na o, alo? Egbea míele nu ƒom tso nɔnɔme aɖe si wɔ nuku vie ŋu, gake enyo ŋutɔ be míanya nu tso eŋu. Woyɔa esia be cryoglobulinemia. Ŋkɔa aɖi nya sesẽ vie, gake mègatsi dzi o, mina míaɖe eme bɔbɔe.

Nukae nye cryoglobulinemia? Kpuie ko la,...

Kpuie ko la, cryoglobulinemia nye nɔnɔme si me protein aɖewo siwo mesɔ o siwo le wò ʋu me, siwo woyɔna be cryoglobulins, sesẽna, ƒoa ƒu, eye wowɔa ʋumenugbagbeviɣidɔ ne wotsɔe de dzoxɔxɔ si fa miamiamia me. Bu eŋu abe koklozi ƒe ami si le tsikpe me ne ètsɔe de tsi fafɛ me ene. Gake esia dzɔna le míaƒe ʋu me. Le nyateƒe me la, nɔnɔme sia nye ʋukawo me dɔléle ƒomevi aɖe. Enye wò ʋukawo, siwo nye ʋuka suesuesue siwo tsɔa ʋu toa wò ŋutilã katã me, ƒe abi, abe vuvu ene. Ne ʋuka siawo xɔ dzo la, ʋu ate ŋu atɔtɔ. Nukae dzɔna ɣemaɣi? Wò ŋutigbalẽ, lãmekawo, ƒunukpeƒewo, lãmekawo, kple vevietɔ wu la, ŋutinu ememetɔwo abe wò ayiku ene, ate ŋu agblẽ. Woyɔa esia ɣeaɖewoɣi be cryoglobulinemic vasculitis.

Ðe cryoglobulinemia ƒomevi aɖewo lia?

Ẽ, protein siawo siwo woyɔna be cryoglobulins hã nye dɔlékuiwutike ƒomevi aɖe. Le dɔlékuiwutike ƒomevi si míaƒe ŋutilã wɔ nu la, woate ŋu ama cryoglobulinemia ɖe hatsotso vevi etɔ̃ me:

• Cryoglobulinemia Ƒomevi I: Zi geɖe la, kansa siwo do ƒome kple wò ʋu alo kansa siwo do ƒome kple wò dɔlélenutsiŋutete gbɔe esia tsona.
• Cryoglobulinemia Ƒomevi II kple Cryoglobulinemia Ƒomevi III: Wokpɔa ƒomevi eve siawo zi geɖe kple dɔdzẽ ƒe nɔnɔme siwo nɔa anyi didi (si fia be exɔa ɣeyiɣi didi). Le kpɔɖeŋu me, woate ŋu akpɔ wo le amesiwo ŋu dɔlélenutsiŋutete ƒe dɔlélewo le ŋu . Vevietɔ la, Type II Cryoglobulinemia bɔ ŋutɔ le amesiwo ŋu Hepatitis C dɔlékui (HCV) le la me. Wotsɔa ƒomevi eve siawo ƒoa ƒu eye woyɔa wo be Mixed Cryoglobulinemia.

Aleke gbegbee nɔnɔme sia bɔe?

Le nyateƒe me la, cryoglobulinemia nye dɔléle si mebɔ kura o.Gake numekulawo mete ŋu gblɔ ame agbɔsɔsɔme si tututu dɔlélea le kokoko o. Esi wònye be cryoglobulin siawo ƒe agbɔsɔsɔ si mede ame aɖewo ƒe ʋu me o gake womeɖea dzesi aɖeke fiana o ta la, numekulawo bu akɔnta be dɔlélea dzea ame abe ɖeka le miliɔn ɖeka me ene le xexeame katã.

Nukawoe nye dzesiawo? Ðe dzesiwo dzena le amesiame ŋua?

Ao, menye amesiame si ŋu cryoglobulinemia le la akpɔ dzesiawo o. Ðewohĩ ame aɖewo made dzesi naneke o. Gake ne dzesiawo dze la, dzesi si bɔ wue nye ŋutigbalẽ ƒe ʋuʋu si woyɔna be purpura. Esia dzena abe teƒe dzĩwo alo aɖabɛ dzĩwo ene le afɔ siwo le ete. Àte ŋu ase le ɖokuiwò me hã be ɖeɖi te ye ŋu eye ƒunukpeƒewo le veve sem. Dzesi bubuwo hã ate ŋu ado mo ɖa. Esiawo dometɔ aɖewoe nye:

• Ne wotsɔe de dzoxɔxɔ si fa miamiamia me la, ʋuka siwo le asiwo kple/alo afɔwo me la xaxa, si wɔnɛ be wozua blɔ. Woyɔa esia be Raynaud ƒe nudzɔdzɔ .
• Kpekpeme dzi ɖeɖe kpɔtɔ .
• Ʋusɔgbɔdɔ (Hypertension).
• Vuvu, vevietɔ le afɔkpodzi kple afɔwo (Edema).
• Ŋutilã me abi kple ɣeaɖewoɣi lãmenugbagbeviwo ƒe ku (gangrene).
• Aklã si lolo (Hepatomegaly) alo aklã si lolo (Splenomegaly).
• Numbness , ʋuʋudedi, alo gbɔdzɔgbɔdzɔ le abɔwo kple afɔwo me.
• Ayikuwo ƒe gbegblẽ.

Bu eŋu kpɔ, menye wò abɔ kple afɔwo ƒe blɔ le vuvɔ ta koe nye esia o. Esia ate ŋu anye kuxi gã aɖe si le wò ŋutilã me ƒe dzesi. Esia tae wòle vevie be nànɔ ŋudzɔ ɖe nu siawo tɔgbe ŋu ɖo.

Nukawoe hea cryoglobulinemia vɛ?

Numekulawo menya nusi tututu hea cryoglobulinemia vɛ haɖe o. Gake abe alesi míedzro eme va yi ene la, enye dɔléle ƒomevi aɖe si dɔlélenutsiŋutete wɔna si woyɔna be vasculitis, si nye ʋukawo ƒe dɔdzẽ. Ne wò ŋutilã ŋutɔ ƒe dɔlélenutsiŋutete, si nye ŋutilã ƒe ametakpɔnu si kpɔa tawò tso dɔléle me, dze wò ŋutɔ wò lãmeka siwo le lãmesẽ me dzi vodadatɔe ko. Nu geɖe li siwo ate ŋu ana nuwɔna sia nadzɔ:

• Domenyiŋusẽfianu: Ne dɔlélea le ame aɖe ŋu le ƒomea me la, ate ŋu agblẽ nu le eŋu.
• Atike ƒomevi aɖewo: Menye atikewo katãe o, ke boŋ ɖewo.
• Dɔlékuiwo kple dɔlékuiwo: Vevietɔ dɔlékuiwo ƒe dɔlékuiwo.
• Nutoa me ƒe nɔnɔmewo: Nu aɖewo le nuto si ƒo xlã mí me.

Cryoglobulinemia ate ŋu adzɔ le eɖokui si ɣeaɖewoɣi evɔ womekpɔ nusi gbɔ wòtso si dze ƒã o (woyɔa esia be idiopathic), gake zi geɖe la, edzɔna le kadodo me kple dɔléle bubuwo. Dɔléle siawo dometɔ aɖewoe nye:

• Aklãdɔléle C ƒe dɔléle: Esiae nye kadodo vevitɔ si wokpɔna wu eye wokpɔnɛ wu.
• Nusiwo mesɔ o le ʋumenugbagbeviɣiwo me: Le kpɔɖeŋu me, kansa ƒe nɔnɔmewo abe ʋumenugbagbeviɣidɔ kple ʋumenugbagbeviɣidɔ ene.
• Kadodo ƒe dɔlélewo: Kpɔɖeŋu aɖee nye lupus.

Amekae le afɔku me wu le esia ta?

Edze abe cryoglobulinemia gblẽa nu le nyɔnuwo ŋu wu ŋutsuwo ene, eye wòbɔ ɖe amesiwo xɔ wu ƒe 50 me wu.

Ðe kuxiwo ate ŋu ado mo ɖa ne womedae nyuie oa?

Ẽ, keŋkeŋ. Ne womeda cryoglobulinemia nyuie o la, ate ŋu agblẽ nu le wò ŋutigbalẽ, lãmekawo, kple ŋutinuwo ŋu tegbee. Kuxi sesẽ siwo ate ŋu ado mo ɖa dometɔ aɖewoe nye:

• Ŋutilã me dɔlékuiwo alo abi siwo meda gbe le o.
• Ŋutilã ƒe ku (necrosis).
• Ayiku ƒe dɔmawɔmawɔ nyuie.
• Aklã ƒe dɔmawɔmawɔ nyuie.

Esiawo nye nɔnɔme sesẽwo ŋutɔŋutɔ, si tae wòle vevie be woakpɔ dɔlélea ahadae kaba ɖo.

Aleke ɖɔktawo wɔa dea dzesi dɔléle siae?

Ne èyi ɖɔkta gbɔ la, abia wò atikewɔwɔ ŋutinya gbã eye wòado wò ŋutilã kpɔ. Emegbe, woaɖe gbe be woawɔ ʋudodokpɔ tɔxɛ aɖe atsɔ akpɔe ɖa be cryoglobulins le wò ʋu me hã. Ʋudodokpɔ sia ate ŋu ana nànya cryoglobulin ƒomevi si le asiwò hã. Esia ate ŋu akpe ɖe ŋuwò ɣeaɖewoɣi be nànya nusi gbɔ wò dɔlélea tso kple alesi nàdae. Tsɔ kpe ɖe ʋudodokpɔ sia ŋu la, wò ɖɔkta ate ŋu aɖe gbe be woawɔ dodokpɔ bubu geɖe atsɔ aɖo kpe dɔlélea dzi ahase nɔnɔmea gɔme:

• Aɖuɖɔ dodokpɔ (Urinalysis).
• Akɔta ƒe X-ray.
• CT-dɔdamɔnu (Computed tomography (CT) scan) ƒe fotoɖeɖe.
• Angiogram (si léa ŋku ɖe ʋukawo ƒe nɔnɔme ŋu).
• MRA (magnetic resonance angiogram) alo CT ʋukawo ƒe dodokpɔ (CT angiogram) dodokpɔwo.
• Lãmetsiŋusẽ ƒe ʋuʋu ƒe dodokpɔ.
• Elektromyography (EMG) dodokpɔ (kpɔ lãmekawo ƒe dɔwɔwɔ).
• Biopsy (lãmenugbagbevi sue aɖe ɖeɖe, ɖewohĩ tso ŋutigbalẽ alo ayiku me, hena dodokpɔ).

Aleke wowɔa nu ɖe ​​esia ŋui?

Cryoglobulinemia dada nɔ te ɖe ŋutinu siwo ŋu wògblẽ nu le, alesi gbegbe wògblẽe, kple nenye be atikewɔwɔ me dɔléle bubuwo le ŋuwò dzi.Ele vevie be woada dɔléle bubu siwo ate ŋu ado ƒome kple cryoglobulinemia, abe aklãdɔléle C ene, kpakple nɔnɔme bubu siwo ate ŋu ado ƒome kplii. Esia le alea elabena nɔnɔme bubu mawo dada ate ŋu akpe ɖe ame ŋu ɣeaɖewoɣi be woaɖe cryoglobulinemia ƒe dzesiwo dzi akpɔtɔ. Ne wò dzesiawo mesẽ o la, wò ɖɔkta ate ŋu aɖo aɖaŋu na wò be nàzã vevesesenutsitike siwo womeƒlena le atikedzraƒe o (abe NSAID ene) eye wòaɖo aɖaŋu na wò be nàƒo asa na dzoxɔxɔ si nu fa miamiamia . Woate ŋu aɖo aɖaŋu hã be nàdo wò kpɔ edziedzi be nàlé ŋku ɖe wò nɔnɔmea ŋu. Le dɔléle siwo nu mesẽ o, alo esiwo le titina va ɖo esiwo nu sẽ me la, atikewɔwɔ ate ŋu ato vovo vie:

• Dɔlélenutsiŋutete ƒe atikewo: Esiae nye atike vevitɔ. Wonaa corticosteroids, abe prednisone ene, kpena ɖe atike bubuwo ŋu ɣeaɖewoɣi. Esia nɔ te ɖe ŋutinu si ŋu wògblẽ nu le kple alesi gbegbe wògblẽe dzi.
• Dɔlékuiwutikewo: Ne wò ɖɔkta kpɔe be dɔléle bubu aɖe le ŋuwò, abe aklãdɔléle C ene la, ate ŋu aɖo aɖaŋu na wò be nàzã dɔlékuiwutikewo. Woate ŋu aɖo wò ɖe aklãŋutinunyala (aklãŋutinunyala) hã gbɔ.
• Nu gbagbewo: Rituximab nye atike si wozãna tsɔ daa cryoglobulinemia. Biologics nye protein sesẽ siwo wowɔ tso nugbagbevi siwo tɔa ŋku dɔlélenutsiŋutete ƒe akpa aɖewo koŋ be woatsɔ aɖu dɔdzẽ dzi.
• Plasmapheresis: Esia hã nye atikewɔwɔ bubu. Ewɔa dɔ to cryoglobulins ƒe agbɔsɔsɔ si le wò ʋu me dzi ɖeɖe kpɔtɔ me. Le esia wɔwɔ me la, woɖea cryoglobulins la ɖa le wò ʋumenugbagbeviɣi (wò ʋu ƒe akpa si nye tsi) me. Esia kpena ɖe ame ŋu be cryoglobulins la nagaxe wò ʋukawo o, si xea mɔ na ʋu ƒe sisi eye wòɖea ŋutinuwo ƒe gbegblẽ dzi kpɔtɔna.

Mina míanya nu tso atikewɔwɔ ƒe nugbegblẽ le ame ŋu kple kuxi siwo dona tso eme hã ŋu.

Atike siwo ɖɔktawo ŋlɔna na ame be woatsɔ ada cryoglobulinemia ate ŋu agblẽ nu le ame ŋu vevie. Wo dometɔ vevitɔwoe nye ƒumeŋuɖui kple ŋutete si le ŋutilãa ŋu be wòawɔ avu kple dɔlékuiwo dzi ɖeɖe kpɔtɔ. Eyata ele vevie ŋutɔ be nàyi ɖɔkta gbɔ edziedzi be woado ye kpɔ. Emegbe, wò ɖɔkta ate ŋu aŋlɔ atike bubuwo na wò be nàtsɔ aɖu eƒe nugbegblẽ le ame ŋu siawo dzi. Ele vevie hã be nàkpɔ ɖokuiwò ta tso dɔlékuiwo me. Eyata ƒo nu kple wò ɖɔkta tso atikewɔmɔnu siwo ate ŋu aɖe dɔlékuiwo xɔxɔ ƒe afɔkua dzi akpɔtɔ ŋu.

Ðe mɔ aɖe li si dzi woato axe mɔ ɖe nɔnɔme sia nua?

Esi womenya nusi tututu gbɔ cryoglobulinemia tsona o ta la, mɔ aɖeke koŋ meli si dzi woato axe mɔ ɖe enu o. Gake ne míeƒo asa na vuvɔ nɔnɔ ate ŋu akpe ɖe ŋuwò .Ate ŋu akpe ɖe ŋuwò nàɖu dzesi aɖewo, abe Raynaud ƒe nudzɔdzɔa ene, dzi. Ele vevie ŋutɔ hã be woado Hepatitis C dɔlékui kpɔ eye woakpɔ atike ne exɔe.

Nukae nye nyagblɔɖi na amesi le dɔléle sia lém?

Wò nukpɔsusu, si fia alesi dɔlélea anɔ, nɔ te ɖe nu geɖe dzi:

• Atikewɔwɔ me nɔnɔme bubu siwo le ŋuwò.
• Afisi wò ŋutinuwo gblẽ le.
• Aleke gbegbe nèwɔa nu ɖe ​​atikewɔwɔ ŋui.

Azɔ hã, alesi dɔlélea nu sẽe la toa vovo tso ame ɖeka gbɔ yi bubu gbɔ. Ðewohĩ dzesi aɖeke manɔ ame aɖewo ŋu kura o, alo woƒe nɔnɔmea nu fa ale gbegbe be mahiã be woawɔ atike na wo o. Le amesiwo ƒe dɔlélea le titina alo esiwo nu sẽ gome la, dɔlélea didi kaba kple edada ate ŋu akpe ɖe wo ŋu woaɖe dzesiawo dzi akpɔtɔ eye woaxe mɔ ɖe kuxi siwo nɔa anyi didi nu. Ne wò ŋutinuwo megblẽ tegbee o la, ke nɔnɔmea nyo ŋutɔ.

Aleke malé be na ɖokuinye? Amekae li akpe ɖe ŋunye?

Nu nyuitɔ si nàte ŋu awɔe nye be nàwɔ dɔ kplikplikpli kple wò atikewɔlawo ƒe ƒuƒoƒoa. Le ŋutinu siwo dzi wò cryoglobulinemia gblẽ nu le nu la, ahiã be nàwɔ dɔ kple ɖɔktawo ƒe ƒuƒoƒo si me tɔwo nye dɔwɔla vovovowo. Esiawo ate ŋu anye:

• Ðɔkta siwo bi ɖe ƒunukpeƒewo kple kadodoŋusẽdɔlélewo me (Rheumatologists).
• Ŋutilãŋutinunyalawo.
• Ʋumenugbagbeviɣidɔŋutinunyalawo.
• Ðɔkta siwo bi ɖe ayikudɔlélewo me (Nephrologists).
• Dzidɔŋutinunyalawo.
• Ahɔhɔ̃ŋutinunyalawo.
• Aklãŋutinunyalawo.

Nya wò atikewɔlawo ƒe ƒuƒoƒoa nyuie. Ƒo nu na ɖokuiwò. Bia nya aɖewo. Ne nane tsi dzi na wò le wò atikewɔwɔ ƒe ɖoɖoa ŋu la, ƒo nu tso eŋu. Wò ɖɔktawo li be yewoaɖo to wò ahakpɔ egbɔ be yese nusianu si kpɔa ŋusẽ ɖe wò lãmesẽ kple beléle na wò dzi gɔme bliboe.

Ɣekaɣie wòle be makpɔ ɖɔkta?

Ne cryoglobulinemia ƒe dzesi aɖewo le ŋuwò la, ele be nàyi atikewɔƒe enumake. Azɔ hã, ne aklãdɔléle C le ŋuwò eye dzesi siawo dometɔ aɖe dze la, yi ɖɔkta gbɔ. Ne wodae nyuie gɔ̃ hã la, dɔlélea ate ŋu agadzɔ ake ɣeaɖewoɣi (agbugbɔe adze egɔme). Ne dzesi yeyewo va dze ŋuwò, ne wò dzesi siwo li xoxo la gagblẽ ɖe edzi, alo ne wò dzesiwo gadze la, yi ɖɔkta gbɔ. Atikewɔlawo ƒe dodokpɔ edziedzi kple edziyiyi edziedzi le vevie be woade dzesi dɔléle ɖesiaɖe si gbugbɔna dzɔna kaba eye woaxe mɔ ɖe kuxiwo nu.

Nya kawoe wòle be mabia ɖɔktaa?

Ne èyi ɖɔkta gbɔ la, anyo be nàbia nya siawo tɔgbe:

• Nukae na mexɔ dɔléle sia?
• Atikewɔwɔ kawoe nèkafu?
• Atikewɔwɔ ƒe nugbegblẽ kawo ŋue wòle be matsi dzi ɖo?
• Kuxi kawoe ate ŋu ado mo ɖa le nɔnɔme sia ta?
• Nukae mate ŋu awɔ be dɔlélea nagagadzɔ o?

Nu vevitɔ kekeake siwo dzi wòle be míaɖo ŋkui (Take-Home Message) .

Agbenɔnɔ kple cryoglobulinemia ate ŋu asesẽ ɣeaɖewoɣi. Atikewo ƒe dzesiwo kple nugbegblẽ le ame ŋu ate ŋu akpɔ ŋusẽ gã aɖe ɖe wò susu ƒe nyonyo dzi. Ate ŋu akpɔ ŋusẽ ɖe wò agbenɔnɔ ƒe akpa bubu geɖewo hã dzi.

Gake ɖo ŋku edzi be menye wò ɖeka koe o. Bia wò ɖɔkta be wòakpe ɖe ye ŋu, eye nàdi kpekpeɖeŋunaha siwo me ame bubu siwo le nɔnɔme mawo tɔgbe me tom ate ŋu aƒo ƒu ɖo. Wò nuteƒekpɔkpɔwo kple nusiwo nènya gbɔgblɔ ate ŋu akpe ɖe ŋuwò nànɔ agbe kple cryoglobulinemia. Takpɔkpɔ tso vuvɔ me, atikewɔlawo ƒe aɖaŋuɖoɖo didi, atamanono, kple nuɖuɖu si da sɔ ɖuɖu katã le vevie.

Mele mɔ kpɔm be nyatakaka sia aɖe vi na wò. Nɔ lãmesẽ me!