Obutoffaali bwo obw’omusaayi bumenyeka mangu? Ka twogere ku hemolysis!

Oluusi owulira bukoowu n’okuziyira? Oba oluusi owulira ng’olususu lwo lwa kyenvu katono, ate enjeru z’amaaso go nga za kyenvu? Kino kiyinza okuba nga kikwatagana n’obutoffaali bwo obumyufu, ekimu ku bika by’obutoffaali obukulu mu musaayi gwo. Leero tugenda kwogera ku mbeera eyitibwa hemolysis , nga eno y’obutoffaali obumyufu bwe bumenyeka ne busaanawo nga tebunnatuuka. Tofaayo, kikulu okukimanya kino.

Ddala hemolysis kye ki?

Mu ngeri ennyangu, hemolysis kwe kusaanyaawo obutoffaali obumyufu mu mubiri gwaffe . Omanyi obutoffaali buno obumyufu bulinga abakozi abatono mu musaayi gwaffe. Bano be baggya omukka gwa oxygen mu mawuggwe nga tussa ne bagutuusa mu buli katoffaali n’ebitundu ebirala ebiri mu mubiri. Kiba ng’okuleeta ssiringi ya ggaasi awaka. Kale, omubiri gwaffe gukozesa omukka guno okukola amaanyi ge gwetaaga. Ate era, obutoffaali buno bwe bumu obumyufu buyamba okutwala kaboni dayokisayidi gwe tutayagala azimba mu mubiri gwaffe okudda mu mawuggwe ne tumufulumya omukka.

Mu budde obwabulijjo, emibiri gyaffe gisaanyaawo obutoffaali obumyufu obukadde oba obunafu buli kiseera ne bugikyusa ne gissaamu obutoffaali obumyufu obupya obulungi. Kino kiringa okugoba enkadde n’ofuna empya. Enzirukanya eno ey’okusaanyaawo n’okukola y’ensonga lwaki bulijjo tulina obutoffaali obumyufu obutuufu mu mibiri gyaffe.

Kyokka, oluusi obutoffaali buno obumyufu butandika okukutuka nga tebunnatuuka, kwe kugamba, amangu ennyo . Kino kiyinza okubaawo ng’omubiri gwaffe tegunnafuna budde kukola butoffaali bupya okuziba ekituli. Okusaanawo kuno okw’amangu okw’obutoffaali obumyufu kuyitibwa hemolysis. Singa omuwendo gw’obutoffaali obumyufu mu mubiri gukendeera nnyo olw’okusengejja omusaayi kuno, embeera eyo tugiyita hemolytic anemia , oba anemia.

Lwaki obutoffaali obumyufu busaanawo mu ngeri eno?

Akatoffaali akamyufu katera okuwangaala ennaku nga 120. Ku nkomerero y’ekiseera kino, obutoffaali obwo bwe bukaddiwa, bufulumya obubonero obw’enjawulo. Obubonero buno buleetera enseke (esangibwa ku ludda olwa kkono olw’olubuto) mu mubiri gwaffe okusaanyaawo obutoffaali buno obukadde mu ngeri entegeke. Nga bwe tugoba ebintu eby’omu nnyumba eby’edda, ebimenyese mu nnyumba yaffe.

Obutoffaali obupya obumyufu bukolebwa mu kitundu ky'amagumba gaffe ekiringa sipongi ekiyitibwa obusigo bw'amagumba . Olwo obutoffaali obumyufu obupya obukolebwa mu busimu buno ne bufulumizibwa mu musaayi.

Kyokka, oluusi obulema mu nkula oba mu butonde bw’obutoffaali obumyufu busobola okukendeeza ku bulamu bwabwo. Oba, obutoffaali obumyufu busobola okwonooneka olw’ensonga ez’ebweru ne bufa ng’omubiri tegunnakola butoffaali bupya.

Bika ki ebikulu eby’okusengejja omusaayi?

Okusengejja omusaayi kuyinza okwawulwamu ebika bibiri ebikulu. Amannya gano gategeeza obutoffaali obumyufu we busaanawo.

1. Extravascular hemolysis: Kino kye kiseera obutoffaali obumyufu bwe busaanawo ebweru w’emisuwa gyaffe (i.e., emisuwa, emisuwa, n’emisuwa). Ebiseera ebisinga, kino kibaawo mu nnywanto . Omusaayi bwe guyita mu nseke, ekika ky’obutoffaali obweru obw’enjawulo obuyitibwa macrophages (buno bulinga abakuumi b’omubiri gwaffe) butegeera obutoffaali obumyufu obukadde obwonooneddwa ne bubusaanyawo.

2. Intravascular hemolysis: Kino obutoffaali obumyufu bwe busaanawo munda mu misuwa. Bwe zisaanawo, ebitundutundu by’obutoffaali obwo bitambula mu mubiri gwonna n’omusaayi gwaffe.

Biki ebivaako omusaayi okusasika?

Tewali kimu kyokka ekivaako omusaayi okusasika, wabula waliwo ebintu ebiwerako ebiyinza okugukosa. Ka tukitunuulire mu bujjuvu katono.

1. Obulema mu butoffaali obumyufu bwennyini

Oluusi, singa wabaawo obutali bwa bulijjo oba ekikyamu mu nkula oba ensengekera y’obutoffaali obumyufu, akatoffaali ako kasobola okusaanawo amangu. Ebiseera ebisinga obulema ng’obwo buva ku ndwadde ezimu ezizaalibwa oba ez’obuzaale .

• Obutabeera mu ntebenkevu bwa hemoglobin: Hemoglobin ye puloteyina eyamba okutambuza omukka gwa oxygen munda mu butoffaali obumyufu. Embeera ezireeta obutali butebenkevu buno mulimu okukendeera kw’omusaayi mu busimu obuyitibwa sickle cell anemia (obutoffaali obumyufu mwe bufuuka obw’ekika kya sickle) ne thalassemia .
• Obutabeera na enzymes: Embeera eno era esobola okubaawo nga enzymes ezimu ezeetaagisa okukola emirimu gy’obutoffaali obumyufu teziriiwo. Eby'okulabirako mulimu obutaba na G6PD n'obutaba na pyruvate kinase .
• Obulema mu lususu: Embeera nga waliwo obulema mu kibikka eky’ebweru eky’obutoffaali obumyufu, oluwuzi lw’obutoffaali. Eby’okulabirako mulimu obuzaale obuyitibwa spherocytosis ( obutoffaali bufuuka obw’enkulungo) n’obuzaale obuyitibwa elliptocytosis (obutoffaali bufuuka buwanvu).

2. Endwadde ezikwatagana n’abaserikale b’omubiri

Oluusi abaserikale baffe bennyini abaziyiza endwadde (enkola etukuuma obutakwatibwa ndwadde) mu nsobi batandika okulumba obutoffaali bwaffe obumyufu. Kino kiyitibwa autoimmune hemolytic anemia (AIHA) . Eno embeera etatera kubaawo. Waliwo n’ebika bya kino:

• Obulwadde bwa agglutinin obw’ennyonta ( obubonero bweyongera bw’okwatibwa ennyonta) .
• Obulwadde bwa agglutinin obw’ebbugumu

Embeera endala ezimu eziyinza okuvaako AIHA mulimu Mycoplasma pneumonia , lymphoma , leukemia (bino bika bya kookolo), lupus, n’endwadde z’enkizi (zino nazo ndwadde ezikwatibwa abaserikale b’omubiri).

Embeera endala ezitali za musimu:

• Obulwadde bwa hemoglobinuria obunnyogovu obuva mu paroxysmal
• Obulwadde bwa hemoglobinuria obw’ekiro obuyitibwa paroxysmal

3. Yinfekisoni

Ebiwuka ebimu, akawuka, ne bakitiriya ebiyingira mu mibiri gyaffe bisobola okwonoona obutoffaali bwaffe obumyufu, ne bubusaanyaawo nga tebunnakyusibwa. Ekyokulabirako ekirungi ku kino ye musujja . Ekiwuka ekivaako omusujja kilumba butereevu obutoffaali obumyufu.

Ebirala ebivaako obulwadde buno:

• Obulwadde bwa Babesiosis
• Obulwadde bwa Carrion
• Rocky Mountain yafunye omusujja
• Obulwadde bwa ssennyiga wa Haemophilus
• Akawuka akalwaza abaserikale b’omubiri mu bantu (HIV) .

4. Eddagala erimu

Eddagala erimu lye tumira era, wadde nga teritera nnyo, liyinza okusitula abaserikale baffe abaserikale okulumba obutoffaali obumyufu ne bubusaanyaawo amangu. Kino kiyitibwa okukendeera kw’omusaayi mu mubiri (DIHA) . Kino tekitera kubaawo nnyo.

Eddagala erimu eriyinza okuvaako omusaayi okusaanuuka:

• Acetaminophen ( ekirungo kya paracetamol) .
• Eddagala erimu eritta obuwuka erya cephalosporin
• Clopidogrel eddagala eriyitibwa Clopidogrel
• Dapsone, omusajja
• Eddagala lya Heparin
• Obulwadde bwa Levodopa
• Eddagala lya Levofloxacin
• Ekirungo kya Methyldopa
• Ekirungo kya Nitrofurantoin
• Eddagala lya penicillin
• Eddagala lya Phenazopyridine
• Eddagala lya Quinidine
• Quinine, eddagala eriweweeza ku bulwadde
• Rifampin nga ye
• Ebimu ku bikozesebwa mu kukola sulfonamides

Ekikulu: Totya olw’olukalala luno olw’eddagala. Eddagala lino teritera kuleeta musaayi. Omusawo bw’aba akuwandiikidde eddagala lino, goberera ebiragiro bye. Bw’oba ​​olina ekibuuzo kyonna, yogerako n’omusawo wo.

5. Ebizibu ebibaawo ng’oli lubuto

Ebizibu ebimu ebibaawo ng’oli lubuto nabyo bisobola okuvaako obutoffaali obumyufu okumenya amangu.

• Obulwadde bwa HELLP
• Obulwadde bwa preeclampsia
• Obulwadde bwa Eclampsia

Olw’okuba zino mbeera za maanyi eziyinza okubaawo ng’oli lubuto, kyetaagisa okugenda amangu mu basawo amagezi singa obubonero bulabika.

6. Ebikozesebwa mu by’obujjanjabi n’obujjanjabi

Kino nakyo tekitera kubaawo. Okusasika omusaayi kuyinza okubaawo ng’ebyuma ebimu eby’obujjanjabi biteekeddwa mu mubiri, oba mu kiseera ky’obujjanjabi obumu, okutuusa ng’omubiri gubimanyiira.

• Okulongoosa omusaayi mu balwadde b’ekibumba
• Ekyuma ekiyita omutima n’amawuggwe (ekikozesebwa mu kulongoosa okunene) .
• Okukyusa vvaalu z’omutima
• Ebyuma ebirala ebikozesebwa mu mbeera nga omutima okulemererwa, okugeza intra-aortic balloon pumps ne Impella devices .
• Okuteekebwamu omusaayi (nga bwe baweebwa omusaayi ogutakwatagana) .

7. Obutwa n’obutwa

Obutwa obumu bwe bumira busobola okwonoona obutoffaali obumyufu ne buvaako omusaayi okusasika.

• Ekirungo kya Arsenic
• Ekikomo ( singa kiyitirira) .
• Okukulembera
• Arsine ( omukka ogw’obutwa) .
• Stibine ( omukka ogw’obutwa) .
• Obutwa bw’omusota

Okugatta ku ekyo, embeera yonna ng’ennywanto ekola ekisusse (hypersplenism) nayo esobola okuvaako omusaayi okusaanuuka. Mu ngeri y’emu, puleesa okulinnya ennyo eyinza okuvaako obutoffaali obumyufu okukutuka ng’omusaayi gutambula mangu mu misuwa.

Bubonero ki obulaga nti omuntu alina omusaayi (hemolysis)?

Obubonero businziira ku bungi bw’obutoffaali obumyufu bwo obutono. Singa omuwendo gw’obutoffaali obumyufu teguba mutono nnyo, oyinza obutalaba bubonero bwonna. Ebiseera ebisinga, obubonero bubaawo kubanga obutoffaali n’ebitundu by’omubiri tebifuna mukka gwa oxygen gumala olw’obutoffaali obumyufu obutono.

Obubonero obutera okulabika:

• Obukoowu
• Okuziyira
• Olususu olumyufu
• Omutima okukuba omukka / tachycardia
• Okussa obubi / okussa obubi
• Okufuuka okwa kyenvu kw’olususu n’enjeru y’amaaso (Jaundice) (Kino kiva ku kukuŋŋaanyizibwa kwa bilirubin, ekintu ekifuluma ng’obutoffaali obumyufu bumenyese, mu musaayi)
• Ensigo egaziye / splenomegaly

Obubonero obumu buyinza okwawukana okusinziira ku mbeera entongole ereeta omusaayi. Okugeza, omuntu alina obulwadde bwa cold agglutinin ayinza okufuna omusaayi okukendeera okutuuka ku nsonga z’engalo n’ebigere, ekivaako okufuuka bbululu n’okuzirika (Raynaud’s phenomenon) .

Bikebere ki ebikolebwa okuzuula oba waliwo obuzibu obukwata ku kusengejja omusaayi?

Omusawo ajja kukwata sampuli y’omusaayi gwo era akole okukeberebwa okuwerako okulaba oba obutoffaali bwo obumyufu obutono buva ku kusengejja omusaayi.

• Okubala omusaayi mu bujjuvu (CBC): Kino kiyinza okukubuulira bingi ku bika by’obutoffaali byonna ebiri mu musaayi gwo naddala obutoffaali bwo obumyufu. Kisobola okukebera ebintu nga hemoglobin level yo n’ekifo obutoffaali bwo obumyufu bwe butwala mu musaayi gwo (hematocrit).
• Omuwendo gwa reticulocyte: Kino kitundu ku kukebera kwa CBC. Reticulocytes butoffaali obumyufu obupya obutondeddwawo nga tebunnakula mu bujjuvu. Bwe wabaawo okusasika kw’omusaayi, omuwendo gw’obutoffaali obuyitibwa reticulocytes guyinza okweyongera ng’omubiri gwanguya okukola obutoffaali obupya okudda mu kifo ky’obwo obusaanawo.
• Peripheral blood smear: Okukebera kuno kuyinza okukebera oba tewali buzibu mu nkula n’obunene bw’obutoffaali bwo. Obutoffaali obutali bwa bulijjo butera okusaanawo amangu.
• Lactate dehydrogenase (LDH): LDH ye enzyme esangibwa munda mu butoffaali obumyufu. Obutoffaali obumyufu bwe bumenyekamenyeka amangu okusinga ku bwa bulijjo, emiwendo gya LDH mu musaayi giyinza okweyongera.
• Okukebera Haptoglobin: Haptoglobin ye puloteyina ekwatagana ne hemoglobin. Obutoffaali obumyufu bwe bumenyekamenyeka (nga mu kusengejja omusaayi), hemoglobin nnyingi zifuluma mu musaayi. Olwo emiwendo gya Haptoglobin ne gikendeera.
• Bilirubin etali ya kuyungibwa: Bilirubin ekolebwa nga hemoglobin mu butoffaali obumyufu emenyekedde. Ebirungo bya bilirubin ebingi mu musaayi biraga nti obutoffaali obumyufu bungi busaanawo (kino kye kivaako obulwadde bwa jaundice).
• Direct Coombs test: Okukebera kuno kusobola okuzuula oba olina antibodies ezikwata ku butoffaali bwo obumyufu ne buzisaanyaawo mangu (kino kiyinza okuyamba okuzuula embeera nga AIHA).

Okugatta ku ekyo, omusawo ayinza okwekenneenya omusulo okukebera oba omusaayi ne bilirubin mu musulo gwo, ebiyinza okuba obubonero bw’embeera eyitibwa hemolytic anemia.

Obulwadde bwa hemolysis bujjanjabwa butya?

Obujjanjabi bwo bujja kusinziira ku kivaako omusaayi gwo n’obubonero bwo bwe buli obw’amaanyi. Obujjanjabi buyinza okuli vitamiini, eddagala, okulongoosebwa, n’okuteekebwamu omusaayi.

Ekisinga obukulu kwe kwogera n’omusawo wo ku bujjanjabi obusinga okukuyamba, okusinziira ku bulwadde bw’ozudde.

Emibiri gyaffe buli kiseera gigezaako okukuuma omuwendo omutuufu ogw’obutoffaali obumyufu. Kyokka, yinfekisoni, endwadde ezizaalibwa n’ebintu eby’ebweru bisobola okutaataaganya enkola eno ne bireetera obutoffaali obumyufu okusaanawo amangu ennyo. N’ekyavaamu, obutoffaali obumyufu busobola okukendeera, ekivaako okukendeera kw’omusaayi mu musaayi.

Kyokka, amawulire amalungi gali nti ebintu bingi ebivaako omusaayi okusaanuuka bisobola okujjanjabibwa. Omusawo bw’amala okuzuula ekivaako omusaayi gwo, ajja kukuwa obujjanjabi obukuyamba okuzza omuwendo gw’obutoffaali obumyufu mu musaayi gwo mu mbeera eya bulijjo.

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

• Hemolysis kwe kusaanyaawo obutoffaali obumyufu nga tebunnatuuka.
• Kino kiyinza okuleeta obubonero ng’okukoowa ennyo, okuziyira, n’olususu okufuuka olwa kyenvu (jaundice) .
• Wayinza okubaawo ebivaako bingi; obulema mu butoffaali obumyufu bwennyini, obuzibu mu baserikale b’omubiri, yinfekisoni, eddagala erimu, ebizibu ebibaawo ng’oli lubuto n’ebirala.
• Bw’oba ​​olina obubonero buno, mazima ddala funa amagezi g’omusawo .
• Okukebera omusaayi kuyinza okuyamba okuzuula ekivaako n’okuwa obujjanjabi obutuufu.
• Ebivaako bingi bisobola okujjanjabibwa okuzzaawo obutoffaali obumyufu mu musaayi. Kale kikulu obutasattira n’okunoonya obulagirizi obutuufu obw’abasawo.

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

` Hemolysis, obutoffaali obumyufu, okukendeera kw’omusaayi, ennywanto, obusigo bw’amagumba, jaundice, okukebera omusaayi