Yu dɔn yɛri bɔt dis sik usay yu kin tɔn blu we yu kol ɛn fil bad bad wan? (Kol Aglutinin Sik) .

Sɔntɛnde yu kin fil blu na yu finga ɛn fut finga dɛn we yu rili kol? Ɔ yu kin fil lɛk se yu taya ɛn wik fɔ natin? Sɔntɛm yu skin dɔn tɔn blak. If yu gɛt dɛn kayn sik ya, de kɔz kin bi wan sik wae nɔr kin bɔrku, bɔt na tin wae wi ɔl nid fɔ no bɔt. Tide, wi go tɔk bɔt dis kɔndishɔn we dɛn kɔl `Cold Agglutinin Disease (CAD),' we min "cold blood cell aggregation disease" insay Sinhala.

Wetin na `Kold Agglutinin Disease (CAD)`? Lɛ wi ɔndastand am rili simpul wan.

Fɔ tɔk am simpul wan, `Cold Agglutinin Disease (CAD)` na wan blɔd sik we nɔ kin bɔku we wi bɔdi in imyun sistɛm – di sistɛm we de protɛkt wi frɔm sik lɛk di sojaman dɛn na wi bɔdi – kin mistek atak wi yon wɛlbɔdi rɛd blɔd sɛl dɛn .

imajin, wi imyun sistεm nכmal wan de prodyuz wan spεshal tכp protin we dεn kכl `antibodies` fכ pwεl di bad bad jεm dεm we de kam insay di bכdi. bכt insay dis kes fכ CAD, wi imyun sistεm de prodyuz wan spεshal tכp `antibodi` we dεn kכl `autoantibody`, we dεn kכl bak `kol agglutinin`. Di spɛshal tin bɔt dis na dat i de atak ɛn pwɛl di wɛlbɔdi rɛd blɔd sɛl dɛn na wi bɔdi.

As yu no, rɛd blɔd sɛl na wan rili impɔtant kayn sɛl we de kɛr ɔksijɛn ɔlsay na wi bɔdi. Dis ɔksijɛn de ɛp wi sɛl dɛn fɔ mek di ɛnaji we dɛn nid. So, we di nɔmba fɔ di rɛd blɔd sɛl dɛn de go dɔŋ, dat na we anemia de apin, wi bɔdi kin gɛt difrɛn kayn tin dɛn we kin mek wi nɔ fil fayn.

`Kol Agglutinin Disease` de pan wan grup we dεn kכl `hεmolytic anemia.` `Hemolytic anemia` na we wi bon mכro de brok dכn rεd bכdi sεl dεm fast pas aw i kin mek nyu wan dεm. I tan lɛk bɔkit we gɛt ol insay ɛn bigin fɔ lik wata.

Aw kכmכn na dis kכndyushכn we dεn kכl `Cold Agglutinin Disease`?

Dis na rili wan sik we nɔ kin apin so ɔltɛm . Na lɛk wan pan ɛvri 100,000 pipul dɛn nɔmɔ kin gɛt dis sik ɛvri ia. I kin mɔs pan uman dɛm wae ol bitwin 40 ɛn 80. Bɔt di nɔmba fɔ pipul dɛm wae gɛt dis sik pas ɔl na pipul dɛm wae dɔn pas 60 ia.

Aw `Cold Agglutinin Disease` de afɛkt mi bɔdi?

Dis sik kin mek yu gɛt sayn dɛm wae de sho se yu nɔr gɛt blɔd. Anemia na we di bɔdi nɔ gɛt bɛtɛ rɛd blɔd sɛl. Dis sik kin bi fɔ lɔng tɛm ɔ fɔ shɔt tɛm . Dɔn bak, di tin dɛn we kin apin to di bɔdi kin difrɛn frɔm we i nɔ kin izi fɔ am to we i kin rili bad .

Fɔ ɛgzampul, if CAD nɔr tranga, di sayn dɛm kin apia sloslo. I kin tek sɔm ia fɔ mek dɛn no di sik. Bɔt if i siriɔs, CAD kin mek pɔsin gɛt siriɔs at prɔblɛm, ivin we kin mek pɔsin in layf de pan denja.I pɔsibul se i go apin.

Di nem fɔ dis sik gɛt di wɔd "kol" insay. As a so, dɛn kin fil dɛn sik ya mɔ na say dɛn we kol ɔ na kol de.

Wetin na di sayn dɛm fɔ `Kold Agglutinin Disease`?

Bɔku tɛm, di sayn dɛm fɔ CAD kin gɛt fɔ du wit anemia ɛn blɔd we nɔ de flɔ fayn ɔlsay na di bɔdi. Dɛn sayn ya na:

• Fɔ fil taya bad bad wan (Fatigue) : Nɔto jɔs taya, bɔt na filin se yu nɔ gɛt layf.
• Wiknɛs : Di bɔdi kin wik sote i nɔ kin ebul fɔ du ɛnitin.
• Diziz : Na filin fɔ spin.
• Swetin : Swet fɔ natin.
• I nɔ izi fɔ blo (dyspnea) : I nɔ izi fɔ blo ivin if yu tray smɔl.
• di hat rεt de inkrεs (tachycardia) : Di hat rεt de inkrεs.
• Pallor : Di skin kin lɔs in blɔd saplai ɛn i kin bi pale.
• Finga, fut finga, ɛn yes kin tɔn blu we yu de na kol (Raynaud’s phenomenon) : We yu go na ples we kol lɛk Nuwara Eliya, ɔ we yu tɔch kol wata, yu finga, fut finga, ɛn yes kin tɔn blu, sɔm tɛm dɛn kin wayt. Dis kin kam bak wit yu swɛt.

Yu kin gɛt sayn dɛn bak we gɛt janda . We di rɛd blɔd sɛl dɛn dɔn pwɛl, dɛn kin pul wan yɔlɔ tin we dɛn kɔl bilirubin. We dis bilirubin bɔku na di bɔdi, jaundice kin apin. Di sayn dɛm fɔ janda na:

• Urin we gɛt dak brawn.
• Pas, di wayt dεm na di yay dεm εn di iris dεm na yכlכ.

Wetin na di tin dɛm wae kin mek pɔrsin gɛt `Kold Agglutinin Disease`?

Kol Aglutinin Disiz na wan kayn ɔtoimyun ɛmolaytik anemia. Dis min se wi yon imyun sistɛm de atak wi yon sɛl dɛn. insay CAD, wi imyun sistεm de aktibכt bay kol kכndishכn dεm εn i de prodyuz wan כtoantibodi we de "tag" rεd bכdi sεl dεm fכ pwεl dεm. di rεd bכdi sεl dεm we dεn tεg de stik tכgeda εn kכlכp tכgeda (agglutinate). di sεl dεm we gεt kכlכmp kin izi fכ kech εn dεstroy bay כda pat pan wi imyun sistεm we dεn kכl makrofag.

dis prכsεs de bigin we di tεmprachכ dכn dכn dכn 3-4 digri sεlshiכs (37-39 digri Fεnhayt). Tink bɔt di tɛmpracha we wi bɔdi kin gɛt na lɛk 37 digri sɛlshiɔs. Dis prɔblɛm kin bigin we wi de pan tɛmpracha we rili smɔl pas dat.

CAD de ambɔg di nɔmal schedule fɔ wi bɔdi fɔ mek wɛlbɔdi rɛd blɔd sɛl. Nɔmal wan, wan rɛd blɔd sɛl kin liv fɔ lɛk 120 dez so. Insay dis tɛm, wi bon mɛro kin mek nyu rɛd blɔd sɛl dɛn fɔ tek di ples fɔ di wan dɛn we de day. Bɔt insay CAD, dis saykl kin ambɔg.

Risach pipul dɛn stil nɔ no bɛtɛ bɛtɛ wan wetin mek wi imyun sistɛm de atak di sɛl dɛn we gɛt wɛlbɔdi.Sɔntɛnde, CAD kin kam bikɔs ɔf ɔda ɔndalayn mɛdikal kɔndishɔn. Dɛn kɔl dis `sɛkɔndari CAD`. if dεn nכ fכnshכn dis kayn link, we min se CAD de divεlכp witout kכz, dεn kכl am `primary CAD` כ `idiopathic CAD`.

Us ɔda kɔndishɔn dɛn kin gɛt fɔ du wit `Kold Agglutinin Disease`?

Sεkɔndari CAD kin gɛt fɔ du wit infεkshכn, כtoimyun sik dεm, εn limfoproliferativ dizכrd. Fɔ ɛgzampul:

• `Infεkshɔn mononyukliɔsis` (glandular fiva) .
• Maykoplasma nyumonia
• `Saytomegalovayrɔs`
• Lupus we gɛt di sik
• Rimatɔyd at at sik
• `Nɔn-Hɔdgkin limfoma`
• Kronik limfosaytik lukimiya
• ``Waldenstrom makroglobulinemia''.

Dɛn nem ya kin tan lɛk se yu kɔnfyus smɔl, bɔt dɛn nem ya na patikyula nem dɛn we dɔktɔ dɛn kin yuz, so i fayn fɔ mek yu no dɛn.

Aw fɔ no di sik we dɛn kɔl `Kold Agglutinin Disease`? (Diagnosis) .

Yu dɔktɔ go aks bɔt yu sik ɛn rivyu yu mɛdikal istri. Dɔn, dɛn go ɔda sɔm spɛshal blɔd tɛst fɔ chɛk if yu gɛt ɛmolaytik anemia ɛn if yu gɛt ɔtoantibodi dɛn we gɛt fɔ du wit CAD.

Blɔd tɛst dɛn we dɛn kin yuz fɔ no if pɔsin gɛt ɛmolaytik anemia na:

• Kɔmplit blɔd kɔnt (CBC) : Dis de gi ditayla infɔmeshɔn bɔt yu rɛd blɔd sɛl dɛn. I kin chɛk ɔmɔs rɛd blɔd sɛl dɛn yu gɛt, aw dɛn big, ɛn yu ɛmoglobin lɛvɛl. Ɛmoglobin na wan impɔtant prɔtin we de ɛp di rɛd blɔd sɛl dɛn fɔ kɛr ɔksijɛn.
• `rεtikulכsayt kכnt` : dis de mכsu כl di immature rεd bכdi sεl dεm (`rεtikulכsayt`) yu gεt na yu bכdi. We di imyun sistɛm pwɛl di machɔ rɛd blɔd sɛl dɛn, di bɔdi kin tray fɔ mek mɔ pan dɛn sɛl dɛn ya we nɔ machɔ as we fɔ kɔmpɛns.
• di sεrum lεvεl tεst : di εlevεt lεvεl fכ `lactate dehydrogenase (LDH)` εn `bilirubin` na di bכdi, εn di dכn lεvεl fכ `haptoglobin` na sayn dεm fכ `hεmolytic anemia`.

Dɔn, fɔ no if na CAD de mek yu gɛt ɛmolaytik anemia, yu dɔktɔ go chɛk fɔ si if ɔtoantibodi dɛn de we de atak di rɛd blɔd sɛl dɛn. Di tɛst dɛm we dɛn kin du fɔ dis na:

• Direct Coombs test (DAT) : Dis tεst de chεk fכ di prεsεns כf כtoantibodi dεm we de asai fכ CAD. Insay di tɛst, dɛn kin pul yu rɛd blɔd sɛl dɛn frɔm di ɔda pat dɛn na yu blɔd ɛn put dɛn na say we dɛn kin kɔntrol. Dɔn dɛn kin ad wan spɛshal sɔlv. if di rεd bכdi sεl dεm stik togeda wit di sכlushכn εn kכlכm tכgeda (agglutinate), di tεst de positifu, we min se di כtoantibodi de de.
• `Kol agglutinin tayt tεst`: Dis tεst de mכsu di kכnsantreshכn, כ kwantiti, fכ dεn `autoantibodies` dεm ya na yu bכdi. di hכy kכnsantreshכn fכ dεn `autoantibodies` ya na sayn fכ CAD.

Wae dɛn dɔn kɔnfyus yu diagnosis, yu dɔktɔ go chɛk bak fɔ si if yu CAD gɛt fɔ du wit wan ɔndalayn kɔndishɔn (`sɛkɔndari CAD`).

Aw dɛn kin trit `Kold Agglutinin Disease`?

I kin dipen pan aw yu sik, di tritmɛnt kin bi fɔ chenj yu layf, fɔ tek mɛrɛsin, ɛn sɔntɛnde yu kin gi yu blɔd we yu gɛt ɛnitin fɔ du wit am .

• Layf : If yu gɛt CAD, yu dɔktɔ go advays yu fɔ avɔyd kol tɛmpracha . Dis na di tin we impɔtant pas ɔl. Yu fɔ du tin dɛn lɛk fɔ wɛr wam klos, nɔ fɔ shaw we kol, ɛn nɔ travul na say dɛn we kol.
• Mεdikeshכn : Di mεdikeshכn we dεn kin yus fכ trit CAD na `Rituximab` . dis de wok bay we i de stכp yu imyun sistεm fכ mek `autoantibodies` we de atak yu rεd bכdi sεl dεm. Wan nyu drɔg we dɛn kɔl `Sutimlimab` sɛf dɔn gɛt aprɔval i nɔ tu te yet. Dis kin wok bay we i de stɔp di imyun sistɛm fɔ atak yu rɛd blɔd sɛl dɛn dairekt wan.
• Blɔd transfyushɔn ɛn plasma chenj : If yu CAD kam akyu, yu dɔktɔ go nid fɔ gi yu blɔd ɔ chenj plasma fɔ mek yu kɔndishɔn stebul. Plasma ɛkshɛnj de wok bay we i de ridyus di ɔtoantibodi dɛn we de na yu blɔd.

If yu gɛt `sɛkɔndari CAD`, yu dɔktɔ go trit di ɔndalayn kɔndishɔn bak.

Yu tink se dɛn kin mek dɛn nɔ gɛt CAD?

Bɔt i sɔri fɔ no se, Kol Aglutinin Sik nɔto sik we pɔsin kin ebul fɔ avɔyd. Bɔt yu kin ebul fɔ kɔntrol di sayn dɛm ɛn liv fayn layf.

Aw lɔŋ yu kin liv wit `Cold Agglutinin Disease`?

Pipul dɛm wae dɛn no se gɛt CAD kin liv lɔng lɛk pipul dɛm wae gɛt dɛn ej wae nɔr gɛt CAD. Wan stɔdi we dɛn jɔs du, sho se pipul dɛn we dɛn dɔn no se dɛn gɛt dis sik we dɛn ol 68 ia, kin tink se dɛn go liv te dɛn ol 80 ia, pan ɔl we dɛn kin du am. Dat min se if yu gɛt di rayt tritmɛnt ɛn manej yu, yu go ebul fɔ tink se yu go liv fayn layf.

Us kwɛstyɔn dɛn a fɔ aks mi dɔktɔ?

If dɛn no se yu gɛt CAD, i go fayn fɔ aks yu dɔktɔ kwɛstyɔn dɛn lɛk dɛn wan ya:

• Mi CAD gɛt fɔ du wit wan sik we de ɔnda am?
• Wetin na de sayn dɛm wae go ɛp mi fɔ no if mi sik de bɛtɛ ɔr de wɔs?
• A go gɛt fɔ kɔntinyu fɔ tek mɛrɛsin fɔ dis sik?
• Wetin na di bɛst klaymat fɔ pɔsin we gɛt CAD fɔ liv insay?
• Us tɛmpracha rɛnj a fɔ avɔyd fɔ kɔntrol mi sik dɛn?

Yu ɛkspiriɛns wit Kol Agglutinin Disease (CAD) de dipen pan if na praymari (‘primary’) ɔ sɛkɔndari (‘sɛkɔndari’). Di kayn bad bad sik wae yu gɛt go afɛkt bak aw yu nid tritmɛnt fɔ agresiv wan. We yu dɔktɔ trit di sik we de ɔnda yu, i go ebul fɔ mɛn yu CAD. Ivin if yu gɛt CAD fɔ lɔng tɛm, yu kin kɔntrol yu anemia simptom dɛm ɛn de wɛl bay we yu avɔyd kol ɛn tek yu mɛrɛsin dɛm lɛk aw dɛn tɛl yu.

Di tin dɛn we impɔtant pas ɔl fɔ mɛmba frɔm wetin wi dɔn tɔk bɔt (Take-Home Message) .

• Kol Agglutinin Disease (CAD) na wan sik we nɔ kin apin so ɔltɛm we wi yon imyun sistɛm kin atak wi rɛd blɔd sɛl dɛn ɛn i kin wɔs we kol.
• Di sayn dɛm kin bi we yu jɔyn dɛn kin pen, taya pasmak, yu skin kin shayn, yu finga dɛn kin tɔn blu we yu kol, ɛn sɔntɛnde yu kin gɛt janda .
• Dis kin bi `praymari` (we nɔ kin kɔz) ɔ `sɛkɔndari` (we kin kam wit ɔda sik).
• Blɔd tɛst dɛn de fɔ no if pɔsin gɛt am.
• Di tritmɛnt kin min fɔ avɔyd kol, tek mɛrɛsin, ɛn sɔntɛnde fɔ transfyushɔn blɔd.
• Pan ɔl we dɛn nɔ go ebul fɔ stɔp dis, if yu de manej yu fayn fayn wan, yu go ebul fɔ liv gud layf.
• If yu gɛt dɛn sik ya, nɔ shem fɔ go to dɔktɔ. Di kwik we yu no am, na di mɔ i izi fɔ trit.

Mɛmba se dis atikul na fɔ infɔmeshɔn nɔmɔ. If yu gɛt ɛni sayn, mek shɔ se yu go to dɔktɔ fɔ advays.

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