Isifo iAddison

Isifo iAddison sisifo esenzeka xa amadlala eadrenal engavelisi iihomoni ezaneleyo.

Amadlala adrenal ngamalungu amancinci akhupha iincindi zamadlala aphezulu phezu kwentliziyo nganye. Zenziwe ngenxalenye engaphandle, ebizwa ngokuba yi-cortex, kunye nenxalenye yangaphakathi, ebizwa ngokuba yi-medulla.

Icortex ivelisa iihomoni ezintathu:

• Iihomoni zeGlucocorticoid (ezinje ngecortisol) zigcina iswekile (iswekile) yokulawula, ukunciphisa (ukucinezela) impendulo yomzimba, kunye nokunceda umzimba uphendule kuxinzelelo.
• Amaminerali e-Mineralocorticoid (njenge-aldosterone) alawula i-sodium, amanzi kunye ne-potassium.
• Ihomoni zesondo, i-androgens (eyindoda) kunye ne-estrogens (eyasetyhini), ichaphazela ukukhula ngokwesondo kunye nokuqhuba ngesondo.

Isifo iAddison siphumela kumonakalo kwi-adrenal cortex. Umonakalo ubangela ukuba i-cortex ivelise amanqanaba e-hormone asezantsi kakhulu.

Lo monakalo unokubangelwa koku kulandelayo:

• Amajoni omzimba ahlasela ngempazamo iadrenal gland (isifo sokuzimela)
• Usulelo olunje ngesifo sephepha, i-HIV, okanye usulelo lokungunda
• Ukopha kwiincindi zamadlala
• Amathumba

Izinto ezinobungozi zohlobo lwe-Addison oluzenzekelayo lubandakanya ezinye izifo ezizimeleyo:

• Ukudumba (ukudumba) kwedlala lengqula okuhlala kukhokelela ekunciphiseni ukusebenza kwe-thyroid (isifo esinganyangekiyo)
• Idlala lengqula livelisa idlala lengqula elininzi kakhulu (isifo esinganyangekiyo, isifo sengcwaba)
• Ukurhawuzelela ukurhawuzelela ngamaqhuma kunye namadyungudyungu (dermatitis herpetiformis)
• Izibilini zeParathyroid entanyeni azivelisi i-hormone ye-parathyroid eyaneleyo (hypoparathyroidism)
• Idlala lengqula alivelisi isixa esiqhelekileyo kwezinye okanye zonke iihomoni zalo (hypopituitarism)
• Isifo sokuzimela komzimba esichaphazela imithambo-luvo kunye nezihlunu abazilawulayo (myasthenia gravis)
• Umzimba awunazo ngokwaneleyo iiseli ezibomvu ezisempilweni (i-anemia eyingozi)
• Amatyhalarha akakwazi ukuvelisa amadlozi okanye amadlala angamadoda (ukusilela kwamatyhalarha)
• Chwetheza isifo seswekile
• Ukulahleka kombala omdaka (i-pigment) kwiindawo zolusu (vitiligo)

Ezinye iziphene zemfuza ezinqabileyo zinokubangela ukungoneliseki kwe-adrenal.

Iimpawu zesifo iAddison zinokubandakanya oku kulandelayo:

• Intlungu zesisu
• Urhudo olungapheliyo, isicaphucaphu, kunye nokugabha
  
• Ubumnyama besikhumba
• Ukuphelelwa ngamanzi emzimbeni
• Ukuba nesiyezi xa umi
• Umkhuhlane ophantsi
• Iswekile esezantsi yegazi
• Uxinzelelo lwegazi oluphantsi
• Ubuthathaka obugqithisileyo, ukudinwa, kunye nokucotha, ukuhamba kancinci
• Isikhumba esimnyama ngaphakathi kwizidlele nemilebe (i-buccal mucosa)
• Ukulangazelela ityuwa (ukutya ukutya ngetyuwa eninzi)
• Ukuthoba umzimba kunye nokunciphisa ukutya

Iimpawu zisenokungabikho ngalo lonke ixesha. Abantu abaninzi banezinye okanye zonke ezi mpawu xa benosulelo okanye olunye uxinzelelo emzimbeni. Ngamanye amaxesha, abanazimpawu.

Umboneleli wezempilo uya kwenza uvavanyo lomzimba kwaye abuze malunga neempawu.

Iimvavanyo zegazi ziya kuyalelwa kwaye zingabonisa:

• Ukwanda kwepotassium
• Uxinzelelo lwegazi olusezantsi, ngakumbi ngokutshintsha komzimba
• Inqanaba le-cortisol ephantsi
• Inqanaba lesodium ephantsi
• IP ephantsi
• Amanqanaba e-testosterone aqhelekileyo kunye namanqanaba e-estrogen, kodwa kwinqanaba eliphantsi le-DHEA
• Inani eliphezulu le-eosinophil

Iimvavanyo ezongezelelweyo zaselebhu zinoku-odolwa.

Olunye uvavanyo lunokubandakanya:

• X-ray esiswini
• Ukuskena kwe-CT esiswini
• ICosyntropin (ACTH) yovavanyo lokukhuthaza

Unyango ngokutshintsha i-corticosteroids kunye ne-mineralocorticoids iya kulawula iimpawu zesi sifo. La mayeza ahlala efuna ukuthathwa ubomi babo bonke.

Ungaze weqe amayeza akho kule meko kuba iimpendulo ezisongela ubomi zinokwenzeka.

Umboneleli wakho unokukuxelela ukuba wandise idosi yakho ngexesha elifutshane ngenxa:

• Usulelo
• Ukwenzakala
• Uxinzelelo
• Ugqirha

Ngexesha lokudodobala kwe-adrenal insufficiency, ebizwa ngokuba yingxaki ye-adrenal, kufuneka utofe i-hydrocortisone kwangoko. Unyango lwexinzelelo lwegazi olusezantsi zihlala zifuneka ngokunjalo.

Abanye abantu abanesifo iAddison bafundiswa ukuba bazinike inaliti engxamisekileyo yehydrocortisone ngexesha loxinzelelo. Soloko uphethe i-ID yonyango (ikhadi, isongo, okanye isacholo somqala) esithi awonelanga yi-adrenal. Isazisi kufuneka kwakhona sichaze uhlobo lwamayeza kunye nedosi oyifunayo kwimeko kaxakeka.

Ngonyango lwehomoni, abantu abaninzi abanesifo iAddison bayakwazi ukukhokela ubomi obuqhelekileyo.

Iingxaki zinokwenzeka ukuba uthatha incinci kakhulu okanye unehomoni yeadrenal.

Fowunela umnikezeli wakho ukuba:

• Awunakho ukugcina amayeza akho phantsi ngenxa yokugabha.
• Unoxinzelelo olufana nosulelo, ukonzakala, ukwenzakala, okanye ukomisa. Kuya kufuneka ukuba uhlengahlengiso kunyango lwakho.
• Ubunzima bakho buyanda ngokuhamba kwexesha.
• Amaqatha akho aqala ukudumba.
• Uba neempawu ezintsha.
• Kunyango, ukhula ube neempawu zesifo esibizwa ngokuba yiCushing syndrome

Ukuba unempawu zeengxaki ze-adrenal, zinike inaliti engxamisekileyo yeyeza lakho elimiselweyo. Ukuba ayifumaneki, yiya kwigumbi lezongxamiseko elikufutshane okanye utsalele umnxeba ku-911.

Iimpawu zentlekele ye-adrenal zibandakanya:

• Intlungu zesisu
• Kunzima ukuphefumla
• Utywala okanye intloko
• Uxinzelelo lwegazi oluphantsi
• Ukuncipha kwenqanaba lokuqonda

Uhanahaniso lwe-Adrenocortical; Ukusilela okungapheliyo kwe-adrenocortical; Ukungabikho ngokwaneleyo kwe-adrenal

• Amadlala endocrine

UBarthel A, uBenker G, uBerens K, et al. Ukuhlaziywa kwesifo sika-Addison. Exp Eklinikhi yesifo seswekile. Ngo-2019; 127 (2-03): 165-175. IINKCUKACHA: 30562824 www.ncbi.nlm.nih.gov/pubmed/30562824.

U-Bornstein SR, u-Allolio B, u-Arlt W, okqhubekayo. Ukufumanisa isifo kunye nokunyanga ukungabikho ngokwaneleyo kwe-adrenal: Isikhokelo se-Endocrine Society sonyango. J Ikliniki ye-Endocrinol Metab. Ngo-2016; 101 (2): 364-389. IINKCUKACHA: PMC4880116 www.ncbi.nlm.nih.gov/pmc/articles/PMC4880116.

UNieman LK. I-adrenal cortex. Ku: IGoldman L, iSchafer AI, ii-eds. Amayeza eGoldman-Cecil. Umhla wama-25. IPhiladelphia, PA: Elsevier Saunders; I-2016: isahluko 227.