He natna hi i hre tawh em, khaw lum laiin i blue a, i chau hle tih i hria em? (Cold Agglutinin Natna) 1.1.

I vawt tak tak lai hian i kut zungtang leh ke ruhteah blue a awm fo thin em? A nih loh leh chhan awm lovah chuan danglam takin i chau a, i chak lo tih i inhria em? I vun chu a lo hring tawh mai thei. Heng symptoms te hi i neih chuan a chhan hi thil awm lo tak a ni thei a, mahse kan hriat vek a ngai a ni. Vawiin hian he natna hi `Cold Agglutinin Disease (CAD) an tih hi kan sawi dawn a, chu chu Sinhala tawngin "cold blood cell aggregation disease" tihna a ni.

`Cold Agglutinin Disease (CAD)` tih hi eng nge ni? A awlsam zawngin i hrethiam ang u.

A awlsam zawngin, `Cold Agglutinin Disease (CAD)` hi thisen natna hmuh tur awm lo tak a ni a, kan taksaa immune system – kan taksaa sipaite ang bawka natna laka min humhimtu system – hian kan thisen sen hrisel tak takte chu a rawn bei sual a ni

Ngaihtuah teh, kan immune system hian a tlangpuiin protein chi khat `antibodies` tih chu taksaa lut hrik hlauhawm tak takte tichhe turin a siam chhuak thin. Mahse he CAD-ah hian kan immune system hian `antibody` chi khat bik `autoantibody` an tih chu a siam chhuak a, chu chu `cold agglutinin` tia hriat bawk a ni. Hei hi a specialty chu kan taksaa thisen sen hrisel tak takte a bei a, a tichhia a ni.

I hriat angin thisen sen (red blood cells) hi kan taksa pum puia oxygen phurtu cell chi pawimawh tak a ni. He oxygen hian kan cell te chu an mamawh chakna siam turin a pui thin. Chuvangin, thisen zam (red blood cells) a tlem chuan, chu chu thisen tlakchham (anemia) a awm chuan kan taksa hian harsatna chi hrang hrang a tawk thin.

`Cold Agglutinin Disease` hi thisen tlakchhamna pawl pakhat `hemolytic anemia an tih zinga mi a ni.` `Hemolytic anemia` tih hi kan ruhro hian thisen sen thar a siam theih aia rang zawka a tihchhiat hian a ni. Bucket chhungah khur a awm a, tui a chhuak tan ang mai a ni.

He natna hi `Cold Agglutinin Disease` an tih hi engtiang chiahin nge a awm?

Hei hi a takah chuan thil awm lo tak a ni . Kum tin mi 100,000 zinga pakhat vel chauh he natna hi hmuhchhuah thar an ni. Hmeichhia kum 40 leh 80 inkar ah a tam ber a, mahse, a natna hmuhchhuah tam ber chu kum 60 bawr vel an ni.

Engtin nge `Cold Agglutinin Disease` hian ka taksa a nghawng?

He natna hian thisen tlakchhamna (anemia symptoms) a thlen thei a ni. Anemia chu taksain thisen sen (red blood cells) a neih tlem vang a ni. A chhan azirin he natna hi rei tak emaw, hun rei lote chhunga awm emaw pawh a ni thei . Tin, taksaa nghawng a neih dan pawh a nasat loh atanga a nasat thlengin a inang lo thei bawk .

Entirnan, CAD hi a na lo a nih chuan symptoms a lang zawi hle thei. He natna hi hriat theih nan kum tam tak a ngai thei. Mahse, a nasat chuan CAD hian thinlung natna khirh tak, nunna atana hlauhawm tak pawh a thlen thei a ni.A thleng thei a ni.

He natna hmingah hian "khawsik" tih thumal a awm a. Chutiang a nih avang chuan heng symptoms te hi khaw lum awmna hmunah emaw, ni lum takah emaw a lang nasa ber a ni.

`Cold Agglutinin Disease` natna lan chhuah dan chu engte nge ni?

CAD symptoms hi thisen tlakchhamna leh taksa pum puia thisen kal tha lo nen a inzawm fo thin. Heng symptoms te hi:

• Chau lutuk (Fatigue) : Chauhna mai ni lovin, nunna nei lo anga inhriatna.
• Chak lo : Taksa chu a chak lo em em a, engmah a ti thei lo.
• Dizziness : A rilru a buai em em a, a rilru a buai em em bawk.
• Sweating : Thawhrimna hlawk lo.
• Thâwk harsa (dyspnea) : Thawhrimna tlemte pawh nise thawk harsa.
• Heart rate a sang (tachycardia) : Heart rate a sang.
• Pallor : Vun hian a thisen supply a hloh a, a rawn sen (pale) thin.
• Kut zungtang, ke ruh leh beng te chu khawsik a awm chuan a sen a (Raynaud-a phenomenon) : Nuwara Eliya ang hmun lum i kal chuan emaw, tui lum i khawih chuan i kut zungtang, ke ruh leh beng te chu a sen a, a chang chuan a var a ni. Hei hi rilru hahna nen pawh a inzawm thei bawk.

Jaundice symptoms i nei thei bawk . Thisen sen (red blood cells) a tihchhiat chuan thil sen (yellow substance) bilirubin an tih chu a chhuak thin. He bilirubin hi taksaah a lo punkhawm chuan jaundice a awm thin. Jaundice natna lan chhuah dan chu:

• Zun dum dum.
• Pass, mit var leh iris te chu a sen a ni.

`Cold Agglutinin Disease` awm chhante chu engte nge ni?

Cold Agglutinin Disease hi autoimmune hemolytic anemia chi khat a ni a. Chumi awmzia chu kan taksa hriselna (immune system) hian keimahni cell-te a bei tihna a ni. CAD-ah chuan kan immune system hi khaw lum vangin a thawk a, autoantibody a siam a, chu chuan thisen sen (red blood cells) chu "tag" in a tichhia a ni. Tagged red blood cells te hi an inzawm khawm a, an inzawm khawm (agglutinate). Clumped cells te hi awlsam takin kan immune system peng dang, macrophages an tih hian a man thei a, a tichhia thei bawk.

Hetiang thil hi a lumna chu 3-4 degree Celsius (37-39 degree Fahrenheit) hnuai lam a nih atanga tan a ni. Kan taksa lumna pangngai chu 37 degree Celsius vel a ni tih hi han ngaihtuah teh. He harsatna hi chu aia temperature hniam zawka kan awm atanga intan a ni.

CAD hian kan taksain thisen sen hrisel a siam theihna tura schedule pangngai a tibuai a. A tlangpuiin thisen sen (red blood cell) hi ni 120 vel a dam thin. Hemi hun chhung hian kan ruhro hian thisen sen thar a siam thei a, chu chuan thite chu a thlak thei a ni. Mahse CAD-ah chuan he cycle hi a tibuai a ni.

Kan immune system hian cell hrisel tak tak a beih chhan hi zirchiangtute chuan an la hre chiang lo.A châng chuan CAD hi a hnuaia damdawi lam dinhmun dang vang a ni thei bawk. Hei hi `secondary CAD` an ti a. Chutiang link hmuh theih a nih loh chuan, CAD chu chhan awm lovin a lo thang lian tihna a nih chuan `primary CAD` emaw `idiopathic CAD` emaw an ti a ni.

`Cold Agglutinin Disease` nen hian eng natna dang nge inzawm thei?

Secondary CAD hi infection, autoimmune diseases, leh lymphoproliferative disorders te nen a inzawm tlangpui. Entir nan:

• `Infectious mononucleosis` (thil natna hrik kai) (glandular fever) tih hi a ni.
• Mycoplasma pneumonia natna a ni
• `Cytomegalovirus` tih a ni
• Lupus a ni
• Rheumatoid arthritis natna a ni
• `Non-Hodgkin lymphoma` tih a ni
• Lymphocytic leukemia natna rei tak awm thei
• ``Waldenstrom macroglobulinemia a awm a ni'' tih hi a ni.

Heng hmingte hi i tan chuan a buaithlak deuhin a lang thei a, mahse heng hmingte hi doctor-te hman thin hming bik a nih avangin i hriat chian a tha hle.

`Cold Agglutinin Disease` hi engtin nge kan hriat theih ang? (Diagnosis) tih a ni.

I doctor chuan i symptoms te a zawt ang a, i medical history a enfiah ang. Tichuan, hemolytic anemia i neih leh neih loh leh CAD nena inzawm autoantibodies i neih leh neih loh enfiah nan thisen test bik thenkhat an order ang.

Hemolytic anemia hriat theihna atana thisen test hman thinte chu:

• Complete blood count (CBC) : Hei hian i thisen sen (red blood cells) chungchang chipchiar takin a pe a ni. Thisen sen engzat nge i neih, engzat nge a lian tih leh i hemoglobin level a enfiah thei a ni. Hemoglobin hi protein pawimawh tak a ni a, thisen sen (red blood cells) oxygen phurh nan a pui a ni.
• `Reticulocyte count` : Hei hian i taksaah thisen sen (`reticulocytes`) puitling lo engzat nge i neih tih a teh a ni. Immune system-in thisen sen puitlingte a tihchhiat hian taksain heng cell puitling lote hi siam belh a tum a, chu chu a rulhna tur a ni.
• Serum level test : Thisenah `lactate dehydrogenase (LDH)` leh `bilirubin` level sang, leh `haptoglobin` level tlahniam te hi `hemolytic anemia` chhinchhiahna a ni.

Tichuan, CAD hi i hemolytic anemia thlentu a ni em tih hriat nan i doctor chuan thisen sen (red blood cells) beitu autoantibodies a awm leh awm loh a enfiah ang. Chumi atana test tih turte chu:

• Direct Coombs test (DAT) : He test hian CAD nena inzawm autoantibodies a awm leh awm loh a enfiah thin. Test-ah hian i thisen sen (red blood cells) te chu i thisen dang atanga then hranin controlled environment-ah dah a ni. Tichuan solution bik a dah belh leh a. Thisen sen te chu solution nen an inzawm khawm a, an inzawm khawm (agglutinate) chuan test chu positive a ni a, chu chu autoantibody a awm tihna a ni.
• `Cold agglutinin titer test` tih a ni: He test hian i thisena heng `autoantibodies` awm zat, a nih loh leh a zat a teh thin. Heng `autoantibodies` concentration sang tak hi CAD chhinchhiahna a ni.

I diagnosis tih chian a nih hnuah i doctor chuan i CAD hi underlying condition (`secondary CAD`) nen a inzawm em tih a enfiah bawk ang.

Engtin nge `Cold Agglutinin Disease` hi enkawl a nih?

I natna lan chhuah dan nasat dan azirin, enkawlnaah chuan nunphung tihdanglam te, damdawi ei te, leh a châng chuan emergency-a thisen pek te pawh a tel thei a ni .

• Nunphung : CAD i neih chuan i doctor chuan khaw lum lutuk lo turin a fuih mai thei che . Hei hi a pawimawh ber a ni. Thawmhnaw lum hak te, tui lum taka inbual loh te, leh khaw lum hmuna zin chhuah khap te ang chi thil i ti tur a ni.
• Damdawi : CAD enkawlna atana hman tlanglawn ber chu `Rituximab` a ni. Hei hian i immune system-in i thisen sen (red blood cells) beitu `autoantibodies` a siam chu a titawp a ni. Tun hnaiah damdawi thar `Sutimlimab` tih chu pawm a ni bawk. Hei hian i thisen sen (red blood cells) a beih loh nan immune system direct-in a titawp a ni.
• Thisen pek leh plasma inthleng : I CAD a acute chuan i doctor chuan i dinhmun a nghet theih nan thisen pek emaw plasma exchange emaw a pek a ngai mai thei. Plasma exchange hian i thisena autoantibodies awm zat a tihtlem avangin hna a thawk a ni.

`Secondary CAD` i neih chuan i doctor pawhin a hnuaia awm chu a enkawl ang.

CAD hi ven theih a ni em?

Vanduaithlak takin Cold Agglutinin Disease hi ven theih a ni lo. Mahse, a natna lan chhuah dan chu i enkawl thei a, nun tha tak i hmang thei bawk.

`Cold Agglutinin Disease` nen hian eng chen nge i dam theih ang?

CAD vei nia hriatte chu an kum rualpui CAD nei lote angin an dam rei tlangpui. Tun hnaia zirchianna pakhatah chuan kum 68-a natna hmuhchhuah tawhte chuan kum 80 vel an dam theih an beisei a, a vaiin an dam thei a ni. Chumi awmzia chu inenkawlna leh enkawl dan dik tak nen chuan nun tha tak i beisei thei tihna a ni.

Doctor hnenah eng zawhna nge ka zawh ang?

CAD i vei tih hmuhchhuah a nih chuan doctor hnenah hetiang zawhna hi zawh a tha ang:

• Ka CAD hi natna hnuaia awm nen a inzawm em?
• Ka dinhmun a ṭhat lehzual lehzual loh hriat theihna tur symptoms engte nge ni?
• Hetiang dinhmun hi damdawi ka ei chhunzawm zel a ngai dawn em ni?
• CAD vei tan chuan eng boruak nge a awm tha ber?
• Ka natna lan chhuah dan tur enkawl nan eng temperature range nge ka pumpelh tur?

Cold Agglutinin Disease (CAD) i tawn dan chu primary (‘primary’) emaw secondary (‘secondary’) emaw a nih danah a innghat. I symptoms nasat dan hian engtiang chiahin nge aggressive taka enkawlna i mamawh tih pawh a nghawng dawn a ni. A hnuaia dinhmun enkawl hian i doctor chuan i CAD chu a tidam thei mai thei. Hun rei tak chhung CAD i nei a nih pawhin, i thisen tlakchhamna (anemia symptoms) i control thei a, i dam thei bawk a, khawsik pumpelh a, i damdawi ei tur a tih angin i ei thei bawk.

Kan sawiho tawh a\anga hriat reng tur pawimawh ber berte (Take-Home Message) .

• Cold Agglutinin Disease (CAD) hi natna hmuh tur awm lo tak a ni a, keimahni immune system-in kan thisen sen (red blood cells) a bei a, khawsik hian a tizual a ni.
• A lan chhuah dan chu ruh natna, hah lutuk, vun hring, khawsik laiin kut zungtang sen, leh a châng chuan jaundice .
• Hei hi `primary` (a chhan awm lo) emaw, `secondary` (natna dang avanga lo awm) emaw pawh a ni thei.
• Thisen test a awm a, chu chu hriat chian theih a ni.
• Inenkawlnaah chuan khawsik pumpelh te, damdawi ei te, leh a châng chuan thisen inthlâk te pawh a tel thei a ni.
• Hei hi pumpelh theih ni lo mah se, enkawl dan mumal tak nen chuan nun tha tak i hmang thei a ni.
• Heng symptoms te hi i neih chuan doctor thurawn la hreh suh. I hriat hma poh leh enkawl a awlsam zawk.

He thuziak hi hriattirna atan chauh a ni tih hre reng ang che. Symptoms i neih chuan doctor pan ngei ngei tur a ni.

` Cold Agglutinin Disease, CAD, thisen tlakchhamna, thisen sen, immune system, khawsik, autoimmune, hemolytic anemia, thisen natna