Ðe lãkusi si woyɔna be thyroid gland kpɔa ŋusẽ ɖe wò ŋkuwo dzia? Mina míasrɔ̃ nusianu tso Thyroid Eye Disease ŋu!

Èse kpɔ be lãkusi ƒe kuxiwo ate ŋu agblẽ nu le wò ŋkuwo ŋua? Ɣeaɖewoɣi la, woate ŋu atsɔ dɔléle ɖeka asɔ kple bubu le mɔ siwo míenya gɔ̃ hã o nu. Emae nye nusi woyɔna be thyroid eye dɔléle, alo abe alesi woyɔnɛ le ɖɔktawo dome ene (Thyroid Eye Disease - TED). Esiae nye esime lãkusi tsɛ siwo ƒo xlã wò ŋkuwo vuvu. Esia ate ŋu ana wò ŋkuwo nase veve eye wòase veve. Zi geɖe la, wokpɔa nɔnɔme sia le amesiwo ŋu dɔlélenutsiŋutete ƒe dɔléle siwo dzea lãkusia dzi le la ŋu. Esia bɔ ɖe amesiwo ŋu dɔléle aɖe si woyɔna be (Graves ƒe dɔléle) le koŋ. Esia tae ɖɔktawo yɔnɛ ɣeaɖewoɣi be Graves ƒe Ŋkudɔléle.

Nuka tututue nye ŋkudɔ (TED)?

Kpuie ko la, Thyroid Eye Disease (TED) nye dɔléle aɖe si gblẽa nu le lãkusi siwo ƒo xlã wò ŋkuwo ŋu, si wɔnɛ be wovuvuna. Enye dɔléle si dɔlélenutsiŋutete ŋutɔ wɔna, si fia be wò ŋutilã ŋutɔ ƒe dɔlélenutsiŋutete dzea lãkusia kpakple lãkusi siwo ƒo xlã wò ŋkuwo dzi vodadatɔe.

Bu eŋu abe míaƒe dɔlélenutsiŋutete le abe aʋakɔ si kpɔa míaƒe dukɔa ta ene. Gake ɣeaɖewoɣi la, asrafoha sia wɔa vodada hedzea eya ŋutɔ ƒe amewo dzi. Emae nye nusi dzɔna le dɔléle siwo dɔlélenutsiŋutete hena vɛ me.

TED menye nɔnɔme si vaa ame gbɔ eye wòdzona o. Afɔɖeɖe vovovowoe le esi. Vuvu kple vevesesea ate ŋu ava eye wòadzo ƒe eve alo esi wu nenema. Dzesiawo toa vovo tso ame ɖeka gbɔ yi bubu gbɔ; ame aɖewo ate ŋu akpɔ nu ʋɛ aɖewo ko, evɔ ame bubuwo ya ate ŋu akpɔ dzesi sesẽwo. Le ame akpa gãtɔ gome la, menye nya vevi aɖekee wònye o. Gake ne eva nu sẽ la, ate ŋu agblẽ nu le ŋkuwo ŋu tegbee, woƒe dzedzeme natrɔ, eye woƒe ŋkuwo natsi.

Ðewohĩ èse ɖɔktawo zã ŋkɔ bubuwo na dɔléle sia kpɔ. Ŋkɔ siawo dometɔ aɖewoe nye:

• Thyroid ŋkudɔléle
• Thyroid orbitopathy ƒe dɔléle
• Graves ƒe ŋkudɔléle
• Graves ƒe orbitopathy ƒe dɔléle

Esiawo katã nye ŋkɔ vovovowo ko na nɔnɔme ɖeka, eyata mègatsi dzi o.

Nukae nye ŋkudɔ (TED) ƒe dzesiwo?

Azɔ na míakpɔ alesi nàte ŋu ade dzesi nɔnɔme sia ɖa. Kpɔe ɖa be dzesi siawo dometɔ ɖeka alo esi wu nenema le ŋuwò hã:

• Proptosis: Edze abe ŋkuawo lolo eye wodo ɖe gota ene.
• Ŋku siwo le ʋuʋum, siwo le dzo dam: Ðeko wòsena le ɖokuiwò me be yemele dedie o, abe ɖe nane gblẽ le wò ŋkuwo ŋu ene.
• Ŋku ƒe vuvu kple bibi (Blepharitis): Ŋku ƒe gowo ate ŋu avuvu eye woabiã.
• Ŋku ƒuƒu alo aɖatsi ŋeŋe enuenu: Ame aɖewo ƒe ŋkuwo ƒuna, eye ɖeko ame bubuwo ya tea aɖatsi.
• Ŋkuʋuʋu enuenu: Ŋkuwo ƒe ʋuʋu enuenu, si dzi womate ŋu aɖu o.
• Kekeli ƒe seselelãme (Fotovɔvɔ̃): Ŋkuwo va zua blɔ, ne ɣea tsi alo akaɖiawo le bibim gɔ̃ hã, si wɔnɛ be nukpɔkpɔ sesẽna.
• Ŋku ƒe vevesese kple taɖuame:Ate ŋu anye vevesese si ƒo xlã ŋkuwo, si ate ŋu anye taɖuame.
• Ŋkuwo ʋuʋu sesẽ: Ewɔna nam abe ɖe wòsesẽna be woaʋuʋu ŋkuwo ne wole ŋku lém ɖe dzi, le anyime, alo le axadzi ene.
• Diplopia: Nu ɖeka kpɔkpɔ be enye eve.

Zi geɖe la, dzesi siawo dzea ŋku evea siaa dzi, gake ɣeaɖewoɣi la, ŋku ɖeka ko dzie woate ŋu akpɔ dzesi siawo le.

Nukawoe nye Graves ƒe Ŋkudɔléle ƒe kuxiwo?

Ne thyroid ŋkudɔ ƒe akpa si le dɔ wɔm wu enu la, tɔtrɔ siwo vaa ŋkuawo ƒe dzedzeme kple nukpɔkpɔ me ate ŋu anyo ɖe edzi. Gake menye ɣesiaɣie esia dzɔna o. Ɣeaɖewoɣi la, lãkusi siwo ƒo xlã ŋkuawo ate ŋu axɔ abi eye womagatrɔ ava nɔ abe tsã ene o. Azɔ hã, ŋkua ƒe akpa aɖewo siwo gblẽa nu le nukpɔkpɔ ŋu ate ŋu agblẽ tegbee. Gake mègatsi dzi o, woate ŋu atsɔ amekoko ada nusiawo.

Tɔtrɔ siwo ate ŋu adzɔ le dzedzeme me tegbee:

• Ŋku ƒe ʋuʋu ɖe megbe
• Ŋku siwo do ɖe gota
• Ŋku siwo le kotoku me
• Ŋku dzĩwo

Tɔtrɔ siwo anɔ anyi ɖaa le nukpɔkpɔ me ate ŋu ava:

• Nukpɔkpɔ si me mekɔ o
• Nukpɔkpɔ eve
• Nukpɔkpɔ ƒe bublu sesẽ - Esia mebɔ kura o, gake enyo be woanya.

Nukatae míexɔa ŋkudɔ (TED)?

Abe alesi míegblɔe va yi ene la, enye dɔléle si dɔlélenutsiŋutete hena vɛ. Esia fia be wò ŋutilã ŋutɔ ƒe dɔlélenutsiŋutete dzea wò lãkusi kple lãkusi siwo ƒo xlã wò ŋkuwo dzi. Graves ƒe dɔléleae nye nusi gbɔ wòtsona wu. Gake ate ŋu adzɔ le amesiwo ŋu dɔléle bubu siwo dɔlékuiwo ƒe dɔlélenutsiŋutete hena vɛ, abe Hashimoto ƒe dɔléle ene, le hã dzi. Nukutɔe la, ɣeaɖewoɣi la, amesiwo ŋu thyroid kuxi aɖeke mele o eye thyroid hormone ƒe agbɔsɔsɔ si sɔ la ate ŋu axɔ TED.

Le dɔléle siawo me la, dɔlékuiwutike aɖewo siwo wò dɔlélenutsiŋutete wɔna wɔa dɔ abe lãkusi me lãmetsiwo ene eye woléna ɖe lãkusi me lãmetsiŋusẽxɔlawo ŋu. Lãmetsiŋusẽ siawo ƒe akpa gãtɔ le lãkusi me, gake ɖewo hã le lãkusi siwo le ŋkua megbe hã me. Eyata dɔlékuiwutike mawo ke siwo gblẽa nu le lãkusi ŋu la kpɔa ŋusẽ ɖe ŋkuwo hã dzi.

Amekae le afɔku me wu be wòaxɔ (TED)?

Anɔ bɔbɔe be dɔléle sia nadze ame aɖewo dzi. Kpɔe ɖa be èdze ɖe hatsotso siawo dometɔ ɖeka me hã:

• Ne nyɔnue nènye: Nyɔnuwo ate ŋu axɔ Graves ƒe dɔléle kple Graves ƒe ŋkudɔ abe zi gbɔ zi atɔ̃ ene wu ŋutsuwo. (Gake ne ŋutsu aɖe va xɔe la, anɔ eme be asẽ wu.)
• Ne wò lãkusi me lãmetsiŋusẽ ƒe agbɔsɔsɔ mesɔ o la:Lãmetsiŋusẽ ƒe agbɔsɔsɔ si dzi ɖe edzi (hyperthyroidism) kple esi dzi ɖe kpɔtɔ (hypothyroidism) siaa ate ŋu ana TED nadzɔ. Lãmetsiŋusẽ siawo, abe dɔlékuiwutike siwo ŋu míeƒo nu tsoe va yi ene, doa ŋusẽ lãmenugbagbevi siwo le ŋkua ƒe lãkusiwo me.
• Ne èwɔ radioiodine-dɔdamɔnu (RAI dɔdamɔnu) kpɔ: RAI-dɔdamɔnu nye atike vevitɔ na ʋumenugbagbeviɣidɔ si gbɔ eme. Gake ate ŋu awɔ akpa aɖe le TED me alo agblẽe ɖe edzi.
• Ne ènoa atama: Esia le vevie ŋutɔ. Amesiwo noa atama eye wodoa go atama si wozãna tsã la le afɔku gã aɖe me be woaxɔ thyroid ŋkudɔ. Azɔ hã, dzesiawo nu sẽna wu eye wonɔa anyi didi wu le atamanolawo gome. Ne TED le ŋuwò la, nu nyuitɔ si nàte ŋu awɔ na ɖokuiwòe nye be nàdzudzɔ atamanono.

Aleke mawɔ anya ne ɖɔktawo (TED) li?

Wò ɖɔkta ate ŋu anya nɔnɔme sia ne edo ŋku kpɔ ŋutɔŋutɔ eye wòlé ŋku ɖe wò ŋkume kple ŋkume ŋu nyuie.

Ne ɖikeke sia do mo ɖa la, woaɖe gbe be woado ʋu na wò zi geɖe atsɔ akpɔ wò lãkusi me lãmetsiŋusẽ ƒe agbɔsɔsɔ kple nenye be dɔlékuiwutike mawo sɔ gbɔ akpa alo wosɔ gbɔ akpa le wò ʋu me hã.

Tsɔ kpe ɖe eŋu la, ɖɔktaa ate ŋu abia be woawɔ dodokpɔ bubu geɖe:

• Ultrasound dodokpɔ le ŋkuwo ŋu
• CT Scan (Kɔmpiutadziɖoɖo - CT) dodokpɔ
• MRI (Magnetic Resonance Imaging - MRI) dodokpɔ

Dodokpɔ siawo ate ŋu anya alesi tututu lãkusi siwo ƒo xlã ŋkuawo vuvu kple nenye be nyaƒoɖeamenu aɖe le lãmekawo ŋu.

Nukawoe nye atike siwo wozãna na (TED)?

Atikewɔwɔ si ƒomevi nèhiã la anɔ te ɖe afisi dɔlélea le kple alesi wòsesẽe dzi. (TED) Le dɔwɔwɔ ƒe akpaa me la, atikewɔmɔnu aɖewo li siwo ate ŋu akpe ɖe ame ŋu wòaɖe dzesiawo dzi akpɔtɔ. Esiawo ate ŋu anye aƒeme atikewo, atike siwo womeƒlena le atikedzraƒe o, alo atike siwo woŋlɔ na amewo. Ne dɔwɔwɔ ƒe akpaa wu enu la, ahiã be woawɔ dɔ na wò be wò dzedzeme nagadze alo aɖɔ wò nukpɔkpɔ ɖo.

Atikewɔwɔ be woaɖe dzesiawo dzi akpɔtɔ

Atikewɔwɔ siawo ate ŋu akpe ɖe ame ŋu ne TED le dɔ wɔm:

• Ŋkutike: Ŋkutike ƒomevi vovovowo li be woatsɔ aɖe ŋku siwo ƒu, siwo biã, alo esiwo le veve sem la dzi akpɔtɔ.
• Selenium kpeɖeŋutɔ: Wokpɔe be selenium ƒe anyimanɔmanɔ nana TED ƒe dzesiwo dzina ɖe edzi, eyata wò ɖɔkta ate ŋu akafu esiawo.
• Scleral lenses: Esiawo sɔ kple ŋkumeɖonu, gake wotsyɔa ŋkua ƒe akpa si lolo wu, si naa ametakpɔnu bubu. Woate ŋu azã wo hã atsɔ ana atikewo.
• Nukpɔkpɔ ƒe kpekpeɖeŋunuwo:Ne èkpɔa nu zi eve la, wò ɖɔkta ate ŋu aɖo aɖaŋu na wò be nàzã ŋkumeɖonu alo ado ŋkumeɖobolo si ŋu prism tɔxɛwo le.
• (Thionamides) Atikewo: Ne (hyperthyroidism) (le Graves ƒe dɔlélea ta) le ŋuwò la, woate ŋu ana atikewo abe (methimazole) kple (propylthiouracil) be woatsɔ aɖe thyroid hormone ƒe agbɔsɔsɔ dzi akpɔtɔ.
• Corticosteroids: Ne wò dzesiwo nu sẽ la, wò ɖɔkta ate ŋu aŋlɔ corticosteroids na wò hena ɣeyiɣi kpui aɖe be wòaɖe abi dzi akpɔtɔ. Woate ŋu ana esiawo abe atikekui siwo woano to nu me ene alo abe atike si wodona ɖe ʋuka me (IV).
• (Teprotumumab - Tepezza®): Esia nye atike tɔxɛ gbãtɔ si dzi woda asi ɖo le United States le ƒe 2020 me be woatsɔ ada (TED). Esia nye atike yeye aɖe le hatsotso aɖe si woyɔna be (biologics) me si ɖea dɔdzẽ dzi kpɔtɔna. Wole atike geɖe wu abe esia ene tom vɛ fifia.
• Kekelidɔdada: Bu keklẽŋusẽdɔdamɔnu ŋu be wòatsrɔ̃ dɔlélenutsiŋutete ƒe lãmenugbagbevi siwo le dɔ wɔm le ŋkua megbe eye woaɖe abi dzi akpɔtɔ. Wò ŋkudɔdala ate ŋu aɖo wò ɖe kansadɔdala si zãa keklẽŋusẽ.

Ðo ŋku edzi be ne atikewɔmɔnu siawo mewɔ dɔ na wò o la, wò atikewɔlawo ƒe ƒuƒoƒoa ana atikewɔmɔnu bubuwo. Ƒã hafi wòhiãna be woawɔ dɔ na ame le Graves ƒe ŋkudɔ ƒe dɔwɔwɔ ƒe akpa si le dɔ wɔm me. Zi geɖe la, wobua amekoko ŋu ne wò nɔnɔmea li ke. Ema ko hafi míate ŋu anya tɔtrɔ siwo ava le dzedzeme kple nukpɔkpɔ me anɔ anyi ɖaa la kple kakaɖedzi.

Amekoko na (TED) .

Le go aɖewo me la, ate ŋu ahiã be woawɔ dɔ na ame:

• Orbital decompression surgery: Ƒã ŋutɔ la, amekoko sia hiã ne ʋuʋudedi le nyaƒoɖeamenu hem vɛ na ŋku ƒe lãkusi. Amekolaa ɖea ƒu aɖe ɖa be wòaɖe nyaƒoɖeamenua dzi akpɔtɔ. Wowɔa esia hã be woatsɔ aɖe ŋkua ƒe ʋuʋu dzi akpɔtɔ ne dɔlélea nu fa vɔ.
• Thyroidectomy: Atikewɔwɔ na ʋumenugbagbeviɣidɔ sesẽ aɖe. Ne atikewo mete ŋu ɖu lãkusi me lãmetsiŋusẽ ƒe agbɔsɔsɔ dzi o la, ahiã be woaɖe lãkusia ɖa.
• Ŋku ƒe dɔwɔwɔ: Ne wò ŋkumewo ge ɖe eme la, wowɔa amekoko sia be woagaɖo woƒe nɔnɔme gbãtɔ me. Menye ɖeko esia ɖea ŋku ƒe vevesese dzi kpɔtɔna ko o, ke enaa ŋkua ƒe dzedzeme nyona ɖe edzi eye wòkpɔa ŋkua ta tso ŋku ƒe ʋuʋu me.
• Ŋku ƒe lãmekawo ƒe dɔwɔwɔ: Amekoko sia ate ŋu ahiã ne abi le lãmeka siwo ʋãa ŋkuwo ŋu eye wòsesẽna be woaʋuʋu ŋkuwo, alo ne ŋkuawo mesɔ o eye nèkpɔa nu le mɔ vovovo eve nu.
• Ŋku ƒe dɔwɔwɔ: Esia bia be woagbugbɔ lãkusi falɛfalɛwo kple/alo ƒu siwo ƒo xlã ŋkua atu. Ate ŋu akpɔ atsyɔ̃ɖoɖo ƒe kuxiwo abe ŋku siwo do ɖe gota kple akplo siwo le ŋkuwo te ene gbɔ.
• Ŋku ƒe ŋkume ƒe ʋuʋu:Ne ŋkua ƒe ŋkume ƒe ŋkumeʋuʋu gblẽ vevie le ŋkua ƒe dzedzeme le dɔlélea ƒe dɔwɔwɔ ƒe akpaa me ta la, woate ŋu abu ŋkume ƒe ŋkumeʋuʋu dodo na ame ŋu be wòana nukpɔkpɔ nanyo ɖe edzi.

(TED) Nukae nye nɔnɔmea ƒe mɔkpɔkpɔ?

Le ame akpa gãtɔ gome la, TED mesẽna boo o, eyata zi geɖe la, nukpɔsusua nyona. Dzesi siwo nu mesẽna o nɔa ame akpa gãtɔ ŋu, eye zi geɖe la, wo nu yina le wo ɖokui si. Gake dzesiawo ate ŋu asẽ wu le amesiwo xɔ wu ƒe 50. Ne TED sesẽ aɖe le ŋuwò la, ɖewohĩ ahiã be nàzã atike vovovowo atsɔ akpɔ egbɔe. Ame aɖewo ate ŋu atrɔ asi le woƒe ŋkuwo ŋu tegbee, si ate ŋu abia be woawɔ dɔ na wo.

Ɣekaɣie wòle be makpɔ ɖɔkta?

Ne thyroid ŋkudɔ le ŋuwò la, ele vevie be nàna wò lãmesẽnyawo gbɔ kpɔha nanya ne wò dzesiwo gagblẽ ɖe edzi. Ele be nàgblɔe na wo hã ne ède dzesi tɔtrɔ aɖewo le wò nukpɔkpɔ me. Tɔtrɔ aɖewo ate ŋu abia be woawɔ atike na wo kpata. Ƒo ka na wò ɖɔkta enumake ne ède dzesi nu siwo gbɔna la dometɔ aɖe:

• Ne edze abe wò nukpɔkpɔ ƒe akpaa le kpuie ene, alo ne èle nu kpɔm le mɔ ɖeka nu.
• Ne amadedeawo ƒe dzedzeme to vovo na alesi wòle be woanɔ.
• Ne kasia ŋku le veve sem vevie.

Graves ƒe ŋkudɔ ate ŋu akpɔ ŋusẽ ɖe wò agbenɔnɔ ƒe nyonyome dzi ŋutɔŋutɔ. Dzesi sesẽ aɖeke mele ame geɖe ŋu o, gake ate ŋu aɖe fu na ame ŋutɔ ne wokpɔe. Vuvu si ƒo xlã wò ŋkuwo ate ŋu akpɔ ŋusẽ ɖe wò akɔfafa, nukpɔkpɔ, kple dzedzeme dzi. Ebia ɖɔktawo ƒe ƒuƒoƒo aɖe be woakpe ɖe ŋuwò nànɔ te ɖe nusiawo katã nu. Ele vevie hã be kpekpeɖeŋu nanɔ asiwò le wò ŋutɔ wò agbe me. Ne mèle kpekpeɖeŋu si nèhiã la xɔm o la, bia wò atikewɔlawo ƒe ƒuƒoƒoa. Ðewohĩ woate ŋu agblɔ dɔwɔnu siwo ate ŋu akpe ɖe ŋuwò le wò susu ƒe lãmesẽ ŋu na wò.

Nu vevi siwo dzi wòle be woaɖo ŋkui (Take-Home Message) .

Enyo, eyata mina míaƒo nu tso nusiwo dzi wòle be nàɖo ŋkui tso nusiwo ŋu míeƒo nu tsoe me la dometɔ aɖewo ŋu kpuie:

• Thyroid eye disease (TED) nye dɔléle si gblẽa nu le ŋkuwo ŋu si do ƒome kple kuxi siwo le thyroid gland ŋu.
• Nya nyuie le dzesiwo abe ŋkuwo ƒe ʋuʋu, ŋku ƒe ʋuʋu, vuvu, kple nukpɔkpɔ zi eve ene ŋu.
• Ne ènoa atama la, ke dzudzɔ godoo. Esiae nye kpekpeɖeŋu gãtɔ kekeake si nàte ŋu awɔ.
• Ne dzesiawo nu sẽ alo ne ède dzesii be yeƒe ŋkuwo trɔ la , di atikewɔlawo ƒe aɖaŋuɖoɖo enumake.
• Le ame akpa gãtɔ gome la, nɔnɔme sia mesẽna o, eye atike vovovowo li woate ŋu azã. Eyata mègatsi dzodzodzoe o, gake ele vevie be nàdi atikewɔla nyuitɔ.
• Wò susu ƒe lãmesẽ hã le vevie ŋutɔ le ɣeyiɣi sia me. Mègahe ɖe megbe le kpekpeɖeŋu didi ɖe ema hã ta ne èhiãe o.

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

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