I rilru a hah fo em, sawifiah theih loh khawpa khawsik i nei fo em, leh ruh natna avangin i taksa rihna i tlahniam fo em? Chûngte chu thil pangngai angin lang mah se, a châng chuan hêng chhinchhiahna hnung lama thup bo chu natna, kan hriat vak loh, tlema kan ngaihsak tâwk a ni thei. Vawiin hian hetiang natna hmuh tur awm lo mahse pawimawh tak, kan fimkhur tur chungchang kan sawi a ni. Hei hi microscopic polyangiitis an ti a, doctor-te’n an tih angin MPA an ti a ni.
A awlsam zawngin, Microscopic Polyangiitis (MPA) hi eng nge ni?
A awlsam zawngin sawi ila, MPA hi kan taksaa thisen kalna (blood vessels) te tak te leh lian lo te chu a lo hring chhuak a, chu chu a hring chhuak tihna a ni. Damdawi lamah chuan he thisen kalna kawng hring hi ‘vasculitis’ kan ti tlangpui. Hei hi natna hmuh tur awm lo tak a ni.
Chutianga thisen kalna kawngte a lo inflamed chuan thisen an pekna organs te chu an tichhe tan thin. MPA-a taksa peng hrang hrang a nghawng theih berte chu:
- Kidney a ni
- Chuap
- Nerves a awm
- Vun
- Joints (joints) te chu 1.1.
‘Vasculitis’ tih hi eng nge ni? Eng nge a thlen?
Kan taksa pum puia thisen kalna kawng (blood vessel system) hi tui phurtu pipe system angin han ngaihtuah teh. Heng pipe te hi a hring emaw, a hring emaw a nih chuan harsatna engemaw zat a awm thei a ni.
1. Thisen kalna kawng chak lo: A hring vangin thisen kalna bang chu a chak lo a, balloon ang maiin a bulge thei. Hei hi ``(Aneurysm)`` kan ti a. A châng chuan he hmun chak lo tak hi a puak darh thei a, a chhehvel tissue-ah thisen a chhuak thei bawk.
2. Thisen kalna kawng a zim: Thil dang pakhat chu thisen kalna kawng chu a chhunga a hring avangin a zim thei a, a chang chuan a inkhar kim vek thei bawk. Tichuan, chu thisen kalna kawng atanga thisen leh oxygen dawngtu taksa pengte chu a chhe tan ta a ni. Thingkung tui a tlakchham laia a thi ang chiah hian.
Chu chu MPA-ah a thleng thin. Thisen kalna kawng te te hian a nghawng avangin thisen petu taksa peng sensitive tak tak, kal leh lung te chu an tichhia a ni.
He natna hi tuin nge vei? Eng thilin nge a thlen?
Hei hi natna hmuh tur awm lo tak a ni. Statistics atanga a lan dan chuan he natna hian khawvela mi maktaduai tin zinga 13 atanga 19 inkar a vei a ni. Kum eng pawhah a lo awm thei a, hmeichhia leh mipa pawh inang tlangin a nghawng niin a lang.
He natna thlentu dik tak hi hriat chhuah a la ni lo a, mahse hetiang zat hi a chiang hle:
- Hei hi cancer a ni lo.
- Natna hrik kai theih a ni lo.
- A tlangpuiin thlahtu natna a ni lo.
Research-in a tam zawkah chuan hei hi kan taksa ngeia immune system a thawk tha lo avanga lo awm a ni tih a tarlang. A awlsam zawngin kan taksa venghimtu tur immune system hian tihsualin kan thisen kalna kawngte chu a rawn bei tan ta a ni. Chu chu he inflammation thlentu a ni.
MPA natna lan chhuah dan chu engte nge ni?
MPA hian taksa peng hrang hrang a nghawng avangin a natna lan chhuah dan hi a inang lo thei hle a, mi hrang hrangah pawh a inang lo thei bawk.
| A nghawng part | Symptoms awm thei te |
|---|---|
| Thil awm dan tlangpui | Chauhna, khawsik, chaw ei chak lohna, taksa rihna tlahniam, taksa ruh leh ruh na. |
| Chuap | Thâwk harsa, thisen chhuak khuh. |
| Nerves a awm | Hriatthiamna danglam tak (electric shock, rulhut tlan kual ang chi), a hnuah rilru hahna, chakna hloh. |
| Vun | Vunah hian a sen emaw, a sen emaw a awm (rashes). |
| Kidney a ni | Hei hi a hlauhawmna hmun a ni. When the kidneys are affected , a tir lamah chuan symptoms a awm lo fo thin. I kal (kidney) te hnathawh a chawlhsan hma loh chuan i hre lo pawh a ni thei. |
Kidney natna hi a lan chhuah loh theih avangin vasculitis nei nia rinhlelh tu pawh zun test tir hi a pawimawh hle.
He natna hi engtin nge doctor hian a hriat theih ang?
MPA hmuhchhuah hi step khata tih a ni lo. Doctor chuan thutlukna siam tûrin thil engemaw zat a thlunzawm a ngai a ni.
- Chipchiar zawka zawh i ni ang: Doctor chuan i natna lan chhuah dan te, a lo intan dan te, leh i damdawi lam chanchin te ngun takin a ngaithla ang.
- Taksa enfiahna: I doctor chuan i taksa chu eng organ nge a nghawng tih hriat tumin a enfiah ang.
- Thisen leh zun test: Thisen test hian a bik takin antibody ``(ANCA - Antineutrophil Cytoplasmic Antibodies)`` tih chu a zawng thin. Hei hi MPA ang natnaah pawh positive a ni thei. Tin, zun-a protein leh thisen sen awm leh awm loh enfiah hi kal (kidney) dinhmun hriat nan a pawimawh hle.
- Scan: X-ray, CT scan, MRI scan hmangin lung ang chi taksa peng hrang hranga thil dik lo awm leh awm loh enfiah a ni.
- Biopsy: Natna rinhlelh a nih chuan a natna hmun (e.g., kal, vun) atanga tissue te tak te la chhuakin microscope hmangin an enfiah thin. Hei hi vasculitis i neih leh neih loh finfiahna tha ber a ni.
ANCA thisen test a positive vang mai mai chuan natna i nei tihna a ni lo. Diagnosis-a tanpuitu chauh a ni. Definitive tur chuan biopsy neih a ngai fo thin.
MPA enkawl dan tur chu engte nge ni?
MPA enkawlna tum ber chu kan immune system overactivity control a, thisen kalna kawng chhiatna tihtawp hi a ni. Chumi atan chuan immunosuppressive damdawi hman a ni.
Natna a nasat hunah
Organ lian tak tak, kal leh lung te na taka a nghawng chuan corticosteroid hi immunosuppressive damdawi chak dang Cyclophosphamide (Cytoxan®) emaw Rituximab (Rituxan®) te nen pek thin a ni.
Natna hi chutiang khawpa na lo a nih chuan
A na lo zawkah chuan corticosteroid leh methotrexate te hman hmasak theih a ni.
Enkawlna tum ber chu natna hi thunun kim vek a, thiltih theih lohna dinhmunah thlen a ni. Hei hi ‘remission’-a luh an ti. Natna hi a thunun tawh chuan doctor chuan zawi zawiin steroid dose a tihhniam ang.
Damdawi chak zawk `Cyclophosphamide` ang chi hi natna control theih a nih hma (thla 3-6 vel) chauh pek thin a ni. Chumi hnuah chuan natna thunun theih nan leh a lo let leh tawh loh nan `Maintenance Medication`, `Azathioprine (Imuran®)` emaw `Mycophenolate Mofetil (Cellcept®)` emaw ah i thlak leh thin. He maintenance treatment hi kum khat emaw kum hnih emaw tal ei a ngai mai thei.
"Hengte hi cancer damdawi a ni lawm ni?"
Hetah hian mi tam takin zawhna an nei a. Damdawi `Cyclophosphamide` leh `Methotrexate` tih te hi cancer tan pawh pek a ni a, chuvangin hengte hi `Chemotherapy` damdawi a ni an ti. Ni e, hengte hi cancer tan pawh pek a ni. Mahse `Vasculitis` dose pek hi cancer dose pek aiin a let 10-100 in a hniam zawk. Hetah hian heng damdawi te hnathawh hi cancer cell tihhlum a ni lo va, immune system hnathawh thunun a ni.
Heng damdawi te hian immune system a tihbuai avangin natna khirh tak tak kai theihna a awm a ni. Tin, damdawi tin hian side effect engemaw zat a nei thei bawk. Chuvangin, a hun taka test neih a, doctor-in a tih angin doctor enkawlna hnuaia awm reng a pawimawh hle.
He natna nen hian nun hi eng ang nge ni ang?
MPA hi natna khirh tak ni mah se, enkawlna dik tak a awm chuan mi tam zawk chuan hlawhtling takin an thunun thei a ni. Natna a nasat dan azirin outcome a inang lo. Amaherawhchu, a tlangpuiin mi 80% aia tam chu he natna vei hmuhchhuah a nih atanga kum 5 hnuah dam leh dam an ni.
Hriat hmasak leh enkawl hmasak hian taksa peng hrang hrang chhiatna a ti tlem thei hle. Doctor nen pawh inbiak reng a pawimawh bawk.
Natna chu thunun theih a nih hnuah, chu chu ``Remission``-a a luh hnuah, a chang chuan a lo let leh thei a ni. Hei hi ``Relapse`` kan ti a. Damlo 50% vel chuan hetiang natna hi an nei leh thin. Chuvangin, symptom thar i neih chuan doctor hnenah i hriattir nghal tur a ni.
Take-Home Thuchah a ni
- MPA hi natna hmuh tur awm lo tak a ni a, keimahni immune system hian thisen kalna kawng a bei thin.
- Hei hian taksa peng pawimawh tak tak, kal, lung leh nerve te a tichhe thei a ni. A bik takin kal (kidney) a nghawng chuan a tir lamah chuan symptom a awm lo thei.
- A hmaa hriatchhuah leh enkawl chuan hun rei tak chhung chhiatna a veng thei a ni.
- Immunosuppressive damdawi hi enkawlna atana hman a nih avangin damdawi lam enkawlna hnuaia awm reng a, natna hrik laka inven a pawimawh hle.
- Natna hi thunun a nih pawhin a lo let leh theihna a awm. Chuvangin, symptom thar i neih chuan, a tenau pawh nise, i doctor hnenah hrilh nghal rawh.
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