Kodi mukudziwa za Hemophilia B? Tiyeni tikambirane mwachidule!

Kodi mwaonapo kuti anthu ena amapitiriza kutuluka magazi ngakhale pa bala laling'ono? Kapena mwaonapo kuti popanda chifukwa, ziwalo za thupi lanu zimasanduka buluu ndipo zimakhala ndi mikwingwirima ya magazi? Chifukwa chimodzi cha zinthuzi chingakhale vuto lomwe tikambirane lero lotchedwa Hemophilia B. Musadandaule, tikambirana za izi m'njira yosavuta yomwe mungamvetse.

Kodi Hemophilia B ndi chiyani?

Mwachidule, hemophilia B ndi matenda otuluka magazi omwe amabadwa nawo. Amayamba pamene pali kusintha kwa majini komwe kumathandiza magazi kuundana. Anthu omwe ali ndi hemophilia B ali ndi milingo yochepa ya factor IX (yomwe imadziwikanso kuti factor 9, F9, FIX), puloteni yofunika kwambiri yomwe imathandiza magazi kuundana. Ngati sanalandire chithandizo, vutoli likhoza kukhala pachiwopsezo. Nkhani yabwino ndi yakuti madokotala akulichiza ndi mankhwala enaake 9. Mankhwala atsopano, monga gene therapy, akufufuzidwanso.

Kodi vutoli limakhudza bwanji thupi lanu?

Monga mitundu ina ya hemophilia, anthu omwe ali ndi hemophilia B amatuluka magazi ambiri komanso kwa nthawi yayitali kuposa masiku onse akavulala, kuchitidwa opaleshoni, kapena kuchotsedwa dzino. Matendawa amakhudza kwambiri amuna, koma amathanso kukhudza akazi.

Madokotala amaika hemophilia m'gulu la matenda ofatsa, ofatsa, komanso oopsa . Anthu omwe ali ndi hemophilia B yoopsa amatha kutuluka magazi m'malo olumikizirana mafupa. Izi zimawawa kwambiri, ndipo pakapita nthawi, zimatha kuyambitsa matenda monga nyamakazi. Anthu ena amafunika opaleshoni kuti achotse mafupa owonongeka ndikuwasintha. Amathanso kutuluka magazi m'maubongo mwawo, zomwe zingakhale zoopsa kwa moyo.

Kodi hemophilia B ndi yofala bwanji?

Malinga ndi ziwerengero ku United States, amuna pafupifupi 4 mwa amuna 100,000 ali ndi hemophilia B. Akazi nawonso ali ndi hemophilia, koma n'zovuta kunena kuti ndi angati kwenikweni. Chifukwa ngakhale ali ndi zizindikiro monga kusamba kwambiri, anthu ambiri saganiza kuti zikugwirizana ndi hemophilia.

Kodi mukudziwa kusiyana pakati pa hemophilia A ndi B?

Matenda a Hemophilia A ndi B onse ndi matenda obadwa nawo otuluka magazi. Ngakhale kuti zizindikirozo zimafanana kwambiri, kusintha kwa majini komwe kumayambitsa matendawa ndi kosiyana. Kafukufuku wasonyeza kuti zizindikiro za hemophilia B zitha kukhala zochepa pang'ono poyerekeza ndi za hemophilia A. Izi zikutanthauza kuti hemophilia B ndi matenda oopsa, koma anthu omwe ali ndi vutoli sangakhale ndi mavuto ambiri otuluka magazi ambiri. Nazi kusiyana kwina:

• Kafukufuku akusonyeza kuti anthu omwe ali ndi hemophilia B amakhala ndi magazi ochepa m'malo olumikizirana mafupa (hemathroses) komanso mafupa amawonongeka pang'ono.
• Kutuluka magazi mwadzidzidzi sikuchitika kawirikawiri kwa anthu omwe ali ndi hemophilia B.
• Nthawi zina, pochiza matenda a hemophilia, thupi limapanga ma antibodies omwe amasokoneza chithandizocho. Komabe, anthu omwe ali ndi hemophilia B nthawi zambiri samakhala ndi mavuto amenewa.

N’chifukwa chiyani izi zinkatchedwa kale kuti ‘matenda a Khirisimasi’?

Nkhani iyi ndi yosangalatsa kwambiri. Kwa zaka zoposa 100, madokotala ankaganiza kuti pali mtundu umodzi wokha wa hemophilia. Koma mu 1952, wofufuza wina anagwiritsa ntchito madzi a m'magazi ochokera kwa anthu asanu ndi awiri omwe ali ndi hemophilia (mmodzi wotchedwa 'Christmas') pochiza anthu ena omwe ali ndi hemophilia. Chodabwitsa n'chakuti, chithandizocho chinagwira ntchito! Pamenepo ofufuza anazindikira kuti a Christmas anali ndi mtundu wina wa hemophilia, kutanthauza kuti, unayambitsidwa ndi kusintha kwa majini. Choncho anatcha mtundu wachiwiri wa hemophilia uwu kuti 'Christmas factor' kapena 'Christmas disease'. Pambuyo pake unatchedwa hemophilia B.

Kodi n’chiyani chimayambitsa matenda a hemophilia B?

Monga tanenera kale, hemophilia B ndi matenda obadwa nawo chifukwa cha magazi. Ngati muli ndi hemophilia B, zikutanthauza kuti mwalandira jini yosadziwika bwino yomwe imakhudza kuchuluka kwa factor 9. Nthawi zambiri, pamakhala jini yotchedwa F9, yomwe imakuuzani momwe mungapangire factor 9. Hemophilia B imachitika pamene jini ya F9 iyi imasintha, ndikupanga jini yosadziwika bwino yomwe imachepetsa kuchuluka kwa factor 9, kapena kuchotsa kwathunthu factor 9. Nthawi zambiri, anyamata amalandira hemophilia B ngati amayi awo ndi omwe amanyamula matendawa.

Umu ndi momwe zimachitikira:

• Tonsefe timalandira ma chromosome awiri a X kuchokera kwa amayi athu, chromosome imodzi ya X ndi chromosome imodzi ya Y kuchokera kwa abambo athu.
• Ngati mkazi ali ndi jini ya F9 yosazolowereka pa imodzi mwa ma chromosome ake a X, adzakhala ndi hemophilia B, koma sadzawonetsa zizindikiro. Izi zili choncho chifukwa ali ndi jini ya F9 yabwinobwino pa chromosome yake ina ya X.
• Mkazi uyu akhoza kupatsira mwana wake chromosome ya X yokhala ndi jini ya F9 yosazolowereka. Popeza ana aamuna ali ndi chromosome imodzi yokha ya X, adzakhala ndi hemophilia B.

Nthawi zina, kusintha kwadzidzidzi sikuchokera kwa mayi kupita kwa mwana.Hemophilia B ingathenso kuyambitsidwa ndi njira yotchedwa involution. Izi zimachitika pamene dzira ndi umuna zimagwirizana kupanga mwana wosabadwayo, yemwe kenako amagawanika ndikuyamba kupanga maselo atsopano. Maselo atsopanowa amakhala ndi makope a majini omwe anali mu selo loyambirira. Chifukwa chake, nthawi zina zolakwika, kapena kusintha kwa majini, zimatha kuchitika majini awa akakopedwa. Ngati cholakwika chichitika pamene jini ya F9 ikukopedwa, mwana wanu akhoza kukhala ndi hemophilia B kapena kukhala wonyamula hemophilia B. (Akatswiri a mbiri yakale ndi ofufuza azachipatala amakhulupirira kuti izi zinachitika kwa Mfumukazi Victoria wa ku England. Ngakhale kuti palibe m'banja lake amene anali ndi hemophilia, iye anali ndi hemophilia. Anapatsira matendawa kwa ana ake. Ana amenewo atakwatirana m'mabanja achifumu a ku Spain ndi Russia, ana awo nawonso anatenga matendawa. Pambuyo pake adadziwika kuti hemophilia B.)

Kodi zizindikiro za hemophilia B ndi ziti?

Tanena kale kuti zizindikiro za hemophilia B zimagawidwa m'magulu awiri: zofatsa, zapakati, komanso zoopsa. Madokotala amagawa izi kutengera kuchuluka kwa chinthu 9 m'magazi.

Hemophilia wofatsa B

Anthu omwe ali ndi milingo ya factor 9 pakati pa 6% ndi 49% ali ndi hemophilia B yocheperako. Zizindikiro zake zimakhala zochepa. Nthawi zina, anthu omwe ali ndi hemophilia B yocheperako amapezeka atakula, akamakonzekera opaleshoni, akatsala pang'ono kubereka mwana, atavulala kwambiri, kapena, kwa akazi, akamalandira chithandizo cha magazi ambiri a msambo.

Hemophilia B yocheperako

Anthu omwe ali ndi milingo ya factor 9 pakati pa 1% ndi 5% ali ndi hemophilia B yochepa. Zizindikiro zakenso zimakhala zochepa. Ana omwe ali ndi vutoli nthawi zambiri amayamba kusonyeza zizindikiro ali ndi miyezi 18.

Ana awa akhoza kukhala ndi zizindikiro monga:

• Mabala: Amaphwanya ndi kuphwanya mosavuta.
• Kutuluka magazi kosazolowereka: Ngati mwachitidwa opaleshoni, bala lotuluka magazi, kapena kuchotsedwa dzino, mukhoza kutuluka magazi ambiri komanso kwa nthawi yayitali kuposa masiku onse.
• Kutuluka magazi mwadzidzidzi: Nthawi zambiri, kutuluka magazi kungayambe popanda chifukwa chomveka.

Hemophilia B yoopsa

Anthu omwe ali ndi milingo ya factor 9 yochepera 1% ali ndi hemophilia B yoopsa. Zizindikiro zake zimakhala zoopsa kwambiri. Ana ena amayamba kutuluka magazi akangobadwa, atangobadwa kumene, kapena atangodulidwa. Ana ena sangasonyeze zizindikiro mpaka miyezi ingapo atangobadwa kumene. Zizindikiro zodziwika bwino ndi izi:

• Kutuluka magazi: Makanda aang'ono ndi ana aang'ono amatha kutuluka magazi mkamwa mwawo ngati chinthu chaching'ono, monga chidole, chalowa mkamwa mwawo.
• Matumbo otupa pamutu pawo: Ngati mwana wamng'ono wagunda mutu wake kwinakwake, amatha kukhala ndi matumbo omwe amaoneka ngati mazira a tsekwe.
• Kulira pafupipafupi, kusakhazikika, kapena kukana kukwawa kapena kuyenda:Izi zitha kuchitika ngati mwana ali ndi magazi m'minofu kapena malo olumikizirana mkati mwa thupi lake. Angawoneke abuluu komanso otupa m'malo ena. Angamve kutentha akakhudza ndipo mwanayo akhoza kumva kupweteka.
• Ma hematoma: Ma hematoma ndi magazi omwe amaundana pansi pa khungu. Mwana amathanso kukhala ndi ma hematoma atalandira jakisoni.
• Kuvuta kupuma: Nthawi zina, lilime la mwana limatha kutupa chifukwa cha kutuluka magazi ndikutseka njira yopumira.

Kodi madokotala amazindikira bwanji izi?

Madokotala amazindikira hemophilia B mwa kuchita mayeso akuthupi, kufufuza zizindikiro monga kuvulala ndi kutupa kwa mafupa, ndikufunsa ngati pali aliyense m'banjamo amene ali ndi hemophilia kapena matenda ena a magazi.

Kuphatikiza apo, mayeso otsatirawa amachitikanso:

• Kuwerengera Magazi Konse (CBC): Izi zimayang'ana mitundu ya maselo m'magazi ndi kuchuluka kwawo.
• Mayeso a Prothrombin Time (PT): Izi zimayesa momwe magazi anu amaundana mofulumira.
• Mayeso a Nthawi Yogwiritsidwa Ntchito Pang'ono Pang'ono a Thromboplastin: Awa ndi mayeso omwe amayesa nthawi yomwe magazi amaundana kuti apangidwe.
• Kuyeza kwa Fibrinogen: Kuyeza komwe kumayesa kuchuluka kwa puloteni yotchedwa fibrinogen, yomwe imathandiza magazi kuundana.
• Kuyesa magazi kuundana: Ichi ndi chomwe chimathandiza kudziwa mtundu weniweni wa hemophilia ndi kuopsa kwa matendawa.

Kodi mankhwala ochizira izi ndi otani?

Madokotala nthawi zambiri amachiritsa hemophilia B pogwiritsa ntchito njira yosinthira zinthu . Izi zimaphatikizapo kubaya jekeseni ya chinthu chokhazikika 9 mumtsempha. Chinthu chokhazikikachi 9 chimagwira ntchito m'malo mwa chinthu chosowa, kuthandiza kupewa kutuluka magazi kwambiri kapena kuwongolera kutuluka magazi akachitika.

Kawirikawiri, anthu omwe ali ndi hemophilia B yochepa mpaka yocheperako amafunika chithandizo ichi pokhapokha ngati akufunika kuchitidwa opaleshoni. Komabe, anthu omwe ali ndi hemophilia B yoopsa angafunike chithandizo chosinthira zinthu nthawi zonse.

Kodi pali mavuto aliwonse omwe angachitike panthawi ya chithandizo?

Mavuto ena amatha kuchitika mwa anthu omwe akumwa mankhwalawa. Zovuta zazikulu ndi kukula kwa mankhwala oletsa komanso matenda opatsirana ndi mavairasi .

Zoletsa

Mankhwala oletsa magazi amayamba pamene thupi sililandira mankhwala obwezeretsa magazi ngati gawo la magazi ake abwinobwino. Mankhwala oletsa magazi amenewa amaletsa kuti mankhwala obwezeretsa magazi asagwire ntchito bwino. Izi zimapangitsa kuti zikhale zovuta kwambiri kuletsa kapena kuchepetsa kutuluka magazi. Anthu omwe ali ndi matenda aakulu otuluka magazi omwe akulandira mankhwala ambiri a mankhwala ochepetsa magazi amakhala ndi vuto limeneli. Madokotala amachiritsa vutoli pogwiritsa ntchito zinthu zina zomwe zingapangitse magazi kuundana popanda kupitirira muyezo wa 9.

Matenda opatsirana ndi mavairasi

Matenda opatsirana ndi mavairasi monga hepatitis C nthawi zambiri amatha kuchitika pamene mankhwala olowa m'malo mwa zinthu zina agwiritsidwa ntchito, opangidwa kuchokera ku magazi operekedwa. Komabe, pogwiritsa ntchito njira zoyesera zomwe zilipo panopa, chiopsezochi n'chochepa kwambiri.

Kodi chiopsezo cha izi chingachepe?

Popeza hemophilia B ndi matenda obadwa nawo, simungathe kuletsa kuti isakule kapena kupatsira ana anu. Tiyeni tiphunzire zambiri za momwe majini amakhalira ndi matendawa:

• Ngati ndinu mkazi ndipo muli ndi jini ya F9 yosazolowereka pa imodzi mwa ma chromosome anu a X (kutanthauza kuti ndinu wonyamula), ana anu aamuna ali ndi mwayi wa 50% wokhala ndi hemophilia B, ndipo ana anu aakazi ali ndi mwayi wa 50% wokhala ndi matendawa.
• Ana anu aakazi, omwe amalandira jini iyi, amatha kupatsira ana awo aamuna hemophilia B. Ana awo aakazi akhoza kutenga matendawa.
• Ana anu aamuna omwe ali ndi hemophilia B akhoza kupatsira ana awo aakazi chromosome iyi.
• Ngati ndinu mwamuna ndipo muli ndi hemophilia B, ana anu aamuna sadzakhala ndi matendawa. Koma ana anu aakazi onse adzakhala ndi chromosome yokhala ndi jini ya F9 yosadziwika bwino.

Uphungu wa majini ndi wofunika kwambiri pankhaniyi. Ngati inu kapena wina m'banja mwanu ali ndi vuto la hemophilia, ndi bwino kukumana ndi mlangizi wa majini musanayambe kukhala ndi mwana.

Ngati ndili ndi pakati, kodi ndingadziwe pasadakhale ngati mwana wanga ali ndi vutoli?

Inde, mungathe. Madokotala angatenge chitsanzo cha magazi kuchokera mu umbilical cord yanu ndikuyesa kuti aone ngati pali zinthu zomwe zimayambitsa magazi kuundana. Mwanjira imeneyi, inu ndi iwowo mutha kudziwa pasadakhale zomwe mungayembekezere mukabereka mwana wanu komanso zomwe mungachite kuti mupewe mavuto omwe angabwere chifukwa cha kutuluka magazi.

Ngati ndili ndi hemophilia B, ndiyenera kuyembekezera chiyani?

Hemophilia B ndi matenda osatha. Madokotala sangathe kuchiza matendawo kwathunthu. Komabe, pali mankhwala omwe angapewe kapena kuchepetsa kupweteka kwambiri kwa mafupa ndi mavuto ena azachipatala. Anthu ambiri omwe ali ndi hemophilia B amatha kukhala ndi thanzi labwino akalandira chithandizo.

Anthu omwe ali ndi vuto la hemophilia B yoopsa ayenera kulandira jakisoni wolowetsedwa m'malo mwa chinthu china (ma infusions kapena jakisoni) nthawi zonse kuti achiritse mavuto otuluka magazi. Angapite kwa dokotala kuti akalandire chithandizo, achibale awo kapena osamalira awapatse jakisoni, kapena atha kupereka jakisoni okha. Komabe, anthu omwe ali ndi hemophilia B yoopsa amafunika chithandizo nthawi zonse kuti apewe kutuluka magazi kwambiri.

Angayambenso matenda ena omwe amakhudza thanzi lawo lonse komanso moyo wawo wonse. Mwachitsanzo, anthu ambiri omwe ali ndi hemophilia B ali ndi mavuto aakulu m'mawondo awo kapena m'chiuno, zomwe zimafuna opaleshoni kuti achotse mafupa owonongeka ndikuyika atsopano. Ngati muli ndi hemophilia B, funsani dokotala zomwe mungayembekezere. Iye ndiye munthu wabwino kwambiri wokupatsani chidziwitso chabwino kwambiri chifukwa amadziwa vuto lanu komanso thanzi lanu lonse.

Kodi ndiyenera kudziwa chiyani ngati mwana wanga ali ndi vutoli?

Ngati mwana wanu ali ndi hemophilia B yocheperako kapena yocheperako, ndikofunikira kudziwitsa dokotala wanu za vutoli kuti athe kupewa kutuluka magazi ambiri ngati mwana wanu achitidwa opaleshoni kapena kuchotsedwa dzino. Nazi malingaliro ena. Dokotala wanu atha kukhala ndi malingaliro ena:

• Ana anu akadali aang'ono kwambiri, onetsetsani kuti mipando yawo yayitali ndi mipando yamagalimoto ili ndi malamba oyenera otetezera.
• Akakula pang'ono n'kusewera ndi ana ena, osamalira awo ndi aphunzitsi a kusukulu ayenera kudziwa chochita ngati mwanayo wavulala mwangozi ndikuyamba kutuluka magazi.
• Mwana wanu ayenera kupewa zinthu zina, monga masewera omwe amakhudza kwambiri ena kapena kuthekera kogwa.

Nanga bwanji ngati mwana wanga ali ndi hemophilia B yoopsa?

Ana omwe ali ndi vuto lalikulu la hemophilia B adzafunika chithandizo chamankhwala kwa moyo wawo wonse - kuti apewe kapena kuchepetsa kutuluka magazi, kapena kuti athetse zizindikiro. Nazi zina mwa mavuto omwe mungakumane nawo, ndi malingaliro ena omwe angathandize:

• Makanda omwe ali ndi hemophilia B, akamaphunzira kuyenda, amatha kuyamba kutuluka magazi ngati agunda kapena kugwa. Sizotheka kupewa kugwa konse, koma ndi bwino kuyika zophimba zoteteza pamakona akuthwa a mipando m'nyumba.
• Pamene mwana wanu akukula ndikuyamba kuthamanga ndi kulumpha, lankhulani ndi dokotala wanu za zida zodzitetezera monga chisoti ndi mawondo. Ndipotu, ana onse ayenera kuvala chisoti akamakwera njinga. Mwana wanu angafunike chitetezo chowonjezera kuti apewe kugundana komwe kungayambitse kutuluka magazi.
• Mwana wanu adzafunika kupeza chithandizo chamankhwala nthawi zonse kuti asiye kutuluka magazi. Angakwiye komanso kukhumudwa chifukwa chosatha kukhala ndi anzake komanso kusowa ntchito ya kusukulu akamapita kukalandira chithandizo.
• Mwana amene ali ndi vuto la magazi otaya magazi amadziwa kuti aphunzitsi ake ndi ena amadziwa za vuto lake. Angamve kusasangalala aphunzitsi ndi ena kusukulu akamayesa kumuthandiza koma amamuchitira zinthu mosiyana.
• Ana okalamba ndi achinyamata angafunike thandizo pothana ndi malingaliro awo komanso kuthana ndi zomwe ena akuchita. Ngati mwana wanu ali mumkhalidwe wofanana, lankhulani ndi dokotala wanu za mapulogalamu kapena magulu othandizira achinyamata.

Ndili ndi hemophilia B. Kodi ndimadzisamalira bwanji?

Kukhala ndi hemophilia B kumatanthauza kutenga njira zina zowonjezera kuti muteteze thanzi lanu lonse, pamene mukusamalira chithandizo chanu. Nazi malingaliro ena:

• Dzitetezeni ku matenda: Funsani dokotala wanu za katemera woyenera kwa inu.
• Khalani ndi kulemera kwabwino: Ngati mukuvutika kuyenda chifukwa cha kutuluka magazi mkati ndi kuwonongeka kwa mafupa, kuwongolera kulemera kwanu kungakuthandizeni.
• Yambani kuchita masewera olimbitsa thupi: Mungaope kuvulala mukuchita masewera olimbitsa thupi. Lankhulani ndi dokotala wanu za njira zochepetsera chiopsezo chanu chotuluka magazi mukuchita masewera olimbitsa thupi.
• Sinthani kupsinjika kwanu: Hemophilia B ndi vuto lomwe limakhalapo kwa moyo wanu wonse. Zingafunike khama lowonjezera kuti ligwirizane ndi maudindo anu a m'banja komanso kuntchito.
• Pewani mankhwala ena ochepetsa ululu: Ngati muli ndi hemophilia B, simuyenera kumwa aspirin kapena ibuprofen. Mankhwala ochepetsa ululu amenewa amasokoneza magazi kuundana.

Muyenera kuonana ndi dokotala wanu kuti akupatseni chithandizo chomwe mwakonza komanso nthawi iliyonse mukakhala ndi zizindikiro zina, monga kutuluka magazi kosazolowereka kapena kupweteka kwambiri kwa mafupa.

Kodi ndi liti pamene muyenera kupita kuchipatala chadzidzidzi?

Ngati mwavulala mutu , muyenera kupita kuchipatala nthawi yomweyo. Zizindikiro izi zingasonyeze kuti muli ndi magazi m'mutu mwanu (intracranial hemorrhage):

• Mutu.
• Kufooka.
• Kusanza ndi kusanza.
• Kusanza kapena kufooka.

Ngati simungathe kuletsa kutuluka magazi kuchokera ku bala lililonse, kapena ngati mwayamba kutuluka magazi popanda chifukwa, onani dokotala wanu kapena pitani kuchipatala chadzidzidzi nthawi yomweyo.

Pomaliza, zinthu zoti muzikumbukira (Uthenga Wopita Nawo Kunyumba)

Hemophilia B ndi mtundu wina wosowa wa matenda osowa. Monga hemophilia A, hemophilia B ndi matenda obadwa nawo otuluka magazi. Ngakhale kuti kafukufuku akusonyeza kuti anthu omwe ali ndi hemophilia B angakhale ndi zizindikiro zochepa kuposa omwe ali ndi hemophilia A, hemophilia B ikadali vuto lomwe limayambitsa mavuto ambiri azachipatala, moyo, komanso maganizo.

Azimayi omwe ali ndi vutoli angadandaule kuti ana awo adzalandira matendawa. Makolo a mwana yemwe ali ndi hemophilia B angadandaule kuti ateteze mwana wawo ku kuvulala mwangozi. Pambuyo pake, angafunike kuthandiza mwana wawo yemwe akukula kuphunzira kukhala ndi hemophilia B. Anthu omwe ali ndi hemophilia B yoopsa angafunike chithandizo cha moyo wawo wonse kuti apewe kutuluka magazi kwambiri.

Koma pali chiyembekezo! Ofufuza akufufuza njira zatsopano zochiritsira, monga kusintha majini ndi chithandizo cha majini. Izi zingapangitse kusiyana kwakukulu pa momwe hemophilia B yoopsa imachiritsidwira. Ngati inu kapena mwana wanu ali ndi vutoli, funsani dokotala wanu za mayeso azachipatala omwe angakhale oyenera kwa inu. Kumbukirani, ndi upangiri woyenera wachipatala ndi chithandizo, mutha kukhala ndi moyo wopambana komanso wathanzi ndi hemophilia B.

Hemophilia B, kutuluka magazi, matenda a majini, magazi kuundana, Factor IX, matenda obadwa nawo, matenda a Khirisimasi