Wan sik wae nɔr kin bɔrku wae kin afɛkt di bren: Yu no bɔt PML? (Progresiv Maltifokal Lukoɛnsɛfalɔpati - PML)

Yu dɔn ɛva yɛri bɔt wan sik we dɛn kɔl PML (Progressive Multifocal Leukoencephalopathy)? Sɔntɛm yu nɔ sabi dis nem. Di rizin na dat PML na wan infekshɔn we nɔ kin apin so ɔltɛm we kin afɛkt wi bren. Wetin kin apin pan dis na dat di sɛl dɛn we de mek maylin, we na wan tin we de protɛkt rawnd di nɛv sɛl dɛn na wi bren, kin pwɛl smɔl smɔl. Maylin na sɔntin we tan lɛk ɔyl. dis na wetin de protεkt di nyuron dεm na di bren εn di spεnal kכd (wi sεntri nεv sεstem). So we dis maylin dɔn lɔs, di wayt tin we de na di bren kin pwɛl.

Wetin di nem PML min?

Naw lɛ wi si wetin di lɛta dɛn we de na di nem PML min. We yu ɔndastand dis, dat go mek yu no bɔt di sik.

• P — Progressive: Dis min se di sik de wɔs smɔl smɔl . Dis min se di sayn dɛm kin bɔku as tɛm de go.
• M — Multifocal: Dis min se di sik nɔ de jɔs de na wan eria na di bren, bɔt i de afɛkt bɔku say dɛn . I tan lɛk se smɔl smɔl lɛsin dɛn de na bɔku say dɛn na di bren.
• L — Leukoencephalopathy: Dis wɔd de sawnd smɔl kɔmplikɛt, nɔto so? Fɔ tɔk am simpul wan, i min se di sik kin mɔna di maylin ɔ wayt tin we de na di bren .

So, PML de mek di bren pwɛl. Dis damej kin mek yu gɛt difrɛn kayn nyurolɔjik prɔblɛm dɛn. Fɔ ɛgzampul, i nɔ kin ebul fɔ tink gud wan, i nɔ kin si fayn, ɛn i nɔ kin izi fɔ waka. Bikɔs PML na sik we de go bifo, i kin wɔs as tɛm de go. Bɔt fɔ sɔm pipul dɛn, tritmɛnt kwik kin mek di sik nɔ go bifo kwik kwik wan.

Wetin na di fɔs sayn dɛm fɔ PML?

Fɔ bɔku pipul dɛn, di sayn dɛm fɔ PML kin bigin fɔ rili shɔt. Dɔn bak, di sayn dɛm kin difrɛn difrɛn wan bay us pat na di bren we di infekshɔn afɛkt. Tink bɔt am lɛk we wan tik in branch day, ɔl di ɔda tin dɛn we de na da branch de kin stɔp fɔ wok.

Di fɔs sayn dɛm fɔ PML kin bi:

• Klɔmsi ɔ nɔ gɛt kɔdineshɔn
• I nɔ izi fɔ tɔk ɔ tink
• Fɔ fil wik na di bɔdi

As di infekshɔn de go bifo, yu kin gɛt sɔm sayn dɛn bak lɛk:

• Dimɛnshɔn, we pɔsin nɔ de mɛmba fayn
• Nɔ ebul fɔ tɔk
• We pɔsin nɔ de si fayn igen
• Di we aw pɔsin de biev ɛn di pɔsin we i bi kin chenj

Sɔm pipul dɛn kin gɛt ed we de at ɔr kin gɛt sik bak, bɔt dis nɔ kin apin so ɔltɛm. I sɔri fɔ no se, PML kin wɔs as tɛm de go, ɛnBɔku tɛm, i kin kil pɔsin. Bɔt di tin dɛn we kin apin kin difrɛn fɔ di sikman in ɔndalayn mɛdikal kɔndishɔn ɛn aw i kin biev to di tritmɛnt.

Wetin kin mek pɔsin gɛt PML?

PML na wan vayrɔs we dɛn kɔl JC vayrɔs (JCV) . Dɛn gi di vayrɔs in nem afta di fɔs lɛta na di nem fɔ di pɔsin we bin gɛt di vayrɔs fɔs (John Cunningham). Dɛn kin kɔl dis vayrɔs bak human polyomavirus 2.

I sɔprayz fɔ no se lɛk 85% pan di big pipul dɛn gɛt di JC vayrɔs na dɛn bɔdi. Bɔt masta sabi pipul dɛn stil nɔ shɔ aw di vayrɔs kin pas to pipul dɛn. Sɔm pruf de fɔ se pikin dɛn kin gɛt am tru it ɔ wata. Dɛn dɔn si di vayrɔs bak pan urine test. So, i posibul se i kin pas tru urine-oral contamination.

Bɔt pan ɔl we bɔku pipul dɛn gɛt di JC vayrɔs na dɛn bɔdi, i nɔ kin bi aktif, i jɔs de slip. So, no sayn nɔ de apin. Bɔt pan pɔsin we in imyun sistɛm wik, dis vayrɔs kin bi aktif na di bɔdi ɛn divɛlɔp to PML. I tan lɛk ɛnimi we de slip we de wek ɛn atak wi we wi wik.

Udat de pan denja fɔ gɛt dis sik?

PML kin apin nɔmɔ pan pipul dɛn we gɛt rili wik imyun sistɛm. Yu kin gɛt dis sik bak if yu gɛt ɛni wan pan dɛn tin ya:

• HIV/AIDS infɛkshɔn
• Kansa na di blɔd ɛn bon mɛro, fɔ ɛgzampul, lukimiya
• Kansa na di limfatik sistɛm, fɔ ɛgzampul, limfoma ɔ Hodgkin sik
• Di sik dɛn we pɔsin kin gɛt we i de fɛt insɛf, lɛk rεumatoid at, mכltipl sklεrosis (MS), ɔ lupus

Dɔn bak, if yu na pɔsin we de gi yu ɔgan ɛn yu de tek mɛrɛsin dɛn we de mek yu bɔdi nɔ gri fɔ tek di ɔgan, yu kin de pan denja bak.

Aw dɔktɔ dɛn kin no se pɔsin gɛt PML?

Yu dɔktɔ go fɔs chɛk yu ɛn tek tɛm lisin to yu sayn dɛn. Dɔn, dɛn kin kɔnfɔm PML bay we dɛn de du sɔm tɛst dɛn we de chɛk yu bren ɛn yu spɛnal kɔd. Yu kin nid fɔ gɛt tɛst dɛn lɛk dɛn wan ya:

• Bren MRI skan: Dis kin tek pikchɔ fɔ di lɛsin dɛn we de na di wayt tin na di bren. I tan lɛk kamɛra we de luk insay di bren.
• spεnal tap/lכmba pankshכn: Dis min fכ tek sכm sכm sכm sכm sכm sכm sכm sכm sכm sכm sכmtin dεm we de fכm yu sεribrospεnal fכluid (CSF), di wata we de rawnd yu bren εn spεnal kכd. Dis kin chɛk fɔ si if di JC vayrɔs de.
• Bren bayɔpsi: Dɛn nɔ kin du dis. Dɛn kin du am nɔmɔ we i at fɔ kɔnfɔm di diagnosis.

Aw dɛn kin trit PML?

Di men tin we yu fɔ pe atɛnshɔn pan fɔ trit PML na fɔ mek yu imyun sistɛm strɔng. Mɛmba se sik kin apin we wi bɔdi nɔ ebul fɔ fɛt. So, di tin we impɔtant pas ɔl na fɔ mek da difens de strɔng bak.

• Fɔ ɛgzampul, if yu gɛt AIDS, dɛn kin gi yu antiretroviral therapy (ART) . Dɛn mɛrɛsin ya de wok bay we dɛn de ridyus di HIV na yu bɔdi. Dis tritmɛnt kin ɛp yu imyun sistɛm fɔ wok to sɔm mak.
• Sɔm pipul dɛn kin bɛnifit bak frɔm wan tritmɛnt we dɛn kɔl plasma exchange . Dis tritmɛnt de pul sɔm pan di mɛrɛsin dɛn we de mek yu bɔdi nɔ gɛt bɛtɛ wɛlbɔdi na yu blɔd. Dis tritmɛnt kin ɛp yu imyun sistɛm bak fɔ fɛt di JC vayrɔs bay we i de mek i wok fayn fayn wan.

Naw, sayɛnsman dɛn de tɛst bɔku nyu mɛrɛsin dɛn fɔ mɛn PML. Di US Food and Drug Administration (FDA) dɔn gi spɛshal permishɔn fɔ sɔm pipul dɛn fɔ yuz dɛn mɛrɛsin ya, bɔt di rizɔlt dɛn nɔ miks.

Ustɛm a fɔ go to dɔktɔ?

If yu no se yu imyun sistɛm wik ɛn yu fil lɛk se yu de gɛt sɔm kayn sik dɛn we yu tink se kin gɛt fɔ du wit Progressive Multifocal Leukoencephalopathy (PML), i rili impɔtant fɔ go to dɔktɔ wantɛm wantɛm ɛn chɛk yu.

Us kwɛstyɔn dɛn a fɔ aks mi dɔktɔ?

We yu go to yu dɔktɔ, yu kin aks kwɛstyɔn dɛn lɛk dɛn wan ya:

• Wetin na mi risk fɔ gɛt PML?
• Ɛnitin de we a go du fɔ ridyus dis risk?
• Us simptom dɛm a fɔ luk fɔ pan PML?
• Wetin na di prɔblɛm dɛn we kin apin we pɔsin tek di mɛrɛsin dɛn we de mek pɔsin nɔ ebul fɔ fɛt di sik?
• Ɔda tritmɛnt dɛn de fɔ mi sik?
• Wetin na di prɔblɛm ɛn bɛnifit dɛn we dɛn kin gɛt we dɛn de trit dɛn naw?

We yu aks dɛn kwɛstyɔn ya, yu go ɔndastand di sik ɛn aw fɔ trit am fayn fayn wan.

Wetin na di layf we pɔsin we gɛt PML kin liv?

Dis na tɔpik we rili at fɔ tɔk bɔt. PML na sik we de go bifo. Dis min se di sayn dɛm kin wɔs as tɛm de go. Di layf we pɔsin we gɛt PML kin liv kin dipen pan aw di sik kin tranga ɛn di tritmɛnt we dɛn kin gɛt. Bitwin 30% ɛn 50% pan pipul dɛm kin day insay di fɔs mɔnt afta dɛn dɔn no se dɛn gɛt di sik. Pipul wae de liv lɔng kin kɔntinyu fɔ gɛt de sik, ɛn dɛn sayn dɛn de kin wɔs. Dɛn sayn ya kin mek yu gɛt siriɔs prɔblɛm, lɛk wae yu nɔr de tɔk fayn ɛn yu nɔr de si fayn fayn wan.

Bɔt nyu stɔdi dɔn sho se smɔl nɔmba pan pipul dɛm wae gɛt HIV-infected PML kin mek dɛn sik stebul ɛn liv lɔng. Bifo dɛn kam wit antiretroviral therapy (ART) fɔ trit HIV infɛkshɔn, na 10% pan di pipul dɛn we gɛt PML bin liv pas wan ia. Naw, wit ART, di wan ia sɔvayv rɛt dɔn go ɔp to 50%. Sɔntɛnde, ART kin ɛp di imyun sistɛm fɔ fɛt di JC vayrɔs.

I pɔsibul fɔ mek yu wɛl ɔltogɛda frɔm PML?

Pipul dεm wae gεt PML wae dεn de tek immunosuppressant dεm kin bכn afta dεn stכp dεn dεm. Pipul dɛm wae dɔn trit fayn fayn wan wit ART kin wɛl bak frɔm PML. Bɔt 80% pan di pipul dɛm wae de liv frɔm PML nɔr kin gɛt dɛn sik kam bak. dis na biכs nyu maylin nכ de prodyuz na di εria dεm we dεn dכn pwεl. Pɔrmɛnt nyurolɔjik damej na kɔmɔn tin. Bɔt sɔm pipul dɛn kin liv te to 15 ia afta PML dɔn klia.

Wetin na di ɛkspɛkteshɔn fɔ di wan dɛn we de du plasma ɛkshɛnj?

If yu PML simptom dɛn bigin bikɔs ɔf wan mɛrɛsin we de stɔp yu bɔdi, yu sik kin go wans yu dɔn stɔp fɔ tek da mɛrɛsin de. Yu kin gɛt plasma ɛkshɛnj bak fɔ pul sɔm pan di mɛrɛsin dɛn we de mek yu bɔdi nɔ gɛt bɛtɛ wɛlbɔdi. Di gol fɔ chenj plasma na fɔ mek yu imyun sistɛm go bifo. Fɔ sɔm pipul dɛm, plasma exchange kin slo di prɔgrɛs fɔ PML ɛn lɔng layf. Bɔt dɛn nɔ ɔndastand gud gud wan yet di bɛnifit dɛn we dis kin gɛt.

Bɔku pipul dɛn kin kɔntinyu fɔ gɛt sayn dɛm fɔ PML afta dɛn dɔn stɔp fɔ tek mɛrɛsin ɔ afta dɛn dɔn gɛt plasma ɛkshɛnj. Ɔda pipul dɛn kin gɛt prɔblɛm wit dɛn nyurolɔjik. Ɔda prɔblɛm dɛn de bak we pɔsin kin gɛt we i stɔp fɔ tek wan mɛrɛsin. So, e fayn fɔ tɔk to yu dɔktɔ we yu de disayd bɔt yu mɛrɛsin dɛn.

Aw a go no if a de pan denja fɔ gɛt Progressive Multifocal Leukoencephalopathy (PML)?

If yu gɛt wan sik we de mek yu imyun sistɛm wik, aks yu dɔktɔ bɔt yu risk fɔ gɛt PML.

Ɔda mɛrɛsin dɛn kin mek a gɛt PML?

Pipul wae gɛt sik lɛk multiple sclerosis (MS) ɔ Crohn’s disease fɔ gɛt blɔd tɛst bak fɔ chɛk fɔ si if dɛn gɛt kɔndishɔn lɛk HIV we de mek dɛn gɛt JC vayrɔs infɛkshɔn.

Bɔku tɛm, dɔktɔ dɛn kin gi dɛn wan mɛrɛsin we dɛn kɔl Natalizumab (Tysabri®) fɔ mɛn MS ɔ Crohn’s disease. Dis drɔg kin mek di risk fɔ gɛt PML bɔku.

Ivin if yu gɛt inaktiv JC vayrɔs ɛn nɔ gɛt ɛni simptom, yu kin ebul fɔ tek natalizumab. Bɔt i impɔtant fɔ tɔk to yu dɔktɔ bɔt di bad tin dɛn we kin apin ɛn di bɛnifit dɛn we i kin gɛt.

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

Progressive Multifocal Leukoencephalopathy (PML) na wan rare bren infεkshכn we de kכz fכ di riaktivεshכn fכ di JC vayrus. Bɔrku pipul dɛn gɛt di JC vayrɔs we de slip na dɛn bɔdi. I nɔ de kɔz ɛni bad tin to pipul dɛn we nɔ gɛt wikɛd imyun sistɛm.

If yu gɛt wik imyun sistɛm, i impɔtant fɔ no bɔt di sayn dɛm fɔ PML ɛn wok wit yu dɔktɔ fɔ du dat.

Dis sik kin wɔs as tɛm de go. Bɔt sɔm tritmɛnt dɛn de we kin ɛp fɔ mek di sik nɔ go bifo kwik kwik wan ɛn mek yu liv lɔng. So, nɔ giv ɔp fɔ op. Di tin we impɔtant pas ɔl na fɔ go to dɔktɔ kwik kwik wan.

` PML, Progresiv Multifocal Leukoencephalopathy, JC vayrus, bren infεkshכn, imyun sistεm, nyurolכjik sik dεm, maylin