Porphyria
Porphyrias o se kulupu o le seasea tupuʻaga faʻafitauli. O se vaega taua o le hemoglobin, e taʻua o le heme, e le faia lelei. Hemoglobin o se porotini i mumu toto sela e ave le okesene. O le Heme e maua foi i le myoglobin, o se polotini e maua i ni maso faapitoa.
Masani ai, o le tino faia heme i se tele-laasaga gaioiga. Porphyrins e faia i le taimi o laasaga o lenei gaioiga. O tagata e maua i le porphyria e le o iai ni enzymes e manaʻomia mo lenei faiga. Lenei mafua ai le le masani ai aofaʻiga o porphyrins poʻo ni vailaʻau fesoʻotaʻi e fausia i luga o le tino.
E tele ituaiga eseese o porphyria. O le ituaiga taatele o le porphyria cutanea tarda (PCT).
Fualaʻau, faʻamaʻi, 'ava malosi, ma homone e pei o le estrogen e ono faʻaosoina osofaʻiga o nisi ituaiga o porphyria.
Porphyria e tofi. O lona uiga o le faʻamaʻi na pasia e aiga.
Porphyria mafua ai tolu tetele faʻailoga:
- Manava manava poʻo cramping (na o nisi ituaiga o faʻamaʻi)
- Malamalama lelei i le malamalama e mafai ona mafua ai rashes, afaina, ma maʻila o le paʻu (photodermatitis)
- Faʻafitauli ma le neula io ma maso (faoa faamalosi, faʻaletonu mafaufau, faʻaleagaina neula)
O osofaʻiga e mafai ona tupu faʻafuaseʻi. E masani ona latou amata ile tiga o le manava tiga mulimuli ane ma le puaʻi ma le papala. O le i ai i fafo o le la e mafai ona mafua ai tiga, lagona o le vevela, pupula, ma le paʻu mumu ma fulafula. O le palu e faʻamalolo lemu, e masani ona faʻapea ona suia le maʻila poʻo le paʻu o lanu. O le maʻila e ono faʻaleagaina. E mūmū pe enaena le mimi peʻa maeʻa se osofaʻiga.
Isi faʻailoga aofia ai:
- Tiga maso
- Musika vaivaiga po o le supa
- Fuafua pe tingling
- Tiga i lima poʻo vae
- Tiga i le tua
- Tagata suia
O osofaiga e mafai i nisi taimi ona lamatia ai le ola, gaosia:
- Maualalo le toto
- Ogaoga le paleni electrolyte
- Teʻi
O lau fomaʻi e faia se suʻega faʻapitoa, e aofia ai ma le faʻalogo i lou fatu. Atonu e vave sau fatu fatu (tachycardia). E ono iloa e le tagata e faʻapea e le aoga lelei lau loloto tendon reflexes (tulivae tuli poʻo isi).
Toto ma miaga suʻega ono faʻaalia ai fatuga faʻafitauli poʻo isi faʻafitauli. O nisi o suʻega e ono faia e aofia ai:
- Kasa kasa
- Faʻatulagaina metabolic vaega
- Porphyrin tulaga ma tulaga o isi vailaʻau fesoʻotaʻi ma lenei tulaga (siaki i le toto poʻo miaga)
- Ultrasound o le manava
- Urinalysis
Nisi o vailaʻau faʻaaoga e togafitia ai se faʻafuaseʻi (matuitui) osofaʻiga o porphyria ono aofia ai:
- Hematin na tuʻuina atu i se alatoto (faʻaalu)
- Paʻu vailaʻau
- Propranolol e faʻatonutonu le tata o le fatu
- Faʻaola e fesoasoani ia te oe ia lagona le toʻamalie ma le le popole
Isi togafitiga ono aofia ai:
- Beta-carotene faʻaopoopoga e faʻaititia ai le malamalama i ata
- Chloroquine i le maualalo o tui e faʻaititia ai le maualuga o porphyrins
- Fluids ma kulukose e faʻamalosia ai gaʻo tulaga, e fesoasoani faʻagataina le gaosia o porphyrins
- Aveʻesea o le toto (phlebotomy) e faʻaititia ai tulaga o porphyrins
Faʻamoemoeina i le ituaiga o porphyria o loʻo ia oe, e ono taʻu atu e lau tautua ia oe:
- Aloʻese uma 'ava malosi
- Aloese mai fualaʻau e ono mafua ai se osofaʻiga
- Aloese mai le manuʻa o le paʻu
- Aloese mai le susulu o le la i le mea e mafai ai ma faʻaaoga le sunscreen pe a fai o fafo
- Taumafa i meaʻai maualuga-suka
O faʻamatalaga nei e mafai ona maua mai ai nisi faʻamatalaga i luga ole porphyria:
- American Porphyria Foundation - www.porphyriafoundation.org/for-patients/patient-portal
- National Institute of Diabetes ma Digestive ma Fatugaʻo Faʻamaʻi - www.niddk.nih.gov/health-information/liver-disease/porphyria
- National Organisation for Rare Disorder - rarediseases.org/rare-diseases/porphyria
Porphyria o se gasegase tumau-ola ma auga e sau ma alu. O nisi ituaiga o faʻamaʻi e mafua ai sili atu faʻailoga nai lo isi. Mauaina lelei togafitiga ma nofo ese mai afaina e mafai ona fesoasoani faʻalautele ai le taimi i le va o osofaʻiga.
Faʻafitauli e ono aofia ai:
- Koma
- Maa maa
- Supa
- Maʻi manava (ona o le vaivai o maso o le fatafata)
- Maila le paʻu
Maua se fesoasoani faafomaʻi i le taimi lava e i ai ni faʻailoga o se ogaoga osofaʻiga. Talanoa i lau tautua e uiga i lou tulaga lamatia mo lenei tulaga pe afai oe i ai se umi talafaasolopito o le le iloa faʻamaonia manava tiga, maso ma neula faafitauli, ma le malamalama i le susulu o le la.
O faʻamatalaga faʻavae e mafai ona faʻamanuiaina ai tagata e fia maua ni fanau ma o latou aiga talaʻaga o soʻo se ituaiga porphyria.
Porphyria cutanea tarda; Porphyria soʻona faʻamamaina; Tofiina coproporphyria; Porphyria erythropoietic fanau; Erythropoietic protoporphyria
- Porphyria cutanea tarda i lima
Bissell DM, Anderson KE, Bonkovsky HL. Porphyria. N Engl J Med. 2017; 377 (9): 862-872. PMID: 28854095 www.ncbi.nlm.nih.gov/pubmed/28854095.
Fuller SJ, Wiley JS. Heme biosynthesis ma ona faʻaletonu: porphyrias ma sideroblastic anemias. I: Hoffman R, Benz EJ, Silberstein LE, et al, eds. Hematology: Faavae Autu ma Faʻataʻitaʻiga. 7th ed. Filatelefia, PA: Elsevier; 2018: mata 38.
Habif TP. Malamalama fesoʻotaʻi ma faʻamaʻi o pigmentation. I le: Habif TP, ed. Togafitiga Dermatology: O Se Valivali Taiala i Suʻesuʻega ma togafitiga. 6th ed. Filatelefia, PA: Elsevier; 2016: mata 19.
Hift RJ. O porphyrias. I totonu: Goldman L, Schafer AI, eds. Faʻafomaʻi Goldman-Cecil. 25th lomiga. Filatelefaia, PA: Elsevier Saunders; 2016: mata 210.