Ua hoʻonui ʻia kou mau hono manamana lima a ua loli kou mau kui? E aʻo kākou e pili ana i kēia Hypertrophic Osteoarthropathy!

Ua ʻike anei ʻoe he nui loa kou mau manamana lima a manamana wāwae paha, a ua kūlou kou mau kui i lalo a i ʻole he ʻano ʻē? I kekahi manawa, ʻaʻole mākou e nānā nui i kēia mau mea. Eia nō naʻe, inā ʻike ʻoe i kēia mau hōʻailona, ​​​​hiki ke lilo i hōʻailona o kahi maʻi i kapa ʻia ʻo 'Hypertrophic Osteoarthropathy' . Ua kapa ʻia hoʻi kēia ʻo HOA no ka pōkole. ʻAʻole weliweli loa ke ʻano, akā ʻo nā maʻi ʻē aʻe e hoʻokumu ai e pono ai ka mālama ʻana. No laila, e kamaʻilio kākou e pili ana i kēia HOA me nā kikoʻī a aʻo hou aku.

He aha ka hypertrophic osteoarthropathy (HOA)?

I ka ʻōlelo maʻalahi, ʻo ka hypertrophic osteoarthropathy (HOA) kahi kūlana e hoʻoulu ai i nā wēlau o kou mau manamana lima a i ʻole kou mau manamana wāwae e pehu a poepoe (clubbing) a me nā loli i kou mau kui. Hiki i ke kanaka me HOA ke:

• Lilo i mea nui a pehu nā wēlau o nā manamana lima a i ʻole nā ​​manamana wāwae .
• Kūlou nā kui i lalo a lilo i ʻano piʻo, me he mea lā ua huki ʻia i luna.

Hiki i ka HOA ke hoʻomaka i kekahi manawa i ka wā kamaliʻi a i ʻole ka wā ʻōpio. No kekahi poʻe, hiki nō hoʻi ke ulu aʻe ma hope o ke ola. ʻOiai ʻaʻole ia he mea ʻino ka HOA ponoʻī, inā he maʻi kumu e hoʻokumu ai, he mea nui e mālama iā ia.

He aha nā ʻano nui o kēia?

ʻElua ʻano nui o nā HOA:

1. ʻO ka Osteoarthropathy Hypertrophic Mua (PHO): He ʻano hoʻoilina kēia ʻano, ʻo ia hoʻi, hiki ke hoʻoilina ʻia mai nā mākua a i nā keiki.

2. Secondary Hypertrophic Osteoarthropathy (SHO): Hoʻokumu ʻia kēia ʻano e nā maʻi maʻi e like me ka maʻi puʻuwai a me ka maʻi māmā. Hoʻohaʻahaʻa pinepine kēia mau kūlana i nā pae oxygen i loko o kou koko.

ʻO wai ka mea i ʻoi aku ka paʻakikī o ka loaʻa ʻana o kēia maʻi?

ʻO ka mea ʻoiaʻiʻo, hiki i kekahi, me ka nānā ʻole i ke kāne a i ʻole ka lāhui, ke hoʻomohala i kēia ʻano i kapa ʻia ʻo hypertrophic osteoarthropathy.

Eia nō naʻe, ʻike pinepine ʻia ka HOA mua (PHO) i loko o ka makahiki mua o ke ola a i ʻole i ka wā ʻōpio.

• ʻOi aku ka maʻamau i waena o ka poʻe ʻeleʻele.
• ʻIke pinepine ʻia ia i nā kāne.

ʻO ka HOA Lua (SHO) kahi kūlana i ʻike pinepine ʻia i nā poʻe ma waena o 55 a me 75 mau makahiki.

Pehea ka maʻamau o kēia kūlana?

ʻAʻole hiki i nā kānaka noiʻi ke ʻōlelo pololei i ka nui o ka poʻe i loaʻa iā HOA. Akā ua ʻike ʻia aia ma waena o 95% a me 97% o ka poʻe me HOA ke ʻano lua (SHO) . ʻO ke ʻano kēia, loaʻa i ka hapa nui o ka poʻe kēia mau hoʻololi manamana lima ma muli o kekahi kūlana ʻē aʻe.

No ke aha i hoʻokumu ʻia ai kēia HOA? He aha nā kumu?

E nānā kākou i ke kumu o kēia.

Nā kumu no ka HOA mua (PHO)

Hoʻokumu ʻia kēia e nā hoʻololi genetic i loaʻa i ka wā hānau . Hiki i ke keiki ke hoʻoilina i kēia hoʻololi genetic mai ka makuahine, ka makuakāne, a i ʻole nā ​​​​mea ʻelua.

Nā kumu no ka HOA lua (SHO)

ʻO ke kumu nui o ka HOA lua (SHO) ʻo ia ka maʻi māmā . Ke hana ʻia kēia ʻano e ka maʻi māmā, ua kapa ʻia ʻo ia ʻo Hypertrophic Pulmonary Osteoarthropathy (HPOA) .

ʻO ka maʻi nui o ka māmā e hiki ai ke hoʻoulu i ka HPOA, ʻo ia ka maʻi kanesa o ka māmā , ʻoiai ke kanesa o ka māmā ʻaʻole liʻiliʻi . Eia kekahi, ʻo nā maʻi māmā ʻē aʻe e hiki ai ke hoʻoulu i ka HPOA:

• Nā puʻupuʻu fibrous maikaʻi o ka pleura
• Nā maʻi maʻi māmā mau loa
• ʻO Cystic Fibrosis (kahi maʻi genetic e hoʻopilikia ai i ka ʻōnaehana hanu)
• ʻO Mesothelioma (ka maʻi ʻaʻai o ka uhi o nā māmā)
• ʻO ke kanesa i laha mai nā wahi ʻē aʻe a hoʻopilikia i nā māmā (Maʻi māmā metastatic)
• ʻO ka malformation arteriovenous pulmonary (nā ʻano ʻē o nā kīʻaha koko i loko o nā māmā)
• ʻO ka maʻi puʻuwai
• ʻO Sarcoidosis (nā ʻōpuʻu o nā cell ma nā ʻāpana like ʻole o ke kino)

Aia kekahi mau kumu ʻē aʻe e hiki ke hoʻopilikia i ka HOA lua (SHO):

• Nā maʻi o ke akepaʻa, ka bile, a me ka gallbladder (nā kūlana hepatobiliary):
• ʻO ka Biliary Atresia (Ka Paʻa ʻana o ka ʻAuwai Bile i nā Keiki ʻUʻuku)
• Ka maʻi ʻaʻai
• ʻO ka Cirrhosis o ke akepaʻa
• ʻO ka Cholangitis Biliary mua
• ka maʻi o Wilson (ka hōʻiliʻili ʻana o ke keleawe i loko o ke kino)
• Nā maʻi puʻuwai:
• ʻO ka myxoma atrial (kahi puʻupuʻu ʻaʻole kanesa e hana ʻia i loko o ka puʻuwai)
• ʻO ka maʻi puʻuwai Cyanotic (maʻi puʻuwai kahi e emi ai ka oxygen i loko o ke koko)
• Ka maʻi ʻana o ka ʻili o loko o ka puʻuwai (Infective Endocarditis)
• Nā kūlana gastrointestinal:
• Ka hoʻohana pono ʻana i nā laxatives
• ʻAkalasia (kahi pilikia me ka hana o ka sphincter esophageal)
• Ka maʻi ʻaʻai
• ʻO ka Familial Adenomatous Polyposis (nā ulu liʻiliʻi i loko o ka ʻōpū nui)
• Maʻi ʻōpū mumū

Ma waho aʻe o kēia, hiki i kekahi mau kūlana ʻē aʻe ke hana i ka SHO:

• ʻO ka maʻi Celiac (allergic gluten)
• Nā maʻi ʻōpū e like me ka dysentery
• ʻO ka maʻi o Graves (hyperthyroidism)
• Hyperthyroidism
• ʻO ka Myelofibrosis (kahi maʻi o ka iwi iwi)
• ka maʻi POEMS
• ʻO ka Thymoma (kahi puʻupuʻu o ka thymus gland)

E noʻonoʻo, ua ʻū kekahi kanaka āu i ʻike ai no kekahi manawa a ua loli ko lākou mau manamana lima e like me kēia, a ma hope o ka ʻike ʻana i ke kauka ua ʻike lākou he pilikia ia o ka māmā. No laila he mea nui e hoʻolohe i kēia mau hōʻailona.

He aha nā hōʻailona o ka HOA?

ʻO ka hōʻailona nui o HOA ka ʻūlū ʻana a i ʻole ka pehu ʻana o nā manamana lima a i ʻole nā ​​manamana wāwae. Hoʻopilikia pinepine kēia i nā ʻaoʻao ʻelua o ke kino. E ʻike paha ʻoe i nā mea e like me:

• Ua pehu a poepoe nā wēlau o nā manamana lima a i ʻole nā ​​manamana wāwae.
• Ke nalo nei nā wrinkles ma nā hono kokoke i nā manamana lima.
• Ua piʻo nā kui i lalo a me he mea lā e lana ana.
• Lilo ka ʻili ma ke kumu o ke kui i ʻālohilohi a lahilahi .
• Palupalu nā kui.
• ʻUlaʻula nā wēlau o nā manamana lima a i ʻole nā ​​manamana wāwae a mehana ke ʻano .

ʻO nā hiʻohiʻona HOA ʻē aʻe āu e ʻike ai:

• ʻO ka hypertrophy glandular. Hiki i kēia ke hana i nā kūlana e like me ka ʻākena, ka hou nui (hyperhidrosis), ka hāʻule ʻana o nā lihilihi o luna (ptosis lihilihi o luna), a me ka dermatitis seborrheic.
• ʻO ka periostitis ka mumū o nā membrane e uhi ana i nā iwi. Hiki i kēia ke hōʻeha i nā kuʻekuʻe wāwae, nā pulima lima, a i ʻole nā ​​kuli.
• Ka pehu ʻana o nā ʻiʻo palupalu o nā wāwae (ʻaʻohe lua i loko o ka ʻōpū).
• Ka mānoanoa o ka iwi ma nā kuʻekuʻe wāwae a me nā pulima.
• Mānoanoa o ka ʻili (Pachydermia). Hiki i ka ʻili ma ka maka a me ke poʻo ke lilo i ʻāwili a he mau kualono hohonu.

He aha nā ʻano kūikawā o ka HOA lua (SHO)?

Ma waho aʻe o nā hōʻailona maʻamau o HOA i ʻōlelo ʻia ma mua, hiki i ka poʻe me ka HOA lua (SHO) ke loaʻa i nā effusions hui . ʻO kēia ka wā e hōʻiliʻili ai ka wai keu i loko o nā ʻiʻo i loko a puni nā hono. Hiki i nā effusions hui ke hana i:

• ʻEha
• ʻUlaʻula
• ʻOʻoleʻa
• Pehu ʻana

ʻO ka pehu ʻana o nā hono e pili ana me SHO ka mea i ʻike pinepine ʻia ma nā kuli a me nā pulima .

Pehea ʻoe e ʻike ai i kēia? He aha nā hoʻokolohua a nā kauka e hana ai?

Ke hele ʻoe e ʻike i ke kauka, ʻo ka mea mua a lākou e hana ai, ʻo ia ke nānā i ka ʻeha ma kou manamana lima a i ʻole kou manamana wāwae. Eia kekahi, e nānā pū lākou i kēia mau mea i ka wā o ka hoʻokolokolo kino:

• Ua lilo anei nā hiʻohiʻona o ka helehelena i ʻoʻoleʻa?
• Ua pehu kou mau wāwae?
• He ʻeha anei ke kaomi ʻana i nā kuʻekuʻe wāwae, nā kuli, a i ʻole nā ​​pulima lima?
• Ke mānoanoa nei nā iwi ma nā kuʻekuʻe wāwae a me nā pulima?

Inā kānalua ke kauka i kahi kūlana i kapa ʻia ʻo HOA, hiki iā ia ke hana i kekahi mau hoʻokolohua, e like me:

• Ka hōʻailona pilikino o Lovibond:Ke nānā ʻoe i kou manamana lima mai ka ʻaoʻao, e ʻike pinepine ʻoe i kahi kihi ākea "V" kahi e hui ai ka papa kui me ka pelu ʻili ma ke kumu o ke kui (pelu kui proximal). Inā loaʻa iā ʻoe ka HOA, ua kūlou kou kui i lalo, e hoʻonui ana i kēia kihi. I loko o kahi kui maʻamau, he 160 degere a emi mai paha kēia kihi. I loko o kahi kui i hui ʻia me ka lāʻau, he 180 degere a ʻoi aku paha.
• Laki hohonu Phalangeal: ʻEkolu ou iwi (phalanges) i kēlā me kēia manamana lima. ʻOi aku ka pōkole o ka iwi e paʻa ana i ke kui (distal phalange) ma mua o ka iwi e pili ana iā ia (middle phalange). Inā loaʻa iā ʻoe ka HOA, ʻoi aku ka pōkole o kāu middle phalange ma mua o kāu distal phalange.
• ʻO ka hōʻailona Schamroth: E kau i nā kui o kou mau manamana lima kuhikuhi. E nānā i kahi hakahaka (puka makani) ma waena o ke kumu o ke kui a me nā cuticles. Inā ʻaʻohe hakahaka, he HOA paha kāu.

Nā hoʻāʻo hou aʻe e ʻike i ka HOA lua (SHO)

Inā manaʻo ke kauka aia kekahi maʻi olakino ʻē aʻe e hoʻoulu ai i ka HOA, hiki iā ia ke kuhikuhi i kekahi mau hoʻokolohua ʻē aʻe:

• Angiography (ka nānā ʻana i nā kīʻaha koko)
• Hoʻāʻo kinoea koko arterial
• Nā hoʻāʻo koko
• Nānā iwi
• X-ray umauma
• ʻO ka scan CT (Computed Tomography scan) a i ʻole ka scan ultrasound (Ultrasound)
• ʻEchocardiogram a i ʻole Electrocardiogram (EKG)
• MRI Scan (MRI - Magnetic Resonance Imaging)
• Hoʻāʻo hana pulmonary

Hiki i kēia mau hoʻāʻo ke kōkua i kāu kauka e ʻike i ke kumu o kāu HOA. Inā hōʻike kahi scan i kahi ulu ʻano ʻē (e like me ka puʻupuʻu), hiki i kāu kauka ke kuhikuhi i kahi biopsy (lawe ʻana i kahi laʻana o nā cell a hoʻāʻo iā lākou). Hiki i kēia ke kōkua i ka hoʻoholo ʻana i ke kumu pololei o ka ulu ʻana.

Pehea e mālama ʻia ai kēia?

ʻOkoʻa nā ʻano lapaʻau ma muli o ke ʻano o ka HOA.

Ka mālama ʻana i ka HOA mua (PHO)

Inā ʻaʻohe ou ʻeha a ʻaʻole paha i koʻikoʻi kou mau hōʻailona, ​​ʻaʻole paha ʻoe e pono i kekahi lāʻau lapaʻau kūikawā no ka HOA mua (PHO). Eia nō naʻe, inā loaʻa iā ʻoe nā hōʻailona, ​​hiki paha iā ʻoe ke hoʻohana i nā lāʻau lapaʻau e like me:

• Nā lāʻau anti-inflammatory non-steroidal (NSAIDs)
• Nā mea hoʻopaʻa COX-2
• Nā Bisphosphonates
• ʻOktreotide

Ka mālama ʻana i ka HOA lua (SHO)

I ka mālama ʻana i ka HOA lua (SHO), ʻo ka mea nui ka mālama ʻana i ke kumu kumu . Hiki i ka mālama ʻana ke komo pū me:

• ʻO ka lāʻau antimicrobial no ka mālama ʻana i ka maʻi puʻupuʻu
• ʻO ka Chemotherapy e mālama ai i ka maʻi kanesa o ka māmā
• Nā kāpili ʻana o ke akepaʻa a i ʻole ka hoʻoili ʻana o ke akepaʻa no ka maʻi akepaʻa
• ʻO ke ʻoki hoʻoili māmā no ka cystic fibrosis
• ʻO ka ablation radiofrequency no nā ʻōpū māmā (me ka hoʻohana ʻana i ka wela e luku ai i nā ʻōpū)
• ʻO ke ʻoki kino no ka maʻi puʻuwai a i ʻole ke kanesa māmā

Inā ʻaʻole hiki ke mālama ʻia ke kūlana kumu i hoʻokumu ai i ka SHO, hiki i ke kauka ke kuhikuhi i nā lāʻau lapaʻau e kaohi i nā hōʻailona.

ʻEhia ka lōʻihi e ho'ōla ai mai ka lāʻau lapaʻau?

Aia maoli kēia i ke ʻano o ka HOA āu e loaʻa ai, ke koʻikoʻi o ke kūlana, a me ka lāʻau lapaʻau āu e loaʻa ai. Ke mālama ʻia ke kūlana kumu, e nalowale koke paha ka clubbing.

Aia kekahi mea e hiki ai iā mākou ke hana e hōʻemi i ka hanana ʻana o kēia?

Ka pilikia HOA mua (PHO)

ʻOiai he mea hoʻoilina ka PHO, ʻaʻohe mea hiki iā mākou ke hana e hōʻemi i kona hoʻokumu ʻia ʻana.

Ka pilikia HOA lua (SHO)

I mea e hōʻemi ai i ka pilikia o ka loaʻa ʻana o ka SHO, he mea nui loa ka hahai ʻana i kahi nohona olakino . He mea nui loa kēia inā ʻoe e pilikia ana i ka maʻi puʻuwai a i ʻole ka maʻi māmā. Eia kekahi mau mea hiki iā ʻoe ke hana:

• Ka mālama ʻana i ke kaumaha olakino.
• Ka ʻai ʻana i ka meaʻai olakino no ka puʻuwai.
• Hoʻoikaika kino mau.
• Ka palena ʻana i ka hoʻohana ʻana i ka waiʻona a me nā lāʻau lapaʻau.
• Ka haʻalele ʻana i ka puhipaka. He mea nui loa kēia, no ka mea, ʻo ka puhipaka kekahi kumu nui o nā maʻi māmā he nui.
• Hoʻemi i ke kaumaha.

He aha ka mea e hiki mai ana no kekahi me ka HOA?

No kekahi me ka HOA mua (PHO)

Hiki paha i ka PHO ke oki i ka ʻino ma kāna iho. I kekahi manawa, ʻoi aku hoʻi ma hope o ka wā ʻōpio, hiki paha ke hoʻomaikaʻi loa.

No kekahi me ka HOA lua (SHO)

Inā mālama pono ʻia ke kumu kumu, hiki ke ho'ōla loa ʻia ke kūlana. Eia nō naʻe, inā ʻaʻole hiki ke mālama pono ʻia ke kumu kumu (no ka laʻana, he maʻi ʻaʻai koʻikoʻi), hiki ke hoʻomau ke kūlana.

He aha ka mea e hana ai inā lōʻihi ka manawa o ke kūlana HOA?

Inā ua lōʻihi ka manawa o ke kūlana HOA, hiki iā ʻoe ke loaʻa i nā mea e like me:

• Ka nalowale o ka laulā o ka neʻe ʻana i nā hono
• ʻO ka Osteoarthritis (ʻeha hui)
• ʻEha

Eia nō naʻe, e hoʻomanaʻo e hiki ke kāohi ʻia ka nui o kēia mau hōʻailona me ka mālama kūpono .

Inā he HOA, pehea ʻoe e mālama ai iā ʻoe iho?

Inā loaʻa iā ʻoe ka HOA, ʻo ka mea maikaʻi loa hiki iā ʻoe ke hana, ʻo ia ka hoʻomau i ka lawe ʻana i ka lāʻau i hāʻawi ʻia iā ʻoe e kāohi i kāu mau hōʻailona. He mea nui loa ia e hahai i nā ʻōlelo a kāu kauka.

Āhea ʻoe e ʻike ai i ke kauka?

Pono ʻoe e makaʻala i kēia mau mea:

• Ma hope o ka mālama ʻanaInā hoʻi hou mai nā hōʻailona o ke kalapu ʻana, e ʻike i ke kauka. He hōʻailona paha kēia i ka hoʻi hou ʻana o ke kūlana kumu.
• Inā he mau hopohopo kāu e pili ana i nā hopena ʻaoʻao mai ka mālama ʻana .
• Inā ʻaʻole ʻike ʻia kahi hoʻomaikaʻi ʻana me ka mālama ʻana no kekahi manawa.

I ia mau hihia, hiki i kāu kauka ke kuhikuhi i nā lāʻau ʻē aʻe e kūpono iā ʻoe.

Hōʻuluʻulu Manaʻo: Nā Mea e Hoʻomanaʻo ai (Leka Lawe-Home)

ʻAe, e hoʻomanaʻo pōkole kākou i ka mea a kākou i kamaʻilio ai.

ʻO ka hypertrophic osteoarthropathy (HOA) kahi kūlana e pehu ai nā wēlau o nā manamana lima a hoʻololi ʻia nā kui. Hiki ke kumu mua (genetic) a i ʻole lua (i hoʻokumu ʻia e kekahi maʻi ʻē aʻe). ʻO nā kumu nui o ka HOA lua, ʻo ia ka maʻi māmā a me ka puʻuwai.

• Nā Hōʻailona: Ka pehu ʻana o nā manamana lima, nā kui kuʻekuʻe wāwae i loko o ke kino, ka ʻeha o nā hono, a me ka mānoanoa o ka ʻili.
• ʻIke: Hoʻokolokolo lapaʻau, nā hoʻokolohua kūikawā (Lovibond, Shamroth scores), a me nā scan e ʻimi i ke kumu.
• Lapaʻau: No ka PHO, hāʻawi ʻia ka lāʻau lapaʻau e like me nā hōʻailona. No ka SHO, ʻo ka mea nui ka mālama ʻana i ka maʻi kumu.
• ʻO ka mea nui loa: Inā ʻike ʻoe i kekahi mau loli i kou mau manamana lima, mai hoʻowahāwahā iā lākou a e ʻimi i ke aʻo lapaʻau. No ka mea, ʻoiai ʻaʻole weliweli ka HOA, hiki i ka maʻi kumu ke hoʻopilikia.

Manaʻolana wau he mea pono kēia ʻike nou. E ola kino!

ʻO ka Hypertrophic Osteoarthropathy, ka pehu ʻana o ka manamana lima, nā loli o nā kui, PHO, SHO, maʻi māmā, maʻi puʻuwai, ʻeha hui, clubbing