Yu no bɔt Takayasu in Arteritis? Lɛ wi tɔk bɔt am!

Yu dɔn ɛva yɛri bɔt wan sik we dɛn kɔl Takayasu in Arteritis? Di nem kin tan lɛk se i strenj smɔl, nɔto so? Bɔt na wan sik we nɔ kin apin so ɔltɛm we kin afɛkt wi blɔd vesel dɛm, mɔ di big big blɔd vesel dɛm we de stat na di at ɛn di branch dɛm we de branch frɔm am. Sɔntɛnde dɛn kin kɔl am bak ‘pulseless disease.’ Tide, wi go tɔk bɔt am ditayli, rili simpul, so dat yusɛf go ɔndastand am mɔ.

Wetin rili na Takayasu in Arteritis?

Fɔ tɔk am simpul wan, Takayasu in at na inflamɛns na wi blɔd vesel dɛm, we min se wi de swel ɔ inflamɛns (vasculitis). I kin afɛkt di big big blɔd vesel dɛn na wi bɔdi mɔ. Tink bɔt am, di men blɔd vesel we de kɛr blɔd we gɛt ɔksijɛn frɔm wi at to di wan ol bɔdi, we wi kɔl di ‘great aorta’ ɔ ‘aorta’. Dis sik kin mɔs afɛkt di aorta, ɛn di ɔda big blɔd vesel dɛn we de branch frɔm am ɛn kɛr blɔd go na wi an, nɛk, ɛn bren. Yu no wetin kin apin we dis inflamɛns kin apin? Di wɔl dɛn na wi blɔd vesel dɛn kin pwɛl. Dɔn sɔm pat dɛn pan dɛn blɔd vesel dɛn de kin wik ɛn dɛn kin bɔl lɛk balɔ. Wi kin kɔl dis ‘aneurysm’. Dɔn bak, di blɔd vesel dɛn kin swel ɛn smɔl. Dɔn dɛn kin stɔp di blɔd fɔ flɔ. sכmtεm wan bכdi kin blok kכmplit wan, we dεn kכl am ‘oklushכn’. Na smɔl tɛm nɔmɔ, dis sik kin afɛkt bak di at dɛn we de gi blɔd to di at, intestinal, kidni, ɛn leg.

Udat dɛn dis kayn tin kin afɛkt mɔ?

Takayasu in Arteritis (TAK) na wan sik wae kin afɛkt yɔŋ pipul dɛm bɔrku tɛm. I kin pasmak pan uman dɛm wae ol bitwin 20 ɛn 40. Bɔrku tɛm de sik pipul dɛm kin ol bitwin 15 ɛn 35 ia wae dɛn no se dɛn gɛt dis sik. Na lɛk 80% to 90% pan di wan dɛm wae gɛt dis sik na uman dɛm. Dɔktɔ dɛn kin si dis sik mɔ na kɔntri dɛn lɛk Jepan ɛn pipul dɛn we kɔmɔt na Mɛksiko, Indian, ɛn Is Eshia. Ivin na kɔntri dɛn lɛk Amɛrika, na tu to tri nyu pipul dɛn nɔmɔ kin gɛt dis sik ɛvri ia. Dis min se na wan sik wae nɔr kin bɔrku.

Aw di at we Takayasu gɛt kin afɛkt mi bɔdi?

We di blɔd vesel dɛn kin smɔl, di blɔd we kin rich na di ɔgan ɛn tisu dɛn we dɛn blɔd vesel dɛn de gi kin go dɔŋ. Tink bɔt am lɛk wata paip we dɔn lɔk, we de mek di wata we de pas nɔ bɔku. Bɔt pan Takayasu in at (TAK), dɛn chenj ya kin apin smɔl smɔl ɛn smɔl smɔl. So wi bɔdi gɛt tɛm fɔ yus fɔ kɛr blɔd tru ɔda we dɛn. Dɛn ɔda rod dɛn ya tan lɛk di smɔl smɔl baypas dɛn we wi kin yuz we dɛn blok wan men rod. Bɔt dɛn baypas ya nɔ kin ebul fɔ kɛr bɔku blɔd lɛk di fɔs big blɔd vesel. Nɔmal wan, di blɔd we de flɔ pas di blɔk na inf fɔ gi di tisu dɛn di smɔl ɔksijɛn ɛn blɔd we dɛn nid fɔ liv. Bɔt i nɔ kin apin so ɔltɛm, if dɛn ɔda blɔd vesel ya nɔ de wok fayn, di tisu dɛn kin day bikɔs dɛn nɔ gɛt ɔksijɛn ɛn blɔd.

Wetin na di sayn dɛm fɔ dis sik?

Sɔm pipul dɛm wae gɛt Takayasu arteritis (TAK) nɔr kin gɛt ɛni sayn. Bɔt lɛk af pan di sik pipul dɛn kin gɛt jenɛral malaise ɛn wik. Di fɔs sayn dɛm (stej 1): Dis na di sayn dɛm wae de sho wae de sik bigin:

• Fiva.
• Fɔ fil se yu taya bad bad wan ( Fatigue ).
• Mɔsul ɛn jɔyn dɛn pen .
• Fɔd nɔ kin te .

Leta stej simptom dεm (stej 2): As di sik de go bifo, simptom dεm lεk dis kin sho:

• Chɛst pen .
• I nɔ kin izi fɔ yu fɔ blo .
• Ed de at .
• Fɔ fil se yu gɛt diziz.

Di sayn dɛm we kin kam bikɔs di blɔd vesel dɛn kin smɔl ɛn di blɔd nɔ kin gɛt bɛtɛ blɔd:

• Taya, pen, ɔ kramp na yu an ɛn fut.
• Bɛlɛ de pen bikɔs di blɔd nɔ de flɔ na di intestinal.
• di ay blɔd prɛshɔn bikɔs di blɔd nɔ de flɔ na di kidni dɛn.
• Stroke (dis kin rili rare).
• At atak (dis bak nɔ kin apin so ɔltɛm).

Wetin bin mek Takayasu gɛt at at?

Infakt, nɔbɔdi nɔ no di rayt tin we kin mek pɔsin gɛt Takayasu in at (TAK).. Bɔt dɔktɔ ɛn risach pipul dɛn tink se i kin bi ‘ɔtoimyun kɔndishɔn’. Dat min se, wi bɔdi in imyun sistɛm we de fɛt sik, kin mistek atak in yon wɛlbɔdi tisu dɛn. I tan lɛk se wi yon difens de ambɔg wi. Sɔm pipul dɛn we de stɔdi bɔt dis kin tink se sɔm tin dɛn we kin apin to Takayasu in at, kin kɔmɔt frɔm wan jin we dɛn mama ɛn papa ɔl tu gɛt. Dɛn mama ɛn papa dɛn de nɔ kin gɛt di sik, bikɔs na wan kɔpi nɔmɔ dɛn kin kɛr di jin. Bɔt if yu gɛt da patikyula jin de frɔm yu mama ɛn papa, yu kin gɛt di sik ɛn di sayn dɛn we i kin gɛt.

Aw dɛn kin no dis sik?

Yu dɔktɔ go no se Takayasu gɛt at at bay we i luk sɔm tin dɛn togɛda, nɔto jɔs wan.

• Wan kɔmplit mɛdikal istri ɛn fɔ chɛk yu bɔdi: Dɛn kin du dis fɔ mek yu nɔ gɛt ɔda sik dɛn we gɛt di sem sayn dɛn we yu gɛt. We yu dɔktɔ yuz stetɔskɔp fɔ chɛk yu blɔd vesel, dɛn kin yɛri wan sawnd we nɔ kɔmɔn we dɛn kɔl ‘bruit’ insay di blɔd vesel. We di blɔd vesel dɛn tu smɔl, i kin at fɔ mek blɔd flɔ tru dɛn, we na di tɛm we dɛn kin yɛri di sawnd.
• X-ray: Dɛn wan ya de sho usay yu at dɔn pwɛl ɛn aw di at dɔn pwɛl.
• Tεst dεm fכ no se di blכd vεsul dεm כ anεrizm dεm dכn sכmtεm: Difrεn we dεn de fכ tεst fכ dis.

Wetin na di tɛst dɛn we dɛn kin du fɔ no if pɔsin gɛt sik?

Bɔku tɛst dɛn de we kin ɛp di dɔktɔ fɔ no if pɔsin gɛt di sik:

• Magnetic Resonance Imaging (MRI): Dis na tɛst we dɛn nɔ de yuz ɛkstrem rayt. Dɛn kin yuz big magnet, ilɛktromagnetik ɛnaji wev, ɛn kɔmpyuta fɔ mek di pikchɔ dɛn.
• Computed Tomography (CT) scan: X-ray ɛn kɔmpyuta kin mek pikchɔ dɛn bɔt di ɔgan dɛn we de insay, inklud big blɔd vesel dɛn.
• Angiography: Dis min se yu fɔ tek ɛkstrem pikchɔ dɛn we de insay yu blɔd vesel dɛn. Yu dɔktɔ kin put wan tint, lɔng tiub we dɛn kɔl kateta insay wan big at we de na yu groin ɔ yu an ɛn gayd am go ɔp to di at we nid fɔ chɛk. Dɔn, dɛn kin put wan spɛshal day (kɔntrast matirial) tru di kateshɔn insay di blɔd vesel. We dɛn tek ɛkstrem rayt, di day kin mek di blɔd vesel dɛn sho klia wan na di pikchɔ dɛn. Sɔntɛnde, dɛn kin yuz MRI bak fɔ du angiografi.
• Positron Emission Tomography (PET scan): Insay dis tɛst, yu dɔktɔ kin injɛkt wan redioaktiv tin tru wan nidul insay wan vein na yu an. As di tin de travul na yu bɔdi, wan skan mashin de no am ɛn mek pikchɔ dɛn.
• Ultrasound: Dis kin ɛp fɔ mek pikchɔ dɛn fɔ di blɔd vesel dɛn we dɛn de yuz sawnd wev.

Aw dɛn kin trit Takayasu in at at?

Mɛrɛsin kin kɔntrol di inflamɛns, ɔ inflamɛns. Bɔt sɔm pipul dɛn kin nid ɔpreshɔn fɔ mek dɛn nɔ ebul fɔ pas di blɔd vesel we dɔn blok ɛn mek nyu rod fɔ mek blɔd go. Kɔtikosterɔyd: Kɔtikosterɔyd, lɛk prɛdnison (e.g., Rayos®, Sterapred®) ɔ prɛdnisolon (e.g., Flo-Pred®, Orapred®), na di tritmɛnt dɛn we dɛn kin yuz mɔ fɔ Takayasu in atraytis (TAK).

Dɛn mɛrɛsin ya kin du wɔndaful tin fɔ pul di aktif inflamɛns na di blɔd vesel dɛm ɛn put di sik na rɛmishɔn.

Yu dɔktɔ go ridyus di doz fɔ prednisone smɔl smɔl to di doz we go wok fayn pas ɔl fɔ mek i nɔ gɛt bɔku sayd ɛfɛkt dɛn. Sɔm pipul dɛn kin stɔp fɔ tek di mɛrɛsin smɔl smɔl ɛn dɛn nɔ kin gɛt di sik bak. Bɔt dɛn kɔtikosterɔyd ya nɔ kin wok fɔ sɔm pipul dɛn ɔl. Dɔn bak, pas af pan di pipul dɛm wae de tek dɛn mɛrɛsin ya kin gɛt di sik bak ɔr dɛn sik kin wɔs. Immunosuppressive medications: Dɔktɔ dɛn kin gi mɛrɛsin bak we de stɔp di imyun sistɛm, lɛk:

• Mεtotreksεt (e.g. Riumatrεks®, Trεksal®) .
• Azatioprin (e.g. Imuran®, Azasan®) we de mek pɔsin gɛt di sik.
• Maykofenolayt (e.g. Sɛlsɛpt®, Mayfɔtik®) .
• Leflunomide we dɛn kɔl
• Sayklɔfosfamid

We dɛn yuz dɛn immunosuppressant ya wit prednisone, lɛk 50% pan di pipul dɛn we bin dɔn gɛt flawa bifo kin gɛt dɛn simptom dɛn we dɔn sɔlv ɛn smɔl smɔl dɛn kin stɔp fɔ tek prednisone. Tumor-Necrosis Factor (TNF) inhibitors: Dɛn kin gi sɔm pipul dɛn mɛrɛsin bak we dɛn kɔl TNF inhibitors fɔ ɛp fɔ fɛt inflamɛns. Sɔm ɛgzampul dɛn bɔt dɛn tin ya na:

• Etanercept we dɛn kɔl Etanercept
• Infliximab we gɛt di sik
• Tosilizumab we dɛn kɔl tosilizumab

Ɔl togɛda, lɛk 25% pan di pipul dɛn we gɛt Takayasu in at nɔ kin ebul fɔ kɔntrol di sik ful wan if dɛn nɔ kɔntinyu fɔ tek mɛrɛsin.

Wetin na di sayd ɛfɛkt dɛm we di tritmɛnt kin gɛt?

Di mɛrɛsin dɛm wae dɛn kin yuse fɔ trit Takayasu in at kin gɛt sɔm siriɔs sayd ɛfɛkt dɛm. Bɔt ɔda mɛrɛsin dɛn kin ɛp fɔ kɔntrol dɛn bad bad tin ya. Di sayd ɛfɛkt dɛn kin bi:

• Di rεsistεns to infεkshכn dεm dεn dכn dכn.
• Di bon mas we de dכn (כstioporosis).
• I nɔ izi fɔ si.
• Di sik dɛn we kin mek pɔsin sik.

Kɔtikosterɔyd kin bigin fɔ wok insay sɔm awa afta yu bigin fɔ trit yu, so yu kin fil fri kwik kwik wan.

Us ɔda tritmɛnt dɛn dɛn kin yuz?

Sɔntɛnde, di ay blɔd prɛshɔn (haypa prɛshɔn) kin kam bikɔs di at dɛn we de go na di kidni dɛn kin smɔl. If na so i bi, di dɔktɔ kin yuz sɔntin lɛk balyɔn fɔ mek di blɔd vesel we dɔn smɔl, big, we dɛn kɔl angioplasty. Ɔ, dɛn kin du baypas ɔpreshɔn fɔ mek blɔd flɔ nɔmal wan to di kidni dɛn. Dis kin ɛp fɔ mek yu blɔd prɛshɔn nɔmal we yu nɔ tek mɛrɛsin fɔ ay blɔd prɛshɔn. Sɔm pipul dɛn kin gɛt siriɔs prɔblɛm wit di blɔd vesel dɛn we kin smɔl na dɛn an ɔ leg, we kin mek i nɔ izi fɔ waka ɔ du ɔda tin dɛn. Baypas ɔpreshɔn kin kɔrɛkt dɛn prɔblɛm ya bak. If aneurism de, dɛn kin mek am bak wit ɔpreshɔn ɔ baypas. Sɔm pipul dɛm wae gɛt Takayasu in arteritis kin nid bak fɔ gɛt aorta valv riplesmɛnt.

Aw a kin kia fɔ misɛf?

Bɔrku pipul dɛm wae gɛt Takayasu in at at sik kin gɛt ay blɔd prɛshɔn bak (haypa blɔd prɛshɔn). I impɔtant fɔ kɔntrol dis. If yu nɔr de trit ay blɔd prɛshɔn, tin lɛk dis kin apin:

• Strok.
• At sik.
• Kidni we nɔ de wok fayn.

If yu tek mɛrɛsin dɛn we de stɔp yu imyun sistɛm, tink bɔt fɔ gɛt dɛn vaysin ya fɔ protɛkt yu frɔm infɛkshɔn:

• Vaysin fɔ flu.
• Nyumonia vaysin.
• Hɛpi zosta (Shingles) vaysin.

Wetin pɔsin we gɛt Takayasu in at kin ɛkspɛkt?

Pan ɔl we no mɛrɛsin nɔ de fɔ Takayasu in at, na sik we pɔsin kin mɛn. Bɔrku pipul dɛm wae gɛt dis sik kin wɛl wit tritmɛnt. Bɔt bɔku pipul dɛn kin gɛt disabled to sɔm mak, ɔr nɔr kin gɛt disabled ɔlsay, bikɔs ɔf dis sik. Di ifɛkt dɛm wae de sik kin gɛt kin gɛt bɔrku impak pan di tin dɛm wae dɛn kin du ɛvride. Na lɛk af pan di pipul dɛm wae gɛt Takayasu in arteritis kin gɛt fɔ chenj dɛn woke. Bɔt, lɛk 25% pan di pipul dɛm wae gɛt dis sik kin liv kɔmplit nɔrmal layf. Ɔda 25% dɔn gɛt fɔ mek sɔm chenj dɛn na dɛn aktiviti dɛn. Pipul wae gɛt dis sik wae nɔr de mɛn, nid fɔ de chɛk dɛn ɔltɛm na dɔktɔ ɛn if nid de, dɛn fɔ chenj dɛn mɛrɛsin. Dɔktɔ dɛn nid bak fɔ wach di bad tin dɛn we di mɛrɛsin dɛn kin du ɛn du blɔd tɛst. Dɛn tin ya kin bi prɔblɛm dɛn we kin kam wit Takayasu in at:

• At we nɔ de wok fayn.
• Strok.
• Blɔd we de klɔt.
• Wan at atak we pɔsin kin gɛt.

Takayasu arteritis na wan sik wae kin teik lɔng tɛm wae kin kam smɔl smɔl. Yu go nid tritmɛnt fɔ lɔng tɛm, bɔku tɛm wit mɛrɛsin. Na kɔntri dɛm lɛk Amɛrika ɛn Jepan, lɛk 3% pan di pipul dɛm wae gɛt Takayasu arteritis kin day insay avrej fayv ia frɔm di sik. Dis kin bi bikɔs dɔktɔ dɛn kin ebul fɔ no di sik kwik kwik wan ɛn trit am di rayt we. Na ɔda pat dɛn na di wɔl, di tin we kin apin kin wɔs bikɔs dɛn kin delay fɔ no di sik ɛn trit ɔr nɔr kin gɛt wɛl bɔdi savis. If dɛn nɔ trit am, Takayasu arteritis kin kil pɔsin.

Aw a go kia fɔ mi wɛlbɔdi biznɛs?

I impɔtant fɔ kip trak fɔ aw yu de fil ɛn de kɔntakt yu dɔktɔ ɔltɛm so dat yu go ebul fɔ kech ɛni nyu ɔr we de wɔs kwik kwik wan.

Ustɛm a fɔ go to dɔktɔ?

If yu Takayasu arteritis simptom kam bak we yu de trit yu ɔ afta yu dɔn trit yu, go to yu dɔktɔ wantɛm wantɛm. If yu de plan fɔ gɛt bɛlɛ, tɔk to yu dɔktɔ bɔt am. i posibul fכ gεt saksesful bεlε wit Takayasu arteritis, bכt i implεnt fכ no aw fכ mεnεj am.

Ustɛm a fɔ go na Imejɛnsi Tritmɛnt Yunit (ETU) ?

If yu gɛt ɛni wan pan dɛn sik ya, kɔl 911 wantɛm wantɛm (na Sri Lanka, kɔl di 1990 Suwaseriya Ambulans Savis ɔ go na di ɔspitul we de nia yu):

• Chɛst de pen.
• I nɔ kin izi fɔ yu fɔ blo.
• Wik puls.
• di simptom dεm fכ hat atak (e.g., siriכs chεst pen we de rayt dכn di an, swet, nכs).
• Sayn dεm fכ strok (e.g., fכ dכp na wan say na di fes, yu an de sכmtεm, i at fכ tכk).

Us kwɛstyɔn dɛn a fɔ aks mi dɔktɔ?

• Aw lɔŋ a go gɛt fɔ tek mɛrɛsin fɔ Takayasu in at at?
• Aw ɔltɛm a nid fɔ kam fɔ fala-ap apɔntinmɛnt?
• Yu tink se dɛn go ebul fɔ kɔntrol mi sik we dɛn nɔ du ɔpreshɔn pan mi?
• Aw ɔltɛm a nid fɔ du imej tɛst?

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

Bikɔs Takayasu in Arteritis na wan sik we de te, ɔ ‘krɔnik’, yu go nid fɔ go to dɔktɔ ɔltɛm. As tɛm de go, yu sik kin kɔmɔt frɔm wae yu nɔr de kɔntrol am to yu nɔr de kɔntrol yu. Na dat mek i impɔtant fɔ de tɔk to yu dɔktɔ ɔltɛm. Nɔr frayd fɔ tɛl yu dɔktɔ if yu notis ɛni chenj na yu wɛl bɔdi. Yu dɔktɔ go want fɔ no bɔt am, bikɔs na da tɛm de i go ɛp yu.

Mɛmba se ivin wit dis sik, if yu gɛt di rayt tritmɛnt ɛn fala dɔktɔ advays, yusɛf go ebul fɔ liv gud layf. Stay strɔng!

Takayasu in at, Takayasu in at, sik we nɔ gɛt puls, vaskulaytis, aorta, at, blɔd vesel sik, ay blɔd prɛshɔn, ɔtoimyun sik