Izifo ezinqabileyo

Isifo se-Cushing yimeko apho i-pituitary gland ikhupha kakhulu i-adrenocorticotropic hormone (ACTH). I-pituitary gland iyilungu le-endocrine system.

Isifo se-Cushing luhlobo lwe-Cushing syndrome. Ezinye iintlobo ze-Cushing syndrome zibandakanya i-exogenous Cushing syndrome, i-Cushing syndrome ebangelwa yi-adrenal tumor, kunye ne-ectopic Cushing syndrome.

Isifo se-Cushing sibangelwa sisisu okanye ukukhula okugqithileyo (i-hyperplasia) ye-pituitary gland. Idlala lengqula libekwe nje emazantsi engqondo. Uhlobo lwesifo sethumba esibizwa ngokuba yi-adenoma sesona sizathu sixhaphakileyo. I-adenoma sisifo esibuhlungu (hayi umhlaza).

Ngesifo seCushing, i-pituitary gland ikhupha i-ACTH kakhulu. I-ACTH ivuselela imveliso kunye nokukhululwa kwe-cortisol, ihormone yoxinzelelo. Uninzi lwe-ACTH lubangela ukuba iadrenal amadlala yenze i-cortisol eninzi kakhulu.

ICortisol ihlala ikhutshwa ngexesha loxinzelelo. Ineminye imisebenzi emininzi, kubandakanya:

• Ukulawula ukusetyenziswa komzimba kwee-carbohydrate, amafutha, kunye neeprotheni
• Ukunciphisa ukuphendula kwamajoni omzimba kukudumba (ukudumba)
• Ukulawula uxinzelelo lwegazi kunye nokulinganisela kwamanzi emzimbeni

Iimpawu zesifo seCushing zibandakanya:

• Ukutyeba kakhulu emzimbeni (ngaphezulu kwesinqe) kunye neengalo nemilenze ebhityileyo
• Ujikeleze, ubomvu, ubuso obugcweleyo (ubuso benyanga)
• Izinga lokukhula kancinci kubantwana

Utshintsho lolusu oluhlala lubonwa lubandakanya:

• Amabala okanye usuleleko lolusu
• Amanqaku athambileyo (1/2 intshi okanye 1 cm okanye ngaphezulu ububanzi), ebizwa ngokuba yi-striae, kwesikhumba sesisu, amathanga, iingalo eziphezulu kunye namabele
• Ulusu olucekeceke ngokugruzuka ngokulula, ikakhulu ezingalweni nasezandleni

Utshintsho lwemisipha kunye nethambo lubandakanya:

• Umqolo obuhlungu, owenzeka ngemisebenzi yesiqhelo
• Intlungu yethambo okanye ukuthamba
• Ukuqokelelwa kwamafutha phakathi kwamagxa (inyathi yenyosi)
• Ukwenza buthathaka kwamathambo, okukhokelela kumbambo kunye nakumqolo wokuqhekeka
• Izihlunu ezibuthathaka ezibangela ukunganyamezelani komzimba

Abasetyhini banokuba:

• Ukukhula okungaphezulu kweenwele ebusweni, entanyeni, esifubeni, esiswini nasemathangeni
• Umjikelo wokuya exesheni ongahambi kakuhle okanye oyekayo

Amadoda anokuba:

• Ukunciphisa okanye akukho mnqweno wesini (i-libido ephantsi)
• Iingxaki zokwakhiwa

Ezinye iimpawu okanye iingxaki zinokubandakanya:

• Utshintsho lwengqondo, olufana nokudakumba, unxunguphalo, okanye utshintsho kwindlela yokuziphatha
• Ukudinwa
• Rhoqo izifo
• Intloko ebuhlungu
• Ukwanda ukoma kunye nokuchama
• Igazi elonyukayo
• Seswekile

Umboneleli wezempilo uya kwenza uvavanyo lomzimba kwaye abuze malunga neempawu zakho.

Uvavanyo lwenziwa kuqala ukuqinisekisa ukuba ininzi kakhulu i-cortisol emzimbeni, emva koko kufunyaniswe unobangela.

Ezi mvavanyo ziqinisekisa kakhulu i-cortisol:

• Iiyure ezingama-24 zomchamo i-cortisol
• Uvavanyo lokucinezelwa kweDexamethasone (idosi ephantsi)
• Amanqanaba e-cortisol ye-salivary (kusasa ekuseni nasemva kobusuku)

Olu vavanyo luchaza unobangela:

• Inqanaba legazi le-ACTH
• I-Brain MRI
• I-Corticotropin-ekhulula uvavanyo lwehomoni, olusebenza kwincindi yebhinqa ukwenza ukukhutshwa kwe-ACTH
• Uvavanyo lokucinezelwa kweDexamethasone (idosi ephezulu)
• Isampulu yesampulu yesifo esingaqhelekanga (IPSS) -imilinganiselo yamanqanaba e-ACTH kwimithambo ekhupha i-pituitary gland ngokuthelekiswa nemithambo esifubeni

Olunye uvavanyo olunokwenziwa lunokubandakanya oku kulandelayo:

• Ukuzila ukutya kweglucose kunye ne-A1C ukuvavanya isifo seswekile
• Uvavanyo lwe-Lipid kunye ne-cholesterol
• I-Bone mineral density scan ukukhangela i-osteoporosis

Ngaphezulu kovavanyo olunye lokuvavanya kunokufuneka ukuba kufunyaniswe isifo seCushing. Umboneleli wakho unokucela ukuba ubone ugqirha ojolise kwizifo zepituitary.

Unyango lubandakanya utyando lokususa ithumba lesikhumba, ukuba kunokwenzeka. Emva kotyando, idlala lengqula lisenokuqalisa ukusebenza kwakhona lize libuyele esiqhelweni.

Ngexesha lenkqubo yokubuyisela kwimeko yoqhaqho, unokufuna unyango lwe-cortisol yokutshintsha ngenxa yokuba i-pituitary ifuna ixesha lokuqala ukwenza i-ACTH kwakhona.

Unyango lwe-pituitary lungasetyenziselwa ukuba i-tumor ayisuswanga ngokupheleleyo.

Ukuba ithumba aliphenduli kuqhaqho okanye kwimitha, unokufuna amayeza ayeke umzimba wakho ekwenzeni i-cortisol.

Ukuba olu nyango aluphumelelanga, iadrenal amadlala inokufuna ukuba isuswe ukumisa amanqanaba aphezulu e-cortisol ekuvelisweni. Ukususwa kwamadlala we-adrenal kunokubangela ukuba i-pituitary tumor ibe nkulu kakhulu (i-Nelson syndrome).

Ukunganyangwa, isifo esingxamisekileyo sinokubangela ukugula kakhulu, nokufa. Ukususwa kwethumba kungakhokelela ekuvuseleleni ngokupheleleyo, kodwa ithumba linokukhula kwakhona.

Iingxaki zempilo ezinokubangelwa sisifo seCushing zibandakanya:

• Ukucinezeleka koqhekeko emqolo
• Seswekile
• Igazi elonyukayo
• Usulelo
• Amatye eentso
• Imood okanye ezinye iingxaki zengqondo

Tsalela umnxeba umboneleli wakho ukuba uphuhlisa iimpawu zesifo seCushing.

Ukuba ususwe ithumba lesifuba, tsalela umnikezeli wakho ukuba unempawu zeengxaki, kubandakanya neempawu ezibuyileyo.

Isifo sePituitary Cushing; Ukufihlwa kwe-adenoma ye-ACTH

• Amadlala endocrine
• I-Striae kwi-popliteal fossa
• Striae emlenzeni

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Molitch MNA. Indawo yangaphakathi. Ku: IGoldman L, iSchafer AI, ii-eds. Amayeza eGoldman-Cecil. Umhla wama-25. IPhiladelphia, PA: Elsevier Saunders; I-2016: isahluko 224.

Stewart PM, Newell-Price JDC. I-adrenal cortex. Ku: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, ii-eds. Incwadi ebhaliweyo kaWilliam ye-Endocrinology. Umhla we-13. IPhiladelphia, PA: Elsevier; 2016: isahluko 15.