Yu smɔl pikin dɔn gɛt smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl smɔl. Ɔ skin rash ɔ itchy rash we nɔ go wɛl? sכmtεm dεn tin ya na nכmal, bכt sכmtεm dεn kin bi sayn dεm fכ wan rεr kכndyushכn we dεn kכl Langerhans Cell Histiocytosis (LCH). Na nɔmal tin fɔ mek yu fil fred we yu yɛri dis nem, bikɔs nɔto sɔntin we wi dɔn yus fɔ yɛri. Bɔt nɔ wɔri, lɛ wi tɔk bɔt am insay simpul wɔd dɛn.
Fɔ tɔk am simpul wan, wetin na LCH?
Tink bɔt wi bɔdi as big kɔntri. Ami de fɔ protɛkt dis kɔntri, ɛn na dat na wi imyun sistɛm . Wan spɛshal kayn sojaman we de na dis ami na in dɛn kɔl Langerhans cells . Dɛn sɛl ya na wan kayn wayt blɔd sɛl. Dɛn men wok na fɔ fɛt di jem ɛn infɛkshɔn dɛn we de kam insay wi bɔdi ɛn protɛkt wi frɔm sik. Dɛn sojaman ya de ɔlsay na wi bɔdi, mɔ na di skin, di lɔng, limf no, bon mɛro, splin, ɛn liva.
bכt insay di kes fכ LCH, dεn Langerhans sεl dεm ya de mכltiply we dεn nכ de kכntro εn dεn de kכmכt na difrεn pat dεm na di bכdi. I tan lɛk se bɔku sojaman dɛn jɔs tinap rawnd na wan ples we dɛn nɔ fɛt. We dɛn gɛda lɛk dis, dɛn kin bigin fɔ pwɛl di wɛlbɔdi tisu dɛn na dɛn ples dɛn de. Lɛsin dɛn kin fɔm na dɛn ples dɛn de.
De gud nyus bɔt dis sik na dat bɔrku pikin dɛn kin wɛl frɔm di sik ɔltogɛda if dɛn trit dɛn fayn. Sɔntɛnde, mɔ if i jɔs afɛkt di skin, i kin go fɔ insɛf we dɛn nɔ gɛt ɛni tritmɛnt. כltu, if dεn sεl dεm ya afekt di imכtant כgan dεm lεk di bon mכro, spεlin כ liva, i kin nid fכ trit mכr intensiv.
Na LCH kansa?
Dis na kwɛstyɔn we bɔku pipul dɛn gɛt. Infakt, smɔl tin dɛn stil de we dɔktɔ dɛn nɔ gri bɔt dis. Bɔku pipul dɛn we de stɔdi bɔt dis kin tek LCH as sik we fiba kansa, dat na, niɔplasm . Dat min se, di sɛl dɛn we nɔ de gro fayn. Bɔt ɔda pipul dɛn tink se na sik we de mek di bɔdi wam.
Bɔt na ɔnkɔlɔjis dɛn de trit LCH, we spɛshal pan kansa ɛn blɔd sik dɛn. Sɔntɛnde, dɛn kin yuz tritmɛnt fɔ mɛn kansa lɛk kemotɛrapi bak fɔ trit am.
Udat kin gɛt dis sik pas ɔlman?
Bɔku tɛm dɛn kin si LCH pan pikin dɛn we dɛn jɔs bɔn ɛn pikin dɛn we ol bitwin 1 ɛn 15. Di big pipul dɛn nɔ kin bɔku, bɔt i nɔ kin izi.
Fɔ sho se na wan ɔ tu pan ɛvri milyɔn pikin dɛn we dɛn jɔs bɔn, dɛn kin bɔn wit dis sik ɛvri ia. Dis min se na wan sik we nɔ kin apin so ɔltɛm .
Wetin na di sayn dɛm fɔ LCH?
LCH nɔ de afɛkt ɔl pikin di sem we. Pan ɔl we sɔm pikin dɛn kin jɔs gɛt wan pat na dɛn bɔdi we kin afɛkt, ɔda wan dɛn kin gɛt bɔku say dɛn na dɛn bɔdi we kin afɛkt. So, di sayn dɛm kin difrɛn difrɛn wan fɔ di pat pan di bɔdi wae gɛt dis sik. Lɛ wi tek wan luk pan wetin dɛn bi.
| Di pat na di bɔdi we dɛn afɛkt | Simptom dɛm wae yu kin si |
|---|---|
| Bɔn dɛn | LCH de afekt di bon dεm na lεk 80% pan di sik pipul dεm. Lump ɔ swel kin apin na say dɛn lɛk di skel, di bon dɛn we de rawnd di yay, biɛn di yes, di jawbon, di an ɛn fut, di spayna, ɛn di hip. Pen kin de ɔ nɔ kin de. Apat frɔm dat, yu kin si ed we de at, nɛk/bak pen, i nɔ kin izi fɔ waka, ɛn yu kin si swɛt. |
| Kanda | Di rash we kin bɔku pas ɔl na we pɔsin kin gɛt rash na di skin. kredul kap kin bi wan kכndishכn we nכ de hεl we de sho na di pikin in ed. Rɛd, skel pat kin apia na di groin, di armpit, bɛlɛ, chɛst, ɛn bak. Dɛn tin ya kin kɔmɔt ɛn it ɔ i kin mek yu fil pen. Di nel dɛn kin chenj kɔlɔ bak ɔ fɔdɔm. |
| Mɔt | Tit we lɔs ɔ lɔs, tit we de go bak, gam we swel, sos na di lip, tɔŋ, insay di chɛst, ɔ na di ruf na di mɔt. |
| Liva ɔ Splin | If di liva ɔ splin big, i kin mek yu bɛlɛ swel, yu yay ɛn yu skin kin yɔlɔ (jaundice), i kin it, yu taya pasmak, ɛn i kin izi fɔ mek yu brus ɔ blɔd. |
| Bɔn Mɛro | Anemia, paleness, taya, ɛn nɔ want fɔ it bikɔs di rɛd blɔd sɛl dɛn de go dɔŋ. Infɛkshɔn ɔltɛm ɛn fiva bikɔs di wayt blɔd sɛl dɛn de dɔŋ. I izi fɔ brus bikɔs di pletlɛt dɛn de dɔŋ. |
| εndokrin Sistem (Endokrin Sistem - כmon dεm) . | If di pituitary gland afɛkt: yu tɔsti pasmak ɛn yu de pis bɔku tɛm (diabetes insipidus), yu nɔ de gro fayn, yu nɔ go ebul fɔ bɔn kwik ɔ yu de te, yu go gɛt mɔ wet. If di tayroyd gland afɛkt: di gland de swel, i nɔ izi fɔ blo. |
| Yes | Yu kin gɛt infɛkshɔn na yu yes bɔku tɛm, wata kin kɔmɔt na yu yes, yu yes kin rɛd, yu yes kin it, yu yes kin pen, ɛn yu nɔ kin yɛri fayn. |
| Yay | Di yay dɛn we de bɔl, we de swel ɔp di yay, we pɔsin nɔ de si fayn. |
| Limf Nod dɛn | Swel ɛn pen na lumps (lumps) na di nɛk, armpit, ɔ groin. |
| Sɛntral Nɛvɔs Sistɛm | Ed pen, diziz, vɔmit, i nɔ kin izi fɔ waka, i nɔ kin balans (ataxia), i nɔ kin izi fɔ tɔk ɔ si, i kin gɛt sik, i kin chenj di we aw pɔsin de biev ɛn mɛmba. |
| Lɔng | Dis kin apin to big pipul dɛn, mɔ di wan dɛn we de smok. Chɛst pen, dray kɔf, i nɔ izi fɔ blo, di lɔng we de fɔdɔm (nyumothorax). |
| Trakt we de na di gεstrointestinal | Bɛlɛ pen, vɔmit, dayarɛa, blɔd na di stɔl, ɛn nɔ gro fayn bikɔs i nɔ gɛt bɛtɛ tin fɔ it. |
De impɔtant tin na dat, yu kin si dɛn sayn ya bak pan bɔrku ɔda kɔmɔn sik dɛm. So nɔr frayd LCH jɔs bikɔs yu gɛt wan ɔ tu pan dɛn sik ya. Bɔt if dɛn sik ya kɔntinyu, i rili impɔtant fɔ go to dɔktɔ ɛn gɛt di rayt diagnosis.
Wetin na di patikyula tin we kin mek pɔsin gɛt LCH?
Fɔ tɔk am simpul wan, wi sɛl dɛn gɛt jin dɛn we de tɛl dɛn fɔ "divayd naw, stɔp naw." lεk af pan di pikin dεm we gεt LCH gεt sכm chenj, כ m כtεshכn, na dεn jin we dεn kכl `BRAF .' dis jin de mek wan protin we de kכntro di sεl dεm we de gro. biכs fכ dis mכtεshכn, dat protin nכ de gεt di kכmand fכ "stכp fכ divayd." I tan lɛk se di ‘on’ switch dɔn stɔp. So di Langerhans sɛl dɛn kin kɔntinyu fɔ sheb ɛn jɔyn.
Dis nɔto sɔntin we mama ɛn papa kin gɛt frɔm pikin dɛn. dis jεnεtik mכtεshכn de apin randomly afta di pikin bכn na di mama in bεlε.
apat frכm di `BRAF` jin, risechar dεm dכn fכnshכn se dis sik kin kכz bak bay mכtεshכn insay כda jin dεm lεk `MAP2K1`, `RAS`, εn `ARAF`.
Aw yu go fɛn dis, Dɔktɔ?
We yu kɛr yu pikin go to dɔktɔ, i go aks yu fɔs bɔt di sik dɛn we yu pikin gɛt. Dɔn, dɛn go tek tɛm chɛk yu pikin. Bikɔs LCH kin afɛkt bɔku difrɛn pat dɛn na di bɔdi, dɛn kin nid fɔ du sɔm tɛst fɔ kɔnfirm di sik.
| Test tayp | Fɔ tɔk am simpul wan... |
|---|---|
| Tɛst fɔ Blɔd | We dɛn kɔl kɔmplit blɔd kɔnt (CBC) de sho di nɔmba fɔ di rɛd sɛl dɛn, wayt sɛl dɛn, ɛn di pletlɛt dɛn we de na di blɔd. Dɛn kin du blɔd tɛst bak fɔ chɛk tin dɛn lɛk aw di liva de wok. |
| Bayopsi we dɛn kin du | Dis na di mɔs difinitiv we fɔ kɔnfɔm LCH.dεn tek sכm sכm tisu frכm wan lכmp כ lεshכn כnda anεsthεsia εn dεn egzamin am כnda maykroskכp fכ kכnfכm if LCH sεl dεm de. If dɛn tink se di bon mɛro involv, dɛn kin du bon mɛro bayɔpsi bak. |
| Tɛst fɔ Jɛnɛtiks | di tisu sεmpl we dεn tek frכm di bayopsi dεn de yuz fכ tεst fכ mכtεshכn na di `BRAF` jin. |
| Tɛst dɛn we dɛn kin yuz fɔ tek pikchɔ | Tεst dεm lεk X-ray, CT skan, MRI skan, εn PET skan kin no aw LCH de du di intanεt כgan dεm lεk di bon dεm, bren, εn lכng dεm. |
Bay di rizɔlt fɔ dɛn tɛst ya, yu dɔktɔ go rifer yu pikin to pikin dɛn ɛmatɔlɔjis/ɔnkɔlɔjis.
Wetin na di tritmɛnt dɛm fɔ LCH?
Nɔto ɔl pikin dɛn we gɛt LCH nid di sem kayn tritmɛnt. Di tritmɛnt de dipen pan usay di sik de ɛn aw i siriɔs.
Dɔktɔ dɛn kin put LCH insay tu men kayn dɛn:
1. Singl sistεm LCH: di sik de afekt כnli wan כgan sistεm na di bכdi (e.g., na di bon dεm nכmכ כ di skin nכmכ).
2. mכlti-sistεm LCH: di sik de afekt tu כ mכr כgan sistεm dεm na di bכdi (e.g., skin εn liva).
כlso, dεn kin tek כgan dεm lεk di liva, splin, εn bon mכro as "high-risk" כgan dεm, we dεn kin tek כgan dεm lεk di skin, bon dεm, εn lכng dεm as "low-risk." Dis klasification de ditarmin di tritmɛnt plan.
Bɔku men we dɛn de fɔ trit pɔsin:
- Stɛroyd tɛrapi: Ɛspɛshali we na di skin nɔmɔ dɛn afɛkt, dɛn kin yuz stɛroyd mɛrɛsin lɛk prɛdnison as pils ɔ ɔntmɛnt.
- כpεrayshכn: dεn kin du כpεrayshכn lεk kכ retεj f כ pul wan LCH tכmכro na wan bon.
- Kimotɛrapi: Dis na wan kayn mɛrɛsin we dɛn kin gi fɔ kil kansa sɛl dɛn. Bikɔs di LCH sɛl dɛn kin sheb kwik kwik wan, dɛn mɛrɛsin ya kin stɔp dɛn fɔ gro. Dɛn kin gi dɛn mɛrɛsin ya as pils, injɛkshɔn, ɔ as krim we dɛn put pan di skin.
- rεdyushכn tεrapi: I de yuz ay-εnεji rayt fכ pwεl di LCH sεl dεm. Naw, dɛn nɔ kin yuz dis bɔku tɛm.
- Tɛrapi we dɛn de tɔk to:fכ pikin dεm we gεt di `BRAF` jin mכtεshכn, dכg dεm de (BRAF inhibito dεm) we de tכk to da mכtεshכn de. Dɛn tin ya nɔ kin pwɛl di sɛl dɛn we gɛt wɛlbɔdi.
- Imyun tεrapi: fכ mek di pikin in כwn imyun sistεm fכ fכt di LCH sεl dεm.
- Stem sel transplant: Na tritmɛnt opshɔn we dɛn kin tink bɔt pan rili siriɔs kes dɛm we nɔ kin mɛn wit ɔda tritmɛnt dɛm.
Aw di tin kin bi afta dɛn dɔn trit am?
Di prɔgnosis fɔ LCH de dipen pan sɔm tin dɛm, lɛk us pat na di bɔdi di sik dɔn afɛkt, aw fa i dɔn skata, ɛn aw i de ansa fayn to tritmɛnt.
- di kכl rεt fכ pikin dεm we כnli "lכw-risk" כgan involvmεnt (כl tu singl-sistεm εn mכlti-sistεm) de nia 100% . Dis min se no risk nɔ de fɔ mek pɔsin day. Bɔt, risk de fɔ mek i kam bak ɔr ɔda prɔblɛm dɛn we go de fɔ lɔng tɛm.
- di kכndyushכn fכ pikin dεm we dεn "high-risk" כgan dεm, lεk di liva, spεlin, εn bon mכro, de afekt kin bi mכr siriכs.
So, i rili impɔtant fɔ fala yu dɔktɔ fɔ bɔku ia, ivin afta dɛn dɔn dɔn di tritmɛnt. Yu nid fɔ de chɛk yu ɔltɛm fɔ si if yu gɛt di sik bak.
Mɛsej we dɛn kin kɛr go na os
- Langerhans Cell Histiocytosis (LCH) na wan sik we nɔ kin apin so ɔltɛm we wan kayn imyun sɛl de gro we dɛn nɔ kin kɔntrol. Dɛn kin si am mɔ pan pikin dɛn.
- Pan ɔl we dɛn nɔ kin put am na kansa, di wan dɛn we de mɛn kansa kin trit am bay we dɛn de yuz mɛrɛsin fɔ mɛn kansa.
- di simptom dεm (skin lεsin, bon nodul dεm, infεkshכn we de fכm bכku tεm) kin difrεn bכku dipכnt pan di pat pan di bכdi we di sik afekt.
- Bayɔpsi impɔtant fɔ no di sik klia wan.
- Fɔ bɔku pikin dɛm, mɔ di wan dɛm we de na di "low-risk" kategori, tritmɛnt kin mɛn di sik ɔltogɛda.
- Ivin afta di tritmɛnt dɔn, i rili impɔtant fɔ gɛt mɛdikal fɔlɔp fɔ sɔm ia fɔ si if di sik kam bak.
- Tɔk bɔt ɛni kwɛstyɔn ɔ wɔri we yu gɛt bɔt yu pikin in kɔndishɔn opin wan wit yu dɔktɔ.
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