I taksain natna a do theihna a tlahniam em? (Immunocompromised) Hemi chungchang hi han sawi ila!

Khawsik i vei fo thin a, mahse ni rei lo te chhungin a reh lo em ni? A nih loh leh midang aiin natna kai awlsam zawkin i inhria em? I taksain natna a do theihna, chu chu i immunity a tlahniam a ni mai thei. Hei hi `(Immunocompromised)` condition kan ti a. Lungngai suh, he thu hi chipchiar takin sawi ila.

A awlsam zawngin, he dinhmun hi eng nge `(Immunocompromised)` an tih?

Kan taksa chhungah hian defence army kan nei a, ram ang maiin han ngaihtuah teh. He sipai hian pawn lam atanga natna thlentu hrik doin min hrisel tir thin. Hei hi immune system kan ti a . Chuvangin, ``Immunocompromised'' tih hian i immune system a thawk tha lo tihna a ni a, chu chu a chak lo tihna a ni. Tichuan a tul angin natna a do thei lo.

Hetiang dinhmun hi i piang a ni mai thei. A nih loh leh, i dam chhung zawnga natna hrik ṭhenkhat, damdawi, cancer ang chi, a nih loh leh hrisêlna lama harsatna dang emaw avânga i taksa chakna chu a chak lo thei bawk. Hei hi ``Immunosuppression'' tih pawh i hre mai thei.I pianpui thil chiang tak a ni lo va, a hnu lama enkawlna emaw natna emaw, i immune system tihhniamtu a ni zawk.

Engtin nge he natna hi i nei tih i hriat theih ang?

Hei hi a lan chhuah dan ber chu natna i neih fo thin a, i damloh chuan a dam leh theih nan hun rei tak danglam tak a ngai thin. Mahse, natna vei fo zawng zawng hian immune system chak lo an nei vek lo. Natna chi hrang hrang i neih hi a pawimawh bawk. Entîr nân, naupang tê tête hian khawsik an vei fo hi thil awmze nei tak a ni.

Mahse, bacteria infection, pneumonia ang chi natna emaw, natna bik dang emaw i neih fo chuan i immune system a thawk tha lo tih chhinchhiahna a ni thei. Immunocompromised state-ah chuan hetiang thil hi a thleng thei a:

• Natna nei lovin midangte chu a tlangpuiin a hlat tir thin natna hrik atanga i natna a ni.
• Natna na lo leh mi tam zawk tana tihdam theih chu i tan a pawi hle thei a ni.
• Natna atanga dam leh tur chuan hun rei tak a ngai thin.
• Natna avanga harsatna (e.g., thawkna virus hnua pneumonia vei) hi midang aiin i nei tam zawk.
• Viral infection thenkhat, a hmaa lo thianghlim tawh, entirnan Epstein-Barr virus emaw varicella-zoster virus (chickenpox thlentu virus) te chu a lo lang leh thei a ni.
• Vaccine i dawng a nih pawhin i taksain antibody a siam lo mai thei.

Immunocompromised a nih avangin symptom bik i nei lo mai thei. Mahse, he natna thlentu natna (cancer chi hrang hrang ang chi) i neih chuan, hetiang ang chi hi i nei thei a ni:

• Chau lutuk tih hriat (Fatigue) .
• Zan a thawk hah
• Khawsik lo awm leh thin
• Tum loh taka taksa rihna tihtlem
• Lymph node a lo hring chhuak

Infection bik, taksa chak lohna nei te zingah a awm thin

Infection thenkhat chu mi hrisel takin awlsam taka a do let theih leh a hneh theih tur a awm. Mahse chutiang natna hrik i neih chuan doctor chuan i immune system a chak lo hle niin a ringhlel mai thei. Chutiang hri kai zingah chuan:

• Pneumocystis pneumonia (PCP) hi pneumonia chi khat a ni a.
• Cytomegalovirus (CMV) natna lan chhuah dan
• Fungal infection, lung atanga taksa peng dang (e.g. coccidioidomycosis, cryptococcosis, histoplasmosis) a darh thin
• Bacteria natna kai fo thin
• Hri kai tam emaw, hun rei tak emaw, pneumonia, herpes simplex, campylobacter, emaw cyclosporiasis te.

Hetianga immunity tlahniam hi engte nge ni?

Vawi tam tak chu immune system chak lo chhan ber chu damdawi lam thil thenkhat, damdawi thenkhat side effects, leh organ emaw stem cell transplant ang chi thil te hi a ni. Heng zawng zawng hian kawng hrang hrangin i immune system a tichak lo thei a ni.

Natna leh dinhmun, taksa hriselna tichak lo thei

Natna \henkhat chuan kan immune cells te a tichhe emaw, an insiamthat dan tur dik tak a nghawng emaw a ni. Chutiang natnate chu:

• Primary immunodeficiency: Hei hi i taksa hriselna tichak lo theitu dinhmun eng pawh a ni a, chu chu i pianpui emaw, nakin lawkah i taksa hriselna a pianphungah a chak lo emaw pawh nise.
• HIV (human immunodeficiency virus) infection: Hei hian immune system chu direct-in a bei a.
• Cancer: Thisen kaihhnawih cancer, a bik takin leukemia, lymphoma, multiple myeloma te hi kan taksa hriselna tichhe thei cancer tam ber an ni. Amaherawhchu, cancer chi dang pawh hian immune system a nghawng thei bawk.
• Zunthlum natna `(Diabetes Mellitus)`
• Autoimmune diseases: Hei hi immune system-in taksa cell ngei a beih hian a ni.
• Sickle cell natna a ni
• Liver cirrhosis a awm thin
• Viral hepatitis (liver natna) 1.1.

Chutiang bawkin thymus (kan T cells, immune cell chi khat, puitlingna hmun) emaw, spleen (thisen var awmna leh control tu organ) nei lote pawhin immunity an nei tlem hle.

Immune-suppressing damdawi leh enkawlna te

Enkawlna thenkhat, radiation therapy leh cancer enkawlna chemotherapy te hian side effect angin immune system a tichak lo thei a ni. An hnathawhna hmuna immune system titawp thei enkawlna dang pawh a awm bawk. Entirnan, bone marrow transplant hian i immune system zawng zawng a tichhe vek a, a aiah a tha zawkin a thlak thin.

Autoimmune natna damdawi tam tak hian immune system a tichak lo va, cell hrisel tak takte a beih loh nan a titawp a ni. Hengte hi immunosuppressive damdawi (immune system hnathawh tihtlemtu) emaw, immunomodulatory damdawi (immune system hnathawh dan tidanglamtu) emaw kan ti a.

Damdawi leh damdawi lam enkawlna thenkhat, immunity titawp thei chu:

• Bone marrow emaw solid organ emaw thlak danglam a ni
• Chemotherapy hmanga enkawl a ni
• Radiation hmanga enkawlna a ni
• Corticosteroids (e.g. prednisone, prednisolone, dexamethasone) te hi a tha ber pawl a ni.
• `Azathioprine (Imuran®) hmanga siam a ni`
• ``Cyclosporine (Gengraf®, Neoral®) tih a ni a, a man pawh a tlawm hle.
• `Hydroxychloroquine (Plaquenil®) hmanga siam a ni`
• `Leflunomide (Arava®) hmanga siam a ni`
• `Methotrexate (Rheumatrex®, Trexall®) hmanga tihdam theih a ni`
• ``Sulfasalazine (Azulfidine®) tih hi a awm lo.

Hei hian eng side effect nge a neih theih?

I immune system a chak loh chuan natna hrik avanga nunna atana hlauhawm harsatna i neih theihna a sang zawk a ni. I taksain natna a do theih loh avangin natna hrik hi i taksa pum puiah a darh thei a ni. Hei hian taksa peng hrang hrang a tichhe thei a, sepsis (thisen rimchhia ang chi natna), leh septic shock (thisen sang tlahniam nasa tak) a thlen thei bawk. Chung zawng zawng chu thihna thlen thei a ni. Harsatna nasa tak i tawk a nih chuan emergency room hnai ber pan la.

Engtin nge doctor hian hei hi a hriat theih?

Doctor-te chuan immunodeficiency leh a thlentu natnate chu i thisen leh taksa tissue te enfiahin an hmuchhuak thin. Hei hi test bik thenkhat hman a ni a:

• Thisen chhiar kim (CBC) 1.1.
• Antibody test a ni
• Flow cytometry (immune cell chhiar) hmanga tih a ni.
• Genetic testing hmanga taksa hriselna tichhe thei genetic change zawng chhuah
• Urinalysis tih a ni
• HIV test a ni
• Lymph node biopsy hmanga enfiah a ni
• Bone marrow biopsy hmanga tih a ni
• Liver biopsy a ni
• CT scan emaw radiological test dang emaw hmanga enfiah a ni

Immune system hniam tak nei chu engtin nge i enkawl?

Immune system chak lo enkawlna chu a chhan a innghat a ni. Doctor te hian a hnuaia awm thenkhat chu an enkawl thei a, i immune system tihchak nan an pui thei bawk. Chutiang enkawlnaah chuan:

• Antiretroviral therapy: Heng enkawlnate hian i taksaa HIV awm zat chu nasa takin a tihtlem thei a ni. A tihtlem tawk chuan i immune system a nghawng lo.
• Cancer enkawl dan: 1.1.Immune system tichhe thei cancer te hi chemotherapy, radiation therapy leh immunotherapy hmanga enkawl an ni.
• Pegfilgrastim injection (Fulphila®, Neulasta®): I thisen var cell count a tlem hle (neutropenia) chuan he injection hian i taksain thisen var tam zawk siam turin a pui a, i immune system a tichak bawk.
• Granulocyte transfusion: Hei hi neutropenia na tak tan thisen pekna tlemte a ni.
• Stem cell transplant: Stem cell transplant hi taksa hriselna tichak lo natna thenkhat tihdam emaw control nan emaw tih theih a ni.

Infection venna emaw do thei tur enkawlna dang a awm bawk.

Immunity a hniam laia infection enkawl

I immune system a chak loh chuan i damloh hunah over-the-counter damdawi hmangin i dam thei lo mai thei. I doctor chuan antibiotic, antifungal, antiviral, emaw antiparasitic treatment a tan nghal fo thin a, chu chu natna chi hrang hrang a zirin a ni.

Infection dona pui turin damdawi inah pawh admit i ni thei bawk. Chutah chuan enkawlna hrang hrang pek i ni thei a, chungte chu:

• Monoclonal antibody a awm bawk
• Plasma dam leh thei
• Interferon gamma injection hmanga tihdam theih a ni
• Immune globulin (IVIG) chu thisen kal tlanga pek a ni.

Hetiang dinhmun nen hian eng nge i beisei tur?

Immune system chak lo nei zawng zawng hi an inang vek lo. Mi thenkhat tan chuan inthlak danglamna tlemte a ni thei a, thenkhat tan erawh chuan an nunphung zawng zawng a thlak danglam thei a ni.

Tin, mi thenkhat immunity hi hun rei lote chhung chauh a tlahniam thin. Mi dangte chuan dam chhung zawnga immune-modulating damdawi emaw, natna emaw an mamawh thei bawk. I dinhmun a zirin eng nge i beisei tur tih chu i healthcare team nen sawiho rawh.

A tlangpuiin, taksa hriselna chak lo nei mi pakhat tan chuan a chhan bulpuiah a innghat a ni. Immune system tichak lotu natna tam tak chu thunun theih a ni. Mahse, hri kai laka invenna tur emaw, a lo thlen huna enkawlna zawng tur emaw chuan dam chhung zawnga fimkhur hle a ngai fo thin.

Hei hi ven theih a ni em?

Immunosuppressive natna tam zawk hi chu ven theih a ni lo. Amaherawhchu, mi dang atanga hri kai laka inven hi harsatna lian tham tak laka invenna tha ber a ni. Immunosuppressive natna thenkhat laka invenna atan pawh a pui thei bawk.

Hri kai theihna tihziaawm nan hengte hi i ti thei ang:

• Kawng him zawk: I kut sil fo la, sex him tak hmang la, ei leh in himna dan zawm bawk ang che.
• Vaccine: I tana vaccine rawt zawng zawng chu la vek rawh. Vaccine thenkhat chuan immune system chak lote chu a ti na thei a ni. Chuvangin i doctor hnenah eng vaccine nge i tan a tha tih zawt rawh.
• Pre- exposure prophylaxis: HIV kai theihna chance sang tak i neih chuan Preexposure prophylaxis (PrEP) i ei thei ang. HIV kai tawh i nih chuan Post-exposure prophylaxis (PEP) i ei thei ang. Hepatitis B vei tan hian post-exposure prophylaxis option pawh a awm bawk.
• Exposure tihtlem: Mi damlo emaw, damlo nena inhmu tawh emaw te chu pumpelh rawh. Store-ah kal la, mi an tlem laiin thil lei tur lei rawh. Hei hi khawsik leh flu hunlai leh COVID-19 hri kai tam lai hian a pawimawh hle.
• Enkawlna tan hma: I doctor chuan natna hrik kai loh nan antibiotics emaw antifungals emaw a pe thei ang.
• Infection testing: Immunosuppressive therapy i tan hmain i doctor chuan HIV, hepatitis, tuberculosis, fungal infection, leh parasitic infection ang chi thil te a test thei che a ni.

Engtin nge i in enkawl ang?

I immune system a chak lo a nih chuan i hriselnaah i fimkhur hle a ngai a ni. Khawsik pawh hian a ti na hle thei che a ni. Natna laka invenna atana fimkhurna bik neih bakah hian i in enkawl dan tur dang tlemte a awm bawk:

• I hriselna enfiah: I doctor hnenah eng natna chhinchhiahna nge i en tur tih leh i neih chuan eng nge i tih tur tih zawt rawh. Entirnan, khawsik (temperature) aia sang, symptoms awm reng, etc.
• Ruahman lawk rawh: Mask leh hand sanitizer i kutah dah la. Khualzinnaah i kalna apiangah damdawi lam tanpuina i hmuh theihna tur hmun hre reng ang che. Mi thenkhat chuan an taksa hriselna a tlahniam tih ziakna card an keng thin.
• I hmangaihte hrilh rawh: I chhungte leh i thiante nen fimkhur dan tur sawipui rawh. Hrisel taka awmtir turin an pui thei che tih an hriatthiam a ngai a ni. Natna an hriat chuan an hmuh hmain an hrilh che a ngai a ni.
• I sikul/hnathawhna hmun nen ruahmanna siam rawh: I company-a human resources department emaw, sikul emaw (i fate sikul a nih chuan) hnenah hrisel leh him taka awm theihna tura i tihdanglam tur eng emaw zat sawipui rawh. Nangmah emaw i fa emaw hnathawh/sikul kal theih loh huna awmna tur dang chipchiar taka tarlanna tur ruahmanna siam turin i doctor nen thawhhona i neih a ngai mai thei.
• I doctor nen zalen takin inbiakna nei rawh: Mi thenkhat chuan midang bula awm hlauvin medical appointment an pumpelh thin. Risk awm lovin damdawi lam enkawlna i hmuh theih dan tur tha ber chu i doctor nen sawiho rawh. Virtual visit (video call ang chi) emaw, off-peak hour-a appointment emaw i schedule theih leh theih loh en rawh.
• Nunphung inthlak danglamna hian a pui thei em tih en rawh: Exercise emaw ei leh in emaw hian i taksa hriselnaah danglamna a thlen thei em tih doctor zawt rawh.
• Rilru hriselna dah pawimawh rawh: I taksa hriselna enkawl reng hian i rilru hriselna a nghawng thei bawk.Mental health counselor nena inbiakna te, nitin kea kal te, leh mahni in enkawl dan dangte hian i stress level a tihziaawm thei a ni. Chu chuan i immune system a pui bawk.

Doctor hmuh/damdawi in pan tur hian engtik lai nge ka mamawh?

I taksa chak lohna i neih chuan engtikah nge i hmuh leh tur tih te, natna hrik i neih nia i hriat chuan eng nge i tih tur tih te chu i doctor nen sawiho rawh. Symptom engemaw zat i neih chuan emergency room-ah kal nghal turin an ti mai thei che. I dinhmun bik ah hian thil tam tak a innghat a, mahse thil engemaw i ngaihtuah chuan check out a tha ber.

Engtikah nge Emergency Treatment Unit (ETU) ah i kal ang ?

I doctor hnenah eng symptom nge en tur tih leh engtikah nge emergency room pan tur tih zawt rawh. Infection na tak chhinchhiahna i neih chuan ER-ah kal fo ang che:

• Khawsik (a tlangpuiin 100.4 Fahrenheit/38 Celsius aia sang eng pawh) .
• Buaina emaw, hriatna tihdanglam emaw
• Lu na na tak
• Kawngkhar a nghet lo
• Luak chhuak emaw, luak chhuak fo emaw
• Hliam chu a sen, a hring, a na, a chhuak chhuak a, a khawih pawhin a lum a nih chuan

Doctor hnenah eng zawhna nge i zawh tur?

I doctor hnenah hetiang zawhna hi zawh hi a \angkai thei ang:

• Eng chen nge ``immunocompromised'' ka nih ang? Hei hi hun eng emaw chen atan nge a awm reng ang?
• Infection laka inven nan eng step nge ka tih theih ang?
• Eng natna chhinchhiahna nge ka fimkhur tur?
• Engtikah nge emergency room-ah ka kal ang?
• Engtikah nge ka hmuh leh ang che?

Mite chu chhan hrang hrang avangin ``immunocompromised`` an ni thei. I thil tawn chu midang tawn nen a danglam thei. Immunosuppressive damdawi i hman tan hmain he thu hi i chhiar a ni mai thei, i duhzawng thil tih a khap loh beiseiin. Damdawi inah i awm a ni mai thei, hri kai dang nen, hmalam hun eng nge thleng dawn tih ngaihtuah chungin. A nih loh leh i fa chu ``immunocompromised`` a ni a, i chhungte hian "just" an nei ngai lo tih khawvel hriattir i tum a ni.

Immune system chak lo nei zawng zawngte thil inang pakhat chu, mi dangte’n an duh loh theih loh tur inthlak danglamna leh fimkhurna an neih a ngai hi a ni. I hriselna enkawl dan tur midangte hrilhfiah chu a harsa thei hle. I medical team-ah innghat rawh. Support group leh himna leh hrisel taka awm theihna tur kawng dangte rawtna an nei thei bawk.

I hriat mi pakhat chu immunocompromised a nih chuan an mamawh chu ngaithla rawh. An rilru leh taksa hriselna humhim tura pui turin an tih che chu ti rawh.

I hriat tur thil (Take-Home Message) .

Immune system hniam neih hi hlauh tur a ni lo va, mahse a fimkhur a, a tul anga hma lak a pawimawh hle.

• I damlo fo a nih chuan emaw, i natnain a dam theih nan hun rei tak a mamawh a nih chuan damdawi lam thurawn zawng la.
• Immunity tlahniam thei chhan hrang hrang a awm a; chu chu hrethiam rawh.
• Doctor enkawl dan leh thupek dik tak zawm rawh.
• Infection laka inven nan theihtawp chhuah rawh. Kut sil hi tih danah siam la, mipui tamna hmun chu pumpelh rawh.
• I rilru hriselna pawh a pawimawh hle. I mamawh chuan tanpuina dawng hreh suh.
• Nangmah chauh i ni lo. I tanpui tur doctor, chhungte leh thiante an awm a.

He thu hi hriattirna atan chauh a ni tih hre reng ang che. Hriselna lama harsatna i neih chuan doctor rawn la.

` Immunocompromised, immunosuppression, natna awm fo, immune system, hri kai, enkawl