Naawe owulira ng’oli munafu? Mpozzi eno mbeera eyitibwa myopathy!

Oluusi owulira ng’ebitundu byo eby’omubiri binafu era nga bikooye? Osanga obuzibu okukola wadde ebintu ebyangu gamba ng’okusituka mu ntebe, okusitula ekintu ekizito oba okusenya enviiri? Bw’oba ​​owulira ng’ebinywa byo bigenda binafuwa awatali nsonga, tomala gagoba nti kya bulijjo. Mpozzi ekivaako obubonero buno y’embeera eyitibwa ‘myopathy’, gye tugenda okwogerako leero. Teweeraliikiriranga, kino tujja kukyogerako mu ngeri ennyangu gy’osobola okutegeera.

Obulwadde bwa myopathy kye ki? Mu ngeri ennyangu...

Myopathy, mu ngeri ennyangu, kibinja kya ndwadde ezikosa ebinywa ebinyweredde ku magumba gaffe. Endwadde zino zoonoona obuwuzi bw’ebinywa byaffe ne bunafuya. Nga yingini y’emmotoka bw’efuuka enafu, n’efuuka enzibu okuvuga, ebinywa bwe binafuwa, emibiri gyaffe gikaluubirirwa okukola emirimu egya bulijjo.

Waliwo ebika by’obulwadde bw’emisuwa obw’enjawulo?

Yee, obulwadde bw’emisuwa busobola okugabanyizibwa mu ngeri ez’enjawulo. Okusinga zaawulwamu ebika bibiri: obulwadde bw’emisuwa obusikira n’obufunibwa . Ka tulabe buli kimu ku bika bino.

Endwadde z’obusimu ezisikira (Inherited Myopathies) kye ki?

Bino bika bya myopathy ebiva ku kusikira enkyukakyuka y’obuzaale etali ya bulijjo ebeera mu mubiri gwaffe nga tuzaalibwa, ebiseera ebisinga okuva ku maama oba taata waffe.

• Obulwadde bw’emisuwa obuzaalibwa nabwo:

Obubonero butera okutandika nga bazaalibwa oba nga bakyali bato. Kyokka, oluusi zisobola okulabika nga zikyali bato oba n’oluvannyuma. Ekintu eky’enjawulo ku kika kino kwe kuba nti obunafu tebukoma ku binywa ebiriraanye wakati w’omubiri, wabula buyinza okukosa ebinywa by’omubiri gwonna, era obulwadde buno butera obutagenda mu maaso.

• Obulwadde bw’emisuwa gy’omubiri (mitochondrial myopathies):

Obutoffaali bwaffe bulina amakolero amatonotono agayitibwa mitochondria agakola amaanyi. Ekika kino eky’obulwadde bw’emisuwa kiva ku bulema mu mitochondria zino. Ng’oggyeeko okunafuwa kw’ebinywa, embeera zino zisobola n’okukosa enkola z’ebitundu by’omubiri ebirala, gamba ng’omutima, obwongo, n’enkola y’omu lubuto. Ziyinza okukula olw’enkyukakyuka mu buzaale, ka kibeere nti waliwo ebyafaayo by’amaka oba nedda.

• Endwadde z’emisuwa gy’omubiri (metabolic myopathies):

Obulwadde buno obw’emisuwa buva ku bulema mu buzaale obukola enziyiza eziyamba ebinywa okukola n’okutambula obulungi. Kiyinza okuvaako obukoowu ng’okola dduyiro, okulumwa ebibegabega n’ebisambi ng’okola dduyiro, oba embeera eyitibwa rhabdomyolysis, ng’ebinywa bimenyeka awatali buvune. Oluusi obubonero buno buyinza okujja ne bugenda, ng’ebinywa binafuye ate ne bidda mu mbeera eya bulijjo.

• Obulwadde bw’ebinywa:

Mu mbeera zino, ebinywa binafuwa mpolampola ne bikendeera olw’obutabeera bwa bulijjo oba obutaba na puloteyina eziwanirira enzimba ezeetaagisa ebitundu by’ebinywa. Mu buli mbeera, emikono ne/oba amagulu bikosebwa ku ddaala ery’enjawulo. Oluusi ebinywa by’amaaso oba mu maaso nabyo bisobola okukosebwa.

Endwadde z’emisuwa ezifunibwa kye ki?

Bino bika bya myopathies ebikula nga bakuze. Ziyinza okuva ku bintu ebitali bimu, omuli endwadde endala, yinfekisoni, okubeera n’eddagala erimu, n’obutakwatagana mu masanyalaze mu mubiri.

• Obulwadde bw’emisuwa obuziyiza endwadde/okuzimba:

Ekibaawo mu kino kwe kuba nti abaserikale b’omubiri gwaffe bennyini balumba ebinywa byaffe. N’ekyavaamu, emirimu gy’ebinywa gikosebwa. Kiringa abazibizi baffe bennyini okwelumba.

• Obulwadde bw’obutwa mu myopathy:

Embeera eno ebaawo ng’obutwa oba eddagala litaataaganya ensengekera oba enkola y’ebinywa.

• Obutwa: Omwenge, toluene (ekintu ekiwunya ekisangibwa mu bintu nga langi abantu abamu kye bassa okusobola okufuna waggulu).
• Eddagala: Eddagala eriziyiza obusimu obuziyiza endwadde (e.g., pembrolizumab, nivolumab), corticosteroids (e.g., prednisone), eddagala erikendeeza kolesterol (statins), amiodarone, colchicine, chloroquine, eddagala eritta akawuka n’eriziyiza protease okukwatibwa akawuka ka siriimu, omeprazole.

• Endwadde z’emisuwa gy’omubiri (endocrine myopathies):

Embeera eno ebaawo ng’ekikolwa ky’obusimu mu mubiri gwaffe kikosa ebinywa.

• Ensigo ya thyroid: Wadde ng’obusimu bwa thyroid obutono (hypothyroidism) businga kubaawo, obuzibu era busobola okubaawo olw’obusimu bwa thyroid obungi (hyperthyroidism).
• Parathyroid gland: Obulwadde bwa hyperparathyroidism buvaako calcium okweyongera mu musaayi.
• Endwadde y’ekibumba: `Obulwadde bwa Addison` ne `Obulwadde bwa Cushing`.

• Endwadde z’emisuwa ezisiigibwa:

Yinfekisoni ez’enjawulo zisobola okukosa enkola y’ebinywa.

• Endwadde z’akawuka: `HIV`, `ssennyiga`, `Epstein-Barr`.
• Yinfekisoni za bakitiriya: `bacterial pyomyositis`.
• `Obulwadde bwa Lyme`.
• Yinfekisoni z’ebiwuka: `trichinosis`, `toxoplasmosis`, `cysticercosis`.
• Obulwadde bwa ffene: Candida, Coccidiomycosis.

• Obutakwatagana mu busannyalazo:

Okwongera oba okukendeera kw’obusannyalazo obumu obukulu mu mubiri gwaffe kiyinza okukosa enkola y’ebinywa.

• Potassium: yakendeera (`hypokalemia`), yeeyongedde (`hyperkalemia`).
• Magnesium: Yeeyongedde (`Hypermagnesemia`).

• Obulwadde obw’amaanyi obulwaza myopathy mu kisenge ky’abalwadde abayi:

Eno mbeera ekosa ebitundu by’omubiri n’ebinywa by’okussa mu bantu abalwadde ennyo era nga bafuna obujjanjabi mu ddwaaliro ly’abalwadde abayi (ICU) . Kiyinza okuva ku butatambula okumala ebbanga oba okukozesa eddagala eriweweeza ku binywa, eddagala eriyitibwa corticosteroids, n’empeke ez’okwebaka ezikozesebwa ng’ajjanjabwa.

Ani asinga okulwala obulwadde bwa myopathy? Embeera eno ya bulijjo etya?

Mu butuufu omuntu yenna asobola okufuna obulwadde bw’emisuwa, naye abantu abamu bali mu bulabe obusingako katono.

Ensonga eziyinza okwongera ku bulabe:

• Singa omuntu mu maka alina obulwadde bwa myopathy, olwo emikisa mingi egy’okusikira obulwadde buno mu buzaale.
• Okubeera omusajja. Ebika by’obulwadde bw’emisuwa ebimu biyisibwa mu X chromosome, kale biyinza okukwata abasajja okusinga abakazi. Wabula ebika by’obulwadde bw’emisuwa obuzaalibwa nga buyisibwa mu chromosomes endala bikosa buli muntu kyenkanyi.
• Okubeera n’obulwadde obuva ku busimu obuziyiza endwadde, obuva mu mubiri oba obw’omubiri (endocrine disease).
• Okukwatibwa eddagala oba obutwa obumu (laba ekitundu ekikwata ku bulwadde bw’emisuwa obw’obutwa bwe twayogeddeko emabegako).

Obunene bw’obulwadde bw’emisuwa bwawukana okusinziira ku kika. Okugeza, obulwadde bw’emisuwa obubeerawo oluvannyuma lw’obulamu:

• Obulwadde bw’okuzimba emisuwa n’obw’omubiri (endocrine myopathies) butera okusinga ebika ebirala, era butera mu bakyala okusinga mu basajja.
• Abantu 9 ne 32 ku buli 100,000 balina obulwadde bw’okuzimba emisuwa.
• Wakati wa 25% ne 79% ku bantu abakulu abalina obulwadde bwa hypothyroidism bayinza okufuna obubonero obukwatagana n’ebinywa, naye emirundi gy’obulwadde bw’emisuwa egy’olwatu giyinza okuba wansi nga 10%.

Obulwadde bw’emisuwa obusinga okuzaalibwa nabwo bwe buzibu bw’ebinywa, obutera okubeera mu basajja.

• Obulwadde bwa Duchenne ne Becker’s muscular dystrophies bwe businga okukwata abantu nga 7 ku buli bantu 100,000 mu nsi yonna.
• Endwadde za mitochondrial zikwata omuntu omu ku buli bantu 5,000, era ezisinga obungi ku zino zikwata ebinywa by’amagumba.
• Ebika ebirala eby’obulwadde bw’emisuwa obuzaalibwa nabyo tebitera nnyo.

Kale, bubonero ki obw’obulwadde bw’emisuwa?

Ebika bingi eby’obulwadde bw’emisuwa birina obubonero obuwerako. Bino bye bino:

• Obunafu bw’ebinywa.Naddala ebinywa by’ebibegabega, emikono egy’okungulu, n’ebisambi (bino bye bisinga okukosebwa era ebisinga okukosebwa ennyo).
• Ebinywa okuzimba, okukaluba n’okusannyalala.
• Okuwulira ng’okooye amangu ng’okola dduyiro oba ng’okola wadde akatono.
• Okuwulira nga tolina bulamu era nga tolina maanyi.

Ddala obulwadde bwa myopathy buwulira butya?

Mu myopathies nnyingi, ebinywa ku njuyi zombi ez’omubiri (symmetric) binafuwa kyenkanyi. Ebinywa ebiriraanye wakati w’omubiri (ebinywa eby’okumpi), gamba ng’ebibegabega, emikono egya waggulu, ebisambi, n’ebisambi, bye bisinga okukosebwa. N’ekyavaamu, oyinza okufuna obubonero nga:

• Okukaluubirirwa okukola emirimu egya bulijjo, gamba ng’okunaaba, okwambala, n’okusika enviiri.
• Obuzibu okusituka okuva mu ntebe, okulinnya amadaala, oba okukola emirimu egyetaagisa okutuuka waggulu w’omutwe gwo (e.g., okukyusa bbaatule mu kisenge).
• Okuwulira ng’ebinywa binyiganyiga n’okukankana.
• Ebinywa bikoowa mangu nga beenyigira mu mulimu.
• Okukaluubirirwa okussa nga okola dduyiro.

Ebiseera ebisinga tekikosa binywa bya bisambi n’engalo.

Obubonero obulala bwawukana okusinziira ku kika ky’obulwadde bw’emisuwa.

• Obunafu bw’ebinywa buyinza okuba nga buli kiseera (obutagenda mu maaso) oba okugenda mu maaso mpola. Mu ndwadde ezimu, obunafu bw’ebinywa buyinza okujja ne bugenda, ate mu biseera ebirala wayinza okubaawo amaanyi aga bulijjo.
• Okulwawo okukula kw‟obukugu mu kukola emirimu (e.g. okutambula, okubuuka, okulinnya amadaala, okukwata ekijiiko oba ekkalaamu) mu baana abato.
• Obutasobola kukwatagana na baana balala nga bazannya emizannyo oba nga bazannya ebweru (e.g., okuzannya catch).
• Obuzibu ku binywa ebiyamba mu kumira n’okwogera. Kino kiyinza okuvaako emmere okusibira n’okwogera okuvuma.

Nkole ntya singa nteebereza nti nnina obulwadde bwa myopathy?

Bw’oba ​​olina obubonero buno, olina okusooka okwogera n’omusawo wo omukulu. Okusinziira ku bubonero bwo, ayinza okukusindika ew’omusawo omukugu, gamba ng’omusawo w’obusimu oba omusawo w’enkizi.

Obulwadde bwa myopathy buzuulibwa butya?

Omusawo ajja kukubuuza ku byafaayo by’obujjanjabi bwo, oba waliwo omuntu yenna mu maka go eyabadde n’embeera ezifaananako bwe zityo, eddagala ki ly’omira, n’obubonero bwo. Olwo bajja kukola okukebera omubiri. Zijja kukebera olususu lwo, engeri gy’owuliramu, amaanyi g’ebinywa, bbalansi n’engeri gy’owuliramu.

Ebika by’okukebera omusawo by’ayinza okulagira:

• Okukebera omusaayi:
• Mu bulwadde obumu obw’emisuwa, emiwendo gy’enziyiza y’ebinywa nga creatine kinase (CK) oba aldolase giyinza okweyongera olw’okumenya kw’ebiwuzi by’ebinywa.
• Emiwendo gy’obusannyalazo nga sodium, magnesium, potassium, calcium, ne phosphorus.
• Okukebera endwadde z’abaserikale b’omubiri: Okugeza, `Antinuclear Antibodies (ANA), `Rheumatoid Factor', `Sedimentation Rate' ne `C-reactive protein'.
• Okukebera endwadde z’omubiri: okugeza, emiwendo gy’obusimu bwa thyroid.
• Electromyography (EMG) n’okunoonyereza ku kutambuza obusimu: Ebigezo bino bipima ekika n’obunene bw’okwonooneka kw’ebinywa nga bipima engeri amasannyalaze gye gatambulamu mu busimu n’okuyingiza empiso entonotono mu binywa.
• Okukebera ebinywa mu ngeri ya magnetic resonance imaging (MRI) .
• Okukebera obuzaale.
• Muscle biopsy: Kino kizingiramu okulongoosa okuggyamu akatundu akatono ak’ebinywa okwekebejjebwa.

Obulwadde bwa myopathy bujjanjabwa butya?

Ekika ky’obulwadde bw’emisuwa ekituufu bw’olina bwe kimala okuzuulibwa, omusawo wo ajja kukola enteekateeka y’obujjanjabi ng’etuukana n’obubonero bwo.

Obujjanjabi obusinga obungi mulimu okujjanjaba omubiri, okujjanjaba emirimu, n’okukola dduyiro mu ngeri emu . Obujjanjabi obulala bukwata ku kika ky’obulwadde bw’emisuwa. Okutwaliza awamu, obulwadde bw’emisuwa obusinga obungi obufunibwa busobola okuddukanyizibwa obulungi, okukendeeza ku bunafu n’obubonero. Endwadde z’emisuwa ezimu ezizaalibwa zirina obujjanjabi obw’enjawulo obuyinza okukendeeza ku kukula kw’obulwadde buno. Mu kiseera kino, tewali bujjanjabi bwa njawulo ku bulwadde bw’emisuwa obusinga obungi obuzaalibwa, naye obujjanjabi bw’omubiri n’ebika ebimu eby’okukola dduyiro bisobola okuyamba.

Endwadde z’emisuwa ezikwata ku kuzimba n’obusimu obuziyiza endwadde

Ekigendererwa ky’okujjanjaba bino kwe kukendeeza ku buzimba n’okuddamu kw’omubiri okuziyiza endwadde. Obujjanjabi obutera okukozesebwa ku bulwadde buno obw’emisuwa mulimu:

• Eddagala erikyusa obusimu obuziyiza endwadde/eriziyiza obusimu obuziyiza endwadde: Okugeza, methotrexate, cyclosporine, tacrolimus, azathioprine, mycophenolate, rituximab, ne immunoglobulin eriweebwa mu misuwa (IVIg) oba wansi w’olususu (SubQIg).
• `Eddagala eriyitibwa corticosteroids`: Okugeza `prednisone` oba `methylprednisolone`.

Obulwadde bw’emisuwa obusikira n’obuzaale

Endwadde z’emisuwa nnyingi ezizaalibwa n’obuzaale tezirina bujjanjabi bwa njawulo oba okuwona mu bujjuvu.Okuddukanya okusinga kuyita mu kufuga obubonero n’engeri ez’enjawulo ez’obujjanjabi. Okugezesebwa kw’obujjanjabi okuwerako kugenda mu maaso mu bitundu by’okunoonyereza eby’enjawulo ebikwata ku bujjanjabi n’obujjanjabi bw’obuzaale.

Embeera eziyitibwa Duchenne muscular dystrophy ne Pompe disease zisobola okujjanjabibwa n’eddagala eryetongodde.

Endwadde endala ezifunibwa mu myopathies

Abasawo bajjanjaba obulwadde bw’emisuwa obuva ku bitundu by’omubiri ebiyitibwa endocrine, obutwa n’okusiigibwa nga bajjanjaba obulwadde obwali buvaako obulwadde bw’emisuwa. Endwadde z’emisuwa ez’obutwa zijjanjabwa nga ziyimiriza ekintu ekinyiiza (e.g., omwenge, toluene) oba eddagala (e.g., statins). Obubonero bw’ebinywa obuva ku bakitiriya, akawuka oba ebirungo ebirala ebisiigibwa bitera okutereera ng’obulwadde buno bujjanjabiddwa butereevu n’eddagala eritta obuwuka.

Nlabirira ntya obulamu bwange?

Ka kibeere nti obulwadde bwa myopathy bwazaalibwa, obufunibwa oba embeera ey’ekiseera ekiwanvu (obutawona), waliwo ebintu by’oyinza okukola okukuuma obulamu bwo n’okuddukanya embeera eyo. Mu bino mulimu:

• Lya emmere ennungi era ey’enjawulo. Mu mmere yo ssaamu ebibala n’enva endiirwa eby’enjawulo bingi.
• Sigala ng’okola ng’okola dduyiro omutono ow’emisuwa n’emisuwa. Okusinziira ku kika ky’obulwadde bw’emisuwa gyo, oyinza okuweebwa amagezi obutakola bika bya kusitula buzito ebimu. N’olwekyo yogerako n’omusawo wo nga tonnatandika pulogulaamu yonna ey’okukola dduyiro.
• Kuuma omugejjo omulungi.
• Bw’oba ​​olina ekizimba ku lususu ekiva ku bulwadde bwa dermatomyositis, kuuma olususu lwo okuva ku musana. Kino kiyinza okwongera okusiiyibwa. Yambala engoye ezikuuma n’enkoofiira buli lwe kiba kisoboka. Tewerabira okusiiga eddagala eriziyiza omusana nga lirimu waakiri SPF 30 nga tonnafuluma bweru.
• Bw’oba ​​olina obuzibu mu kumira, lya emmere ennyogovu oba etali nkalu. Osobola n’okufumba emmere yo. Bw’oba ​​oli ku kitanda, okulya ng’otudde waggulu ku kitanda.
• Eddagala lyonna eriragiddwa limira mu budde.
• Singa obujjanjabi nga okujjanjaba omubiri, okujjanjaba emirimu, oba okujjanjaba okwogera kusemba, weetabamu.

Jjukira nti olw’okuba waliwo ebika by’obulwadde bw’emisuwa bingi, omusawo wo ajja kuba alina okukola enteekateeka y’obujjanjabi ekwata ku kika ky’obulwadde bw’emisuwa gyo n’obubonero bwo. N’olwekyo kikulu okugoberera ddala ebiragiro bye. Ate era faayo ku mubiri gwo. Weetegereze enkyukakyuka yonna mu mbeera yo oba obuzibu bw’obubonero bwo. Laba omusawo wo ku nteekateeka eya bulijjo (oba amangu ddala singa olaba enkyukakyuka yonna). Mu ngeri eno, osobola okukola enkyukakyuka mu nteekateeka yo ey’obujjanjabi amangu ddala ng’obubonero bulabika.

N’ekisembayo, ebintu ebisinga obukulu by’olina okujjukira

Obulwadde bwa myopathy si kintu kya kutya, naye nayo si mbeera ya kubuusa maaso.

• Bw’oba ​​ofuna obunafu bw’ebinywa obutasalako, okulumwa oba okukoowa, kakasa nti ogenda ew’omusawo.
• Waliwo ebika by’obulwadde bw’emisuwa mingi, n’olwekyo okuzuula obulungi obulwadde kikulu nnyo.
• Waliwo obujjanjabi n’enkola z’okuddukanya ebika bingi eby’obulwadde bw’emisuwa.
• Bw’ogoberera ebiragiro by’omusawo, n’omira eddagala erikulagidde, n’okubeera n’obulamu obulungi, osobola okubeera n’obulamu obulungi ng’olina embeera eno.

Nsuubira nti amawulire gano osanga nga gayamba. Bw’oba ​​olina ekibuuzo ekirala kyonna, totya kwogera na musawo essaawa yonna.

` Obulwadde bwa myopathy, obunafu bw’ebinywa, obulumi mu binywa, endwadde z’obuzaale, endwadde z’abaserikale b’omubiri, obubonero bw’ebinywa, obujjanjabi bwa myopathy