Lipidodistrofi Ya Mu Mara

Indwara ya Whipple ni indwara y'ubwandu bwa bakteriya gake cyane isanzwe igaragara cyane mu mifubyo no mu gice cy'igogorwa. Indwara ya Whipple ibuza igogorwa risanzwe rikorwa neza binyuze mu kubangamira gusenywa kw'ibiribwa, no kubangamira ubushobozi bw'umubiri bwo kunywa intungamubiri, nka amavuta na karubone.

Ibimenyetso n'ibibonwa bisanzwe

Ibimenyetso n'ibibonwa byo mu buryo bw'igogorwa biba bisanzwe mu ndwara ya Whipple kandi bishobora kuba birimo:

• Impiswi
• Kubabara mu nda no kuyigirira, ibyo bishobora kurushaho kuba bibi nyuma yo kurya
• Kugabanuka k'uburemere, bifitanye isano no kudakoresha neza intungamubiri

Ibindi bimenyetso n'ibibonwa bikunze kugaragara bifitanye isano n'indwara ya Whipple birimo:

• Amagufa y'amagufa, cyane cyane mu birenge, mu mavi no mu maboko
• Umunaniro
• Intege nke
• Ubusembwa

Indwara ya Whipple itera akaga gakomeye ku buzima, ariko isanzwe ivurwa. Suhuka kwa muganga niba ufite ibimenyetso bidasanzwe cyangwa ibimenyetso, nko kugabanuka k'uburemere bitazwi cyangwa ububabare bw'ingingo. Muganga wawe ashobora gukora ibizamini kugira ngo amenye icyateye ibimenyetso byawe.

Ndetse na nyuma y'aho iyi ndwara imenyekanye kandi ukaba uhawe ubuvuzi, menyesha muganga wawe niba ibimenyetso byawe bitakira. Rimwe na rimwe, imiti ya antibiyotike ntikora kuko udukoko tuba turwanya imiti runaka urimo gufata. Indwara ishobora gusubira, bityo ni ngombwa kwitondera ibimenyetso bisubira.

Indwara ya Whipple iterwa na ubwoko bw'ibyorezo bita Tropheryma whipplei. Ibi byorezo byibasira imbere y'amara mato, bigatuma haba ibyo kubabaza (ibisebe) mu rwaho rw'amara. Ibi byorezo binangiza ibice bito bimeze nk'ubwoya (villi) biri mu mara mato.

Nta byinshi bizwi kuri ibi byorezo. Nubwo bigaragara ko biri hose mu bidukikije, abahanga ntibabizi aho bituruka cyangwa uko byandura abantu. Si buri wese ufite ibi byorezo urwara iyo ndwara. Bamwe mu bashakashatsi bemeza ko abantu barwaye iyo ndwara bashobora kuba bafite ikibazo mu mikorere y'ubwirinzi bwabo bw'umubiri, bigatuma babasaba kurwara iyo babonye ibyo byorezo.

Indwara ya Whipple ni inyoro cyane, igaragara ku bantu bake cyane, ku gipimo cy'abantu batagera kuri umwe kuri miliyoni.

Kubera ko hari bike bizwi ku bifuza bitera indwara ya Whipple, ibintu byongera ibyago byo kurwara iyo ndwara ntibiramenyekana neza. Hashingiwe ku makuru aboneka, bigaragara ko ikunda kwibasira:

• Abagabo bafite imyaka iri hagati ya 40 na 60
• Abazungu bo muri Amerika ya Ruguru no mu Burayi
• Abahinzi n'abandi bantu bakora imirimo yo hanze kandi bakunda guhura n'amazi y'ibyondo n'amazi y'imisarani

Akavuyo k'umwanya muto w'amara gafite ibice bito bimeze nk'ububya (villi) bifasha umubiri wawe gukuramo intungamubiri. Indwara ya Whipple irangiza villi, igabanya gukuramo intungamubiri. Kubura intungamubiri ni bintu bisanzwe ku bantu barwaye indwara ya Whipple kandi bishobora gutera umunaniro, intege nke, igihombo cy'uburemere n'ububabare bw'ingingo.

Indwara ya Whipple ni indwara itera imbere kandi ishobora kwica. Nubwo iyi ndwara ari nke, ibitero byayo bikomeza gutangazwa. Ibi biterwa ahanini no kubura ubuvuzi bwiza no gutinda kuvurwa. Urupfu rugaragara kenshi bitewe no kwandura kwanduye mu mutwe, bishobora gutera ibibazo bitakongera gukira.

Uburyo bwo kuvura indwara ya Whipple busanzwe burimo ibizamini bikurikira:

Ubuvivi. Intambwe y'ingenzi mu kuvura indwara ya Whipple ni ukuraho igice cy'umubiri (ubuvvi), busanzwe bukura mu gifu gito. Kugira ngo abaganga babikore, bakora ubuvuzi bwo kureba imbere mu gifu. Muri ubwo buvuzi, hakoreshwa umuyoboro muto, woroshye (iscope) ufite umucyo na kamera biyiriho, uca mu kanwa, mu muhogo, mu muyoboro w'umwuka no mu gifu kugera mu gifu gito. Iyo scope ifasha muganga kubona inzira z'igogorwa ry'ibiribwa no kuraho ibice by'umubiri.

Mu gihe cy'ubwo buvuzi, abaganga bakuraho ibice by'umubiri mu bice bitandukanye by'igifu gito. Muganga arapimisha ubwo buryo bwo kugenzura microscope mu igenzura. Areba niba hari udukoko dutera indwara n'ibikomere byadutse (ibikomere), cyane cyane bakareba niba hari udukoko twa Tropheryma whipplei. Niba ibyo bice by'umubiri bitagaragaza indwara, muganga ashobora kuraho igice cy'umubiri mu mpfuru y'amaraso yabaye nini cyangwa akora ibindi bipimo.

Mu bihe bimwe bimwe, muganga ashobora kukusaba kunywa capsule ifite kamera nto. Iyo kamera ishobora gufata amashusho y'inzira z'igogorwa ry'ibiribwa kugira ngo muganga abibone.

Isuzuma rishingiye kuri ADN rizwi nka polymerase chain reaction, riboneka muri bimwe mu bigo nderabuzima, rishobora kubona udukoko twa Tropheryma whipplei mu bice by'umubiri cyangwa mu mabuye y'umugongo.

• Isuzuma ry'umubiri. Muganga atangira asuzumye umubiri. Azareba ibimenyetso n'ibibonwa bigaragaza ko iyi ndwara iriho. Urugero, muganga ashobora kureba niba hari ububabare mu gifu n'umukara ku ruhu, cyane cyane mu bice by'umubiri byagaragaye izuba.
• Ubuvivi. Intambwe y'ingenzi mu kuvura indwara ya Whipple ni ukuraho igice cy'umubiri (ubuvvi), busanzwe bukura mu gifu gito. Kugira ngo abaganga babikore, bakora ubuvuzi bwo kureba imbere mu gifu. Muri ubwo buvuzi, hakoreshwa umuyoboro muto, woroshye (iscope) ufite umucyo na kamera biyiriho, uca mu kanwa, mu muhogo, mu muyoboro w'umwuka no mu gifu kugera mu gifu gito. Iyo scope ifasha muganga kubona inzira z'igogorwa ry'ibiribwa no kuraho ibice by'umubiri.

Mu gihe cy'ubwo buvuzi, abaganga bakuraho ibice by'umubiri mu bice bitandukanye by'igifu gito. Muganga arapimisha ubwo buryo bwo kugenzura microscope mu igenzura. Areba niba hari udukoko dutera indwara n'ibikomere byadutse (ibikomere), cyane cyane bakareba niba hari udukoko twa Tropheryma whipplei. Niba ibyo bice by'umubiri bitagaragaza indwara, muganga ashobora kuraho igice cy'umubiri mu mpfuru y'amaraso yabaye nini cyangwa akora ibindi bipimo.

Mu bihe bimwe bimwe, muganga ashobora kukusaba kunywa capsule ifite kamera nto. Iyo kamera ishobora gufata amashusho y'inzira z'igogorwa ry'ibiribwa kugira ngo muganga abibone.

Isuzuma rishingiye kuri ADN rizwi nka polymerase chain reaction, riboneka muri bimwe mu bigo nderabuzima, rishobora kubona udukoko twa Tropheryma whipplei mu bice by'umubiri cyangwa mu mabuye y'umugongo.

• Ibizamini by'amaraso. Muganga ashobora kandi gutegeka ibizamini by'amaraso, nko kubara amaraso yose. Ibizamini by'amaraso bishobora kugaragaza uburwayi bumwe na bumwe bufite aho buhuriye n'indwara ya Whipple, cyane cyane ububabare bw'amaraso, ari bwo kugabanuka kw'umubare w'utubuto tw'amaraso atukura, no kugabanuka kw'ibipimo bya albumine, poroteyine iri mu maraso yawe.

Umuti wa indwara ya Whipple ni antibiyotike, yaba ari yo yonyine cyangwa ikaba ifatanyije n'izindi, zishobora kurimbura udukoko dutera iyo ndwara.

Umuti uba ari igihe kirekire, ubusanzwe ukamara umwaka umwe cyangwa ibiri, hagamijwe kurimbura udukoko. Ariko kugabanyuka kw'ibimenyetso byayo biba vuba cyane, akenshi mu cyumweru kimwe cyangwa bibiri bya mbere. Abantu benshi badafite ibibazo byo mu bwonko cyangwa mu mikorere y'imiterere y'umubiri bakira neza nyuma yo gukoresha antibiyotike mu gihe cyose.

Mu gihe hatowe antibiyotike, abaganga bakunda guhitamo izo zirimbura ubwandu mu ruhago rw'amara ndetse zinarenga urwego rw'umwenda ruri hafi y'ubwonko bwawe (uruzitiro rw'amaraso n'ubwonko). Ibi bikorwa kugira ngo habeho kurimbura udukoko dushobora kuba winjiye mu bwonko bwawe no mu mikorere y'umubiri.

Kubera ikoreshwa ry'antibiyotike igihe kirekire, muganga wawe azakenera gukurikirana uko uhagaze kugira ngo amenye niba hari ubudahangarwa bw'imiti. Niba ugize ikibazo cyo gusubira mu ndwara mu gihe cyo kuvurwa, muganga wawe ashobora guhindura antibiyotike.

Mu bihe byinshi, kuvura indwara ya Whipple bitangira mu byumweru bibiri kugeza kuri bine bya ceftriaxone cyangwa penicillin bitangwa binyuze mu mutsi wo mu kuboko kwawe. Nyuma y'ubuvuzi bwambere, ushobora gufata umuti wa sulfamethoxazole-trimethoprim (Bactrim, Septra) mu kanwa igihe cy'umwaka umwe cyangwa ibiri.

Ingaruka mbi zishoboka za ceftriaxone na sulfamethoxazole-trimethoprim harimo allergie, impiswi nke, cyangwa isereri n'kuruka.

Ibindi bitonyanga byasabwe nk'ibindi bishobora gukoreshwa mu bihe bimwe na bimwe birimo doxycycline (Vibramycin, Doryx, ibindi) ifatanije n'umuti wica imiti y'amafiriti hydroxychloroquine (Plaquenil), ushobora kuzakenera gufata igihe cy'umwaka umwe cyangwa ibiri.

Ingaruka mbi zishoboka za doxycycline harimo kubura ubushake bwo kurya, isereri, kuruka no kugira uburibwe ku zuba. Hydroxychloroquine ishobora gutera kubura ubushake bwo kurya, impiswi, kubabara umutwe, kubabara mu nda no guhinda umutwe.

Ibimenyetso byawe bikwiye kugabanuka mu cyumweru kimwe cyangwa bibiri utangiye kuvurwa na antibiyotike kandi bikavaho burundu mu mezi hafi.

Ariko nubwo ibimenyetso bigabanuka vuba, ibizamini by'ubushakashatsi bishobora kugaragaza ubukoko nyuma y'imyaka ibiri cyangwa irenga utangiye gufata antibiyotike. Gukurikirana ibizamini bizafasha muganga wawe kumenya igihe ushobora kureka gufata antibiyotike. Gukurikirana buri gihe bishobora kandi kumenya iterambere ry'ubudahangarwa ku muti runaka, akenshi bigaragara mu kudakira kw'ibimenyetso.

Ndetse no nyuma yo kuvurwa neza, indwara ya Whipple ishobora gusubira. Abaganga bakunda kugira inama yo gukora isuzuma buri gihe. Niba warigeze kugira ikibazo cyo gusubira mu ndwara, uzakenera gusubiramo kuvurwa na antibiyotike.

Kubera ibibazo byo kudakira intungamubiri bifitanye isano n'indwara ya Whipple, muganga wawe ashobora kugira inama yo gufata intungamubiri n'imyunyungugu kugira ngo habeho imirire ihagije. Umubiri wawe ushobora gusaba vitamine D, acide folique, calcium, fer na magnésium byiyongereye.