Takayasu-a Arteritis hi i hre tawh em? Kan sawi dawn nia!

Natna pakhat Takayasu’s Arteritis tih hi i hre tawh em? A hming hi a mak deuh mai thei, a dik em? Mahse kan thisen kalna kawng, a bik takin thinlung atanga intan thisen kalna lian ber ber leh a atanga branch chhuak branch te nghawng thei thil awm lo tak a ni. A chang chuan 'pulseless disease' an ti bawk. Vawiin hian chipchiar takin kan sawi dawn a, awlsam takin, nang pawhin i hriatthiam theih nan.

Takayasu-a Arteritis hi eng nge ni tak tak?

A awlsam zawngin sawi ila, Takayasu’s arteritis hi kan thisen kalna kawng a inflammation a ni a, chu chu swelling or inflammation (vasculitis) tihna a ni. A bik takin kan taksaa thisen kalna kawng lian ber berte a nghawng a ni. Ngaihtuah teh, kan thinlung atanga taksa pum puia oxygen tamna thisen phurtu thisen kalna kawngpui ber, chu chu ‘great aorta’ emaw ‘aorta’ emaw kan ti a ni. He natna hian aorta a nghawng ber a, chuta tang chuan thisen kalna kawng lian dang, a branch chhuak a, kan kut, kan kawr leh kan thluak thlenga thisen a thlen thinte pawh a nghawng nasa hle. Hetiang inflammation hi a lo awm hian eng nge thleng tih i hria em? Kan thisen kalna bangte hi a chhe vek a. Tichuan, chu thisen kalna kawng ṭhenkhat chu a chak lo va, balloon ang maiin a pung thei a ni. Hei hi ‘aneurysm’ kan ti a. Tin, thisen kalna kawngte pawh a hring thei a, a zim thei bawk. Tichuan thisen kal dan khap a ni. A châng chuan thisen kalna kawng chu a inkhar vek thei a, chu chu ‘occlusion’ an ti a ni. A tlem berah chuan he natna hian thinlung, ril, kal leh ke-a thisen petu thisen kalna kawngte pawh a nghawng thei a ni.

He dinhmun hian tute nge a nghawng ber?

Takayasu’s Arteritis (TAK) hi thalai te a vei tam ber a ni. Hmeichhia kum 20 leh 40 inkar ah a tam ber a, damlote hi kum 15 leh 35 inkar an ni tlangpui. He natna vei zinga 80% atanga 90% vel chu hmeichhia an ni. Doctor-te chuan Japan ang ram leh Mexican, Indian leh East Asian hnam chhuakteah he natna hi an hmu tam zawk a ni. United States ang ramah pawh kum tin mi maktaduai khatah hri kai thar pahnih atanga pathum chauh hmuhchhuah a ni. Hei hian a awmzia chu a tlem hle tihna a ni.

Takayasu arteritis hian engtin nge ka taksa a nghawng?

Thisen kalna kawng a zim chuan chu thisen kalna kawngte atanga thisen pek chhuah taksa peng leh tissue-te hnena thisen thleng chu a tlahniam ta a ni. Tui pipe khar ang maiin ngaihtuah la, chu chuan tui luang chhuak a ti tlem a ni. Mahse Takayasu’s arteritis (TAK) ah chuan heng inthlak danglamna te hi zawi zawiin leh zawi zawiin a thleng fo thin. Chuvangin kan taksa hian kawng dang hmanga thisen phurh thiam hun a nei a ni. Heng kawng dang (alternative route) te hi kawngpui lian (main road) a inkharkhip huna kan hman thin bypass te te ang mai a ni. Mahse heng bypass te hian a tir lama thisen kalna kawng lian tak angin thisen an phur thei lo fo mai thei. A tlangpuiin, blockage kal tlanga thisen kal zat hi tissue-te dam khawchhuahna atana an mamawh oxygen leh thisen tlem ber supply turin a tawk a ni. Mahse a tlem hle a, heng thisen kalna kawng inthlak danglamna te hian hna an thawk tha lo a nih chuan oxygen leh thisen an tlakchham avangin tissue te chu an thi thei a ni.

He natna lan chhuah dan engte nge ni?

Takayasu arteritis (TAK) vei thenkhat chuan symptom an nei lo mai thei. Mahse, damlo zinga a chanve vel chuan general malaise leh chak lohna an nei thei a ni. A lan chhuah hmasak dan (stage 1): Hengte hi natna bul tan tirh atanga lo lang thinte chu an ni:

• Khawsik.
• Chau lutuk tih hriatna ( Fatigue ).
• Muscle leh ruh natna .
• Chaw ei chu a thlum lo .

Later stage symptoms (stage 2): Natna a lo zual zel chuan hetiang symptoms hi a lo lang thei a ni:

• A rilru a na .
• Thâwk lak harsat .
• Lu na .
• Lung a na hle tih a hriat.

Thisen kalna kawng a zim leh thisen pek tlem avanga natna lan chhuah dan:

• Kut leh kea chau, natna, emaw, hliam emaw.
• Intestines- a thisen kal tlem vanga pum na.
• Kidney -a thisen kal tlem vangin thisen sang.
• Stroke (hei hi a tlem hle).
• Heart attack (hei pawh hi a tlem hle).

Eng thilin nge Takayasu-a arteritis hi a thlen?

Dik tak chuan Takayasu-a arteritis (TAK) hi a chhan dik tak chu tumahin an hre lo .. Mahse doctor leh zirchiangtute chuan ‘autoimmune condition’ a ni mai thei niin an ngai. Chu chu kan taksa immune system, natna dotu hian a taksa hrisel tak takte chu a bei sual a ni. Mahni invenna hian min tichhe ve ang mai a ni. Researcher thenkhat chuan Takayasu’s arteritis case thenkhat chu nu leh pa pahnih atanga gene rochun vang a ni thei niin an ngai. Chu nu leh pate chuan symptom an nei lo mai thei, a chhan chu gene copy pakhat chauh an keng tel a ni. Mahse chu gene bik chu nu leh pa pahnih atanga i rochun chuan chu natna leh a natna lan chhuah dan chu i nei thei a ni.

He natna hi engtin nge an hriat chhuah?

I doctor chuan Takayasu-a arteritis hi thil pakhat chauh ni lovin thil engemaw zat a en dun chuan a hmuchhuak ang.

• Medical history kimchang leh taksa enfiahna: Hei hi i natna lan chhuahna ang chi natna dang awm lo turin tih a ni. I doctor-in stethoscope hmanga i thisen kalna kawng a enfiah hian thisen kalna chhungah ‘bruit’ an tih thawm danglam tak an hre thei a ni. Thisen kalna kawng a zim lutuk chuan thisen kal a har a, chu chu thawm hriat a nih lai a ni.
• X-ray: Hengte hian i thisen kalna kawng a chhiatna hmun leh a chhiatna nasat dan a tarlang a ni.
• Thisen kalna kawng emaw, thisen kalna kawng (aneurysm) a zim tih hriat theihna tura test: Hei hi test dan hrang hrang a awm a.

Diagnostic test te hi engte nge ni?

Doctor-in a natna a hriat chian theihna tur test engemaw zat a awm a:

• Magnetic Resonance Imaging (MRI): Hei hi X-ray hmang lo test a ni. Thlalak te hi magnet lian tak, electromagnetic energy wave leh computer hmanga siam a ni.
• Computed Tomography (CT) scan: X-ray leh computer hmangin chhungril taksa peng hrang hrang, thisen kalna kawng lian tak tak te pawh a awm a.
• Angiography: Hei hi i thisen kalna kawng chhung lam X-ray thlalak lak a ni. I doctor chuan i groin emaw, i kut emaw chhunga thisen kalna lian takah catheter an tih tube te tak te, sei tak a dah a, chu chu enfiah ngai thisen kalna thlengin a kaihruai a ni. Tichuan, catheter kaltlangin thisen kalna kawngah dye bik (contrast material) an inject leh a. X-ray lak a nih chuan dye hian thisen kalna kawngte chu thlalak-ah chiang takin a lantir a ni. A chang chuan MRI hmangin angiography pawh an ti thei bawk.
• Positron Emission Tomography (PET scan): He test-ah hian i doctor chuan i kut vein pakhatah needle hmangin radioactive substance a inject a. Chu thil chu i taksaah a kal zel a, scanner chuan a hmuchhuak a, thlalak a siam chhuak thin.
• Ultrasound: Hei hian sound wave hmangin thisen kalna kawng lem siam nan a pui thin.

Takayasu-a arteritis hi engtin nge enkawl a nih?

Damdawi hian inflammation, a nih loh leh inflammation a control thei. Mahse, mi ṭhenkhat chuan thisen kalna kawng khar chu bypass a, thisen kalna tur kawng thar siam turin operation an mamawh mai thei. Corticosteroids: Corticosteroids, prednisone (e.g., Rayos®, Sterapred®) emaw prednisolone (e.g., Flo-Pred®, Orapred®) te hi Takayasu’s arteritis (TAK) enkawlna atana hman tlanglawn ber a ni.

Heng damdawi te hian thisen kalna kawnga active inflammation tihbo leh natna chu remission-a dahna kawngah thilmak an ti a ni.

I doctor chuan prednisone dose chu a tihhniam zauh zauh ang a, side effects a tih tlem theih nan. Mi thenkhat chuan symptoms lo let leh lovin damdawi ei hi zawi zawiin an chawlhsan thei a ni. Mahse, heng corticosteroids te hi mi thenkhat tan chuan a thawk tha kim lo. Tin, heng damdawi ei thin zinga a chanve aia tam chuan an natna lanchhuahna a lo let leh emaw, an dinhmun a na zual emaw thei bawk. Immunosuppressive damdawi: Doctor-te pawhin immune system titawp thei damdawi an pe tlangpui bawk a, chungte chu:

• Methotrexate (e.g. Rheumatrex®, Trexall®) te hi a tha hle a ni.
• Azathioprine (e.g. Imuran®, Azasan®) te hi a tha ber pawl a ni.
• A rilru a buai em em a, a rilru a hah em em bawk a.
• Leflunomide hmanga siam a ni
• Cyclophosphamide hmanga siam a ni

Heng immunosuppressants te hi prednisone nena hman a nih chuan a hmaa flares nei tawh zinga 50% vel chuan an natna lanchhuahna chu a reh thei a, zawi zawiin prednisone ei hi an chawlhsan thei a ni. Tumor-Necrosis Factor (TNF) inhibitors: Mi thenkhat chu inflammation dona atana pui turin TNF inhibitor an tih damdawi pek an ni thei bawk. Chungte entirnan:

• Etanercept tih a ni
• Infliximab a ni
• Tocilizumab hmanga enkawl a ni

A pum puiin Takayasu’s arteritis vei zinga 25% vel chuan damdawi ei chhunzawm loh chuan natna hi an thunun kim thei lo.

Enkawlna hian eng side effect nge a neih?

Takayasu’s arteritis enkawlna atana hman damdawi te hian side effect na tak tak a nei thei a ni. Mahse, damdawi dang hian heng side effects te hi a control thei a ni. Side effects te chu:

• Infection laka invenna a tlahniam.
• Ruh a tlahniam (osteoporosis).
• Hmu harsa.
• Seizures a awm thin.

Corticosteroids hian enkawlna i tan atanga darkar tlemte chhungin hna a thawk tan a, chuvangin hahdamna i nei nghal mai thei.

Eng enkawlna dang nge hman?

A then phei chuan thisen sang (hypertension) hi kal (kidney) thlenga thisen kalna kawng (arteries) a zim vang a ni thei. Chutiang a nih chuan doctor chuan balloon ang chi thil hmangin thisen kalna kawng zim chu a tizau thei a, chu chu angioplasty an ti a ni. A nih loh leh, kal (kidney)-ah thisen a kal dan pangngaia a kal theih nan bypass operation tih theih a ni bawk. Hei hian thisen sang damdawi ei lovin thisen sang a tihdanglam theih nan a pui thei a ni. Mi thenkhat chuan an kut emaw ke emawa thisen kalna kawng a zim avangin harsatna nasa tak an nei thei a, chu chuan kea kal emaw, thil dang tih emaw a ti harsa thei a ni. Bypass surgery pawh hian heng harsatnate hi a siam tha thei bawk. Aneurysm a awm chuan surgery emaw bypass emaw hmangin siamthat theih a ni. Takayasu’s arteritis vei thenkhat chuan aortic valve thlak a ngai thei bawk.

Engtin nge ka in enkawl ang?

Takayasu’s arteritis vei tam tak pawhin thisen sang (hypertension) an nei bawk. Hei hi thunun a pawimawh. Thisen sang i enkawl loh chuan hetiang thil hi a thleng thei a ni:

• Thai.
• Lung natna.
• Kidney tha lo a awm.

I taksa hriselna tichhe thei damdawi i ei a nih chuan, natna hrik laka invenna atan heng vaccine te hi lak hi ngaihtuah rawh:

• Flu vaccine pek a ni.
• Pneumonia vaccine pek a ni.
• Herpes zoster (Shingles) vaccine pek a ni.

Takayasu arteritis vei chuan eng nge a beisei theih ang?

Takayasu’s arteritis hi damdawi awm lo mah se, enkawl theih natna a ni. He natna vei tam zawk hi enkawl a nih chuan an dam leh thin. Mahse, mi tam tak chu he natna avang hian eng emaw chen, a nih loh leh a pum puia chak lohna an nei tlem hle. He natnain nghawng a neih dan hian nitin hnathawhnaah nghawng lian tak a nei thei a ni. Takayasu’s arteritis vei zinga a chanve vel chuan an hnathawhnaah inthlak danglamna an siam a ngai a ni. Mahse, he natna vei zinga 25% vel chuan nun pangngai tak an hmang a ni. 25% dang chuan an hnathawhnaah inthlak danglamna engemaw zat an siam a ngai tawh bawk. He natna khirh tak vei te hian medical check-up neih fo a ngai a, a tul chuan an damdawi ei tur pawh thlak danglam a ngai bawk. Doctor-te pawhin an damdawi ei tur (side effects) an enfiah a ngai a, thisen test pawh an tih a ngai bawk. A hnuaia mi hi Takayasu’s arteritis avanga harsatna awm thei a ni:

• Lung lam chak lohna.
• Thai.
• Thisen a chhuak thin.
• Lung natna a ni.

Takayasu arteritis hi natna rei tak a ni a, zawi zawiin a lo awm thin. Hun rei tak enkawlna i mamawh ang a, a tam zawkah chuan damdawi hmanga enkawl i mamawh ang. United States leh Japan ang ramah chuan Takayasu arteritis vei zinga 3% vel chu a vaiin kum nga chhungin an thi a ni. Hei hi Doctor-te’n natna an hriat chian hma leh an enkawl dan dik tak an neih vang pawh a ni thei. Khawvel hmun dangah chuan a rah chhuah chu a chhe zawk thei a, a chhan chu natna hmuhchhuah leh enkawl hun sawn a nih vang emaw, hriselna lama service hmuh that loh vang emaw a ni. Enkawl loh chuan Takayasu arteritis hi a thihpui thei a ni.

Engtin nge ka hriselna ka enkawl ang?

I rilru put hmang hriat reng a pawimawh a, i doctor nen inbiak reng a pawimawh a, chutiang chuan symptom thar emaw, a zual zel emaw i neih chuan i man hma thei ang.

Engtikah nge Doctor ka hmuh ang?

I Takayasu arteritis symptoms te kha enkawl lai emaw, enkawl zawhah emaw a lo lang leh a nih chuan doctor pan nghal rawh. Naupai i tum a nih chuan i doctor nen inbia ang che. Takayasu arteritis vei hian naupai hlawhtling tak neih theih a ni a, mahse enkawl dan tur hriat a pawimawh hle.

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

Heng symptoms te hi i neih chuan 911 ah call nghal rawh (Sri Lanka ramah chuan 1990 Suwaseriya Ambulance Service call emaw, damdawi in hnai ber pan emaw):

• A rilru a na.
• Thâwk harsa.
• Pulse chak lo tak.
• Heart attack chhinchhiahna (e.g., rilru natna nasa tak, kut hnuai lam atanga radiate chhuak, thawk hah, rilru hahna).
• Stroke chhinchhiahna (e.g., hmai sir khata tlak, kut pakhata bengchheng, tawng harsa).

Doctor hnenah eng zawhna nge ka zawh ang?

• Eng chen nge Takayasu arteritis damdawi ka ei a ngai dawn?
• Follow-up appointment atan engzat nge ka lo kal ngai?
• Ka dinhmun hi operation tel lovin control theih a ni em?
• Engzat nge imaging test neih a ngai?

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

Takayasu’s Arteritis hi hun rei tak, a nih loh leh ‘chronic’, natna a nih avangin doctor pan fo a ngai dawn a ni. Hun a kal zel a, i natna lan chhuah dan chu thunun theih loh atanga thunun theih lohah a kal thei a ni. Chuvang chuan doctor nen inbiak reng a pawimawh. I hriselnaah inthlak danglamna i hmuh chuan doctor hnenah hrilh hreh suh. I doctor chuan a hriat duh ngei ang, a chhan chu chutih hunah chuan a pui thei che a ni.

He natna hi nei chung pawhin, enkawl dan dik leh damdawi lam thurawn zawm chuan nang pawhin nun tha tak i hmang thei tih hre reng ang che. Chak takin awm rawh!

Takayasu thisen zam, Takayasu thisen zam, pulseless disease, vasculitis, aorta, arteritis, thisen kalna kawng natna, thisen sang, autoimmune natna