A chang chuan rang takin i lu a buai thin em? A nih loh leh i pum chhungah thil mak tak a awm emaw, i hmui a vawt emaw, i thawk i thunun thei lo ang maiin i inhria em? Chûngte chu thil pangngai angin lang mah se, a châng chuan a hnung lamah thawnthu buaithlâk zâwk a awm thei a ni. Chu chu vawiin a kan sawi tur dinhmun hmuh tur awm lo, mahse hriat hlawh tak tak zinga mi a ni.
Hei hi eng nge ni ``Autoimmune Autonomic Ganglionopathy - AAG'' hi? A awlsam zawngin hrethiam ila, kan hrethiam ang em?
A awlsam zawngin sawi ila, ``Autoimmune Autonomic Ganglionopathy'' emaw ``(AAG)'' tih hi kan taksa ngeia kan invenna system, chu chu immune system-in kan autonomic nervous system a rawn bei sual thinna a ni. Ngaihtuah teh, hei hi kan ram humhalh tura ngaih sipaite hian kan hmun pawimawh tak takte hi tihsual palhin kan bei a nih chuan eng nge thleng ang tih ang chi hi a ni.
Kan taksa autonomic nervous system hi kan ``automatic system'' ang a ni. Chu chu thil tam tak, automatic-a thleng, kan hriat lohvin a thunun tihna a ni. Entir nan:
- I thawk chhuah dan
- Lungphun (thinlung chakna) .
- Thisen sang a ni
- Thawmhnaw hak
- Chaw ei dan (digestion) a ni
Heng thil tam tak hi kan ngaihtuah chian loh a ni. Automatic takin an thleng thin. Autonomic nervous system hi chu automatic function te chu a kal tha thei ang bera kalpui theihna tura puitu a ni. AAG-ah chuan he system pawimawh tak hi a chhe vek a ni. Hei hi autonomic neuropathy, a nih loh leh dysautonomia an tih natna a ni.
Engvangin nge keimahni taksa ngeiin hetiang hian a tih? A chhan engte nge ni?
Dik tak chuan doctor-te pawhin he `(AAG)` lo awm chhan dik tak hi eng nge ni tih chiang takin an la sawi thei lo. Mahse thudik thenkhat chu hmuhchhuah a ni tawh.
- A tam zawkah chuan, chu chu mi panga zinga pathum velin ``AAG'' vei an nei a, he natna hi natna dang atanga an dam leh hnuah emaw, natna kai hnuah emaw a lo awm thin. Chu natna side effect ang mai a ni.
- Mi thenkhat chuan paraneoplastic AAG an tih natna an nei thei bawk. Hei hi cancer ang chi natna chhanna atana kan immune system siam antibodies thenkhat chu an kal a, autonomic nervous system an beih hun a ni.
Hei hian kan taksaah eng nge a tih? Ngun zawkin han thlir ila.
Kan autonomic nervous system ah hian nerve cell clusters autonomic ganglia an ti a . Chûngte chu rel inkalpawhna ang mai a ni. Heng hmang hian thuchah chi hrang hrang thawn leh dawn a ni. Hetianga thuchah inthlengna hi kan taksa thiltih automatic, chu chu kan thunun loh thiltih (reflexes) te hi kan thunun theih nan a pawimawh hle.
AAG-ah chuan kan immune system hian heng ganglia-a receptor bikte hi a bei thin. Receptor hi message dawnna hmun a ni. Chuvangin heng receptor te hi a chhiat chuan chu nerve message te chu a kal tha lo va, a kal tlang tha lo bawk. Chumi avang chuan thil thleng tak tak, thisen sang control leh thawk hah ang chi te chu a buai tan ta a ni.
Ngaihtuah teh, i in `main switch board`-a `connection` pakhat a lo chhuak a, light a eng lo va, fan a inher lo, etc. Hetiang hi a ni.
Hetiang dinhmun hi engtiang chiahin nge `(AAG)` tia koh a nih?
Hei hi a takah chuan thil awm lo tak a ni. Entirnan, United States-ah chuan kum tin mi 100 vel chauh he natna hi an vei tih hmuhchhuah a ni. Chuvangin Sri Lanka ramah chuan a tlem hle. Chuvangin he thu i hriat hian hlau suh, hei hi mi tam tak chunga thil thleng a ni lo.
`(AAG)` natna lanchhuahna chu engte nge ni? Engtin nge kan hriat chian?
Hetiang natna lan chhuah dan hi mi hrang hrangah a inang lo thei. Mi zawng zawng hian symptom inang an nei vek dawn lo. A lan chhuah dan tlangpui chu:
- Constipation: Hei hian constipation leh toilet kal harsa tihna a ni.
- Dilated pupils (Adie’s pupils): A chang chuan mit pakhat chauh hi a dilated thei a, light a sensitive thei bawk.
- Kawng a vawt emaw, mit a vawt emaw: Mit chhunga hmui emaw mittui emaw awm lo ang maia hriatna.
- Fainting / Syncope: A chhan hriat lohvin i muhil nghal mai thei.
- Neurogenic orthostatic hypotension: Thut atanga ding emaw, khum atanga tho emaw a luak chhuak leh lu hah lutuk. Hei hi thisen sang tlahniam nghal vang a ni .
- Zun harsa / Urinary retention: Zun duh viau chung pawha zun theih loh anga inhriatna.
AAG vei mi pathum zinga pahnih vel chuan an thisenah ganglionic acetylcholine receptor antibodies (g-AChR antibodies) an tih antibodies a sang hle tih hmuhchhuah a ni. Researcher te chuan heng g-AChR antibodies level leh symptoms nasat dan hi inzawmna a awm niin an ngai.
He natna `(AAG)` hi engtin nge doctor hian a hriat theih ang?
Hetiang symptoms i neih chuan doctor-in a tih hmasak ber tur chu i symptoms chungchang zawtin a enfiah che a ni. Tichuan, i autonomic nervous system hnathawh dan enfiah turin test bik engemaw zat an ti thei ang.
Chung zinga ṭhenkhat chu hetiang hi a ni:
- Digestive system test: Entirnan, ``Gastric emptying`` test. Hei hian chaw ei hian i pum atanga a chhuah chak dan a test thin.
- `Quantitative sudomotor axon reflex test (QSART)`: Hei hian i sweat glands te hnathawh that dan a teh thin.
- `Thermoregulatory sweat test`: He test hi taksa thawkna a tlahniam nge a pung tih hriat chian a ni a, a chhan chu eng nge ni.
- `Tilt table test`: He test-ah hian khum bik chungah mu turin an siam che a, khum chu zawi zawiin dinglam hawiin an inher a, i heart rate leh thisen sang inthlak dan an enfiah thin.
- Urinalysis: Hei hian i bladder a thawk tha em tih hriat theihna a pe thei che a ni.
Chu bakah, a chunga kan sawi tak `(g-AChR antibodies)` level enfiah nan thisen test pawh tih theih a ni bawk . He antibody level hi a sang a nih chuan `(AAG)` a ni thei tih finfiahna dang a ni. Mahse, he thisen test hi `AChR antibody test` nen a danglam a, chu chu neurological disease dang `(Myasthenia Gravis) an tih chu enfiah nan hman a ni.`
Hei hi enkawl dan tur a awm em? Eng nge tih theih ang?
AAG hi chutiang khawpa natna hlauhawm tak a nih avangin standard a la awm lo, "hei hi enkawlna a ni" tih hi a la ni lo. Most of the time , a ngaih pawimawh ber chu symptom management lam a ni.
Doctor-te chuan enkawl dan hrang hrang inzawmkhawmin enkawl dan tur ruahmanna an siam a. Chung zinga ṭhenkhat chu:
- Plasma exchange / plasmapheresis: Hei hian i thisen thenkhat lak a, plasma atanga antibodies ang chi thil tha lo tak tak te chu paih chhuakin, chu thisen thianghlim chu i taksaah pek let leh a ni.
- Intravenous immunoglobulin (IVIG) therapy: Hei hian mi hrisel hnen atanga lak i taksa immunoglobulin (natna dotu plasma peng pakhat) pek a huam a ni. Hei hian immune system a ti reh thei a ni.
- Intravenous corticosteroids: Anti-inflammatory steroids dose sang tak, methylprednisolone (Solu-Medrol®) emaw hydrocortisone (Solu-Cortef®) te hi injection hmanga pek thin a ni.
- Immunosuppressive medications: Hengte hian immune system hnathawh tam lutuk tihziaawmna hmangin hna an thawk a ni. Entirnan, damdawi rituximab (Rituxan®) ang chi te.
Hetiang `(AAG)` dinhmun hi ven dan tur a awm em?
Hei hi ven theih dan tur chiang tak a awm lo tak zet a, a tlem hle a ni. Mahse, cancer ang chi natna thenkhat chuan i vei theihna chu tlem a tipung thei a ni. Cancer i vei tawh a nih chuan i hriselna zawng zawng enkawlna atana i tih theih thenkhat chu hetiang hi a ni:
- Exercise neih fo: a bik takin aerobic exercise.
- `(Dysautonomia)` i neih chuan chi leh tui tamna diet ei hian i thisen sang control nan a pui thei a ni. (Hei hi doctor nen in sawiho tur a ni.)
- Stress enkawl dan: Exercise tih te, ṭhian nena inbiakna te, journal-a ziah te ang chi hmanraw hrisel tak tak hmang rawh.
- Mut tha rawh: Ni khatah darkar 7-8 tal mut thin ang che.
- Compression garments bun: Hengte hian thisen kal dan a tichak a, a hring (a bik takin keah) a ti tlem bawk.
He `(AAG)` dinhmun hi a dam kim thei ang em? Nakinah eng nge thleng dawn?
Ka sawi tur chu, lungngai mah ila, .AAG hi tihdam theih a ni lo. Mahse, mi tam tak chuan hun rei tak chhung chu an symptoms te hi an enkawl tha thei hle. Mak tak maiin AAG vei mi pathum zinga pakhat vel chu enkawlna engmah awm lovin an dam zauh zauh ang. Mahse, mi tam zawk chuan an dam chhungin symptom thenkhat an hmachhawn a ngai dawn a ni.
Doctor hnenah eng nge zawh belh i duh?
Hetiang dinhmun hi i nei nia i rinhlelh chuan doctor tha tak pan a, a hnuaia mite hi zawh a pawimawh hle.
- Ka natna lan chhuah chhan ber chu eng nge ni?
- `(AAG)` ka neih leh neih loh chiang taka hriat theih nan eng test nge ka tih ang?
- `(AAG)` enkawl dan tur chu engte nge ni?
- Enkawlna tel lo pawhin `(AAG)` symptoms a reh theihna chance engzat nge ni?
- Ka hriselna zawng zawng tihchangtlun nan eng nunphung tihdanglam nge ka tih ang?
Eng immune condition dang nge autonomic neuropathy nena inzawm?
``(AAG)`` hi a danglam bik a, a chhan chu, kawng khatah chuan immune system nena inzawm natna a nih vang a ni a, kawng dangah chuan nervous system-a autoimmune disease a nih vang a ni.
Tin, immune system nena inzawm natna dang thenkhat pawh ``dysautonomia'' (autonomic nervous system lama harsatna) vei theihna a tipung bawk. Entirna thenkhat chu:
- Celiac natna a ni
- `(Guillain-Barré natna)` (Guillain-Barré natna) tih a ni.
- `(Lupus / systemic lupus erythematosus)` (Lupus natna) tih hi a awm lo.
- `(Rheumatoid arthritis)` (Rheumatoid arthritis) a ni a, a rilru a hah lutuk a, a rilru a buai em em bawk a.
- `(Sjögren-a natna)` (Sjögren-a natna) .
Chuvangin i hmu thei ang, hengte hi thil awmdan inzawmkhawm theih a ni.
A tawp berah chuan thil hriat reng tur (Take-Home Message) .
Okay, chuti a nih chuan tunah chuan `(Autoimmune Autonomic Ganglionopathy - AAG)` hi natna hmuh tur awm lo tak a ni tih i hre ta a, chu chu kan defence system ngeiin kan autonomic nervous system a bei a ni. A lan chhuah dan chu hriatna hloh nghal, ding laia `pressure` tlahniam, leh pum lama harsatna te a ni thei.
He thu i hriat hian hlauthawng suh. Hei hi a tlem hle. Tin, hei hi enkawlna atan immunosuppressant damdawi leh `plasmapheresis` te hman a ni bawk. Dam kim theih ni lo mah se, mi tam zawk chuan a natna lan chhuah dan chu an thunun thei a, nun pangngaiin an hmang thei a ni.
A pawimawh ber chu heng symptoms te hi i neih chuan a rang thei ang bera doctor thiam tak pan a ni. I hriat hma chuan enkawlna i tan thei a, i nunah nghawng a neih chu i ti tlem thei bawk. Nangmah chauh i ni lo va, tanpui theitu doctor an awm bawk.
` Autoimmune Aneurysmal Ganglionopathy, AAG, Autoimmune Nervous System, Immune System, Thluak lam natna, A lan chhuah dan, Enkawl dan
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