Ðe wò asibidɛwo lolo eye wò ɖawo trɔa? Mina míasrɔ̃ nu tso Hypertrophic Osteoarthropathy sia ŋu!

Ède dzesii kpɔ be wò asibidɛwo alo afɔbidɛwo lolo le mɔ si mebɔ o nu, eye wò ɖawo bɔbɔ alo woƒe nɔnɔme to vovoa? Ɣeaɖewoɣi la, míeléa ŋku ɖe nusiawo ŋu boo o. Gake ne èkpɔ dzesi siawo la, ate ŋu anye nɔnɔme aɖe si woyɔna be ‘Hypertrophic Osteoarthropathy’ ƒe dzesi . Wogayɔa esia be HOA kpuie. Nɔnɔmea ŋutɔ menye afɔku nenema gbegbe o, ke boŋ nɔnɔme bubu siwo le ete siwo henɛ vɛ ate ŋu ahiã be woawɔ atike na wo. Eyata, mina míaƒo nu tso HOA sia ŋu tsitotsito eye míasrɔ̃ nu geɖe.

Nukae nye ƒunukpeƒetetedɔ (HOA)?

Kpuie ko la, ƒunukpeƒetetedɔ (HOA) nye dɔléle si nana wò asibidɛwo alo afɔbidɛwo ƒe nugbɔwo vuvuna henɔa goglo (woƒoa ƒu) eye wònana wò ɖawo trɔna. Ame si ŋu HOA le ate ŋu:

• Asibidɛwo alo afɔbidɛwo ƒe nugbɔwo lolona eye wovuvuna .
• Wobɔbɔa ɖaawo ɖe anyi eye wodzena abe ɖe wole ƒoƒom ene, abe ɖe wohe wo yi dzi ene.

HOA ate ŋu adze egɔme ɣeaɖewoɣi le ɖevime alo ƒewuiwo me. Le ame aɖewo gome la, ate ŋu adzɔ le woƒe tsitsime hã. Togbɔ be HOA ŋutɔ megblẽa nu le ame ŋu o hã la, ne nɔnɔme aɖe li si gbɔ wòtso la, ele vevie be woadae.

Nukawoe nye esia ƒomevi veviwo?

HOA ƒomevi vevi eve li:

1. Primary Hypertrophic Osteoarthropathy (PHO): Domenyiŋusẽfianu sia ƒomevi nye, si fia be woate ŋu anyie tso dzilawo gbɔ na ɖeviwo.

2. Secondary Hypertrophic Osteoarthropathy (SHO): Nɔnɔme sia ƒomevi tsoa nɔnɔme siwo nɔa anyi didi abe dzidɔ kple lãkusidɔ ene gbɔ. Zi geɖe la, nɔnɔme siawo nana oxygen ƒe agbɔsɔsɔ si le wò ʋu me dzi ɖena kpɔtɔna.

Amekawoe ate ŋu axɔ nɔnɔme sia wu?

Le nyateƒe me la, ame sia ame, eɖanye ŋutsu alo nyɔnu alo ameƒomevi ka kee wònye o, ate ŋu axɔ nɔnɔme sia si woyɔna be hypertrophic osteoarthropathy.

Gake zi geɖe la, HOA gbãtɔ (PHO) dzena le eƒe agbenɔƒe ƒe gbãtɔ me alo le ƒewuiwo me. PHO ƒe nɔnɔme:

• Ebɔ ɖe ameyibɔwo dome wu.
• Edzɔna ɖe ŋutsuwo dzi wu.

HOA evelia (SHO) nye dɔléle si wokpɔna zi geɖe le amesiwo xɔ tso ƒe 55 va ɖo ƒe 75 me.

Aleke gbegbee nɔnɔme sia bɔe?

Numekulawo mate ŋu agblɔ ame agbɔsɔsɔme si tututu HOA le o. Gake wonya be amesiwo ŋu HOA le ƒe 95% va ɖo 97% ƒe ƒomevi evelia (SHO) le wo ŋu . Esia fia be ame akpa gãtɔ ƒe asibidɛ ƒe tɔtrɔ siawo le nɔnɔme bubu aɖe ta.

Nukatae wole HOA sia ɖom anyi? Nukawoe nye susu siwo tae?

Na míakpɔ nusi gbɔ esia tso ɖa.

Susu siwo tae woawɔ HOA Gbãtɔ (PHO) .

Domenyiŋusẽfianu ƒe tɔtrɔ siwo nɔa anyi le vidzidzi me gbɔe esia tsona . Ðevia ate ŋu anyi domenyiŋusẽfianu ƒe tɔtrɔ sia ƒe dome tso dadaa, fofoa, alo wo ame evea siaa gbɔ.

Susu siwo tae wòle be woawɔ HOA evelia (SHO) .

Nusi koŋ gbɔ HOA evelia (SHO) tsonae nye lãkusidɔ . Ne lãkusidɔ gbɔe nɔnɔme sia tso la, woyɔnɛ be Hypertrophic Pulmonary Osteoarthropathy (HPOA) .

Aɖuɖɔtoedɔléle vevitɔ si ate ŋu ahe HPOA vɛ enye lãkusi me dɔdzẽ , vevietɔ lãkusi me dɔdzẽ si menye lãmenugbagbevi suewo o . Tsɔ kpe ɖe eŋu la, lãkusidɔ bubu siwo ate ŋu ahe HPOA vɛ dometɔ aɖewoe nye:

• Fibrous tumors siwo me dɔlékui aɖeke mele o le lãkusi me
• Aɖuɖɔtoedɔléle siwo nɔa anyi didi
• Cystic Fibrosis (domenyiŋusẽfianu ƒe dɔléle si gblẽa nu le gbɔgbɔtsixe ŋu) .
• Mesothelioma (kansa si le lãkusi me) .
• Kansa si kaka tso teƒe bubuwo eye wògblẽa nu le lãkusiwo ŋu (Metastatic lung disease) .
• Pulmonary arteriovenous malformation (ʋuka siwo le aklã me ƒe dɔmawɔmawɔ nyuie) .
• Aklã me Yɔmekpe
• Sarcoidosis (lãmenugbagbeviwo ƒe ƒuƒoƒo le ŋutilã ƒe akpa vovovowo) .

Nu bubuwo hã li siwo ate ŋu akpɔ ŋusẽ ɖe HOA evelia (SHO) dzi:

• Aklã, ʋumenugbagbeviɣi, kple aɖuɖɔtoedɔlélewo (aklã kple ʋuka me dɔlélewo):
• Biliary Atresia (Bile Duct ƒe Mɔxexe Ðe Ðevi Suewo Me) .
• Kansa
• Aklã ƒe ʋuka me dɔléle
• Biliary Cholangitis Gbãtɔ
• Wilson ƒe dɔléle (akɔbli si ƒoa ƒu ɖe ŋutilã me) .
• Dzidɔlélewo:
• Atrial myxoma (dɔdzẽ si menye kansa o si dzɔna le dzitodzito me) .
• Cyanotic Heart Disease (dzidɔ si me oxygen dzi ɖena kpɔtɔna le ʋua me) .
• Dɔlékuiwo ƒe gege ɖe dzia ƒe akpa si le eme (Infective Endocarditis) .
• Dɔgbo ƒe nɔnɔmewo:
• Atike siwo naa aɖuɖɔtoewo zazã ɖe mɔ gbegblẽ nu
• Achalasia (kuxi si le nuɖuɖutome ƒe dɔwɔwɔ ŋu) .
• Kansa
• Ƒome ƒe Adenomatous Polyposis (nu suesuesue siwo tsina le dɔgbo gã me) .
• Dɔgbo ƒe Dɔléle si Naa Dɔdzẽ

Tsɔ kpe ɖe esia ŋu la, nɔnɔme bubu geɖewo ate ŋu ahe SHO vɛ:

• Celiac Dɔléle (gluten ƒe dɔléle) .
• Dɔgbo me dɔlékuiwo abe aɖuɖɔtoe ene
• Graves ƒe Dɔléle (ʋumenugbagbeviɣidɔ) .
• Lãmetsiŋusẽ ƒe dɔléle si gbɔ eme
• Myelofibrosis (ƒumeŋuɖui ƒe dɔléle) .
• POEMS ƒe dɔléle si nye POEMS ƒe dɔléle
• Thymoma (si nye dɔdzẽ si le lãkusi me) .

Bu eŋu kpɔ, ame aɖe si nènya la le akɔta ƒom hena ɣeyiɣi aɖe eye woƒe asibidɛwo trɔ alea, eye esi wokpɔ ɖɔkta vɔ ko hafi wova kpɔe be lãkusidɔe. Eyata ele vevie be nàlé ŋku ɖe dzesi siawo ŋu.

Nukae nye HOA ƒe dzesiwo?

HOA ƒe dzesi vevitɔe nye asibidɛwo alo afɔbidɛwo ƒe ƒoƒo alo woƒe vuvu . Zi geɖe la, esia gblẽa nu le ŋutilãa ƒe akpa eveawo siaa ŋu sɔsɔe. Àte ŋu ade dzesi nuwo abe:

• Asibidɛwo alo afɔbidɛwo ƒe nugbɔwo vuvu eye wole goglo .
• Ʋuʋudedi siwo le ƒunukpeƒe siwo te ɖe asibidɛwo ŋu la le bubum.
• Woƒoa ɖaa ɖe anyi eye wòdzena abe ɖe wole tsia dzi ene.
• Ŋutilã si le ɖaa gɔme la klẽna eye wònɔa tsɛ .
• Aɖabɛwo va fa miamiamia .
• Asibidɛwo alo afɔbidɛwo ƒe nugbɔ biã eye dzoxɔxɔ le wo me .

HOA ƒe nɔnɔme bubu siwo nàte ŋu akpɔ dometɔ aɖewoe nye:

• Glandular ƒe dzidziɖedzi fũu akpa. Esia ate ŋu ahe nɔnɔmewo abe aklãdɔ, fifia fũu akpa (hyperhidrosis), ŋkume ƒe akpa si le etame ƒe gege ɖe anyi (ŋku ƒe akpa si le etame ƒe ptosis), kple ŋutigbalẽ ƒe dɔléle si nye seborrheic dermatitis vɛ.
• Periostitis nye lãkusi siwo tsyɔ ƒuwo dzi ƒe dɔdzẽ. Esia ate ŋu ana afɔkpodziwo, asibidɛwo, alo klowo nase veve.
• Afɔwo ƒe lãkusi falɛfalɛwo ƒe vuvu (non-pitting edema).
• Ƒu ƒe ƒoƒo ɖe afɔkpodzi kple asibidɛwo me.
• Ŋutilã ƒe ƒoƒo (Pachydermia). Mo kple ta ƒe ŋutigbalẽ ate ŋu azu ƒuƒlu eye aŋgba goglowo anɔ eŋu.

Nukae nye HOA evelia (SHO) ƒe nɔnɔme tɔxɛwo?

Tsɔ kpe ɖe HOA ƒe dzesi siwo bɔ siwo míeyɔ va yi ŋu la, amesiwo ŋu HOA evelia (SHO) le hã ate ŋu axɔ ƒunukpeƒetetedɔ . Esiae nye ne tsi bubu ƒo ƒu ɖe lãkusi siwo le ƒunukpeƒewo kple esiwo ƒo xlã wo me. Ƒunukpeƒetetedɔ ate ŋu ana:

• Vevesese
• Dzodzodzoetsitsi
• Nu sesẽ wɔwɔ
• Tete

Klowo kple asibidɛwo mee wokpɔa ƒunukpeƒewo ƒe vuvu si do ƒome kple SHO zi geɖe wu .

Aleke nèwɔ kpɔ esia? Dodokpɔ kawoe ɖɔktawo wɔna?

Ne èyi ɖɔkta gbɔ la, nu gbãtɔ si woawɔe nye be woakpɔe ɖa be ƒoƒoe le wò asibidɛwo alo afɔbidɛwo ŋu hã. Tsɔ kpe ɖe eŋu la, woadi nusiwo gbɔna hã le ŋutilãmedɔdada me:

• Ðe mo ƒe dzedzeme va le ƒuƒlua?
• Ðe wò afɔwo vuvua?
• Ðe vevesese aɖe li ne èzi afɔkpodzi, klo, alo asibidɛwo dzia?
• Ðe ƒu siwo le afɔkpodzi kple asibidɛwo me le ƒoƒom?

Ne ɖɔktaa susui be nɔnɔme aɖe si woyɔna be HOA le eŋu la, ate ŋu awɔ dodokpɔ geɖe, abe:

• Lovibond ƒe nɔnɔmetata ƒe dzesi:Ne èlé ŋku ɖe wò asibidɛ ŋu tso axadzi la, zi geɖe la, àkpɔ dzogoe gbadza aɖe si le abe "V" ene afisi ɖa ƒe agbalẽvi la do go ŋutigbalẽ ƒe akpa si le ɖaa ƒe gɔme (proximal nail fold). Ne HOA le ŋuwò la, wò ɖaa bɔbɔna ɖe anyi, si wɔnɛ be dzogoe sia dzina ɖe edzi. Le ɖa si sɔ me la, dzogoe sia nyea dzidzenu 160 alo esi mede nenema o. Le ɖa si wotsɔ ati ƒoe me la, eƒe dzoxɔxɔ nyea dzidzenu 180 alo esi wu nenema.
• Phalangeal depth ratio: Ƒu etɔ̃ (phalanges) le asibidɛ ɖesiaɖe me. Zi geɖe la, ƒu si léa ɖaa (distal phalange) nɔa kpuie wu ƒu si te ɖe eŋu (middle phalange). Ne HOA le ŋuwò la, wò titina phalange le kpuie wu wò distal phalange.
• Schamroth ƒe dzesi: Da wò asibidɛ siwo wotsɔ fiaa nu ƒe ɖawo ɖekae. Di dometsotso (fesre) si le abe daimɔnd ene le ɖaa ƒe gɔme kple ɖaa ƒe lãkusiwo dome. Ne dometsotso aɖeke meli o la, ke anɔ eme be HOA le ŋuwò.

Dodokpɔ bubu siwo woawɔ atsɔ ade dzesi HOA evelia (SHO) .

Ne ɖɔktaa susui be atikewɔwɔ me nɔnɔme bubu aɖee le HOA la hem vɛ la, ate ŋu aɖo aɖaŋu be woawɔ dodokpɔ bubu geɖe:

• Angiography (ʋukawo me dzodzro) .
• Ʋukawo me ʋu ƒe gas dodokpɔ
• Ʋudodokpɔwo
• Ƒuwo ƒe ʋuʋu
• Akɔta ƒe X-ray
• CT-dɔdamɔnu (Computed Tomography scan) alo ultrasound-dɔdamɔnu (Ultrasound) .
• Echocardiogram alo Elektrikdzitodzito (EKG) .
• MRI Scan (MRI - Magnetic Resonance Nɔnɔmetatawo Ƒe Nɔnɔmetata) .
• Aklã ƒe dɔwɔwɔ dodokpɔ

Dodokpɔ siawo ate ŋu akpe ɖe wò ɖɔkta ŋu wòanya nusi gbɔ wò HOA tso. Ne fotoɖemɔ̃ aɖe ɖee fia be tsitsi si mesɔ o (abe dɔdzẽ ene) la, wò ɖɔkta ate ŋu ado susu ɖa hã be woaɖe lãmenugbagbeviwo ƒe lãmenugbagbeviwo ɖa (woaɖe lãmenugbagbeviwo ƒe kpɔɖeŋu eye woado wo kpɔ). Esia ate ŋu akpe ɖe mía ŋu míanya nusi tututu gbɔ tsitsia tso.

Aleke wowɔa nu ɖe ​​esia ŋui?

Atikewɔwɔ ƒe mɔnuwo toa vovo le HOA ƒe ƒomevi nu.

HOA gbãtɔ (PHO) dada .

Ne vevesese mele ŋuwò o alo wò dzesiwo mesẽ o la, ɖewohĩ màhiã atike tɔxɛ aɖeke na HOA gbãtɔ (PHO) o. Gake ne dzesiwo le ŋuwò la, àte ŋu azã atikewo abe:

• Atike siwo me steroid mele o siwo tsia dzodzodzoetsitsi nu (NSAIDs) .
• COX-2 ƒe mɔxenuwo
• Bisphosphonates ƒe atikewo
• Octreotide ƒe atike

HOA evelia (SHO) ƒe atikewɔwɔ .

Ne wole HOA evelia (SHO) dam la, nu vevitɔe nye be woada nusi gbɔ wòtsona . Atikewɔwɔ ate ŋu anye:

• Dɔlékuiwutikewo zazã atsɔ ada yɔmekpe
• Atikewo zazã atsɔ ada aɖuɖɔtoemekansa
• Aklã dodo alo aklã dodo na ame hena aklãdɔléle
• Amekoko si wowɔna tsɔ doa aklã na ame le cystic fibrosis ta
• Radiofrequency ablation na lãkusi me dɔdzẽ (dzoxɔxɔ zazã atsɔ atsrɔ̃ dɔdzẽwo) .
• Amekoko na dzidɔ alo lãkusi me dɔdzẽ

Ne womate ŋu ada nɔnɔme si gbɔ SHO la tso o la, ɖɔkta ate ŋu aɖo aɖaŋu be woazã atikewo atsɔ aɖu dzesiawo dzi.

Ɣeyiɣi didi kae wòxɔna hafi wòhayana tso atikewɔwɔ me?

Esia nɔ te ɖe HOA ƒomevi si le ŋuwò, alesi dɔlélea nu sẽe, kple atike si woawɔ na wò dzi ŋutɔŋutɔ. Ne wonya da dɔléle si gbɔ wòtso ko la, ƒoƒo ate ŋu nu ayi kaba.

Ðe nane li míate ŋu awɔ atsɔ aɖe nusia ƒe dzɔdzɔ dzi akpɔtɔa?

HOA (PHO) ƒe afɔku gbãtɔ

Esi wònye domenyiŋusẽfianue PHO nye ta la, naneke meli míate ŋu awɔ atsɔ aɖe eƒe wɔwɔme dzi akpɔtɔ o.

HOA (SHO) ƒe afɔku evelia

Be woaɖe afɔku si le SHO xɔxɔ me dzi akpɔtɔ la, ele vevie ŋutɔ be woazɔ ɖe agbenɔnɔ si me lãmesẽ le dzi . Esia le vevie ŋutɔ ne dzidɔ alo lãkusidɔ ate ŋu adze dziwò. Nu siwo nàte ŋu awɔ dometɔ aɖewoe nye esi:

• Kpekpeme si sɔ me léle ɖe asi.
• Nuɖuɖu si naa dzidɔ ɖuɖu.
• Kamedede edziedzi.
• Ahanono kple atikevɔ̃ɖizazã dzi ɖeɖe kpɔtɔ.
• Atamanono dzi ɖeɖe kpɔtɔ. Esia le vevie ŋutɔ, elabena atamanono nye nu vevi aɖe si hea lãkusidɔ geɖe vɛ.
• Nuteɖeamedzi dzi ɖeɖe kpɔtɔ.

Nukae etsɔme ahe vɛ na amesi si HOA le?

Le amesi si HOA (PHO) gbãtɔ le gome la .

PHO ate ŋu adzudzɔ gbegblẽ le eɖokui si. Ɣeaɖewoɣi, vevietɔ le sɔhɛmenɔɣi megbe la, ate ŋu anyo ɖe edzi kura gɔ̃ hã.

Le amesi si HOA evelia (SHO) le gome la .

Ne woda nusi gbɔ wòtso dzidzedzetɔe la, woate ŋu ada dɔlélea keŋkeŋ. Gake ne womate ŋu ada nusi gbɔ wòtso la dzidzedzetɔe o (le kpɔɖeŋu me, kansa sesẽ aɖe) la, nɔnɔmea ate ŋu anɔ anyi.

Nukae adzɔ ne HOA ƒe nɔnɔmea nɔ anyi ɣeyiɣi didi?

Ne HOA ƒe nɔnɔmea le edzi yim ɣeyiɣi didi aɖe la, àte ŋu ato nusiwo le abe:

• Afisi ƒunukpeƒewo mate ŋu aʋuʋu le o
• Ƒumeŋuɖui (ƒunukpeƒeveame) .
• Vevesese

Gake ɖo ŋku edzi be woate ŋu aɖu dzesi siawo dometɔ geɖe dzi ne woda wo nyuie .

Ne HOA li la, aleke nèléa be na ɖokuiwòe?

Ne HOA le ŋuwò la, nu nyuitɔ si nàte ŋu awɔe nye be nàyi edzi anɔ atike si wona wò be nàtsɔ aɖu wò dzesiwo dzi. Ele vevie ŋutɔ be nàwɔ ɖe wò ɖɔkta ƒe mɔfiamewo dzi.

Ɣekaɣie wòle be nàkpɔ ɖɔkta?

Ele be nàɖɔ ŋu ɖo le nu siawo ŋu:

• Le atikewɔwɔ vɔ megbeNe klabu ƒe ƒoƒo ƒe dzesiwo gadze ake la, yi ɖɔkta gbɔ. Esia ate ŋu afia be nɔnɔme si gbɔ wòtso la gadze ake.
• Ne ètsi dzi ɖe atikewɔwɔ ƒe nugbegblẽ le ame ŋu ŋu la .
• Ne womekpɔ ŋgɔyiyi aɖeke o togbɔ be wowɔ atike nɛ hena ɣeyiɣi aɖe hã.

Le nɔnɔme mawo me la, wò ɖɔkta ate ŋu aɖo aɖaŋu na wò be nàzã atike bubu siwo asɔ na wò.

Kpuie ko la: Nusiwo Dzi Nàɖo Ðo (Take-Home Message) .

Enyo, mina míaɖo ŋku nusi ŋu míeƒo nu tsoe dzi kpuie ko.

Hypertrophic osteoarthropathy (HOA) nye dɔléle si me asibidɛwo ƒe nugbɔwo vuvuna eye ɖawo vuvuna. Ate ŋu anye gbãtɔ (domenyiŋusẽfianu) alo evelia (si tso dɔléle bubu gbɔ). Nusiwo koŋ gbɔ HOA evelia tsonae nye lãkusi kple dzidɔ.

• Dzesiawo: Asibidɛwo ƒe nugbɔwo vuvu, afɔbidɛ siwo tsi ɖe eme, ƒunukpeƒewo ƒe vevesese, kple ŋutigbalẽa ƒe ƒoƒo.
• Dɔlélea didi: Atikewɔlawo ƒe dodokpɔ, dodokpɔ tɔxɛwo (Lovibond, Shamroth ƒe dzesiwo), kple fotoɖeɖe be woadi nusi gbɔ wòtso.
• Atikewɔwɔ: Le PHO gome la, wonaa atike le dzesiawo nu. Le SHO gome la, nu vevitɔe nye be woada dɔléle si gbɔ wòtso.
• Vevietɔ wu: Ne ède dzesi tɔtrɔ aɖewo le wò asibidɛwo ŋu la, mègaŋe aɖaba ƒu edzi o eye nàdi atikewɔlawo ƒe aɖaŋuɖoɖo. Elabena, togbɔ be HOA menye afɔku o hã la, dɔléle si gbɔ wòtsona ate ŋu anye afɔku.

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

` Hypertrophic Osteoarthropathy, asibidɛ ƒe vuvu, ɖa ƒe tɔtrɔ, PHO, SHO, lãkusidɔ, dzidɔ, ƒunukpeƒeveame, ƒoƒo