ʻO ka ʻōnaehana pale o kou kino, ʻo ia hoʻi ka ʻōnaehana pale kino, ua like ia me kahi pūʻali koa e pale ana i kahi ʻāina. ʻO ka hana a kēia pūʻali koa, ʻo ia ke ʻike a hoʻouka i nā ʻenemi e like me nā huakino a me nā maʻi e hele mai ana mai waho mai, a hoʻopakele iā mākou mai nā maʻi. Akā, e noʻonoʻo i ke ʻano o ka luku e hiki mai ana inā hele hewa iki kēia pūʻali koa a hoʻomaka e hoʻouka i nā poʻe maikaʻi ma ko mākou ʻāina ponoʻī, me ka manaʻo he ʻenemi lākou? ʻO ia ka mea e hana ʻia ana i kahi maʻi i kapa ʻia ʻo Autoimmune Pancreatitis (AIP). Maanei, manaʻo hewa kā mākou ʻōnaehana pale ponoʻī he ʻenemi ko mākou pancreas ponoʻī a hoʻomaka e hoʻouka iā ia.
I ka ʻōlelo maʻalahi, he aha ka Autoimmune Pancreatitis (AIP)?
He ʻano maʻi laha ʻole kēia. E like me kā mākou i ʻōlelo ai ma mua, hoʻouka ko mākou ʻōnaehana pale i ko mākou pancreas, e hoʻoulu ai i ka mumū mau loa, a i ʻole pancreatitis. ʻO ka wā wale nō e hana ʻia ai kēia pōʻino i ka hala ʻana o ka manawa e hoʻomaka ai nā pilikia koʻikoʻi. I ka manawa pinepine, ʻaʻole paha mākou e ʻike i kekahi mau hōʻailona a hiki i ka wā e hana ʻia ai ka pōʻino nui.
Hiki ke paʻakikī ke ʻike i kēia maʻi. ʻO kēia no ka mea he maʻi laha ʻole ia, ʻaʻole maopopo mau nā hōʻailona, a ma nā scans, hiki ke like me nā maʻi ʻē aʻe, ʻoiai ke kanesa pancreatic . Hiki ke hopohopo kēia no nā poʻe he nui. Akā ʻo ka mea maikaʻi loa, ke loaʻa iā ʻoe ka maʻi a hoʻomaka i ka lāʻau kūpono, hiki iā ʻoe ke hoʻōla koke .
ʻElua mau ʻano nui o ka Autoimmune Pancreatitis (AIP):
ʻElua ʻano nui o kēia maʻi. He ʻokoʻa iki ke ʻano o ko lākou hoʻopilikia ʻana i ko mākou kino. E nānā kākou i ke ʻano o lākou.
| Hiʻona | ʻAno 1 (ʻAno 1 AIP) | ʻAno 2 (ʻAno 2 AIP) |
|---|---|---|
| Nā inoa ʻē aʻe | ʻIke ʻia hoʻi ʻo ka maʻi e pili ana iā IgG4. | ʻIke ʻia hoʻi ʻo ka idiopathic duct-centric chronic pancreatitis (IDCP). |
| Nā kino i hoʻopilikia ʻia | Ma waho aʻe o ka pancreas, hiki ke hoʻopilikia ʻia nā ʻōpū ʻē aʻe e like me nā ʻāpana bile, nā puʻupaʻa, ke akepaʻa, nā māmā, a me nā kelepa salivary. | Hoʻopaʻa pinepine ʻia ia i ka pancreas . |
| Nā hoʻāʻo koko | Ke piʻi nei ka nui o nā antibodies IgG4 i loko o ke koko. | ʻAʻole piʻi pinepine nā pae IgG4. |
| Makahiki maʻamau loa | ʻO ka maʻamau ma hope o 60 mau makahiki. ʻOi aku ka maʻamau i nā kāne. | ʻIke pinepine ʻia i ka wā ʻōpiopio . Hoʻopilikia like ia i nā kāne ʻelua. |
| Nā maʻi pili ʻē aʻe | Hiki ke pili pū me nā maʻi autoimmune ʻē aʻe. | Ma kahi o 30% o nā maʻi e loaʻa paha i kahi maʻi i kapa ʻia ʻo ka maʻi ʻōpū mumū (IBD) . |
| Hoʻi hou | Aia kahi manawa kūpono e hoʻi hou mai nā hōʻailona ma hope o ka hoʻōki ʻana o ka lāʻau lapaʻau. | Haʻahaʻa ka manawa kūpono o ka hoʻi hou ʻana o nā hōʻailona. |
ʻIke hou aku e pili ana i ka Type 1 AIP...
I ka ʻōlelo maʻalahi, ʻo kēia kekahi ʻāpana o kahi hui nui o nā maʻi i kapa ʻia ʻo nā maʻi e pili ana iā IgG4. ʻO IgG4 kahi ʻano antibody a ko mākou kino e hana ai. I loko o kēia maʻi, hui pū ʻo IgG4 a me nā pūnaewele pale i kapa ʻia ʻo nā pūnaewele plasma e hele ma waena o nā ʻiʻo o ka pancreas, e hana ana i ka mumū a me ka ʻeha.
ʻIke hou aku e pili ana i ka Type 2 AIP...
I kēia ʻano, ʻaʻole e piʻi aʻe nā pae IgG4. ʻAʻole hoʻi e hoʻopilikia ʻia nā ʻōpū ʻē aʻe. Eia nō naʻe, hiki i kēia poʻe ke loaʻa i kekahi manawa nā hanana hou o ka pancreatitis ʻāʻī. ʻO ia hoʻi, lilo koke ka pancreas i pehu a ʻike ʻia nā hōʻailona, a laila e emi iho ma hope o kekahi mau lā.
He aha nā hōʻailona o kēia maʻi?
ʻOiai ʻaʻohe paha he mau hōʻailona no ka manawa lōʻihi, ʻo ka hōʻailona mua e ʻike pinepine ʻia ʻo ia ka jaundice ʻeha ʻole . He hōʻailona koʻikoʻi loa kēia. Hiki i kekahi poʻe ke ʻeha ma ka ʻōpū o luna a i ʻole ke kua. ʻO kēia no ka mea aia ko mākou pancreas ma waena o ka ʻōpū a me ka iwi kuamoʻo.
E noʻonoʻo, aia kekahi kanaka ma kahi o 65 mau makahiki. Ua melemele koke kona mau maka, ua melemele kona kino. Ua emi kona kaumaha. Akā, ʻaʻohe ʻeha nui i loko o kona ʻōpū. E makaʻu paha kekahi ke ʻike i kekahi mea e like me kēia. I kona hele ʻana i ke kauka a hana i nā hoʻokolohua like ʻole, ʻike ʻo ia ʻaʻole kēia he maʻi kanesa, akā, he Autoimmune Pancreatitis.
Eia kekahi, hiki iā ʻoe ke ʻike i kēia mau hōʻailona:
- ʻO ka mimi ʻeleʻele a me nā ʻōpala maeʻele (e mae ana i ke keʻokeʻo)
- Luhi
- ʻAʻai ʻole
- Ka nalowale o ka makemake a me ka pohō kaumaha
- Ka luaʻi a me ka luaʻi
No ke aha e loaʻa ai kēia maʻi? He aha nā kumu pilikia?
ʻO kaʻoiaʻiʻo, ʻaʻole hiki i nā kānaka ʻepekema ke ʻōlelo maopopo i ke kumu o ka ulu ʻana o kēia mau maʻi autoimmune. Manaʻo lākou he hui pū ʻana ia o nā genes a me nā kumu kaiapuni . No ka laʻana, ke loaʻa i ko mākou kino kahi maʻi koʻikoʻi, hiki i kā mākou ʻōnaehana pale ke lilo i mea hana nui e hakakā iā ia. I kekahi manawa, ma hope o ka pau ʻana o ke kaua, hiki i ka ʻōnaehana ke poina pehea e mālie ai a hoʻomaka e hoʻouka i kāna mau cell ponoʻī.
Eia kekahi, ʻoi aku ka nui o ka loaʻa ʻana o ka AIP i kekahi kanaka i loaʻa i kahi maʻi autoimmune ʻē aʻe. Eia kekahi laʻana:
- ʻO ka maʻi o Hashimoto (kahi maʻi e pili ana i ka thyroid gland)
- ʻO ka colitis ulcerative (ka mumū o ka ʻōpū nui)
- ʻO ka ʻāʻī rheumatoid
- ʻO ka maʻi Sjögren (kahi maʻi e maloʻo ai nā ʻōpū salivary a me nā waimaka)
He aha nā pilikia e hiki mai ana o kēia maʻi?
Hiki i ka mumū lōʻihi ke hōʻino i ko kākou mau kino. ʻO kēia ke alakaʻi i ka hoʻokumu ʻia ʻana o nā ʻiʻo ʻeha. Hiki i kēia ʻeha ke hoʻopilikia i ka hana o ka pancreas. A laila, hoʻōki ko kākou kino i ka hana ʻana i nā hormones a me nā enzymes e pono ai, hiki ke alakaʻi i nā pilikia ʻōpū a me ka maʻi diabetes.
ʻElua mau pilikia nui e hiki ke ʻike ʻia:
1. ʻO ke koʻikoʻi o ka biliary: ʻO nā ʻauwai bile e lawe ana i ka bile, kahi wai i hana ʻia i loko o ko kākou ake, i nā ʻōpū e hele ma o ka pancreas. Ke pehu a ʻeha paha ka pancreas, hiki ke ālai ʻia kēia mau ʻauwai. A laila, hōʻiliʻili ka bile i loko o ke kino, e hana ana i ka jaundice.
2. Ka pilikia o ke kanesa pancreatic: ʻO kēia ka mea a ka poʻe he nui e makaʻu nei. ʻAʻole ka pancreatitis autoimmune he kanesa. Eia nō naʻe, ʻo ka mea me ka pancreatitis mau, no kekahi kumu, he liʻiliʻi loa ka pilikia (ma kahi o 1% - 2%) o ka loaʻa ʻana o ke kanesa pancreatic. ʻOiai ua like nā hōʻailona o nā maʻi ʻelua, he mea nui e hoʻokaʻawale ma waena o nā mea ʻelua. ʻO ia ke kumu e nānā pono ai kāu kauka i kēia.
Pehea e ʻike pololei ai nā kauka i kēia maʻi?
Ua like kēia me kahi moʻolelo mākaʻi. ʻAʻole hiki i kahi hoʻāʻo hoʻokahi ke hōʻoia i ka maʻi. Pono nō hoʻi e kāpae i nā maʻi ʻē aʻe, ʻoiai ke kanesa. ʻO ia ke kumu e hana ai ke kauka i kekahi mau hoʻāʻo.
| ʻAno hoʻāʻo | He aha ka mea e hana ʻia nei? |
|---|---|
| Nā hoʻāʻo koko | Nānā ʻia nā pae antibody IgG4, nā pae enzyme o ke akepaʻa a me ka pancreas. Hiki ke hoʻāʻo ʻia nā mea e like me nā māka maʻi kanesa e ʻike inā he maʻi kanesa. |
| Nā hoʻokolohua kiʻi | Nānā nā scan MRI a i ʻole CT i ka pehu ʻana a i ʻole ka ʻeha ma ka pancreas a me nā ʻōpū ʻē aʻe. Nānā pono kahi scan MRI kūikawā i kapa ʻia ʻo MRCP i nā ʻauwai bile a me ka ʻōnaehana ʻauwai pancreatic. |
| Biopsy | ʻO ka Endoscopic Ultrasound, kahi ʻano hana e lawe ʻia ai kahi ʻāpana liʻiliʻi o ka ʻiʻo mai ka pancreas me ka hoʻohana ʻana i ka endoscope a nānā ʻia ma lalo o kahi microscope, he 100% pololei ia i ka ʻike ʻana i ka maʻi. |
| Hoʻāʻo lapaʻau | I kekahi mau hihia, e hoʻomaka ke kauka i ka lāʻau lapaʻau i hoʻohana ʻia no AIP (corticosteroids) a ʻike inā hoʻomaikaʻi nā hōʻailona. Inā hoʻomaikaʻi koke nā hōʻailona, he hōʻike nō hoʻi ia e kākoʻo i ka hōʻailona. |
He aha nā lāʻau lapaʻau?
ʻO ka lāʻau lapaʻau nui a maikaʻi loa no ka pancreatitis autoimmune he papa o nā lāʻau i kapa ʻia ʻo corticosteroids . ʻO Prednisone ka lāʻau i hoʻohana nui ʻia. Hana kēia mau lāʻau lapaʻau ma ka hōʻoluʻolu ʻana i kā mākou ʻōnaehana pale kino ikaika loa a me ka hōʻemi ʻana i ka mumū.
Hoʻomaka pinepine ka lāʻau lapaʻau me kahi mahele nui o ka lāʻau . Ke hoʻomaikaʻi ʻia kāu mau hōʻailona a me nā hopena hoʻāʻo, e hōʻemi mālie kāu kauka i ka mahele. I kekahi manawa, ma hope o kou hoʻōki ʻana i ka lawe ʻana i nā steroids, hiki ke hāʻawi ʻia iā ʻoe nā lāʻau lapaʻau immunosuppressant ʻē aʻe e kōkua i ka kaohi ʻana i ka maʻi.
Inā he mau pilikia, e like me ke ālai ʻana o ke aʻa bile, pono e mālama ʻokoʻa ʻia kēia. No ka laʻana, hiki ke kau ʻia kahi stent e wehe i ke aʻa i ālai ʻia. He mea kākaʻikahi loa, pono paha ke ʻoki kino.
Pehea lā ke ʻano o ke ola me kēia maʻi?
ʻO ka nūhou maikaʻi, he maʻi hiki ke mālama ʻia ka pancreatitis autoimmune. Hiki iā ʻoe ke ʻike i kahi hoʻomaikaʻi koʻikoʻi i kāu mau hōʻailona i loko o kekahi mau pule o ka hoʻomaka ʻana i ka lāʻau steroid. Hiki i nā poʻe he nui ke hoʻōki loa i ka lawe ʻana i ka lāʻau lapaʻau i ka hala ʻana o ka manawa.
Eia nō naʻe, i kekahi manawa (ʻoi aku hoʻi i ka Type 1 AIP) hiki ke hoʻi hou mai nā hōʻailona (relapse) ma hope o ka hoʻōki ʻana i ka lāʻau lapaʻau. I ia mau hihia, pono paha ʻoe e hoʻomau i ka lawe ʻana i ka lāʻau lapaʻau ma kahi mahele haʻahaʻa. E hoʻomau kāu kauka i ka nānā ʻana i kou kūlana a hoʻomohala i kahi hoʻolālā lapaʻau i kūpono loa iā ʻoe.
Hiki i kēia ke lilo i maʻi ʻano ʻino. Hiki ke ʻike ʻole ʻia nā hōʻailona no nā makahiki, a i ka wā e ʻike ʻia ai nā hōʻailona, hiki ke huikau. No laila hiki ke lōʻihi ka manawa e loaʻa ai kahi hōʻailona pololei. Eia nō naʻe, e hoʻomanaʻo he mau lāʻau lapaʻau kūpono loa no kēia maʻi, a me ka lāʻau lapaʻau, hiki iā ʻoe ke ho'ōla koke. ʻO ia ka mea e hāʻawi iā ʻoe i ka ikaika nui.
Leka Lawe-Home
- ʻO ka Autoimmune Pancreatitis (AIP) kahi maʻi i hoʻokumu ʻia e kā mākou ʻōnaehana pale ponoʻī e hoʻouka ana i kā mākou pancreas.
- ʻO ka jaundice ʻeha ʻole a me ka pohō kaumaha i wehewehe ʻole ʻia paha nā hōʻailona nui.
- ʻOiai paha e like me ke kanesa pancreatic ma nā scans, ʻaʻole ʻo AIP he kanesa. He mea nui e hoʻokaʻawale i nā mea ʻelua ma o ka hoʻāʻo kūpono.
- Hoʻopaneʻe maikaʻi loa kēia maʻi i ka mālama ʻana me nā corticosteroids a hiki ke ho'ōla koke ʻia.
- Inā loaʻa iā ʻoe kēia mau hōʻailona, mai hopohopo a e ʻike koke i kāu kauka no ka ʻōlelo aʻo.
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