E aʻo pono kākou e pili ana i nā maʻi ʻē e hele pū me ke kanesa (Paraneoplastic Syndromes)!

Ua lohe paha ʻoe i kekahi kanaka me ke kanesa e ʻike nei i nā hōʻailona ʻaʻole ma muli o ke kanesa ponoʻī, akā ua hoʻokumu ʻia e nā maʻi ʻē aʻe? Me he mea lā aia ke kanesa ma kekahi ʻāpana o ke kino, akā ke pālahalaha nei kona hopena i nā ʻāpana ʻē aʻe. ʻO ia ka mea a mākou e kapa nei (Paraneoplastic Syndromes) . He mea paʻakikī paha kēia, akā e kamaʻilio kākou e pili ana i nā mea e hana nei. Mai makaʻu, he mea nui loa ka makaʻala i kēia.

He aha ka maʻi paraneoplastic?

I ka ʻōlelo maʻalahi, ke loaʻa iā ʻoe ka maʻi kanesa, kapa mākou ia he Paraneoplastic Syndrome , ʻo ia ka wā e ʻike ʻia ai nā hōʻailona ʻē aʻe i loko o ke kino me ka ʻole o ke kumu pololei ʻia e nā hunaola kanesa. E noʻonoʻo, aia kahi maʻi kanesa i loko o ke kino, akā ʻo kekahi mau hormones a i ʻole nā ​​​​protein i hūnā ʻia e ia e hoʻomaka ai kahi ʻōnaehana i loko o ke kino e hana ʻokoʻa. A i ʻole, i kekahi manawa ʻo kā mākou ʻōnaehana pale , ʻoiai e hoʻāʻo nei e luku i nā hunaola kanesa, hoʻouka hewa i nā hunaola maikaʻi. Kapa mākou i kēia he pane autoimmune . Hiki ke loaʻa kēia mau hōʻailona i ia mau hihia.

Hiki i nā maʻi Paraneoplastic ke hoʻopilikia i nā ʻōnaehana like ʻole o ke kino. No ka laʻana, hiki ke hoʻopilikia ʻia kāu ʻōnaehana nerve , ʻōnaehana endocrine (ka ʻōnaehana e hana ana i nā hormones), nā puʻupaʻa , nā iwi , nā hono , ka ʻili, a me ke koko .

I ka manawa pinepine, ʻo nā hōʻailona o kekahi o kēia (Paraneoplastic Syndromes) nā hōʻailona mua o ka maʻi kanesa. No laila, he mea nui loa ka makaʻala i kēia.

ʻO wai ka mea i pilikia nui ʻia e kēia maʻi? (ʻO wai ka mea i pilikia i nā syndromes paraneoplastic?)

ʻOi aku ka maʻamau o nā syndromes paraneoplastic i nā poʻe waena a me nā poʻe ʻelemakule, ʻoi aku hoʻi ka poʻe me nā maʻi e like me ke kanesa māmā , ke kanesa lymphatic , ke kanesa ovarian , a i ʻole ke kanesa umauma . ʻO nā kumu like e hoʻoulu ai i ke kanesa hiki ke hoʻoulu i kēia mau syndromes.

Pehea ka maʻamau o kēia mau mea? (Pehea ka maʻamau o nā syndromes paraneoplastic?)

ʻIke ʻia nā Paraneoplastic Syndromes ma waena o 8% a me 20% o ka poʻe me ka maʻi kanesa. ʻO ke ʻano kēia, ʻaʻole nā ​​​​maʻi kanesa āpau e loaʻa iā lākou, akā hiki iā lākou ke hoʻopilikia i kahi heluna nui.

He aha nā maʻi kanesa e pili ana me nā syndromes paraneoplastic?

ʻO kēlā me kēia kanaka me ka maʻi kanesa (Paraneoplastic Syndrome)ʻOiai hiki i kekahi ke loaʻa, aia kekahi mau ʻano maʻi kanesa e pili pinepine ʻia me kēia mau kūlana:

• Ka maʻi ʻaʻai umauma
• Ka maʻi ʻōpū
• Leukemia
• ʻO ka maʻi ʻōpū
• Ka maʻi ʻaʻai māmā (ʻoi aku ka maʻi ʻaʻai māmā liʻiliʻi)
• Ka maʻi ʻōpū
• Ka maʻi ʻaʻai pancreatic
• Ka maʻi ʻaʻai prostate
• Ka maʻi ʻaʻai puʻupaʻa
• Ka maʻi ʻaʻai testicular

He aha ke kumu o nā syndromes paraneoplastic?

Ua kūkākūkā mua mākou he ʻelua kumu nui no kēia.

1. Nā mea i hoʻopuka ʻia e nā hunaola kanesa: Hoʻopuka kekahi mau kanesa i nā hormones a me nā protein . Hoʻopilikia kēia mau mea i kekahi mau ʻōkana i ke kino i ka hana maʻamau ʻole. Inā ʻaʻole mālama ʻia, hiki i kēia ke hōʻeha mau loa.

2. Ka hana hewa ʻana o ka ʻōnaehana pale: Aia ka ʻōnaehana pale o ko mākou kino e pale iā mākou mai nā maʻi. Hoʻopuka kēia ʻōnaehana i nā mea i kapa ʻia he antibodies . Hoʻomaopopo a luku kēia mau antibodies i nā cell maʻamau ʻole, e like me nā cell cancer. Akā i kekahi manawa, hui pū ʻia kēia mau hōʻailona a hoʻomaka nā antibodies e hoʻouka i nā cell olakino. ʻO ia ka manawa e ʻike ʻia ai nā hōʻailona o kahi (Paraneoplastic Syndrome) .

He aha nā hōʻailona o nā syndromes paraneoplastic?

Hiki ke ʻokoʻa nā hōʻailona e ʻike ʻia ma kēia mai kēlā kanaka a kēia kanaka. Aia ia i ka ʻōnaehana o ke kino i hoʻopilikia ʻia. ʻO ka mea kupanaha, ma mua o 60% o nā hihia, ʻike ʻia nā hōʻailona o kēia maʻi ma mua o ka ʻike ʻia ʻana o ke kanesa. No laila, inā ʻike mua ʻia kēia mau hōʻailona, ​​​​hiki ke ʻike ʻia ke kanesa a mālama ʻia i ka wā mua. A laila ʻoi aku ka kiʻekiʻe o ka kūleʻa o ka lāʻau.

Nā hōʻailona maʻamau

Eia kekahi o nā hōʻailona maʻamau:

• kuni
• Ka nalowale o ka makemake a me ka pohō kaumaha
• Nā hou o ka pō

Ke hoʻopilikia ʻia ka ʻōnaehana nerve

Inā pili kāu ʻōnaehana nerve waena (ʻo ia hoʻi, kou lolo a me ke kaula spinal) a me ka ʻōnaehana nerve peripheral (nā aʻalolo e puka ana i waho o ka lolo a me ke kaula spinal), hiki iā ʻoe ke ʻike i nā hōʻailona e like me:

• Pōʻino
• ʻIke pālua
• Paʻakikī i ka ʻōlelo
• Poho hoʻomanaʻo
• Nā kūlana epileptic ( nā hopu ʻana )
• Nāwaliwali o nā ʻiʻo
• Hoʻemi ʻia nā reflexes, ka manaʻo a i ʻole ka hoʻonohonoho ʻana
• Ka nalowale o ka manaʻo ma kou mau lima a me kou mau wāwae

E noʻonoʻo, ua loaʻa i kekahi ka maʻi ʻaʻai māmā, akā hoʻomaka koke lākou e nalowale i ko lākou hoʻomanaʻo, ʻōlelo ʻino i kā lākou ʻōlelo ke ʻōlelo lākou, a paʻakikī ke mālama i ko lākou kaulike ke hele lākou. ʻO ia ka manawa e manaʻo ai nā kauka he (Paraneoplastic Syndrome) kēia.

I ka wā e hoʻopilikia ʻia ai ka ʻōnaehana endocrine

Inā hoʻopilikia ʻia kāu ʻōnaehana hormonal, hiki iā ʻoe ke ʻike i nā hōʻailona e like me:

• Luhi nui
• Ke koko kiʻekiʻe
• Nāwaliwali o nā ʻiʻo
• Ka luaʻi a me ka luaʻi
• Piʻi koke ke kaumaha me ke kumu ʻole

Ke hoʻopilikia ʻia nā hono, nā iwi a me nā ʻiʻo (Nā hono, nā iwi a me nā ʻiʻo - rheumatologic)

Inā pilikia kēia mau ʻōnaehana:

• Nā kūlana e like me ka arthritis
• ʻEha hui, pehu a ʻoʻoleʻa paha

I ka wā e pili ai i ka ʻili (ʻIli)

I kekahi manawa hiki ke hoʻopilikia ʻia ka ʻili:

• ʻĀnai
• Ka holoi ʻana
• ʻIli mānoanoa
• Nā ulu ʻili maikaʻi (ʻaʻole hiki ke hoʻopilikia ʻia)

He aha nā ʻano o nā syndromes paraneoplastic?

Aia kekahi mau ʻano o nā Paraneoplastic Syndromes . Ua hoʻokaʻawale ʻia lākou e like me ke ʻano o ko lākou hoʻopilikia ʻana i kēlā me kēia ʻōnaehana.

Nā maʻi paraneoplastic o ka ʻōnaehana nerve

ʻO kekahi mau laʻana:

• `(Cerebellar degeneration)`: He hōʻino kēia i ka cerebellum, e hoʻopilikia ana i nā mea e like me ke kaulike a me ka hele wāwae.
• Dysautonomia: Hoʻopilikia i ka hana o ka ʻōnaehana nerve autonomic.
• ʻEncephalitis: Ka mumū o ka lolo.
• Encephalomyelitis: ʻO ka mumū o ka lolo a me ke kaula spinal.
• ʻO ka maʻi myasthenic Lambert-Eaton (LEMS): Hoʻonāwaliwali nā ʻiʻo.
• ʻO Myasthenia gravis (MG): ʻO kēia kekahi ʻano e hoʻonāwaliwali ai nā ʻiʻo.
• Myelopathy: Nā maʻi e pili ana i ke kaula spinal.
• Neuromyotonia: Hana mau o nā ʻiʻo.
• `(Opsoclonus-myoclonus syndrome)`: Nā neʻe ʻano ʻē o nā maka a me nā ʻiʻo.
• `(Neuropathy (neuropathy peripheral))`: Ka hōʻino ʻana i nā aʻalolo peripheral.
• `(Stiff-person syndrome)`: ʻOʻoleʻa o nā ʻiʻo a me nā ʻūmiʻi ʻeha.

Nā maʻi paraneoplastic o ka ʻōnaehana endocrine

Nā Laʻana:

• ʻO ka maʻi Cushing (Cushing's syndrome): He kūlana i hoʻokumu ʻia e ka piʻi ʻana o ka hormone cortisol.
• Hypercalcemia: Hoʻonui ʻia ka nui o ka calcium i loko o ke koko.
• ʻO ka `(Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH))`: He kūlana e hoʻonui ai i ka paʻa ʻana o ka wai i loko o ke kino.

Nā maʻi paraneoplastic Rheumatic

(hoʻopilikia i nā hono, nā iwi, nā ʻiʻo a me nā ʻiʻo pili)

Nā Laʻana:

• ʻO ka fasciitis eosinophilic
• ʻErythromelalgia (ʻErythromelalgia)
• `(Osteoarthropathy Hypertrophic)`
• ʻO ka fasciitis palmar
• ʻO ka polyarthritis paraneoplastic

Nā maʻi paraneoplastic koko

Nā Laʻana:

• `(Paraneoplastic erythrocytosis)`: Hoʻonui ʻia nā hunaola koko ʻulaʻula.
• `(Paraneoplastic thrombocytosis)`: Hoʻonui ʻia nā platelets koko.

Nā maʻi paraneoplastic ʻili

Nā Laʻana:

• ʻO ka acanthosis nigricans: Nā wahi ʻeleʻele a mānoanoa ma luna o ka ʻili.
• Dermatomyositis: Ka mumū o ka ʻili a me nā ʻiʻo.
• ʻO ka vasculitis leukocytoclastic: Ka mumū o nā kīʻaha koko liʻiliʻi.
• `(Paraneoplastic pemphigus)`: He kūlana e hoʻoulu ai i ka pehu ʻana o ka ʻili.
• `(Sweet syndrome)`: Kuni a me nā ʻeha ʻili ʻeha.

Nā maʻi paraneoplastic puʻupaʻa

ʻO ka paraneoplastic glomerulonephritis kahi maʻi e hoʻopilikia ai i nā puʻupaʻa.

Pehea e ʻike ʻia ai nā maʻi paraneoplastic?

E ʻike kāu kauka i kēia kūlana ma ka nīnau ʻana iā ʻoe e pili ana i kou mōʻaukala olakino, hana i kahi hoʻokolokolo kino, a hana i kekahi mau hoʻokolohua ʻē aʻe.

• Hoʻokolohua Neurological: No ka mea, hoʻopilikia pinepine kēia maʻi i ka ʻōnaehana nerve, e noi aku kāu kauka iā ʻoe e hana i kekahi mau mea e nānā ai pehea e hana ai kou lolo a me nā ʻiʻo. E nānā lākou i nā loli i kou ikaika, hoʻomanaʻo, a me ka hoʻonohonoho ʻana.
• Nā hoʻāʻo kiʻi: Hiki ke hoʻohana ʻia nā hoʻāʻo e like me CT scans , MRIs , a me ultrasounds e ʻike ai inā he puʻupuʻu e hoʻoulu ai i nā hōʻailona.
• Nā hoʻāʻo koko: Hiki i nā hoʻāʻo koko ke hōʻike i nā mea e hoʻāla ai i nā kānalua e pili ana i ka maʻi kanesa. Hiki iā lākou ke nānā i nā antibodies e pili ana i nā syndromes paraneoplastic . Hiki i kēia mau hoʻāʻo ke hoʻoholo inā ua hoʻokumu ʻia nā hōʻailona e nā kumu ʻē aʻe, e like me nā maʻi a i ʻole nā ​​​​​​hōmona kaulike ʻole.
• ʻO ke kī ʻana o ka iwi kuamoʻo / lumbar puncture: I kekahi mau hihia, hoʻāʻo ʻia kāu wai cerebrospinal (CSF) e ʻike inā he mau antibodies e hoʻouka ana i nā cell olakino. Pili kēia i ke kau ʻana i kahi nila liʻiliʻi i loko o kou kua haʻahaʻa a lawe i kahi laʻana o ka wai. A laila e nānā ʻia.

Pehea e mālama ʻia ai a mālama ʻia paha kēia mau kūlana? (Pehea e mālama ʻia ai a mālama ʻia ai paha nā syndromes paraneoplastic?)

ʻO ka mea nui loa, ʻo ia ka mālama ʻana i ke kanesa kumu e hoʻoulu ai i kāu mau hōʻailona. I ka manawa like, hoʻokele pū ʻoe i kāu mau hōʻailona e hōʻemi i ka hōʻino ʻana i nā ʻōpū a i ʻole nā ​​​​ʻōnaehana o kou kino.

ʻO kekahi o nā lāʻau lapaʻau i hoʻohana ʻia e mālama i nā Paraneoplastic Syndromes :

• Nā Corticosteroids:Nā lāʻau lapaʻau e like me `(Cortisone)` a i ʻole `(prednisone)`. Hana kēia mau mea ma ka hōʻemi ʻana i ka mumū (pehu ʻana) i loko o ke kino.
• Immunosuppression: Nā lāʻau lapaʻau e hōʻemi i ka pane o ka ʻōnaehana pale o kou kino. E kuhikuhi kāu kauka i ka lāʻau lapaʻau e pili ana i ke ʻano o ka paraneoplastic syndrome āu e loaʻa ai.
• ʻO ka immunoglobulin intravenous (IVIG): Hana kēia lāʻau lapaʻau ma ka luku ʻana i nā antibodies ʻino. Ma kēia, hāʻawi ʻia nā antibodies olakino ma ke ʻano he injection, kahi e luku ai i nā antibodies ʻino.
• Plasmapheresis: Pili kēia i ka wehe ʻana i ka plasma (ka ʻāpana wai o ke koko) mai ke koko e hōʻemi i ka nui o nā antibodies, i loaʻa i loko o kēia plasma a hiki ke hōʻino i nā ʻiʻo olakino.
• Hoʻōla kino a me ka ʻōlelo: Pili kēia i nā hoʻomaʻamaʻa ʻiʻo e hoʻomaikaʻi i nā hana e like me ka ʻōlelo ʻana a me ka neʻe ʻana. Pono paha ʻoe i kēia lāʻau lapaʻau inā loaʻa iā ʻoe kahi maʻi paraneoplastic e pili ana i ka ʻōnaehana nerve.

He aha kaʻu e manaʻo ai inā loaʻa iaʻu kahi paraneoplastic syndrome?

ʻO kou wānana e hilinaʻi nui ʻia ma ke kahua o kou maʻi ʻaʻai. I kekahi mau hihia, hiki ke maʻalahi a pōkole nā ​​​​hōʻailona i hoʻokumu ʻia e kēia maʻi. I nā hihia ʻē aʻe, hiki ke koʻikoʻi nā hōʻailona a pono e mālama ʻia no ka wā lōʻihi.

E kamaʻilio me kāu kauka e pili ana i ke ʻano o ke kahua o kou maʻi ʻaʻai a me kāu pane ʻana i ka lāʻau e pili ai i kou hoʻōla ʻana.

He aha nā pilikia e pili ana me nā syndromes paraneoplastic?

Hiki i kēia ke alakaʻi i nā ʻano pilikia like ʻole. He mea liʻiliʻi paha kekahi, aʻo kekahi hiki ke koʻikoʻi a hoʻoweliweli paha i ke ola inā ʻaʻole mālama ʻia. E wehewehe kāu kauka i nā pilikia a me nā koho lapaʻau iā ʻoe.

Āhea wau e kāhea aku ai i ke kauka e pili ana i nā syndromes paraneoplastic?

Inā loaʻa iā ʻoe nā hōʻailona o ka maʻi paraneoplastic me ke kumu ʻole, e ʻike i ke kauka. ʻOi loa aku inā ua mālama ʻia ʻoe no ka maʻi kanesa i nā makahiki ʻelima i hala iho nei a ke ʻike nei ʻoe i kēia mau hōʻailona, ​​​​he manaʻo maikaʻi e hoʻāʻo hou ʻia. E kōkua nō hoʻi kēia i kāu kauka e hoʻoholo inā ua hoʻi mai ka maʻi kanesa.

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

ʻO kekahi mau nīnau hiki iā ʻoe ke nīnau i kāu kauka:

• He aha ke kumu o koʻu mau hōʻailona?
• Pehea ka hopena o kaʻu (Paraneoplastic Syndrome) i kaʻu hoʻolālā lapaʻau maʻi kanesa?
• He aha nā koho lapaʻau e loaʻa iaʻu?
• KoʻuPehea ka hopena o ka Paraneoplastic Syndrome i koʻu ho'ōla hou ʻana?
• E hoʻomaikaʻi anei koʻu mau hōʻailona ma hope o ka mālama ʻana i ka maʻi kanesa?
• Pehea e mālama ai i nā hōʻailona i ka wā pōkole? Pehea e mālama ai i nā hōʻailona i ka wā lōʻihi?

ʻO ka mea hope loa, leka lawe i ka home

Hiki i nā ʻōpū kanesa ke hana i nā loli i manaʻo ʻole ʻia i loko o ke kino. I kekahi manawa, hiki iā lākou ke hoʻokomo pū i nā hōʻailona o ka maʻi paraneoplastic . No ka mea he nui nā ʻano o kēia mau maʻi a he ʻokoʻa nā hōʻailona, ​​​​hiki ke lōʻihi ka manawa no kāu kauka e ʻike ai ua pili kāu mau hōʻailona i ka maʻi kanesa. Eia nō naʻe, i ka wā e hōʻoia ʻia ai ka hōʻailona, ​​​​hiki iā ia ke mālama i nā hōʻailona a, ʻo ka mea nui loa, mālama i ke kanesa kumu .

ʻO ke ala maikaʻi loa e mālama ai i ka Paraneoplastic Syndrome , ʻo ia ka loaʻa ʻana o ka lāʻau lapaʻau kūpono loa no ke kanesa. No laila, mai hoʻowahāwahā i nā hōʻailona. Inā he kānalua kou, e ʻike koke i ke kauka. A laila wale nō e hiki ai iā kākou āpau ke noho olakino.

Nā maʻi Paraneoplastic, maʻi kanesa, nā hōʻailona, ​​​​ʻōnaehana nerve, ʻōnaehana endocrine, ʻōnaehana pale, mālama ʻana i ka maʻi kanesa