Oluusi owulira ng’okooye nnyo era nga tolina bulamu ng’olunaku lugenda luyitawo? Naddala ng’amaaso go gawulira nga gaggadde, era nga kizibu okwogera, okulya oba n’okusitula omukono oba okugulu? Ebintu bino biyinza okusinga okukoowa kwokka. Leero tugenda kwogera ku Myasthenia Gravis , oba (MG) mu bufunze, embeera ekalubye katono, naye esobola okuddukanyizibwa obulungi singa eddukanyizibwa bulungi .
Obulwadde bwa Myasthenia Gravis kye ki? Mu ngeri ennyangu...
Myasthenia gravis mbeera ya busimu obuziyiza endwadde . Kiki? Kyangu nnyo. Tulina abaserikale b’omubiri mu mibiri gyaffe. Kiringa eggye mu mibiri gyaffe. Omulimu gwayo kwe kutukuuma nga tulwanyisa obuwuka n’endwadde eziva ebweru. Naye, oluusi eggye lino likola ensobi entono. Kilowooza nti n’obutoffaali obulamu obulungi mu mibiri gyaffe bwe bulabe. Olwo n’etandika okulumba obutoffaali obwo obulamu. Ekyo kye kibaawo mu myasthenia gravis.
Kino okusinga kikwata ku binywa by'amagumba . Kwe kugamba, ebinywa ebisibye ku magumba gaffe ne bituyamba okutambula. Lowooza ku kino, oyimusa omukono, oziba amaaso, oyogera, oseka, olya, otambula... Ebinywa bino biyamba ku bino byonna. Mu muntu alina obulwadde bwa myasthenia gravis, ebinywa bino binafuwa era tebirina bulamu.
Ekikulu nti obunafu buno obw’ebinywa bweyongera ng’okola era ng’okola emirimu, ate bukendeera ng’owummuddeko katono . Ne bw’oba ozuukuse ku makya ng’oli bulungi, olunaku bwe lugenda luyitawo n’okola emirimu gyo, mpolampola weeyongera okukoowa n’ebinywa byo ne binafuwa.
Buno bulwadde obutawona , ekitegeeza nti tebuggwaawo mu bbanga ttono. Naye teweeraliikiriranga, waliwo obujjanjabi obulungi obukuyamba okufuga obubonero bwo n’okubeera n’obulamu obwa bulijjo .
Lwaki kino kigenda mu maaso? Kiki ekigenda mu maaso munda mu mibiri gyaffe?
Okusobola okutegeera kino, ka tutwale ekyokulabirako ekitono. Teeberezaamu ng’olaba omupiira gwa cricket.
Obusimu bwaffe bwe buba ensuwa. Bano be baweereza obubaka mu binywa.
Ebinywa byaffe bye bikwata. Bano be bakwata obubaka.
Ekifo kino bombi we bawanyisiganya obubaka kiyitibwa neuromuscular junction . Ekyo kye kisaawe ky'okuzannyiramu.
Kati, obusimu bwe bwetaaga okuweereza obubaka eri ekinywa, obusimu bufulumya eddagala eriyitibwa acetylcholine (guno gwe mupiira). Ebinywa birina ebifo eby’enjawulo we bikwata acetylcholine eno, eyitibwa acetylcholine receptors (eno ye glove y’omukuumi).
Nga omupiira bwe gukuba glove, ekinywa kikonziba, kwe kugamba, kikola, nga acetylcholine agenda ne yeesiba ku receptors ezo. Kino kibaawo mangu nnyo, awatali kutaataaganyizibwa kwonna, mu mubiri gw’omuntu omulamu obulungi.
Naye, ekibaawo mu muntu alina obulwadde bwa myasthenia gravis kiri nti abaserikale b’omubiri be twayogeddeko emabegako mu nsobi basaanyaawo oba nebaziba ebirungo bino ebikwata acetylcholine (catcher’s glove) . Olwo obubaka (omupiira) obuva mu busimu tebusobola kukwatibwa bulungi kinywa (omukuumi). Okuwanyisiganya obubaka kubaawo mpola nnyo, oba nedda n’akatono. Eno y’ensonga lwaki ebinywa binafuwa. Otegedde?
Waliwo ebika bya myasthenia gravis eby’enjawulo?
Yee, okusinga waliwo ebika ebiwerako:
- Autoimmune myasthenia: Kino kye kika ekisinga okubeerawo. Nga bwe twayogeddeko emabegako, kiva ku baserikale b’omubiri obutakola bulungi. Wadde ng’ekituufu ekivaako kino tekimanyiddwa, kirowoozebwa nti kiva ku kukola ebika by’obutoffaali obumu .
- Neonatal myasthenia: Kino kibaawo ng’omwana afunye obutoffaali obumu obuziyiza endwadde okuva eri maama alina myasthenia gravis ng’ali lubuto. Oluvannyuma lw’okuzaalibwa, omwana ayinza okuba n’akaaba akagonvu katono n’okukaluubirirwa okuyonka. Wabula kino kya kaseera buseera era ebiseera ebisinga kitereera oluvannyuma lw’emyezi nga esatu.
- Congenital myasthenia: Eno si mbeera ya busimu obuziyiza endwadde. Kika kya njawulo ekiva ku nkyukakyuka mu buzaale .
Waliwo n’ebika bibiri ebikulu eby’obulwadde bwa autoimmune myasthenia gravis:
1. Ocular myasthenia: Mu kino, ebinywa ebitambuza amaaso n’okusitula ebikoola by’amaaso binafuwa. Ebikowe by’amaaso biyinza okugwa (ptosis) , oba kiyinza okuba ekizibu okukuuma amaaso nga gaggule. Abantu abamu era bayinza okulaba ebintu bibiri (okulaba emirundi ebiri). Ebiseera ebisinga, akabonero akasooka ak’obulwadde bwa myasthenia bwe bunafu mu maaso . Nga kitundu ku bantu abalina ekika kino eky’obulwadde bw’amaaso oluvannyuma bajja kufuna ekika ekirala.
2. Generalized myasthenia: Mu kino, ng’oggyeeko ebinywa by’amaaso, ebinywa bya ffeesi, ensingo, emikono, amagulu n’emimiro nabyo binafuwa. Kiyinza okuba ekizibu okwogera, okumira emmere, okusitula emikono, okusituka mu ntebe, okutambula ebanga eddene, n’okulinnya amadaala.
Bubonero ki obulaga obulwadde bwa myasthenia gravis?
Wadde ng’obubonero buyinza okwawukana, obusinga okulabika bwe buno:
- Obunafu bw’ebinywa mu mikono, engalo, amagulu n’ensingo.
- Okukoowa ennyo (okukoowa) .
- Ekibikka ky’amaaso ekigwa (ptosis) .
- Okulaba okuzibu oba emirundi ebiri .
- Okukaluubirirwa okulaga enneeyisa mu maaso (nga obutasobola kumwenya bulungi, okukola ffeesi).
- Okukaluubirirwa okwogera, okumira oba okukamula . Ng’ekyokulabirako, eddoboozi lyo liyinza okukyuka mpolampola ng’oyogera, ne kikuleetera okuwulikika ng’oyogera mu ddoboozi eriwunya.
- Okukaluubirirwa okutambula .
Obubonero obusooka obw’obulwadde bwa myasthenia gravis busobola okulabika kumpi mu bwangu. Nga bwe twagambye emabegako, ebinywa byo binafuwa ng’okola emirimu, era biddamu amaanyi ng’owummudde . Obunafu buno obw’ebinywa buyinza okwawukana buli lunaku. Abantu bangi bawulira bulungi ku ntandikwa y’olunaku ate ku nkomerero baba ku bunafu bwabwe.
Si bulijjo nnyo, myasthenia gravis nayo esobola okukosa ebinywa by’enkola y’okussa . Kino kiyinza okuvaako okussa obubi oba obuzibu obw’amaanyi mu kussa. Bw’owulira ng’olina obuzibu mu kussa, kiba kya mangu. Olina okugenda mu ddwaaliro erikuli okumpi mu bwangu. Kino ebiseera ebisinga tekibaawo omulundi gumu.
Ani asinga okubeera mu bulabe olw’ensonga eno?
Wadde ng’obulwadde bwa myasthenia gravis busobola okukula ku myaka gyonna, butera okubeera mu bakyala abali wansi w’emyaka 40 n’abasajja abasukka mu myaka 60 .
Oyinza okuba mu bulabe obw’amaanyi obw’okufuna embeera eno olw’ensonga zino wammanga:
- Bw’oba olina embeera endala ez’abaserikale b’omubiri (e.g. rheumatoid arthritis, lupus).
- Bwoba olina obulwadde bwa thyroid .
Bw’oba olina dda obulwadde bwa myasthenia gravis, ebintu ebimu biyinza okukusajjula obubonero:
- Eddagala erimu eriwonya omusujja n’obuzibu bw’omutima.
- Okulongoosebwa .
- Obulwadde bwa yinfekisoni .
Enkolagana ki eriwo wakati w’endwadde ya thymus ne myasthenia gravis?
Abantu bangi abalina obulwadde bwa myasthenia gravis balina obuzibu ku thymus gland yaabwe . Endwadde ya thymus kitundu kitono mu kifuba kyaffe ekya waggulu, wansi ddala w’eggumba ly’amabeere. Kitundu ku nkola yaffe ey’amazzi. Kye kitundu ekikola obutoffaali obweru era kiyamba okulwanyisa yinfekisoni.
Abantu nga bibiri ku bisatu abalina obulwadde bwa myasthenia gravis balina thymic hyperplasia , embeera ng’endwadde ya thymus ekola ekisusse. Okugatta ku ekyo, omuntu nga omu ku buli kkumi afuna ebizimba mu nseke eziyitibwa thymomas . Bino biyinza okuba nga bya kookolo oba ebitali bya bulabe. Kirowoozebwa nti obutali bwa bulijjo buno mu nnywanto ya thymus buvaako abaserikale b’omubiri obutakola bulungi.
Bizibu ki ebiyinza okuva mu bulwadde bwa myasthenia gravis?
Ekikulu mbeera eyitibwa myasthenic crisis . Mu kino, ebinywa ebikuyamba okussa biba binafu nnyo. Olwo, oyinza okwetaaga ekintu ng’ekyuma (respirator/mechanical ventilation) okukuyamba okussa. Eno mbeera ya mangu ey’obujjanjabi eyinza okutta omuntu.Kigambibwa nti abantu nga omu ku buli bataano abalina obulwadde bwa myasthenia gravis ajja kufuna embeera eno waakiri omulundi gumu mu bulamu bwe.
Okugatta ku ekyo, obunafu buno obw’ebinywa n’obukoowu bisobola okukulemesa okwetaba mu mirimu gy’onyumirwa. Era kiyinza okuvaako situleesi n'okwennyamira . Wabula okunoonyereza kulaga nti abantu bangi abalina obulwadde bwa myasthenia gravis basobola okukola emirimu emitonotono n’okukola dduyiro buli lunaku.
Abasawo bazuula batya obulwadde bwa myasthenia gravis?
Singa omusawo ateebereza kino oluvannyuma lw’okuwuliriza obubonero bwo n’okukeberebwa omubiri, ajja kukola okukebera okuwerako okukikakasa:
- Okukebera obutoffaali obuziyiza endwadde mu musaayi: Abantu nga 85% abalina obulwadde bwa myasthenia gravis balina obutoffaali obuziyiza obulwadde bwa acetylcholine receptor bungi mu musaayi gwabwe mu ngeri etaali ya bulijjo. Ebitundu ebirala 6% balina obuziyiza obuziyiza ebinywa-specific kinase (MuSK) .
- Sikaani z’okukuba ebifaananyi: Bakola MRI (Magnetic Resonance Imaging) oba CT scan (Computed Tomography scan) okukebera oba waliwo ebizibu ng’ebizimba mu nnywanto ya thymus.
- Electromyography (EMG): Okukebera kuno kupima amasannyalaze g’ebinywa n’obusimu. Kisobola okuzuula obuzibu mu mpuliziganya wakati w’obusimu n’ebinywa.
Abasawo bagabanya obulwadde bwa myasthenia gravis okusinziira ku buzibu bw’obulwadde buno. Okutwalira awamu waliwo ebika bitaano (Ekibiina I - V). Class I mbeera ya maanyi nnyo ekwata amaaso gokka, ate Class V mbeera ya maanyi ekosa okussa, oluusi nga yeetaaga okuteekebwamu empewo oba okuyingiza empewo mu byuma .
Bujjanjabi ki obw’obulwadde bwa myasthenia gravis?
Tewali ddagala lya myasthenia gravis, naye waliwo obujjanjabi obulungi obuyinza okukuyamba okuddukanya obubonero bwo n’okubeera n’obulamu obulungi.
- Eddagala:
- Cholinesterase inhibitors / anticholinesterase: Eddagala lino likola nga lilongoosa empuliziganya wakati w’obusimu n’ebinywa, okwongera amaanyi g’ebinywa.
- Eddagala eriziyiza obusimu obuziyiza endwadde: Eddagala nga corticosteroids likola nga likendeeza ku kukola ennyo kw’abaserikale b’omubiri n’okukendeeza ku kukola obutoffaali obwo obukyamu.
- Antibodies eziyitibwa monoclonal antibodies: Zino puloteyina ezikoleddwa mu biramu. Ziweebwa nga empiso mu misuwa (IV) oba nga empiso wansi w’olususu (SQ) . Zifuga abaserikale b’omubiri okukola ennyo.
- Plasma exchange / plasmapheresis: Ekyuma kiggya plasma mu musaayi, omuli antibodies ez’obulabe, ne kigikyusa ne plasma oba plasma solution okuva mu muntu agigaba.
- Immunoglobulin eyingizibwa mu misuwa oba wansi w’olususu (IV oba SQ Immunoglobulin - IVIG oba SCIG): Obuziyiza okuva mu bagaba buweebwa nga buweebwa empiso mu misuwa (IV) okumala ennaku bbiri oba ttaano. Eno ddagala lya buzibu bwa myasthenic nga kwotadde n’obulwadde bwa generalized myasthenia gravis.
- Okulongoosa: Okulongoosa thymectomy kwe kulongoosa okuggyamu endwadde ya thymus. Okulongoosa kuno kirungi eri abantu abalina obulwadde bwa thymoma, wamu n’abantu abatalina kizimba kya thymus.
Obujjanjabi buno bwonna buyinza okuba n’ebizibu ebimu, n’olwekyo yogerako n’omusawo wo nga tonnatandika ddagala lyonna eppya.
Kiki kye nsobola okukola awaka okukendeeza ku bubonero?
Bw’oba olina obulwadde bwa myasthenia gravis, gezaako ebintu bino okukendeeza ku bukoowu bw’owulira n’okwongera amaanyi g’ebinywa:
- Dduyiro buli kiseera: Naye ng’omaze okwebuuza ku musawo, tandika enteekateeka y’okukola dduyiro etali ya bulabe ng’akusaanira. Dduyiro anyweza ebinywa, alongoosa embeera y’omuntu n’okuwa omubiri gwo amaanyi.
- Weewale okugenda ebweru mu budde obw’ebbugumu ennyo: Ebbugumu liyinza okwonoona obubonero. Bw’owulira ebbugumu lingi, teeka olugoye olunyikiddwa mu mazzi agannyogoga mu bulago ne mu kyenyi.
- Mu mmere yo ssaamu ebirungo ebizimba omubiri (protein ne carbohydrates) bingi: Biwa omubiri amaanyi ag’enjawulo.
- Kola emirimu gy’osinga okukooya nga bukyali: awo w’osinga okuba n’amaanyi.
- Fuba akaseera katono oba wummulako emisana: Kino kijja kuwa omubiri gwo okuwummulako katono.
Ebiseera by’omu maaso eby’obulwadde bwa myasthenia gravis bye biruwa? (Endowooza)
Myasthenia gravis bulwadde obujjanjabwa . Obubonero buyinza okuva ku butono okutuuka ku buzibu. Obubonero butera okutuuka ku ntikko mu mwaka gumu oba esatu oluvannyuma lw’okusooka okuzuulibwa.
Abantu bangi babeera mu bulamu obujjuvu, obw’okukola ennyo nga balina obujjanjabi.
Oluusi obulwadde buno busobola okugenda mu kusonyiyibwa . Kino kitegeeza nti obubonero buno bubula okumala akaseera. Kino kiyinza okuba eky’akaseera obuseera oba eky’olubeerera. Kino bwe kibaawo, omusawo ajja kukyusa enteekateeka yo ey’obujjanjabi.
Abantu bangi abalina obulwadde bwa myasthenia gravis babeera mu bulamu obwa bulijjo . Ebivaamu ebiyinza okutta obulamu bibaawo ng’okussa kukoseddwa, gamba ng’ekizibu ky’okuzimba omubiri (myasthenic crisis) kye twayogeddeko.
Myasthenia gravis n’okufuna embuto
Tekitera kubaawo, olubuto luyinza okuvaako obubonero bwa myasthenia gravis okulabika omulundi ogusooka. Bw’oba olina dda embeera eno, obubonero bwo buyinza okweyongera mu kiseera ky’olubuto olusooka oba ng’omaze okuzaala omwana wo. Kyokka mu mbeera ezimu, obubonero bwo buyinza okutereera ng’oli lubuto.
Obujjanjabi obumu tebulina bulabe mu kiseera ky’olubuto n’okuyonsa. N’olwekyo kikulu okunoonya obulagirizi bw’omusawo mu kiseera kino okulaba ng’ofuna olubuto olulungi.
Ddi lwe nnina okulaba omusawo?
Laba omusawo bw’oba olina obubonero buno:
- Okulaba okuzibu oba okulaba emirundi ebiri.
- Okukaluubirirwa okutambula, okwogera oba okulya.
- Okukoowa ennyo ebinywa oba okunafuwa.
- Okukaluubirirwa okussa.
Jjukira nti bw’oba olina obuzibu mu kussa, kiba kya mangu! Kuba 911 (ennamba yo ey’amangu mu kitundu kyo) mu bwangu oba genda mu ddwaaliro erikuli okumpi.
Bibuuzo ki bye nnina okubuuza omusawo wange?
Osobola okubuuza omusawo ebibuuzo nga bino:
- Kiki ekivaako obubonero buno?
- Bujjanjabi ki obusinga obulungi gyendi?
- Biki ebiva mu bujjanjabi obwo?
- Nkyukakyuka ki mu bulamu bwe nneetaaga okukola?
- Bubonero ki bwe nsaanidde okwegendereza ku bikwata ku bizibu ebivaamu?
- Nsobola okutandika obulungi enteekateeka y’okukola dduyiro?
- Waliwo ekibiina ekiyamba abalwadde kye nsobola okwegatta?
N’ekisembayo, by’olina okujjukira (Obubaka bw’okutwala awaka) .
Myasthenia Gravis eyinza okuba embeera esoomooza. Wadde ng’oyagala okusigala ng’okola, oluusi oyinza okuwulira ng’okooye nnyo era ng’oli munafu. Kino kiyinza okukosa obulamu bwo obw’omutwe n’omubiri ng’obudde bugenda buyitawo.
Naye jjukira nti wadde tewali ddagala, singa bafuna obujjanjabi, abantu bangi basobola okubeera n’obulamu obujjuvu era obw’okukola. Obulemu obw’amaanyi okuva mu myasthenia gravis tebutera kubaawo. Omusawo asobola okukuwa amagezi ku ngeri gy’oyinza okuddukanyaamu obubonero bwo osobole okusigala ng’oli bulungi. Tosattira, era togezaako kukola ku kino wekka. Goberera amagezi g’omusawo wo ofune obuyambi bwe weetaaga. Mbaagaliza okuwona amangu!
` Myasthenia Gravis, Myasthenia Gravis, Obunafu bw’ebinywa, Endwadde z’abaserikale b’omubiri, Acetylcholine, Thymus gland, Neuromuscular junction











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