Wetin na Langerhans Sεl Histiocytosis (LCH)? Yu smɔl pikin de pan denja?

Yu dɔn ɛva yɛri bɔt Langerhans Cell Histiocytosis, ɔ wetin wi kɔl LCH fɔ shɔt? Sɔntɛm di nem tan lɛk se i kɔmplikt smɔl ɛn i de mek pɔsin fred. Bɔt fɔ tru, dis na sik we nɔ kin apin so ɔltɛm we kin mɔna wi yɔŋ pikin dɛn, mɔ di pikin dɛn we dɛn jɔs bɔn ɛn pikin dɛn we nɔ rich 15 ia yet. So nɔ wɔri, lɛ wi tɔk bɔt am simpul wan, insay Sinhala we yu kin ɔndastand gud gud wan, ditayli, lɛk se yu de tɔk to yu tayt padi.

Wetin na (LCH) rili?

Fɔ tɔk am simpul wan, (LCH) na wan sik we kin apin we pikin in bɔdi gɛt tumɔs Langerhans sɛl dɛn, we na wan kayn spɛshal sɛl na wi imyun sistɛm. Dɛn Langerhans sɛl ya na rili wan kayn wayt blɔd sɛl. Dɛn men wok na fɔ fɛt di jem dɛn we de kam insay wi bɔdi ɛn protɛkt wi frɔm sik.

Dɛn sɛl ya kin de ɔlsay na wi bɔdi, mɔ na di skin, lכng, limf no, bon mכro, splin, εn liva. כltu, insay di kes fכ (LCH), dεn Langerhans sεl dεm ya de kכ mכt pasmak na wan כ mכr ples. we dis apin, dεn כgan dεm ya kin pwεl εn lεsin kin fכm.

Aw de sik kin difrɛn frɔm wan pɔrsin to ɔda pɔrsin. Sɔm pikin dɛn kin wɛl kpatakpata frɔm di sik if dɛn gɛt di rayt tritmɛnt. I sɔprayz fɔ no se sɔntɛnde, mɔ if i jɔs afɛkt di skin, i kin bɛtɛ if dɛn nɔ gɛt ɛni tritmɛnt. Bɔt if di sik (LCH) afɛkt di impɔtant ɔgan dɛm lɛk di pikin in bon mɛro, splin ɔ liva, i kin nid fɔ gɛt mɔ tritmɛnt.

Na (LCH) kansa?

Dis na kwɛstyɔn we bɔku pipul dɛn gɛt. Infakt, bɔku pan di wan dɛn we de du risach kin tek LCH as kansa, dat na, niɔplasm. Bɔt naw sɔm sayɛnsman dɛn de si am se na sik we de mek pɔsin in bɔdi wam. Bɔt, ɔnkɔlɔjis na dɔktɔ dɛn we spɛshal pan kansa ɛn blɔd sik dɛn. Sɔntɛnde, dɛn kin yuz bak tritmɛnt fɔ kansa lɛk kemotɛrapi fɔ mɛn di sik.

Udat dɛn kin afɛkt mɔ pan dis (LCH) kɔndishɔn?

LCH kin kכmכn bכku pan pikin dεm we dεn bכn εn pikin dεm we ol bitwin 1 εn 15. LCH pan big pipul dεm nכ kin bכku, bכt i nכ kin impכtant.

Aw kɔmɔn tin dis?

Akɔdin to sɔm statystik, wan ɔ tu pan ɛvri milyɔn nyu bɔbɔ dɛn kin gɛt LCH ɛvri ia. Dɔn bak, na lɛk fayv pan ɛvri milyɔn pikin dɛn we nɔ rich 15 ia yet, dɛn kin gɛt dis sik. So yu kin si se dis na tin we nɔ kin apin so ɔltɛm.

Wetin na di sayn dɛm fɔ (LCH)?

Di sayn dɛm fɔ LCH kin difrɛn bad bad wan frɔm wan pɔsin to ɔda pɔsin. I kin afɛkt jɔs wan pat na di bɔdi, ɔ i kin afɛkt bɔku say dɛn. So, di sayn dεm de dipכnt pan us pat pan di pikin in bכdi de afekt.

If di bon dɛn afɛkt:

כlmost 80% pan di pikin dεm we gεt LCH de divεlכp lεsin na wan כ mכr pan dεn bon dεm. Wetin kin mek dis apin?

• Swel ɔ lump kin kam na say dɛm lɛk di skel, di bon dɛm we de rawnd di yay, di yes bon dɛm, di jaw bon dɛm, di limb dɛm, di spayna, di hip dɛm, ɔ di rib dɛm. Dis swel kin mek yu fil pen ɔ i kin go.
• Ed de at.
• Nek ɔ bak pen.
• Fraktrɔs dɛn.
• I nɔ izi fɔ waka.
• Limp we yu de limp.

Na di skin:

Dɛn kin si rash as sayn dɛm fɔ kansa na di skin (LCH).

• pan yכŋ pikin dεm, wan rash we lεk kredul kכp kin apia na di sכl.
• Na pikin ɛn big pipul dɛn we dɔn big, i kin mek dɛn gɛt flaky rash we tan lɛk dandruff.
• Dɛn rash ya kin apin bak na ɔda pat dɛn na di bɔdi (groin, an, armpit, bɛlɛ, bak, chɛst). Dɛn kin fil pen, it, ɔr at.
• Sɔm pikin dɛn kin gɛt blista dɛn we de kɔmɔt.
• Tin dɛn lɛk fɔ chenj di kɔlɔ, fɔ mek di nel dɛn at, ɔ fɔ pul di nel dɛn kin apin bak.

We i kam pan di mɔt:

Di sayn dɛm wae yu kin si insay di mɔt na:

• Tut we de lus ɔ we de lɔs tit.
• Tut we dɛn pul.
• Di gɔm dɛn we de swel.
• Sɔl na di lip, tɔng, insay di chɛst, ɔ na di ruf na di mɔt.

Liva ɔ Splin we gɛt fɔ du wit am:

If dɛn ɔgan ya afɛkt, sɔm sayn dɛn lɛk:

• di bכdi de swεla bikoz di liva εn/כ di splin de big.
• Di skin kin yɔlɔ ɛn di yay kin wayt (jaundice).
• I de it.
• Taya.
• I izi fɔ brus ɛn/ɔ blɔd.

If di bon mכro dεn afekt:

Di bon mכro na di say we dεn de mek blכd sεl dεm. If i afɛkt:

• Anemia, pale skin, taya, ɛn nɔ kin want fɔ it bikɔs di rɛd blɔd sɛl dɛn kin go dɔŋ.
• Infɛkshɔn ɔltɛm ɛn fiva bikɔs di wayt blɔd sɛl dɛn nɔ bɔku.
• I izi fɔ brus ɛn/ɔ blɔd bikɔs di pletlɛt dɛn nɔ bɔku.

εndokrin Sistem (Endokrin Sistem - כmon dεm):

LCH kin afekt di pikin in εndokrin sistεm, we na di say we dεn de mek כmon dεm, lεk di pituitary gland εn di tayroyd gland.

• If di pituitary gland afɛkt: yu tɔsti pasmak (polydipsia) ɛn yu de pis bɔku tɛm (dɛn kin kɔl am bak dayabitis insipidus), yu nɔ de gro fayn, yu nɔ go ebul fɔ bɔn kwik ɔ yu de te, ɛn yu go gɛt mɔ wet.
• If di tayroyd gland afɛkt: di tayroyd gland de swel, di sayn dɛm we de sho se di tayroyd ɔmon lɛvɛl nɔ de (hypothyroidism), ɛn i nɔ izi fɔ blo.

We i kam pan di yes dɛn:

• Infekshɔn na yu yes bɔku tɛm.
• Fluid we de kɔmɔt na di yes.
• Rɛdnɛs.
• Itchy rash we de mek pɔsin it.
• I de pen na yu yes.
• I nɔ de yɛri fayn igen.

We i kam pan di yay dɛn:

• Ay dɛn we de bɔl.
• Swel ɔp di yay.
• Prɔblɛm dɛn we pɔsin kin gɛt we i de si.

Limf Nod dɛn: .

• di limf no dεm we de swεla εn we de mek yu fil pen na di nεk, di armpit dεm, εn/כ di groin.

Sɛntral Nɛvɔs Sistɛm: .

dis min se di bren εn/כ di spεnal kכd de afekt.

• Ed de at.
• Diziz we pɔsin kin gɛt.
• Fɔ vɔmit.
• Fɔ tɔsti pasmak.
• Fɔ pis bɔku tɛm.
• I nɔ izi fɔ waka.
• Lɔs fɔ balans.
• Inability fכ kכntrol di bכdi muvmεnt dεm (ataxia).
• I nɔ izi fɔ tɔk ɔ si.
• Di sik dɛn we kin mek pɔsin sik.
• Chenj na di bihayvya ɛn/ɔ mɛmori.

Lɔng:

Pulmonary LCH, na wan sik wae de afekt di lכng dεm, na in bכku pan big pipul dεm. Pipul dɛn we de smok kin de pan denja mɔ.

• Chɛst de pen.
• Dray kɔf.
• I nɔ kin izi fɔ yu fɔ blo.
• Fɔ kɔf blɔd.
• Lɔng we nɔ de wok fayn (nyumothorax).

Trakt we de na di gεstrointestinal:

If di pikin in bɛlɛ, in smɔl intestinal, ɛn/ɔ in big intestinal afɛkt:

• Bɛlɛ de pen.
• Fɔ vɔmit.
• Rɔnbɛlɛ.
• Blɔd we de na di stɔl.
• Growth failure bikɔs ɔf malnutrishɔn.

Impɔtant: Dɛn sayn ya kin kam bikɔs ɔf ɛni nɔmba ɔf ɔda kɔndishɔn, nɔto jɔs LCH. So, if yu pikin gɛt dɛn sik ya, i impɔtant fɔ go to dɔktɔ wantɛm wantɛm fɔ mek dɛn no di sik fayn fayn wan.

Wetin na di tin dɛn we kin mek pɔsin gɛt (LCH)?

na כnli lεk af pan di pipul dεm we gεt LCH gεt somatik mכtεshכn na wan jin we dεn kכl BRAF. somatik mכtayshכn na chenj dεm we de apin insay sכm sεl dεm afta dεn bכn. dεn nכ de gεt frכm di mama εn papa, bכt dεn kin apin randomly di tεm we di εmbrayo de divεlכp.

di (BRAF) jin de mek wan protin we de kכntro di sεl dεm we de gro εn divεlכpmεnt. nכmal wan, dis protin kin כn εn כf akɔdin to kεmikכl signal dεm. כltu, we mכtεshכn de insay dis jin, di protin de stכk כltεm na di "on" stet. dis de mek (LCH) sεl dεm de gro εn divayd pasmak. dis na wetin de mek di tisu dεm de damej εn di tכmכro dεm de fכm.

Sayɛnsman dɛn dɔn kam fɔ no bak se we sɔm ɔda jin dɛn chenj kin mek pɔsin gɛt dis sik bak. fכ egzampl, di jin dεm (MAP2K1), (RAS), εn (ARAF). Sɔm pipul dɛn we de stɔdi bɔt dis biliv se di pɔyzin we de na di envayrɔmɛnt ɛn di vayrɔs infɛkshɔn kin mek bak di sik kam.

Wetin na di risk factor dɛm fɔ (LCH)?

Sɔm tin dɛn kin mek yu pikin gɛt mɔ chans fɔ gɛt LCH. Dɛn tin ya na:

• Fɔ gɛt famili istri bɔt LCH.
• Fɔ gɛt Hispanik etnik grup (pan ɔl we dis nɔ rili impɔtant to wi kɔntri, dɛn tɔk bɔt am na sɔs).
• Smok (especially fɔ big pipul dɛn we gɛt lɔng kansa (LCH)).
• Fɔ gɛt sɔm kemikal dɛn we yu gɛt bɛlɛ.
• Fɔ gɛt mɛtal, granit, ɔ wud dɔst na di wokples.
• Infεkshכn dεm we de insay di nyu bכbi in tεm.
• Nɔ fɔ gɛt di vaysin dɛn we dɛn dɔn rɛkɔmɛnd we dɛn smɔl.

Wetin na di pɔsibul kɔmplikeshɔn dɛm fɔ (LCH)?

Na lɛk 50% pan di pikin dɛn we gɛt LCH kin gɛt difrɛn kɔmplikeshɔn dɛn bikɔs ɔf dis kɔndishɔn. Fɔ ɛgzampul:

• Skaring we de mek pɔsin gɛt skata.
• Di we aw pɔsin nɔ de gro fayn.
• Disabiliti fɔ di mɔskul ɛn skel.
• Wan kɔndishɔn lɛk dayabitis (Diabetes insipidus).
• Di ɔmon dɛn we nɔ balans.
• I nɔ de yɛri fayn.
• Prɔblɛm wit yu maynd (lɛk pwɛl hat, wɔri).
• Bɔn ɛn lɔng prɔblɛm dɛn.
• Liva sirosis sik.
• Sεkכnd kεnsar dεm (e.g. lukimiya, limfoma, Ewing sarkoma).

Aw dɛn kin no LCH?

Yu pikin in dɔktɔ go aks yu pikin in mɛdikal istri fɔs ɛn du in bɔdi ɛgzam. Dɔn, dɛn go ɔda fɔ du sɔm tɛst dɛn dipen pan di sayn dɛn we yu pikin de gɛt. Dipen pan di rizɔlt fɔ dɛn tɛst ya, dɛn kin sɛn yu pikin to pikin dɛn ɛmatɔlɔjis/ɔnkɔlɔjis, we go kɔdinɛt yu pikin in tritmɛnt ɛn kia.

Us tɛst dɛn kin du fɔ no if pɔsin gɛt di sik?

Bikɔs LCH kin afɛkt difrɛn pat dɛn na di bɔdi, dɛn nid fɔ du bɔku tɛst fɔ no di sik kɔrɛkt wan.

• Blɔd tɛst dɛn:
• Kɔmplit blɔd kɔnt (CBC): Dis kin chɛk di pikin in rɛd blɔd sɛl, wayt blɔd sɛl, ɛn di pletlɛt lɛvɛl.
• Blɔd kemistri tɛst: Dɛn tin ya kin chɛk di lɛvɛl dɛn we sɔm tin dɛn we di bɔdi in ɔgan ɛn tisu dɛn kin pul kin kɔmɔt.
• di tεst dεm we di liva de wok: dεn ya de chεk di lεvεl dεm fכ di tin dεm we di liva de kכmכt.

• Test fɔ yu urine:
• Urinalysis: Dɛn kin chɛk di ɔmɔs rɛd blɔd sɛl, wayt blɔd sɛl, prɔtin, ɛn shuga we de na di pikin in urine.
• Tεst fכ wata dεprivεshכn: Dis de tεst aw di pikin de pis εn if di urine de kכnsantreyt we dεn nכ gi am wata.

• Bayɔpsi dɛn:
• Bayopsi: Dɔktɔ tek wan tisu sɛmpul, ɛn wan dɔktɔ we de mɛn sik dɛn kin luk am ɔnda maykroskɔp fɔ chɛk fɔ si if LCH sɛl dɛn de.
• di bon mכro aspirεshכn εn bayopsi: dεn kin yuz olo nidul fכ pul bon mכro, blכd, εn sכm bon we de na di pikin in hip bon. Wan dɔktɔ we de mɛn sik dɛn kin chɛk dis bak.

• Tɛst fɔ di jɛnɛtiks:
• dεn de yuz bכdi כ tisu sεmpl fכ chεk fכ chenj dεm na di (BRAF) jin.

• Di tɛst dɛn we dɛn kin du fɔ tek pikchɔ:
• X-ray: Dɛn kin tek pikchɔ dɛn bɔt di bon dɛn ɛn di ɔgan dɛn na di bɔdi. Sɔntɛnde, dɛn kin du wan skel sɔv fɔ di wan ol bɔdi fɔ luk fɔ tin dɛn we nɔ fayn.
• Bon skan: Dɛn kin injɛkt wan redioaktiv tin insay wan vein ɛn dɛn kin yuz skan fɔ luk fɔ di tin dɛn we nɔ de na di bon dɛn. Dɛn nɔ de yuz dis bɔku igen.
• CT scan (Computed tomography - CT scan): Dɛn kin gi di pikin spɛshal wata fɔ drink ɔ injɛkt am insay wan vein, ɛn dɛn kin tek ditayla pikchɔ dɛn frɔm difrɛn angul dɛn insay di bɔdi.
• Positron emission tomography (PET scan): Dɛn kin put smɔl redioaktiv shuga (glucose) insay wan vein, ɛn dɛn kin muv di skan rawnd di bɔdi fɔ tek pikchɔ usay dɛn de yuz di shuga. Di sɛl dɛn we gɛt sik kin sho brayt pan dis skan.
• MRI skan (Magnetic resonance imaging - MRI scan): Dɛn kin injɛkt wan tin we dɛn kɔl gadolinium insay wan vein ɛn dɛn kin tek sɔm ditayli pikchɔ dɛn bay we dɛn yuz magnet, redio wev, ɛn kɔmpyuta. Di say dɛn we sik kin tan lɛk se i brayt mɔ.
• Ultrasound: I de yuz sawnd wev dεm we gεt hכy εnεji fכ mek imej dεm fכ di insay pat na di bכdi bay we i de rεflek bak iko dεm frכm כgan dεm εn tisu dεm.

Aw dɛn kin trit LCH?

di tritmεnt fכ LCH dipכnt pan usay di LCH sεl dεm de na di pikin in bכdi εn if di sik na "lכw-risk" כ "high-risk."

Ɔgan dɛn we nɔ gɛt bɔku risk na:

• Kanda
• Bon
• Lɔng
• Di limf no dɛm
• Gεstrointestinal sistεm
• Pituitary gland we de na di bɔdi
• Tayrɔyd gland we dɛn kɔl
• Taymus we dɛn kɔl

Ɔgan dɛn we gɛt ay risk na:

• Liva
• Spleen we de na di bɔdi
• Bɔn mɛrɔ
• Sɛntral nɛv sistɛm (CNS) .

Dɔktɔ dɛn kin klas di kɔndishɔn (LCH) as "single-system LCH" ɛn "multi-system LCH." Dis min se:

• Singl-sistim (LCH): LCH sεl dεm de fכnshכn na wan pat nכmכ pan wan כgan כ bכdi sistεm. di kayn we we kכmכn pas כl na LCH we de afekt כnli di bon dεm.
• Multisystem (LCH): sεl dεm de insay tu כ mכr כgan dεm, כ כlsay na di bכdi (LCH). dis nכ kin kכmכn sכmtεm pas singl-sistεm (LCH).

Sɔm tɛm, mɔ di wan dɛn we de afɛkt di skin ɔ bon nɔmɔ (LCH), di sik kin sɔlv if dɛn nɔ gɛt ɛni tritmɛnt. If dɛn kayn tin ya apin, dɔktɔ dɛn go de wach di sik fɔ si if i kam bak ɔ i go skata.

(LCH) Tritmɛnt Opshɔn dɛn:

• Stɛroyd tɛrapi: Yu dɔktɔ kin yuz stɛroyd, lɛk prɛdnison, mɔ fɔ di skin LCH. dis dεm de ridyus di aktiviti fכ di wayt bכdi sεl dεm, we kin afekt di LCH sεl dεm bak.
• כpεrayshכn: dεn kin pul di LCH tכmכro dεm εn di tisu dεm we de rawnd am bay כpεrayshכn. wan prosidכs we dεn kכl curettage involv fכ skrap di LCH sεl dεm frכm di bon wit wan shap, spun lεk instrכmεnt (curette).
• Kimotɛrapi: Dis kin min fɔ gi di kansa sɛl dɛn mɛrɛsin fɔ mek dɛn nɔ gro. Dɛn kin kil di sɛl dɛn ɔ dɛn kin stɔp dɛn fɔ sheb. Dɛn kin tek dɛn mɛrɛsin ya bay mɔt, dɛn kin put dɛn na wan vein ɔ mɔsul, ɔ sɔntɛnde dɛn kin put dɛn na di skin lɛk krim.
• Radieshɔn tɛrapi: Dɛn kin yuz ɛkstrem rayt ɔ ɔda kayn raytin we gɛt bɔku ɛnaji fɔ kil di kansa sɛl dɛn ɔ fɔ stɔp dɛn fɔ gro ɛn sheb.
• Immunotherapy: Na we fɔ yuz di pikin in yon imyun sistɛm fɔ fɛt kansa. Di bɔdi in natura difens dɛn kin strɔng bay we dɛn yuz tin dɛn we di bɔdi insɛf mek ɔ di wan dɛn we dɛn mek na lɛbɔtri.
• Targeted therapy: Yuz drɔgs ɔ ɔda tin fɔ no ɛn atak sɔm patikyula kansa sɛl dɛm. fכ egzampl, dεn dεm we dεn kכl BRAF inhibito kin kil di kεnsar sεl dεm bay we dεn de blכk di protin dεm we dεn nid fכ mek di sεl gro. monoklonal antibodi dεm na imyun sistεm protin dεm we dεn mek na di lab.
• Stem sel transplant: Transplant nyu sɛl dɛn fɔ tek ples fɔ di sɛl dɛn we de mek blɔd we dɛn dɔn pwɛl bay kemotɛrapi.

Yu tink se dɛn kin ebul fɔ stɔp LCH?

LCH na big tin we pɔsin kin ebul fɔ avɔyd bikɔs na wan jɛnɛtik muteshɔn kin mek am. Wi nɔ kin ebul fɔ kɔntrol sɔm tin dɛn we kin mek wi gɛt prɔblɛm, lɛk di famili istri ɛn di trayb we wi kɔmɔt. Bɔt sɔm tin dɛn de we wi kin ebul fɔ kɔntrol:

• Nɔ smok.
• Fɔ avɔyd sɔm bad bad kemikal dɛn we yu gɛt bɛlɛ.
• Fɔ gɛt ɔl di vaysin dɛn we dɛn dɔn rɛkɔmɛnd.

Wetin na di prɔgnosis fɔ (LCH)?

Di luk fɔ LCH dipen pan sɔm tin dɛn:

• Ɔmɔs bɔdi sistɛm ɔ ɔgan dɛn kin afɛkt?
• Us bɔdi sistɛm ɔ ɔgan dɛn de afɛkt.
• Aw di sik kin ansa fayn to tritmɛnt.

jεnarali, pikin dεm we gεt singl-sistεm (LCH) εn mכltisistεm (LCH) we nכ de afekt di liva, splin, כ bon mכro de fכl insay di "lכw-risk" kεtכgrεf. Wit tritmɛnt, pikin dɛm we de na dis kategori gɛt klos to 100% chans fɔ liv. Bɔt di sik kin kam bak ɛn/ɔr kin gɛt ɔda prɔblɛm dɛn we kin te fɔ lɔng tɛm.

Pikin dεm we gεt mכltisistεmik lukimiya (LCH) we de afekt di liva, splin, כ bon mכro de fכl insay di "high risk" kεtכgrεf.

Ustɛm mi pikin fɔ go to dɔktɔ?

Ivin afta yu pikin dɔn dɔn di tritmɛnt, di dɔktɔ go nid fɔ si yu pikin ɔltɛm. Dis na bikɔs di risk fɔ mek di sik kam bak kin bɔku. So, dɛn go nid fɔ de wach yu pikin fɔ sɔm ia. We dɛn de du dɛn fɔlɔp tɛst ya, dɛn go nid fɔ ripit di sem tɛst dɛn we dɛn bin du we dɛn no se di pikin gɛt di sik, lɛk ɔltra saund, MRI, CT skan, ɛn PET skan. Di dɔktɔ go tɛl yu ɔmɔs tɛm yu fɔ briŋ yu pikin kam.

Us kwɛstyɔn dɛn a fɔ aks mi pikin in dɔktɔ?

Yu kin gɛt bɔku kwɛstyɔn bɔt aw yu pikin gɛt di sik. I fayn fɔ rayt dɛn ɛn kam wit dɛn na yu nɛks dɔktɔ apɔntinmɛnt. Na sɔm kwɛstyɔn dɛn we yu kin aks:

• Aw di Langerhans sel histiocytosis go afɛkt mi pikin?
• Mi pikin nid tritmɛnt?
• Us tritmɛnt dɛn de fɔ mi pikin?
• Wetin na di sayd ɛfɛkt dɛm we di tritmɛnt kin gɛt?
• Yu tink se mi pikin go wɛl kpatakpata wit dɛn tritmɛnt ya?
• Wetin na di lukin-grɔn fɔ mi pikin in sik?
• Ɛni sɔpɔt grup dɛn de we yu go rɛkɔmɛnd?

Fɔ dɔn, wan Mɛsej we dɛn kin kɛr go na os

Langerhans Cell Histiocytosis (LCH) na wan sik we nɔ kin apin so ɔltɛm we kin afɛkt pikin dɛn bɔku tɛm. If yu pikin de go tru dis, yu kin fil bɔku bɔku tin dɛn. Yu kin fil bad ɛn fred fɔ yu pikin. Yu kin rili fred insay, bɔt yu kin tray fɔ strɔng na do. Ɔl di we aw yu de fil na tru. Bɔt mɛmba se yu nɔ nid fɔ go tru dis waka yu wan. Yu pikin in mɛdikal tim no wetin yu de go tru. Dɛn de fɔ ɛp yu ɛvri step na di rod, fɔ ɔndastand yu pikin in kɔndishɔn, ɛn fɔ gi yu trɛnk fɔ bia wit di prɔblɛm.

Mɛmba se if yu no di sik kwik kwik wan ɛn trit yu pikin fayn, dat kin mek yu gɛt bɛtɛ wɛlbɔdi. Nɔ fred, fes dis wit kɔrej.

` Langerhans Cell Histiocytosis, LCH, pikin dεm, kεnsar, jεnεtik mכtεshכn, simptom dεm, tritmεnt