Ðe wò ŋutilã ŋutɔ ƒe ametakpɔnu le fefem ɖe ŋuwòa? Mina míasrɔ̃ nu tso Autoimmune Pancreatitis ŋu le mɔ bɔbɔe aɖe nu!

Ametakpɔnu wɔnuku aɖe le míaƒe ŋutilã me, alo? Emae míeyɔna be dɔlélenutsiŋutete. Ekpɔa mía ta to avuwɔwɔ kple dɔlékuiwo, dɔlékuiwo, kple dɔlékui siwo hea dɔléle vɛ me. Gake bu eŋu kpɔ, ne ɣeaɖewoɣi míaƒe ametakpɔnu sia tututu tɔtɔ kple lãmenugbagbevi nyui siwo le mía ŋutɔwo míaƒe ŋutilã me eye wòdze wo dzi dzedze gɔme ya ɖe? Ɣemaɣie wòdzɔna, si woyɔna be ``Autoimmune Pancreatitis''. Kpuie ko la, wò ŋutɔ wò dɔlélenutsiŋutete dzea dɔwɔwɔ gɔme ɖe wò dɔgbo ŋu.

Nukae nye ``Autoimmune Pancreatitis''? Kpuie ko la,...

Bu wò ŋutilã ƒe dɔlélenutsiŋutete be enye aʋakɔ si kpɔa dukɔ aɖe ta. Asrafoha sia ƒe dɔe nye be wòakpɔ dukɔa ta tso gotagome futɔwo (abe dɔlékuiwo kple dɔlékuiwo ene) si me. Gake le `(Autoimmune Pancreatitis)` me la, asrafoha sia wɔa vodada eye wòdzea eya ŋutɔ ƒe dukɔ me dumevi maɖifɔwo dzi (si nye lãmenugbagbevi siwo le lãmesẽ me le dɔgboa me) hesusuna be yewonye futɔwo. Esia wɔnɛ be dɔgboa va xɔa abi, exɔa abi, eye eƒe dɔwɔwɔ meganɔa dɔ wɔm nyuie o. Esiae nye nusi míeyɔna be autoimmune pancreatitis .

Aleke gbegbee dɔléle sia bɔe?

Le nyateƒe me la, `(Autoimmune Pancreatitis)` nye dɔléle si mebɔ kura o . Zi geɖe la, edzɔna le ame siwo ade ame akpe alafa ɖeka ɖesiaɖe me. Ne míetsɔ dɔdzẽ ƒe nɔnɔme siwo nɔa anyi didi (`chronic pancreatitis`) la, wo dometɔ siwo ade 2% koe dzena le `(Autoimmune Pancreatitis)` ƒe hatsotso sia me. Eyata, esia menye dɔléle si dzea amesiame dzi o.

Ðe `(Autoimmune Pancreatitis)` ƒomevi aɖewo lia?

Ẽ, `(Autoimmune Pancreatitis)` ƒomevi eve koŋue li. Na míakpɔ nusiwo wonye ɖa.

1. Dɔlélenutsiŋutete ƒe Dɔlékuiwutike Ƒomevi 1

Esiae nye ƒomevi si bɔ wu . Le esia me la, protein si woyɔna be `(Immunoglobulin G4)` alo `(IgG4)` geɖe wu le míaƒe ŋutilã me. `(IgG4)` sia nye dɔlékuiwutike ƒomevi aɖe. Ne vuvu alo abi le ŋutilã ƒe akpa ɖesiaɖe la, `(IgG4)` sia ƒe agbɔsɔsɔ dzina ɖe edzi.

Gake le ƒomevi gbãtɔ sia me la, menye dɔgboa ɖeɖeko ŋue kuxia le o. Ate ŋu akpɔ ŋusẽ ɖe míaƒe ŋutilã ƒe ŋutinu bubuwo hã dzi. Le kpɔɖeŋu me:

• Aɖuɖɔtoewo: Esiawo nye ʋuka siwo le abe mɔ̃ ene siwo tsɔa ʋumenugbagbeviɣi tso aklã me yia dɔgbo suea me.
• Ayiku ƒe ʋukawo: Ayiku siwo le ayiku me.
• Aklã
• Dzitodzito
• Aɖuɖɔtoe
• Aɖuɖɔtoewo
• Thyroid ƒe lãkusi

Ate ŋu avuvu ahagblẽ nu le teƒe siawo tɔgbe hã.

2. Dɔlélenutsiŋutete ƒe Dɔlékuiwutike Ƒomevi 2 lia

Dɔgboa koe ƒomevi sia gblẽa nu le eŋu . Nusi dzɔna le afisia enye be ʋumenugbagbevi ɣi ƒomevi aɖe si woyɔna be ``neutrophils`` gblẽa nu le dɔgboa kple dɔgbo ƒe mɔ̃wo ŋu. Wokpɔa nɔnɔme sia zi geɖe le sɔhɛwo gome.Anɔ eme hã be dɔgbo ƒe dɔléle si naa dɔgboa (IBD) naxɔ wo.

Nukae nye nusiwo gbɔ `(Autoimmune Pancreatitis)` tsona? Ðe afɔku aɖewo lia?

Numekulawo gale agbagba dzem be yewoanya nusi tututu gbɔ wòtso , gake zi geɖe la, edzɔna le amesiwo xɔ tso ƒe 50 va ɖo ƒe 60. Gake ate ŋu adzɔ do ŋgɔ. Ŋutsuwo ate ŋu axɔ dɔlélea zi gbɔ zi eve wu nyɔnuwo.

Ɣeaɖewoɣi la, wosusuna be enye ŋutilã ƒe dɔlélenutsiŋutete ƒe nuwɔna ɖe dɔlékui aɖe ƒe dɔléle aɖe ŋu. Tsɔ kpe ɖe eŋu la, amesiwo ŋu dɔlélenutsiŋutete ƒe dɔléle bubuwo le la le afɔku gã aɖe me be woaxɔe. Le kpɔɖeŋu me:

• (Hashimoto ƒe thyroiditis): Esia nana be thyroid gland la mewɔa dɔ boo o (hypothyroidism).
• (Dɔléle si tsoa dɔgbo me - IBD): Vevietɔ nɔnɔmewo abe `(ulcerative colitis)`.
• (Bliary cholangitis gbãtɔ) .
• Retroperitoneal fibrosis: Lãmetsi siwo le abe abi ene ƒe wɔwɔme le ƒodo ƒe megbeƒu me.
• Rheumatoid arthritis: Ƒunukpeƒewo ƒe dɔdzẽ.
• (Sarcoidosis ƒe dɔléle) .
• (Sjögren ƒe dɔlélea) .

Ne autoimmune dɔléle bubuwo abe esia ene le ŋuwò la, anyo be nàtsi dzi vie ɖe Autoimmune Pancreatitis hã ŋu.

Nukae nye `(Autoimmune Pancreatitis)` ƒe dzesiwo?

Le dɔléle sia ƒe gɔmedzedze la , ɖewohĩ dzesi aɖeke manɔ eŋu o . Gake ne dɔlélea le sesẽm ɖe edzi la, dɔgboa ƒe ʋukawo tea tsitsi, si wɔnɛ be dɔlékui siwo dona le dɔgboa me la mete ŋu toa eme nyuie o.

Ne dɔgboa ƒe ʋuka xe la, ate ŋu ahe dzesiwo abe:

• Ƒodo si le etame ƒe vevesese
• Titina akɔtave
• Dɔmetɔtrɔ
• Aɖuɖɔtoe/ʋuʋudedi
• Kpekpeme dzi ɖeɖe kpɔtɔ

Vevietɔ: Woate ŋu akpɔ dzesi siawo dometɔ aɖewo le dɔdzẽ si le dɔgboa me hã me. Eyata ne dzesi siawo le ŋuwò la, nunya anɔ eme be màgatsi dzodzodzoe ahayi ɖɔkta enumake be yeanya nusi tututu kuxia nye o . `(Autoimmune Pancreatitis)` ƒe amesinɔnɔ mefia be kansa le ŋuwò o.

Tsɔ kpe ɖe eŋu la, dɔlékuiwutikewo ƒe dɔdzẽ ate ŋu ana dɔdzẽ navuvu, wòatsi si menye kansa o, eye tsi yɔ fũu le dɔgboa me. Ne ʋuʋudedi, ƒunukpeƒetetedɔ, alo ʋuʋudedi siawo va le wò dɔgbo ƒe ta me la, woate ŋu axe ʋuka si me ʋu sina tona, si ate ŋu axe mɔ na ʋumenugbagbeviɣidɔ be wòagage ɖe dɔgbo suea me nyuie o. Amadede aɖe si woyɔna be bilirubin le ʋuka me. Ne bilirubin sia ƒo ƒu ɖe ʋua me la, ate ŋu ana ame naxɔ aɖuɖɔtoe.Ŋkuwo ƒe ŋutigbalẽ kple ɣiwo va zua ɣie (jaundice), eye ɖewohĩ ɖeɖi te ŋuwò. Ne bilirubin dzi ɖe edzi le aɖuɖɔ me la , aɖuɖɔa doa viviti . Ne woɖe bilirubin do goe le dɔgboa me la , aɖuɖɔa ate ŋu azu amadede dzẽ .

Nukae nye kuxi siwo ate ŋu ado tso `(Autoimmune Pancreatitis)` me?

Dɔdzẽ si nɔa dɔgboa me atraɖii ate ŋu ana ame natsi ƒodo, eƒe lolo dzi naɖe akpɔtɔ, eye wòase veve atraɖii le ƒodo ƒe akpa si le etame kple akɔta. Azɔ hã, ne lãmenugbagbevi siwo wɔa insulin le dɔgboa me gblẽ la , suklidɔ ate ŋu adze ame dzi.

IgG4 dɔlékuiwutikewo ate ŋu adze menye dɔgboa ɖeɖeko dzi o, ke woate ŋu adze ŋutinu bubuwo hã dzi, vevietɔ le Ƒomevi 1. Ŋutinu mawo dometɔ aɖewoe nye:

• Ʋuka siwo me ʋu sina tona
• Aɖuɖɔtoewo
• Aɖatsi ƒe lãkusiwo
• Lãmetsiŋusẽ ƒe lãkusi (`Thyroid`) .
• Ayikuwo
• Dzi
• Aklã kple lãkusi (aɖuɖɔtoe ƒe akpa si le lãkusi me) .

Aleke wowɔa wokpɔa Autoimmune Pancreatitis?

Be woate ŋu anya dɔléle sia nyuie ahaka ɖe edzi be menye dɔdzẽe le dɔgboa me o la, ahiã be woawɔ dodokpɔ geɖe. Ahiã be woawɔ dodokpɔwo abe esiawo ene:

• Ʋudodokpɔ: Esiawo léa ŋku ɖe IgG4 ƒe agbɔsɔsɔ si mesɔ o ŋu, kpakple aklã ƒe dɔwɔwɔ kple ʋumenugbagbevi ƒomevi aɖewo ƒe agbɔsɔsɔ ŋu.
• Nɔnɔmetatawo dodokpɔ: Esiawo léa ŋku ɖe dɔgboa ƒe lolome ŋu, ne abi aɖewo le eŋu, alo nenye be ʋukaawo xaxa. Dodokpɔ siawo ƒe kpɔɖeŋuwoe nye `(CT scan)` kple `(MRI scan)`.
• Biopsy: Esia bia be woaɖe lãkusi sue aɖe le wò dɔgboa me ahalé ŋku ɖe eŋu le nusuekpɔmɔ̃ me. Zi geɖe la, wowɔa esia to dɔlékuiwo me toto si me womewɔa nu boo aɖeke le o si woyɔna be Endoscopic Ultrasound (EUS) dzi. Le dɔ sia wɔwɔ me la, wò ɖɔkta tsɔa mɔ̃ didi aɖe si te ŋu trɔna bɔbɔe (si me akaɖi kple ultrasound-mɔ̃ le eƒe nugbɔ ɖeka) dea wò dɔgbo kple dɔgbowo me be wòalé ŋku ɖe wò dɔgbo ŋu. Emegbe woɖea biopsy sample to wò dɔgbo alo dɔgbowo me. Ɣeaɖewoɣi la, ahiã be amekola naɖe wò ŋutigbalẽ sue aɖe (laparoscopy) hafi axɔ ŋutilã ƒe akpa aɖe ƒe kpɔɖeŋu.
• Corticosteroid dodokpɔ: Esia kpena ɖe ame ŋu hã be woaɖo kpe dɔlélea dzi. Wona steroid wò hena ɣeyiɣi kpui aɖe be nàkpɔe ɖa be wò IgG4 ƒe agbɔsɔsɔ dzi ɖe kpɔtɔ eye wò nɔnɔmetata dodokpɔwo nyo ɖe edzi hã.

Aleke wowɔa atike na `(Autoimmune Pancreatitis)`?

Nukutɔe la, le ame ʋɛ aɖewo ŋutɔ gome la, dɔléle sia nu tsona le eɖokui si atike aɖeke manɔmee . Gake le ame geɖe gome la, ehiã be woawɔ atike na ame .

Wotsɔa corticosteroids koŋ daa dɔlékuiwutikewo ƒe Dɔlélenutsiŋutete.Atike ƒomevi aɖe si woyɔna be steroid. Le kpɔɖeŋu me, atike abe `(prednisone)` alo `(prednisolone)` ene. Atike siawo wɔa dɔ to abi dzi ɖeɖe kpɔtɔ kple dɔlélenutsiŋutete si wɔa dɔ fũ akpa ƒe fafa me. Zi geɖe la, wodzea atikewɔwɔ gɔme kple steroid agbɔsɔsɔme si wozãna. Emegbe woɖea agbɔsɔsɔme si wozãna dzi kpɔtɔna vivivi (`tapered`).

Ne kuxi aɖeke mele ŋuwò o la, zi geɖe la, mèhiã atike bubu aɖeke kpee o. Atikewɔwɔ si hiã la nɔ te ɖe kuxi si ƒomevi wòdo tso eme dzi. Ne dɔgboa ƒe mɔ̃a ƒe kpuiƒe aɖe li (`duct narrowing`) la, woate ŋu awɔ dɔ aɖe atsɔ aʋu ʋukaa eye woatsɔ mɔ̃ si me do le (`stent`) ado ŋusẽe.

Ðe mate ŋu axe mɔ ɖe `(Autoimmune Pancreatitis)` xɔxɔ nua?

Le nyateƒe me la, naneke meli nàte ŋu awɔ atsɔ axe mɔ ɖe dɔléle sia nu o elabena enye kuxi na mía ŋutɔwo ƒe dɔlélenutsiŋutete.

Nukae nye mɔkpɔkpɔ na amesiwo ŋu `(Autoimmune Pancreatitis)` le?

Ame akpa gãtɔ hayana nyuie le corticosteroid zazã vɔ megbe , eye kuxi aɖeke menɔa eme o. Dɔlélenutsiŋutete ƒe dɔdzẽ si le ame ŋu mekpɔa ŋusẽ ɖe wò agbenɔƒe dzi o .

Ke hã, `(Autoimmune Pancreatitis)` ate ŋu agava (gbugbɔgadzɔ) . Esia bɔ vevietɔ le amesiwo si ƒomevi gbãtɔ (`Ƒomevi 1`) le me. Anɔ eme wu be dɔlélea agadze le ƒe etɔ̃ gbãtɔ siwo me wokpɔ dɔlélea le vɔ megbe. Amesi ŋu dɔlélea gadzena ake hã ate ŋu adze kuxiwo gɔme.

Nukae dzɔna ne dɔlélea gadze ake?

Ne wokpɔ egbɔ dzidzedzetɔe la, amesiwo ŋu dɔlélea gbugbɔna gɔ̃ hã ate ŋu anɔ agbe si me dzo le, si me lãmesẽ le .

Ðewohĩ ahiã be nàgadze corticosteroids zazã gɔme ake. Ame aɖewo yia steroid zazã dzi ƒe geɖe be dzesiawo nagatrɔ ava o. Ðɔktawo ate ŋu ate atike bubu siwo daa dɔlélenutsiŋutete si wɔa dɔ fũu akpa hã kpɔ (atike siwo trɔa dɔlélenutsiŋutete kple esiwo tsia dɔlélenutsiŋutete nu).

Aleke mase le ɖokuinye me le atikewɔwɔ me?

Nu gbegblẽ aɖewo ate ŋu ado mo ɖa ne wole steroid zãm. Le kpɔɖeŋu me, dɔgbo ƒe veve, nuɖuɖu ƒe dzodzro dzina ɖe edzi, dziɖeleameƒo, kple alɔ̃dɔdɔ sesẽna. Nu gbegblẽ siawo ate ŋu agblẽ nu le gbesiagbegbenɔnɔ ŋu vie, gake wonɔa anyi ɣeyiɣi kpui aɖe . Be nàkpɔ viɖe geɖe tso wò Autoimmune Pancreatitis dɔdamɔnua me la, ele vevie be nàyi edzi anɔ steroid-tikeawo nom abe alesi wò ɖɔkta gblɔe ene .

Ne eƒe nugbegblẽ le ame ŋu ɖea fu na wò akpa be nàdo dzi la, kpɔ egbɔ be yena wò ɖɔkta nanya hafi adzudzɔ atikewɔwɔ. Ate ŋu aŋlɔ atike bubuwo na wò be wòakpe ɖe ŋuwò nàkpɔ gbɔdzɔe, alo atrɔ wò atikewɔwɔ ƒe ɖoɖoa.

Ɣekaɣie mate ŋu atrɔ ayi dɔwɔna siwo sɔ gbɔ le `(Autoimmune Pancreatitis)` ƒe atikewɔwɔ vɔ megbe?

Zi geɖe la, steroid zazã naa gbɔdzɔe tso `(Autoimmune Pancreatitis)` ƒe dzesiwo me le kwasiɖa ʋee aɖewo me.Ame geɖe trɔna yia woƒe dɔwɔna siwo wowɔna ɖaa dzi ne woƒe dzesiwo nu yi.

Autoimmune Pancreatitis nye dɔdzẽ ƒe dɔléle si mebɔ o si ate ŋu akpɔ ŋusẽ ɖe dɔgboa ƒe dɔwɔwɔ dzi. Ðɔkta si nya nu tso dɔgbo ƒe dɔlélewo ŋu yiyi ate ŋu akpe ɖe ŋuwò nàkpɔ beléle nyuitɔ kekeake si nèhiã. Ame akpa gãtɔ hayana bliboe le steroid nono vɔ megbe . Ame aɖewo ate ŋu ahiã Autoimmune Pancreatitis ƒe atike bubuwo be woakpɔ gbɔdzɔe ɣeyiɣi didi.

Mlɔeba la, ɖo ŋku esia dzi (Take-Home Message) .

• Dɔlélenutsiŋutete ƒe Dɔdzẽ nye dɔléle si mebɔ o si me wò ŋutɔ wò dɔlélenutsiŋutete dzea wò dɔgbo dzi.
• Ne dzesiwo abe ƒodo ƒe veve, lolo dzi ɖeɖe kpɔtɔ, alo ʋuʋudedi ene le ŋuwò la, kpɔ egbɔ be yedi atikewɔlawo ƒe aɖaŋuɖoɖo .
• Esia menye dɔdzẽ si le dɔgboa me o, gake dzesiawo sɔ, eyata ehiã be woakpɔ dɔlélea nyuie .
• Atikewɔwɔ vevitɔe nye corticosteroids.
• Ame geɖe hayana nyuie ne wowɔ atike na wo, gake dɔlélea ate ŋu agava.
• Ele vevie ŋutɔ be nàwɔ ɖe ɖɔkta ƒe mɔfiamewo dzi pɛpɛpɛ be wòahaya kaba .

Ðo ŋku edzi be menye wò ɖeka koe o. Enye nusi sɔ be susu geɖe nanɔ susu me na wò le nɔnɔme sia tɔgbe me. Eyata, gblɔ wò ɖɔkta faa eye nàbia wò nyawo. Wole afisia be yewoakpe ɖe ŋuwò.

` Dɔlélenutsiŋutete ƒe Dɔdzẽ, Dɔdzẽ, Dɔlélenutsiŋutete, IgG4, Dɔgbo ƒe lãmesẽ, Dɔdzẽ Sinhala, Nuɖuɖumeŋusẽ ƒe lãmesẽ