Isifo se-Cushing syndrome

I-Exogenous Cushing syndrome luhlobo lweCushing syndrome eyenzeka kubantu abathatha i-glucocorticoid (ekwabizwa ngokuba yi-corticosteroid, okanye i-steroid) iihormone.

I-Cushing syndrome sisifo esenzeka xa umzimba wakho ukwinqanaba eliphezulu kune-cortisol yehomoni. Le hormone iqhele ukwenziwa kwiincindi zamadlala.

Izinto ezingaqhelekanga ezibangelwa yinto engaphandle komzimba. I-Exo native Cushing syndrome yenzeka xa umntu ethatha amayeza elenziwe ngumntu (elenziweyo) le-glucocorticoid ukunyanga isifo.

I-Glucocorticoids inikezelwa kwizifo ezininzi, ezinje ngezifo zemiphunga, iimeko zolusu, isifo sokukrala kwamathumbu, umhlaza, izicubu zobuchopho kunye nezifo ezidibeneyo. La mayeza eza ngeendlela ezininzi, kubandakanya ipilisi, intravenous (IV), inaliti kwilungu, i-enema, izithambiso zolusu, inhalers, kunye nethontsi lamehlo.

Uninzi lwabantu abane-Cushing syndrome bane:

• Ujikeleze, ubomvu, ubuso obugcweleyo (ubuso benyanga)
• Izinga lokukhula kancinci (ebantwaneni)
• Ukutyeba ngokonyuka kwamafutha esiqwini, kodwa ukulahleka kwamafutha ezingalweni, emilenzeni nasezimpundu (ukutyeba kakhulu)

Utshintsho lolusu oluhlala lubonwa lubandakanya:

• Usulelo 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

Utshintsho lwemisipha kunye nethambo lubandakanya:

• Umqolo obuhlungu, owenzeka ngemisebenzi yesiqhelo
• Intlungu yethambo okanye ukuthamba
• Ukuqokelelwa kwamafutha phakathi kwamagxa nangaphezulu kwethambo lekhola
• Iimbambo kunye nokuqhekeka komqolo okubangelwa kukuncipha kwamathambo
• Izihlunu ezibuthathaka, ngakumbi ezinqeni nasemagxeni

Iingxaki zomzimba ngokubanzi (zenkqubo) zinokubandakanya:

• Uhlobo lwe-2 yeswekile
• Igazi elonyukayo
• I-cholesterol ephezulu kunye ne-triglycerides

Abasetyhini banokuba:

• Amaxesha angabikho mgaqweni okanye ayeke

Amadoda anokuba:

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

Ezinye iimpawu ezinokuthi zenzeke zibandakanya:

• Utshintsho lwengqondo, olufana nokudakumba, unxunguphalo, okanye utshintsho kwindlela yokuziphatha
• Ukudinwa
• Intloko ebuhlungu
• Ukwanda ukoma kunye nokuchama

Umboneleli wezempilo uya kwenza uvavanyo lomzimba kwaye abuze malunga neempawu zakho kunye namayeza owathathayo. Xelela umboneleli ngawo onke amayeza owasebenzisileyo kwezi nyanga zidlulileyo. Xelela umboneleli malunga neefoto ozifumene kwiofisi yomboneleli.

Ukuba usebenzisa i-cortisone, i-prednisone, okanye enye i-corticosteroids, ezi ziphumo zovavanyo zilandelayo zinokuphakamisa i-Cushing syndrome engaphandle:

• Inqanaba eliphantsi le-ACTH
• Inqanaba le-cortisol ephantsi (okanye inqanaba eliphezulu le-cortisol) egazini okanye kumchamo, kuxhomekeke kumayeza owathathayo
• Impendulo engaqhelekanga kuvavanyo lokukhuthaza i-cosyntropin (ACTH)
• Phezulu kune-glucose eqhelekileyo yokuzila
• Inqanaba eliphantsi le-potassium yegazi
• Ukuxinana kwamathambo asezantsi, njengoko kulinganiswa kuvavanyo lweeminerali zovavanyo
• I-cholesterol ephezulu, ngakumbi i-triglycerides ephezulu kunye ne-lipoprotein ephezulu (HDL)

Indlela ebizwa ngokuba kukusebenza okuphezulu kwe-chromatography yolwelo (i-HPLC) inokubonisa inqanaba eliphezulu leyeza elikrokrelwayo kumchamo.

Unyango luyancipha kwaye ekugqibeleni uyeke ukuthatha nayiphi na i-corticosteroids. Oku kunokwenziwa kancinci okanye ngokukhawuleza, kuxhomekeke ekubeni kutheni uphathwa nge-corticosteroid. Sukuyeka ukuthatha nawaphi na amayeza ngaphandle kokuqala uthethe nomboneleli wakho. Ukuyekisa ngesiquphe i-corticosteroids emva kokuyithatha ixesha elide kunokubangela imeko esongela ubomi ebizwa ngokuba yingxaki ye-adrenal.

Ukuba awukwazi ukuyeka ukuthatha iyeza ngenxa yesifo (umzekelo, udinga amayeza e-glucocorticoid ukunyanga isifuba esibi), landela imiyalelo yomboneleli wakho malunga nendlela yokunciphisa ukubakho kwengxaki, kubandakanya:

• Ukunyanga iswekile ephezulu yegazi ngokutya, amayeza omlomo, okanye i-insulin.
• Ukunyanga i-cholesterol ephezulu ngokutya okanye amayeza.
• Ukuthatha amayeza ukuthintela ukulahleka kwethambo. Oku kunokunceda ukunciphisa umngcipheko wokuqhekeka ukuba uphuhlisa i-osteoporosis.
• Ukuthatha amanye amayeza ukunciphisa inani lamayeza e-glucocorticoid oyifunayo.

Ukucothisa kancinci amayeza abangela imeko kunokunceda ukuguqula iziphumo ze-adrenal gland shrinkage (atrophy). Oku kungathatha iinyanga kude kube ngunyaka. Ngeli xesha, unokufuna ukuqala kwakhona okanye ukonyusa idosi ye-steroids yakho ngexesha loxinzelelo okanye lokugula.

Iingxaki zempilo ezinokubangela ukuphuma kwe-Cushing syndrome kubandakanya nayiphi na kwezi zinto zilandelayo:

• Amajoni omzimba asezantsi, anokukhokelela kukosuleleka rhoqo
• Ukonakala kwamehlo, izintso, kunye nemithambo-luvo ngenxa yeswekile ephezulu yegazi enganyangekiyo
• Seswekile
• Amanqanaba aphezulu e-cholesterol
• Umngcipheko okhulayo wokuhlaselwa sisifo seswekile esinganyangekiyo kunye ne-cholesterol ephezulu
• Umngcipheko owandayo wamahlwili egazi
• Amathambo abuthathaka (i-osteoporosis) kunye nomngcipheko owandayo wokuqhekeka

Ezi ngxaki zinokuthintelwa ngonyango olufanelekileyo.

Biza ukuqeshwa kunye nomboneleli wakho ukuba uthatha i-corticosteroid kwaye uhlakulela iimpawu ze-Cushing syndrome.

Ukuba uthatha i-corticosteroid, yazi iimpawu kunye neempawu zesifo seCushing. Ukufumana unyango kwangoko kunokunceda ukuthintela naziphi na iziphumo zexesha elide zeCushing syndrome. Ukuba usebenzisa i-inhaled steroids, unganciphisa ukubonakaliswa kwakho kwi-steroids ngokusebenzisa i-spacer kunye nokucoca umlomo wakho emva kokuphefumla kwi-steroids.

I-Cushing syndrome-i-corticosteroid eyenziweyo; ICorticosteroid-indened Cushing syndrome; Isifo seIatrogenic Cushing

• Imveliso yehypothalamus hormone

UNieman LK, uBiller BM, uKufumana uJW, et al.Unyango lwe-Cushing's syndrome: Isikhokelo sonyango se-Endocrine Society.UJ Clin Endocrinol Metab. Ngo-2015; 100 (8): 2807-2831. IINKCUKACHA: 26222757 www.ncbi.nlm.nih.gov/pubmed/26222757.

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