Natna engemaw zat damdawi thar i ei tan chauh niin han ngaihtuah teh. Kar khat emaw kar hnih emaw vel hnuah chuan i rilru a na hle a, khawsik i neih dawn ang maiin i awm a. I taksa a na a, i khawsik a, i khur... Tichuan rang takin i taksa chu a rawn chhuak tan a, chu chu zawi zawiin tuiah a chang a, i vun chu kang tawh ang maiin a rawn chhuak tan ta a ni. Hei hi thil hlauhawm tak, hrehawm tak leh nunna atana hlauhawm tak a ni. Vawiin hian he dinhmun hlauhawm tak hi kan sawi dawn a, chu chu Toxic Epidermal Necrolysis (TEN) a ni.
A awlsam zawngin sawi ila, Toxic Epidermal Necrolysis (TEN) hi eng nge ni?
Toxic Epidermal Necrolysis, a tawi zawngin TEN tih hi vun natna nasa tak leh nunna atana hlauhawm tak a ni. I taksa hmun zau tak, a tlangpuiin i taksa 30% tal chu a ti hring (blistering) a, a ti hring (peeling) thin. He peeling hi mucous membrane awmna hmunah pawh a awm thei a, chu chu hmui, mit leh mipat hmeichhiatna hmunah te pawh a awm thei bawk.
He dinhmun hlauhawm tak hi damdawi thenkhat kan ei avanga natna khirh tak angin a lo awm fo thin. Hetiang taka vun a chhiat chuan tui tlakchhamna leh natna khirh tak tak a thlen theihna a sang hle.
A dik tak chuan TEN hi vun natna dang Stevens-Johnson syndrome (SJS) tih hming pu na ber a ni. SJS ah chuan taksa vun 10% aia tlem lo a luang chhuak thin. Taksa 10% atanga 30% vel a nghawng chuan SJS-TEN overlap condition kan ti thin. Vun 30% aia tam a chhuah chuan TEN anga ngaih a ni.
He natna hi tu nge vei thei ber?
Immune system chak lote chu Stevens-Johnson syndrome (SJS) emaw TEN emaw an vei tam zawk. Immune system chak lohna chhan hrang hrang a awm thei.
- Human immunodeficiency virus (HIV) vei te.
- Cancer thenkhat nei, lymphoma ang chi te.
Chu bakah, genetic factors pawhin hmun a chang thei bawk. Mi thenkhat taksa hi a chhe thei lo va, damdawi thenkhat chu a pangngaiin a metabolize thei lo. Hei hi an gene atanga lo chhuak a ni. Chutiang hunah chuan chu damdawi chu taksaah a pung khawm thei a, SJS emaw TEN emaw ang chi reaction na tak a thlen thei a ni. Tin, gene thenkhata inthlak danglamna (mutations) avang hian mi thenkhat chuan damdawi thenkhat an dawng nasa zawk thei bawk.
TEN hi kum eng pawhah a awm thei a, mahse kum upa zawkah chuan a tam zawk. Mahse, a natna hi a awm lo hle .Khawvel pumah SJS leh TEN te hi an inzawm khawm chuan kum khatah mi maktaduai khat emaw maktaduai hnih vel chauh an nghawng tih hriat reng a pawimawh.
TEN vei chhan berte chu engte nge ni?
Thil tam takah chuan doctor-te chuan damdawi thenkhat hi TEN thlentu ber niin an ngai. Eng damdawi nge risk sang zawk tih hi han thlir ila.
| Ruihhlo chi hrang hrang | Hrilhfiahna awlsam tak |
|---|---|
| Allopurinol a ni | Kidney stone leh gout ang chi natna enkawlna atana hman thin damdawi. |
| Anticonvulsants a ni | Seizures ang chi condition control nana pek damdawi class. |
| Anti-retroviral damdawi hman tur a ni | A bik takin HIV hrik kai enkawlna atana hman damdawi (e.g. nevirapine). |
| Oxicams te chu a awm | Hengte hi NSAIDs group-a tel, painkiller leh anti-inflammatory drug class pakhat an ni. |
| Sulfonamides hmanga siam a ni | Hengte hi antibiotic damdawi chi khat a ni. |
Heng damdawi bakah hian a tlem hle a, infection emaw vaccine thenkhat emaw hian TEN a thlen thei bawk. Mahse hei hi a tlem hle. A châng chuan TEN awm chhan hi hmuh theih a ni lo.
TEN natna lan chhuahna chu engte nge ni?
Damdawi thar ei tan atanga kar tlemte chhungin symptom sawm a lang tan tlangpui. Khawsik ang chi atanga tan a ni.
- Taksa natna
- Khuh
- Khawsik leh khawsik
- Lu na
- Mit sen leh inflammation
Heng a tir lama a lan chhuah hnu hian vunah hian natna sen (rash) a lo lang tan thin. Heng hmunte hi a lian zauh zauh a, tuiin a khat blister-ah a chang a, a tawpah chuan vun chu a lo chhuak tan ta a ni. Vun a hring chhuah atanga hliam lo awm chu erosion an ti a . Hengte hi hliam na tak, inhawng, kang na tak ang maia lang an ni.
Heng hliamte hi hmai leh rilruah a lang hmasa a, chumi hnuah taksa peng dangah a darh thei a ni.
- Mit: Mit chhung (conjunctiva) leh mit dum pawn lam (cornea) a chhe thei.
- Mucous membranes: Ka chhung, hnar, kawchhung leh thawkna kawng chhungah hliam a awm thei.
- Urethral tract, anus, leh genitals: Heng hmunte hian hliam na tak a tuar thei bawk.
Heng hliamte hian hna awlsam tak tak ei leh in, ei, thawk, mit khap, leh zun chhuah te pawh hi a ti na hle a, a ti harsa hle bawk.
TEN avanga harsatna lian tham lo thleng thei
TEN hi condition awlsam taka ngaih tur a ni lo. Harsatna lian tak tak, nunna atana hlauhawm tak a thlen thei a ni.
- Infection: Vun a chhiat chuan taksaah natna hrik a luh theihna chance a sang zawk. Heng natna hrik te hi thisenah an luh chuan natna hlauhawm tak, sepsis an tih hi a lo awm thei a ni.
- Multiple organ failure: Taksa a inflammation leh infection nasa tak a awm chuan chhungril organ te, kal, thin, leh lung te a tichhe thei a ni.
- Pneumonia: Thlawhna kawng hliam vangin lung natna vei theihna a sang hle.
Chutiang harsatna nasa tak a thlen theih avangin TEN symptoms nei chu damdawi inah dahin enkawl nghal tur a ni .
He natna hi Doctor ten engtin nge an hriat chian?
Doctor thiam tak chuan i vun enfiah a, i natna lan chhuah dan zawtin TEN a hriat theih tlangpui. A châng chuan, a natna hriat chian nân vun biopsy lak a ngai thei bawk.
Hei hian vun natna atanga vun te tak te tak te chu anesthesia hmanga lak a, microscope hmanga enfiah a ni. He test hian vun cell thi (necrotic cells) a awm leh awm loh leh vun chunglam (epidermis) chu a hnuai lam atanga a inthen em tih chiang takin a hmu thei a ni.
Hei hi eng enkawlna nge ni?
A pawimawh ber chu TEN hi medical emergency a ni.Hei hi in lama enkawl theih natna a ni lo. Damdawi in Emergency Treatment Unit (ETU) ah i kal nghal tur a ni.
Damdawi inah chuan damlo chu intensive care unit (ICU) emaw burn center-ah dah a ni fo a, heng damlote hian kangmei damlo hnena pek thin ang chi specialized care an mamawh avangin.
Enkawl dan hi hmunpui pahnih ah then theih a ni.
| TEN enkawlna tur kawng hrang hrang | |
|---|---|
| Enkawl nghal vat tur a ni | |
| Causative drug chu tihtawp a ni | TEN thlentu nia rinhlelh damdawi zawng zawng chu tihtawp nghal vek a ni. |
| Taksa tui level control | Skin peeling hian taksa atanga tui tam tak a paih chhuak thin. Chuvangin saline (IV fluids) hi vein kaltlangin taksa tui level control nan an pe thin. |
| Infection laka invenna | Hliam inhawngah antiseptic cream emaw ointment emaw an hnawih thin. Antibiotics hi natna lan chhuah hmasak berin pek thin a ni. |
| Enkawlna bik dang | |
| Immune globulin (IVIG) hmanga enkawl a ni. | Hei hi vein hmanga pek chhuah liquid a ni. Mi hrisel thisen plasma atanga lak chhuah antibody a pai a ni. Hengte hian taksain immune response tha lo a control theih nan a pui thin. |
| Immunosuppressant hmanga taksa hriselna tichhe thei | Taksa immune system-in a cell-te a beih loh nan damdawi pek a ni a, a hnathawh a tichak lo hle. |
| Plasmapheresis tih a ni | Hei hian damlo thisen chu machine bik-ah thawn a, thisen plasma-a antibody tha lo awmte chu thliar hrangin paih chhuakin, thisen thianghlim chu taksaah thawn kir leh a huam a ni. |
Dam leh hnua hun rei tak chhunga nghawng a neih dan
TEN damchhuakte chuan hun rei tak chhunga nghawng engemaw zat an nei thei. Vun hi a dam vek a nih pawhin harsatna dang a awm thei.
- Vun, sam leh nail: nail than dan pangngai lo emaw, a hring emaw, vun hring (black or white), hmun thenkhatah sam tlakchham (alopecia areata), vun ro leh itchy, thawk hah lutuk.
- Mit: Hun rei tak chhunga mit natna emaw, a sen emaw, mit vawt, mitmeng dik lo, êng hriatna, mitdel emaw, a tlem berah chuan mitdel emaw.
- Kawng, hnar leh thawkna kawng: Bronchitis, lung natna chi hrang hrang COPD, hmui vawt, hmui natna, thlum leh rim hloh, lung chhiatna.
- Urinary and reproductive system: Hmeichhiaah hian hun rei tak chhung hliam emaw, zunthlum emaw, zunthlum emaw, zun harsatna, zunthlum (vaginal dryness) a awm.
Heng hun rei tak chhunga nghawng a neih dante hi doctor nen inbiakna neihpui a, a tul anga enkawlna zawn hi a pawimawh hle.
Take-Home Thuchah a ni
- Toxic Epidermal Necrolysis (TEN) hi damdawi thenkhat ei avanga natna khirh tak, nunna atana hlauhawm tak a ni.
- Khawsik leh taksa na ang chi symptoms tlanglawn tak tak atanga tan a ni a, mahse a kal zel a, natna hrik leh vun kang chhuak a, vun a ti hring chhuak thin.
- Hei hi medical emergency a ni. Heng symptoms te hi i neih chuan damdawi in Emergency Treatment Unit (ETU) ah i kal nghal tur a ni.
- Damdawi thar i ei tan hnua vun rawng, vun rawng, a nih loh leh thil dang danglam tak i neih chuan ngaihthah ngai suh. Doctor hmu nghal rawh.
- Damdawi eng pawh allergy i neih tawh chuan damdawi ei tur i kal apiangin i doctor hnenah hriattir ngei ang che.
💬 Comments (0)
Comment a la awm lo. Hetah hian i comment hi a vawikhatna atan add rawh.
I comment kha add rawh