Ke hāʻule nei hoʻi kou mau maka maka? Ke manaʻo nei ʻoe ua make ʻoe? ʻO ia anei ka myasthenia gravis?

Ke manaʻo nei ʻoe i kekahi manawa ua maikaʻi ʻoe ke ala ʻoe i ke kakahiaka, akā i ka hala ʻana o ke ao, hoʻomaka kou kino e nalowale i ka ikaika? ʻOi loa aku hoʻi i ka wā e kaumaha ai kou mau lihilihi maka a hāʻule, ua paʻakikī kāu mau ʻōlelo ke ʻōlelo ʻoe, a i ʻole he mea paʻakikī iā ʻoe ke hāpai i kahi lima a i ʻole ka wāwae? Inā kamaʻāina kēia iā ʻoe, he mea nui iā ʻoe e ʻike i ke ʻano a mākou e kamaʻilio nei i kēia lā, i kapa ʻia ʻo Myasthenia Gravis , a i ʻole MG no ka pōkole.

I ka ʻōlelo maʻalahi, he aha ka Myasthenia Gravis?

He maʻi autoimmune kēia e hiki ke mau i ke ola holoʻokoʻa. I ka ʻōlelo maʻalahi, hoʻomaka hewa ka ʻōnaehana pale o ko mākou kino, ʻo ia hoʻi ka ʻōnaehana pale, e hoʻouka i nā ʻāpana olakino o ko mākou kino ponoʻī. I loko o MG, kuhikuhi kēia hoʻouka i nā pilina ma waena o ko mākou mau aʻalolo a me nā ʻiʻo.

E noʻonoʻo, ke haʻi aku nei ko kākou lolo i kahi ʻiʻo, "ʻAe, i kēia manawa e ʻūlū ana ʻoe." Pono kēia leka e hele ma nā aʻalolo a hiki i ka ʻiʻo. Akā i loko o kekahi me MG, ua hoʻopilikia ʻia nā "mea loaʻa" kahi e lawe ʻia ai kēia leka e kā lākou ʻōnaehana pale ponoʻī. Ua like ia me ka nalowale ʻana o ka hōʻailona ke hoʻāʻo ʻoe e kelepona.

ʻO ka hopena, ua nāwaliwali nā hōʻailona i hoʻouna ʻia i nā ʻiʻo i ka wā e hoʻohana ʻia ai, a nalowale mālie nā ʻiʻo i ko lākou ikaika. Akā ma hope o kahi manawa pōkole o ka hoʻomaha, hoʻi lākou i ka maʻamau. ʻO kēia ka hiʻohiʻona ʻokoʻa loa o MG. ʻOiai hiki ke loaʻa kēia ʻano maʻi i kēlā me kēia makahiki, ʻoi aku ka maʻamau i nā wahine ma lalo o 40 mau makahiki a me nā kāne ma luna o 60 mau makahiki.

No ke aha e hana ai ko kākou kino i kēia iā ia iho? He aha nā kumu?

ʻAʻole maopopo loa ke kumu e hoʻouka ai ka ʻōnaehana pale i ko kākou neuromuscular junction ponoʻī ma kēia ʻano. Akā ʻo ke kumu nui, ʻo ia ka hana ʻana o ke kino i nā antibodies e kūʻē i nā receptors e loaʻa ana i ka neurotransmitter acetylcholine. ʻO kēia acetylcholine ka "ʻelele" e lawe ana i ka leka e haʻi aku i nā ʻiʻo e ʻūlū. No laila, ke ālai ʻia kahi hana o kēia ʻelele, ʻaʻole hana pono nā ʻiʻo.

Hoʻomohala pū kekahi poʻe i nā antibodies e kūʻē i nā protein ʻē aʻe. ʻOiai ua manaʻo ʻia he hopena genetic kēia, ʻaʻohe o ka poʻe he nui me MG i loko o ko lākou ʻohana i loaʻa i ka maʻi.

Eia kekahi, ua ʻike ʻia ua pili ka thymus gland , kahi ʻano ma ka umauma o luna. Ua hoʻonui ʻia kēia gland i kekahi poʻe me MG. Manaʻo nā kānaka noiʻi i kekahi manawa ke kuhi hewa nei kēia gland i ke kino a hoʻoulu iā ia e hana i kēia mau antibodies i makemake ʻole ʻia.

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He aha nā hōʻailona nui e ʻike ʻia?

ʻOkoʻa nā hōʻailona o MG mai kēlā kanaka a kēia kanaka. Hiki i kekahi poʻe ke loaʻa koke nā hōʻailona. Hiki i kekahi ke loaʻa mālie. E nānā kākou i nā wahi nui i hoʻopilikia ʻia a me nā hōʻailona.

Pilikia: Ka pilikia Myasthenia

I kekahi manawa, ma kahi o 15% a 20% o ka poʻe me MG hiki ke ʻike koke i ka nāwaliwali nui o ka puʻu a me nā ʻiʻo hanu. Ua kapa ʻia kēia he pilikia myasthenia.He pilikia olakino kēia. Inā pilikia ʻoe i ka hanu ʻana, e hele koke i ka ʻOihana Pilikia (ETU) o ka haukapila kokoke loa.

Pehea ʻoe e ʻike pono ai he maʻi kēia?

Inā loaʻa iā ʻoe kēia mau hōʻailona, ​​​​pono ʻoe e ʻike mua i kāu kauka ʻohana. Inā kānalua ʻo ia i kēia, e kuhikuhi ʻo ia iā ʻoe i kahi neurologist. E nīnau ʻo ia iā ʻoe e pili ana i kāu mau hōʻailona a hana i kahi hoʻokolokolo kino. Eia kekahi, aia kekahi mau hoʻokolohua e hiki ke hana ʻia e hōʻoia i ka hōʻailona:

• Nā hoʻāʻo koko: E nānā i kou koko no kēlā mau antibodies ʻino (acetylcholine receptor antibodies) a mākou i kamaʻilio ai ma mua.
• Hoʻāʻo Edrophonium: Nānā kēia hoʻāʻo e ʻike inā hoʻonui kahi lāʻau i kou ikaika ʻiʻo no kekahi manawa. Inā piʻi koke ka ikaika, he hōʻailona paha ia o MG.
• Nā hoʻāʻo neurostimulation: Hoʻokomo ʻia kahi nila liʻiliʻi i loko o kahi ʻiʻo a ana ʻia ka wikiwiki o nā hōʻailona aʻalolo. Hiki ke hoʻohana ʻia kēia e ʻike i ka wikiwiki o ka nāwaliwali o kahi ʻiʻo ke hoʻohana pinepine ʻia (electromyography).
• Hoʻāʻo ʻeke hau: Hoʻokomo ʻia kahi ʻeke hau ma luna o kahi lihilihi e hāʻule ana no kekahi mau minuke e ʻike ai inā e hāpai ana ka lihilihi. Hiki i kēia ke hāʻawi i kahi manaʻo o ke kūlana no ka mea hoʻomaikaʻi ke anu i ka kamaʻilio neuromuscular no kekahi manawa.
• Kiʻi: Ke hōʻoia ʻia ka hōʻailona, ​​​​hiki ke hana ʻia kahi CT scan a i ʻole MRI scan e nānā i nā pilikia me kāu thymus gland, e like me ka tumor (thymoma).

He aha nā lāʻau lapaʻau i loaʻa?

He maʻi ʻo MG i hiki ʻole ke ho'ōla piha ʻia, akā hiki ke hoʻokele pono ʻia. E koho kāu kauka i ka lāʻau lapaʻau kūpono loa nāu ma muli o ke koʻikoʻi o kou mau hōʻailona, ​​​​kou mau makahiki, a me kou olakino holoʻokoʻa.

1. Nā lāʻau hoʻoikaika ʻiʻo: ʻO ka laina mua o ka lāʻau lapaʻau he mau lāʻau e like me pyridostigmine. Hana kēia mau mea ma ka hoʻonui ʻana i ka nui o ka acetylcholine ma ka neuromuscular junction. Hāʻawi kēia lāʻau i ka ikaika i loko o 15-30 mau minuke o ka lawe ʻana, a mau ia no kahi o 3-4 mau hola.

2. Nā mea hoʻopau i ka ʻōnaehana pale: Pono ka nui o ka poʻe i kēia mau lāʻau lapaʻau no ka mea ua hoʻokumu ʻia ka maʻi e ko mākou ʻōnaehana pale ponoʻī. ʻO ka mea mua, hāʻawi ʻia nā steroids e like me prednisone, a laila hoʻololi ʻia nā lāʻau lapaʻau ʻē aʻe e like me azathioprine. Hiki i kēia ke hala i kekahi mau mahina e hōʻike i nā hopena.

3. Thymectomy: Inā paha he puʻupuʻu i loko o ka thymus gland a ʻaʻole paha, ʻo ka wehe ʻana iā ia me ke ʻoki ʻana e hōʻemi nui i nā hōʻailona i kekahi mau maʻi.

4. Lapaʻau IV:Hāʻawi ʻia kēia lāʻau lapaʻau ke koʻikoʻi loa nā hōʻailona, ​​a i ʻole i nā hihia e like me ka myasthenia crisis.

• Plasmapheresis: Hoʻopau kahi mīkini kūikawā i nā antibodies ʻino mai kou koko a hoʻihoʻi i ka plasma olakino i kou kino.
• Lapaʻau IVIG: Ma ka hāʻawi ʻana i nā antibodies (immunoglobulin) i lawe ʻia mai nā mea hāʻawi olakino i ke kino, hoʻololi ia i ka hana o ka ʻōnaehana pale kino no kekahi manawa.
• Nā antibodies Monoclonal: He mau antibodies kūikawā kēia i hana ʻia i loko o kahi hale hana e kuhikuhi ana a hoʻouka i nā ʻāpana kikoʻī o ka ʻōnaehana pale e hana hewa ana.

Pehea ʻoe e mālama ai iā ʻoe iho?

Me ka lāʻau lapaʻau, hiki iā ʻoe ke loaʻa ka hōʻoluʻolu nui mai nā loli liʻiliʻi i kou nohona.

• E kiʻi i ka meaʻai maikaʻi: E ʻai i kekahi mau meaʻai liʻiliʻi i ka lā ma mua o hoʻokahi meaʻai nui. E ʻai i kāu mau meaʻai nui i ka wā e loaʻa ai iā ʻoe ka ikaika nui loa. E kamaʻilio me kāu kauka e pili ana i ka lawe ʻana i nā lāʻau hoʻoikaika ʻiʻo ma mua o ka ʻai ʻana.
• E hoʻoikaika kino, akā e ʻike i kou mau palena: ʻOiai hiki i ka hoʻoikaika kino ke hāʻawi iā ʻoe i ka ikaika lōʻihi, e pale i ka hoʻoikaika nui ʻana. E nīnau i kāu kauka a mea hoʻoponopono kino paha i nā hoʻoikaika kino kūpono iā ʻoe.
• E hoʻomaha i ka wā e luhi ai ʻoe: E hoʻomau i kāu hana maʻamau i kēlā me kēia lā. Akā i ka wā e hoʻomaka ai ʻoe e luhi, e hoʻomaha iki. E hoʻolohe i kou kino.
• E ʻike i ka mea e hoʻoulu ai i ka maʻi: Hiki i kekahi poʻe ke ʻike i ka hoʻonui ʻia o nā hōʻailona MG ke maʻi lākou, ke kaumaha lākou, i ka wā o ka menstruation i nā wahine, a ma muli o kekahi mau lāʻau lapaʻau. E kamaʻilio me kāu kauka e pili ana i kēia.