Hliam te tak te atang pawhin thisen a chhuak nasa em? ITP (Immune Thrombocytopenia) hi han en ila!

Engvangin nge hliam tenau pawh hi hliam lian takah a chantir tih i ngaihtuah fo em, a nih loh leh engvangin nge hliam te tak te hian thisen a chhuah loh ang? A nih loh leh, chhan awm lovin hnar thisen chhuak, ha i sil laiin i hmui thisen chhuak ang chi thil i tawk em? Heng thilte hi i chungah a thleng fo a nih chuan tunlaia kan sawi mek ITP (Immune Thrombocytopenia) tih hi i hriat chian a pawimawh hle mai thei. Ngaihtuah buai suh, he thu hi awlsam takin sawi ila.

ITP (Immune Thrombocytopenia) hi eng nge ni?

A awlsam zawngin, ITP (Immune Thrombocytopenia) hi i thisenah platelet an tih cell te tak te a awm tlem tihna a ni. Heng platelet te hi kan taksa hmun dangah hliam kan neih chuan thisen chhuah tihtawp nan a pui thin. Anni hian clot an siam a , thisen chhuah chu an titawp thin . Chuvangin, heng platelet te hi a tlem chuan i thisen chu a clot awlsam lo. Chuvangin hliam tenau tak pawh hian thisen a chhuah tam thei a, a nih loh leh i taksa a ti na mai thei bawk.

Hei hi ITP an ti a, `Immune` tih hian immune system nena inzawm thil a kawk a ni. `Thrombocytopenia` tih awmzia chu platelet hniam tihna a ni. So, what happens in this is that your own immune system , natna laka min humhimtu sipaite chuan i platelet cells te hi pawn lam hmelma niin an ngai sual a, an rawn bei a, an tichhia a ni. Mahni in chhunga mi pakhat, rukru nia inngaia beih ang mai a ni.

A châng chuan ITP hi damdawi hmang emaw tel lo emaw pawhin enkawl theih a ni a, hun kal zelah a ṭha chho zel bawk. Mahse mi thenkhat tan chuan natna khirh tak a ni thei. Chumi awmzia chu symptoms control theih a nih laiin a dam kim a harsa tihna a ni. Chutiang miteah chuan an dam chhung zawngin inenkawl a ngai mai thei.

ITP hming dang engte nge ni?

Doctor i pan chuan ITP tih loh hming dang an hmang mai thei. Chuvangin heng hmingte pawh hi hriat reng a tha:

• ``Autoimmune Thrombocytopenic Purpura'' tih a ni a, a chhuahna tur hmun leh a hmanna tur hmun chu a in ang lo.
• ``Immune Thrombocytopenic Purpura'' tih a ni a, a chhuahna tur hmun tur chu a hriat theih loh.
• `Idiopathic Thrombocytopenic Purpura` (He hming hi tun hma chuan an hmang nasa hle a, `Idiopathic` tih awmzia chu a chhan dik tak hriat loh tihna a ni)
• `Werlhof natna` tih a ni
• `Autoimmune Thrombocytopenia` tih a ni

Eng hming pawh vuah mah la, damdawi lam dinhmun inang a kawk fo thin.

ITP hi engtiang chiahin nge a hluar?

Dik tak chuan ITP hi a awm lo deuh a ni. Mi zawng zawng tuar thei natna a ni lo. Statistics-ah chuan America ang ramah hian kum tin naupang sang za zinga pali (4/100,000) vel leh puitling sang za zinga pathum (3/100,000) vel chu he natna hi hmuhchhuah thar an ni. Hetiang dinhmun hi Sri Lanka-ah pawh hmuh tur a awm a, mahse a chungchangah hian statistics dik tak hmuh a harsa deuh. Mahse, chuvangin, mi pakhatin he natna hi a neih chuan an tan harsatna lian tak a ni thei a ni lawm ni?

ITP chi hrang hrang a awm em?

Ni e, ITP hi chi hnih ah then theih a ni:

1. ITP hmasa ber: 1.1.Hei hi nangmah ngeiin i immune system-in chhan hriat loha i platelets a beih lai a ni. ITP vei zinga zaa 80 (80%) velin he chi hi an nei a ni. ``Autoimmune disorder'' a ni a, chu chu immune system hnathawh that loh vang a ni tihna a ni.

2. Secondary ITP: Hei hi damdawi lam dinhmun dang, hri kai emaw, damdawi emaw avanga side effect anga platelet count a tlahniam chuan a thleng thin. Entir nan:

• Hun rei tak chhunga natna hrik kai ṭhenkhat, HIV, Hepatitis C, emaw H. pylori (rilru natna thlentu bacteria) .
• Thisen cancer natna a awm
• Thil dang `(autoimmune disorders)` (e.g. lupus - SLE) te pawh a awm bawk.
• Damdawi thenkhat vang pawh a ni thei bawk.

Doctor-te pawhin ITP hi eng chen nge a awm tawh tih a zirin an classified bawk:

• Acute ITP: Hei hi thla thum chhungin a dam tlangpui. Naupangah a tam ber.
• Persistent ITP: Hei hi thla thum atanga thla sawm leh pahnih (kum khat) thleng a daih thei.
• Chronic ITP: Hei hi kum khat aia rei a daih. Puitlingah a tam ber.

ITP natna lan chhuah dan chu engte nge ni?

Mi thenkhat chuan ITP an nei thei a, symptoms nei lovin an nei thei bawk. Mahse, symptoms a awm tak tak chuan zawi zawiin emaw, rang takin emaw a lo lang thei a ni. A lan chhuah dan ber chu:

• Petechiae: Hei hi i vunah, a bik takin ke hnuai lam, a sen emaw, sen emaw te te i hmuh hian a ni. Rash ang maiin an lang. Hengte hi anmahniin an kal bo ngai lo.
• Purpura: A hmaa kan sawi tawh petechiae te hi an inzawm khawm a, a sen lian zawk, sen, sen emaw, sen emaw an siam thin. Hengte hi hliam aiin a te zawk a, mahse chutiang hmun aiin a lian zawk thung. Hei hi vun hnuaia thisen kalna kawng te tak te atanga thisen tlem a chhuak vang a ni.
• Bruise awlsam: Khawi hmunah pawh bump tlemte pawh hian hliam lian tak emaw, hliam emaw a thlen thei. A châng chuan, chhan hriat lohvin hliam a lo lang thei bawk.
• Ha i thisen chhuah: I ha i silfai lai emaw, i la awm lai chauh emaw chuan i hmui a thisen a chhuak thei. I hmui pawh a hring niin a lang thei bawk.
• Thisen in stool: I stool chu a dum hle a, tar ang maiin a lang a nih chuan internal bleeding a ni thei.
• Zun chhunga thisen: I zun laiin toilet bawm chhunga tui chu pink emaw sen emaw a nih chuan zun chhungah thisen a awm vang pawh a ni thei.
• Hmeichhiaah thlasik hun rit tak: Thla khata i period chu ni sarih aia rei a nih chuan, emaw, a tlangpui aia thisen chhuak tam zawk (`Menorrhagia`) a nih chuan, chu pawh chu ITP chhinchhiahna a ni thei bawk.
• Hnar thisen chhuak fo.
• Hripui lian tak (Hematoma): A chang chuan hmun khata thisen tam tak a awm chuan hliam lian tak, hring (`Hematoma`) a lo awm thei.
• Chau lutuk tih hriat (Fatigue).

Pawimawh: Heng symptoms pakhat emaw a aia tam emaw i neih chuan doctor pan vat a, thurawn lak a pawimawh hle.

ITP awm chhante chu engte nge ni?

Kan sawi tawh ang khan ITP hi i immune system hian i platelets laka antibody a siam sual a, chu chuan immune cell dangte chu tihchhiat turin a hrilh a ni. I taksaa thisen kalna kawng a chhiat chuan platelet te chu a hmunah lo kal a, a inzawm khawm a, thisen zam a siam a, thisen chhuahna a titawp thin. Hei hi ``primary hemostasis'' an ti a.

Mahse, mithiamte pawhin he immune system hian a platelet a beih tan chhan chiah hi an la chiang lo.

Mahse, zirchianna thenkhatah chuan:

• `(HIV)` (Human Immunodeficiency Virus) vei te tan .
• Bacteria infection `(H. pylori)` (Helicobacter pylori) an tih te tan (hei hi pum ulcer leh gastritis nen a inzawm fo thin)
• Thin natna `(Hepatitis C)` an tih te tan

ITP vei theihna a sang hle. Chungte chuan secondary ITP a thlen thei a ni.

Engtin nge ITP hi hmuhchhuah a nih?

Doctor-in ITP i neih leh neih loh a hriat hmain taksa enfiahna uluk tak an nei hmasa ang a, thisen chhuah, hliam, leh petechiae leh purpura ang chi spot awm leh awm loh an enfiah hmasa ang. Chumi hnuah chuan i damdawi lam chanchin hlui te, damdawi i ei te, leh i chhungte zingah thisen chhuahna lama harsatna nei tawh leh awm loh te an zawt ang.

ITP symptoms hi thisen zam natna dang emaw, thisen cancer ang chi natna khirh zawk emaw nen a inang thei a, chuvangin doctor chuan ITP definitive diagnosis a siam hmain a chhan dang zawng zawng (a diagnosis of exclusion) a paih chhuak vek ang.

ITP hriat theihna atan eng test nge hman thin?

Doctor ten heng test te hi an ti tlangpui a:

• Complete Blood Count (CBC): Hei hian i thisena cell chi hrang hrang awm zat a enfiah a, chung zingah chuan red cells, white cells, leh a bik takin platelets te pawh a tel a ni . ITP ah chuan heng platelet te hi a hniam hle mai thei.
• Peripheral Blood Smear: He test-ah hian thisen tla khat lak a ni a, glass slide-ah theh darh a ni a, microscope hmangin platelet pianzia leh a lian zawng a pangngai em tih enfiah a ni a, thil danglam dang a awm em tih enfiah a ni.

I doctor chuan HIV, Hepatitis C, H. pylori vei hlauhawma a ngaih chuan chutiang natna hrik te chu test an ti thei bawk. A chang chuan bone marrow biopsy pawh tih theih a ni a, mahse hei hi mi zawng zawng tan tih a ni lo.

ITP enkawl dan tur chu engte nge ni?

A tam zawkah chuan, .Naupangin ITP an neih chuan a natna lan chhuah dan a na lo a nih chuan enkawl ngai loin a dam leh ang. Mahse, puitlingte hian enkawl an ngai fo thin a, a bik takin an platelet count a hniam lutuk emaw, thisen chhuah theihna a awm chuan emaw.

Enkawlna i mamawh chuan i doctor chuan i platelet count tihpun nan emaw, i immune system-in i platelet a beih loh nan emaw damdawi a pe thei che a ni. Damdawi chi hrang hrang hman berte chu:

• Corticosteroids: (e.g. Prednisolone) te hi a tha hle. Chûngte chuan platelet tichhe thei antibodies siam chhuah chu hun engemaw chen titawp chungin hna an thawk a ni. Hengte hi first-line treatment a ni.
• Immunoglobulin (IVIg): Hei hi thisen kal tlanga pek thin damdawi a ni. Tin, immune system hnathawh dan a tidanglam a, platelet tihchhiatna a ti tlem bawk.
• Thrombopoietin receptor agonists (TPO-RAs): Heng damdawi te hian taksain platelet tam zawk siam turin a pui thin.
• Immunosuppressants: (e.g. Rituximab, Mycophenolate) te hi a tha lo hle a ni. Chungte chuan immune system hnathawh a ti tlem a, platelet tihchhiatna a titawp bawk.

Heng damdawi bakah hian doctor chuan thil dang a rawt thei bawk:

• Infection hnuaia awm enkawl dan: Secondary ITP a awm chuan a thlentu infection enkawl a nih veleh platelet count chu a normal leh thei a ni.
• Damdawi thenkhat chawlhsan: Thisen tithianghlimtu damdawi, aspirin ang chi, thisen chhuah theihna tipungtu i ei a nih chuan i doctor chuan ei tawh loh turin a ti thei che a ni.
• Platelet transfusion: I thisen chhuah a nasat em em a, i platelet count a tlem hle a nih chuan midang donation atanga platelet pek i ni thei bawk. Mahse, hei hi hun eng emaw chen atana chinfelna a ni.
• Splenectomy: Spleen hi taksa peng pakhat a ni a, thisen cell hlui leh chhia te, chubakah platelet antibodies hmanga chhinchhiah tawh te pawh paih chhuaktu a ni. Mi thenkhatah chuan enkawlna dangin natna a thunun thei lo a nih chuan zai hmangin an ril chu an la chhuak thin. Hei hian ITP dinhmun hi nasa takin a thunun thei a ni. Mahse, spleen lakchhuah hian natna thenkhat i vei theihna a tipung thei a ni.

Enkawlna avanga side effects awm thei

Damdawi emaw, enkawlna emaw ang bawkin ITP enkawlna hian side effect engemaw zat a nei thei a ni . Entirnan, corticosteroids hian taksa rihna a tipung thei a, hmai a ti na thei a, mut theih lohna a thlen thei a, mood a tidanglam thei bawk. I doctor chuan hengte hi eng nge an nih leh i tan eng ang nge an nih tih a hrilhfiah ang che. Chutiang chuan i hre lawk thei a, ngaihtuahna i neih chuan i sawi thei bawk.

ITP hmalam hun chu eng nge ni?

Mi hrang hrangah outlook/prognosis a inang lo a, ITP chi hrang hrang a zirin a inang lo.

• Naupang tanAcute ITP a lo awm chuan mi tam zawk chu kar tlemte emaw thla engemaw zat emaw chhungin enkawl lohvin an dam vek ang.
• Puitlingte hian chronic ITP an neih chuan dam chhung zawnga natna a ni thei. Mahse, ngaihtuah buai a ngai lo. Mi tam zawk chuan damdawi leh enkawlna dang hmangin an natna lan chhuah dan chu uluk takin an enkawl thei a, nun pangngaiin an hmang thei bawk. Doctor-te chuan ITP hi an tidam kim thei lo nain, chronic ITP vei tam tak chuan kum sawm tam tak chhung chu he natna hi an nei tha hle.

Engtin nge ka in enkawl ang?

ITP i neih chuan i taksain platelet a siam tlem theih nan i dam chhung zawng damdawi i ei a ngai mai thei. Tin, hliam leh thisen chhuahna hlauhawma awm thei thiltih leh tih dan te pawh i pumpelh a ngai bawk ang. Ngaihtuah teh, tlu tlemte pawh hi harsatna lian tak a ni thei a ni lawm ni? Chuvangin heng thilte hi hre reng ang che:

• Contact sports, vuakna, tlu, leh taksa inzawmna khauh tak , football, rugby, boxing, karate, basketball, leh ice hockey ang chite chu a theih ang angin hlat rawh.
• I fain ITP a neih chuan eng thil pawh, cycle khalh, skateboarding, roller skating ang chi a tih hunah helmet, khup khuhna leh elbow pad ang chi invenna hmanrua a bun ngei ngei tur a ni.
• Car emaw van emaw-a i zin hunah seat belt vuah fo ang che , i fate seat belt dik taka khih emaw, car seat-a dah emaw theihnghilh suh.
• Over-the-counter damdawi emaw, herbal supplement emaw i ei a nih chuan, i doctor nen sawiho la, an phalna la rawh . Painkiller thenkhat, aspirin leh ibuprofen te bakah herbal remedies thenkhat te hian thisen chhuah theihna a tipung thei a ni.

Engtikah nge Doctor ka hmuh ang?

ITP vei nia hriat i nih a, enkawlna i dawng a nih chuan i doctor chuan a enfiah fo ang che. Mahse, chutih lai chuan:

• Hliam thar i hmuh chuan , .
• I vunah hian dots sen te te (`petechiae`) i neih chuan, .
• A hma aia awlsam zawka thisen chhuak ang maia i inhriat chuan,

Chumi awmzia chu i dinhmun a chhe zual thei tihna a ni a, i platelet count pawh a tlahniam thei tihna a ni. Chutiang a nih chuan a rang thei ang bera doctor pan rawh. I platelet level chu a enfiah leh thei a, a tul chuan i enkawlna chu a siamrem thei bawk.

Engtikah nge Emergency Department (ETU) ah ka kal ang ?

Hei hi a tlem hle a, mahse a chang chuan ITP hian i platelet count a tlahniam lutuk a , thunun theih lohvin thisen a chhuak tan thei bawk. Entirnan, hnar thisen chhuak tawp lo, i hmui thisen chhuak, thlasik thisen chhuak nasa tak, emaw, hliam i hrual lai pawhin thisen chhuak tawp lo tur i neih chuan medical emergency a ni.Chutiang a nih chuan damdawi in hnai ber emergency room-ah i kal nghal tur a ni. Tin, i lu i vuak a nih chuan, emaw, thluak chhunga thisen chhuak chhinchhiahna i neih chuan, lu na lutuk, luak chhuak emaw, mit hmuh dan inthlak danglam emaw a nih chuan damdawi in pan nghal tur a ni.

Doctor hnenah eng zawhna nge ka zawh ang?

ITP i nei tih i hriat chuan zawhna tam tak i nei mai thei. Chu zawng zawng chu i doctor zawh chu hlau lo la, zak suh. Zawhna i zawh theih ṭhenkhat chu hetiang hi a ni:

• Eng ang ITP nge ka neih? (Acute, chronic, primary, secondary?) tih hi a dik lo a ni.
• Eng enkawlna nge min rawt ang? Engati nge?
• Chutiang enkawlnate chuan damdawi/result a siam theih nan eng chen nge a la ngai ang?
• He damdawi hi nitin ka ei a ngai dawn em ni?
• Enkawlna hmasa ber a hlawhtling lo a nih chuan engtin nge a awm leh ang?
• Heng enkawlnate hian eng side effect nge a neih? An lo thleng a nih chuan engtin nge ka tih ang?
• Ka ei leh in leh nun danah eng inthlak danglamna nge ka siam ang?
• Eng exercise nge ka tan a tha? Eng exercise nge ka tan a tha lo?

ITP ka neih laiin nau ka pai a nih chuan eng nge thleng ang?

Naupai emaw, naupai tum emaw i nih chuan ITP i vei tih hriat chu a hlauhawm hle thei. Mahse hei hi i hriat chuan thlamuanna i nei thei ang: ITP hian i naute piang lai chu direct-in a nghawng lo tlangpui.

Naute pian tirh hian platelet count hi a tlem deuh thei a, mahse hei hi a tlangpuiin hun rei lote chhung atan a ni a, ni rei lote chhungin a pung ang. Doctor ten naute platelet level an enfiah ang.

Naupai laiin ITP na lo tak i neih a, i natna lan chhuah dan a na lo a nih chuan enkawlna engmah i mamawh lo mai thei. Mahse, i platelet count a hniam lutuk emaw, thisen chhuah hlauhawmna i neih chuan enkawl a ngai mai thei. Chutiang hunah chuan i obstetrician leh hematologist te chuan nang leh i naute tan enkawlna him ber thlang turin an thawk ho ang . Nau neih laiin a bik takin an enkawl dawn bawk a ni.

A tawp berah chuan thil hriat reng tur (Take-Home Message) .

Okay, chuti a nih chuan tunah chuan kan sawi thin kha i hrethiam tawh a, ITP (Immune Thrombocytopenia) kha. Hriat reng tur pawimawh thenkhat chu hetiang hi a ni:

• ITP hi i immune system hian nangmah ngeiin i platelet a tichhia a, thisen zam a tihtlem phah thin.
• A lan chhuah dan chu hliam awlsam tak, vunah hmun sen, leh thisen chhuak fo te a ni thei.
• Naupangte chunga hetiang thil a thlen hian hun kal zelah a tha chho fo thin. Puitlingte chuan hun rei tak enkawl an ngai mai thei.
• ITP hi tihdam kim theih ni lo mah se, enkawlna tha tak a awm chuan a natna lan chhuah dan chu thunun theih a ni a, nunphung tha tak a awm thei bawk.
• Heng symptoms te hi i neih chuan Doctor pan hreh suh. A tul angin thurawn leh enkawlna a pe ang che.
• Hliam lakah inveng la, damdawi lam thurawn zawm la, i damdawi ei tur a tih angin ei rawh.

ITP hi hlauhawm tak a ni thei a, a bik takin thisen chhuak mai mai a nih chuan. Mahse, nangmah chauh i ni lo. Doctor puitu leh enkawltu tur che an awm. Chuvangin, he dinhmun hi huaisen takin hmachhawn rawh. Thil ngaihtuah tur i neih chuan i doctor nen inbia ngei ang che.

` ITP, Immune Thrombocytopenia, platelet, thisen zam, thisen chhuak, taksa hriselna, hliam, petechiae, purpura