Ganda rako rinongoerekana ratsvuka, raita maronda, uye rabvaruka here? Ngatidzidzei nezvechirwere ichi chine njodzi cheStevens-Johnson Syndrome (SJS) here?

Wakamboona here, kana kuti zvakaitika kwauri, mapundu akangoerekana atsvuka mumuviri wako, oita semapundu, obva abuda maronda uye ganda robva rabuda? Mapundu aya anogonawo kuoneka mumuromo, mumaziso, uye munzvimbo yepabonde. Ichi hachisi chinhu chiri nyore, uye chinogona kuva chirwere chakakomba chinoda kuendeswa kuchipatara nekukurumidza . Nhasi, tichataura nezvechirwere ichi chinonzi Stevens-Johnson Syndrome (SJS).

Chii chinonzi Stevens-Johnson Syndrome (SJS)?

Zvichitaurwa zviri nyore, Stevens-Johnson Syndrome (SJS) neToxic Epidermal Necrolysis (TEN) zvirwere zviviri zvakakomba zveganda. Chinoitika ndechekuti ganda rako rinotanga kubuda mapundu matsvuku, anokwenya, ayo anobva abuda mavanga uye obva abuda. Izvi zvinogona kukanganisawo maziso ako, nhengo dzesikarudzi, uye mucous membranes mumuromo mako. Kana ukava nematambudziko aya, zvechokwadi uchafanira kuendeswa kuchipatara kuti unorapwa.

Vamwe vanachiremba vanoona SJS neTEN sezvirwere zviviri zvakasiyana, nepo vamwe vachiti zvikamu zvakasiyana zvechirwere chimwe chete. SJS rudzi rwechirwere rusina kunyanya kuoma pane TEN. Semuenzaniso, muSJS, pasi pe10% yeganda pamuviri wese rinogona kurasika. MuTEN, anopfuura 30% yeganda anogona kurasika. Zvisinei, zvakakosha kuyeuka kuti mamiriro ese ari maviri anogona kuisa hupenyu panjodzi .

Ndeapi mamwe mazita ane SJS?

Ehe, izvi zvinodanwa nemamwe mazita akati wandei. Semuenzaniso:

• Chirwere cheLyell
• Stevens-Johnson syndrome/toxic epidermal necrolysis
• Stevens-Johnson syndrome ine chepfu epidermal necrolysis spectrum

Dzimwe nguva, zita rinoshanduka zvichienderana nechikonzero. Kana zvakakonzerwa nemushonga, zvinogona kunzi ``drug-induced Stevens-Johnson syndrome'', uye kana zvakakonzerwa nehutachiona hunonzi ``Mycoplasma'', zvinogona kunzi ``mycoplasma-induced Stevens-Johnson syndrome''.

Ndiani ane mukana mukuru wekuwana chirwere cheSJS?

SJS inowanzoonekwa muvechidiki vari pasi pemakore makumi matatu uye muvana vadiki. Zvisinei, inogona kuitika kuvanhu vemazera ese, kunyanya vakwegura. Vakadzi vane mukana mukuru wekuwana SJS kupfuura varume.

Fungidzira, kana mwana mudiki akawana chirwere chakadai sepneumonia obva aita dambudziko reganda rakadai... rinogona kunge riri SJS. Chikonzero chikuru cheSJS muvana hutachiona hwakadai sepneumonia. Asi muvakuru, SJS/TEN inonyanya kukonzerwa nemishonga yavanotora.

Ndezvipi zvinhu zvinokonzera njodzi yekukura kweSJS?

Hapana chikonzero chimwe chete chechirwere ichi, asi musanganiswa wezvinhu. Chinonyanya kukosha pane izvi inyaya yemajini. Kureva kuti, majini ako anogona kunge aine simba. Zvimwe zvinhu zvezvakatipoteredza zvinogonawo kumutsa majini iwayo. Chimwe chezvinhu izvi zvemajini inhengo dzemuviri wedu dzinonzi `(Human Leukocyte Antigens - HLAs). Vanhu vane mamwe marudzi e`(HLAs)` aya vari panjodzi huru yekubatwa neSJS kana TEN kupfuura vamwe.

Ndezvipi zviratidzo zveSJS?

Kune zviratidzo zvakawanda zvinogona kuitika muSJS. Zvakakosha kuziva izvi:

• Kurwadziwa kwakanyanya paganda: Kutanga, ganda rinotanga kurwadza.
• Fivha: Une fivha.
• Kurwadziwa kwemuviri: Zvinonzwa sekunge muviri wako wese unorwadza.
• Mavara matsvuku kana kuti mavanga paganda: Mavara matsvuku kana kuti mavanga anoonekwa paganda.
• Kukosora.
• Maronda nemaronda: Maronda nemaronda zvinogona kuitika kwete paganda chete, asiwo paganda remukati memuromo munzvimbo dzakadai semuromo, pahuro, mumaziso, panhengo dzesikarudzi, uye mudura. Fungidzira, maronda ari mumuromo anoita kuti zviome kwete kungodya chete asiwo kutaura.
• Kubviswa kweganda: Ganda rinobviswa kubva pamapundu.
• Kudonhedza mate: Nekuda kwemaronda emuromo, mate anobuda kana usingakwanise kuvhara muromo wako.
• Kuzvimba kwemaziso: Maronda nekuzvimba kwemaziso zvinoita kuti maziso azvimbe zvekuti haakwanise kuvhurwa.
• Marwadzo panguva yekuzviitira weti: Maronda ari mudumbu anokonzera marwadzo akanyanya panguva yekuzviitira weti.

Fungidzira watanga mushonga mutsva, uye mukati memazuva mashoma unonzwa kusanzwa zvakanaka, une fivha, uye kurwadziwa, uye ipapo kamwe kamwe mavara matsvuku anoonekwa paganda rako uye maronda anoonekwa... Ndipo paunofanira kutanga kufungidzira kuti iyi iSJS.

Chii chinokonzera SJS?

Kune zvikonzero zvikuru zveSJS:

• Kurwara nemushonga: Ichi ndicho chikonzero chikuru chezvirwere zvakawanda zveSJS uye zvese zvine gumi. Izvi zvinogona kuitika kana ukarasikirwa nemushonga wauri kutora.
• Utachiona: Semuenzaniso, hutachiona hwakadai seMycoplasma pneumonia, Herpes virus, uye Hepatitis A.
• Chirwere chegraft-versus-host: Ichi chirwere chinogona kuitika, kunyanya mushure mekuisirwa mubofu.
• Hapana chikonzero chakawanikwa: Dzimwe nguva SJS inogona kukura pasina chikonzero chakajeka.

Kana uine SJS nekuda kwemushonga, zviratidzo zvinowanzotanga kuoneka mukati mevhiki imwe, mbiri, kana nhatu mushure mekutanga mushonga. Unogona kutanga nefivha, kukosora, uye musoro, zvichiteverwa nemapundu eganda uye kusviba. Mune vamwe vanhu vane TEN, bvudzi nenzara zvinogona kutodonha. Kashoma, SJS inonzi inokonzerwa nejekiseni rakapihwa munguva pfupi yapfuura.

Ndeipi mishonga inonyanya kukonzera SJS?

Kune mimwe mishonga ine njodzi huru yekukonzera SJS. Iyi inosanganisira:

• Mishonga yesulfa inorwisa mabhakitiriya.
• Mishonga yekurwisa pfari: Mienzaniso inosanganisira Phenytoin (Dilantin®), Carbamazepine (Tegretol®), Lamotrigine (Lamictal®), uye Phenobarbital (Luminal®).
• `(Allopurinol (Aloprim®, Zyloprim®))`: Uyu mushonga unoshandiswa pakurapa gout nematombo eitsvo.
• Mishonga isingashandisi steroidal inorwisa kuzvimba (NSAIDs): Mienzaniso inosanganisira Piroxicam (Feldene®), Nevirapine (Viramune®), uye Diclofenac (Cambia®, Flector®).
• Mamwe maantibayotiki.

Zvakakosha: Izvi hazvirevi kuti munhu wese anotora mishonga iyi achabatwa nechirwere cheSJS. Zvisinei, mishonga iyi yakawanikwa iine njodzi yakakura yekubatwa nechirwere cheSJS.

Pane zvimwe zvinhu zvinowedzera njodzi yekubatwa nechirwere cheSJS here?

Ehe, kune mamwe mamiriro ezvinhu anowedzera njodzi yekubatwa neSJS. Aya ndiwo:

• Mushure mekuisirwa mapfupa emupfupa.
• Kuva nezvirwere zve autoimmune zvakaita se `(Systemic lupus erythematosus - SLE)`.
• Utachiona hweHIV (Human immunodeficiency virus).
• Zvimwe zvirwere zvisingaperi zvemajoini nematishu akabatana.
• Kenza.
• Kuva nedziviriro yemuviri isina simba.
• Kana mumwe munhu mumhuri yako akambova neSJS (nhoroondo yemhuri).
• Kuva nerudzi rwejini rakasiyana rinonzi ``Human Leukocyte Antigen-B - HLA-B''.

Vanachiremba vanoongorora sei chirwere ichi cheSJS?

Vanachiremba vanoongorora SJS neTEN nekufunga nezvezvinhu izvi:

• Kuongororwa kweganda rakakanganiswa uye matumbu: Kazhinji kacho matumbu maviri anokanganiswa.
• Zvichienderana nekurwadziwa kwaunonzwa.
• Zvichienderana nekuti ganda rako rakakurumidza sei kukanganiswa.
• Zvichienderana nekuti ganda rako rakanganiswa zvakadii.
• Kuongororwa kweganda: Dzimwe nguva, ganda diki rinotorwa roongororwa pasi pemaikorosikopu kuti rionekwe kuti chirwere chacho chakaonekwa here.

SJS inorapwa sei ?

SJS chirwere chinoda kuendeswa kuchipatara nekukasika uye kurapwa. Kuedza kuchirapa uri kumba kunogona kuita kuti chirwere chacho chiwedzere kuipa. Aya ndiwo mamwe emishonga:

• Mira mushonga unofungidzirwa kuti ndiwo uri kukonzera dambudziko nekukasika: Ichi ndicho chinhu chekutanga chekuita.
• Mvura inopinzwa mutsinga (IV) yekudzoreredza ma electrolytes: Izvi zvinoitirwa kudzora kurasikirwa kwemvura mumuviri sezvo ganda richibviswa.
• Kuisa machira asina kunamira paganda rakakanganiswa.
• Kupa chikafu chine macalorie akawanda kuti ukurumidze kupora: Dzimwe nguva, kudyisa mwana nechubhu kunogona kudiwa.
• Kupa mishonga inorwisa mabhakitiriya kana zvichidikanwa kudzivirira hutachiona.
• Kupa mishonga inoderedza marwadzo.
• Kurapwa muchipatara, pamwe muIntensive Care Unit (ICU) kana muBurn Unit.
• Kutsvaga rubatsiro kubva kumapoka enyanzvi akadai seDermatology neOphthalmology (kana maziso akakuvara).
• Mune zvimwe zviitiko, mishonga chaiyo yakadai se IV immunoglobulin, cyclosporine, IV steroids, kana amniotic membrane grafts (yemaziso) inogona kupihwa.

Ndezvipi zvinetso zvinogona kuitika nekuda kweSJS?

Nekuti SJS neTEN zvirwere zvakakomba, matambudziko anogona kuva akaoma.

• Rufu: Iri ndiro dambudziko guru. Vanenge 10% yevarwere vane SJS uye vanenge 50% yevarwere vane TEN vanogona kufa.
• Chirwere chemabayo.
• Sepsis: Utachiona hwebhakitiriya hwakakomba, hwakafanana nekuchetura ropa.
• Mamiriro ekuvhunduka `(Kuvhunduka)`.
• Kukundikana kwemitezo yakawanda.

Imhaka yematambudziko aya akakomba anoita kuti zvirwere zveSJS/TEN zvide kuendeswa kuchipatara nekukasika.

SJS inogona kudzivirirwa here?

Kutaura zvazviri, kazhinji, SJS haigone kudzivirirwa. Nekuti inowanzo kukonzerwa nekuita kwemushonga usingatarisirwi, hapana nzira yekuziva kana izvi zvichaitika usati watora mushonga.

Zvisinei, kana ukaonekwa uine chirwere chinokonzerwa nemishonga, chinhu chakakosha ndechekuti usazomboshandisa mushonga iwoyo kana mimwe mishonga yakafanana nayo zvakare. Zvakakosha kuzivisa chiremba wako nezveizvi uye kuzvinyora muzvinyorwa zvako zvekurapa.

Chii chiri tarisiro yemunhu ane SJS? (Outlook)

Havasi vese vane SJS vanowana zviratidzo zvakafanana. Vamwe vanhu vanopora mukati memavhiki mashoma. Zvisinei, kana zviratidzo zvacho zvakanyanya, zvinogona kutora mwedzi kuti vapore zvizere. Vamwe vanhu vanogona kusangana nemigumisiro yenguva refu. Semuenzaniso:

• Ganda: Ganda rakaoma, kuvaviwa, ganda richichinja ruvara.
• Maziso: Kuzvimba kana kuoma nguva nenguva, kuzvimba kwemaziso nguva nenguva, kuona zvisipo, kunzwa chiedza (photophobia).
• Kudikitira zvakanyanya.
• Kukuvara kwemapapu: Matambudziko akadai sechirwere chemapapu chinogara kwenguva refu (COPD), asima.
• Nzara dzinodonha kana kuti dzinova dzakaremara.
• Kudonha kwebvudzi (Alopecia).
• Kuoma kwemukati memukati: Izvi zvinogona kukonzera matambudziko akaita sekuita weti.
• Chirwere chekuneta kwenguva refu.
• Kuchinja kwekuravira.

Chinokosha ndechekuti chirwere ichi chinogona kudzoka kana munhu akadzokera kuchirwere chacho. Kana izvozvo zvikaitika, zviratidzo zvacho zvinowanzova zvakanyanya kechipiri.

Vanenge 10% yevarwere veSJS uye 30% yevarwere veTEN vanofa, kunyanya nekuda kwe sepsis, acute respiratory distress syndrome (ARDS), uye multiple organ failure.

Heano zvimwe zvinhu zvaunofanira kuyeuka kubva pane zvatataura nezvazvo (Mharidzo Yekuenda Kumba):

Zvakanaka, saka tataura zvakawanda nezvechirwere ichi chine njodzi chinonzi SJS. Heano zvimwe zvinhu zvaunofanira kuyeuka:

• Stevens-Johnson Syndrome (SJS) uye Toxic Epidermal Necrolysis (TEN) zvirwere zvakakomba zvikuru, zvinotouraya ganda.
• Kana ukaona zviratidzo zvakaita sekurwadziwa kweganda, mavanga matsvuku, maronda, ganda riri kusvuuka, kana maronda emuromo kana emaziso mushure mekutanga mushonga mutsva, kunyanya mukati mevhiki imwe kana maviri, tsvaga rubatsiro rwechiremba nekukasika. Inogona kunge iri SJS.
• Gara uchiudza chiremba wako kana wakambova neallergy kana kuti wakambosangana nedambudziko rakakura remushonga kare.
• Usamboshandisa mushonga kana mimwe mishonga yakafanana yakaonekwa kuti ndiyo inokonzera SJS zvakare.**
• Kana uchifungidzira kuti chirwere ichi chingaitika, usagare kumba, enda kuchipatara nekukasika. Kurapwa nekukurumidza kunogona kuponesa hupenyu hwako.

Ndinovimba ruzivo urwu ruchakubatsira. Ramba uine hutano hwakanaka!

` Stevens-Johnson Syndrome, SJS, Toxic Epidermal Necrolysis, TEN, Zvirwere zveganda, Kurwara, Migumisiro yemishonga, Mapundu, Mapundu eganda, Zvirwere zveganda