Cushing syndrome chifukwa cha chotupa cha adrenal

Cushing syndrome chifukwa cha adrenal chotupa ndi mawonekedwe a Cushing syndrome. Zimachitika pamene chotupa cha adrenal gland chimatulutsa kuchuluka kwa hormone cortisol.

Cushing syndrome ndi vuto lomwe limachitika thupi lanu likakhala ndi mahomoni ochulukirapo kuposa a cortisol. Hormone iyi imapangidwa m'matenda a adrenal. Kuchuluka kwa cortisol kumatha kukhala chifukwa cha zovuta zosiyanasiyana. Vuto limodzi lotere ndi chotupa pachimodzi mwazigawo za adrenal. Zotupa za adrenal zimatulutsa cortisol.

Zotupa za adrenal ndizochepa. Amatha kukhala osachita khansa (owopsa) kapena a khansa (oopsa).

Zotupa zopanda khansa zomwe zingayambitse matenda a Cushing ndi awa:

• Adrenal adenomas, chotupa chofala chomwe nthawi zambiri chimapanga cortisol yochulukirapo
• Macronodular hyperplasia, yomwe imapangitsa kuti adrenal gland ikukulitse ndikupanga cortisol yochulukirapo

Zotupa za khansa zomwe zingayambitse Cushing syndrome zimaphatikizaponso adrenal carcinoma. Ichi ndi chotupa chosowa, koma nthawi zambiri chimapanga cortisol yochulukirapo.

Anthu ambiri omwe ali ndi matenda a Cushing ali:

• Chozungulira, chofiira, nkhope yathunthu (nkhope ya mwezi)
• Kukula pang'onopang'ono kwa ana
• Kulemera ndi mafuta omwe amapezeka pamtengo, koma kutaya mafuta m'manja, miyendo, ndi matako (kunenepa kwambiri)

Kusintha kwa khungu komwe kumawonekera:

• Matenda a khungu
• Zizindikiro zofiirira (1/2 inchi kapena 1 sentimita kapena kupitilira apo), yotchedwa striae, pakhungu la pamimba, ntchafu, mikono yakumtunda, ndi mabere
• Khungu loyera lokhala ndi mabala osavuta

Kusintha kwa minofu ndi mafupa kumaphatikizapo:

• Mmbuyo, yomwe imachitika ndi zochitika wamba
• Kupweteka kwa mafupa kapena kukoma
• Kutolere mafuta pakati pamapewa komanso pamwamba pa kolala
• Nthiti ndi mafupa a msana amayamba chifukwa cha kupindika kwa mafupa
• Minofu yofooka, makamaka m'chiuno ndi m'mapewa

Kusintha kwa thupi lonse (systemic) kumaphatikizapo:

• Type 2 matenda a shuga
• Kuthamanga kwa magazi
• Kuchulukitsa cholesterol ndi triglycerides

Amayi nthawi zambiri amakhala ndi:

• Kukula kwa tsitsi kumaso, m'khosi, pachifuwa, pamimba, ndi ntchafu (zofala kwambiri kuposa mitundu ina ya matenda a Cushing)
• Nthawi zomwe zimakhala zosasintha kapena kusiya

Amuna akhoza kukhala ndi:

• Kuchepetsa kapena kusakhala ndi chilakolako chogonana (low libido)
• Mavuto okonzekera

Zizindikiro zina zomwe zingachitike ndi monga:

• Kusintha kwamaganizidwe, monga kukhumudwa, kuda nkhawa, kapena kusintha kwamachitidwe
• Kutopa
• Mutu
• Kuchuluka kwa ludzu ndi kukodza

Wothandizira zaumoyo adzakuyesani ndikufunsani za matenda anu.

Kuyesa kutsimikizira Cushing syndrome:

• Chitsanzo cha mkodzo wa maola 24 kuti muyese milingo ya cortisol ndi creatinine
• Kuyesa magazi kuti muwone kuchuluka kwa ACTH, cortisol, ndi potaziyamu
• Mayeso opondereza a Dexamethasone
• Magulu a cortisol yamagazi
• Mulingo wamagazi DHEA
• Mulingo wamaliseche wa cortisol

Kuyesa kudziwa chomwe chimayambitsa kapena zovuta ndi monga:

• M'mimba CT
• ACTH
• Kuchuluka kwa mafupa amchere
• Cholesterol
• Kusala shuga

Opaleshoni yachitika kuti achotse chotupa cha adrenal. Nthawi zambiri, adrenal gland yonse imachotsedwa.

Chithandizo chothandizira m'malo mwa glucocorticoid nthawi zambiri chimafunikira mpaka adrenal gland ina itachira kuchitidwa opaleshoni. Mungafunike mankhwalawa kwa miyezi 3 kapena 12.

Ngati opaleshoni siyotheka, monga matenda a khansa ya adrenal yomwe yafalikira (metastasis), mankhwala amatha kugwiritsidwa ntchito poletsa kutuluka kwa cortisol.

Anthu omwe ali ndi chotupa cha adrenal omwe achita opaleshoni amakhala ndi chiyembekezo chabwino. Kwa khansa ya adrenal, opaleshoni nthawi zina sizingatheke. Kuchita opareshoni sikuchiza khansa nthawi zonse.

Zotupa za khansa za adrenal zitha kufalikira pachiwindi kapena m'mapapu.

Itanani omwe akukuthandizani ngati mukukumana ndi matenda aliwonse a Cushing.

Chithandizo choyenera cha zotupa za adrenal zitha kuchepetsa chiopsezo cha zovuta kwa anthu ena omwe ali ndi vuto lodana ndi chotupa cha Cushing.

Chotupa cha Adrenal - Cushing syndrome

• Matenda a Endocrine
• Adrenal metastases - CT scan
• Chotupa cha Adrenal - CT

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Nieman LK, Biller BM, Wopeza JW, et al. Chithandizo cha matenda a Cushing's: malangizo othandizira a Endocrine Society. J Clin Endocrinol Metab. 2015; 100 (8): 2807-2831. PMID: 26222757 www.ncbi.nlm.nih.gov/pubmed/26222757.

Stewart PM, Newell-Price JDC. Kachilombo kotchedwa adrenal cortex. Mu: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, olemba. Buku la Williams la Endocrinology. Wolemba 13. Philadelphia, PA: Elsevier; 2016: chap 15.