Omwana wo atera okufuna omusujja? Kyandiba nga kiva ku ddagala lya SAIDs (Systemic Autoinflammatory Diseases)?

Oh, omwana wo omuto atera okufuna omusujja ennaku zino? Mu kiseera ky’olowooza nti oteredde, kiddamu okubumbulukuka? Oluusi ekivaako kino kiyinza obutaba kawuka oba bakitiriya aba bulijjo. Leero tugenda kwogera ku mbeera ekalubye katono, naye nga kikulu nnyo okumanya. Kino kiyitibwa SAIDs, ekitegeeza Systemic Autoinflammatory Diseases . Edda kino kyayitibwanga `(Periodic Fever Syndromes)` oba `(Recurrent Fever Syndromes)`.

SAIDs kye ki? Ka tukitegeere mu ngeri ennyangu.

Mu ngeri ennyangu, SAIDs kibinja kya ndwadde eziva ku butakola bulungi oba ekizibu ky’okulungamya mu baserikale b’omubiri gwaffe abazaalibwamu . Eno y’ensonga lwaki omwana asobola okufuna omusujja enfunda eziwera ne bw’aba talina yinfekisoni (nga akawuka oba obuwuka).

Ekisinga obukulu kiri nti embeera zino eziyitibwa SAIDs tezirina kutabulwa na `(Autoimmune Diseases)` (okugeza `(Rheumatoid Arthritis)` oba `(Lupus)` z'oyinza okuba nga wali owuliddeko. Mu ndwadde za `(Autoimmune)`, olw'ensobi ezimu mu mubiri gwaffe `(adaptive immune system)`, enkola eyo elumba obutoffaali bwayo obulamu. Naye mu SAIDs, waliwo eky’enjawulo ekibaawo.

SAIDs tezitera nnyo okusinga endwadde z’abaserikale b’omubiri. Zitera okuba ez'obuzaale era nga ziva ku nkyukakyuka mu buzaale .

Ebiseera ebisinga, naye si bulijjo, obubonero bwa SAID butandika ng’omwana akyali muto nnyo, oba ng’akyali muwere oba ng’akyali muto . Omwana wo ayinza okuba n'ebiseera "ebiseera" by'omusujja n'obubonero obulala n'embeera eno. Wakati w’ensonga zino, omwana wo ayinza obutaba na bubonero bwonna. Wadde nga tewali ddagala lya SAIDs, emirundi mingi wabaawo obujjanjabi obuyamba okufuga obubonero bw’omwana wo.

Bika ki ebikulu ebya SAIDs?

Abanoonyereza bazudde ebika bya SAID nga 60, era ebipya bikyazuulibwa. Bino bye bimu ku bika bya SAID ebisinga okukozesebwa:

• Omusujja gw’amaka (FMF): Guno gwe gusinga okubeera mu bulwadde bw’omusujja obusikira obuzaale, obuddamu. Kiyinza okuvaako okuzimba olubuto, ekifuba n’ennyondo mu baana nga biruma.
• Omusujja ogw’ekiseera, aphthous-stomatitis, pharyngitis, adenitis (PFAPA): Kino kitera okutandika mu baana abato nga tebannaweza myaka 4. Oluusi, embeera eno esobola okutereera ku bwayo oluvannyuma lw’emyaka 10.
• Tumor necrosis factor receptor-associated periodic syndrome (TRAPS): Kino kiyinza okubaawo mu buto, mu myaka gy’obutiini oba n’okukula.
• Obutabeera na mevalonate kinase (MKD): Edda kyayitibwa ``Hyper-IgD syndrome'', kino kitera okutandika nga omwana tannaweza mwaka gumu.
• Endwadde ezikwatagana ne NLRP3 ez’okwezimba:Kino edda kyayitibwanga `(Cryopyrin-associated periodic syndromes - CAPS)`. Waliwo ebika ebirala bisatu ebitonotono munda mu kino.
• Obulwadde bwa Still obutandika mu bantu abakulu (AOSD): Nga erinnya bwe liraga, buno ngeri ya mbeera ya buto etandika mu bantu abakulu ``Systemic Juvenile Idiopathic Arthritis (JIA)``.
• Obulwadde bwa NOD-2-associated granulomatous disease (Blau syndrome): Buno butera okutandika nga tannaweza myaka 4. Businga kukwata lususu lw’omwana, amaaso n’ennyondo.

Bubonero ki obulaga obulwadde bwa SAIDs?

Obubonero bwa SAIDs butera okutandika mu buto. Akabonero akakulu era akasinga okulabika ye musujja ogw'ekiseera . Mu biseera by’omusujja, abantu batera okuba abalamu obulungi nga tebalina bubonero bwonna. Wabula wayinza okubaawo obubonero obulala obukwata ku buli kika kya SAID. Ka tulabe kye bali:

• FMF: Kino kiyinza okuvaako omwana okuzimba n’okulumwa ennyo mu lubuto, mu kifuba, n’ennyondo . Wayinza n’okubaawo okusiiyibwa ku magulu aga wansi oba ku bisambi.
• PFAPA: Kino kiyinza okuvaako okulumwa emimiro, okulumwa mu kamwa, n’okuzimba enseke mu bulago . Okugeza omwana wo bw’aba alaga obubonero ng’okulwala ennyo tonsillitis n’amabwa mu kamwa, kiyinza okuba PFAPA.
• EMITEGO: Kino kiyinza okuvaako okuwunya n’okulumwa ebinywa mu mugongo/omubiri n’emikono . Era kiyinza okuvaako ekizimba ekimyufu ekiruma nga kitandikira ku mikono n’amagulu ne kisaasaana wansi mu mubiri.
• MKD: Kino kiyinza okuleeta obubonero ng’okuziyira, okulumwa omutwe, okulumwa olubuto, obutayagala mmere, n’obubonero obulinga obwa ssennyiga .
• Endwadde za NLRP3: Embeera eno esobola okuvaako okusiiyibwa ku lususu, okulumwa omutwe, okulemererwa, okulumwa ennyondo, n’okuzimba amaaso aga pink/conjunctivitis .
• AOSD: Eno mbeera emanyiddwa ng’okusiiyibwa ku lususu, okulumwa ennyondo, n’okulumwa ebinywa . Abantu abamu bayinza n’okulumwa emimiro, okulumwa olubuto, okukoowa n’okutabuka.
• Obulwadde bwa Blau: Kino kiyinza okuvaako omwana wo okufuna ebiwundu ku lususu ku mikono, amagulu, oba ekitundu kya wakati . Era kiyinza okuvaako okulumwa ennyondo n'okulumwa amaaso .

Biki ebivaako obulwadde bwa SAID?

SAID nnyingi ndwadde za buzaale . Kwe kugamba, enkyukakyuka (variant) eyeetongodde mu ggiini entongole ereeta buli bulwadde. Teebereza nti omubiri gwaffe gulina ebiragiro (genes) ebitubuulira engeri y’okukolamu buli mulimu, n’olwekyo ennukuta emu mu kitabo ekyo bw’eba nkyamu, eyinza okuvaako omulimu ogusigaddewo okutambula obubi.

Bino bye bika bya SAID ebikulu n’obuzaale obukwatagana nabyo:

• FMF:Ensengekera y’obutonde `MEFV` y’ewa ebiragiro ku ngeri y’okukolamu puloteyina `(pyrin)`.
• PFAPA: Ekituufu ekivuddeko kino tekinnategeerekeka .
• EMITEGO: Ensengekera y’obutonde `TNFRSF1A`. Kino kiragira okukola puloteyina eyitibwa `(tumor necrosis factor receptor - TNFR)`.
• MDK: Ensengekera y’obutonde eyitibwa `MVK`. Kino kiragira okukola puloteyina eyitibwa `(mevalonic kinase)`.
• Endwadde za NLRP3: Ensengekera y’obutonde `NLRP3`. Kino kiragira okukola puloteyina eyitibwa `(cryopyrin)`.
• AOSD: Ekituufu ekivuddeko kino tekinnazuulibwa .
• Obulwadde bwa Blau: Ensengekera y’obutonde `NOD2`. Kino kiragira okukola puloteyina eyitibwa `(NOD2)`.

Kikulu okukitegeera nti bino bwe biva ku buzaale, si musango gwa bazadde. Zino nkola za biramu nzibu nnyo.

Ebizibu ebiva ku SAIDs

Kikulu nnyo okufuna obujjanjabi obutuufu ku mbeera zino. Kubanga, singa okuzimba kugenda mu maaso mu mubiri, kuyinza okuvaako embeera eyitibwa `(Amyloidosis). `(Amyloidosis)` ye puloteyina etereka mu nsigo . Kino kiyinza okuleeta okwonooneka kw'ensigo okw'olubeerera . N’olwekyo, singa wabaawo obubonero, kyetaagisa okugenda mu maaso n’abasawo amagezi.

SAIDs zizuulibwa zitya?

Mu butuufu, okuzuula SAIDs kiyinza okusoomoozebwa katono kubanga obubonero buyinza okufaananako n’obw’embeera endala ez’amaanyi, gamba nga lupus oba lymphoma. N’olwekyo, kikulu okulaba omusawo alina okutendekebwa okw’enjawulo mu ndwadde ezizimba (omusawo w’endwadde z’enkizi) okuzuula obulungi n’okuddukanya embeera y’omwana wo.

Omusawo w’endwadde z’enkizi ow’omwana wo ajja kukozesa ebintu ebiwerako okuzuula obulwadde bwa SAIDs. Ajja kubuuza ku bubonero bw’omwana wo n’okumanya oba waliwo omuntu yenna mu maka go abadde n’embeera zino (biological family history). Omusawo ayinza okuteebereza nti omwana wo alina obulwadde bwa Periodic Fever Syndrome singa:

• Bw’oba ​​olina omusujja ogutera okugwa
• Singa omuntu yenna mu maka alina ebyafaayo by’omusujja ogw’oluusi n’oluusi nga guno
• Bw’oba ​​oli mu kibinja ky’abantu abatera okufuna omusujja ogw’engeri eno

Bigezo ki ebikozesebwa?

Omusawo ayinza okukuwa amagezi okukeberebwa okuwerako okukakasa nti omuntu azuuliddwa. Mu bino biyinza okuli:

• Okukebera mu laabu: Okukebera nga `(C-reactive protein - CRP)` ne `(Complete Blood Count - CBC)` kusobola okukebera okuzimba mu mubiri. Ebigezo bino biba `(positive)` nga waliwo omusujja, era bidda ku miwendo egya bulijjo ng'omusujja guweddewo.
• Okukebera omusulo:Okukebera obutoffaali bw’omusulo kuyinza okukolebwa okukebera oba obutoffaali bungi mu musulo. Mu MKD, okukebera omusulo okuzuula asidi ez’obutonde kijja kulaga nti asidi wa mevalonic ali waggulu.
• Okukebera obuzaale: Kino kiyinza okukebera enjawulo mu buzaale. Wabula abaana abamu abalina SAIDs bayinza obutaba na nkyukakyuka ya buzaale ezuuliddwa. N'olwekyo, ne bwe kiba nti ebyava mu kukebera biba ``negative``, okusobola kwa SAID tekuyinza kugobwa.

SAIDs zikwatibwa zitya?

Obujjanjabi bwa SAIDs bwawukana okusinziira ku kika n'obuzibu bw'obulwadde buno . Wadde ng’endwadde zino teziyinza kuwonyezebwa ddala, obubonero bw’omwana busobola okufugibwa obulungi ng’akozesa eddagala . Okugeza, singa omwana wo afuna omusujja guno emirundi mitono gyokka mu mwaka, eddagala eriweweeza ku bulumi n’eddagala eriziyiza okuzimba (NSAIDs) litera okufuga obubonero. Kyokka singa obulwadde buba buzibu nnyo, omusawo ayinza okumuwa amagezi ku ngeri endala ez’obujjanjabi.

Wano waliwo obujjanjabi obw’engeri eno:

• FMF: Kino osobola okukijjanjaba n’eddagala eriyitibwa `(Colchicine)` okukendeeza ku buzimba. Bwoba tosobola kumira `(Colchicine)`, osobola okugezaako ekika ky'eddagala `(Biologic)` eriyitibwa `(Canakinumab)`.
• PFAPA: Ebizibu ebiva mu PFAPA bisobola okukendeezebwa nga bawa eddagala lya steroids (emirundi mingi prednisone). Abaana abamu basobodde okufuga obubonero bwabwe nga bakozesa eddagala lya cimetidine erijjanjaba amabwa mu lubuto.
• TRAPS: Eddagala `(Canakinumab)` likola nnyo ku TRAPS. Ekirala, eddagala eriweweeza ku bulwadde eriwandiikiddwa omusawo nga `(Glucocorticoids)` nalyo liyinza okuyamba okumalawo obubonero.
• MKD: `(Canakinumab)` nkola nnungi ku bujjanjabi bwa MKD. Okukozesa `(NSAIDs)` oba `(Steroids)` mu kiseera ky'omusujja nakyo kiyinza okuyamba.
• Endwadde za NLRP3: Ebirungo ebirala ebikyusa obusimu obuziyiza endwadde nga Canakinumab ne Rilonacept, Anakinra, bikola bulungi mu kujjanjaba endwadde za NLRP3.
• AOSD: Ebika by’eddagala ery’enjawulo eriziyiza okuzimba likozesebwa ku AOSD. Mu bino mulimu `(Steroids)`, `(Eddagala eriziyiza endwadde ezikyusa endwadde - DMARDs)`, ne `(Biologics)`.
• Obulwadde bwa Blau: Okusinziira ku bubonero bw’omwana, eddagala eriweweeza ku busimu bw’omubiri, eddagala eriweweeza ku bulwadde bwa tumor necrosis factor (TNF), ne/oba eddagala ly’amaaso eriweebwa ku mubiri liyinza okugezesebwa.

Embeera ya SAIDs etereera ku bwayo?

SAID ezimu zisobola okumala obulamu bwonna . Ebirala biyinza okumala emyaka mitono ne bitereera ng’emyaka gigenda gikula. Wadde ng’embeera ezimu zibeera za bulamu bwonna, emirundi gy’omusujja giyinza okukendeera oluvannyuma lw’ekiseera era obubonero buyinza obutaba bwa maanyi nnyo . Omusawo wo asobola okukuwa ebikwata ku mbeera y’omwana wo entongole.

Okulabirira omwana alina SAID kiyinza okuba ekizibu. Mpozzi ggwe kennyini OYOGEDDE, naye osobola okukozesa by’oyitamu okuyamba omwana wo okulabirira n’okumuyamba okugumira embeera eno ey’obulamu bwe bwonna.

Ekisinga obukulu kwe kunoonya obujjanjabi okuva mu bakugu abamanyi obulungi obuzibu bw’eddagala lya SAID. Ziyinza okuyamba okuddukanya obubonero bw’omwana wo n’okumuyamba okufuna obuto obusinga obulungi.

Ebintu ebikulu by'olina okujjukira (Take-Home Message)

Okay, kale ka tufunze ebimu ku bintu by’olina okujjukira okuva mu bye twogeddeko.

• Omwana wo bw’aba alina omusujja ogutera, ogutategeerekese , yogerako n’omusawo wo ku nsonga eyo. Kiyinza okuba akabonero ka SAID.
• SAIDs kizibu kya innate immune system , so si bulwadde bwa bulijjo obusiigibwa.
• Bino bya njawulo ku ndwadde za ``Autoimmune'' .
• Ebiseera ebisinga, bino biva ku nsonga z’obuzaale .
• Kikulu okulaba omusawo w’endwadde z’enkizi okuzuula ekituufu.
• Obujjanjabi busobola okufuga obulungi obubonero .
• Okujjanjaba amangu kyetaagisa nnyo okuziyiza ekibumba okwonooneka.

Bw’oba ​​olina ekibuuzo ekirala kyonna ku nsonga eno, totya kubuuza musawo wa famire yo oba omusawo w’abaana. Bajja kusobola okwongera okukuyamba.

` SAIDs, omusujja ogw’obuzaale, omusujja ogutera, omusujja mu baana, abaserikale b’omubiri, endwadde z’obuzaale, omusawo w’endwadde z’enkizi