Kei te raru ō uaua toto? Me kōrero tātou mō te GPA (Granulomatosis me te Polyangiitis)!

I ētahi wā ka rongo koe i te taumaha rawa o tō tinana, ka mamae ētahi wāhi, kāore he take, ka rongo tonu rānei koe i te makariri, engari kāore i rite ki te makariri noa? I ētahi wā, kei muri i ēnei mea, tera pea he mate kāore e tino rangona ana, engari he mea nui kia mōhio. Ko tētahi o aua āhuatanga e kiia nei ko te GPA.

He aha te GPA (Granulomatosis me te Polyangiitis)? Kia mārama tātou!

Āe, me titiro tātou he aha tēnei GPA (Granulomatosis me te Polyangiitis). Kaua e manukanuka, ka whakamārama noa ahau. I mua ko te ingoa '(Wegener's Granulomatosis)'. Engari ko te ingoa '(Granulomatosis me te Polyangiitis)' e whakamahia ana i ēnei rā he nui ngā kōrero mō tēnei mate.

Ki te kī māmā noa, ko te GPA he mumura, he pupuhi rānei o ō uaua toto. Ka karangahia tēnei e ngā tākuta ko te "vasculitis." Whakaarohia pēnei: ​​he rite ngā uaua toto puta noa i ō tātou tinana ki ngā paipa wai. Ina he he te āhua o ēnei paipa, ka whakararuraruhia te rere o te toto, tika? Koinei te mea e tupu ana i konei.

Inaianei e rua atu ngā mea motuhake mō tēnei GPA:

• Polyangiitis: Ko te tikanga o tēnei ka puta te mumura i roto i ngā momo uaua toto rerekē o tō tinana, inā koa ko ngā mea iti . Kāore e herea ki te kotahi wāhi anake.
• Granulomatosis: He kupu uaua pea tēnei, engari ko tōna tikanga he pupuhi iti, he pūkohu, he mumura e kiia nei ko ngā granuloma ka puta i roto i ō oko toto me ētahi okana. Ka taea e ēnei pupuhi te kino i ō oko toto me ō okana.

Nō reira, he maha ngā momo o tēnei mate "vasculitis", engari ko te momo e kiia nei ko te GPA ka pā ki ngā oko toto iti rawa o tō tātou tinana. Nā te mea kei te tinana katoa ēnei oko toto iti, ka taea e te GPA te whakararu i ngā wāhanga maha o te tinana, inā koa ngā whekau he maha ngā oko toto iti. I te nuinga o te wā, ka pā ki tō pūnaha manawa (te pūnaha manawa) me ngā whatukuhu.

Ka taea e tēnei mumura o ngā oko toto te pupuhi, te pakū, tae noa ki te toto. Waihoki, ka taea e ngā oko toto te whaiti nā te mea he kiriuhi. Ka ahatia? Kāore ō tātou kiko e whiwhi i te hāora me ngā matūkai e hiahiatia ana e rātou. I ētahi wā, ka taea e te GPA te whakaputa i tētahi āhuatanga e kiia nei ko te "pūkahukahu-renal syndrome", e turuturu ai te toto mai i ngā whatukuhu me ngā pukahukahu.

He aha ngā tohu ka puta ina puta te GPA?

Inaianei kei te whakaaro pea koe, 'Āe, mēnā he mate pēnei tēnei, me pēhea tātou e mōhio ai? He aha ngā tohu?' Me kōrero tāua mō tēnā.

E ai ki te kōrero i mua ake nei, ko te nuinga o te wā ka pā te GPA ki te pūnaha manawa me ngā whatukuhu. Heoi anō, ka pā pea ki ētahi atu okana me ngā kiko, tae atu ki tō oranga whānui. Nā te mea ka aro ki ngā oko toto iti puta noa i te tinana.

I ētahi wā, ka puta te mamae o te uaua me te hononga (arthritis) i te vasculitis i roto i ō kiko honohono.Haunga ēnei āhuatanga, tera pea ka pāngia koe e te ahua o te koretake o te tinana . Waihoki, ko te ngenge tonu, te kore hiahia kai, me te whakaheke taumaha he tohu noa iho.

Ngā tohu o te pūnaha manawa

He tokomaha te hunga e whakapae tuatahi ana kei a rātou te GPA, ā, ka rapu maimoatanga nā te mea he mate manawa. I ngā wāhanga tōmua, ka rite pea ēnei tohu ki te makariri noa, te rewharewha, te rewharewha rānei. Heoi, ka roa ake i te tikanga. Tirohia mēnā kei a koe ētahi o ēnei:

• He ānini nui, he pēhanga rānei i te rohe o te ihu.
• He maha ngā wā ka puta ngā mate sinus.
• He ihu pupuhi tonu, ā, ka puta he kiriuhi huri noa i te pongaponga.
• Kua pūngāwerewere tōku ihu.
• Te toto pinepine o te ihu, kāore he take.
• He mamae tōku taringa.
• E mamae ana tōku uma.
• He maremare tonu tōku.
• Te poto o te manawa (pērā i te maremare).

I te kaha haere o te GPA, ka pāngia pea koe e te mumura (polychondritis) o te kiriuhi i roto i ō taringa, ihu, me te korokoro. Ka puta pea ngā tohu kino atu, pēnei i:

• Ka pupuhi rawa te ihu, ā, ka totohu te tihi o te ihu ki roto (e kiia ana hoki tēnei ko te ihu nohoanga).
• Ka whaiti te korokoro, te wāhanga o runga rānei o te pūhā (subglottic stenosis). Ka puta he reo pākū me te tangi whiowhio i te wā e manawa ana (wheezing, stridor rānei).
• Ka taea e te mumura o te taringa o roto te whakapouri (vertigo) me te ngaronga o te rongo.

Waihoki, tera pea kei te toto koe i ō pukahukahu. Ki te tupu tēnei, tera pea ka uaua ki a koe te manawa, ka maremare toto rānei.

Ngā tohu e pā ana ki te whatukuhu

Kāore pea koe e mamae i ō whatukuhu ina he GPA tōu. Heoi, tera pea ka kite koe i ngā huringa o tō mimi. Hei tauira, he mimi huka, he toto rānei i roto i tō mimi. Waihoki, ko te pupuhi o te mata, o ngā waewae rānei (edema) tētahi atu tohu o te mate whatukuhu.

Mena kei a koe te GPA, ka tirotirohia e ngā tākuta ō whatukuhu i ia wā, ahakoa kāore he tohu. Nā te mea kāore pea te GPA e pā ki ō whatukuhu i ngā wāhanga tōmua, engari i roto i te wā, tata tonu ka pā ki ō whatukuhu.

Ngā tohu e pā ana ki te kanohi

Ka pāngia hoki ō kanohi e te GPA. Ka puta te mumura i te mata, i roto rānei o te kanohi. Ka puta te mamae o te kanohi, te pēhanga, te whero, me te pupuhi . I ngā wā tino kino, ka ngaro pea te tirohanga.

Ngā tohu kiri

Ka taea e te vasculitis i roto i tō kiri te whakaputa i ngā tohu penei:

• He rite te mata o te kiri ki tētahi tauira kikorangi-whero (kiri kōwhaiwhai).
• Ka puta mai ngā ira papura, whero, parauri rānei (purpura).
• Tērā pea ka puta ake he puku mārō (ngā pona) he puku iti rānei rite ki te mirumiru (ngā papule) ki te kiri.
• Tērā pea ka puta ngā patunga kore e ora (ngā mate pukupuku).

Ngā tohu o te pūnaha io

Ka pāngia hoki tō pūnaha io e te GPA. I te nuinga o te wā, ka pāngia tō pūnaha io taha – arā, ngā io e rere ana mai i tō taurakira ki ētahi atu wāhanga o tō tinana.

Ka taea e te mumura me te pupuhi te pakaru i te io kotahi anake, ka puta ngā tohu i te wāhi kotahi (mononeuropathy). Heoi, he maha ngā wā ka pāngia ngā io maha (polyneuropathy). Ko ētahi o ngā tohu ko:

• Ngā tohu mō te nekenekehanga: Pērā i te ngoikore o te uaua.
• Ngā tohu pānga: te ngoikore, te mākūkū, te mamae rānei o ngā io.
• Te ngoikore o te mahi a te pūnaha io motuhake, e whakahaere ana i te toto totoka, te mahi a te pūkahukahu, te werawera rānei.

He aha ngā raruraru nui ka puta mai i te GPA?

Ki te kore e whakahaeretia tika te GPA, ka tūpono pea te ora, ā, ka kino rawa atu hoki ngā whekau. Nō reira, he mea nui kia mōhio koe ki tēnei. Anei ētahi o ngā raruraru nui ka pā mai:

• Te totohu o te pūkahukahu: Ka raru pea te manawa me te ngoikore o te manawa.
• Te glomerulonephritis tere haere: Ka taea e tēnei te arahi ki te ngoikore o te whatukuhu.
• Te ngaronga o te tirohanga, o te whakarongo rānei mō te wā roa.
• Te ngaronga o te rongo kiri, te kore rānei e taea te whakahaere i ngā uaua (peripheral neuropathy).

He aha ngā take e whanake ai te GPA?

Tērā pea kei te whakaaro koe, 'He aha i puta ai tēnei momo mate?' Inaa, ko te GPA, pērā i ētahi atu momo `(vasculitis)`, he `(mate autoimmune`) . Tērā pea he uaua ki te mārama, engari ka whakamārama noa ahau.

I te nuinga o te wā, he rite tō tātou pūnaha ārai mate ki tō tātou kaitiaki. Ka whawhai ia ki ngā mate me ngā huakita mā te whakaputa mumura. Heoi, i roto i ēnei mate ārai mate, ka tīmata tō tātou ake pūnaha ārai mate ki te whakaeke i ō tātou ake pūtau me ngā kiko hauora. I roto i te GPA, ka whakaeke te pūnaha ārai mate i ō tātou ake oko toto.

He aha ngā tino take e hua ai te GPA?

Kāore anō kia tino mōhiotia e ngā kairangahau he aha te pūtake o ngā mate pūnaha ārai mate. Heoi, e whakapono ana rātou he maha ngā āhuatanga e whai wāhi ana ki ēnei mate. I ētahi wā, ka nui rawa te kaha o te ahotea ki te whakahaere i tō tātou pūnaha ārai mate, ā, ka hua ake ēnei momo hapa. Ko ētahi mate huakita me te huaketo kinoKua kitea hoki e ngā rangahau ka puta te GPA i muri i...

Kei roto te GPA i tētahi rōpū mate e kiia nei ko te ANCA-associated vasculitis, ko te AAV rānei. Koinei ngā momo vasculitis e pā ana ki tētahi paturopi motuhake e kiia nei ko te ANCA. E whakapono ana ngā kairangahau he mea nui tēnei ANCA ki te whakaputa i te mumura i roto i ēnei mate, tae atu ki te GPA.

Me pēhea koe e mōhio ai mēnā he GPA tōu?

Mena kei a koe ngā tohu o te GPA, ka pātai tuatahi tō tākuta ki a koe mō ō tohu, ā, ka tirotirohia e ia tō tinana. Mena kei te whakaatu mai ō tohu me tō hītori hauora kei a koe te GPA, ka tonoa e ia ētahi whakamātautau hei tirotiro atu.

Ko ētahi o ngā whakamātautau e whakamahia ana hei whakatau mēnā kei a koe he GPA:

• Ngā whakamātautau toto: Ka tirohia hoki e tēnei ngā paturopi ANCA kua whakahuatia i mua.
• Tātaritanga mimi: He whakamātautau mō te toto me te pūmua i roto i tō mimi.
• Ngā hihi-X o te uma me ngā karapa CT: Ka tirohia e ēnei te āhua o ō pukahukahu.
• He koiora: Ka tangohia he wahi iti o te kiko mai i ngā pukahukahu, i ngā ihu (ngā kōhao ihu), i ngā whatukuhu rānei, ka tirotirohia i raro i te karuārai hei tirotiro mēnā he mate mumura motuhake.

He aha ngā maimoatanga mō te GPA (Wegener's Granulomatosis)?

Āe, me titiro tātou ki te āhua o te rongoā i te GPA. Ka rongoāhia e ngā tākuta te GPA mā te whakamahi i ngā rongoā hei whakaiti i te mumura me te pehi i te pūnaha ārai mate (corticosteroids me ētahi atu immunosuppressants).

He kaha ake ētahi o ēnei rongoā i ētahi atu. Ko te huinga o ngā rongoā e taunakitia ana e tō tākuta ka whakawhirinaki ki te kaha o tō mate me tō tūponotanga o ngā pānga taha.

Te maimoatanga taketake mō te GPA hohe:

• Ka hoatu he horopeta nui o ngā corticosteroids (hei tauira, te prednisone). Ka whakaitihia mārire ēnei horopeta i roto i te wā.
• `(Rituximab)`: He rongoā koiora hou tēnei. Koinei te maimoatanga paerewa e whakamahia whānuitia ana.
• Cyclophosphamide (mō ngā take kino) me te methotrexate rānei (mō ngā take ngawari): Ka whakamahia hoki ēnei rongoā hei rongoā i te mate pukupuku. Heoi, ina hoatu mō te GPA (i roto i ngā horopeta iti iho), ka mahi hei ārai mate.
• Avacopan: Ka taea te whakamahi i tēnei rongoā hei rongoā tāpiri hei whakaiti i te horopeta o ngā corticosteroids.

Mena he nui ngā raruraru, me hiahia pea koe ki ētahi atu maimoatanga. Hei tauira:

• Dialysis (mēnā ka ngoikore ngā whatukuhu)
• Te whakawhitinga okana

Tūnga GPAKia tae ki te wā o te "whakamaramatanga", arā, kua ngaro ngā tohu, ā, kua moe te mate, ka hoatu he rongoā ngāwari hei pupuri i taua āhua. Ko te tikanga kei roto i tēnei:

• `(Rituximab)`
• Ngā rongoā ārai mate ngawari: Hei tauira, `(azathioprine)`, `(methotrexate)` rānei `(mycophenolate mofetil)`.

I roto i tō maimoatanga, ka haere tonu ngā whakamātautau hei aroturuki i tō āhua me te āhua o tō urupare ki te maimoatanga. Ka whakarerekētia e tō tākuta tō whakahaunga me te horopeta i runga i tō urupare.

Kia maumahara, ka pāngia pea ngā rongoā katoa e ngā pānga taha. Ka pāngia pea rātou i ngā wā katoa e rongoatia ana. Nō reira, me whakawhiti rongoā pea hei ārai, hei whakaiti rānei i ētahi pānga taha. Me whakatau katoa ēnei whakatau me te kōrero tahi me tō tākuta.

He aha te āhua o tēnei āhuatanga ā muri ake nei? (Tirohanga)

He mate mō te wā katoa te GPA, ā, me tiaki mō te wā katoa. Mā te maimoatanga, ka memeha haere te mate, ā, ka ngaro haere ngā tohu. Heoi anō, ka taea hoki te hoki mai o ngā tohu (ka hoki anō).

Me tango rongoā pea koe i ia wā, i ia wā, puta noa i tō oranga hei whakahaere i ngā hokinga mai o te mate. Nā te mea ka pehia e ēnei rongoā tō pūnaha ārai mate, me tino tupato hoki koe ki te tiaki i a koe anō i ētahi atu mate.

Ka taea te noho i te ao noa me te GPA?

Mā te maimoatanga whai hua, ka taea e koe te noho i tētahi oranga noa me te GPA. Pērā i te maha o ngā mate pūmau, ka taea te whai wā e memeha ai, e hoki anō ai. Nō reira, ka piki, ka heke te haere o te mate.

He aha te roanga o te oranga o te tangata whai GPA?

Ki te kore he maimoatanga, ko te roanga o te oranga he tata ki te rima marama, ā, iti iho i te 50% o te tangata ka ora i tua atu i te tau. Heoi, me te maimoatanga, e whakaatu ana ngā rangahau whai muri he neke atu i te 80% o te tangata kei te ora tonu i muri i ngā tau e waru . Nō reira, ka kite koe i te hiranga o te whiwhi maimoatanga, tika?

He aha te tino take o te mate i roto i te GPA?

I mua i te maimoatanga, ko te ngoikore o ngā okana te tūponotanga nui rawa atu o te mate i roto i te GPA. I te wā e maimoatanga ana, ina ngoikore tō pūnaha ārai mate, ka nui ake tō tūponotanga ki ngā mate e morearea ai te ora .

Me pēhea taku tiaki i a au anō i a au e noho ana me te GPA?

Mēnā kei te noho tahi koe me tētahi mate pūnaha ārai mate mau tonu pērā i te GPA, he mea nui kia mōhio koe ki tō tinana. Ahakoa kei te tino ora koe, me noho haumaru tonu koe.

Me mahi i ngā mahi hei tiaki i a koe mai i ngā mate noa i a koe e tango ana i ngā rongoā ārai mate. Ki te kite koe i ētahi tohu hou, i ētahi tohu rerekē rānei,Me whakamōhio tonu atu ki tō tākuta.

He maha ngā pānga o te GPA ki a koe, ko ētahi he morearea ki te ora. Mā te mōhio kei te hē tetahi mea, me te whiwhi maimoatanga wawe mōna, ka nui te rerekētanga.

He tokomaha te hunga ka ora kore he tohu, mō tētahi wā pea, me te maimoatanga. Engari ka haere tonu tāu tīma hauora ki te aroturuki i tō āhua. Ko rātou hei hoa mahi mōu mō te oranga tonutanga.

Ngā mea tino nui hei maumahara māu mai i tēnei tuhinga (Karere hei tango mā te kāinga)

Āe, me whakarāpopoto e au ētahi o ngā mea hei maumahara māu i roto i ngā mea kua kōrerohia e tātou:

• Ko te GPA (Granulomatosis me te Polyangiitis) he mate pūnaha ārai mate e pā ana ki ngā oko toto, inā koa ko ngā oko toto iti. Ko te nuinga o te wā ka pā ki te pūnaha manawa me ngā whatukuhu.
• He rerekē ngā tohu. Ko ētahi o ngā tohu ko te makariri noa, te uaua ki te manawa, te toto o te ihu, te ponana kiri, te mamae o ngā hononga, ngā raruraru kanohi, me ngā panoni o te mimi.
• He mate kino tēnei, nō reira he mea nui kia rapu wawe koe i te tohutohu hauora mēnā ka puta ngā tohu.
• He maha ngā maimoatanga whai hua e wātea ana. Ka taea e ēnei maimoatanga te whakahaere i te mate me te pupuri i tōna oranga kia marino.
• He mate tēnei mō te wā katoa, nō reira me noho tonu koe i raro i te tirotiro a te tākuta, me whakamahi tika i te rongoā kua tohua, ā, me tiaki hoki i tō tinana.
• Kaua e manukanuka! Mā te mōhio me te tohutohu hauora tika, ka taea e koe te ora pai me tēnei mate. Kāore koe i te mokemoke, ā, kei reira ngā tākuta hei āwhina i a koe.

GPA , Granulomatosis me te Polyangiitis, Granulomatosis a Wegener, Vasculitis, Mumura o ngā oko toto, Ngā mate pūnaha ārai mate, Ngā mate tākihi, Ngā mate manawa