Obutoffaali bwo obweru butono mu ngeri ey’akabi? Ekyo kibeera kiwuka kya agranulocytosis? Ka twogere ku nsonga eno!

Olwala buli kiseera? Owulira ng’oli munafu era ng’okooye ne bw’omala akaseera katono? Oluusi kino kiyinza okuba nga kiva ku kukendeera okw’akabi mu buziyiza bw’omubiri gwo, kwe kugamba, neutrophils, ekika ky’obutoffaali obweru. Leero twogera ku mbeera ey'amaanyi naye nga esobola okujjanjabibwa eyitibwa agranulocytosis . Tofaayo, kikulu okukimanya kino.

Ddala agranulocytosis kye ki?

Mu ngeri ennyangu, Agranulocytosis mbeera ya bulabe eri obulamu ng’omuwendo gw’obutoffaali obweru obuyitibwa neutrophils mu mubiri gwaffe gukendeera okutuuka ku mutindo ogwa wansi ennyo. Obadde okimanyi nti obutoffaali obweru bulinga abaserikale mu baserikale baffe abaziyiza endwadde? Bano be batukuuma obutakwatibwa buwuka obuleeta endwadde. Omuwendo gwa neutrophils zino bwe gukendeera, omubiri gwaffe gweyongera okukwatibwa obuwuka. N’obuwuka mu budde obutuufu obutatuleetera bulabe bungi busobola okutulwaza. Teebereza, singa ekibinja ky’amagye ag’enjawulo mu magye g’eggwanga lyaffe kibulawo mu bwangu, n’omulabe omutono teyandibadde kizibu kinene? Kino kye kimu. Erinnya "agranulocytosis" liva mu kigambo granulocytes . Granulocytes nazo kika kya butoffaali obweru. Zirimu enziyiza ezisaanyaawo obuwuka. Waliwo ebika bya granulocytes bisatu: Neutrophils , Eosinophils, ne Basophils . Neutrophils ze butoffaali obweru obusinga okubeera mu mibiri gyaffe. Eno y’ensonga lwaki abasawo bakebera emiwendo gya neutrophil okuzuula obulwadde bwa agranulocytosis. Kino oluusi kiyitibwa granulocytopenia .

Njawulo ki eriwo wakati wa Neutropenia ne Agranulocytosis?

Zombi zikwatagana n’okukendeera kw’obusimu obuyitibwa neutrophils. Kyokka, agranulocytosis y’engeri esinga okuba ey’amaanyi ey’okukendeera kw’obusimu obuyitibwa neutropenia .

• Neutropenia mbeera nga omuwendo gwa neutrophils mu musaayi guli wansi okusinga ogwa bulijjo. Abantu abalina neutrophils ezitakka wansi wa 1,500 buli microliter (mL) y’omusaayi kigambibwa nti balina neutropenia.
• Agranulocytosis gwe mutendera ogusembayo, ogusinga okuba ogw’obulabe, ng’omuwendo gwa neutrophil gukka wansi wa 100 buli microliter y’omusaayi. Okukifuna? Eno y’engeri esinga okuba ey’amaanyi ey’okukendeera kw’obusimu obuyitibwa neutropenia.

Waliwo ebika by’obulwadde bwa agranulocytosis?

Yee, kino kiyinza okujja mu ngeri bbiri enkulu: 1. Obulwadde bwa agranulocytosis obusikira:Kino kiva ku buzibu bw’obuzaale. Kwe kugamba, waliwo obuzibu ku buzaale obuyamba omubiri gwaffe okukola obusimu obuyitibwa neutrophils. Embeera eno esinga kukwata balongo n’abaana abato. 2. Acquired agranulocytosis: Kino kiyinza okuba n’ensonga nnyingi. Wabula ebiseera ebisinga (ebiseera nga 70%!) kiva ku buzibu obuva mu ddagala erimu lye tumira. Ekika kino kisinga kubeera mu bantu abakulu.

Embeera eno ya bulijjo etya?

Mu butuufu eno mbeera ya bbula nnyo. Ku kigero, abantu nga musanvu ku buli lukumi bafuna embeera eno buli mwaka. Kale totya mu ngeri eteetaagisa, naye kikulu okubeera nga omanyi.

Bubonero ki obulaga obulwadde bwa Agranulocytosis?

Mu mbeera eno, obubonero obukulu bwekuusa ku yinfekisoni. Bino bisobola okutandika mu bwangu, oba biyinza okweyongera mpolampola ng’ekiseera kigenda kiyitawo. Laba oba obubonero buno buwulikika ng’omanyidde ddala:

• Okufuna omusujja, okuwulira ennyonta n’okukankana.
• Okweyongera kw’okukuba kw’omutima n’okussa.
• Okuwulira nga tolina bulamu n’okukoowa ennyo.
• Okulumwa emimiro (pharyngitis), okukendeera kw’ennyindo, okuvaamu omusaayi mu nnyindo.
• Amabwa mu kamwa n’emimiro, ekizibu okumira emmere n’ebyokunywa.
• Puleesa okukka amangu (hypotension), okuziyira, okuzirika, era nga kiyinzika n’okubulwa amagezi.

Bw’oba ​​olina obubonero nga buno naddala nga butera okulabika, mazima ddala olina okugenda mu basawo amagezi.

Lwaki obulwadde bwa agranulocytosis bubaawo? Biki ebivaako?

Ensonga enkulu evuddeko kino kwe kukendeera okw’akabi mu butoffaali obweru obuyitibwa neutrophils mu mubiri gwaffe. Waliwo ensonga bbiri eziyinza okuvaako kino:

• Oba emibiri gyaffe tegikola neutrophils zimala okukola obulungi.
• Bwe kitaba ekyo, obusimu obuyitibwa neutrophils mu mubiri busaanawo, oba bufa nga tebunnatuuka.

Kati ka tulabe ensonga entongole eziviirako kino.

Obulwadde bwa agranulocytosis obusikira

Mu kino, waliwo obuzibu ku buzaale obuyamba okukola obusimu obuyitibwa neutrophils. Eno mbeera ebeerawo ng’azaalibwa (congenital). Ng’ekyokulabirako, singa tumira obulwadde bwa Kostmann syndrome , oba congenital agranulocytosis , embeera etatera kulabika, abalongo abaakazaalibwa batera okufuna yinfekisoni, omusujja, okuzimba, n’obuzibu bw’amagumba.

Obulwadde bwa agranulocytosis obufunibwa

Wandibaawo ensonga eziwerako eziviirako kino. Ka tulabe kye bali:

• Eddagala erimu: Kino kye kisinga okuvaako . Eddagala erimu eritta obuwuka , eddagala eriweweeza ku bwongo , n’eddagala lya thyroid liyinza okuleeta embeera eno.
• Endwadde z’abaserikale b’omubiri : Zino ndwadde abaserikale b’omubiri mwe balumba obutoffaali bw’omubiri. Eby'okulabirako mulimu lupus n'endwadde z'enkizi .
• Endwadde z’obusimu bw’amagumba n’obuzibu bw’okulemererwa kw’obusimu bw’amagumba: Okugeza , aplastic anemia . Obusigo bw’amagumba we bukolebwa obutoffaali bwaffe obw’omusaayi.
• Kookolo: Kookolo akwata obusigo bw’amagumba naddala obulwadde bwa leukemia .
• Obujjanjabi bwa kookolo (Chemotherapy): Obujjanjabi buno busobola okusaanyaawo obutoffaali obulamu awamu n’obusimu obuyitibwa neutrophils.
• Okukwatibwa obutwa oba eddagala: Okubeera mu bintu nga lead oba mercury okumala ebbanga eddene.
• Yinfekisoni: Yinfekisoni ez’amaanyi nga omusujja , akafuba , n’omusujja ogw’amabala mu Rocky Mountain .
• Obutabeera na mmere: Obutaba na biriisa bikulu nga Vitamin B12 ne Folate.

Ani asinga okubeera mu bulabe bw’embeera eno?

Abakyala batera okufuna embeera eno okusinga abasajja. Ate era, obulwadde bwa agranulocytosis busobola okukwata omuntu yenna ow’emyaka gyonna. Kyokka, abantu bano wammanga be bali mu bulabe obw’enjawulo:

• Abantu abajjanjabwa eddagala lya kookolo.
• Abantu abalina endwadde z'abaserikale b'omubiri nga lupus ne rheumatoid arthritis .
• Abantu abamira eddagala erimu, gamba nga Clozapine (Clozaril®) , eddagala eriweweeza ku bwongo , Trimethoprim/sulfamethoxazole (BactrimTM) , ne Methimazole (Tapazole®), eddagala eriweweeza ku bulwadde bwa thyroid.

Bizibu ki ebiyinza okubaawo olw’obulwadde bwa agranulocytosis?

Embeera eno esobola okuvaako okukwatibwa endwadde enfunda eziwera oba okumala ebbanga eddene (obulwadde obutawona).

Singa obulwadde bwa agranulocytosis buwangaala okumala wiiki ezisukka mu ssatu oba nnya, emikisa 100% egy’okufuna yinfekisoni.

Singa obulwadde bwa sepsis tebujjanjabwa, buyinza okuvaako abaserikale b’omubiri obulwadde obw’amaanyi, obutta obulamu bw’abaserikale b’omubiri obuyitibwa sepsis. Obulwadde bwa Sepsis bulwadde bwa maanyi obusaasaana mu mubiri gwonna. Abantu abasukka mu myaka 65 oba abalina ebizibu ebirala eby’obulamu, gamba ng’endwadde z’omutima, endwadde z’ekibumba oba amawuggwe, bali mu bulabe bwa maanyi okufuna ebizibu bino.

Kino okizuula otya?

Omusawo azuula atya obulwadde bwa agranulocytosis? Ebiseera ebisinga bagoberera emitendera gino:

• Complete Blood Count (CBC) and differential: Okukebera kuno kutunuulira ebika by’obutoffaali eby’enjawulo mu musaayi gwo naddala omuwendo gwa neutrophils. Omuwendo gwa neutrophil ogw’enkomeredde (ANC) ogutakka wansi wa 100 buli microliter y’omusaayi gutwalibwa nga agranulocytosis. (Omuwendo ogwa bulijjo eri omuntu omulamu obulungi gusukka 1,500.)
• Bone marrow biopsy and aspirate: Oluusi, okukebera kuno kuyinza okukolebwa okulaba engeri obusimu bwo gye bukolamu obuwuka obuyitibwa neutrophils.
• Obubonero n’ebyafaayo by’obujjanjabi: Omusawo ajja kukubuuza ku bubonero bwo, eddagala ly’omira, yinfekisoni z’ofunye gye buvuddeko, n’okukozesa eddagala lyonna.
• Okukebera obuzaale: Singa embeera y’obuzaale eteeberezebwa, okukebera obuzaale kuyinza okukolebwa okugikakasa. Kino kiyinza okuzingiramu okukebera olususu oba okukebera omusaayi.

Bujjanjabi ki obukolebwa ku kino?

Amawulire amalungi gali nti waliwo obujjanjabi bw’embeera eno, agranulocytosis. Obujjanjabi businziira ku kivaako.

• Okuyimiriza eddagala erikuleetera obulwadde: Singa eddagala liba likuleetera obubonero, ky’olina okusooka okukola kwe kulekera awo okulimira awatali bulabe ng’omusawo bw’akulagidde. Tolekera awo kumira ddagala nga tewebuuzizza musawo.
• Eddagala eritta obuwuka: Bw’oba ​​olina yinfekisoni, omusawo ajja kukuwa eddagala eritta obuwuka erisaanira n’eddagala eddala okukendeeza ku bubonero.
• Granulocyte colony-stimulating factor (G-CSF): Empiso ey’ekika kino esobola okuweebwa okuyamba omubiri okukola amangu obuwuka obuyitibwa neutrophils. Eby’okulabirako mulimu eddagala nga Filgrastim (Neupogen®) , Pegfilgrastim (Neulasta®) , ne Lenograstim (Granocyte®) .
• Eddagala eriziyiza abaserikale b’omubiri: Singa embeera eno eva ku buzibu bw’abaserikale b’omubiri, eddagala eriziyiza abaserikale b’omubiri, gamba nga Prednisone, liyinza okuwandiikibwa.
• Okusimbuliza obusigo bw’amagumba: Singa obujjanjabi obulala tebukola bulungi, kiyinza okwetaagisa okusimbuliza obusigo bw’amagumba. Mu kino, ojja kuweebwa obusigo bw’amagumba okuva eri omugabi omulamu. Kino kijja kuyamba omubiri gwo okuddamu okukola neutrophils ennungi.
• Okwetangira yinfekisoni: Kino kikulu nnyo. Abantu abalina embeera eno balina okwegendereza ennyo okwewala okukwatibwa yinfekisoni.
• Bulijjo naaba bulungi mu ngalo ne ssabbuuni.
• Weewale ebifo ebirimu abantu abangi nga bwe kisoboka.
• Yambala ekibikka ku maaso/masiki ng’ogenda ebweru.
• Yogerako n’omusawo wo ku biki ebirala by’oyinza okukola okwetangira okulwala.

Ngenda kuwona mangu ntya oluvannyuma lw’okujjanjabibwa?

Ekiseera ky’okuwona kisinziira ku kivaako omuwendo gwa neutrophil zo omutono n’obuzibu bw’embeera. Bwe kiba nga kiva ku ddagala, ebiseera ebisinga kiyinza okutwala wiiki emu okutuuka ku wiiki ssatu omuwendo gwa neutrophil gwo okudda mu mbeera eya bulijjo ng’omaze okulekera awo okumira eddagala.

Kino kisobola okuziyizibwa?

Oluusi, agranulocytosis tesobola kuziyizibwa ddala. Wabula bw’oba ​​omira eddagala eriyinza okukendeeza ku busimu bwo obuyitibwa neutrophils (e.g., chemotherapy, eddagala erimu ery’abalwadde b’emitwe), kikulu okwogera n’omusawo wo n’okukeberebwa buli kiseera emiwendo gy’obusimu bwo. Bw’oba ​​ofuna eddagala eriweweeza ku kookolo, omusawo ayinza okukuwa amagezi okukozesa empiso ya G-CSF okuyamba okwongera ku bungi bw’obutoffaali obukola omusaayi.

Endowooza etya eri omuntu alina obulwadde bwa agranulocytosis?

Wadde nga eno mbeera esobola okujjanjabibwa, ebivaamu bisobola okwawukana okusinziira ku muntu. Bw’ofuna obujjanjabi obutuufu, oba singa eddagala erikendeeza ku busimu obuyitibwa neutrophils liyimirizibwa, embeera eno etera okuwona.

Kyokka singa tebajjanjabwa, yinfekisoni ez’amaanyi n’okufa ziyinza okubaawo. Omuwendo gwa neutrophil gye gukoma okusigala ku ddaala ery’akabi, obulabe bw’okukwatibwa endwadde n’ebizibu gye gukoma okuba omunene. Kino kituufu naddala eri abantu abasukka mu myaka 65 n’abo abalina embeera z’obujjanjabi ezisibukako (nga obulwadde bw’ensigo, omutima oba amawuggwe).

Ddi lw’osaanidde okulaba omusawo?

Agranulocytosis mbeera eyinza okutta omuntu. N’olwekyo, kyetaagisa nnyo okuzuula obulwadde n’obujjanjabi mu bwangu. Laba omusawo mu bwangu bw’oba ​​olina obubonero buno:

• Singa ofuna yinfekisoni enfunda eziwera.
• Singa obuwuka buno butwala ekiseera kiwanvu okuwona.
• Singa ofuna obubonero bw’okukwatibwa yinfekisoni ng’omusujja, okuwunya oba okulumwa emimiro.

Bw’oba ​​olina obulwadde bw’abaserikale b’omubiri oba ng’omira eddagala erikkakkanya obuwuka obuyitibwa neutrophils, tobuuka kukeberebwa musawo. Okwekebeza omusawo buli kiseera kiyinza okukuyamba okulondoola emiwendo gy’obusimu obuyitibwa neutrophil n’okuyamba okuziyiza yinfekisoni.

Ebintu ebikulu bye twetaaga okujjukira (Take-Home Message) .

Okay, kale ka tuddemu okukubaganya ebirowoozo ku bimu ku bintu ebikulu okuva mu bye twogeddeko:

• Agranulocytosis mbeera ya maanyi naye nga esobola okujjanjabibwa nga mu butoffaali obweru obuyitibwa neutrophils bukendeera nnyo.
• Bw’oba ​​olina obubonero ng’okutera okukwatibwa yinfekisoni, omusujja oba okulumwa emimiro, laba omusawo mu bwangu.
• Kino kiyinza okuva ku ddagala erimu, endwadde z’abaserikale b’omubiri, n’obujjanjabi bwa kookolo.
• Obujjanjabi buyinza okuli okuyimiriza eddagala erinyiiza, eddagala eritta obuwuka, empiso za G-CSF, era nga kiyinzika okuba nga n’okusimbuliza obusigo bw’amagumba.
• Okwekuuma obutakwatibwa yinfekisoni kikulu nnyo. Osobola okwekuuma ng’okola ebintu ebyangu ng’okunaaba engalo enfunda eziwera n’okwambala masiki ng’oli mu lujjudde.
• Bw’oba ​​oli mu bulabe bwa kino (e.g., bw’oba ​​omira eddagala erimu), tobuuka kugenda mu basawo.

Nsuubira nti amawulire gano ga mugaso gy’oli. Sigala nga oli mulamu bulungi!