Ke manaʻo nei anei kou kino ua make? ʻO Myasthenia Gravis (MG) paha? E kamaʻilio kākou e pili ana!

Ke manaʻo nei ʻoe i kekahi manawa ua luhi loa a make ke ola ʻole i ka hala ʻana o ke ao? ʻOi loa aku i ka wā e like me kou mau maka e pani ana, a he paʻakikī ke kamaʻilio, ʻai, a hāpai paha i ka lima a i ʻole ka wāwae? Hiki i kēia mau mea ke ʻoi aku ma mua o ka luhi wale nō. I kēia lā e kamaʻilio mākou e pili ana iā Myasthenia Gravis , a i ʻole (MG) no ka pōkole, kahi ʻano paʻakikī iki, akā hiki ke mālama maikaʻi ʻia inā mālama pono ʻia .

He aha ka Myasthenia Gravis? I ka pōkole...

He maʻi autoimmune ka Myasthenia gravis. He aha ia? He mea maʻalahi loa ia. Loaʻa iā mākou kahi ʻōnaehana pale i loko o ko mākou kino. Ua like ia me kahi pūʻali koa i loko o ko mākou kino. ʻO kāna hana ke pale iā mākou ma ke kaua ʻana i nā germs a me nā maʻi e hele mai ana mai waho. Akā, i kekahi manawa hana hewa iki kēia pūʻali koa. Manaʻo ia ʻoiai nā cell olakino i loko o ko mākou kino ka ʻenemi. A laila hoʻomaka ia e hoʻouka i kēlā mau cell olakino. ʻO ia ka mea e hana ʻia ma ka myasthenia gravis.

Hoʻopilikia nui kēia i nā ʻiʻo iwi . ʻO ia hoʻi, nā ʻiʻo i pili i ko kākou mau iwi a kōkua iā kākou e neʻe. E noʻonoʻo e pili ana iā ia, hāpai ʻoe i kou lima, ʻālohilohi i kou mau maka, kamaʻilio, ʻakaʻaka, ʻai, hele... Kōkua kēia mau ʻiʻo i kēia mau mea a pau. I loko o ke kanaka me ka myasthenia gravis, lilo kēia mau ʻiʻo i nāwaliwali a make.

ʻO ka mea nui, ʻo ia ka hoʻonui ʻia ʻana o kēia nāwaliwali o nā ʻiʻo ke hana ʻoe a ke hana nei, a emi iho ke hoʻomaha iki ʻoe . ʻOiai inā maikaʻi ʻoe ke ala ʻoe i ke kakahiaka, i ka hala ʻana o ka lā a hana ʻoe i kāu hana, e luhi mālie ana ʻoe a e nāwaliwali kou mau ʻiʻo.

He maʻi mau kēia, ʻo ia hoʻi, ʻaʻole ia e nalo i loko o kahi manawa pōkole. Akā, mai hopohopo, aia nā lāʻau lapaʻau maikaʻi e kōkua iā ʻoe e kāohi i kāu mau hōʻailona a ola i kahi ola maʻamau .

No ke aha lā kēia e hana nei? He aha ka mea e hana nei i loko o ko kākou kino?

I mea e hoʻomaopopo ai i kēia, e lawe kākou i kahi laʻana liʻiliʻi. E noʻonoʻo e nānā ana i kahi pāʻani kriket.

ʻO ko kākou mau aʻalolo ke kīloi. ʻO lākou ka poʻe e hoʻouna i nā leka i nā ʻiʻo.

ʻO ko kākou mau ʻiʻo ka mea hopu. ʻO lākou ka poʻe e hopu i ka leka.

ʻO kahi e kapa ʻia ai kēia mau leka hoʻololi ʻelua ʻo ka neuromuscular junction . ʻO ia ke kahua pāʻani.

I kēia manawa, ke pono kahi aʻalolo e hoʻouna i kahi leka i kahi ʻiʻo, hoʻokuʻu ke aʻalolo i kahi kemika i kapa ʻia ʻo acetylcholine (ʻo kēia ka pōpō). Loaʻa i nā ʻiʻo nā wahi kūikawā e hopu ai i kēia acetylcholine, i kapa ʻia ʻo acetylcholine receptors (ʻo kēia ka mīkina lima o ka mea mālama).

E like me ka wā e pā ai ka pōpō i ka mīkina lima, e ʻuʻuku ka ʻiʻo, ʻo ia hoʻi, e hoʻāla ʻia, ke hele ka acetylcholine a hoʻopaʻa i kēlā mau mea loaʻa. Hana koke kēia, me ka ʻole o ke keakea, i loko o ke kino o ke kanaka olakino.

Akā, ʻo ka mea e hana ʻia ana i loko o kekahi me ka myasthenia gravis, ʻo ia ka luku hewa ʻana o ka ʻōnaehana pale a mākou i kamaʻilio ai ma mua a i ʻole ke ālai ʻana i kēia mau mea loaʻa acetylcholine (mīkini lima o ka mea hopu) . A laila, ʻaʻole hiki ke hopu pono ʻia ka leka (ka pōpō) e hele mai ana mai ke aʻalolo e ka ʻiʻo (ka mea mālama). Lohi loa ka hoʻololi ʻana o ka leka, a ʻaʻole loa. ʻO ia ke kumu e nāwaliwali ai nā ʻiʻo. Maopopo iā ʻoe?

Aia kekahi mau ʻano like ʻole o ka myasthenia gravis?

ʻAe, aia kekahi mau ʻano nui:

• ʻO ka myasthenia Autoimmune: ʻO kēia ke ʻano maʻamau. E like me kā mākou i kūkākūkā ai ma mua, ua hana ʻia e kahi hana hewa i loko o ka ʻōnaehana pale. ʻOiai ʻaʻole ʻike ʻia ke kumu pololei o kēia, ua manaʻo ʻia ua hana ʻia e ka hana ʻana o kekahi mau ʻano antibodies .
• ʻO ka myasthenia pēpē hānau hou: Hana ʻia kēia ke loaʻa i kahi pēpē kekahi mau antibodies mai kahi makuahine me ka myasthenia gravis i ka wā hāpai. Ma hope o ka hānau ʻana, hiki i ka pēpē ke uē iki a paʻakikī i ka pēpē ke omo. Eia nō naʻe, he manawa pōkole kēia a hoʻomaikaʻi pinepine ʻia ma hope o ʻekolu mahina.
• ʻO ka myasthenia hānau: ʻAʻole kēia he maʻi autoimmune. He ʻano kakaikahi ia i hoʻokumu ʻia e kahi loli genetic .

Aia kekahi ʻelua mau ʻano nui o ka autoimmune myasthenia gravis:

1. Ocular myasthenia: Ma kēia, ua nāwaliwali nā ʻiʻo e hoʻoneʻe ai i nā maka a hāpai i nā lihilihi. Hiki i nā lihilihi ke kūlou (ptosis) , a i ʻole he mea paʻakikī paha ke mālama i nā maka e wehe. Hiki i kekahi poʻe ke ʻike i ʻelua mau mea (ʻike pālua). ʻO ka pinepine, ʻo ka hōʻailona mua o ka myasthenia ka nāwaliwali o nā maka . Ma kahi o ka hapalua o ka poʻe me kēia ʻano ocular myasthenia e loaʻa i ke ʻano ʻē aʻe ma hope.

2. ʻO ka myasthenia laulā: Ma kēia, me nā ʻiʻo o nā maka, nā ʻiʻo o ka maka, ka ʻāʻī, nā lima, nā wāwae, a me ka ʻāʻī e nāwaliwali pū kekahi. Hiki ke paʻakikī ke ʻōlelo, ke ale i ka meaʻai, ke hāpai i kou mau lima, ke ala aʻe mai kahi noho, ke hele i nā wahi lōʻihi, a me ke piʻi ʻana i nā alapiʻi.

He aha nā hōʻailona o ka myasthenia gravis?

ʻOiai hiki ke ʻokoʻa nā hōʻailona, ​​​​ʻo nā mea maʻamau:

• Ka nāwaliwali o nā ʻiʻo ma nā lima, nā manamana lima, nā wāwae, a me ka ʻāʻī.
• Luhi loa (fatigue) .
• Ka lihilihi ʻana o ka maka (ptosis) .
• ʻIke pōwehiwehi a pālua paha .
• Paʻakikī ke hōʻike ʻana i nā hiʻohiʻona helehelena (e like me ka hiki ʻole ke minoʻaka pono, ka hana ʻana i nā helehelena).
• Paʻakikī i ka ʻōlelo ʻana, ka moni ʻana, a i ʻole ka nau ʻana . Eia kekahi laʻana, hiki ke loli mālie kou leo ​​i kou wā e ʻōlelo ana, e hoʻolilo ana iā ʻoe i leo me he mea lā e ʻōlelo ana ʻoe me ka leo palalulu.
• Ka paʻakikī o ka hele wāwae .

Hiki ke ʻike koke ʻia nā hōʻailona mua o ka myasthenia gravis. E like me kā mākou i ʻōlelo ai ma mua, nāwaliwali kou mau ʻiʻo i ka wā e hana ana ʻoe, a loaʻa hou iā lākou ka ikaika ke hoʻomaha ʻoe . Hiki ke ʻokoʻa ke koʻikoʻi o kēia nāwaliwali o nā ʻiʻo i kēlā me kēia lā. Manaʻo ka nui o ka poʻe i ka hoʻomaka ʻana o ka lā a nāwaliwali loa lākou i ka hopena.

I ka manawa kākaʻikahi loa, hiki i ka myasthenia gravis ke hoʻopilikia i nā ʻiʻo o ka ʻōnaehana hanu . Hiki i kēia ke hana i ka pōkole o ka hanu a i ʻole nā ​​​​pilikia hanu koʻikoʻi. Inā manaʻo ʻoe e pilikia ana ʻoe i ka hanu ʻana, he pilikia ia. Pono ʻoe e hele koke i ka haukapila kokoke loa. ʻAʻole hana pinepine kēia i ka manawa hoʻokahi.

ʻO wai ka mea i pilikia nui no kēia?

ʻOiai hiki ke loaʻa ka myasthenia gravis i kēlā me kēia makahiki, ʻoi aku ka maʻamau o nā wahine ma lalo o 40 mau makahiki a me nā kāne ma luna o 60 mau makahiki .

Aia paha ʻoe i ka nui o ka pilikia o ka hoʻomohala ʻana i kēia maʻi no nā kumu aʻe:

• Inā loaʻa iā ʻoe nā maʻi autoimmune ʻē aʻe (e.g. rheumatoid arthritis, lupus).
• Inā he maʻi thyroid kou.

Inā loaʻa iā ʻoe ka myasthenia gravis, hiki i kekahi mau mea ke hoʻonui i kou mau hōʻailona:

• ʻO kekahi mau lāʻau lapaʻau no ka malaria a me nā maʻi puʻuwai.
• Ke hana ʻoki kino nei.
• He maʻi .

He aha ka pilina ma waena o ka thymus gland a me ka myasthenia gravis?

He nui ka poʻe me ka myasthenia gravis e pilikia ana me ko lākou thymus gland . He ʻāpana liʻiliʻi ka thymus gland ma ko mākou umauma luna, ma lalo pono o ka iwi umauma. He ʻāpana ia o kā mākou ʻōnaehana lymphatic. ʻO ia ke ʻano e hana i nā hunaola koko keʻokeʻo a kōkua i ke kaua ʻana i nā maʻi.

Ma kahi o ʻelua hapakolu o ka poʻe me ka myasthenia gravis he thymic hyperplasia , kahi kūlana e lilo ai ka thymus gland i mea hana nui. Eia kekahi, ma kahi o hoʻokahi i loko o ka ʻumi o ka poʻe e hoʻomohala i nā puʻupuʻu i loko o ka thymus gland i kapa ʻia ʻo thymomas . Hiki i kēia ke maʻi kanesa a benign paha. Ua manaʻo ʻia ʻo kēia mau ʻano ʻē i loko o ka thymus gland e kōkua i ka hana hewa ʻana o ka ʻōnaehana pale.

He aha nā pilikia e hiki ke loaʻa mai ka myasthenia gravis?

ʻO ke kumu nui he kūlana i kapa ʻia ʻo myasthenic crisis . I loko o kēia, lilo nā ʻiʻo e kōkua iā ʻoe e hanu i mea nāwaliwali loa. A laila, pono paha ʻoe i kahi mea e like me ka mīkini (respirator/mechanical ventilation) e kōkua iā ʻoe e hanu. He pilikia olakino kēia e hiki ke hoʻoweliweli i ke ola.Ua ʻōlelo ʻia ma kahi o hoʻokahi o kēlā me kēia ʻelima mau kānaka me ka myasthenia gravis e loaʻa i kēia maʻi ma ka liʻiliʻi hoʻokahi i ko lākou ola.

Eia kekahi, hiki i kēia nāwaliwali o nā ʻiʻo a me ka luhi ke pale iā ʻoe mai ke komo ʻana i nā hana āu e hauʻoli ai. Hiki iā ia ke alakaʻi i ke kaumaha a me ke kaumaha . Eia nō naʻe, ua hōʻike nā noiʻi e hiki i nā poʻe he nui me ka myasthenia gravis ke hana i nā hana māmā a hoʻoikaika kino i kēlā me kēia lā.

Pehea e ʻike ai nā kauka i ka myasthenia gravis?

Inā kānalua kāu kauka i kēia ma hope o ka hoʻolohe ʻana i kāu mau hōʻailona a hana i kahi hoʻokolokolo kino, e hana lākou i kekahi mau hoʻokolohua e hōʻoia iā ia:

• Nā hoʻāʻo antibody koko: Ma kahi o 85% o ka poʻe me ka myasthenia gravis he kiʻekiʻe loa nā pae o nā antibodies receptor acetylcholine i loko o ko lākou koko. ʻO kekahi 6% he mau antibodies i ka kinase kikoʻī o ka ʻiʻo (MuSK) .
• Nā scan kiʻi: Hana ʻia kahi MRI (Magnetic Resonance Imaging) a i ʻole CT scan (Computed Tomography scan) e nānā i nā pilikia e like me nā ʻōpū i loko o ka thymus gland.
• Electromyography (EMG): Ke ana kēia hoʻāʻo i ka hana uila o nā ʻiʻo a me nā aʻalolo. Hiki iā ia ke ʻike i nā pilikia me ke kamaʻilio ʻana ma waena o nā aʻalolo a me nā ʻiʻo.

Hoʻokaʻawale nā ​​kauka i ka myasthenia gravis e like me ke koʻikoʻi o ka maʻi. ʻElima mau papa maʻamau (Class I - V). He ʻano maʻalahi ka Class I e hoʻopilikia wale i nā maka, ʻoiai ʻo Class V kahi ʻano koʻikoʻi e hoʻopilikia ai i ka hanu ʻana, i kekahi manawa e pono ai ka intubation a i ʻole ka mechanical ventilation .

He aha nā lāʻau lapaʻau no ka myasthenia gravis?

ʻAʻohe lāʻau lapaʻau no ka myasthenia gravis, akā aia nā lāʻau lapaʻau kūpono e hiki ke kōkua iā ʻoe e mālama i kāu mau hōʻailona a ola i kahi ola maikaʻi.

• Nā lāʻau lapaʻau:
• Nā mea hoʻopale Cholinesterase / anticholinesterase: Hana kēia mau lāʻau lapaʻau ma ka hoʻomaikaʻi ʻana i ke kamaʻilio ʻana ma waena o nā aʻalolo a me nā ʻiʻo, e hoʻonui ana i ka ikaika o nā ʻiʻo.
• Nā Immunosuppressants: Hana nā lāʻau lapaʻau e like me corticosteroids ma ka hoʻemi ʻana i ka hana nui o ka ʻōnaehana pale a me ka hoʻemi ʻana i ka hana ʻana o kēlā mau antibodies hewa.
• Nā antibodies monoclonal: He mau protein bioengineered kēia. Hāʻawi ʻia lākou ma ke ʻano he injection intravenous (IV) a i ʻole ma ke ʻano he injection subcutaneous (SQ) . Hoʻomalu lākou i ka hana nui o ka ʻōnaehana pale.
• Hoʻololi plasma / plasmapheresis: Hoʻoneʻe kahi mīkini i ka plasma mai ke koko, nona nā antibodies ʻino, a pani iā ​​ia me ka plasma a i ʻole kahi hopena plasma mai kahi mea hāʻawi.
• ʻO ka immunoglobulin intravenous a i ʻole subcutaneous (IV a i ʻole SQ Immunoglobulin - IVIG a i ʻole SCIG): Hāʻawi ʻia nā antibodies mai nā mea hāʻawi ma o ka inikini intravenous (IV) ma luna o ʻelua a ʻelima mau lā. He lāʻau lapaʻau kēia no ka pilikia myasthenic a me ka myasthenia gravis maʻamau.
• ʻO ke ʻoki kino: ʻO ka Thymectomy ka wehe ʻana i ka thymus gland. Paipai ʻia kēia ʻoki kino no ka poʻe me ka thymoma, a no ka poʻe me ka ʻole o ka puʻupuʻu thymus.

Hiki i kēia mau lāʻau āpau ke loaʻa kekahi mau hopena ʻaoʻao, no laila e kamaʻilio me kāu kauka ma mua o ka hoʻomaka ʻana i kekahi lāʻau lapaʻau hou.

He aha kaʻu e hana ai ma ka home e hōʻemi i nā hōʻailona?

Inā loaʻa iā ʻoe ka myasthenia gravis, e hoʻāʻo i kēia mau mea e hōʻemi i ka luhi āu e manaʻo ai a hoʻonui i ka ikaika o nā ʻiʻo:

• E hoʻoikaika kino mau: Akā ma hope o ke kūkākūkā ʻana me kāu kauka, e hoʻomaka i kahi papahana hoʻoikaika kino palekana e kūpono iā ʻoe. Hoʻoikaika ka hoʻoikaika kino i nā ʻiʻo, hoʻomaikaʻi i ke ʻano, a hāʻawi i ka ikehu i kou kino.
• Mai hele i waho i ka wā wela loa: Hiki i ka wela ke hoʻonui i nā hōʻailona. Ke manaʻo ʻoe he wela loa, e kau i kahi lole i hoʻomoʻa ʻia i ka wai anuanu ma kou ʻāʻī a me kou lae.
• E hoʻokomo i ka nui o ka protein a me nā kalapona i kāu mau meaʻai: Hāʻawi lākou i ka ikehu keu i ke kino.
• E hana i nā hana āu e ʻike ai he luhi loa i ke kakahiaka nui: ʻo ia ka manawa e loaʻa ai iā ʻoe ka ikaika nui loa.
• E hiamoe iki a hoʻomaha paha i ke ao: E hāʻawi kēia i kou kino i kahi hoʻomaha iki.

He aha ka wā e hiki mai ana o ka myasthenia gravis? (Outlook)

He maʻi hiki ke mālama ʻia ka myasthenia gravis. Hiki i nā hōʻailona ke ʻano like ʻole mai ka maʻalahi a i ka koʻikoʻi. ʻO ka maʻamau, hiki i nā hōʻailona ke piʻi i ko lākou kiʻekiʻe i loko o hoʻokahi a ʻekolu mau makahiki o ka ʻike mua ʻana.

He nui ka poʻe e ola piha ana i nā ola hana me ka lāʻau lapaʻau.

I kekahi manawa hiki i ka maʻi ke hoʻomaha . ʻO ke ʻano kēia e nalowale nā ​​​​hōʻailona no kekahi manawa. Hiki i kēia ke lilo i manawa pōkole a mau loa paha. Inā hana ʻia kēia, e hoʻololi kāu kauka i kāu hoʻolālā lapaʻau.

He nui ka poʻe me ka myasthenia gravis e ola maʻamau . Loaʻa nā hopena hoʻoweliweli ola ke pilikia ka hanu ʻana, e like me ka pilikia myasthenic a mākou i kūkākūkā ai.

ʻO Myasthenia gravis a me ka hāpai ʻana

I kekahi manawa, hiki i ka hāpai ʻana ke hōʻike i nā hōʻailona myasthenia gravis no ka manawa mua. Inā loaʻa iā ʻoe ke ʻano, hiki ke ʻoi aku ka ʻino o kāu mau hōʻailona i ka wā o ka trimester mua o ka hāpai ʻana a i ʻole ma hope o kou hānau ʻana i kāu pēpē. Eia nō naʻe, i kekahi mau hihia, hiki ke hoʻomaikaʻi ʻia kāu mau hōʻailona i ka wā hāpai.

ʻAʻole palekana kekahi mau lāʻau lapaʻau i ka wā hāpai a me ka hānai waiū. No laila, he mea nui e ʻimi i ke alakaʻi a kāu kauka i kēia manawa e hōʻoia i ka hāpai olakino.

Āhea wau e ʻike ai i ke kauka?

E ʻike i ke kauka inā loaʻa iā ʻoe kēia mau hōʻailona:

• ʻIke pōwehiwehi a ʻike pālua paha.
• Ka paʻakikī i ka hele ʻana, ke kamaʻilio ʻana, a i ʻole ka ʻai ʻana.
• Ka luhi nui a i ʻole ka nāwaliwali o nā ʻiʻo.
• Paʻakikī ka hanu ʻana.

E hoʻomanaʻo, inā pilikia ʻoe i ka hanu ʻana, he pilikia ia! E kelepona koke i ka 911 (kou helu pilikia kūloko) a i ʻole e hele i ka haukapila kokoke loa.

He aha nā nīnau e pono iaʻu e nīnau aku i kaʻu kauka?

Hiki iā ʻoe ke nīnau i ke kauka i nā nīnau penei:

• He aha ke kumu o kēia mau hōʻailona?
• He aha ke koho lapaʻau maikaʻi loa noʻu?
• He aha nā hopena ʻaoʻao o nā lāʻau lapaʻau?
• He aha nā hoʻololi o ke ʻano o ka nohona e pono iaʻu e hana?
• He aha nā hōʻailona e pono iaʻu e makaʻala e pili ana i nā pilikia?
• Hiki iaʻu ke hoʻomaka palekana i kahi papahana hoʻoikaika kino?
• Aia kekahi hui kākoʻo maʻi hiki iaʻu ke hui pū?

ʻO ka mea hope loa, nā mea e hoʻomanaʻo ai (Leka Lawe-Home)

Hiki i ka Myasthenia Gravis ke lilo i maʻi paʻakikī. ʻOiai ʻoe e makemake e noho hana, hiki iā ʻoe ke manaʻo luhi loa a nāwaliwali i kekahi manawa. Hiki i kēia ke hoʻopilikia i kou olakino noʻonoʻo a me ke kino i ka hala ʻana o ka manawa.

Akā e hoʻomanaʻo, ʻoiai ʻaʻohe lāʻau lapaʻau, me ka mālama ʻana, hiki i nā poʻe he nui ke ola piha a hana. He mea kākaʻikahi ka maʻi kīnā koʻikoʻi mai ka myasthenia gravis. Hiki i kāu kauka ke kuhikuhi i nā ala e hoʻokele ai i kāu mau hōʻailona i hiki iā ʻoe ke noho maikaʻi. Mai hopohopo, a mai hoʻāʻo e hana me kēia wale nō. E hahai i ka ʻōlelo aʻo a kāu kauka a loaʻa ke kōkua āu e pono ai. Makemake au iā ʻoe e hoʻōla koke!

ʻO Myasthenia Gravis, Myasthenia Gravis, Nāwaliwali o nā ʻiʻo, nā maʻi Autoimmune, Acetylcholine, Thymus gland, Neuromuscular junction