Taɖuame kple ŋku ƒe kuxi siwo dona tso tsitsi me: Mina míasrɔ̃ nu tso Lãmenugbagbevi Gãwo ƒe Ʋukawo ƒe Dɔléle (GCA) alo Temporal Arteritis ŋua?

Ðe ame tsitsi aɖe si le miaƒe ƒomea me, ɖewohĩ dawò, fofowò, alo mamawò, toa nyatoƒoe le taɖuame ŋu zi geɖea? Ðe wòdze abe wò ŋkuwo gbɔdzɔ vie le ɣeyiɣi ma ke mea? Ekema esia nye nusi ate ŋu anɔ vevie na wò. Egbea míele nu ƒom tso dɔléle aɖe si woyɔna be Giant Cell Arteritis (GCA) , si woyɔna tsã be Temporal Arteritis , si dzea ame tsitsiwo dzi zi geɖe ŋu. Naneke meli woavɔ̃ o, nu vevitɔ kekeakee nye be nànɔ ŋudzɔ ɖe esia ŋu.

Nukae nye GCA? Nukatae wòate ŋu anye afɔku?

Kpuie ko la, Lãmenugbagbevi Gãwo ƒe Ʋukawo ƒe Dɔléle (GCA) nye dɔléle si nana ʋuka gã siwo le wò ŋutilã me (vevietɔ esiwo le ta, kɔ, kple abɔwo me) vuvu. Ðɔktawo yɔa esia hã be ``vasculitis.'' Ne ʋukawo vuvu alea la, woƒe gliwo tsina, si wɔnɛ be mɔ si dzi woato ayi ʋu me la dzi ɖena kpɔtɔna. Bu eŋu abe tsi ƒe pɔmpi si woxe mɔ na be wòagasi o ene. Ne ʋu ƒe sisi tɔtɔ le mɔ sia nu la, ate ŋu agblẽ nu le ŋutinu veviwo kple lãkusi siwo ʋuka mawo naa ʋu la ŋu.

Ʋuka siwo le wò ŋgonu ƒe akpa eveawo la naa ʋu wò tagbɔ, aɖu ƒe lãmekawo, kple ŋku ƒe lãmeka, si nye lãmeka si naa nèkpɔa nu. Ne GCA gblẽ nu le ʋuka siawo siwo me ʋu sina tona ŋu la, ate ŋu ahe kuxi sesẽwo abe ŋkuʋuʋu ene vɛ . GCA ate ŋu akpɔ ŋusẽ ɖe aorta, si nye ʋuka gãtɔ kekeake le ŋutilãa me, kple eƒe alɔwo hã dzi. Woyɔa aorta ƒe vuvu sia be aortitis, eye ate ŋu ahe lãmesẽkuxi sesẽwo vɛ.

GCA ate ŋu adzɔ kpe ɖe dɔdzẽ ƒe dɔléle bubu si nye Polymyalgia Rheumatica, alo PMR ŋu. Míaƒo nu geɖe tso PMR ŋu emegbe.

Ðe GCA nye nɔnɔme sesẽ aɖe nyateƒea?

Ẽ, GCA nye dɔléle si ate ŋu asesẽ ne womekpɔe dze sii hedae kaba o . Esia le alea elabena:

• Wò ŋku ate ŋu agblẽ . Ate ŋu adzɔ be màgakpɔ nu nyuie o, alo wò ŋku ɖeka alo evea siaa azu ŋkuagbãtɔ.
• Wò ʋukawo ate ŋu agblẽ . Le kpɔɖeŋu me, nɔnɔme aɖe si woyɔna be aneurysm, si nye ʋuka si dona abe ʋuƒo ene eye wògbãna la nana eƒe gbagbã ƒe afɔkua dzina ɖe edzi.
• Nɔnɔme bubuwo, abe ʋusɔgbɔdɔ alo ʋusɔgbɔdɔ ƒe amedzidzedze ɣeyiɣi kpui aɖe (si woyɔna hã be "mini-strokes"), ateŋu adzɔ.

Esia tae wòle vevie ŋutɔ be míanɔ ŋudzɔ ɖe dzesi siawo ŋu ɖo.

Aleke gbegbee GCA bɔe?

Togbɔ be GCA nye ʋukawo me dɔléle ƒomevi siwo bɔ wu dometɔ ɖeka hã la, enye dɔléle si mebɔ kura le goawo katã me o. Le akɔntabubu siwo le United States nu la, ame 19-23 le ame 100,000 ɖesiaɖe me koe dɔléle sia le. Togbɔ be akɔntabubu aɖeke meli si sɔ pɛpɛpɛ le Sri Lanka o hã la, anyo be woatsi dzi ɖe esia ŋu esi ame tsitsiwo le dzidzim ɖe edzi.

Nukae nye GCA (Temporal Arteritis) ƒe dzesiwo?

GCA ƒe dzesi vevitɔ kple esi bɔ wue nye taɖuame sesẽ si nɔa anyi ɖaa si sena le eɖokui me abe vevesese si le ƒoƒom ene le ta ƒe akpa ɖeka alo evea siaa.Gake tsɔ kpe ɖe esia ŋu la, dzesi bubuwo ate ŋu adze:

• Vevesese ne ètsɔ wò asi da ɖe ta alo ŋgonu ƒe akpa eveawo (towo tame).
• Aɖu ƒe vevesese , vevietɔ ne èle nu ɖum alo le nu ɖum.
• Nukpɔkpɔ ƒe kuxiwo : Nukpɔkpɔ zi eve, nukpɔkpɔ si me kɔ o, alo nukpɔkpɔ ƒe bu kpata hena ɣeyiɣi kpui aɖe.
• Ɖeɖiteameŋu .
• Asrã .
• Nuɖuɖudzroame ƒe vɔvɔ alo lolo dzi ɖeɖe kpɔtɔ .
• Lãmetsiwo ƒe vevesese : Vevesese le abɔta, abɔta, akɔta, ata si le etame, akɔta, kple akɔta.

Èɖo ŋku edzi esime meƒo nu tso dɔléle bubu si kpena ɖe GCA ŋu zi geɖe, si nye Polymyalgia Rheumatica (PMR) ŋua? Esia hã nye nɔnɔme si nana ame ƒe vuvu. PMR nana ame sea veve vevie eye wòsẽna , vevietɔ le abɔta kple akɔta. PMR ate ŋu adzɔ le eɖokui si hã (ebɔ wu be PMR nadzɔ le eɖokui si wu GCA). Ke hã, amesiwo ŋu GCA le dometɔ siwo ade 40-60% hã akpɔ PMR. Azɔ hã, amesiwo ŋu PMR ɖeɖeko le ƒe 10-20% axɔ GCA le woƒe tsitsime.

Nukae hea GCA vɛ?

Numekulawo menya nusi tututu gbɔ GCA tsona haɖe o , gake ame geɖe xɔe se be enye dɔléle si dɔlélenutsiŋutete alo dɔlékuiwutikewo tsona. Kpuie ko la, ne wò ŋutilã ŋutɔ ƒe dɔlélenutsiŋutete dze wò ʋuka siwo le lãmesẽ me dzi vodadatɔe .

Dɔléle sia bɔ ɖe ame tsitsiwo dzi wu, eyata ame aɖewo susuna be edo ƒome kple tsitsi. Wosusui hã be domenyiŋusẽfianu kple nuto si me wole (abe dɔlékui siwo gblẽa nu le dɔlélenutsiŋutete ŋu ene) gbɔe wòtsona.

Amekae GCA gblẽa nu le wu?

Togbɔ be amesiame ate ŋu axɔ GCA hã la, ame siwo gbɔnae le afɔku me wu:

• Ame tsitsiwo : Ɣesiaɣi kloe la, GCA dzea amesiwo xɔ wu ƒe 50. Afɔku si le dɔlélea xɔxɔ me dzina ɖe edzi ne ame tsi. Ebɔ ɖe amesiwo xɔ tso ƒe 70 va ɖo ƒe 80 dzi wu.
• Nyɔnuwo : Dɔléle sia bɔ ɖe nyɔnuwo me wu ŋutsuwo. Gake ŋutsuwo le afɔku gã aɖe me be woagbã ŋku le dɔléle sia ta.
• Yevuwo : Numekukuwo ɖee fia be GCA gblẽa nu le yevu siwo tso Dziehe Europa ŋu zi geɖe wu to bubuwo. Ke hã, esia mefia be to bubu me tɔwo mate ŋu atue ɖo o.

Aleke wowɔa dea dzesi GCA?

Ne GCA ƒe dzesiwo le ŋuwò la, wò ɖɔkta abia wò atikewɔwɔ ŋutinya gbã eye emegbe wòado wò ŋutilã kpɔ. Woalé ŋku ɖe wò ʋu ƒe sisi gbɔdzɔ le wò abɔwo kple afɔwo ŋu hã. Woado wò ta hã kpɔ be veve aɖe le wò ta ŋu eye ne ʋuka siwo le wò ŋgonu ƒe akpa eveawo vuvu hã.

Dodokpɔ kawoe wozãna tsɔ dea dzesi GCA?

Ðɔktaa aɖe gbe be woado ʋu geɖe kpɔ gbã be woatsɔ akpɔ alesi gbegbe dɔdzẽ le wò ŋutilã me. Le kpɔɖeŋu me:

• (Erythrocyte ƒe Tsi ƒe Agbɔsɔsɔme) (ESR) .
• `(C-Protein si wɔa dɔ)` (CRP) .

Dodokpɔ siawo ate ŋu ana nànya alesi gbegbe dɔdzẽ le wò ŋutilã me. Woate ŋu adzidze hemoglobin, si nye wò ʋumenugbagbevi dzĩwo ƒe akpa si tsɔa ɔksidzin, ƒe agbɔsɔsɔ hã be woakpɔe ɖa be ʋusɔgbɔdɔ le ŋuwò hã.

Ne wò ɖɔkta susui be GCA (Temporal Arteritis) la, ate ŋu adɔ be woawɔ temporal artery ultrasound, si nye ʋuka siwo le wò ŋgonu ƒe ultrasound. Alo, woate ŋu aɖe gbe be woawɔ temporal artery biopsy . Esia bia be ɖɔkta si wona hehee naɖe ʋuka sue aɖe si le wò ŋgonu me eye wòaɖoe ɖe dɔléleŋutinunyala aɖe be wòadoe kpɔ le nusuekpɔmɔ̃ me. Esia ana woakpɔ dzesi siwo fia be dɔdzẽ (ʋukawo me dɔléle) le ʋukaa me hã. Esiae nye dodokpɔ vevitɔ si woatsɔ aɖo kpe GCA dzi.

Ɣeaɖewoɣi la, dodokpɔ siawo hã ate ŋu ahiã:

• ``(Computed Tomography)`` alo ``(CT)`` scan dodokpɔ
• Magnetic Resonance Imaging (MRI) ƒe fotoɖeɖefia
• Ultrasound si woɖena le ʋuka gãwo me
• `(Positron Emission Tomography)` alo `(PET)` ƒe dodokpɔ

Nukae nye atike siwo wozãna na GCA (Temporal Arteritis)?

Ele be woadze GCA dada gɔme kaba ale si wòanya wɔ, vevietɔ be woaxe mɔ ɖe nukpɔkpɔ ƒe bublu nu .

Atike vevitɔe nye atike ƒomevi aɖe si woyɔna be ``glucocorticoid''. Atike ƒomevi si bɔ wu enye ``prednisone.'' Àdze egɔme kple miligram 40 va ɖo 60 (mg) gbesiagbe (to nu me) eye nàɖe agbɔsɔsɔa dzi akpɔtɔ vivivi. Ne ŋku ƒe kuxiwo le ŋuwò xoxo alo ŋku megakpɔa nu nyuie o la, wò ɖɔkta ateŋu ana ``glucocorticoids'' ƒe agbɔsɔsɔ gbogbo aɖe wò to cannula si woda ɖe ʋuka me (``(IV)'') dzi.

Vevietɔ: Glucocorticoids nye atike vevi aɖe ŋutɔ hena GCA dzi ɖuɖu. Gake atike siawo ate ŋu ahe nugbegblẽ aɖewo vɛ, eyata wò ɖɔkta alé ŋku ɖe ŋuwò nyuie.

Glucocorticoids nana wò dɔlélenutsiŋutete gbɔdzɔna, si ate ŋu ana nàxɔ dɔlékuiwo eye wòana woasẽ wu . Woate ŋu ana wò ƒuwo hã naɖiɖi , si ana wò ƒuwo ƒe gbagbã ƒe afɔkua nadzi ɖe edzi.

Nu bubu siwo ate ŋu ado tso eme dometɔ aɖewoe nye:

• Ŋku ƒe ʋuʋu
• Ʋusɔgbɔdɔ
• Sukli si sɔ gbɔ ɖe ʋu me
• Alɔ̃ madɔmadɔ
• Seselelãme ƒe tɔtrɔ
• Lãmetsiwo ƒe gbɔdzɔgbɔdzɔ kple gbegblẽ, vevietɔ le afɔwo me
• Vuvu, vevietɔ le mo kple afɔwo me
• Kpekpeme ƒe dzidziɖedzi

Ne èle glucocorticoids nom la, wò ɖɔkta ate ŋu alé ŋku ɖe wò ƒu ƒe kpekpeme ŋu. Ate ŋu akafu kamedede, calcium kple vitamin D kpeɖeŋutɔ, kple ɖewohĩ atike siwo woatsɔ axe mɔ ɖe ƒumeŋuɖui (ƒu ƒe gbagbã) nu hã be wò ƒuwo nasẽ.

Le ƒe 2017 me la, U.S. Nuɖuɖu Kple Atike Ŋuti Dɔwɔƒe da asi ɖe dɔlékuiwutike yeye aɖe si woyɔna be tocilizumab (Actemra®) dzi be woatsɔ ada GCA. Wodoa atike sia abe atike si wodona ɖe ŋutigbalẽ te ene alo abe IV ene. Ate ŋu akpe ɖe ŋuwò nàɖe glucocorticoids ƒe hiahiã dzi akpɔtɔ. Gake tocilizumab ƒe nugbegblẽ le ame ŋu ŋutɔ, eye wò ɖɔkta aɖe eme na wò.

Ɣekaɣie wòle be makpɔ ɖɔkta?

Ne GCA ƒe dzesiwo, dɔlékui aɖe ƒe dzesiwo, alo dzesi yeye aɖe le ŋuwò la, yi ɖɔkta gbɔ enumake . Wò ɖɔkta gbɔ yiyi edziedzi kple ʋudodokpɔ kple fotoɖeɖe ate ŋu akpe ɖe ŋuwò nàde dzesi dɔlélea gbugbɔgadzɔ (`gbugbɔgadzɔ`) kaba.

Nya kawoe wòle be mabia ɖɔktaa?

Àte ŋu abia wò ɖɔkta nyawo abe:

• Atikewɔwɔ kawoe nèkafu?
• Nu gbegblẽ kawoe wòle be manya nu tsoe le atikewɔwɔ me?
• Nukae mate ŋu awɔ atsɔ aɖe atikewɔwɔ ƒe nugbegblẽ le ame ŋu dzi akpɔtɔ?
• Nukawoe nye kuxi siwo ate ŋu ado tso nɔnɔme sia me?
• Aleke mawɔ alé ŋku ɖe nye nɔnɔmea ŋu?
• Nukawoe nye dzesi siwo fia be dɔlélea gadze ame dzi ake?
• Dzesi kawoe wòle be mate ɖe ŋuwò akpɔ?

Nukae nye ame si ŋu GCA le ƒe agbenɔƒe?

Womekpɔe be GCA ƒe amesinɔnɔ nana ame ƒe agbenɔƒe nɔa kpuie o, gake nu vovovowo ate ŋu akpɔ ŋusẽ ɖe esia dzi. Ne wokpɔ dɔlélea dze sii hedae kaba la, emetsonuwo nyona ŋutɔ , eye dzesiawo dzea egɔme nɔa nyonyom le ŋkeke ʋɛ aɖewo megbe.

Gake ne womewɔ atike na GCA kaba o la, ate ŋu ahe kuxi siwo ate ŋu ade ame ƒe agbe afɔku me abe ŋku ƒe nukpɔkpɔ tegbee, ʋukawo ƒe ʋuʋu, kple lãmetutudɔ ene vɛ. Eyata ele vevie ŋutɔ be nàkpɔ ɖɔkta enumake ne dzesi siwo do ƒome kple GCA le ŋuwò.

Ne wonya dze atikewɔwɔ gɔme ko la, afɔku vevitɔ si nàdo goe nye atikewɔwɔa ƒe nugbegblẽ le ame ŋu . Azɔ hã, ne woda gbe le GCA ŋu le gɔmedzedzea me to atikewɔwɔ dzidzedzetɔe me gɔ̃ hã la, ate ŋu atrɔ ava ɣeaɖewoɣi (`gbugbɔgadzɔ`) . Numekulawo menya nusitae esia dzɔna haɖe o.

Aleke malé be na ɖokuinye esime mele GCA gbɔ?

GCA nɔnɔ ate ŋu asesẽ. Be nàkpɔ wò nɔnɔmea gbɔ ahaɖu glucocorticoids ƒe nugbegblẽ le ame ŋu dzi la, te nu siawo kpɔ:

• Ðu nuɖuɖu nyui si me nunyiame le : nuwo abe lã siwo me ami mele o, mɔli, nuku blibowo, atikutsetse kple amagbe yeyewo.
• Na vitamin D kple calcium si sɔ na wò be wòakpɔ wò ƒuwo ta.
• Ƒo ɖokuiwò ɖe kamedede aɖewo me aɖabaƒoƒo 30 ya teti gbesiagbe.
• Dɔ alɔ̃ nyuie gaƒoƒo adre va ɖo enyi ya teti zã sia zã.
• No atike si woŋlɔ na wò ɖe game dzi .
• Kpɔ wò ɖɔkta edziedzi .
• Ðe afɔ aɖewo nàtsɔ akpɔ ɖokuiwò ta tso dɔlékuiwo me .

Nu kawoe wòle be maƒo asa na ne GCA le ŋunye?

Ne GCA le ŋuwò la, anyo wu be nàƒo asa na nusiawo:

• Nusiwo nana wò dɔléle ƒe afɔkua dzina ɖe edzi : Esi GCA ƒe atikewo gbɔdzɔa wò dɔlélenutsiŋutete ta la, anɔ eme be dɔlékuiwo axɔ wò. Bia wò ɖɔkta tso mɔ bubu siwo dzi nàto aɖe dɔlékuiwo xɔxɔ ƒe afɔkua dzi akpɔtɔ, abe alesi nàƒo asa na dɔléle, asikɔklɔ enuenu, kple tete ɖa tso ame siwo le dɔ lém gbɔ ene ŋu.
• Sigaretnono : Sigaretnono ate ŋu ana GCA xɔxɔ ƒe afɔkua nadzi ɖe edzi. Wò ʋukawo ƒe lãmesẽ anyo ɖe edzi ne èdzudzɔ atamanono ko, si aɖe vi na wò le wò agbe me katã.
• Ahanono : Ahanono ate ŋu agblẽ nu le wò dzi kple ʋukawo ƒe lãmesẽ ŋu le mɔ gbegblẽ nu. Ate ŋu ana ƒuwo nabu kabakaba hã eye wòawɔ dɔ kple atike siwo nènona na wò dɔlélea.

Nya vevi aɖewo (Take-Home Message) .

Lãmenugbagbevi Gãwo ƒe Ʋukawo ƒe Dɔléle (si woyɔna tsã be Temporal Arteritis) ate ŋu anye nɔnɔme sesẽ aɖe. Gake ne wokpɔ dɔlélea le ŋuwò kaba eye nèdoa wò kpɔ edziedzi le ɖɔkta bibi gbɔ la, àte ŋu akpɔ emetsonu nyuitɔ sã . Dɔdamɔnua ƒe dzesiwo kple nugbegblẽ le ame ŋu ate ŋu akpɔ ŋusẽ ɖe wò susu ƒe lãmesẽ, wò dɔwɔwɔ, kple wò agbenɔnɔ ƒe akpa geɖe dzi. Gake menye wò ɖeka koe o. Bia wò ɖɔkta be wòakpe ɖe ŋuwò nàkpɔ kpekpeɖeŋunaha aɖe si me ame siwo to nɔnɔme mawo tɔgbe me le. Wò nuteƒekpɔkpɔwo kple aɖaŋuɖoɖowo gbɔgblɔ na ame bubuwo ate ŋu anye akɔfafatsoƒe.

Ðo ŋku edzi be ne dzesi aɖewo siwo mebɔ o abe taɖuame, aɖuveve, alo ŋku ƒe kuxiwo ene le ŋuwò (vevietɔ ne èxɔ ƒe 50 kple edzivɔ) la, mègaŋe aɖaba ƒu edzi o eye nàdi atikewɔlawo ƒe aɖaŋuɖoɖo enumake. Atikewɔwɔ kaba ate ŋu axe mɔ ɖe kuxi sesẽwo nu.

` Lãmenugbagbevi Gãwo ƒe Ʋukawo ƒe Dɔléle, Ɣeyiɣi ƒe Ʋukawo ƒe Dɔléle, GCA, Taɖuame, Ŋkukpɔkpɔ, Ʋukawo ƒe Vuvu, Ame Tsitsiwo ƒe Lãmesẽ, Polymyalgia Rheumatica, Prednisone, Vasculitis