Ngā ānini me ngā raruraru tirohanga e pā mai ana i te koroheketanga: Me ako tātou mō te Giant Cell Arteritis (GCA) me te Temporal Arteritis rānei?

He maha ngā amuamu a tētahi kaumātua o tō whānau, arā, tō whaea, tō pāpā, tō kuia rānei, mō te mamae o te upoko? He ngoikore rānei tō tirohanga i te wā kotahi? He mea nui pea tēnei ki a koe. I tēnei rā kei te kōrero tātou mō tētahi mate e kiia nei ko te Giant Cell Arteritis (GCA) , i mua ko te Temporal Arteritis , e pāngia ana e ngā pakeke. Kāore he mea hei wehi, ko te mea nui ko te mōhio ki tēnei.

He aha te GCA? He aha i kino ai?

I te whakarapopototanga, ko te Giant Cell Arteritis (GCA) he mate e pupuhi ai ngā oko toto nui o tō tinana (ina koa ko ngā mea kei te upoko, te kaki, me ngā ringa). Ka kiia hoki e ngā tākuta ko te "vasculitis." Ina pupuhi pēnei ngā oko toto, ka matotoru ō rātou pakitara, ka whakawhāiti i te ara mō te toto. Whakaarohia he rite ki te paipa wai kua āraia te rere. Ina whakararuhia te rere o te toto pēnei, ka taea te kino i ngā whekau me ngā kiko nui e tukuna ana te toto e aua oko toto.

Ko ngā uaua temporal, kei ia taha o tō rae, e tuku toto ana ki tō angaanga, ki ngā uaua kauae, me te io whatu, arā, te io e homai ana ki a koe te tirohanga. Mēnā ka pāngia ēnei uaua temporal e te GCA, ka pāngia pea koe e ngā raruraru nui, pērā i te matapo . Ka pāngia hoki te aorta e te GCA, te uaua toto nui rawa atu o te tinana, me ōna manga. Ka kiia tēnei pupuhi o te aorta ko te aortitis, ā, ka pāngia pea koe e ngā raruraru hauora nui.

Ka puta te GCA i te taha o tētahi atu mate mumura, te Polymyalgia Rheumatica, te PMR rānei. Ka kōrerohia atu anōtia te PMR i muri mai.

He mate kino rawa te GCA?

Ae, he mate kino te GCA mēnā kāore e kitea wawetia, e rongoatia rānei . Nā te mea:

• Tērā pea ka pakaru tō tirohanga . Tērā pea ka ngaro whakarere tō tirohanga, ka matapo rānei tetahi o ō kanohi, e rua rānei.
• Ka pakaru pea ō uaua toto . Hei tauira, ko te āhua e kiia nei ko te aneurysm, he uaua toto e pupuhi ana pērā i te poihau ka pahū, ka nui ake te mōrearea o tōna pahūtanga.
• Tērā pea ka puta mai ētahi atu āhuatanga, pērā i te whiu , ngā whakaekenga ischemic poto rānei (e kiia ana ko ngā "mini-strokes").

Koia te mea nui kia mōhio koe ki ēnei tohu.

He pēhea te noa o te GCA?

Ahakoa ko te GCA tētahi o ngā momo vasculitis tino noa, he mate tino onge tēnei . E ai ki ngā tatauranga i te Hononga o Amerika, 19-23 noa iho i roto i te 100,000 tāngata e pāngia ana e tēnei mate. Ahakoa kāore he tatauranga tika i Sri Lanka, he mea pai kia āwangawanga mō tēnei mea i te mea ka piki haere te taupori kaumātua.

He aha ngā tohu o te GCA (Temporal Arteritis)?

Ko te tohu matua me te tohu tino kitea o te GCA he mamae upoko kino, pumau, e rite ana ki te mamae uaua i tetahi taha, i nga taha e rua ranei o te upoko.Engari i tua atu i tēnei, tera pea ka puta mai ētahi atu tohu:

• Te ngawari ina whakatakotoria tō ringa ki te tumuaki, ki tētahi taha rānei o te rae (ki runga ake i ngā taringa).
• Te mamae o te kauae , ina koa i te wā e kai ana, e ngaungau ana rānei.
• Ngā raruraru tirohanga : Te tirohanga takirua, te tirohanga pōuri, te ngaronga ohorere rānei o te tirohanga mō te wā poto.
• Te ngenge .
• Kirika .
• Te ngaronga o te hiahia kai, te ngaronga rānei o te taumaha .
• Mamae uaua : Mamae i ngā pakihiwi, i ngā ringa o runga, i ngā hope, i ngā huha o runga, i te tuara o raro, me te papa.

Kei te mahara koe ki taku kōrero i tētahi atu mate e haere tahi ana me te GCA, arā, ko te Polymyalgia Rheumatica (PMR)? He mate anō hoki tēnei e pupuhi ai. Ka puta te mamae nui me te kōpikopiko o te PMR, inā koa i ngā pakihiwi me ngā hope. Ka taea hoki e te PMR te puta takitahi (he mea noa ake te puta takitahi o te PMR i te GCA). Heoi, tata ki te 40-60% o te hunga whai GCA ka pāngia hoki e te PMR. Waihoki, 10-20% o te hunga whai PMR anake ka pāngia e te GCA i muri mai i te oranga.

He aha ngā take o te GCA?

Kāore anō kia mōhiotia e ngā kairangahau te tino take o te GCA, engari he tokomaha e whakapono ana he mate pūnaha ārai mate, he mate mumura rānei. He māmā noa iho, ko te wā tēnei ka whakaekea hētia ai e te pūnaha ārai mate o tō tinana ō oko toto hauora .

Ko te nuinga o te wā ka pāngia te hunga kaumātua e tēnei mate, nō reira e whakaaro ana ētahi he mea e pā ana ki te kaumātuatanga. E whakaarohia ana hoki ko ngā āhuatanga ira me ngā āhuatanga taiao (pērā i ngā mate e pā ana ki te pūnaha ārai mate) te take.

Ko wai te hunga e tino pāngia ana e te GCA?

Ahakoa ka taea e te tangata te whakawhanake i te GCA, ko ēnei tāngata e whai ake nei te hunga tino mōrearea:

• Kaumātua : Tata tonu ka pāngia te hunga neke atu i te 50 tau te pakeke e te GCA. Ka piki ake te mōrearea o te pāngia e te mate i te kaumātuatanga. He mea tino noa tēnei i waenga i te hunga i waenga i te 70 me te 80 tau te pakeke.
• Ngā Wahine : He nui ake te kitea o tēnei mate i roto i ngā wāhine i ngā tāne. Heoi, he nui ake te mōrearea o ngā tāne ki te matapo nā tēnei mate.
• Ngā tāngata Pākehā : Kua whakaatuhia e ngā rangahau he nui ake te pānga o te GCA ki ngā tāngata Pākehā o te uri o Ūropi ki te Raki i ērā atu iwi. Heoi, ehara tēnei i te kī kāore e taea e ētahi atu iwi te whakawhanake i tēnei.

Me pēhea te tātaritanga o te GCA?

Mena kei a koe ngā tohu o te GCA, ka pātai tuatahi tō tākuta ki a koe mō tō hītori hauora, kātahi ka tirotirohia tō tinana. Ka tirohia e rātou mēnā he ngoikore ngā pā o ō ringaringa me ō waewae. Ka tirohia hoki e rātou tō mahunga kia kite mēnā he mamae kei tō tumuaki, ā, mēnā kei te pupuhi ngā uaua i ia taha o tō rae.

He aha ngā whakamātautau e whakamahia ana hei tautuhi i te GCA?

Ka whakahaua e te tākuta ētahi whakamātautau toto hei ine i te taumata o te mumura i roto i tō tinana. Hei tauira:

• (Te Auau Whakatakotoranga o ngā Erythrocyte) (ESR)
• `(Pūmua C-Reactive)` (CRP)

Mā ēnei whakamātautau ka taea e koe te whakaatu i te taumata o te mumura i roto i tō tinana. Ka taea hoki e rātou te ine i te taumata o te hemoglobin, te wāhanga kawe hāora o ō toto whero, kia kitea ai mēnā he anemia tōu.

Mena kei te whakapae tō tākuta kei a koe te GCA (Temporal Arteritis), ka tono pea rātou i tētahi tirotiro oro-matapōkere o te uaua o te rae, arā, he tirotiro o ngā uaua o tō rae. Tērā pea ka tono rātou i tētahi tirotiro koiora o te uaua o te rae . Ko tēnei mahi he tango i tētahi tauira iti o te uaua o tō rae e tētahi tākuta whakangungu, ka tukuna atu ki tētahi tohunga mate pukupuku hei tirotiro i raro i te karuārai. Mā tēnei ka tirohia ngā tohu o te mumura (vasculitis) i roto i te uaua. Koinei te whakamātautau matua hei whakaū i te GCA.

I ētahi wā, ka hiahiatia pea ēnei whakamātautau:

• He whakamātautau matawai ``(Tomography Rorohiko)````(CT)`` rānei
• Matawai Whakaahua Āhua Aukume (MRI)
• Te tirotiro i ngā uaua nui mā te whakamahi i te ultrasound
• He whakamātautau matawai `(Positron Emission Tomography)` `(PET)` rānei

He aha ngā maimoatanga mō te GCA (Temporal Arteritis)?

Me tīmata wawe tonu te maimoatanga mō te GCA, ina koa hei ārai i te ngaronga o te tirohanga .

Ko te maimoatanga matua he momo rongoā e kiia nei ko te "glucocorticoid". Ko te momo rongoā e tino kitea ana ko te "prednisone." Ka tīmata koe me te 40 ki te 60 milligrams (mg) ia rā (mā te waha) ka whakaiti haere i te horopeta. Mena kua raru kē tō tirohanga, kua ngaro rānei tō tirohanga, ka hoatu pea e tō tākuta he horopeta nui o te "glucocorticoids" mā roto i te cannula kua whakanohoia ki roto i te uaua (``(IV)'').

He mea nui: He rongoā tino nui ngā glucocorticoids hei whakahaere i te GCA. Heoi anō, ka pā mai ētahi pānga taha i ēnei rongoā, nō reira ka tirotirohia koe e tō tākuta.

Ka ngoikore tō pūnaha ārai mate nā ngā glucocorticoids, ka nui ake ai te tūponotanga ka pāngia koe e ngā mate, ka kino ake hoki . Ka taea hoki e rātou te whakangāwari i ō wheua , ka nui ake ai te tūponotanga o te whati.

Ko ētahi atu pānga taha ka puta ko:

• Ngā katarata
• toto toto tiketike
• Te huka toto tiketike
• Te kore moe
• Ngā huringa wairua
• Te ngoikore me te ngenge o ngā uaua, inā koa i ngā waewae
• Te pupuhi, inā koa i te mata me ngā waewae
• Te pikinga o te taumaha

I a koe e tango ana i ngā glucocorticoids, ka tirohia pea e tō tākuta te mātotoru o tō wheua. Tērā pea ka tūtohu ia i te whakakori tinana, i ngā tāpiringa konupūmā me te huaora D, me ētahi rongoā pea hei ārai i te osteoporosis (te ngaronga o te wheua) kia mau tonu ai te kaha o ō wheua.

I te tau 2017, i whakaaetia e te U.S. Food and Drug Administration tētahi rongoā koiora hou e kiia nei ko te tocilizumab (Actemra®) hei rongoā mō te GCA. Ka hoatu tēnei rongoā hei werohanga i raro i te kiri, hei werohanga IV rānei. Ka taea e ia te āwhina ki te whakaiti i te hiahia mō ngā glucocorticoids. Heoi anō, he pānga taha anō tō te tocilizumab, ā, mā tō tākuta koe e whakamārama.

Āhea ahau me kite i te tākuta?

Mena kei a koe ngā tohu o te GCA, ngā tohu o te mate, ngā tohu hou rānei, me toro atu ki tō tākuta tonu . Mā te toro atu ki tō tākuta i ia wā, me te whai i ngā whakamātautau toto me ngā karapa, ka āwhina i a koe ki te kite wawe i te hokinga mai o te mate ('relapse').

He aha ngā pātai me pātai atu e au ki te tākuta?

Ka taea e koe te pātai atu ki tō tākuta i ngā pātai pēnei:

• He aha ngā maimoatanga e taunaki ana koe?
• He aha ngā pānga taha me mōhio ahau i te wā e rongoatia ana?
• He aha taku e taea ai hei whakaiti i ngā pānga taha o te maimoatanga?
• He aha ngā raruraru pea ka pā mai i tēnei mate?
• Me pēhea taku aroturuki i tōku āhua?
• He aha ngā tohu o te hokinga mai o te mate?
• He aha ngā tohumate me whakapā atu ahau ki a koe?

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

Kāore i kitea he huarahi hei whakapoto i te roanga o te oranga mēnā he GCA, engari he maha ngā āhuatanga ka pā ki tēnei. Mēnā ka kitea wawetia te mate, ka rongoatia hoki, he tino pai ngā hua , ā, ka tīmata te pai haere o ngā tohu i roto i ētahi rā.

Heoi, ki te kore e rongoatia wawetia, ka taea e te GCA te arahi ki ngā raruraru morearea pērā i te ngaronga tirohanga tuturu, te aneurysms, me te pararutiki. Nō reira, he mea tino nui kia toro atu ki te tākuta tonu mēnā he tohu e pā ana ki te GCA.

Kia tīmata te maimoatanga, ko te mōrearea matua ka pā ki a koe ko ngā pānga taha o te maimoatanga . Waihoki, ahakoa kua ora te GCA i te tīmatanga me te maimoatanga angitu, ka taea tonu te hoki mai ('ka hoki anō') . Kāore anō kia mōhiotia e ngā kairangahau he aha tēnei e puta ai.

Me pēhea taku tiaki i ahau anō i a au e noho tahi ana me te GCA?

He uaua te noho tahi me te GCA. Hei whakahaere i tō āhua me te whakahaere i ngā pānga taha o te glucocorticoids, ngana ki ēnei mea:

• Kai i ngā kai pai, whai kiko hoki : pērā i te mīti kikokore, te pīni, te witi katoa, te hua hou me te huawhenua.
• Kia nui te huaora D me te konupūmā hei tiaki i ō wheua.
• Whakakorikori tinana mō te 30 meneti pea i te iti rawa i te rā.
• Kia pai te moe mō te whitu ki te waru hāora i ia pō.
• Tangohia te rongoā i whakaritea ki a koe i te wā tika .
• Tirohia tō tākuta i ia wā, i ia wā .
• Me mahi i ngā mahi hei tiaki i a koe mai i ngā mate urutā .

He aha ngā mea me karo e au ina pāngia ahau e te GCA?

Mena kei a koe te GCA, he pai ake te karo i ēnei mea:

• Ngā āhuatanga e whakanui ake ai i tō tūponotanga ki te pāngia e te mate : Nā te mea ka ngoikore tō pūnaha ārai mate i ngā rongoā mō te GCA, ka nui ake te tūponotanga ka pāngia koe e ngā mate. Pātai atu ki tō tākuta mō ētahi atu huarahi hei whakaiti i tō tūponotanga ki te pāngia e te mate, pērā i te karo i te pāngia e te mate, te horoi pinepine i ō ringaringa, me te noho tawhiti atu i te hunga e pāngia ana e te mate.
• Te Momi hikareti : Ka taea e te momi hikareti te whakanui ake i tō tupono ki te whakawhanake i te GCA. Ka pai ake te hauora o ō uaua toto ina mutu tō momi hikareti, ā, ka whai hua tēnei mōu mō te wa katoa.
• Te inu waipiro : Ka pā kino te waipiro ki te hauora o tō ngākau me ō uaua toto. Ka taea hoki e ia te whakateretere i te ngaronga o te wheua, ā, ka taunekeneke hoki ki ngā rongoā e tangohia ana e koe mō tō āhua.

Ētahi kōrero tino nui (Karere hei tango ki te kāinga)

He uaua pea te mate Giant Cell Arteritis (i mua ko te Temporal Arteritis). Heoi, ki te kitea wawetia tō mate, ā, ka tirotirohia koe e te tākuta whai tohu, ka pai ake te hua . Ka pā pea ngā tohu me ngā pānga taha o te maimoatanga ki tō hauora hinengaro, ki tō mahi, me ngā āhuatanga maha o tō oranga. Engari kāore koe i te mokemoke. Tonoa atu ki tō tākuta kia āwhina i a koe ki te kimi i tētahi rōpū tautoko me te hunga kua pā ki ngā āhuatanga rite. Mā te whakapuaki i ō wheako me ō tohutohu ki ētahi atu ka taea te whakamarie.

Kia maumahara, ki te pā mai ētahi tohu rerekē pērā i te ānini, te mamae o te kauae, te raruraru tirohanga rānei (ina koa mēnā neke atu i te 50 tau te pakeke), kaua e warewarehia, engari me rapu tohutohu hauora tonu. Mā te maimoatanga tere ka ārai i ngā raruraru nui.

` Te Mate Pūtau Nui, Te Mate Pūtau Wā, GCA, Mamae upoko, Tirohanga kanohi, Pupuhi oko toto, Hauora kaumātua, Polymyalgia Rheumatica, Prednisone, Vasculitis