Abaserikale b’omubiri gwo nkola ya kwekuuma eyeewuunyisa. Naye oluusi enkola eno esobola okukola mu ngeri ey’enjawulo katono. Oluusi kiyinza okusukkiridde okukola ne kikosa omubiri gwaffe, oba oluusi kyetaaga obuyambi okulwanyisa abalabe ng’obutoffaali bwa kookolo. Mu mbeera ng’ezo, twogera ku bujjanjabi obw’enjawulo obuyamba abaserikale baffe abaziyiza endwadde n’okufuga emirimu gyabwo. Ekyo kye kiziyiza (photopheresis).
Mu ngeri ennyangu, photopheresis kye ki?
Photopheresis bujjanjabi obukozesa ekitangaala okukyusa enkola y’obutoffaali bwo obweru obuyitibwa lymphocytes. Obutoffaali buno obuyitibwa lymphocytes, bwe busirikale obukulu obw’abaserikale b’omubiri gwaffe. Bano be basaanyaawo ebintu ng’obutoffaali bwa kookolo, obuwuka, n’akawuka. Kale, bwe wabaawo obuzibu ku lymphocytes zino, obujjanjabi bwa photopheresis bwa mugaso nnyo.
Kilowoozeeko bw’otyo. Bakwata omusaayi gwo ogumu ne baguteeka mu kyuma ne baawula obutoffaali obweru bwokka obuyitibwa lymphocytes. Oluvannyuma, bagitabula n’eddagala ery’enjawulo ne bagiteeka mu kitangaala kya UV ekikyusa engeri obutoffaali obwo gye bukolamu. N’ekisembayo, obutoffaali buno obujjanjabiddwa buzzibwa mu mubiri gwo awamu n’omusaayi gwo gwonna.
Nga tuyita mu nkola eno, tusobola okunyweza abaserikale baffe, oba okugifuga singa eba ekola mu ngeri gye tutayagala. Mu ngeri endala, obujjanjabi buno bulina obusobozi ‘okukoleeza n’okuggyako switch’ abaserikale b’omubiri nga bwe kyetaagisa.
Obujjanjabi buno bukozesebwa mu mbeera ki?
Photopheresis kika kya bujjanjabi bw’abaserikale b’omubiri. Kwe kugamba, nkola ya kujjanjaba ndwadde nga tukozesa abaserikale b’omubiri gwaffe. Waliwo enkozesa enkulu eziwerako ezigikozesa.
| Embeera y’obujjanjabi | Ennyinyonnyola ennyangu |
|---|---|
| Obulwadde bw’obutoffaali bwa T mu lususu (CTCL) . | Kino kika kya kookolo w’omusaayi atatera kulabika ng’akosa olususu. Obujjanjabi bwa photopheresis bwasooka kuleetebwa ng’obujjanjabi bw’obulwadde buno. Ensigo ezijjanjabiddwa bwe ziddamu okuyingizibwa mu mubiri, ziyamba okusaanyaawo obutoffaali bwa kookolo. |
| Obulwadde bwa Graft okusinziira ku Host (GVHD) . | Oluvannyuma lw’ekintu ng’okusimbuliza obusigo bw’amagumba, obutoffaali obupya obufunibwa busobola okutandika okulumba omubiri gwo ng’olinga ‘omulabe’. Obujjanjabi buno busobola okukomya oba okufuga olulumba olwo olutayagala. |
| Okugaana okukyusa ebitundu by’omubiri | Oluvannyuma lw’okusimbuliza ebitundu by’omubiri ebinene, gamba ng’amawuggwe, ekibumba, oba omutima, abaserikale b’omubiri bayinza okugaana ekitundu ekyo ekipya. Obujjanjabi buno buyamba okuziyiza ekyo. |
Embeera endala ez’obujjanjabi
Ng’oggyeeko embeera zino enkulu, abasawo bayinza okukuwa amagezi okukozesa enkola ya photopheresis ku mbeera endala eziwerako ez’obujjanjabi.
- Obulwadde bwa Crohn
- Eczema (Obulwadde bw’olususu obuyitibwa atopic dermatitis) .
- Obulwadde bwa Scleroderma
- Obulwadde bwa Psoriasis, obulwadde bw’olususu
- Ssukaali ow’ekika kya 1
Tulina okwetegeka tutya nga tetunnafuna bujjanjabi?
Omusawo wo ajja kukunnyonnyola kino. Ebiseera ebisinga, bajja kukusaba okulabirira ebintu bino nga tonnafuna bujjanjabi.
- Nywa amazzi amangi: Nywa egiraasi z’amazzi ezitakka wansi wa 8 olunaku okumala ennaku bbiri nga tonnafuna bujjanjabi. Kino kijja kuyamba omusaayi gwo okutambula obulungi, kikwanguyire okuggya omusaayi ng’ojjanjabwa.
- Weewale caffeine n’omwenge: Ebintu nga caayi, kaawa n’omwenge bisobola okuggwaamu amazzi mu mubiri ekikendeeza ku kutambula kw’omusaayi.
- Weewale emmere erimu amasavu: Bw’olya emmere erimu amasavu amangi, gamba ng’emmere enkasiike ne swiiti, kiyinza okukukaluubirira katono ekyuma ekyawula obutoffaali obweru ku musaayi okukola omulimu gwakyo.
Obujjanjabi buno bukola butya?
Enkola eno yonna ebaawo ng’ogalamidde bulungi ku kitanda. Enkola etaliimu bulumi.
1. Okuggya omusaayi: Omusawo oba omusawo ajja kuggya omusaayi mu musuwa oguli mu mukono gwo oba ng’ayita mu ttanka ey’enjawulo (catheter) eteekeddwa mu kifuba kyo. Bwe kiba kyetaagisa, oyinza okusiiga ekizigo ekiziyira mu kitundu ekyo okuziyiza obulumi.
2. Okwawukana kw’obutoffaali:Omusaayi gw’okwata gugenda butereevu mu kyuma eky’enjawulo. Ekyuma kino kyawula obutoffaali obweru bwokka obuyitibwa lymphocytes okuva ku butoffaali obumyufu n’obutoffaali obuyitibwa platelets mu musaayi gwo.
3. Okwongerako eddagala: Eddagala ly’omuddo eritali lya bulabe eriyitibwa `8-methoxypsoralen (8-MOP)` liteekebwa mu butoffaali obweru obwawuddwamu. Eddagala lino likola nga liri mu kitangaala kyokka.
4. Obujjanjabi bw’ekitangaala: Kati, obutoffaali obweru obubeera n’eddagala lino bukwatibwa ekitangaala kya ultraviolet A (UVA light) munda mu kyuma. Olwo, eddagala lino litandika okukola ne likyusa enkola y’obutoffaali obweru.
5. Okuddamu okufuyira: N’ekisembayo, obutoffaali obweru obubadde bujjanjabiddwa mu ngeri eno budda mu mubiri gwo, wamu n’ebitundu ebirala ebyawulwamu emabegako.
Enkola eno yonna esobola okutwala essaawa nga 3-4.
Biki ebivaamu n’ebintu bye tusaanidde okumanya?
Photopheresis is considered a very safe treatment , era abantu abasinga tebafuna buzibu bwonna.
Kyokka, oluusi ebintu ebitonotono bisobola okubaawo.
- Puleesa yo eyinza okukka katono ng’ojjanjabibwa. Kino bwe kibaawo, oyinza okuweebwa amazzi mu misuwa okugazza mu mbeera eya bulijjo.
- Oyinza okuwulira ng’oziyira, ng’oziyira oba ng’onnyogoga, nga bwe kiri ng’owaayo omusaayi. Bw’oba owulira bw’otyo, tegeeza nnansi mu bwangu.
- Oyinza okumyuuka, okuziyira, oba omusujja nga wayise essaawa 6-8 ng’omaze okujjanjabwa. Singa omusujja gwo gusukka diguli 37.8 (diguli 100), tegeeza omusawo wo. Ayinza okukuwa amagezi okumira eddagala nga paracetamol.
Ebintu bye twetaaga okwegendereza naddala nga tumaze okujjanjabibwa
Kino kikulu nnyo. Obujjanjabi bwa photopheresis bufuula olususu lwo n’amaaso go okuwulira ennyo omusana.
Weewale okubeera mu musana obutereevu n’obutatereevu okumala essaawa 24 ng’omaze okujjanjabwa. Omusana ogutali butereevu gwe kitangaala ekiva mu ddirisa oba kateni.
- Bw’ofuluma ebweru, yambala engoye ezibikka omubiri gwo gwonna. Kozesa eddagala eriziyiza omusana eririna SPF 30 oba okusingawo.
- Yambala engatto z’omusana ezikuuma emisinde gya UVA, munda n’ebweru okumala essaawa 24. "wraparound" engatto z'omusana ezibikka amaaso gombi ze zisinga.
Kitwala bbanga ki okulaba ebivaamu?
Kino kijja kwawukana okusinziira ku mbeera yo n’omuwendo gw’obujjanjabi. Abantu abamu balaba okulongoosa okw’amaanyi mu bubonero bwabwe mu myezi 3-4. Ku mbeera ezimu (nga scleroderma), kiyinza okutwala emyezi 6-12 obubonero okutereera. N’olwekyo, obugumiikiriza kikulu mu bujjanjabi buno. Buuza omusawo wo ku kiseera ky’oyinza okusuubira okulaba ebivaamu okusinziira ku mbeera yo.
Obubaka Obutwala Awaka
- Photopheresis ddagala eritali lya bulabe erikozesa ekitangaala okujjanjaba obutoffaali bwo obweru n’okufuga emirimu gy’abaserikale b’omubiri.
- Kino kisinga kukozesebwa ku bintu nga kookolo wa CTCL, embeera za GVHD, n’okuziyiza okugaana oluvannyuma lw’okusimbuliza ebitundu by’omubiri.
- Obujjanjabi buno tebuluma, naye okwekuuma omusana kikakatako okumala essaawa 24 oluvannyuma lw’okujjanjabwa.
- Kiyinza okutwala ekiseera okulaba ebivaamu, n’olwekyo kikulu okubeera omugumiikiriza n’okunoonya obujjanjabi.
- Yogerako mu lwatu n’omusawo wo ku bizibu byonna, okutya oba okubuusabuusa kwonna kw’olina ku nsonga eno.
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