Kodi pali aliyense m'banja mwanu amene ali ndi matenda a "Sickle Cell Disease"? Tiyeni tidziwe bwino!

Lero tikambirana za matenda omwe ndi atsopano kwa anthu ambiri, koma akhoza kukhala ofanana kwambiri ndi mabanja ena. Amatchedwa Matenda a Sickle Cell (SCD). Mwina munamvapo dzinali kale. Ndi matenda omwe amagwirizana ndi magazi athu, kutanthauza kuti, amagwirizana ndi magazi, ndipo ndi obadwa nawo. Tiyeni tiwone chomwe kwenikweni chili, chifukwa chake chimachitika, ndi zina zomwe zingachite pa matendawa.

Kodi Matenda a Sickle Cell ndi chiyani? Tiyeni timvetse mosavuta!

Mwachidule, matenda a sickle cell (SCD) ndi matenda omwe amakhudza maselo ofiira a m'magazi m'thupi lathu, omwe amatengera kwa makolo kwa ana. Uwu ndi umodzi mwa matenda ofala kwambiri padziko lonse lapansi. Tsopano onani, mkati mwa maselo ofiira athu muli puloteni yotchedwa hemoglobin . hemoglobin iyi ndi yofunika kwambiri. Chifukwa, ndi puloteni iyi yomwe imanyamula mpweya m'thupi lathu lonse. Ili ngati taxi ya oxygen. Maselo ofiira a munthu wathanzi nthawi zambiri amakhala ozungulira komanso osinthasintha. Monga mipira yaying'ono ya rabara. Chifukwa cha izi, amatha kukwawa mosavuta kudzera m'mitsempha yaying'ono kwambiri yamagazi m'thupi (timawatcha kuti capillaries) ndikupereka mpweya ku ziwalo zathu zonse ndi minofu. Komabe, chomwe chimachitikira munthu yemwe ali ndi matenda a sickle cell ndikuti pali kusintha pang'ono kwa hemoglobin iyi. hemoglobin yosadziwika bwino iyi imatchedwa hemoglobin S. Izi zimapangitsa maselo ofiira amagazi kukhala ngati mwezi, kapena ngati theka la mwezi, m'malo mozungulira komanso osinthasintha. Sikuti zokha, komanso maselo awa ndi olimba kwambiri, samapindika mosavuta, ndipo amamatirana. Tangoganizirani, chimachitika ndi chiyani maselo ofiira awa akamadutsa m'mitsempha yaying'ono yamagazi? Amamatira! Kenako magazi amasokonekera. Izi zikutanthauza kuti ziwalo ndi minofu yathu yofunika kwambiri siilandira mpweya wokwanira. Ichi ndichifukwa chake mavuto aakulu monga kupweteka kwambiri, matenda osiyanasiyana, kuwonongeka kwa ziwalo, komanso kusagwira ntchito bwino kwa thupi kumatha kuchitika. Chinanso n'chakuti maselo ooneka ngati sikelowa samakhala ndi moyo wautali ngati maselo ofiira a m'magazi wamba. Amafa msanga. Kenako thupi nthawi zonse limakhala ndi kusowa kwa maselo ofiira a m'magazi. Ichi ndi chomwe timachitcha kuchepa kwa magazi m'thupi . Matenda a sikelo ndi matenda omwe amakhalapo kwa moyo wonse. Koma musadandaule, pali mankhwala a izi. Ndi mankhwala awa, mutha kuchepetsa zizindikiro ndikuwonjezera moyo wanu.

Kodi pali mitundu yosiyanasiyana ya matenda a sickle cell?

Inde, pali mitundu ingapo ya matenda a sickle cell. Mitundu iyi imatsimikiziridwa ndi majini omwe munthu amalandira kuchokera kwa makolo ake.

Hemoglobin SS (HbSS)

Uwu ndiye mtundu woopsa kwambiri wa matenda a sickle cell. Pafupifupi 65% ya anthu omwe ali ndi SCD ali ndi mtundu uwu. Anthuwa amalandira majini a hemoglobin S kuchokera kwa makolo onse awiri. Izi zikutanthauza kuti hemoglobin yawo yambiri kapena yonse ndi yolakwika. Izi zimapangitsa kuti azikhala ndi magazi osakwanira.

Hemoglobin SC (HbSC)

Izi ndi zofatsa kapena zocheperako.Mtundu womwe uli pamlingo wapamwamba. Pafupifupi 25% ya anthu omwe ali ndi SCD ali ndi izi. Anthu awa amalandira jini ya hemoglobin S kuchokera kwa kholo limodzi ndipo jini ya mtundu wina wa hemoglobin wosadziwika bwino wotchedwa hemoglobin C kuchokera kwa kholo lina.

Hemoglobin (HbS) Beta Thalassemia

Anthuwa amalandira jini ya hemoglobin S kuchokera kwa kholo limodzi ndi jini yosadziwika bwino yotchedwa beta thalassemia kuchokera kwa kholo lina. Palinso mitundu iwiri ya izi:

• "Plus" (HbS beta +): Uwu ndi mtundu womwe umakhudza pafupifupi 8% ya anthu omwe ali ndi SCD ndipo nthawi zambiri umakhala wofatsa.
• "Zero" (HbS beta 0): Uwu ndi mtundu womwe umakhudza pafupifupi 2% ya anthu omwe ali ndi SCD ndipo ukhoza kukhala woopsa ngati matenda a hemoglobin SS (HbSS).

Mitundu ina yosowa

Kuonjezera pa izi, palinso mitundu ina yosowa monga hemoglobin SD (HbSD), hemoglobin SE (HbSE), ndi hemoglobin SO (HbSO) . Anthuwa amalandira jini imodzi ya hemoglobin S ndi jini ina yosadziwika bwino yotchedwa D, E, kapena O.

Kodi pali kusiyana kotani pakati pa matenda a Sickle Cell Anemia ndi matenda a Sickle Cell?

Apa ndi pomwe anthu ambiri amasokonezeka. Matenda a Sickle Cell (SCD) ndi mawu wamba a mitundu yonse yosiyanasiyana ya matenda a sickle cell omwe atchulidwa pamwambapa. Ali ngati ambulera. Mitundu ina yonse imagwera pansi pa ambulera imeneyo. Madokotala amagwiritsa ntchito mawu oti "Sickle Cell Anemia" okha pa mitundu yoopsa kwambiri ya SCD yomwe imayambitsa kuchepa kwa magazi . Ndiko kuti, mitundu yotchedwa hemoglobin SS (HbSS) ndi hemoglobin beta zero thalassemia. Mwamvetsa?

Kodi kusiyana pakati pa Sickle Cell Trait ndi Matenda ndi kotani?

Anthu ena ali ndi khalidwe la sickle cell lokha. Izi zikutanthauza kuti amalandira jini ya hemoglobin S kuchokera kwa kholo limodzi lokha . Kholo lina limalandira jini lathanzi. Nthawi zambiri, anthu omwe ali ndi khalidwe la sickle cell sasonyeza zizindikiro za matenda a sickle cell. Komabe, amatha kupatsira jini losazolowerekali kwa ana awo. Izi zikutanthauza kuti ndi omwe amanyamula jinili. Komabe, nthawi zambiri, ngakhale anthu omwe ali ndi khalidwe la sickle cell amatha kukhala ndi mavuto azaumoyo ngati atasowa madzi m'thupi kwambiri kapena ngati akuchita masewera olimbitsa thupi . Kafukufuku akupitilizabe pa izi.

Kodi matenda a sickle cell ndi ofala bwanji?

Ofufuza akuti anthu pafupifupi 100,000 ku United States kokha ali ndi matenda a sickle cell. Matendawa amapezeka kwambiri pakati pa anthu ochokera ku Africa. Amapezekanso pakati pa anthu aku America aku Hispanic, komanso anthu ochokera ku Mediterranean, Middle East, India, ndi Asia. Palinso anthu omwe ali ndi matendawa ku Sri Lanka.

Kodi n’chiyani chimayambitsa matenda a sickle cell?

Matenda a sickle cell amayamba chifukwa cha kusintha kwa majini mu jini yotchedwa HBB gene . Jini ya HBB iyi imapanga gawo limodzi la hemoglobin. Anthu omwe ali ndi SCD amalandira majini awiri a HBB omwe amasinthidwa omwe amapanga hemoglobin yolakwika - imodzi kuchokera kwa kholo lililonse. Izi zimatchedwa autosomal recessive inheritance. Izi zikutanthauza kuti makolo onse a mwana yemwe ali ndi SCD amakhala ndi kopi imodzi ya jini yomwe imasinthidwa (zomwe zikutanthauza kuti akhoza kukhala ndi vuto la sickle cell). Komabe, makolo amenewo nthawi zambiri sasonyeza zizindikiro.

Ndani ali pachiwopsezo chachikulu chotenga matenda a sickle cell (SCD)?

Magulu ena a anthu ali ndi mwayi waukulu wopeza matendawa.

• Anthu ochokera ku Africa (monga anthu aku Africa America).
• Anthu aku America aku Spain ku South America ndi Central America.
• Anthu ochokera ku Mediterranean, Middle East, India, ndi Asia.

Kodi zizindikiro za matenda a sickle cell ndi ziti?

Zizindikiro za matenda a sickle cell nthawi zambiri zimayamba kuonekera mwana ali ndi miyezi 5 mpaka 6. Zizindikirozi zimatha kusiyana malinga ndi munthu. Anthu ena amakhala ndi zizindikiro zochepa, pomwe ena amatha kukhala ndi mavuto aakulu. Zizindikiro zazikulu zomwe zingawonekere ndi izi:

• Kupweteka pafupipafupi.
• Kuchepa kwa magazi m'thupi : Izi zingayambitse kutopa kwambiri, kufooka, komanso kufooka.
• Jaundice : Kutuluka kwachikasu pakhungu ndi maso oyera.
• Kutupa kowawa m'manja ndi m'mapazi.

Kodi mavuto a vutoli ndi otani?

Matenda a sickle cell amatha kukhudza ziwalo zambiri za thupi. Zotsatira zina zimayamba mwadzidzidzi (mwadzidzidzi), pomwe zina zimatha nthawi yayitali (nthawi yayitali). Mavutowa amatha kuyamba msanga ndipo amatha moyo wonse.

Ululu

Imeneyi ndi vuto lofala kwambiri la matenda a sickle cell. Ululu umachitika pamene maselo ooneka ngati sickle amamatira m'mitsempha yamagazi ndikuletsa kuyenda kwa magazi. Mutha kukhala ndi ululu woopsa mwadzidzidzi. Izi zimatchedwanso ululu wopweteka, vuto la sickle cell, vaso-occlusive crisis (VOC), kapena vaso-occlusive episode (VOE) . Mavuto a ululu awa akhoza kukhala ochepa kapena ovuta, ndipo angayambe mwadzidzidzi ndipo amatha kwa nthawi yayitali. Ululu nthawi zambiri umakhala pachifuwa, kumbuyo, miyendo, ndi m'manja. Anthu ena akhoza kukhala ndi ululu wosatha , zomwe zikutanthauza ululu womwe umatenga nthawi yoposa miyezi isanu ndi umodzi.

Kuchepa kwa magazi m'thupi

Matenda a sickle cell amayambitsa kuchepa kwa magazi chifukwa maselo ofiira amafa msanga. Kuchepa kwa magazi ndi kusowa kwa maselo ofiira athanzi omwe amatha kunyamula mpweya m'thupi lonse. Ichi ndichifukwa chakeKutopa kwambiri, jaundice, kusakhazikika, chizungulire, komanso kufooka mutu kungachitike.

Matenda Oopsa a Chifuwa

Izi ndi ngozi yachipatala yomwe ingawononge mapapu. Zingawononge mapapu, kuyambitsa kuvutika kupuma, komanso kuchepetsa mpweya wokwanira m'thupi. Vutoli limachitika pamene maselo otupa a sickle cells amaletsa kuyenda kwa magazi ndi mpweya m'mapapo.

Magazi Oundana

Matenda a sickle cell anemia amawonjezera chiopsezo cha magazi kuundana. Izi zimawonjezera chiopsezo cha magazi kuundana mumtsempha wozama (deep vein thrombosis - DVT). DVT imathanso kusweka ndikukhazikika m'mapapo (pulmonary embolism - PE).

Stroke

Ngati maselo otupa agwidwa mumtsempha wamagazi wopita ku ubongo, kuyenda kwa magazi kupita ku ubongo kumatsekedwa. Ubongo sulandira mpweya wokwanira kuti ugwire ntchito. Izi zingayambitse sitiroko . Pafupifupi 10% ya anthu omwe ali ndi SCD adzakhala ndi sitiroko. Anthu omwe ali ndi vuto la kuchepa kwa magazi m'thupi (sickle cell anemia) ali pachiwopsezo chachikulu cha sitiroko.

Mavuto a Masomphenya

Maselo a sikelo amatha kutseka mitsempha yamagazi m'maso. Izi nthawi zambiri zimachitika mu retina . Nthawi zina palibe zizindikiro ndipo masomphenya amatha kutayika mwadzidzidzi, ndipo zimatha kubweretsa khungu losatha.

Kusankhana mitundu

Kudziletsa ndi vuto lomwe maselo ooneka ngati chikwakwa m'mimba mwa mwamuna amatsekeka, zomwe zimapangitsa kuti munthu ayambe kukhwima komanso kumva kupweteka ( priapism ). Kuwonjezera pa ululu, kudziletsa kungayambitse kuwonongeka kosatha komanso kulephera kugwira ntchito bwino kwa chiwerewere . Kudziletsa komwe kumatenga maola opitilira anayi ndi vuto lachipatala.

Kuwonongeka ndi kulephera kwa ziwalo

Anthu omwe ali ndi matenda a sickle cell ali pachiwopsezo cha mavuto a mtima, mapapo, impso, ndi ziwalo zina chifukwa salandira magazi ndi mpweya wokwanira. SCD ingayambitse kulephera kwa ziwalo zambiri .

Kodi matenda kapena chizindikiro cha sickle cell zimakhudza mimba?

Azimayi ambiri omwe ali ndi matenda a sickle cell amakhala ndi mimba zabwino. Koma zoopsa zake zimakhala zazikulu. Matenda a SCD amatha kuonjezera chiopsezo cha kuthamanga kwa magazi, kuundana kwa magazi, kutaya mimba, makanda obadwa ndi kulemera kochepa, komanso kubereka ana asanakwane nthawi . Chifukwa chake ndikofunikira kutsatira malangizo a dokotala wanu.

Kodi matenda a sickle cell amapezeka bwanji?

Ku Sri Lanka, monga m'maiko ambiri padziko lonse lapansi, khanda lililonse lobadwa kumene limayesedwa matenda a sickle cell ngati gawo la kuyezetsa makanda . Izi zimaphatikizapo kutenga magazi ochepa kuchokera pachidendene cha mwana ndikumuyesa. Izi zimafufuzanso matenda ena angapo. Kuti atsimikizire matendawa, dokotala wa mwanayo adzachita mayeso a hemoglobin electrophoresis . Komanso, matenda a sickle cell amatha kupezeka mwana asanabadwe kudzera mu kuyezetsa kwa amayi apakati . Mayesowa akuphatikizapo:Izi zikuphatikizapo chorionic villus sampling ndi amniocentesis .

Kodi pali mankhwala athunthu a matenda a sickle cell?

Inde, kuyika mafupa m'malo osungira mafupa , komwe kumadziwikanso kuti kuyika maselo oyambira, kungachiritse matenda a sickle cell. Izi zimaphatikizapo kutenga mafupa athanzi kuchokera kwa munthu wathanzi komanso wopereka majini oyenera (monga m'bale wake) ndikuyika m'malo mwa wodwalayo. Komabe, pafupifupi 18% yokha ya anthu omwe ali ndi SCD ndi omwe angapeze zofanana ndi izi. Palinso zoopsa ndi zovuta za kuyika mafupa m'malo osungira mafupa. Dokotala wanu adzakambirana nanu izi.

Kodi mankhwala a matenda a sickle cell ndi ati?

Chithandizo cha matenda a sickle cell chimaphatikizapo mankhwala, kuikidwa magazi, kusamutsa mafupa, ndi chithandizo cha majini . Chithandizo chingayambe ndi maantibayotiki . Makanda obadwa kumene omwe ali ndi SCD yayikulu amapatsidwa maantibayotiki kawiri patsiku kwa zaka 5 kuti apewe matenda.

Mankhwala ena

Anthu ambiri omwe ali ndi SCD amagwiritsa ntchito mankhwala kuti achepetse kuopsa kwa matenda awo ndikuchiza zizindikiro. Zina mwa izi ndi izi:

• Voxelotor: Izi zitha kuletsa maselo ofiira a magazi kuti asagwirizane ngati chikwakwa. Izi zitha kuchepetsa kuwonongeka kwa maselo ofiira ena, kusintha kuyenda kwa magazi kupita ku ziwalo, komanso kuchepetsa chiopsezo cha kuchepa kwa magazi m'thupi.
• Crizanlizumab: Mankhwalawa amathandiza kupewa maselo ofiira a magazi ooneka ngati sickle kuti asamamatire m'makoma a mitsempha yamagazi . Izi zingathandize kuti magazi aziyenda bwino komanso kuchepetsa kutupa ndi ululu.
• Hydroxyurea : Izi zitha kuchepetsa kapena kuletsa mavuto angapo a SCD, monga kupweteka pafupipafupi, matenda a chifuwa chachikulu, komanso kuchepa kwa magazi m'thupi.
• L-glutamine: Iyi ndi mankhwala ochepetsa ululu. Ingathandize kuchepetsa kuchuluka kwa ululu womwe mumakumana nawo. Mankhwala ena ochepetsa ululu ndi monga mankhwala oletsa kutupa omwe si a steroidal (NSAIDs) ndi opiates .

Kuika magazi

Dokotala wanu angakulangizeni kuti mupereke magazi kuti muchiritse ndikupewa mavuto a SCD.

• Kuika magazi mwachangu:Izi zimathandiza kuchiza mavuto omwe amayambitsa kuchepa kwa magazi m'thupi. Madokotala amathanso kuzigwiritsa ntchito pamavuto monga sitiroko, matenda a chifuwa chachikulu, komanso kulephera kwa ziwalo.
• Kuika maselo ofiira m'magazi: Izi zitha kuwonjezera kuchuluka kwa maselo ofiira m'magazi ndikupereka maselo ofiira amagazi abwinobwino omwe sali ngati chikwakwa.

Kusamutsa maselo oyambira (komwe kumatchedwanso kusamutsa mafupa)

SCD imatha kuchiritsidwa ndi kuikidwa kwa maselo oyambira. Izi zimafuna wopereka chithandizo woyenera (monga m'bale kapena mlongo). Kafukufuku akuchitikanso kuti awonjezere kuikidwa kwa maselo kuchokera kwa makolo kapena abale omwe ali ofanana pang'ono. Dokotala wanu adzakambirana za zoopsa ndi ubwino wa chithandizochi kutengera momwe mulili.

Chithandizo cha Majini

Ofufuza panopa akufufuza za chithandizo cha majini kuti athetse SCD. Izi zikuphatikizapo kukonza jini ya hemoglobin yolakwika kapena kuyika jini ya hemoglobin yathanzi m'maselo oyambira a munthu. Deta yoyambirira pa izi ndi yodalirika kwambiri. Chiyembekezo ndi chakuti chithandizo cha majini tsiku lina chidzakhala chithandizo chachizolowezi cha SCD.

Kodi izi zingapewedwe?

Matenda a sickle cell ndi matenda a majini, kotero sangapewedwe . Ngati muli ndi pakati, ndi bwino kulankhula ndi dokotala wanu za kuyezetsa majini kapena upangiri wa majini . Izi zikuthandizani inu ndi mnzanu kudziwa ngati muli ndi jini komanso chiopsezo chanu chopatsira ana anu.

Kodi munthu amene ali ndi matenda a sickle cell angayembekezere chiyani?

Anthu omwe ali ndi matenda a sickle cell angakhale ndi moyo wautali pang'ono kuposa anthu onse. Komabe, mankhwala atsopano a SCD athandiza kwambiri kuti anthu azikhala ndi moyo wabwino komanso wabwino . Ngati matendawa athandizidwa bwino, anthu omwe ali ndi matenda a sickle cell amatha kukhala ndi moyo mpaka zaka 50.

Kodi ndingasamalire bwanji mwana wanga ngati ali ndi matenda a sickle cell?

Ngati mwana wanu ali ndi matenda a sickle cell, pali zinthu zambiri zomwe mungachite kuti muchepetse vuto lake:

• Nthawi zonse pitani ndi mwana wanu kwa dokotala.
• Perekani mwana wanu katemera wonse wovomerezeka pa nthawi yake.
• Thandizani mwana wanu kuchita masewera olimbitsa thupi nthawi zonse komanso kudya zakudya zopatsa thanzi .
• Ngati mwana wanu wakumana ndi vuto la ululu, mupatseni madzi okwanira komanso mankhwala oletsa kutupa (NSAID) . Ngati ululuwo sungathetsedwe kunyumba, pitani naye kuchipatala kuti akamwe mankhwala amphamvu ochepetsa ululu.

Kodi ndi liti pamene muyenera kupita ku Emergency Treatment Unit (ETU) ?

Matenda a sickle cell angayambitse mavuto osiyanasiyana omwe angawononge moyo. Ngati inu kapena mwana wanu mukukumana ndi zizindikiro zotsatirazi, imbani 911 kapena pitani ku chipinda chapafupi chadzidzidzi (ER) nthawi yomweyo:

• Ululu waukulu.
• Zizindikiro za kuchepa kwa magazi m'thupi: kutopa kwambiri, chizungulire, komanso kupuma movutikira.
• Malungo opitirira madigiri 101.3 Fahrenheit (38.5 digiri Celsius).
• Mavuto a masomphenya.
• Kuvuta kupuma.
• Kukhazikika kwa mbolo komwe kumatenga maola anayi kapena kuposerapo (priapism).
• Zizindikiro za matenda a chifuwa chachikulu: kupweteka pachifuwa, chifuwa, malungo.
• Zizindikiro za sitiroko: Kufooka mwadzidzidzi mbali imodzi ya thupi, dzanzi, kapena kutaya chidziwitso.

N’chifukwa chiyani matenda a sickle cell amayambitsa ululu?

Mwachidule, maselo ofiira a magazi ooneka ngati chikwakwa amaoneka ngati chilembo C, kapena mwezi wooneka ngati mwezi. Akamayenda m'mitsempha yanu yamagazi, amatsekeka ndikutseka kuyenda kwa magazi. Pamenepo ndi pomwe ululu umayamba. Taganizirani ngati kuchuluka kwa magalimoto pamsewu.

Kodi sickle cell ndi matenda a autoimmune?

Ayi. Ngakhale kuti matenda a sickle cell ali ndi zizindikiro zina za matenda a autoimmune , madokotala saona SCD ngati matenda a autoimmune. Amaona SCD ngati matenda a majini .

Matenda a sickle cell ndi matenda omwe munthu amakhala nawo kwa moyo wake wonse. Kusamutsa maselo oyambira, komwe kungapereke machiritso athunthu, sikungatheke nthawi zonse, ndipo ndi koopsa. Komabe, kuzindikirika msanga ndi chithandizo kungathandize kuchepetsa zizindikiro ndikuchepetsa chiopsezo cha zovuta. Ndi chithandizo chamankhwala nthawi zonse, mutha kukhala ndi moyo wotanganidwa komanso wotanganidwa.

Pomaliza, zinthu zofunika zomwe muyenera kukumbukira (Uthenga Wopita Nawo Kunyumba)

Chabwino, takambirana zambiri zokhudza matenda a sickle cell. Nazi zinthu zofunika kukumbukira:

• Matenda a sickle cell (SCD) ndi matenda obadwa nawo m'magazi omwe mawonekedwe a maselo ofiira amagazi amasintha, zomwe zimayambitsa mavuto pakuyenda kwa magazi.
• Chifukwa chachikulu cha izi ndi mtundu wosadziwika bwino wa hemoglobin wotchedwa hemoglobin S.
• Ululu, kuchepa kwa magazi m'thupi, matenda opatsirana, ndi kuwonongeka kwa ziwalo ndi zofala.
• Kuzindikira msanga ndi kulandira chithandizo choyenera n'kofunika kwambiri. Makanda obadwa kumene amayesedwa kuti adziwe ngati ali ndi matendawa.
• Ngakhale kuti kuika mafupa m'thupi kungakhale mankhwala, sikoyenera aliyense. Pali njira zina zochiritsira, monga mankhwala ndi kuika magazi.
• Mungathe kukhala bwino ndi matendawa mwa kusintha moyo wanu, kutsatira malangizo oyenera a dokotala, komanso kuchitapo kanthu mwachangu pakagwa ngozi .

Ngati inu kapena munthu amene mumamudziwa ali ndi mafunso okhudza matenda a sickle cell, onetsetsani kuti mwaonana ndi dokotala kuti akupatseni upangiri. Palibe choopa kapena kuchita manyazi nacho. Chofunika kwambiri ndikudziwa zambiri! Matenda a sickle cell, hemoglobin, maselo ofiira a magazi, kuchepa kwa magazi m'thupi, matenda a majini, mavuto opweteka, chithandizo cha sickle cell