Thluak tibuaitu thil awm lo tak: PML hi i hre chiang em? (Progressive Multifocal Leukoencephalopathy - PML) a awm a, a rilru a hah lutuk a, a rilru a buai em em bawk a.

PML (Progressive Multifocal Leukoencephalopathy) tih natna hi i hre tawh em? He hming hi i hre lo mai thei. A chhan chu PML hi kan thluak khawih buai em em a ni. Hemi a thil thleng chu kan thluaka nerve cell vel venhimna khuhtu myelin siamtu cell te chu zawi zawiin an tichhia a ni. Myelin hi hriak ang mai a ni. Hei hi thluak leh ruhro (kan central nervous system)-a neurons te humhimtu a ni. Chuvangin he myelin hi a bo chuan thluaka thil var (white matter) chu a chhe ta a ni.

PML tih hming hi eng nge a awmzia?

Tunah chuan PML tih hminga hawrawp awmte hi eng nge a awmzia kan en ang. Hei hi hriatthiamna chuan natna chungchang hi a rough idea a pe ang che.

• P — Progressive: Hei hian natna hi a na zual zel tihna a ni . Chumi awmzia chu hun kal zelah symptoms a pung thei tihna a ni.
• M — Multifocal: Hei hian natna hi thluak hmun khatah chauh a awm lo va, hmun hrang hrang a nghawng tihna a ni . Thluak hmun hrang hrangah hliam te te a awm ang mai a ni.
• L — Leukoencephalopathy: He thumal hi a buaithlak deuhin a ri a ni lawm ni? A awlsam zawngin, chu natna chuan thluaka myelin, a nih loh leh thil var chu a nghawng ber tihna a ni .

Chuvangin, PML hian thluak a tichhia a ni. Hetiang chhiatna hian thluak lam harsatna chi hrang hrang a thlen thei a ni. Entirnan, rilru lama harsatna, mit lama harsatna, leh kal harsa. PML hi natna zual zel a nih avangin hun kal zelah a zual thei hle. Amaherawhchu, mi thenkhat tan chuan a hmaa enkawl hian natna a zual zel dan a tikhawlo thei a ni.

PML natna lan chhuah hmasak berte chu engte nge ni?

Mi tam tak tan chuan PML symptoms hi a intan a, a fiah lo hle. Tin, thluak hmun eng ber nge natnain a nghawng dan azirin a natna lan chhuah dan pawh a inang lo thei bawk. Thing hnah pakhat a thih chuan chu hnah a function dang zawng zawng chu a thawk tawh lo ang maiin han ngaihtuah teh.

PML chhinchhiahna hmasa ber chu:

• Clumsiness emaw, inrem lohna emaw
• Thusawi emaw ngaihtuah harsat
• Taksaah chak lo anga inhriatna

Infection a kal zel chuan symptoms te pawh i nei thei bawk:

• Dementia, hriatrengna hloh
• Thusawi hloh
• Mit hmuhna hloh
• Nungchang leh mize a inthlak danglam thin

Mi thenkhat chuan lu na emaw, seizure emaw an nei thei bawk a, mahse hei hi a tlem hle. Vanduaithlak takin PML hi hun kal zelah a na zual tlangpui a, lehThihna thlen thei a ni fo. Mahse, damlo damdawi lam dinhmun leh enkawlna a dawn dan azirin a chhuah dan a inang lo thei.

Eng thilin nge PML hi a thlen?

PML hi virus pakhat JC virus (JCV) tih atanga lo awm a ni. He virus hi hri kai hmasa ber (John Cunningham) hminga hawrawp hmasa ber atanga siam a ni. He virus hi human polyomavirus 2 tia hriat a ni bawk.

Mak tak maiin puitling 85% velin an taksaah JC virus hi an nei a. Mahse mithiamte chuan he hri hi engtin nge mihringah a kai theih tih erawh an la chiang lo hle. Naupangte hian ei leh in emaw tui emaw hmangin an dawng thei tih finfiahna engemaw zat a awm. He hri hi zun test-ah pawh hmuhchhuah a ni tawh bawk. Chuvangin, zun-oral contamination hmanga kai theih a ni.

Mahse, mi tam takin an taksaah JC virus hi nei mahse, a thawk chhuak lo va, a muhil mai mai a ni. Chuvangin symptoms a awm lo. Amaherawhchu, taksa chak lohna nei mi pakhatah chuan he hri hi taksaah a thawk chhuak thei a, PML-ah a lo thang lian thei a ni. Hmelma muhil, kan chak loh laia harh chhuakin min rawn bei ang mai a ni.

He natna vei theihna hlauhawm ber chu tute nge ni?

PML hi a tlangpuiin immune system chak lo tak tak neiah chauh a awm thin. A hnuaia natnate hi i neih chuan he natna hi i vei thei bawk:

• HIV/AIDS hrik kai a ni
• Thisen leh ruhro cancer, entirnan, leukemia
• Lymphatic system cancer, entirnan, lymphoma emaw Hodgkin natna emaw a awm thei
• Autoimmune natna, rheumatoid arthritis, multiple sclerosis (MS), emaw lupus te hi a ni

Tin, organ donor recipient i nih a, i taksain organ a hnawl loh nan immunosuppressant damdawi i ei a nih chuan i hlauhawm thei bawk.

Doctor-te hian engtin nge PML hi an hriat theih?

I doctor chuan a enfiah hmasa ang che a, i natna lan chhuah dan chu ngun takin a ngaithla ang che. Tichuan, i thluak leh i ruhro enfiahna test eng emaw zat hmangin PML chu an nemnghet thei a ni. Hetiang test hi i neih a ngai mai thei:

• Brain MRI scan: Hei hian thluaka white matter-a hliam awmte thlalak a la thei. Camera in thluak chhung lam thlir ang mai a ni.
• Spinal tap/lumbar puncture: Hei hian i thluak leh i ruhro vel a tui cerebrospinal fluid (CSF) sample tlemte lak a huam a ni. Hei hian JC virus a awm leh awm loh a enfiah thei a ni.
• Brain biopsy: Hei hi tih a tlem hle. Diagnosis finfiah a harsat hunah chauh tih a ni.

PML hi engtin nge enkawl a nih?

PML enkawlna atana thil pawimawh ber chu i taksa hriselna tihchak hi a ni. Kan taksa invenna a chak loh chuan natna a lo awm thin tih hre reng ang che. Chuvangin, a pawimawh ber chu chu defense chu tihchak leh hi a ni.

• Entirnan, AIDS i vei chuan antiretroviral therapy (ART) pek i ni thei bawk . Heng damdawi te hian i taksaa HIV awm zat tihtlem nan hna an thawk a ni. He enkawlna hian i immune system chu eng emaw chen chu a thawk thei a ni.
• Mi thenkhat chuan plasma exchange tih damdawi hi an hlawkpui thei bawk . He enkawlna hian i thisen atanga immunosuppressant damdawi thenkhat a paih chhuak thin. He enkawlna hian i immune system hian JC virus hi a hnathawhna tichakin a do thei bawk.

Tunah hian scientist-te chuan PML enkawlna atan damdawi thar eng emaw zat an enchhin mek a ni. US Food and Drug Administration (FDA) chuan mi thenkhat tan heng damdawi hman phalna bik a pe a, mahse result a inang lo hle.

Engtikah nge Doctor ka hmuh ang?

I immune system a chak lo tih i hriat a, Progressive Multifocal Leukoencephalopathy (PML) nena inzawm nia i ngaih symptoms i neih zauh zauh ang maia i inhriat chuan doctor pan nghal a, check out neih a pawimawh hle.

Doctor hnenah eng zawhna nge ka zawh ang?

Doctor i hmuh hunah hetiang zawhna hi i zawt thei ang:

• PML ka vei theihna tur risk chu eng nge ni?
• He risk tihtlem nan hian ka tih theih tur a awm em?
• PML-ah hian eng symptom nge ka fimkhur tur?
• Immunosuppressant damdawi ei hian eng hlauhawmna nge a neih?
• Ka dinhmun enkawlna dang a awm em?
• Tuna enkawlna hman mekte hian eng hlauhawmna leh hlawkna nge an neih?

Heng zawhnate hi zawh hian natna leh a enkawl dan chungchang hriatthiamna tha zawk i nei thei ang.

PML vei dam rei zawng chu engzat nge ni ang?

Hei hi thupui sawi harsa tak a ni tak zet a ni. PML hi natna zual zel a ni. Chumi awmzia chu hun kal zelah symptoms a na zual tihna a ni. PML vei dam rei zawng chu a kai nasat dan leh a enkawl danah a innghat a ni. Mi 30% leh 50% inkar chu natna hmuhchhuah a nih hnu thla engemaw zat chhungin an thi thin. Mi dam rei zawkte chuan natna lanchhuahna an nei chhunzawm zel a, chu natna lanchhuahna chu a na zual sauh sauh a ni. Heng symptoms te hian harsatna lian tak tak a thlen thei a, chu chu tawng thiam lohna leh mit hmuhna hloh te hi a ni.

Mahse, zirchianna thar chuan HIV kai PML vei mi tlemte chuan an natna chu a ti nghet thei a, an dam rei thei tih a tarlang. HIV hrik kai enkawlna atana antiretroviral therapy (ART) a lo chhuah hma khan PML vei zinga 10% chauh chu kum khat aia tam dam an ni. Mahse tunah chuan ART hmang hian kum khat chhunga damchhuah zat chu 50%-ah a pung ta a ni. A then phei chuan ART hian immune system chu JC virus dona kawngah a pui thei a ni.

PML atanga dam leh vek theih a ni em?

Immunosuppressant damdawi ei laiin PML vei te chu damdawi an chawlhsan hnuah an dam leh thei a ni. ART hmanga hlawhtling taka enkawl tawhte pawhin PML an dam leh thei bawk. Mahse, PML damchhuak zinga 80% chuan an symptoms an nei leh lo. Hei hi a chhan chu a chhe lai hmunah hian myelin thar a chhuak lo. Permanent neurological damage hi a awm fo thin. Mahse, mi thenkhat chu PML clear hnu kum 15 thleng an dam thei a ni.

Plasma exchange nei mekte tan eng nge beisei?

I PML symptoms hi immunosuppressant drug avanga lo awm tan a nih chuan, chu damdawi i ei tawh loh chuan i symptoms chu a bo thei a ni. I taksa atanga immunosuppressant damdawi thenkhat paih chhuah nan plasma exchange i nei thei bawk. Plasma exchange tum ber chu i immune system tihchak hi a ni. Mi thenkhat tan chuan plasma exchange hian PML hmasawnna a tikhawtlai thei a, a dam rei thei bawk. Amaherawhchu, hei hian a hlawkpui zia hi kan la hre kim lo.

Mi tam tak chuan damdawi an chawlhsan hnuah emaw, plasma exchange an dawn hnuah emaw PML symptoms an nei chhunzawm thei a ni. Mi dangte chuan thluak lam harsatna an nei thei bawk. Damdawi ei loh hian hlauhawm dang a awm bawk. Chuvangin, i damdawi ei tur chungchanga thutlukna i siam dawnin i doctor nen inbiakna neih a pawimawh hle.

Engtin nge Progressive Multifocal Leukoencephalopathy (PML) vei theihna hlauhawm ka nih leh nih loh ka hriat theih ang?

I taksa hriselna tichak lo thei damdawi i neih chuan i doctor hnenah PML i vei theihna tur zawt rawh.

Damdawi dangin PML ka vei theihna a tipung em?

Multiple sclerosis (MS) emaw Crohn’s disease ang chi natna nei te pawhin thisen test an neih a ngai a, JC virus kai theihna tipung thei HIV ang chi dinhmun an enfiah bawk tur a ni.

Doctor-te chuan MS emaw Crohn natna enkawlna atan damdawi Natalizumab (Tysabri®) an pe fo thin. He damdawi hian PML vei theihna a tipung thei a ni.

JC virus inactive i nei a, symptom i nei lo a nih pawhin natalizumab hi i ei thei mai thei. Mahse, a hlauhawmna leh a thatna chungchang doctor nen inbiakna neih a pawimawh hle.

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

Progressive Multifocal Leukoencephalopathy (PML) hi thluaka natna hlauhawm tak, JC virus reactivation avanga lo awm a ni. Mi tam zawk chuan JC virus hi an taksaah dormant an nei a. Immune system chak lote tan harsatna a thlen lo.

Immune system chak lo i neih chuan PML symptoms hriat chian a pawimawh a, chutiang ti tur chuan i doctor nen thawhhona tha tak neih a pawimawh.

He natna hi a tlangpuiin hun kal zelah a zual zel a. Mahse, natna zual zel tur tikhawtlai thei tur leh i dam rei thei tur enkawlna a awm. Chuvangin, beiseina bansan suh. A pawimawh ber chu a rang thei ang bera damdawi lam thurawn lak hi a ni.

` PML, Progressive Multifocal Leukoencephalopathy, JC virus, thluak natna, taksa hriselna, thluak lam natna, myelin