Embeera etali ya bulijjo ekosa obwongo: Omanyi PML? (Obulwadde bwa Leukoencephalopathy obugenda mu maaso - PML)

Wali owuliddeko ku mbeera eyitibwa PML (Progressive Multifocal Leukoencephalopathy)? Oyinza okuba nga tomanyi linnya lino. Ensonga eri nti PML yinfekisoni etatera kulabika nnyo era ekosa obwongo bwaffe. Ekibaawo mu kino kwe kuba nti obutoffaali obukola myelin, ekibikka ekikuuma okwetooloola obutoffaali bw’obusimu mu bwongo bwaffe, busaanawo mpolampola. Myelin kintu ekiringa amafuta. Kino kye kikuuma obusimu obuyitibwa neurons mu bwongo n’omugongo (obusimu bwaffe obw’omu makkati). Kale myelin ono bw’abulawo, ekintu ekyeru mu bwongo kyonooneka.

Erinnya PML litegeeza ki?

Kati ka tulabe ennukuta eziri mu linnya PML kye zitegeeza. Kino bw’okitegeera kijja kukuwa endowooza enzijuvu ku bulwadde buno.

• P — Progressive: Kino kitegeeza nti obulwadde buno bweyongera mpolampola . Kino kitegeeza nti obubonero buyinza okweyongera okumala ekiseera.
• M — Multifocal: Kino kitegeeza nti obulwadde tebukoma ku kitundu kimu eky’obwongo, wabula bukosa ebitundu ebingi . Kiringa nga waliwo obuwundu obutonotono mu bitundu by’obwongo ebiwerako.
• L — Leukoencephalopathy: Ekigambo kino kiwulikika nga kizibu katono, si bwe kiri? Mu ngeri ennyangu, kitegeeza nti obulwadde buno okusinga bukosa myelin oba ekintu ekyeru ekiri mu bwongo .

Kale, PML ereeta obwongo okwonooneka. Okwonooneka kuno kuyinza okuvaako obuzibu obw’enjawulo mu busimu. Okugeza, obuzibu mu bwongo, obuzibu mu kulaba, n’okukaluubirirwa okutambula. Olw’okuba PML bulwadde obugenda bweyongera, buyinza okweyongera okumala ekiseera. Kyokka eri abantu abamu, okujjanjaba amangu obulwadde buno busobola okukendeeza ku kukula kw’obulwadde buno.

Bubonero ki obusooka obwa PML?

Ku bantu bangi, obubonero bwa PML butandika nga tebutegeerekeka bulungi. Ate era obubonero buno buyinza okwawukana okusinziira ku kitundu ky’obwongo ekikoseddwa obulwadde buno. Kirowoozeeko ng’ettabi ly’omuti bwe lifa, emirimu emirala gyonna ku ttabi eryo gilekera awo okukola.

Obubonero obusooka obwa PML buyinza okuli:

• Obukodo oba obutakwatagana
• Okukaluubirirwa okwogera oba okulowooza
• Okuwulira nga munafu mu mubiri

Obulwadde bwe bugenda bweyongera, oyinza n’okufuna obubonero nga:

• Obulwadde bw’okubulwa amagezi, okubulwa okujjukira
• Okubulwa okwogera
• Okubulwa okulaba
• Enkyukakyuka mu nneeyisa n’obuntu

Abantu abamu bayinza n’okulumwa omutwe oba okukonziba, naye kino tekitera kubaawo. Ebyembi, PML etera okweyongera okusajjuka okumala ekiseera, era...Emirundi mingi kiyinza okutta omuntu. Naye, ebivaamu biyinza okwawukana okusinziira ku mbeera z’obujjanjabi ezisibukako omulwadde n’engeri omulwadde gy’akwatamu obujjanjabi.

Kiki ekivaako PML?

PML ereetebwa akawuka akayitibwa JC virus (JCV) . Akawuka kano katuumiddwa ennukuta esooka mu linnya ly’omuntu eyasooka okukwatibwa akawuka kano (John Cunningham). Akawuka kano era kamanyiddwa nga human polyomavirus 2.

Ekyewuunyisa, abantu abakulu nga 85% balina akawuka ka JC mu mibiri gyabwe. Wabula abakugu n’okutuusa kati tebakakasa ngeri kawuka kano gye kasiigibwamu abantu. Waliwo obukakafu obulaga nti abaana basobola okubufuna nga bayita mu mmere oba amazzi. Akawuka kano era kazuuliddwa mu kukeberebwa omusulo. Kale, kisoboka okuba nti esobola okusiigibwa okuyita mu bucaafu bw’omusulo-omu kamwa.

Wabula wadde abantu bangi balina akawuka ka JC mu mibiri gyabwe, tekafuuka kakola, kasula busula. N’olwekyo, tewali bubonero bulabika. Wabula mu muntu alina abaserikale b’omubiri abanafuye, akawuka kano kasobola okukola mu mubiri ne kafuuka PML. Kiba ng’omulabe eyeebase azuukuka n’atulumba nga tuli banafu.

Ani asinga okubeera mu bulabe bw’okukwatibwa obulwadde buno?

PML etera okubaawo mu bantu bokka abalina abaserikale b’omubiri abanafu ennyo. Era oyinza okuba mu bulabe bw’okukwatibwa obulwadde buno singa oba olina emu ku mbeera zino wammanga:

• Obulwadde bwa siriimu
• Kookolo w’omusaayi n’amagumba, okugeza, leukemia
• Kookolo w’enkola y’amazzi, okugeza, lymphoma oba obulwadde bwa Hodgkin
• Endwadde z’abaserikale b’omubiri, gamba ng’endwadde z’enkizi, obulwadde bw’okuzimba emisuwa (MS), oba lupus

Ate era bw’oba ​​ng’oli muntu agaba ebitundu by’omubiri era ng’omira eddagala eriweweeza ku busimu bw’omubiri okutangira omubiri gwo okugaana ekitundu ekyo, naawe oyinza okuba mu bulabe.

Abasawo bazuula batya obulwadde bwa PML?

Omusawo ajja kusooka kukukebera era awulirize bulungi obubonero bwo. Olwo, basobola okukakasa PML nga bakola ebigezo ebiwerako ebikebera obwongo bwo n’omugongo. Oyinza okwetaaga okukeberebwa nga bino:

• Brain MRI scan: Kino kisobola okukuba ebifaananyi by’ebiwundu mu kitundu ekyeru eky’obwongo. Kiringa kkamera etunudde munda mu bwongo.
• Spinal tap/lumbar puncture: Kino kizingiramu okutwala akatono ku mazzi go ag’omu bwongo (CSF), amazzi ageetoolodde obwongo bwo n’omugongo. Kino kiyinza okukebera oba waliwo akawuka ka JC.
• Okukebera obwongo: Kino tekitera kukolebwa. Kikolebwa nga kizibu okukakasa nti omuntu azuuliddwa.

PML ejjanjabwa etya?

Ekisinga okussa essira mu kujjanjaba PML kwe kunyweza abaserikale b’omubiri gwo. Kijjukire nti endwadde zibaawo ng’ebiziyiza omubiri gwaffe binafuye. Kale, ekisinga obukulu kwe kuddamu okunyweza obuzibizi obwo.

• Ng’ekyokulabirako, bw’oba ​​olina mukenenya, oyinza okuweebwa eddagala eriweweeza ku siriimu (ART) . Eddagala lino likola nga likendeeza ku siriimu mu mubiri gwo. Obujjanjabi buno busobola okuyamba abaserikale b’omubiri gwo okukola okutuuka ku ddaala eritali limu.
• Abantu abamu era bayinza okuganyulwa mu bujjanjabi obuyitibwa plasma exchange . Obujjanjabi buno buggyamu agamu ku ddagala eriweweeza ku busimu bw’omubiri mu musaayi gwo. Obujjanjabi buno era busobola okuyamba abaserikale b’omubiri gwo okulwanyisa akawuka ka JC nga bongera ku nkola yaako.

Mu kiseera kino bannassaayansi bali mu kugezesa eddagala eppya eriwerako okujjanjaba PML. Ekitongole kya Amerika ekivunaanyizibwa ku by’emmere n’eddagala ekya FDA kiwadde olukusa olw’enjawulo eri abantu abamu okukozesa eddagala lino, kyokka ebyavaamu bibadde bitabuddwatabuddwa.

Ddi lwe nnina okulaba omusawo?

Bw’oba ​​okimanyi nti abaserikale b’omubiri banafu era ng’owulira ng’ogenda ofuna obubonero bw’olowooza nti buyinza okuba nga bwekuusa ku bulwadde bwa Progressive Multifocal Leukoencephalopathy (PML), kikulu nnyo okugenda ew’omusawo mu bwangu n’okukeberebwa.

Bibuuzo ki bye nnina okubuuza omusawo wange?

Bw’olaba omusawo, osobola okubuuza ebibuuzo nga bino:

• Obulabe bwe nnina obw’okulwala PML buliwa?
• Waliwo kye nsobola okukola okukendeeza ku bulabe buno?
• Bubonero ki bwe nnina okwegendereza mu PML?
• Obulabe ki obuli mu kumira eddagala eriweweeza ku busimu bw’omubiri?
• Waliwo obujjanjabi obulala obujjanjaba embeera yange?
• Obulabe n’emigaso ki ebiri mu bujjanjabi obuliwo kati?

Bw’obuuza ebibuuzo bino, osobola okutegeera obulungi obulwadde buno n’engeri gye bujjanjabibwamu.

Obulamu bw’omulwadde wa PML bwe buliwa?

Guno mulamwa muzibu ddala okwogerako. PML bulwadde obugenda mu maaso. Kino kitegeeza nti obubonero bweyongera okumala ekiseera. Obulamu bw’omuntu alina PML businziira ku buzibu bw’obulwadde n’obujjanjabi bw’afuna. Abantu abali wakati wa 30% ne 50% bafa mu myezi egisooka oluvannyuma lw’okuzuulibwa. Abantu abawangaala ennyo beeyongera okuba n’obubonero, era obubonero obwo bweyongera. Obubonero buno buyinza okuvaako ebizibu eby’amaanyi, gamba ng’okubulwa okwogera n’okubulwa okulaba.

Wabula okunoonyereza okupya kulaga nti abantu abatono abalina PML erimu akawuka ka siriimu basobola okutebenkeza obulwadde bwabwe ne bawangaala. Nga eddagala eriziyiza akawuka (ART) okujjanjaba obulwadde bwa siriimu tebunnajja, abantu 10% bokka abalina PML be baawangaala omwaka ogusukka mu gumu. Naye kati, nga balina ART, omuwendo gw’abantu abawangaala omwaka gumu gweyongedde okutuuka ku bitundu 50%. Mu mbeera ezimu, ART esobola okuyamba abaserikale b’omubiri okulwanyisa akawuka ka JC.

Kisoboka okuwona ddala okuva mu PML?

Abantu abafuna PML nga bamira eddagala eriweweeza ku busimu bw’omubiri bayinza okuwona oluvannyuma lw’okukomya eddagala lino. Abantu abajjanjabiddwa obulungi eddagala lya ART nabo basobola okuwona PML. Wabula abantu 80% abawona PML tebaddamu bubonero bwabwe. Kino kiri bwe kityo kubanga myelin omupya takolebwa mu bitundu ebyonooneddwa. Okwonooneka kw’obusimu okw’olubeerera kwa bulijjo. Wabula abantu abamu basobola okuwangaala emyaka 15 nga PML emaze okulongoosa.

Biki ebisuubirwa mu abo abagenda okuwanyisiganyizibwa mu plasma?

Singa obubonero bwo obwa PML bwatandika olw’eddagala erikendeeza ku busimu bw’omubiri, obubonero bwo buyinza okuggwaawo ng’omaze okulekera awo okumira eddagala eryo. Osobola n’okuwanyisiganya omusaayi (plasma exchange) okuggyamu ezimu ku ddagala eriweweeza ku busimu bw’omubiri mu mubiri gwo. Ekigendererwa ky’okuwanyisiganya omusaayi (plasma exchange) kwe kwongera ku baserikale b’omubiri gwo. Ku bantu abamu, okuwanyisiganya plasma kuyinza okukendeeza ku kukula kwa PML n’okuwangaaza obulamu. Kyokka, emigaso egiri mu kino teginnategeerekeka bulungi.

Abantu bangi bayinza okusigala nga balina obubonero bwa PML oluvannyuma lw’okuyimiriza eddagala oba oluvannyuma lw’okufuna plasma exchange. Abalala bayinza okufuna obuzibu mu busimu. Waliwo n’obulabe obulala obuli mu kulekera awo eddagala. Kale, kikulu okwogera n’omusawo wo ng’osalawo ku ddagala lyo.

Ntegeera ntya oba ndi mu bulabe bw’okulwala obulwadde bwa Progressive Multifocal Leukoencephalopathy (PML)?

Bw’oba ​​olina embeera y’obujjanjabi enafuya abaserikale b’omubiri, buuza omusawo wo ku bulabe bw’okufuna PML.

Embeera endala ez’obujjanjabi zongera ku bulabe bwange obw’okukwatibwa PML?

Abantu abalina endwadde nga multiple sclerosis (MS) oba Crohn’s disease nabo balina okwekebeza omusaayi okukebera embeera nga siriimu eyongera obulabe bw’okukwatibwa akawuka ka JC.

Abasawo batera okuwandiika eddagala eriyitibwa Natalizumab (Tysabri®) okujjanjaba obulwadde bwa MS oba Crohn. Eddagala lino liyinza okwongera ku bulabe bw’okukwatibwa PML.

Ne bw’oba ​​olina akawuka ka JC akatali kakola era nga tolina bubonero, oyinza okumira eddagala lya natalizumab. Wabula kikulu okwogera n’omusawo wo ku bulabe n’emigaso.

N’ekisembayo, ebintu by’olina okujjukira (Obubaka bw’okutwala awaka) .

Progressive Multifocal Leukoencephalopathy (PML) bulwadde bwa bwongo obutatera kulabika obuva ku kawuka ka JC okuddamu okukola. Abantu abasinga balina akawuka ka JC nga kasula mu mibiri gyabwe. Tebuleeta bulabe bwonna ku bantu abatalina baserikale ba mubiri banafuye.

Bw’oba ​​olina abaserikale b’omubiri abanafuye, kikulu okumanya obubonero bwa PML era okukolagana n’omusawo wo okukikola.

Obulwadde buno butera okweyongera okumala ekiseera. Wabula waliwo obujjanjabi obuyinza okuyamba okukendeeza ku kukula kw’obulwadde n’okuwangaaza obulamu bwo. Kale, toggwaamu ssuubi. Ekisinga obukulu kwe kunoonya amagezi mu basawo amangu ddala nga bwe kisoboka.

` PML, Progressive Multifocal Leukoencephalopathy, akawuka ka JC, yinfekisoni z’obwongo, abaserikale b’omubiri, endwadde z’obusimu, myelin