Chotupa cham'mimba

Chotupa cha pituitary ndikukula kosazolowereka pamatenda am'mimba. Pituitary ndi kansalu kakang'ono m'munsi mwa ubongo. Amayang'anira kuchuluka kwa thupi kwamahomoni ambiri.

Zotupa zambiri zam'mimbazi sizimayambitsa khansa (zabwino). Kufikira 20% ya anthu ali ndi zotupa za pituitary. Zambiri mwa zotupazi sizimayambitsa zizindikiro ndipo sizimapezeka nthawi ya moyo wamunthuyo.

Pituitary ndi gawo la dongosolo la endocrine. Matendawa amathandiza kuchepetsa kutuluka kwa mahomoni m'matenda ena a endocrine, monga chithokomiro, ma gland (ma testes kapena thumba losunga mazira), ndi adrenal gland. Matendawa amatulutsanso mahomoni omwe amakhudza minyewa yathupi, monga mafupa ndi minyewa ya mkaka wa m'mawere. Mahomoni a pituitary ndi awa:

• Mahomoni a Adrenocorticotropic (ACTH)
• Hormone yakukula (GH)
• Prolactin
• Mahomoni otulutsa chithokomiro (TSH)
• Mahomoni a Luteinizing (LH) ndi mahomoni othandizira (FSH)

Pamene chotupa cha pituitary chimakula, maselo abwinobwino omwe amatulutsa mahomoni amatha kuwonongeka. Izi zimapangitsa kuti pituitary gland isatulutse mahomoni okwanira. Matendawa amatchedwa hypopituitarism.

Zomwe zimayambitsa zotupa za pituitary sizidziwika. Zotupa zina zimayambitsidwa ndi zovuta zakubadwa monga multiple endocrine neoplasia I (MEN I).

Matenda a pituitary amathanso kukhudzidwa ndi zotupa zina zamaubongo zomwe zimapezeka mgawo lomwelo laubongo (tsabola), zomwe zimabweretsa zizindikilo zofananira.

Zotupa zina zam'mimba zimatulutsa mahomoni amodzi kapena angapo. Zotsatira zake, zizindikilo za chimodzi mwazinthu izi zitha kuchitika:

• Hyperthyroidism (chithokomiro chotulutsa chithokomiro chimapangitsa mahomoni ake kukhala ochulukirapo;
• Cushing syndrome (thupi limakhala lokwera kuposa mulingo wabwinobwino wa mahomoni cortisol)
• Gigantism (kukula kosazolowereka chifukwa chokwera kuposa kukula kwanthawi yayitali yaubwana) kapena acromegaly (kuposa kukula kwa mahomoni achikulire)
• Kutulutsa kwamabele ndi kusamba mosasamba kapena kusamba kwa akazi
• Kuchepetsa kugonana kwa amuna

Zizindikiro zomwe zimayambitsa kukakamizidwa ndi chotupa chachikulu cha pituitary zimatha kuphatikiza:

• Zosintha m'masomphenya monga kuwonera kawiri, kuwonongeka kwamasamba (kutaya masomphenya), zikope zothothoka kapena kusintha kwamasomphenya.
• Mutu.
• Kupanda mphamvu.
• Ngalande ya madzi oyera, yamadzi amchere.
• Nseru ndi kusanza.
• Mavuto ndi kununkhiza.
• Nthawi zambiri, izi zimachitika mwadzidzidzi ndipo zimatha kukhala zovuta (pituitary apoplexy).

Wothandizira zaumoyo wanu adzakuyesani. Wothandizirayo azindikira zovuta zilizonse pakuwona kawiri ndi mawonekedwe owonera, monga kutayika kwa mbali (zotumphukira) masomphenya kapena kutha kuwona m'malo ena.

Mayesowa adzawunika ngati pali cortisol (Cushing syndrome) yochulukirapo, mahomoni okula kwambiri (acromegaly), kapena prolactin wochuluka (prolactinoma).

Kuyesa kofufuza momwe endocrine imagwirira ntchito kumatha kulamulidwa, kuphatikiza:

• Mulingo wa Cortisol - dexamethasone suppression test, mkodzo wa cortisol test, salivary cortisol test
• Mulingo wa FSH
• Kukula kwa insulin factor-1 (IGF-1)
• LHlevel
• Mulingo wa practactin
• Magulu a testosterone / estradiol
• Mahomoni a chithokomiro - kuyesa kwa T4 kwaulere, kuyesa kwa TSH

Kuyesa komwe kumatsimikizira kuti matendawa ndi awa:

• Masamba owoneka
• MRI ya mutu

Kuchita opaleshoni kuti muchotse chotupacho kumafunikira nthawi zambiri, makamaka ngati chotupacho chikukakamiza misempha yomwe imayang'anira masomphenya (optic nervo).

Nthawi zambiri, zotupa za pituitary zimatha kuchotsedwa opaleshoni kudzera m'mphuno ndi sinus. Ngati chotupacho sichingachotsedwe motere, chimachotsedwa pamutu.

Mankhwalawa amatha kugwiritsidwa ntchito pochepetsa chotupacho mwa anthu omwe sangathe kuchitidwa opaleshoni. Ikhoza kugwiritsidwanso ntchito ngati chotupacho chimabwerera pambuyo pa opaleshoni.

Nthawi zina, mankhwala amaperekedwa kuti achepetse mitundu ina ya zotupa.

Izi zitha kukupatsirani zambiri pazotupa zamatenda:

• National Cancer Institute - www.cancer.gov/types/pituitary
• Pituitary Network Association - pituitary.org
• Pituitary Society - www.pituitarysociety.org

Ngati chotupacho chingachotsedwe opaleshoni, malingalirowo ndiabwino ngakhale abwino, kutengera ngati chotupa chonsecho chachotsedwa.

Vuto lalikulu kwambiri ndi khungu. Izi zikhoza kuchitika ngati mitsempha ya optic yawonongeka kwambiri.

Chotupacho kapena kuchotsedwa kwake kumatha kuyambitsa kusamvana kwamahomoni amoyo wonse. Mahomoni okhudzidwa angafunike kusintha, ndipo mungafunike kumwa mankhwala kwa moyo wanu wonse.

Zotupa ndi opaleshoni nthawi zina zitha kuwononga pituitary yotsalira (kumbuyo kwa gland). Izi zingayambitse matenda a shuga insipidus, mkhalidwe wokhala ndi zizindikilo zokodza pafupipafupi komanso ludzu lokwanira.

Itanani omwe akukuthandizani ngati mukukumana ndi vuto lililonse lakutupa.

Chotupa - chifuwa; Pituitary adenoma

• Matenda a Endocrine
• Matenda a pituitary

Dorsey JF, Salinas RD, Dang M, ndi al. Khansa yapakati yamanjenje. Mu: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, olemba. Chipatala cha Abeloff's Oncology. Lachisanu ndi chimodzi. Philadelphia, PA: Elsevier; 2020: chap 63.

Melmed S, Kleinberg D. Maselo a pituitary ndi zotupa. Mu: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, olemba. Buku la Williams la Endocrinology. Wolemba 13. Philadelphia, PA: Elsevier; 2016: chap 9.