Prolactinoma

Prolactinoma ndi chotupa chosatulutsa khansa (chosaopsa) chomwe chimapanga mahomoni otchedwa prolactin. Izi zimabweretsa prolactin wambiri m'magazi.

Prolactin ndi timadzi tomwe timayambitsa mabere kutulutsa mkaka (mkaka wa m'mawere).

Prolactinoma ndiye mtundu wofala kwambiri wamatenda am'mimba (adenoma) omwe amatulutsa mahomoni. Amakhala pafupifupi 30% ya ma pituitary adenomas. Pafupifupi zotupa zonse zamatenda osachita khansa (sizabwino). Prolactinoma imatha kuchitika ngati gawo la cholowa chotchedwa multiple endocrine neoplasia mtundu 1 (MEN 1).

Ma prolactinomas amapezeka kwambiri mwa anthu ochepera zaka 40. Amakhala achikazi kwambiri kuposa amuna, koma amapezeka mwa ana.

Osachepera theka la ma prolactinomas onse ndi ochepa kwambiri (ochepera 1 sentimita kapena 3/8 mainchesi m'mimba mwake). Zotupa zazing'ono izi zimachitika kawirikawiri mwa amayi ndipo zimatchedwa microprolactinomas.

Zotupa zazikulu ndizofala kwambiri mwa amuna. Amakonda kuchitika atakalamba. Chotupacho chimakula mpaka kukula kwakukulu zizindikiro zisanachitike. Ziphuphu zazikulu kuposa masentimita 1/8 m'mimba mwake zimatchedwa macroprolactinomas.

Nthawi zambiri chotupacho chimadziwika koyambirira mwa amayi kuposa amuna chifukwa cha kusamba kosasamba.

Kwa akazi:

• Mkaka wosazolowereka umachokera m'mawere mwa mayi yemwe alibe pakati kapena unamwino (galactorrhea)
• Chikondi cha m'mawere
• Kuchepetsa chidwi chogonana
• Kuchepetsa masomphenya ozungulira
• Mutu
• Kusabereka
• Kuleka kusamba kosagwirizana ndi kusintha kwa msambo, kapena kusamba kosasamba
• Masomphenya akusintha

Mwa amuna:

• Kuchepetsa chidwi chogonana
• Kuchepetsa masomphenya ozungulira
• Kukula kwa minofu ya m'mawere (gynecomastia)
• Mutu
• Mavuto okonzekera (kusowa mphamvu)
• Kusabereka
• Masomphenya akusintha

Zizindikiro zomwe zimayambitsidwa ndi chotupa chachikulu zimatha kuphatikizira izi:

• Mutu
• Kukonda
• Ngalande ya m'mphuno
• Nseru ndi kusanza
• Mavuto ndi kununkhiza
• Sinus kupweteka kapena kukakamizidwa
• Masomphenya amasintha, monga masomphenya awiri, zikope zothothoka kapena kutayika m'munda

Pakhoza kukhala palibe zizindikilo, makamaka mwa amuna.

Wothandizira zaumoyo adzakuyesani ndikufunsani za matenda anu. Mufunsidwanso za mankhwala ndi zinthu zomwe mumamwa.

Mayeso omwe atha kulamulidwa ndi awa:

• Pituitary MRI kapena CT scan
• Mulingo wa testosterone mwa amuna
• Mulingo wa practactin
• Mayeso a chithokomiro
• Mayeso ena a ntchito ya pituitary

Mankhwala nthawi zambiri amapambana pochiza prolactinoma. Anthu ena amayenera kumwa mankhwalawa kwa moyo wawo wonse. Anthu ena amatha kusiya kumwa mankhwalawo patadutsa zaka zingapo, makamaka ngati chotupa chawo chinali chaching'ono pomwe chimapezeka kapena chasowa mu MRI. Koma pali chiopsezo kuti chotupacho chikhoza kukula ndikupanganso prolactin kachiwiri, makamaka ngati linali chotupa chachikulu.

Prolactinoma yayikulu nthawi zina imatha kukula panthawi yoyembekezera.

Opaleshoni itha kuchitidwa pazinthu izi:

• Zizindikiro zimakhala zovuta, monga kuwonekera kwadzidzidzi kwa masomphenya
• Simungathe kulekerera mankhwala ochizira chotupacho
• Chotupacho sichimayankha mankhwala

Poizoniyu imagwiritsidwa ntchito mwa anthu omwe ali ndi prolactinoma yomwe imakulabe kapena kukulira pambuyo poyesedwa. Poizoniyu atha kuperekedwa motere:

• Cheza ochiritsira
• Mpeni wa Gamma (stereotactic radiosurgery) - mtundu wa mankhwala othandizira ma radiation omwe amayang'ana kwambiri ma x-ray pamagawo ang'onoang'ono muubongo.

Maganizo nthawi zambiri amakhala abwino, koma zimadalira kupambana kwa chithandizo chamankhwala kapena opaleshoni. Kuyesedwa kuti muwone ngati chotupacho chabwerera mutalandira chithandizo ndikofunikira.

Chithandizo cha prolactinoma chimatha kusintha mahomoni ena mthupi, makamaka ngati opaleshoni kapena radiation ikuchitika.

Mlingo wambiri wa estrogen kapena testosterone umatha kutenga nawo gawo pakukula kwa prolactinoma. Amayi omwe ali ndi ma prolactinomas amayenera kutsatiridwa kwambiri nthawi yapakati. Ayenera kukambirana za chotupacho ndi omwe amawapatsa asadamwe mapiritsi oletsa kubereka okhala ndi zinthu zambiri kuposa estrogen.

Onani omwe akukuthandizani ngati muli ndi zizindikiro za prolactinoma.

Ngati mwakhala ndi prolactinoma m'mbuyomu, itanani omwe akukuthandizani kuti adzatsatire, kapena ngati matenda anu abwerera.

Adenoma - kutulutsa; Prolactin - kutulutsa adenoma a pituitary

• Matenda a Endocrine

(Adasankhidwa) Bronstein MD. Kusokonezeka kwa kutulutsa kwa prolactin ndi ma prolactinomas. Mu: Jameson JL, De Groot LJ, de Kretser DM, et al, olemba. Endocrinology: Akuluakulu ndi Ana. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier Saunders; 2016: mutu 7.

Tirosh A, Shimon I. Njira zamakono zochiritsira ma prolactinomas. Minerva Endocrinol. 2016; 41 (3): 316-323. PMID: 26399371 www.ncbi.nlm.nih.gov/pubmed/26399371. (Adasankhidwa)