Matenda a Addison

Matenda a Addison ndi vuto lomwe limachitika pomwe zopangitsa za adrenal sizipanga mahomoni okwanira.

Matenda a adrenal ndi ziwalo zazing'ono zotulutsa mahomoni zomwe zili pamwamba pa impso iliyonse. Amapangidwa ndi gawo lakunja, lotchedwa kotekisi, ndi gawo lamkati, lotchedwa medulla.

Kortex imatulutsa mahomoni atatu:

• Mahomoni a Glucocorticoid (monga cortisol) amateteza shuga (shuga), amachepetsa (kupondereza) mayankho amthupi, ndikuthandizira thupi kuthana ndi kupsinjika.
• Mahomoni a Mineralocorticoid (monga aldosterone) amawongolera kuchuluka kwa sodium, madzi ndi potaziyamu.
• Mahomoni ogonana, androgens (amuna) ndi estrogens (akazi), zimakhudza kukula kwa kugonana ndi kuyendetsa kugonana.

Matenda a Addison amadza chifukwa cha kuwonongeka kwa kotekisi ya adrenal. Kuwonongeka kumapangitsa kuti kotekisi ipange timadzi totsika kwambiri.

Izi zitha kuwonongedwa ndi izi:

• Chitetezo chamthupi molakwika chikuukira ma adrenal gland (autoimmune matenda)
• Matenda monga chifuwa chachikulu, kachilombo ka HIV, kapena matenda opatsirana
• Kutaya magazi m'matenda a adrenal
• Zotupa

Zowopsa zamtundu wa matenda a Addison zimaphatikizaponso matenda ena amthupi okha:

• Kutupa (kutupa) kwa chithokomiro komwe nthawi zambiri kumabweretsa kuchepa kwa ntchito ya chithokomiro (chronic thyroiditis)
• Chithokomiro chimatulutsa mahomoni ambiri a chithokomiro (chithokomiro chopitilira muyeso, matenda a manda)
• Kuphulika kotentha ndi ziphuphu ndi zotupa (dermatitis herpetiformis)
• Zilonda za parathyroid m'khosi sizimatulutsa mahomoni okwanira (hypoparathyroidism)
• Matenda a pituitary samapanga mahomoni ena ambiri (hypopituitarism)
• Matenda osokoneza bongo omwe amakhudza mitsempha ndi minofu yomwe amawongolera (myasthenia gravis)
• Thupi lilibe maselo ofiira ofiira okwanira (kuchepa kwa magazi m'thupi)
• Machende sangathe kutulutsa umuna kapena mahomoni achimuna (testicular failure)
• Lembani I shuga
• Kutaya mtundu wofiirira (pigment) kuchokera kumadera akhungu (vitiligo)

Zofooka zina zosabadwa zimayambitsanso kusakwanira kwa adrenal.

Zizindikiro za matenda a Addison zitha kukhala izi:

• Kupweteka m'mimba
• Kutsekula m'mimba, nseru, ndi kusanza
  
• Mdima wa khungu
• Kutaya madzi m'thupi
• Chizungulire poyimirira
• Malungo ochepa
• Shuga wamagazi ochepa
• Kuthamanga kwa magazi
• Kufooka kwakukulu, kutopa, komanso kuyenda pang'onopang'ono, ulesi
• Khungu lakuda mkati mwa masaya ndi milomo (buccal mucosa)
• Kulakalaka mchere (kudya chakudya ndi mchere wambiri wowonjezera)
• Kuchepetsa thupi ndikuchepetsa njala

Zizindikiro mwina sizimakhalapo nthawi zonse. Anthu ambiri amakhala ndi zina kapena zizindikilo zonsezi akakhala ndi matenda kapena nkhawa zina pathupi. Nthawi zina, alibe zisonyezo.

Wothandizira zaumoyo adzayesa thupi ndikufunsa za zizindikiro.

Mayeso amwazi atha kuyitanidwa ndipo atha kuwonetsa:

• Kuchuluka kwa potaziyamu
• Kuthamanga kwa magazi, makamaka ndikusintha kwa thupi
• Mulingo wotsika wa cortisol
• Mulingo wochepa wa sodium
• PH yochepa
• Mulingo wabwinobwino wa testosterone ndi estrogen, koma mulingo wochepa wa DHEA
• Kuwerengera kwakukulu kwa eosinophil

Mayeso owonjezera a labotale atha kuyitanidwa.

Mayesero ena atha kuphatikizira:

• X-ray m'mimba
• M'mimba mwa CT scan
• Mayeso olimbikitsira a Cosyntropin (ACTH)

Kuchiza m'malo mwa corticosteroids ndi mineralocorticoids kumatha kuwongolera zizindikilo za matendawa. Mankhwalawa amafunika kumwa nthawi zonse.

Musadumphe mlingo wa mankhwala anu chifukwa cha vutoli chifukwa zochitika zowopsa pamoyo zitha kuchitika.

Wothandizira anu akhoza kukuwuzani kuti muwonjezere mlingo wanu kwa kanthawi kochepa chifukwa cha:

• Matenda
• Kuvulala
• Kupsinjika
• Opaleshoni

Pakakhala vuto lokwanira la adrenal, lotchedwa adrenal mavuto, muyenera kubaya hydrocortisone nthawi yomweyo. Chithandizo cha kuthamanga kwa magazi nthawi zambiri chimafunikanso.

Anthu ena omwe ali ndi matenda a Addison amaphunzitsidwa kuti adzilowetse jakisoni mwadzidzidzi wa hydrocortisone panthawi yamavuto. Nthawi zonse nyamulani chiphaso chachipatala (khadi, chibangili, kapena mkanda) chomwe chimati mulibe mphamvu ya adrenal. Chizindikirocho chiyeneranso kunena mtundu wa mankhwala ndi mlingo womwe mungafune pakagwa vuto ladzidzidzi.

Ndi mankhwala a mahomoni, anthu ambiri omwe ali ndi matenda a Addison amatha kukhala moyo wabwino.

Zovuta zimatha kupezeka ngati mumamwa mahomoni ochepa kwambiri kapena adrenal.

Itanani omwe akukuthandizani ngati:

• Simulephera kusunga mankhwala anu chifukwa chokusanza.
• Muli ndi nkhawa monga matenda, kuvulala, kupwetekedwa mtima, kapena kutaya madzi m'thupi. Mungafunike kuti mankhwala anu asinthidwe.
• Kulemera kwanu kumawonjezeka pakapita nthawi.
• Mawondo anu ayamba kutupa.
• Mumakhala ndi zizindikilo zatsopano.
• Mukalandira chithandizo, mumakhala ndi zizindikilo za matenda otchedwa Cushing syndrome

Ngati muli ndi zizindikilo za vuto la adrenal, dzipatseni jakisoni wamankhwala omwe mwalandira. Ngati sichikupezeka, pitani kuchipatala chapafupi kapena itanani 911.

Zizindikiro za mavuto a adrenal ndi awa:

• Kupweteka m'mimba
• Kuvuta kupuma
• Chizungulire kapena kupepuka
• Kuthamanga kwa magazi
• Kuchepetsa msinkhu wa chidziwitso

Chinyengo cha Adrenocortical; Matenda osakwanira adrenocortical; Kulephera kwapadera kwa adrenal

• Matenda a Endocrine

Barthel A, Benker G, Berens K, ndi al. Zosintha pa matenda a Addison. Exp Clin Endocrinol Matenda a shuga. 2019; 127 (2-03): 165-175. (Adasankhidwa) PMID: 30562824 www.ncbi.nlm.nih.gov/pubmed/30562824.

Bornstein SR, Allolio B, Arlt W, ndi al. Kuzindikira ndikuchiza kusowa koyambira kwa adrenal: malangizo othandizira a Endocrine Society. J Clin Endocrinol Metab. 2016; 101 (2): 364-389. (Adasankhidwa) PMID: PMC4880116 www.ncbi.nlm.nih.gov/pmc/articles/PMC4880116. (Adasankhidwa)

Nieman LK. Adrenal kotekisi. Mu: Goldman L, Schafer AI, olemba. Mankhwala a Goldman-Cecil. Wolemba 25. Philadelphia, PA: Elsevier Saunders; 2016: chap 227.