Mina míasrɔ̃ nu tso dɔléle wɔnuku siwo kpena ɖe kansa ŋu (Paraneoplastic Syndromes) ŋu pɛpɛpɛ!

Èse be ame aɖe si ŋu kansa le la kpɔ dzesi siwo metso kansa la ŋutɔ gbɔ o, gake dɔléle bubuwo gbɔe wòtsona? Ðeko wòle abe ɖe kansa la le ŋutilã ƒe akpa aɖe ene, gake eƒe ŋusẽkpɔɖeamedziwo le kakam ɖe akpa bubuwo. Emae nye nusi míeyɔna be (Paraneoplastic Syndromes) . Esia aɖi nya sesẽ vie, gake mina míaƒo nu tso nusi le edzi yim ŋu. Mègavɔ̃ o, ele vevie ŋutɔ be nànya esia.

Nukae nye paraneoplastic syndrome?

Kpuie ko la, ne kansa le ŋuwò la, míeyɔnɛ be Paraneoplastic Syndrome , si nye ne dzesi bubuwo dze le ŋutilãa me evɔ kansa lãmenugbagbeviwo metso tẽ o. Bu eŋu kpɔ be kansa le ŋutilãa me, gake lãmetsi alo protein aɖewo siwo wòdona ɖe go nana be ɖoɖo aɖe si le ŋutilãa me dzea dɔwɔwɔ gɔme le mɔ bubu nu. Alo, ɣeaɖewoɣi la, míaƒe dɔlélenutsiŋutete , togbɔ be ele agbagba dzem be yeatsrɔ̃ kansa lãmenugbagbeviwo hã la, edzea lãmenugbagbevi nyuiwo hã dzi vodadatɔe. Míeyɔa esia be dɔlélenutsiŋutete ƒe ŋuɖoɖo . Dzesi siawo ate ŋu adze le nɔnɔme mawo hã me.

Paraneoplastic syndromes ate ŋu agblẽ nu le ŋutilãa ƒe ɖoɖo vovovo geɖe ŋu. Le kpɔɖeŋu me, wò lãmekawo , lãmenugbagbeviwo ƒe dɔwɔwɔ (nuɖoanyi si wɔa lãmetsiŋusẽwo), ayiku , ƒuwo , ƒunukpeƒewo , ŋutigbalẽ, kple ʋu katã ate ŋu agblẽ nu le ŋuwò.

Zi geɖe la, esiawo dometɔ ɖeka ƒe dzesiwo (Paraneoplastic Syndromes) ye nyea kansa ƒe dzesi gbãtɔwo. Eyata ele vevie ŋutɔ be míanya esia.

Amekawoe nɔnɔme sia ate ŋu agblẽ nu le wu? (Ameka ŋue paraneoplastic syndromes gblẽa nu le?)

Paraneoplastic syndromes bɔ ɖe ƒe titinatɔwo kple ame tsitsiwo me wu, vevietɔ amesiwo ŋu nɔnɔmewo abe lãkusi me kansa , ʋuka me kansa , azigolo me kansa , alo no me dɔdzẽ ene le. Nu mawo ke siwo hea kansa vɛ hã ate ŋu ahe dɔléle siawo vɛ.

Aleke gbegbee nusiawo bɔe? (Aleke gbegbee paraneoplastic syndromes bɔe?)

Paraneoplastic Syndromes dzɔna le amesiwo ŋu kansa le ƒe 8% va ɖo 20% me. Esia fia be menye kansadɔnɔwo katãe xɔa wo o, gake woate ŋu akpɔ ŋusẽ ɖe xexlẽme ɖedzesi aɖe dzi.

Kansa kawoe do ƒome kple paraneoplastic syndromes?

Amesiame si ŋu kansa ƒe dɔdzẽ le (Paraneoplastic Syndrome) .Togbɔ be wo dometɔ ɖesiaɖe ate ŋu adzɔ hã la, kansa ƒomevi geɖe li siwo do ƒome kple nɔnɔme siawo wu:

• No me dɔdzẽ
• Dɔgbo me kansa
• Ʋumenugbagbeviɣidɔ
• Lãmetsiŋusẽ ƒe dɔléle
• Aklãdɔ (vevietɔ lãmenugbagbevi suewo ƒe lãkusi me dɔdzẽ) .
• Azigolo me kansa
• Dɔdzẽ si le dɔgboa me
• Dɔdzẽ si le ʋuka me
• Ayiku me kansa
• Vidzidɔ me kansa

Nukae hea paraneoplastic syndromes vɛ?

Míeƒo nu tso eŋu xoxo be susu vevi eve aɖewo tae wòle alea ɖo.

1. Nusiwo kansa lãmenugbagbeviwo ɖena doa goe: Kansa aɖewo ɖea lãmetsiwo kple proteinwo ɖe go . Nu siawo nana ŋutilãa ƒe ŋutinu aɖewo wɔa dɔ le mɔ si mesɔ o nu. Ne womewɔ atike na esia o la, ate ŋu agblẽ nu le eŋu tegbee gɔ̃ hã.

2. Dɔlélenutsiŋutete ƒe dɔmawɔmawɔ nyuie: Míaƒe ŋutilã ƒe dɔlélenutsiŋutete le afima be wòakpɔ mía ta tso dɔlélewo me. Nuɖoanyi sia wɔa nusiwo woyɔna be dɔlékuiwutikewo . Dɔlékuiwutike siawo dea dzesi lãmenugbagbevi siwo mesɔ o, abe kansa lãmenugbagbeviwo ene, hetsrɔ̃a wo. Gake ɣeaɖewoɣi la, dzesi siawo tsakana eye dɔlékuiwutikeawo dzea lãmenugbagbevi siwo le lãmesẽ me hã dzi dzedze gɔme. Ɣemaɣie (Paraneoplastic Syndrome) ƒe dzesiwo dzena.

Nukae nye paraneoplastic syndromes ƒe dzesiwo?

Dzesi siwo dzena le esia me ate ŋu ato vovo tso ame ɖeka gbɔ yi bubu gbɔ. Enɔ te ɖe ŋutilã ƒe ɖoɖo si ŋu wògblẽ nu le dzi. Nukutɔe la, le dɔléle siwo wu 60% me la, dɔléle sia ƒe dzesiwo dzena hafi wokpɔa kansa la gɔ̃ hã. Eyata ne wokpɔ dzesi siawo dze sii kaba la, woate ŋu ade dzesi kansa la ahadae le eƒe gɔmedzedze. Ekema mɔnukpɔkpɔ si li be atikewɔwɔa nakpɔ dzidzedze la lolo wu.

Dzesi siwo bɔ

Esiawo nye dzesi siwo bɔ wu dometɔ aɖewo:

• Asrã
• Nuɖuɖudzroame ƒe vɔvɔ kple lolo dzi ɖeɖe kpɔtɔ
• Zã me fifia

Ne lãmekawo ƒe dɔwɔwɔ gblẽ nu le ame ŋu

Ne wò lãmeka siwo le titina (si fia wò ahɔhɔ̃ kple aklã) kple lãmeka siwo le gota (lãmeka siwo dona le ahɔhɔ̃ kple aklã me) gblẽ nu le ŋuwò la, àte ŋu akpɔ dzesiwo abe:

• Taɖuame
• Nukpɔkpɔ eve
• Nuƒoƒo ƒe sesẽ
• Ŋkuɖodzinu ƒe dɔmawɔmawɔ nyuie
• Asrãdɔ ƒe nɔnɔmewo ( alɔ̃madɔmadɔ ) .
• Lãmetsiwo ƒe gbɔdzɔgbɔdzɔ
• Reflexes, sensation alo coordination dzi ɖe kpɔtɔ
• Seselelãme ƒe bu le wò abɔwo kple afɔwo me

Bu eŋu kpɔ be aɖuɖɔtoemekansa le ame aɖe ŋu, gake kasia eƒe ŋku meganɔa nu ŋu o, eƒe nyawo nɔa ɣli dom ne ele nu ƒom, eye wòsesẽna nɛ be wòada asɔ ne ele zɔzɔm. Ɣemaɣie ɖɔktawo susui be esia nye (Paraneoplastic Syndrome) .

Ne egblẽ nu le lãmenugbagbeviwo ƒe dɔwɔwɔ ŋu

Ne wò lãmetsiŋusẽ ƒe dɔwɔwɔ gblẽ la, àte ŋu akpɔ dzesiwo abe:

• Ðeɖiteameŋu si gbɔ eme
• Ʋusɔgbɔdɔ
• Lãmetsiwo ƒe gbɔdzɔgbɔdzɔ
• Aɖuɖɔtoe kple ʋuʋudedi
• Kpekpeme ƒe dzidziɖedzi kpata susu aɖeke manɔmee

Ne ƒunukpeƒewo, ƒuwo kple lãmekawo ŋue wògblẽ nu le (Ƒuƒuwo, ƒuwo kple lãmekawo - rheumatologic) .

Ne egblẽ nu le ɖoɖo siawo ŋu la:

• Nɔnɔmewo abe ƒunukpeƒetetedɔ ene
• Ƒunukpeƒewo ƒe vevesese, vuvu alo woƒe sesẽ

Ne ekpɔ ŋusẽ ɖe ŋutigbalẽ dzi (Ŋutilã) .

Ɣeaɖewoɣi la, ŋutigbalẽa hã ate ŋu agblẽ nu le eŋu:

• Ʋuʋudedi
• Flushing
• Ŋutilã si le ɣie
• Ŋutilã ƒe tsitsi si me dɔlékui aɖeke mele o (si menye kansa o).

Nukawoe nye paraneoplastic syndromes ƒomeviwo?

Paraneoplastic Syndromes ƒomevi vovovowo li . Woda wo ɖe hatsotsowo me le alesi wokpɔa ŋusẽ ɖe ɖoɖo ɖesiaɖe dzii nu.

Lãmetsiŋusẽ ƒe dɔwɔwɔ ƒe paraneoplastic syndromes

Kpɔɖeŋu aɖewo:

• `(Cerebellar degeneration)`: Esia nye nusiwo gblẽ le ahɔhɔ̃mekawo ŋu, si gblẽa nu le nuwo abe dadasɔ kple azɔlizɔzɔ ene ŋu.
• Dysautonomia: Ekpɔa ŋusẽ ɖe autonomic nervous system ƒe dɔwɔwɔ dzi.
• Tagbɔdɔléle: Ahɔhɔ̃ ƒe dɔdzẽ.
• Encephalomyelitis: Ahɔhɔ̃ kple aklã ƒe dɔdzẽ.
• Lambert-Eaton myasthenic syndrome (LEMS): Enaa lãmekawo gbɔdzɔna.
• Myasthenia gravis (MG): Esia nye nɔnɔme bubu si nana lãmekawo gbɔdzɔna.
• Myelopathy: Dɔléle siwo gblẽa nu le aklã ŋu.
• Neuromyotonia: Lãmetsiwo ƒe dɔwɔwɔ ɣesiaɣi.
• `(Opsoclonus-myoclonus syndrome)`: Ŋkuwo kple lãmekawo ƒe ʋuʋu si mesɔ o.
• `(Ahɔhɔ̃mekawo ƒe dɔléle (peripheral neuropathy))`: Nusiwo gblẽ le lãmeka siwo le gota gome ŋu.
• `(Stiff-person syndrome)`: Lãmetsiwo ƒe sesẽ kple vevesese ƒe ʋuʋu.

Dɔlékuiwutikewo ƒe dɔléle siwo nye paraneoplastic syndromes

Kpɔɖeŋuwo:

• `(Cushing ƒe dɔléle): Nɔnɔme si tsoa lãmetsi si nye cortisol ƒe dzidziɖedzi gbɔ.
• Hypercalcemia: Calcium ƒe agbɔsɔsɔ si le ʋu me dzina ɖe edzi.
• `(Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH))`: Nɔnɔme si nana tsi nɔa ŋutilã me geɖe wu.

Lãmetsiŋusẽ ƒe dɔléle siwo nye paraneoplastic syndromes

(egblẽa nu le ƒunukpeƒewo, ƒuwo, lãmekawo kple kadodoŋusẽ ŋu)

Kpɔɖeŋuwo:

• `(Eosinophilic fasciitis ƒe dɔléle)`
• `(Erythromelalgia ƒe dɔléle)`
• `(Hypertrophic ƒunukpeƒetetedɔ)`
• `(Asi ƒe lãkusi ƒe dɔléle)`
• `(Paraneoplastic polyarthritis ƒe dɔléle)`

Ʋu ƒe paraneoplastic dɔlélewo

Kpɔɖeŋuwo:

• `(Paraneoplastic erythrocytosis)`: Ʋumenugbagbevi dzĩwo ƒe dzidziɖedzi.
• `(Paraneoplastic thrombocytosis)`: Ʋumenugbagbeviɣidɔ ƒe dzidziɖedzi.

Ŋutilã ƒe paraneoplastic dɔlélewo

Kpɔɖeŋuwo:

• Acanthosis nigricans: Afisiwo do viviti eye wole ɣie le ŋutigbalẽa ŋu.
• Dermatomyositis: Ŋutilã kple lãmekawo ƒe dɔdzẽ.
• Leukocytoclastic vasculitis: Ʋuka suewo ƒe dɔdzẽ.
• `(Paraneoplastic pemphigus)`: Nɔnɔme si nana ŋutigbalẽa ƒoa ƒu.
• `(Sweet syndrome)`: Asrã kple ŋutigbalẽ ƒe abi siwo le veve sem.

Ayiku ƒe paraneoplastic dɔlélewo

Paraneoplastic glomerulonephritis nye dɔléle si gblẽa nu le ayiku ŋu.

Aleke wokpɔa dɔléle siwo nye paraneoplastic syndromes?

Wò ɖɔkta akpɔ nɔnɔme sia to wò atikewɔwɔ ŋutinya biabia wò, ŋutilãmedɔdada, kple dodokpɔ bubu geɖe wɔwɔ me.

• Ahɔhɔ̃mekadodokpɔ: Esi wònye be dɔléle sia gblẽa nu le lãmekawo ŋu zi geɖe ta la, wò ɖɔkta abia tso asiwò be nàwɔ nu aɖewo atsɔ akpɔ alesi wò ahɔhɔ̃ kple lãmekawo le dɔ wɔm. Woalé ŋku ɖe tɔtrɔ siwo va le wò ŋusẽ, ŋkuɖoɖonudzi, kple nuwɔwɔ ɖe ɖoɖo nu ŋu hã.
• Nɔnɔmetatawo dodokpɔ: Woate ŋu azã dodokpɔwo abe CT scan , MRI , kple ultrasound ene atsɔ akpɔe ɖa be dɔdzẽ aɖe li si na dzesiawo dzena hã.
• Ʋudodokpɔ: Ʋudodokpɔ ate ŋu akpɔ nusiwo ate ŋu ana woake ɖi le kansa ŋu. Woate ŋu alé ŋku ɖe dɔlékuiwutike siwo do ƒome kple paraneoplastic syndromes hã ŋu . Dodokpɔ siawo ate ŋu anya nenye be nu bubuwo abe dɔlékuiwo alo lãmetsiŋusẽ ƒe masɔmasɔ ene gbɔe dzesiawo tso.
• Spinal tap / lumbar puncture: Le go aɖewo me la, wodoa wò ahɔhɔ̃mekawo ƒe tsi (CSF) kpɔna be dɔlékuiwutikewo li siwo dzea lãmenugbagbevi siwo le lãmesẽ me dzi hã. Esia bia be nàde aŋe sue aɖe wò akɔta ƒe akpa si le anyime eye nàɖe tsi si le eme la ƒe kpɔɖeŋu. Emegbe wodzroa eme.

Aleke wokpɔa nɔnɔme siawo gbɔe alo daa wo gbɔe? (Aleke wokpɔa paraneoplastic syndromes gbɔ alo daa woe?)

Nu vevitɔe nye be nàda kansa si le ŋuwò si le wò dzesiwo hem vɛ. Le ɣeyiɣi ma ke me la, èkpɔa wò dzesiwo hã gbɔ be wòaɖe nusiwo gblẽ le wò ŋutilã ƒe ŋutinuwo alo dɔwɔɖoɖowo ŋu dzi akpɔtɔ.

Atike siwo wozãna tsɔ kpɔa Paraneoplastic Syndromes gbɔ dometɔ aɖewo :

• Corticosteroid-tikewo:Atikewo abe `(Cortisone)` alo `(prednisone)` ene. Esiawo wɔa dɔ to dɔdzẽ (ʋuʋudedi) si le ŋutilãa me dzi ɖeɖe kpɔtɔ me.
• Dɔlélenutsiŋutete ƒe dɔmawɔmawɔ nyuie: Atike siwo ɖea wò ŋutilã ƒe dɔlélenutsiŋutete ƒe dɔwɔwɔ dzi kpɔtɔna. Wò ɖɔkta anɔ te ɖe paraneoplastic syndrome ƒomevi si le ŋuwò dzi aŋlɔ atikeawo na wò.
• Intravenous immunoglobulin (IVIG): Dɔdamɔnu sia wɔa dɔ to dɔlékuiwutike siwo gblẽa nu le ame ŋu tsɔtsrɔ̃ me. Le esia me la, wodoa dɔlékuiwutike siwo le lãmesẽ me abe atike si wodona ene, si gblẽa dɔlékuiwutike siwo gblẽa nu le ame ŋu la dome.
• Plasmapheresis: Esia bia be woaɖe ʋumenugbagbevi dzĩ (ʋua ƒe akpa si nye tsi) ɖa le ʋua me be wòaɖe dɔlékuiwutike siwo le ʋumenugbagbeviɣi sia me eye woate ŋu agblẽ nu le lãmenugbagbevi siwo le lãmesẽ ŋu la ƒe agbɔsɔsɔ dzi akpɔtɔ.
• Lãmesẽ kple nuƒoƒo ƒe atikewɔwɔ: Esia bia be woawɔ lãmekawo ƒe kamedede be woana dɔwɔnawo abe nuƒoƒo kple ʋuʋu ene nanyo ɖe edzi. Àte ŋu ahiã atikewɔwɔ sia ne paraneoplastic syndrome si do ƒome kple lãmekawo ƒe dɔwɔwɔ le ŋuwò.

Nukae mate ŋu akpɔ mɔ na ne paraneoplastic syndrome le ŋunye?

Wò nyagblɔɖi nɔ te ɖe afisi wò kansa le dzi koŋ. Le go aɖewo me la, dzesi siwo dɔléle sia hena vɛ ate ŋu anɔ bɔbɔe eye woanɔ anyi ɣeyiɣi kpui aɖe. Le go bubuwo me la, dzesiawo ate ŋu asẽ eye ahiã be woakpɔ wo gbɔ ɣeyiɣi didi.

Ƒo nu kple wò ɖɔkta tso alesi wò kansa ƒe afɔɖeɖe kple alesi nàwɔ nui ɖe atikewɔwɔ ŋu akpɔ ŋusẽ ɖe wò hayahaya dzi ŋu.

Kuxi kawoe do ƒome kple paraneoplastic syndromes?

Esia ate ŋu ahe kuxi vovovowo vɛ. Ðewo ate ŋu anye nu suewo, gake bubuwo ate ŋu anye nu sesẽwo eye woate ŋu ade woƒe agbe afɔku me gɔ̃ hã ne womewɔ atike na wo o. Wò ɖɔkta aɖe kuxi siwo ate ŋu ado mo ɖa kple atikewɔmɔnu siwo woate ŋu azã la me na wò.

Ɣekaɣie wòle be maƒo ka na ɖɔktaa ku ɖe paraneoplastic syndromes ŋu?

Ne paraneoplastic syndrome ƒe dzesiwo dze le ŋuwò le susu aɖeke manɔmee la, yi ɖɔkta gbɔ. Vevietɔ ne woda dɔ na wò le kansa ta le ƒe atɔ̃ siwo va yi me eye nèle dzesi siawo kpɔm la, anyo be nàgadoe kpɔ ake. Esia akpe ɖe wò ɖɔkta hã ŋu wòanya ne kansa la gatrɔ gbɔ.

Nya kawoe wòle be mabia nye ɖɔkta?

Nya aɖewo siwo nàte ŋu abia wò ɖɔkta:

• Nuka gbɔe nye dzesiawo tsona?
• Aleke nye (Paraneoplastic Syndrome) kpɔa ŋusẽ ɖe nye kansa dada ƒe ɖoɖoa dzii?
• Atikewɔwɔmɔnu kawoe le asinye?
• NyeAleke Paraneoplastic Syndrome kpɔa ŋusẽ ɖe nye hayahaya dzii?
• Ðe nye dzesiwo anyo ɖe edzi le kansa dada vɔ megbea?
• Aleke woawɔ akpɔ dzesiawo gbɔ le ɣeyiɣi kpui aɖe me? Aleke woawɔ akpɔ dzesiawo gbɔ le ɣeyiɣi didi me?

Mlɔeba la, gbedasi si woatsɔ ayi aƒemee

Kansa ƒe dɔdzẽ ate ŋu ahe tɔtrɔ siwo womele mɔ kpɔm na o vɛ le ŋutilãa me. Ɣeaɖewoɣi la, woate ŋu anye paraneoplastic syndrome ƒe dzesiwo hã . Esi wònye be dɔléle siawo ƒomevi vovovowo li eye dzesiawo le vovovo ta la, ate ŋu axɔ ɣeyiɣi aɖe hafi wò ɖɔkta nakpɔe be wò dzesiwo do ƒome kple kansa. Gake ne wonya ɖo kpe dɔlélea dzi ko la, ate ŋu ada dzesiawo eye vevietɔ wu la, ate ŋu ada kansa si gbɔ wòtso .

Mɔ nyuitɔ si dzi woato akpɔ Paraneoplastic Syndrome gbɔe nye be woakpɔ kansa la ƒe atike nyuitɔ kekeake. Eyata, mègaŋe aɖaba ƒu dzesi aɖeke dzi o. Ne ɖikeke aɖe le mewò la, yi ɖɔkta gbɔ kaba ale si nàte ŋui. Ema ko hafi mí katã míate ŋu anɔ lãmesẽ me.

` Paraneoplastic syndromes, kansa, dzesiwo, lãmekawo ƒe dɔwɔwɔ, lãmenugbagbeviwo ƒe dɔwɔwɔ, dɔlélenutsiŋutete, kansa dada