Ke hoʻopunipuni nei anei ka ʻōnaehana pale ponoʻī o kou kino iā ʻoe? E aʻo kākou e pili ana i ka Autoimmune Pancreatitis ma ke ala maʻalahi!

He ʻōnaehana pale kupaianaha ko kākou i loko o ko kākou kino, ʻeā? ʻO ia ka mea a kākou e kapa aku nei he ʻōnaehana pale. Mālama ia iā kākou ma ke kaua ʻana i nā germs, bacteria, a me nā virus e hoʻoulu ai i nā maʻi. Akā e noʻonoʻo, pehea inā i kekahi manawa e huikau kēia ʻōnaehana pale ponoʻī o kākou me nā cell maikaʻi i loko o ko kākou kino ponoʻī a hoʻomaka e hoʻouka iā lākou? ʻO ia ka manawa e hana ʻia ai, i kapa ʻia ʻo "Autoimmune Pancreatitis". I ka ʻōlelo maʻalahi, hoʻomaka kāu ʻōnaehana pale ponoʻī e hana kūʻē i kāu pancreas.

He aha ka "Autoimmune Pancreatitis"? I ka pōkole...

E noʻonoʻo i ka ʻōnaehana pale o kou kino e like me kahi pūʻali koa e pale ana i kahi ʻāina. ʻO ka hana a kēia pūʻali koa, ʻo ia ka pale ʻana i ka ʻāina mai nā ʻenemi o waho (e like me nā germs a me nā virus). Akā i loko o ka (Autoimmune Pancreatitis), hana hewa kēia pūʻali koa a hoʻouka i nā kamaʻāina hala ʻole o kona ʻāina ponoʻī (ʻo ia hoʻi, nā cell olakino i loko o ka pancreas) me ka manaʻo he ʻenemi lākou. ʻO ka hopena, lilo ka pancreas i mumū, ʻeha, a ua hoʻopilikia ʻia kāna hana. ʻO kēia ka mea a mākou e kapa nei he autoimmune pancreatitis .

Pehea ka maʻamau o kēia maʻi?

ʻOiaʻiʻo, he maʻi laha ʻole ka (Autoimmune Pancreatitis). Loaʻa pinepine ia i hoʻokahi i loko o hoʻokahi haneli tausani kānaka. Inā mākou e lawe i nā kūlana mumū lōʻihi o ka pancreas (chronic pancreatitis), aia wale nō ma kahi o 2% o lākou e hāʻule i loko o kēia māhele (Autoimmune Pancreatitis). No laila, ʻaʻole kēia he maʻi e hoʻopilikia i nā mea āpau.

Aia kekahi mau ʻano o ka (Autoimmune Pancreatitis)?

ʻAe, ʻelua mau ʻano nui o ka (Autoimmune Pancreatitis). E nānā kākou i ke ʻano o lākou.

1. ʻAno 1 Autoimmune Pancreatitis

ʻO kēia ke ʻano maʻamau . Ma kēia, loaʻa iā mākou kahi protein i kapa ʻia ʻo (Immunoglobulin G4) a i ʻole (IgG4) i loko o ko mākou kino. ʻO kēia (IgG4) kahi ʻano antibody. Ke pehu a mumū paha ma kekahi wahi o ke kino, piʻi ka pae o kēia (IgG4).

Akā ma kēia ʻano mua, ʻaʻole wale ka pilikia me ka pancreas. Hiki iā ia ke hoʻopilikia i nā ʻāpana ʻē aʻe o ko mākou kino. Eia kekahi laʻana:

• Nā ʻauwai bile: He mau ʻauwai like kēia e like me ka ʻauwai e lawe ana i ka bile mai ke akepaʻa a i ka ʻōpū liʻiliʻi.
• Nā ʻōmole puʻupaʻa: ʻO nā ʻōmole i loko o nā puʻupaʻa.
• Ake
• Nā māmā
• ʻŌpū Gall
• Nā ʻōpū salivary
• ʻO ke kele thyroid

Hiki nō hoʻi ke pehu a me ka hōʻino ʻia ma nā wahi e like me kēia.

2. ʻAno 2 Autoimmune Pancreatitis

Hoʻopilikia wale kēia ʻano i ka pancreas . ʻO ka mea e hana ʻia ma ʻaneʻi, ʻo ia ka hōʻino ʻana o kahi ʻano o ke koko keʻokeʻo i kapa ʻia ʻo "neutrophils" i ka pancreas a me nā ducts pancreatic. ʻIke pinepine ʻia kēia ʻano ma ka poʻe ʻōpio.ʻOi aku ka nui o ko lākou loaʻa ʻana i ka maʻi ʻōpū mumū (IBD).

He aha nā kumu o ka (Autoimmune Pancreatitis)? Aia kekahi mau mea pilikia?

Ke hoʻāʻo nei nā kānaka noiʻi e ʻike i ke kumu kikoʻī , akā ʻike pinepine ʻia ia i nā poʻe ma waena o 50 a me 60 mau makahiki. Eia nō naʻe, hiki ke hiki ma mua. ʻOi aku ka pālua o ka loaʻa ʻana o ka maʻi i nā kāne ma mua o nā wahine.

I kekahi manawa, ua manaʻo ʻia he hopena ia o ka ʻōnaehana pale o ke kino i kahi maʻi bacteria. Eia kekahi, ʻoi aku ka nui o ka pilikia o ka poʻe me nā maʻi autoimmune ʻē aʻe i ka loaʻa ʻana. Eia kekahi laʻana:

• (ʻO ka thyroiditis o Hashimoto): ʻO kēia ke kumu e hana iki ai ka ʻōpū thyroid (hypothyroidism).
• (Maʻi ʻōpū mumū - IBD): ʻOi aku hoʻi nā kūlana e like me ka (ulcerative colitis).
• (ʻO ka cholangitis biliary mua)
• ʻO ka fibrosis retroperitoneal: ʻO ke kūkulu ʻia ʻana o nā ʻiʻo e like me ka ʻōpala ma ka ʻaoʻao o ke kua o ka ʻōpū.
• ʻO ka rumatika: Ka mumū o nā hono.
• (ʻO ka maʻi sarcoidosis)
• (ʻO ka maʻi Sjögren)

Inā loaʻa iā ʻoe nā maʻi autoimmune ʻē aʻe e like me kēia, he mea maikaʻi e hopohopo iki e pili ana i ka Autoimmune Pancreatitis pū kekahi.

He aha nā hōʻailona o ka (Autoimmune Pancreatitis)?

I nā pae mua o kēia maʻi , ʻaʻohe paha he mau hōʻailona . Eia nō naʻe, i ka holomua ʻana o ka maʻi, hoʻomaka nā ala pancreatic e haiki, e pale ana i nā enzymes i hūnā ʻia e ka pancreas mai ka hiki ke hele pono.

ʻO ka paʻa ʻana o ka ʻōpū pancreatic e hiki ke hana i nā hōʻailona e like me:

• ʻEha ʻōpū o luna
• ʻEha kua waena
• Ka maʻi pākī
• Ka luaʻi/ka luaʻi ʻana
• Ka emi ʻana o ke kaumaha

He mea nui: Hiki ke ʻike ʻia kekahi o kēia mau hōʻailona i ka maʻi kanesa pancreatic. No laila, inā loaʻa iā ʻoe kēia mau hōʻailona, ​​​​he mea naʻauao ke ʻole e hopohopo a ʻike koke i ke kauka e ʻike pono i ke kumu o ka pilikia . ʻO ka loaʻa ʻana o ka (Autoimmune Pancreatitis) ʻaʻole ia he manaʻo he maʻi kanesa kou.

Eia kekahi, hiki i ka pancreatitis autoimmune ke hoʻoulu i ka pehu ʻana, nā ulu ʻana ʻaʻole maʻi kanesa, a me nā cysts piha i ka wai i loko o ka pancreas. Inā loaʻa kēia mau pehu, puʻupuʻu, a i ʻole cysts i loko o ke poʻo o kou pancreas, hiki iā lākou ke ālai i ke ala bile, hiki ke pale i ka bile mai ke kahe pono ʻana i loko o ka ʻōpū liʻiliʻi. Loaʻa i ka Bile kahi pigment i kapa ʻia ʻo bilirubin. Ke hōʻiliʻili kēia bilirubin i loko o ke koko, hiki iā ia ke hana i ka jaundice.Lilo ka ʻili a me ke keʻokeʻo o nā maka i melemele (jaundice), a luhi paha ʻoe. Ke piʻi ka bilirubin i loko o ka mimi , lilo ka mimi i ʻeleʻele . Ke hoʻokuʻu ʻia ka bilirubin i loko o nā ʻōpū , lilo paha nā ʻōpala i kala melemele .

He aha nā pilikia e hiki mai ana o ka (Autoimmune Pancreatitis)?

Hiki i ka mumū mau o ka pancreas ke hoʻoulu i ka nausea, ka pohō kaumaha, a me ka ʻeha mau ma ka ʻōpū o luna a me ke kua. Eia kekahi, inā ua hōʻino ʻia nā hunaola e hana ana i ka insulin i loko o ka pancreas , hiki ke ulu ka maʻi diabetes .

Hiki i nā antibodies IgG4 ke hoʻouka ʻaʻole wale i ka pancreas, akā i nā ʻōpū ʻē aʻe, ʻoi aku hoʻi i ka Type 1. ʻO ia mau ʻōpū:

• Nā ʻauwai bile
• Nā ʻōpū salivary
• Nā kelepa waimaka
• ʻO ke kelepaʻi thyroid (ʻO ka thyroid)
• nā puʻupaʻa
• Puʻuwai
• Nā māmā a me ka pleura (ka uhi o nā māmā)

Pehea e ʻike ʻia ai ka pancreatitis autoimmune?

I mea e ʻike pololei ai i kēia maʻi a e hōʻoia ʻaʻole ia he maʻi ʻaʻai pancreatic, pono kekahi mau hoʻokolohua. Pono ʻoe e loaʻa nā hoʻokolohua e like me kēia:

• Nā hoʻāʻo koko: Nānā kēia i nā pae kiʻekiʻe o IgG4, a me ka hana o ke akepaʻa a me nā pae o kekahi mau ʻano cell koko.
• Nā hoʻāʻo kiʻi: Nānā kēia i ka nui o ka pancreas, inā he mau ʻeha, a inā paha ua ʻūmiʻi nā ducts. ʻO nā hiʻohiʻona o kēia mau hoʻāʻo ʻo (CT scan) a me (MRI scan).
• Biopsy: Pili kēia i ka lawe ʻana i kahi ʻāpana liʻiliʻi o ka ʻiʻo mai kou pancreas a nānā iā ia ma lalo o kahi microscope. Hana pinepine ʻia kēia ma o kahi kaʻina hana endoscopic minimally invasive i kapa ʻia ʻo Endoscopic Ultrasound (EUS). Ma kēia kaʻina hana, hoʻokomo kāu kauka i kahi paipu lōʻihi a palupalu (me kahi kukui a me kahi mea ultrasound ma kekahi ʻaoʻao) i loko o kou ʻōpū a me nā ʻōpū e nānā i kāu pancreas. A laila lawe ʻia kahi laʻana biopsy ma o kou ʻōpū a i ʻole nā ​​​​ʻōpū. I kekahi manawa, pono paha ke kauka lapaʻau e hana i kahi ʻoki liʻiliʻi i kou ʻili (laparoscopy) e lawe i kahi laʻana biopsy.
• Hoʻāʻo Corticosteroid: Kōkua pū kēia i ka hōʻoia ʻana i ka hōʻailona. Hāʻawi ʻia ʻoe i nā steroids no kahi manawa pōkole e ʻike ai inā e emi ana kāu mau pae IgG4 a hoʻomaikaʻi kāu mau hoʻokolohua kiʻi.

Pehea e mālama ʻia ai ka (Autoimmune Pancreatitis)?

ʻO ka mea kupanaha, no kahi poʻe liʻiliʻi loa, hoʻopau kēia maʻi iā ia iho me ka ʻole o ka lāʻau lapaʻau . Akā no ka poʻe he nui, pono ka lāʻau lapaʻau .

Hoʻomaʻamaʻa pinepine ʻia ka Autoimmune pancreatitis me nā corticosteroids.He ʻano lāʻau lapaʻau i kapa ʻia he steroid. Eia kekahi laʻana, he lāʻau lapaʻau e like me (prednisone) a i ʻole (prednisolone). Hana kēia mau lāʻau lapaʻau ma ka hōʻemi ʻana i ka pehu a me ka hōʻoluʻolu ʻana i kahi ʻōnaehana pale ikaika loa. Hoʻomaka ka lāʻau lapaʻau me kahi mahele nui o nā steroid. A laila hoʻemi mālie ʻia ka mahele (tapered).

Inā ʻaʻohe ou pilikia, ʻaʻole pono ʻoe i kekahi lāʻau lapaʻau hou aʻe. Aia ka lāʻau lapaʻau e pono ai ma ke ʻano o ka pilikia. Inā he ʻūmiʻi o ke ala pancreatic ('duct narrowing'), hiki ke hana ʻia kahi hana e wehe i ke ala a hoʻoikaika iā ia me kahi mea hollow mesh ('stent').

Hiki iaʻu ke pale aku i ka loaʻa ʻana o ka (Autoimmune Pancreatitis)?

ʻOiaʻiʻo, ʻaʻohe mea hiki iā ʻoe ke hana e pale aku i kēia maʻi mai ka ulu ʻana no ka mea he pilikia ia me kā mākou ʻōnaehana pale ponoʻī.

He aha ka manaʻo no ka poʻe me ka (Autoimmune Pancreatitis)?

Hoʻōla maikaʻi ka hapa nui o ka poʻe ma hope o ka mālama ʻana i ka corticosteroid , a ʻaʻohe pilikia. ʻAʻole pili ka loaʻa ʻana o ka pancreatitis autoimmune i kou manaʻolana ola .

Eia nō naʻe, hiki i ka (Autoimmune Pancreatitis) ke hoʻi hou (relapse) . He mea maʻamau kēia i nā poʻe me ke ʻano mua (Type 1). ʻOi aku ka nui o ka maʻi e hoʻi hou i loko o nā makahiki ʻekolu mua ma hope o ka ʻike ʻia ʻana. ʻOi aku ka nui o ka loaʻa ʻana o nā pilikia i ka mea i loaʻa i ka maʻi.

He aha ka mea e hana ʻia inā hoʻi hou mai ka maʻi?

Inā mālama pono ʻia, hiki i ka poʻe me ka maʻi e hoʻi hou ana ke ola i nā ola hana a olakino .

Pono paha ʻoe e hoʻomaka hou i ka hoʻohana ʻana i nā corticosteroids. Hoʻomau kekahi poʻe i ka mālama ʻana i ka steroid no kekahi mau makahiki e pale ai i nā hōʻailona mai ka hoʻi hou ʻana mai. Hiki i nā kauka ke hoʻāʻo i nā lāʻau lapaʻau ʻē aʻe e mālama ai i kahi ʻōnaehana pale overactive (nā lāʻau immunomodulatory a me nā immunosuppressive).

Pehea koʻu manaʻo i ka wā o ka mālama ʻana?

Hiki ke loaʻa kekahi mau hopena ʻaoʻao i ka wā e hoʻohana ai i nā steroids. No ka laʻana, ka ʻōpū ʻeha, ka makemake nui, ka hoʻomaha ʻole, a me ka paʻakikī o ka hiamoe. Hiki i kēia mau hopena ʻaoʻao ke hoʻopilikia iki i ke ola o kēlā me kēia lā, akā he manawa pōkole wale nō . No ka loaʻa ʻana o ka mea nui loa mai kāu lāʻau Autoimmune Pancreatitis, he mea nui e hoʻomau i ka lawe ʻana i nā steroids e like me ke kauoha a kāu kauka .

Inā pilikia loa nā hopena ʻaoʻao e hoʻomanawanui, e hōʻoia e hoʻomaopopo i kāu kauka ma mua o ka hoʻōki ʻana i ka lāʻau. Hiki iā ia ke kuhikuhi i nā lāʻau lapaʻau hou e kōkua iā ʻoe e loaʻa ka hōʻoluʻolu, a i ʻole e hoʻololi i kāu hoʻolālā lapaʻau.

Āhea e hiki ai iaʻu ke hoʻi i nā hana maʻamau ma hope o ka mālama ʻana no ka (Autoimmune Pancreatitis)?

ʻO ka maʻamau, hāʻawi ka lāʻau steroid i ka hōʻoluʻolu mai nā hōʻailona o ka '(Autoimmune Pancreatitis)' i loko o kekahi mau pule.Hoʻi ka nui o ka poʻe i kā lākou hana maʻamau ma hope o ka pau ʻana o kā lākou mau hōʻailona.

He maʻi mumū kakaikahi ka Autoimmune Pancreatitis e hiki ke hoʻopilikia i ka hana o ka pancreas. ʻO ka ʻike ʻana i kahi kauka i kamaʻāina i nā maʻi pancreatic hiki ke kōkua iā ʻoe e loaʻa ka mālama maikaʻi loa āu e pono ai. Hoʻōla piha ka hapa nui o ka poʻe ma hope o ka lawe ʻana i nā steroids . Pono paha kekahi poʻe i nā lāʻau lapaʻau Autoimmune Pancreatitis hou e hoʻokō ai i ka hōʻoluʻolu lōʻihi.

ʻO ka mea hope loa, e hoʻomanaʻo i kēia (Leka Lawe-Home)

• ʻO ka Autoimmune Pancreatitis kahi maʻi kakaikahi kahi e hoʻouka ai kāu ʻōnaehana ponoʻī i kāu pancreas.
• Inā loaʻa iā ʻoe nā hōʻailona e like me ka ʻeha o ka ʻōpū, ka pohō kaumaha, a i ʻole ka jaundice , e ʻimi pono i ke kōkua lapaʻau .
• ʻAʻole kēia he maʻi ʻaʻai pancreatic, akā ua like nā hōʻailona, ​​​​no laila he mea nui ka ʻike pololei .
• ʻO ka lāʻau lapaʻau nui he corticosteroids.
• Hoʻōla maikaʻi nā kānaka he nui me ka lāʻau lapaʻau, akā hiki i ka maʻi ke hoʻi hou mai.
• He mea nui loa e hahai pololei i nā ʻōlelo a ke kauka no ka ho'ōla koke ʻana .

E hoʻomanaʻo, ʻaʻole ʻoe hoʻokahi. He mea maʻamau ka nui o nā manaʻo e holo ana i loko o kou noʻonoʻo i kahi kūlana e like me kēia. No laila, e wehe i kāu kauka a nīnau i kāu mau nīnau. Eia lākou e kōkua iā ʻoe.