Yu kin blɔd bɔku bak ivin if yu gɛt smɔl wund? Lɛ wi luk pan ITP (Immune Thrombocytopenia)!

Sɔntɛnde yu kin wɔnda wetin mek ivin smɔl brus kin tɔn to big brus, ɔ wetin mek smɔl kɔt nɔ go stɔp fɔ blɔd? Ɔ yu kin gɛt tin dɛn lɛk fɔ blɔd na yu nos fɔ natin, ɔ fɔ blɔd na yu gɔm we yu de brus yu tit? If dɛn tin ya kin apin to yu bɔku tɛm, sɔntɛm i rili impɔtant fɔ mek yu no bɔt di sik we wi de tɔk bɔt tide we dɛn kɔl ITP (Immune Thrombocytopenia). Nɔ wɔri, lɛ wi tɔk bɔt dis simpul wan.

Wetin na ITP (Immune Thrombocytopenia)?

Fɔ tɔk am simpul wan, ITP (Immune Thrombocytopenia) na wan sik we yu blɔd gɛt smɔl smɔl smɔl sɛl dɛn we dɛn kɔl pletlɛt . Dɛn pletlɛt ya na dɛn kin ɛp fɔ stɔp blɔd we wi gɛt injuri sɔmsay na wi bɔdi. Dɛn kin mek wan klot ɛn stɔp di blɔd we de kɔmɔt . So, we di nɔmba fɔ dɛn pletlɛt ya de go dɔŋ, yu blɔd nɔ kin klɔt izi wan. Na dat mek ivin smɔl wund kin mek yu blɔd bɔku, ɔ yu kin jɔs brus yu bɔdi.

Dɛn kɔl dis ITP, ɛn di wɔd `Immune` min sɔntin we gɛt fɔ du wit di imyun sistɛm. `Trombocytopenia` min se di pletlet dεm de lכw. So, wetin kin apin pan dis na dat yu yon imyun sistɛm , di sojaman dɛn we de protɛkt wi frɔm sik, kin mistek tink se yu yon pletlɛt sɛl dɛn na ɛnimi we de na do ɛn atak ɛn pwɛl dɛn. I tan lɛk se yu atak pɔsin na yu yon os, yu tink se na tifman.

Sɔntɛnde dɛn kin trit ITP wit ɔ atɔl mɛrɛsin ɛn i kin bɛtɛ as tɛm de go. Bɔt fɔ sɔm pipul dɛn, i kin bi wan sik we nɔ de mɛn . Dis min se pan ɔl we dɛn kin kɔntrol di sayn dɛm, i nɔ kin izi fɔ mɛn am kpatakpata. Na dɛn kayn pipul ya, dɛn kin nid fɔ gɛt tritmɛnt fɔ ɔl dɛn layf.

Wetin na ɔda nem dɛn fɔ ITP?

We yu go to dɔktɔ, dɛn kin yuz ɔda nem dɛn apat frɔm ITP. So i fayn fɔ mɛmba dɛn nem ya bak:

• ``Otoimyun Trombosaytopenik Purpura''.
• ``Imyun Trombosaytopenik Purpura''.
• `Idiopathic Thrombocytopenic Purpura` (Dɛn bin de yuz dis nem bɔku tɛm trade, `Idiopathic` min se dɛn nɔ no di rayt kɔz)
• `Werlhof sik`
• `Otoimyun Trombosaytopenia`

I nɔ mata us nem yu gi am, bɔku tɛm i kin min di sem sik we pɔsin gɛt.

Aw kɔmɔn tin fɔ ITP?

Fɔ tru, ITP na wan kɔndishɔn we nɔ kin apin so ɔltɛm. Nɔto sik we de ambɔg ɔlman. Fɔ sho se na kɔntri lɛk Amɛrika, na lɛk 4 pan ɛvri ɔndrɛd tawzin (4/100,000) pikin dɛn ɛn tri pan ɛvri ɔndrɛd tawzin (3/100,000) big pipul dɛn kin gɛt dis sik ɛvri ia. Dɛn kin si dis kɔndishɔn bak na Sri Lanka, bɔt i at smɔl fɔ fɛn di rayt statystik bɔt am. Bɔt so, if pɔsin gɛt dis sik, i kin bi big prɔblɛm fɔ am, nɔto so?

Yu tink se kayn ITP de?

Yɛs, dɛn kin sheb ITP to tu men kayn dɛn:

1. Praymari ITP: .Dis na we yu yon imyun sistɛm de atak yu pletlɛt fɔ no rizin. Na lɛk 80 pasɛnt (80%) pan di wan dɛn we gɛt ITP gɛt dis kayn. na ``autoimmune disorder'', we min se i de kכz fכ di imyun sistεm we nכ de wok fayn.

2. Sεkɔndari ITP: Dis kin apin we di pletlet kכnt dכn as sayd ifekt fכ כda כndalayn mεdikal kכndyushכn, infεkshכn, כ mεdikeshכn. Fɔ ɛgzampul:

• Sɔm sik dɛn we kin kam fɔ lɔng tɛm, lɛk HIV, Epataytis C, ɔ H. pylori (wan baktri we kin mek pɔsin gɛt ɔlsa na in bɛlɛ) .
• Blɔd kansa dɛn
• Ɔda `(ɔtoimyun dizayd)` (e.g. lupus - SLE)
• I kin bi bak bikɔs ɔf sɔm mɛrɛsin dɛn.

Dɔktɔ dɛn kin klas ITP bak bay aw lɔng i dɔn de:

• Akyu ITP: Dis kin bɛtɛ insay tri mɔnt. I kin apin mɔ pan pikin dɛn.
• ITP we de kɔntinyu: Dis kin las frɔm tri mɔnt to twɛlv mɔnt (wan ia).
• Kronik ITP: Dis kin las fɔ pas wan ia. I kin mɔs bi pan big pipul dɛn.

Wetin na di sayn dɛm fɔ ITP?

Sɔm pipul dɛn kin gɛt ITP we nɔ gɛt ɛni sayn. Bɔt if di sayn dɛn kin apin, i kin kam smɔl smɔl ɔ wantɛm wantɛm. Di men sayn dɛm wae de sho se yu gɛt dis sik na:

• Petechiae: Dis na we yu si smɔl smɔl rɛd ɔ pepul spat dɛn na yu skin, mɔ na di ɔnda leg dɛn. Dɛn kin tan lɛk pɔsin we gɛt rash. Dɛn wan ya nɔ de go fɔ dɛnsɛf.
• Purpura: Di petechiae we wi bin dɔn tɔk bɔt kin jɔyn fɔ mek big big rɛd, pepul, ɔ brawn spat dɛn. Dɛn tin ya smɔl pas brus, bɔt dɛn big pas dɛn spat dɛn de. Dis kin apin bikɔs smɔl blɔd de lik frɔm smɔl smɔl blɔd vesel dɛn we de ɔnda di skin.
• Brus izi: Ivin if yu bɔmp smɔl ɛnisay, dat kin mek yu gɛt big brus ɔ brus. Sɔntɛnde, brus kin apia fɔ no rizin.
• Gɔm we de blɔd: Yu gam kin blɔd we yu de brus yu tit ɔ jɔs we yu stil de. Yu gam dɛn kin tan lɛk se dɛn dɔn swel bak.
• Blɔd na di stɔl: If yu stɔl luk rili dak, lɛk tar, i kin bi blɔd we de kɔmɔt insay yu bɔdi.
• Blɔd we de na yu urine: If di wata we de na di tɔylɛt bol luk pink ɔ rɛd we yu de pis, i kin bi bikɔs blɔd de na di urine.
• Hεvi mεnstral pεriכd pan uman dεm: If yu mεnstral pεriכd pas sεvin dez, כ if yu blכd bכku pas nכmal (`Menorrhagia`), dat kin bi sayn bak fכ ITP.
• Blɔd we de kɔmɔt na yu nos ɔltɛm.
• Big brus (Hematoma): Sɔntɛnde big brus we swel (`Hematoma`) kin fɔm we bɔku blɔd gɛda na wan ples.
• Fɔ fil se yu taya bad bad wan (Fatigue).

Impɔtant: If yu gɛt wan ɔ mɔ pan dɛn sik ya, i rili impɔtant fɔ go to dɔktɔ wantɛm wantɛm fɔ advays.

Wetin na di tin dɛn we kin mek pɔsin gɛt ITP?

as wi bin dכn tכk bכt, ITP kin apin we yu imyun sistεm mistek mek antibodi dεm agens yu כwn pletlεt dεm, we de tεl כda imyun sεl dεm fכ pwεl dεm. We wan blɔd vesel na yu bɔdi pwɛl, na di pletlɛt dɛn kin kam na di sayt, stik togɛda, mek blɔd klɔt, ɛn stɔp di blɔd. dis dεn kכl am ``primary hemostasis''.

Bɔt ivin masta sabi bukman dɛn stil nɔ klia klia wan wetin mek dis imyun sistɛm kin bigin fɔ atak in yon pletlɛt dɛn.

Bɔt sɔm risach dɛn dɔn sho se:

• Fɔ di wan dɛn we gɛt `(HIV)` (Human Immunodeficiency Virus) .
• Fɔ pipul dɛm we gɛt baktriyal infɛkshɔn we dɛn kɔl `(H. pylori)` (Helicobacter pylori) (bɔku tɛm dis kin gɛt fɔ du wit bɛlɛ ɔlsa ɛn gastritis)
• Fɔ pipul dɛm wae gɛt liva sik wae dɛn kɔl `(Epatitis C)`

Risk de fɔ mek yu gɛt ITP. Dɛn tin ya kin mek pɔsin gɛt sɛkɔndari ITP.

Aw dɛn kin no bɔt ITP?

Bifo dɔktɔ no if yu gɛt ITP, dɛn go fɔs du wan gud ɛgzam fɔ yu bɔdi fɔ chɛk fɔ si if yu gɛt sayn dɛn we de sho se yu de blɔd, yu de brus, ɛn yu gɛt spat dɛn lɛk petechiae ɛn purpura. Dɔn dɛn go aks yu bɔt di mɛrɛsin we yu bin dɔn gɛt trade, di mɛrɛsin dɛn we yu de tek, ɛn if ɛnibɔdi na yu famili dɔn gɛt prɔblɛm wit blɔd.

Bikɔs di sayn dɛm fɔ ITP kin tan lɛk ɔda blɔd klot disɔda ɔ ivin mɔ siriɔs sik dɛm lɛk blɔd kansa, di dɔktɔ go pul ɔl di ɔda tin dɛm we kin mek pɔsin nɔ gɛt am (a diagnosis of exclusion) bifo i mek di difinitiv diagnosis fɔ ITP.

Us tɛst dɛn kin yuz fɔ no if pɔsin gɛt ITP?

Bɔku tɛm, dɔktɔ dɛn kin du dɛn tɛst ya:

• Kɔmplit Blɔd Kɔnt (CBC): Dis kin chɛk di nɔmba fɔ difrɛn kayn sɛl dɛn na yu blɔd, lɛk rɛd sɛl dɛn, wayt sɛl dɛn, ɛn mɔ di pletlɛt dɛn . Insay ITP, dɛn pletlɛt ya kin rili smɔl.
• Peripheral Blood Smear: Insay dis tɛst, dɛn kin tek wan drop pan blɔd, spre am pan glas slayd, ɛn chɛk am ɔnda maykroskɔp fɔ si if di shep ɛn saiz fɔ di pletlɛt dɛn nɔmal, ɔ if ɛni ɔda tin de we nɔ fayn.

If yu dɔktɔ tink se yu de pan denja fɔ gɛt HIV, Epataytis C, ɔ H. pylori, dɛn kin du tɛst bak fɔ dɛn sik dɛn de. Sɔntɛnde dɛn kin du bon mɛro bayɔpsi, bɔt dɛn nɔ kin du dis fɔ ɔlman.

Wetin na di tritmɛnt dɛm fɔ ITP?

Bɔku tɛm, .We pikin dɛn gɛt ITP, if di sayn dɛn nɔ rili bad, dɛn go bɛtɛ if dɛn nɔ gɛt ɛni tritmɛnt. Bɔt bɔku tɛm, big pipul dɛn kin nid tritmɛnt, mɔ if dɛn pletlɛt dɛn nɔ bɔku ɔ if dɛn gɛt prɔblɛm fɔ mek dɛn blɔd kɔmɔt.

If yu nid tritmɛnt, yu dɔktɔ kin gi yu mɛrɛsin fɔ mek yu pletlɛt dɛn bɔku ɔ fɔ mek yu imyun sistɛm nɔ atak yu pletlɛt dɛn. Di men kayn mɛrɛsin dɛn we dɛn kin yuz na:

• Kכtikostεroyd: (e.g. Prεdnisolon). Dɛn tin ya kin wok bay we dɛn kin stɔp fɔ mek di antibodi dɛn we kin pwɛl di pletlɛt dɛn fɔ sɔm tɛm. Dɛn tin ya na fɔs layn tritmɛnt.
• Immunoglobulin (IVIg): Dis na mɛrɛsin we dɛn kin gi insay di bɛlɛ. I de chenj bak di we aw di imyun sistɛm de wok ɛn i de ridyus di pwɛl pwɛl we di pletlɛt dɛn de pwɛl.
• Thrombopoietin receptor agonists (TPO-RAs): Dɛn mɛrɛsin ya de ɛp di bɔdi fɔ mek mɔ pletlɛt dɛn.
• Imyun suprεshכn dεm: (e.g. Rituximab, Mycophenolate). Dɛn tin ya de ridyus di wok we di imyun sistɛm de du ɛn stɔp di pwɛl pwɛl we di pletlɛt dɛn de pwɛl.

Apat frɔm dɛn mɛrɛsin ya, di dɔktɔ kin tɛl yu bak fɔ du ɔda tin dɛn:

• Fɔ trit wan ɔndalayn infɛkshɔn: If na sɛkɔndari ITP, di pletlɛt kɔnt kin kam bak to nɔmal wans dɛn dɔn trit di infɛkshɔn we mek i gɛt am.
• Fɔ stɔp sɔm mɛrɛsin dɛn: If yu de tek ɛni mɛrɛsin we de mek yu blɔd tan lɛk aspirin, we de mek yu blɔd bɔku, yu dɔktɔ go tɛl yu fɔ stɔp fɔ tek dɛn.
• Plɛtlɛt transfyushɔn: If yu blɔd rili bad ɛn yu pletlɛt nɔ bɔku, dɛn kin gi yu pletlɛt frɔm ɔda pɔsin in doneshɔn. Bɔt dis na sɔlv fɔ sɔm tɛm.
• Splenectomy: Spleen na pat pan di bɔdi we de pul ol ɛn pwɛl blɔd sɛl dɛn, ɛn bak di pletlɛt dɛn we dɛn dɔn mak wit antibodies. Na sɔm pipul dɛn, if ɔda tritmɛnt dɛn nɔ ebul fɔ kɔntrol di sik, dɛn kin du ɔpreshɔn fɔ pul di splin. dis kin kכntro di kכndishכn fכ ITP bכku bכku wan. Bɔt if yu pul di splin, dat kin mek yu gɛt sɔm infɛkshɔn dɛn.

Di sayd ɛfɛkt dɛn we di tritmɛnt kin gɛt

Lɛk ɛni mɛrɛsin ɔ tritmɛnt, ITP tritmɛnt kin mek sɔm sayd ɛfɛkt dɛn . Fɔ ɛgzampul, kɔtikosterɔyd kin mek yu gɛt mɔ wet, yu fes kin swel, yu nɔ kin ebul fɔ slip, ɛn yu kin chenj yu maynd. Yu dɔktɔ go ɛksplen wetin na dɛn tin ya ɛn aw dɛn tan to yu. Dis we ya, yu kin no dɛn bifo tɛm ɛn tɔk bɔt dɛn if yu gɛt ɛnitin we de mɔna yu.

Wetin na di lukin-grɔn fɔ ITP?

Di lukin-grɔn/prognosis kin difrɛn frɔm wan pɔsin to ɔda pɔsin, i dipen pan di kayn ITP.

• Fɔ pikin dɛnIf akyu ITP de, bɔku pipul dɛn go wɛl ɔltogɛda if dɛn nɔ gɛt tritmɛnt insay sɔm wik ɔ mɔnt.
• If big pipul dɛn gɛt ITP we nɔ de dɔn, i kin bi wan sik we dɛn kin gɛt fɔ ɔl dɛn layf. Bɔt, nid nɔ de fɔ wɔri. Bɔrku pipul kin ebul fɔ kɔntrol dɛn sik fayn fayn wan wit mɛrɛsin ɛn ɔda tritmɛnt ɛn liv nɔrmal layf. Pan ɔl we dɔktɔ dɛn nɔ kin ebul fɔ mɛn ITP ɔltogɛda, bɔku pipul dɛn we gɛt krɛse ITP kin liv fayn wit di sik fɔ bɔku bɔku ia.

Aw a kin kia fɔ misɛf?

If yu gɛt ITP, yu kin nid fɔ tek mɛrɛsin fɔ di res ɔf yu layf fɔ mek shɔ se yu bɔdi mek inof pletlɛt. Yu go nid bak fɔ avɔyd tin dɛn ɛn abit dɛn we de put yu pan denja fɔ wund ɛn blɔd. Tink bɔt am, ivin we pɔsin fɔdɔm smɔl, i kin bi big prɔblɛm, nɔto so? So una fɔ no bɔt dɛn tin ya:

• Nɔ de fa frɔm kɔntakt spɔt dɛn we gɛt fɔ du wit fɔ bit, fɔdɔm, ɛn fɔ kɔntakt yu bɔdi tranga wan , lɛk futbɔl, rɔgbi, bɔksin, karate, baskɛtbɔl, ɛn ays ɔki, as yu ebul.
• If yu pikin gɛt ITP, mek shɔ se i wɛr tin dɛn we de protɛkt am lɛk ɛlmɛt, ni pad, ɛn ɛlb pad we i de du ɛnitin, lɛk fɔ rayd baysikul, fɔ sketbɔd, ɔ fɔ rɔla sket.
• We yu de travul wit motoka ɔ vɛn, wɛr sit bɛlt ɔltɛm , ɛn nɔ fɔgɛt fɔ tay yu pikin in sit bɛlt fayn ɔ put am na motoka sit.
• If yu de tek ɛni mɛrɛsin we yu nɔ de bay ɔ yu de tek ɛni ɔda mɛrɛsin, tɔk to yu dɔktɔ bɔt am ɛn mek i gri fɔ yu . Sɔm mɛrɛsin dɛn we de mek pɔsin fil pen lɛk aspirin ɛn ibuprofen, ɛn sɔm mɛrɛsin dɛn we dɛn kin yuz fɔ mɛn pen kin mek i gɛt mɔ blɔd.

Ustɛm a fɔ go to di dɔktɔ?

If dɛn no se yu gɛt ITP ɛn yu de gɛt tritmɛnt, yu dɔktɔ go chɛk yu ɔltɛm. Bɔt, insay da tɛm de:

• If yu si nyu brus , .
• If yu gɛt smɔl smɔl rɛd dɔt dɛn (`petechiae`) na yu skin, .
• If yu fil lɛk se yu de blɔd izi wan pas aw i kin kɔmɔt, .

Dis min se yu sik kin de wɔs, ɔr yu pletlɛt nɔr kin bɔku. If na so i bi, go to yu dɔktɔ kwik kwik wan. I kin chɛk yu pletlɛt lɛvɛl bak ɛn ajɔst di tritmɛnt we yu de gi if nid de.

Ustɛm a fɔ go na di Imejɛnsi Dipatmɛnt (ETU) ?

Dis nɔ kin apin so ɔltɛm, bɔt sɔntɛnde ITP kin mek yu pletlɛt kɔnt go dɔŋ tumɔs ɛn yu kin bigin fɔ blɔd we yu nɔ ebul fɔ kɔntrol. Fɔ ɛgzampul, if yu gɛt blɔd na yu nos we nɔ go stɔp, yu mɔt de blɔd, yu gɛt bɔku blɔd we yu de gɛt we yu de gɛt mɔnt, ɔ yu gɛt wund we nɔ go stɔp fɔ blɔd ivin we yu swɛt am, na mɛdikal imejensi.If na so i bi, yu fɔ go wantɛm wantɛm na di imejensi rum na di ɔspitul we de nia yu. Dɔn bak, if yu nak yu ed, ɔ if yu gɛt sayn dɛn we de sho se yu de blɔd insay yu bren, lɛk yu ed we de at bad bad wan, yu de vɔmit, ɔ yu de chenj yu yay, go na ɔspitul wantɛm wantɛm.

Us kwɛstyɔn dɛn a fɔ aks mi dɔktɔ?

We yu kam fɔ no se yu gɛt ITP, yu kin gɛt bɔku kwɛstyɔn dɛn. Nɔ fred ɔ shem fɔ aks yu dɔktɔ bɔt dɛn ɔl. Na sɔm kwɛstyɔn dɛn we yu kin aks:

• Us kayn ITP a gɛt? (Akyu, kronik, praymari, sɛkɔndari?)
• Us tritmɛnt yu go rɛkɔmɛnd fɔ mi? Wetin du?
• Aw lɔŋ i go tek fɔ mek dɛn tritmɛnt dɛn de gɛt mɛrɛsin/rizult?
• A go gɛt fɔ tek dis tritmɛnt ɛvride?
• If di fɔs tritmɛnt nɔ wok fayn, wetin afta dat?
• Wetin na di bad tin dɛn we dɛn tritmɛnt ya kin du? Wetin a fɔ du if dɛn apin?
• Us chenj dɛn a fɔ mek pan di we aw a de it ɛn di we aw a de liv mi layf?
• Us ɛgzampul dɛn we fayn fɔ mi fɔ du? Us ɛgzampul dɛn we nɔ fayn fɔ mi fɔ du?

Wetin kin apin if a gɛt bɛlɛ we a gɛt ITP?

If yu gɛt bɛlɛ ɔ yu de plan fɔ gɛt bɛlɛ, fɔ no se yu gɛt ITP kin rili mek yu fred. Bɔt yu kin tek kɔmfɔt we yu no dis: ITP nɔ kin afɛkt yu pikin we yu nɔ bɔn yet dairekt wan.

di pikin in pletlεt kכnt kin sכmtεm we dεn bכn, bכt dis kin bi fכ sכm tεm εn i go bכku insay fכ dez. Dɔktɔ dɛn go chɛk di pikin in pletlɛt lɛvɛl.

If yu gɛt smɔl ITP we yu gɛt bɛlɛ, ɛn yu sayn dɛn nɔ bad, yu nɔ go nid ɛni tritmɛnt. Bɔt if yu pletlɛt nɔ bɔku ɔ yu de pan denja fɔ blɔd, yu kin nid tritmɛnt. If na so i bi, yu dɔktɔ we de mɛn uman dɛn we de bɔn pikin ɛn di dɔktɔ we de mɛn di blɔd go wok togɛda fɔ pik di tritmɛnt we nɔ bad fɔ yu ɛn yu pikin . Dɛn go tek spɛshal kia bak we dɛn de bɔn pikin.

Fɔ dɔn, tin dɛn fɔ mɛmba (Take-Home Message) .

Okay, so naw yu dɔn ɔndastand gud gud wan bɔt wetin wi bin de tɔk bɔt, ITP (Immune Thrombocytopenia). Na sɔm impɔtant tin dɛn we yu fɔ mɛmba:

• ITP na wan sik we yu imyun sistεm de pwεl yu yon pletlεt dεm, we de mek blɔd nɔ de kכlכt.
• Di sayn dɛm kin bi we i izi fɔ brus, yu skin kin gɛt rɛd spat, ɛn yu kin gɛt blɔd ɔltɛm.
• We dis kin apin to pikin dɛn, bɔku tɛm i kin bɛtɛ as tɛm de go. Big pipul dɛn kin nid tritmɛnt fɔ lɔng tɛm.
• Pan ɔl we dɛn nɔ kin ebul fɔ mɛn ITP ɔltogɛda, if dɛn trit am fayn, dɛn kin kɔntrol di sik dɛn ɛn dɛn kin gɛt kwaliti layf.
• If yu gɛt dɛn sik ya, nɔ shek fɔ go to dɔktɔ. I go gi yu di advays ɛn tritmɛnt we yu nid.
• Protɛkt yusɛf frɔm injury, fala dɔktɔ advays, ɛn tek yu mɛrɛsin dɛn lɛk aw dɛn tɛl yu fɔ tek.

ITP kin bi wan kɔndishɔn we de mek yu fred, mɔ we yu jɔs de blɔd. Bɔt nɔto yu wan de. Dɔktɔ dɛn de we go ɛp yu ɛn kia fɔ yu. So, fes dis tin wit maynd. If yu gɛt ɛnitin we de mɔna yu, mek shɔ se yu tɔk to yu dɔktɔ.

` ITP, Imyun Trombosaytopenia, pletlet, blɔd we de klɔt, blɔd, imyun sistɛm, brus, petechiae, purpura