I fa chu a chau deuhin a hria em? Stairs chhoh te, tlan te, inkhelh te chu a harsat hle niin a lang em? A mit leh a hmui vel ah vun sen hring (red-purple) a nei em? A châng chuan hengte hi allergy awlsam tak angin kan ngai a, mahse hei hi thil pawi zawk a ni thei. Vawiin hian Juvenile Dermatomyositis, a tawi zawngin JDM kan sawi dawn a, hei hi natna hlauhawm tak, naupangte vei leh a lan chhuah dan inang lo tak tak a ni. Hming sei hi hlau suh, thumal awlsam takin engkim i sawifiah vek ang u.
Juvenile Dermatomyositis (JDM) hi eng nge ni?
A awlsam zawngin, JDM hi kan taksa ngeia kan invenna system, immune system , chu a lo kal nghal vat a, kan taksa peng hrisel tak takte chu a rawn bei tan ta a ni. A bik takin, kan vun, thisen kalna kawng te te, leh taksa ruhte a nghawng ber a ni . Damdawi lamah chuan kan system ngeiin min dodalna natna hi ‘autoimmune diseases’ an ti a. Kan ram humhalhtu sipaite hian keimahni mite ngei an rawn bei ang tih han ngaihtuah teh.
Hetiang dinhmun hian naupang ruh (muscle) a tichak lo hle. Hei hian ding chhuak te, stairs chho te, tlan te, inkhelh te, a chang chuan sam hrual ang chi thil awlsam tak tak te pawh a ti harsa thin. Nu leh pa i nih angin i fate’n nitin hna an thawh theih lohna tur damdawi lam harsatna eng pawh i hriat hian lungngaihna leh hlauhna i neih hi hriatthiam theih a ni. Mahse a tha ber chu JDM enkawlna hian a natna lan chhuah dan chu hlawhtling takin a thunun thei a , i fa nun a ti tha hle bawk.
He natna hi tuin nge vei tam ber?
JDM hi natna hmuh tur awm lo tak a ni. Naupang kum 5 leh 10 inkar atanga tan a ni tlangpui a, hmeichhiaah pawh mipa aiin a let hnih zetin a tam zawk bawk. Naupang tu pawh a nghawng thei a, mahse zirchiannaah chuan naupang var zingah a tam zawk tih hmuhchhuah a ni.
Puitling pawhin heng symptoms te hi an nei thei bawk. Mahse kum 40 emaw 50 emaw vel ah a thleng tlangpui. He natna hi puitlingah a lo awm chuan Dermatomyositis kan ti thin. JDM leh Dermatomyositis te hi group khatah an awm ve ve a, chu chu natna pahnih an ni a, chu chu Myositis an tih, taksa peng hrang hranga inflammatory diseases group-a tel an ni.
JDM mizia hmasa berte chu engte nge ni?
Natna hriat chhuah hma hian i faah hian danglamna engemaw zat i hmu mai thei. Hengte hi natna chhinchhiahna hmasa ber a ni thei. Hengte hi i ngaihven chuan Doctor i pan vat thei ang.
| A hmasa ber feature | A sawifiahna awlsam tak |
|---|---|
| Chauhna awm reng | Naupang chu a chau reng a, a hma ang bawkin tlan leh inkhelh a ngaihven tawh lo. |
| A chhan awm lova khawsik | Chhan dang vangin i lum emaw, i lum emaw pawh a ni thei. |
| Joint swelling emaw, a nghet lo emaw | Zing i thawh chuan i ruhte chu a nghet hle a, a hring deuh pawh a ni mai thei. |
| Chaw chakna | Ei duhna a tlahniam a, a hma angin chaw i dil lo mai thei. |
| Muscle na a na | Naupang chuan thil tih pangngai emaw, inkhelh laiin emaw an taksa ruh a na tih a sawi thei. |
| Chhan awm lovin taksa rihna tihtlem | Naupangin an ei leh in thunun loha a rihna a tlahniam a nih chuan i ngaihtuah tur a ni. |
| Vun a hring chhuak | Hmai leh kut ah hian vun a lo lang thei. Ni chhuahnaah pawh vun inthlak danglamna a pung thei bawk. |
Natna lanchhuahna lian ber pahnih chungchang hi thui takin sawi ila.
JDM hi a dik tih finfiah a nih veleh hian a natna lan chhuah dan (persistent symptoms) lian ber pahnih a awm a, chungte chu vun inthlak danglam leh taksa ruh chak lohna te an ni.
1. Vun rawng (Vin Rash) a awm
JDM vei naupangte hian vun natna chiang tak tak an nei thei.
- Hmai inthlak danglamna: Hei hi hmui leh mitmeng sen emaw, sen emaw atanga tan a ni . A châng chuan mitmeng chu a hring angin a lang a, chuvangin doctor-te chuan a tirah chuan allergy awlsam tak niin an ngai sual thei a ni.
- Fingernail, khup leh elbows: Hun kal zelah i fa kut zungtang, khup leh elbow-ah hian dry, red patches emaw bumps emaw a lo awm thei a. A hmasa berah chuan hengte hi eczema emaw psoriasis emaw ang mai a ni thei.
- Ni sensitivity: Hei hi symptom pawimawh tak a ni. JDM vei naupang chu ni ênga a awm chuan he vun rawng hi a na zual sauh sauh a ni .
2. Muscle chak lohna
Hei hi JDM symptom lian leh tibuai ber dang a ni. He chak lohna hi taksa lairil hnaih lama taksa ruh (muscles)-ah hian a lang ber a ni. Chu chu:
- A kekawrte
- Nghawng
- Hip area a ni
- Pum chhunga thau (abdominal muscles) te
- Kut leh ke chunglam
Heng taksa ruhte hi a chak loh chuan naupang tan nitin hna thawh a harsa hle thei a ni. Entîr nân, ṭhutna aṭanga tho te, stairs chhoh te, ṭhutphah aṭanga tho te, tlan te, leh an sam hrual te chu a harsa thei hle.
A nasat chuan JDM hian naupang thawk leh ei leh in thau a nghawng thei bawk . Hei hian choking, hoarseness, leh thawk harsa (dyspnea) a thlen thei.
Enkawl loh chuan eng harsatna nge thleng thei?
JDM hi damdawi lam natna a ni a, damdawi lam pan vat a ngai a ni. Enkawl loh chuan harsatna lian tak tak a thleng thei a ni.
- Calcium deposits: Vun hnuaiah hian lump khauh tak tak, chalky ang maia awm a lo awm thei. Chungte chuan taksa ruh chetna a tikhawtlai thei a, natna a thlen thei bawk.
- Muscle contractures: Muscle te chu a tawi a, ruhkawr a ben chuan a inzawm tan thin. Hei hian ke ruh chu tihzauh a harsat phah thei a ni.
- Ulcers: Vunah emaw, chaw kawng chhungah emaw hliam a awm thei.
- Chak lohna nasa tak: Thâwk leh ei chakna nasa tak chuan nunna a tichhe thei a ni.
Mahse hei hi i chhiar zawhah hlau suh. Chumi awmzia chu enkawl loha dah a nih chuan, .Eng thil nge thleng thei? Tun hma chuan he natna enkawlna tha tak a awm loh laiin JDM vei naupang pathum zinga pakhat vel an thi thin. Mahse tunlai hian enkawlna tha zawk a awm tawh avangin naupang 98% aia tam chu an natna hmuhchhuah atanga kum nga hnuah an dam tawh a ni . Chuvang chuan natna hriat hmasak leh enkawl dan dik a pawimawh em em a ni.
Engvangin nge hetiang hi a lo awm? JDM hi eng nge a chhan?
Kan sawi tawh ang khan JDM hi autoimmune disease a ni. Mahse, engvangin nge kan taksa hriselna (immune system) ngei pawh hian min do nghal mai? Doctor te chuan hei hi a chhan bik an la hmu chiang lo tak zet a ni .
Mahse hemi chungchangah hian theory engemaw zat a awm. Theory bulpui pakhat chu thil pakhat, virus infection ang chi taksaa a luh chuan kan immune system hian a do tan thin tih hi a ni. Mahse, hri kai a bo hnuah pawh he immune system hian a beih a titawp lo. Chu ai chuan a thawk chhunzawm zel a, kan taksa cell ngei pawh a rawn bei tan ta zawk niin an ngai. Zirchiangtute pawhin hei hi genetic component a awm thei niin an ngai bawk.
He natna hi Doctor hian engtin nge a hriat chian? (Diagnosis) tih a ni.
Doctor hnena i fa i hruai dawn chuan uluk takin naupang chu a enfiah hmasa ang. A bik takin vun rawng leh taksa ruh chakna an enfiah ang. Tichuan i symptoms te an zawt ang che.
Diagnosis dik tak hriat chian nan test eng emaw zat neih a ni.
- Thisen test: Thisen test pakhat chauh a awm lova, JDM hi a hriat nghal thei lo. Mahse, thisen test hian taksaa inflammation level, taksa ruh a chhiat huna thisena muscle enzymes awm zat, leh JDM-a hmuh fo thin specific proteins (autoantibodies) te ang chi thil te a enfiah thei a ni.
- Electromyography (EMG): He test-ah hian needle ang chi electrode te te te chu taksa peng hrang hrangah dahin, chu ruhte electrical activity chu an teh thin. Hei hian taksa peng hrang hrang hnathawh dan dik lo awm apiang hriatchhuahna kawngah a pui thei a ni.
- MRI (Magnetic Resonance Imaging): MRI scan hian taksa chhung lam chipchiar taka thlalak a siam thei a. Thil chiang takin a hmu thei a, chu chu taksa ruh (muscles)-a natna leh inflammation (inflammation) fiah lo tak tak te hi a ni.
- Muscle biopsy: Hetah hian surgical procedure tenau tak hmangin a natna atanga tissue te tak te tak te chu lakchhuah a ni a, microscope hmangin an enfiah thin. Hei hian taksa peng hrang hrangah inflammation a awm leh awm loh leh JDM emaw, natna dang, Muscular Dystrophy emaw avanga lo awm a nih leh nih loh hriat theih nan a pui thei a ni.
- Nailfold capillaroscopy hmanga enfiah a nih chuan:Hei hi test awlsam tak, hrehawm lo tak a ni. Nausen nail hnuaia thisen kalna kawng te tak te te enfiah nan hian light bik leh magnifying lens nei device an hmang thin. Heng thisen kalna kawngte hi JDM vei naupangteah a hring fo thin.
JDM enkawl dan tur chu engte nge ni?
JDM enkawlna tum ber chu taksaa inflammation tihziaawmna leh naupang nunphung tihchangtlun a ni. Naupang tam tak chu JDM nen hian kum engemawzat an awm a ngai a, mahse enkawlna hian a natna lan chhuahna chu a thunun thei hle. Enkawl zawhah naupang tam tak chu thla tam tak emaw kum tam tak emaw chhung chu natna lanchhuahna nei lovin an kal thin. Hei hi ‘remission’ kan ti a ni.
Enkawl dan hi hmunpui pahnih ah then theih a ni.
| Enkawl dan tur | Hrilhfiahna |
|---|---|
| Damdawi chi hrang hrang | |
| Corticosteroid hmanga tihdam theih a ni | Hengte hi damdawi chi hrang hrang pek hmasak ber a ni. Taksa a inflammation an tihziaawm thuai a, immune system hnathawh pawh an control bawk. |
| Hydroxychloroquine hmanga siam a ni | He damdawi hi vun vun natna tihreh nan an hmang fo thin. |
| Immunoglobulin (IVIG) hmanga thisen kal tlanga hman thin. | Hei hian thisen petu hrisel tak tak atanga antibodies thianghlim tak tak chu saline solution-ah taksaah pek a ni. Hengte hian antibody tha lo tak tak te chu a block a, immune system a ti thlamuang bawk. |
| Methotrexate hmanga siam a ni | He damdawi hi JDM vei naupang zawng zawng deuhthaw hnenah pek thin a ni. Tin, immune system a titawp bawk a, steroid hman tlem nan a pui bawk. |
| Nunphung & Therapies te | |
| Ei leh in lama inthlak danglamna | Thei, thlai, sa thau lo, thau hrisel, leh buh chi hrang hrang nena ei leh in inthlau tak hian inflammation a tiziaawm thei a ni. I ei harsat chuan ei leh in lama thurawn bik pek a ngai mai thei. |
| Taksa lam enkawlna | Physics therapist chuan naupang chu taksa ruh tichaktu, ruh nghet lo tur leh natna vengtu exercise a pe ang. |
| Thusawi hmanga enkawlna (Speech Therapy) a ni | Chaw ei emaw, thawk emawa inrawlh taksa ruhte chu a chak lo a nih chuan, thusawi thiam chuan a hmachhawn dan leh ei leh in him danah a pui thei a ni. |
| Ni laka invenna | Hei hi a pawimawh hle a ni . SPF 30 aia sang sunscreen hmang fo ang che. Kawrfual, sunglass, leh i taksa khuh thei thawmhnaw ha la. A bik takin zing dar 10 leh tlai dar 4 inkarah i fa chu ni chak tak laka venhim a pawimawh hle. |
Take-Home Thuchah a ni
- Juvenile Dermatomyositis (JDM) hi autoimmune natna hmuh tur awm lo tak a ni a, naupangte pawhin an vei a ni. Chumi awmzia chu taksa ngeia immune system hian vun leh taksa ruhte a bei tihna a ni.
- A lan chhuah dan ber chu vunah (a bik takin hmai leh ke ruh-ah) red-purple rash leh taksa ruh chak lohna te hi a ni. I fain hahdamna emaw, stairs chhoh harsatna emaw a lantir chuan lungngai rawh.
- Hei hi hlauh tur a ni lo. Tunlai enkawlna changkang tak takte hmang hian natna lan chhuah dan chu a tam zawkin control theih a ni a, naupang chuan nun pangngai, active takin a hmang thei a ni.
- Ni laka invenna hi a pawimawh hle. Nitin sunscreen hman hi tih danah siam la, lukhum bun bawk ang che. Hei hi natna thunun nan a pawimawh hle.
- I fain heng natna lan chhuah dan hi a nei tih rinhlelhna tlemte pawh i neih chuan doctor thiam tak pan nghal rawh . Hriat chian leh enkawl vat chuan naupang hmalam hun a tichiang thei a ni.
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