Indwara ya Kawasaki ni iki? Ibimenyetso, Impamvu, n’Ubuvuzi

Indwara ya Kawasaki ni uburwayi butera kubyimba mu mitsi y’amaraso mu mubiri wose, cyane cyane bikaba ku bana bari munsi y’imyaka 5. Nubwo izina rishobora kuba ritamenyekanye, iyi ndwara iraboneka kurusha uko ababyeyi benshi babizi, kandi igihe ivuwe neza, abana benshi barakira batagize ingaruka zirambye.

Tekereza ko ubwirinzi bw’umwana wawe bwakabije, bugatuma bugaba igitero ku mitsi y’amaraso imeze neza. Inkuru nziza ni uko abaganga babaye abahanga cyane mu kumenya no kuvura iyi ndwara, cyane cyane igihe yafashwe hakiri kare.

Indwara ya Kawasaki ni iki?

Indwara ya Kawasaki ni uburwayi butera kubyimba, bugira ingaruka ku mitsi y’amaraso, cyane cyane imitsi y’amaraso ijyana amaraso mu mutima. Izwi kandi nka mucocutaneous lymph node syndrome kuko igira ingaruka ku ruhu, ku mumaso, no ku mitsi ya lymph.

Ubu burwayi bugira ingaruka ku bana gusa, hafi 80% by’ababwanduye bakaba ari abana bari munsi y’imyaka 5. Nubwo bishobora gutera ubwoba igihe umwana wawe abonye iyi ndwara, ni ingenzi kumenya ko indwara ya Kawasaki ivurwa, kandi abana benshi bakomeza kubaho ubuzima busanzwe, bwiza.

Iyi ndwara yavumbuwe bwa mbere na Dr. Tomisaku Kawasaki mu Buyapani mu 1967. Uyu munsi, imenyekanye ku isi hose nk’imwe mu mpamvu nyamukuru z’indwara z’umutima ziterwa n’ibindi mu bana mu bihugu byateye imbere, ariko kuvurwa vuba bigabanya cyane ibyago byo kugira ibibazo by’umutima.

Ni ibihe bimenyetso by’indwara ya Kawasaki?

Ibimenyetso by’indwara ya Kawasaki bisanzwe bigaragara mu byiciro, kandi kubimenya hakiri kare bishobora kugira uruhare runini mu kuba umwana wawe yakira. Ikimenyetso nyamukuru ni umuriro mwinshi ukomeza iminsi 5 cyangwa irenga, kandi udatanga umusaruro ku miti isanzwe y’umuriro nka acetaminophen cyangwa ibuprofen.

Dore ibimenyetso nyamukuru abaganga bashaka, kandi ushobora kubibona bigaragara mu minsi myinshi:

• Umuriro mwinshi (102°F cyangwa hejuru) ukomeza iminsi 5 cyangwa irenga kandi udatanga umusaruro ku miti isanzwe y’umuriro
• Amaso atukura, afite amaraso adafite ibinyabutabire cyangwa ibintu byumye, bikagira ingaruka ku maso yombi
• Uruhu rufite ibibara ku mubiri rushobora kugaragara nk’ibice bitukura, ibintu byuzuye, cyangwa bigasa n’igituntu
• Iminwa itukura, yabyimbye, cyangwa yacitse n’“ururimi rw’icunga” rugaragara rutukura kandi rufite ibintu byuzuye
• Imitsi ya lymph yabyimbye mu ijosi, akenshi ku ruhande rumwe kandi ikaba nini kurusha akaguru k’inkoko
• Amaboko n’ibirenge bitukura, byabyimbye bishobora nyuma y’igihe kugira uruhu rw’amaboko n’ibirenge

Umwana wawe ashobora kandi kugira umujinya ukabije kurusha ubusanzwe bw’abana, hamwe n’umunaniro no kubura ubushake bwo kurya. Bamwe mu bana barwara ububabare mu nda, isesemi, cyangwa impiswi.

Ni ingenzi kumenya ko atari buri mwana wese uzagira ibi bimenyetso byose, kandi ntibigaragara igihe kimwe. Ibi bishobora gutuma kuvura bigorana, niyo mpamvu ari ingenzi gushaka ubuvuzi igihe umwana wawe afite umuriro mwinshi ukomeza hamwe n’ibindi bimenyetso.

Ni iki giterwa indwara ya Kawasaki?

Impamvu nyakuri y’indwara ya Kawasaki ntiramenyekana, ibyo bishobora gutera ikibazo ku babyeyi bashaka ibisobanuro. Ariko rero, abashakashatsi bizera ko bishobora guterwa n’ihuriro ry’ibintu by’umurage n’ibintu byo mu kirere, aho kuba impamvu imwe.

Hari imitekerereze myinshi ku byatera iyi ndwara iriko irakorwaho ubushakashatsi:

• Ibinyabuzima byanduza nka virusi cyangwa bagiteri bitera ubwirinzi budasanzwe mu bana bafite ubushobozi
• Ibintu by’umurage bituma bamwe mu bana bahora bafite ibyago byinshi, kuko iyi ndwara iboneka cyane mu bana b’Abayasiya
• Uburozi cyangwa ibintu byo mu kirere bishobora kugira uruhare mu kubyimba
• Ubwirinde bw’umubiri aho ubwirinzi bw’umubiri bugaba igitero ku mitsi imeze neza

Icy’ingenzi ni ukumva ko indwara ya Kawasaki idanduza. Ntushobora kuyanduza undi muntu, kandi umwana wawe ntashobora kuyanduza abavandimwe cyangwa bagenzi be. Ntabwo iterwa n’icyo wakoze cyangwa utakoreye nk’umubyeyi.

Iyi ndwara isa n’iboneka cyane mu mezi y’itumba n’impeshyi, rimwe na rimwe ikaba mu duce duto mu muryango, bigaragaza ko ibintu byo mu kirere bishobora kugira uruhare mu gutera iyi ndwara mu bana bafite ubushobozi bw’umurage.

Ni ryari ukwiye kujya kwa muganga kubera indwara ya Kawasaki?

Ukwiye guhamagara muganga wawe umwana wawe igihe afite umuriro wa 102°F (39°C) cyangwa hejuru ukomeza iminsi irenga 3, cyane cyane igihe uherekejwe n’ibindi bimenyetso byavuzwe haruguru. Ntugatege amatsiko yose kugira ngo agaragare.

Shaka ubuvuzi bwihuse igihe umwana wawe abonye ibimenyetso bikomeye nko kugira ikibazo cyo guhumeka, umujinya ukabije udashobora guhumurizwa, ibimenyetso byo gucika amazi, cyangwa igihe uhangayikishijwe n’ubuzima bwe muri rusange. Izera impano yawe nk’umubyeyi – igihe ikintu kimeze nabi cyane, bihora byiza guhitamo uburyo bwiza.

Kumenya no kuvura hakiri kare ni ingenzi mu gukumira ingaruka, cyane cyane ibibazo by’umutima. Igihe uhangayikishijwe n’indwara ya Kawasaki, ntutinye guharanira umwana wawe no gusaba isuzuma ryuzuye, nubwo umaze kubona muganga kandi umuriro ukomeza.

Ni ibihe bintu byongera ibyago byo kurwara indwara ya Kawasaki?

Nubwo umwana wese ashobora kurwara indwara ya Kawasaki, hari ibintu bimwe na bimwe bishobora kongera ibyago byo kurwara iyi ndwara. Kumenya ibi bintu byongera ibyago bishobora kugufasha kuba maso ku bimenyetso, nubwo ufite ibyago byinshi ntibisobanura ko umwana wawe azayirwara.

Ibintu byongera ibyago nyamukuru birimo:

• Imyaka – Abana bari munsi y’imyaka 5 nibo bakunda kurwara, umubare munini ukaba uri hagati y’imyaka 1-2
• Ubwoko – Abana b’Abayasiya, cyane cyane abo mu Buyapani no muri Koreya, bafite umubare munini
• Igitsina – Abahungu bafite ibyago byinshi kurusha abakobwa
• Amateka y’umuryango – Kugira umuvandimwe warwaye indwara ya Kawasaki byongera ibyago, nubwo bikiri bike
• Aho uba – Umubare munini uboneka mu turere tumwe na tumwe, cyane cyane muri Aziya no mu baturage b’Abayasiya ku isi

Ni ingenzi kwibuka ko abana benshi, ndetse n’abafite ibyago byinshi, batazagira indwara ya Kawasaki. Ibi bintu bifasha abaganga gukora isuzuma no kuba maso ku bimenyetso mu bantu bafite ibyago byinshi.

Ni izihe ngaruka zishoboka z’indwara ya Kawasaki?

Nubwo abana benshi bakira neza indwara ya Kawasaki, ikibazo gikomeye ni ibibazo by’umutima, cyane cyane igihe iyi ndwara idavuwe cyangwa kuvurwa bikadindira. Kumenya ibi bishoboka bishobora gufasha gushimangira akamaro ko kuvurwa hakiri kare.

Ingaruka nyamukuru abaganga bakurikirana harimo:

• Kubyimba kw’imitsi y’amaraso y’umutima – Kugabanyuka no kubyimba kw’imitsi y’amaraso y’umutima, bibaho hafi 25% mu bantu batavuwe ariko bigabanuka kugera kuri 3-5% igihe bavuwe vuba
• Ibibazo by’umuvuduko w’umutima – Umuvuduko w’umutima utari mwiza ushobora gusaba gukurikiranwa
• Kubyimbirwa kw’umutima (myocarditis) – Kubyimbirwa kw’umutima bishobora kugira ingaruka ku mikorere yawo
• Ibibazo by’amavavu – Ibibazo ku mavavu y’umutima acunga amaraso
• Amaraso akabana – Cyane cyane mu bice imitsi y’amaraso yangiritse

Gake, bamwe mu bana bashobora kugira ububabare bw’ingingo, gutakaza kumva, cyangwa kubyimba kw’igifu. Igice kinini cy’izi ngaruka zirindwa hakiri kare, niyo mpamvu kumenya ibimenyetso vuba ari ingenzi cyane.

Igihe havuwe neza, ibyago byo kugira ibibazo bikomeye by’umutima bigabanuka cyane. Abana benshi bavuwe mu minsi 10 ya mbere barwaye bagira ubuzima bwiza igihe kirekire kandi bashobora gukora ibikorwa byose bisanzwe by’abana.

Indwara ya Kawasaki imenyekana ite?

Kumenya indwara ya Kawasaki bishobora kugorana kuko nta kizami kimwe kigaragaza iyi ndwara. Ahubwo, abaganga bakoresha ibipimo by’ubuvuzi bushingiye ku bimenyetso by’umwana wawe kandi bakareba izindi ndwara zishobora gutera ibimenyetso bisa.

Muganga wawe azasuzumana umwana wawe kandi arebe ibimenyetso byihariye. Azategeka kandi ibizami byinshi kugira ngo ashyigikire ubuvuzi kandi arebe ingaruka:

• Ibizami by’amaraso kugira ngo arebe ibimenyetso by’ububyimba, nko kugira umubare munini w’uturemangingo tw’amaraso yera na C-reactive protein
• Echocardiogram (umuvuduko w’umutima) kugira ngo asuzume imitsi y’amaraso y’umutima n’imikorere y’umutima
• Electrocardiogram (ECG) kugira ngo asuzume ibibazo by’umuvuduko w’umutima
• Ibizami by’inkari kugira ngo akureho izindi ndwara kandi arebe poroteyine mu nkari
• Umuco w’umunwa cyangwa indi muco kugira ngo akureho indwara ziterwa na bagiteri

Ubuvuzi busanzwe bukorwa igihe umwana afite umuriro iminsi 5 cyangwa irenga hamwe n’ibintu byihariye byibuze bine muri bitanu. Ariko rero, abaganga bafite ubunararibonye bashobora kuvura “indwara ya Kawasaki itarangiye” igihe ibipimo bike aribyo byuzuye ariko ishusho muri rusange ikaba ihuye.

Muganga wawe ashobora kandi kugisha inama abaganga b’abana, cyane cyane abaganga b’indwara z’umutima cyangwa abaganga b’indwara z’imitsi, kugira ngo yemeze ubuvuzi kandi ategure gahunda y’ubuvuzi bwiza bw’umwana wawe.

Ni iki kivura indwara ya Kawasaki?

Ubuvuzi bw’indwara ya Kawasaki bugamije kugabanya kubyimba no gukumira ibibazo by’umutima. Inkuru nziza ni uko igihe ubuvuzi butangiye hakiri kare, bugira ingaruka nziza mu gukumira ibibazo bikomeye no gufasha abana gukira neza.

Ubuvuzi nyamukuru itsinda ry’abaganga ry’umwana wawe rizakoreshwa harimo:

• Intravenous immunoglobulin (IVIG) – Gutera inshinge nyinshi z’antibody bifasha gutuza ubwirinzi no kugabanya kubyimba
• Aspirine nyinshi – ikoreshwa mu ntangiriro kugira ngo igabanye kubyimba n’umuriro, hanyuma ikomeza mu bwinshi buke kugira ngo ikumire amaraso akabana
• Corticosteroids – Rimwe na rimwe byongerwa ku bana bafite ibyago byinshi byo kugira ibibazo by’umutima cyangwa abatanga umusaruro ku buvuzi bwa mbere
• Imiti yongeyeho – nka infliximab cyangwa indi miti ihindura ubwirinzi ku bana barwaye cyane cyangwa batavuwe

Ubuvuzi busanzwe butangira mu bitaro, aho umwana wawe ashobora gukurikiranwa hafi. Abana benshi batangira kumva neza mu masaha 24-48 nyuma yo guhabwa IVIG, umuriro ugabanuka kandi umujinya ugabanuka cyane.

Igihe cyo kuvura gitandukanye, ariko abana benshi bashobora gutaha mu minsi mike igihe umuriro wabo uhagaritse kandi bameze neza. Kwitabwaho nyuma y’ubuvuzi ni ingenzi kandi bizaba birimo gukurikirana umutima buri gihe hakoreshejwe echocardiograms kugira ngo habeho kugenzura ko nta ngaruka zibaye.

Uko watanga ubuvuzi bw’i mu rugo mu gihe cyo gukira indwara ya Kawasaki

Igihe umwana wawe avuye mu bitaro, hari uburyo bwinshi bw’ingenzi ushobora gushyigikira gukira kwe no kumufasha kumva aruhutse. Ikintu nyamukuru ni ugukurikiza amabwiriza y’itsinda ry’abaganga bawe mugihe utanga ubufasha buhumuriza, bufite urukundo.

Dore uko ushobora gufasha umwana wawe mu gihe cyo gukira:

• Gucunga imiti – Fata aspirine uko yategetswe, nubwo umwana wawe yumva ameze neza, kandi ntuyihebe nta burenganzira bwa muganga
• Ibintu bihumuriza – Tanga ibiryo byoroshye, bikonje kubera umunwa n’ijosi bibabaza, kandi koresha amavuta adafite impumuro nziza ku ruhu rw’amaboko n’ibirenge
• Guhindura ibikorwa – Reka gukina utuje no kuruhuka uko bishoboka, ariko wirinde ibikorwa bikomeye by’umubiri kugeza igihe muganga abyemeje
• Gukurikirana – Kora isuzuma ry’ibimenyetso bishya kandi uzirikane uko umwana wawe ameze umunsi ku munsi
• Gusubira kwa muganga – Ntiwibagirwe gusubira kwa muganga, nubwo umwana wawe asa n’ameze neza rwose

Umwana wawe ashobora kugira uruhu rw’amaboko n’ibirenge mu gihe cyo gukira, ibyo ni ibisanzwe kandi ntibibabaza. Ibi bisanzwe bibaho ibyumweru 2-3 nyuma y’indwara kandi bizakira ubwabyo.

Ni ibisanzwe ko abana bananiwe kurusha ubusanzwe ibyumweru byinshi nyuma y’indwara ya Kawasaki. Reka aruhuke cyane kandi ntutinye igihe umwana wawe akeneye ibitotsi byinshi cyangwa igihe cyo gutuza kurusha ubusanzwe mu gihe cyo gukira.

Uko wakwitegura kujya kwa muganga

Kwitunganya kujya kwa muganga kw’umwana wawe bishobora gufasha kugira ngo ubone ubuvuzi bwiza kandi buhamye. Kwitunganya neza no gukora isuzuma ryuzuye bishobora kugira uruhare runini mu kuba byakira.

Mbere y’isura, kora isuzuma ry’ibi bintu by’ingenzi:

• Igihe ibimenyetso byagaragaye – Andika igihe buri kimenyetso cyatangiye, igihe cyakomeje, n’impinduka wabonye
• Inyandiko y’ubushyuhe – Kora inyandiko y’ubushyuhe bw’umwana wawe, harimo ubushyuhe nyabwo n’igihe
• Amafoto – Fata amafoto y’ibibara, amaso atukura, cyangwa ibindi bimenyetso bigaragara kugira ngo ubigaragarize muganga
• Inyandiko y’imiti – Harimo imiti yose, ibintu byongera imbaraga, n’imiti yo mu rugo wagerageje
• Ibibazo – Andika impungenge zawe n’ibibazo byawe kugira ngo wibuke iby’ingenzi

Mu gihe cy’isura, ntutinye kubabaza ibibazo cyangwa gusaba ibisobanuro igihe utumva ikintu. Menya ko usobanukiwe gahunda y’ubuvuzi, icyo ukwiye kwitondera i mu rugo, n’igihe ukwiye guhamagara muganga.

Igihe uhangayikishijwe n’indwara ya Kawasaki, bivuge kuri muganga wawe. Nubwo azasuzuma ibintu byinshi, ibitekerezo byawe ku mpungenge runaka bishobora gufasha kuyobora isuzuma rye kandi bikabuza ikintu cy’ingenzi kitagira icyo gikora.

Icy’ingenzi cyo kwibuka ku bijyanye n’indwara ya Kawasaki

Ikintu cy’ingenzi cyo kwibuka ku bijyanye n’indwara ya Kawasaki ni uko kumenya no kuvura hakiri kare bigira ingaruka nziza ku bana benshi. Nubwo iyi ndwara ishobora gutera ubwoba, cyane cyane igihe umwana wawe arwaye, ubuvuzi bw’ubu bumaze kuyivura.

Izera impano yawe nk’umubyeyi. Igihe umwana wawe afite umuriro mwinshi ukomeza hamwe n’ibindi bimenyetso bibangamira, ntutinye gushaka ubuvuzi. Kuvurwa hakiri kare bishobora gukumira ingaruka zikomeye kandi bifasha umwana wawe gusubira mu bikorwa bisanzwe vuba.

Abana benshi bavuwe vuba indwara ya Kawasaki bakomeza kubaho ubuzima busanzwe, bwiza nta ngaruka zirambye. Hamwe no gukurikirana neza no gukurikirana, ushobora kwizera ko umwana wawe azakira neza kandi akomeze gutera imbere.

Ibibazo byakunze kubaho ku bijyanye n’indwara ya Kawasaki

Q1: Ese indwara ya Kawasaki iranduza?

Oya, indwara ya Kawasaki ntiranduza. Umwana wawe ntashobora kuyanduza undi muntu, kandi ntashobora kuyanduza abavandimwe, bagenzi be, cyangwa undi muntu uwo ari we wese. Bishoboka ko iterwa no kudakora neza kw’ubwirinzi mu bana bafite ubushobozi bw’umurage, aho kuba ikintu cyanduza kidanduzwa umuntu ku wundi.

Q2: Ese abantu bakuru barwara indwara ya Kawasaki?

Indwara ya Kawasaki ikunda kugaragara ku bana, hafi 85% by’ababwanduye bakaba ari abana bari munsi y’imyaka 5. Abantu bakuru barwaye iyi ndwara ni bake cyane, kandi igihe bibaye, bakunze kwitwa “Kawasaki-like syndrome.” Igice kinini cy’ababwanduye ni abana bato.

Q3: Ese umwana wanjye azakomeza gufata aspirine iteka ryose?

Abana benshi ntibakenera gufata aspirine igihe kirekire. Igihe cyo gufata imiti biterwa n’uko umwana wawe abonye ibibazo by’umutima. Igihe nta kibazo cy’imitsi y’amaraso y’umutima, aspirine isanzwe ihagarara nyuma y’ibyumweru 6-8. Abana bafite ibibazo by’umutima bashobora gukomeza gufata aspirine igihe kirekire, ariko ibyo bigenwa n’umuganga w’umwana wawe.

Q4: Ese indwara ya Kawasaki ishobora gusubira?

Gusubira kw’indwara ya Kawasaki ni bike, bibaho hafi 1-3% by’abana bayirwaye mbere. Igihe umwana wawe yarwaye indwara ya Kawasaki rimwe, ntabwo ashobora kuyirwara ukundi, ariko biracyari ingenzi kwitondera ibimenyetso igihe abonye umuriro ukomeza mu gihe kizaza.

Q5: Ni izihe ngaruka zirambye z’indwara ya Kawasaki?

Abana benshi bavuwe vuba nta ngaruka zirambye bagira kandi bashobora gukora ibikorwa byose bisanzwe harimo siporo. Abana bafite ibibazo by’imitsi y’amaraso y’umutima bashobora gukenera gukurikiranwa umutima buri gihe kandi rimwe na rimwe bagafata ingamba zo kwirinda, ariko ndetse n’abo bana bakunda kumera neza bafite ubuvuzi bwiza no gukurikirana.