Isifo seCushing

I-Cushing syndrome sisifo esenzeka xa umzimba wakho ukwinqanaba eliphezulu le-cortisol yehomoni.

Esona sizathu sixhaphakileyo se-Cushing syndrome sithatha iyeza le-glucocorticoid kakhulu okanye iyeza le-corticosteroid. Olu hlobo lwe-Cushing syndrome lubizwa ngokuba yi-Cushing syndrome engaphandle. I-Prednisone, i-dexamethasone, kunye ne-prednisolone yimizekelo yolu hlobo lwamayeza. I-Glucocorticoids ilingisa isenzo sehomoni yendalo yomzimba wecortisol. La machiza asetyenziselwa ukunyanga iimeko ezininzi ezinje nge-asthma, ukudumba kolusu, umhlaza, isifo samathumbu, iintlungu ezidibeneyo, kunye nesifo samathambo.

Abanye abantu bakhula isifo seCushing ngenxa yokuba umzimba wabo uvelisa kakhulu i-cortisol. Le hormone yenziwa kwiincindi ze-adrenal. Oonobangela becortisol eninzi zezi:

• Isifo se-Cushing, esenzeka xa i-pituitary gland yenza kakhulu i-hormone ye-adrenocorticotrophic hormone (ACTH). I-ACTH emva koko isayina iadrenal amadlala ukuba ivelise kakhulu i-cortisol. Ithumba lengqula linokubangela le meko.
• Ithumba ye-adrenal gland
• Ithumba kwenye indawo emzimbeni evelisa i-corticotropin-releasing hormone (CRH)
• Amathumba kwenye indawo emzimbeni avelisa i-ACTH (ectopic Cushing syndrome)

Iimpawu ziyahluka. Asinguye wonke umntu one-Cushing syndrome eneempawu ezifanayo. Abanye abantu baneempawu ezininzi ngelixa abanye bengenazo kwaphela iimpawu.

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 lunokubandakanya:

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

Utshintsho lwemisipha kunye nethambo lubandakanya:

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

Utshintsho lomzimba ngokubanzi (systemic) lubandakanya:

• Uhlobo lwe-2 yeswekile
• Uxinzelelo lwegazi (uxinzelelo lwegazi)
• Ukonyusa i-cholesterol kunye ne-triglycerides (hyperlipidemia)

Abasetyhini abane-Cushing syndrome banokuba:

• Ukukhula okungaphezulu kweenwele ebusweni, entanyeni, esifubeni, esiswini nasemathangeni
• Amaxesha angabikho mgaqweni okanye ayeke

Amadoda anokuba:

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

Ezinye iimpawu ezinokuthi zenzeke kwesi sifo:

• 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.

Iimvavanyo zaselebhu ezinokuthi zenziwe ukufumanisa isifo seCushing kunye nokuchonga unobangela zezi:

• Inqanaba legazi le-cortisol
• Iswekile yegazi
• Inqanaba le-Saliva cortisol
• Uvavanyo lokucinezelwa kweDexamethasone
• Umchamo weyure ezingama-24 ze-cortisol kunye ne-creatinine
• Inqanaba le-ACTH
• Uvavanyo lokukhuthaza i-ACTH (kwiimeko ezinqabileyo)

Uvavanyo lokufumanisa unobangela okanye iingxaki zinokubandakanya:

• Isisu se-CT
• I-MRI yePituitary
• Ubuninzi bamaminerali amathambo

Unyango luxhomekeke kwisizathu.

I-Cushing syndrome ebangelwa kukusetyenziswa kwe-corticosteroid:

• Umboneleli wakho uya kukuyalela ukuba unciphise kancinci umthamo weyeza. Ukuyeka iyeza ngesiquphe kunokuba yingozi.
• Ukuba awukwazi ukuyeka ukuthatha iyeza ngenxa yesifo, iswekile yegazi lakho liphezulu, amanqanaba aphezulu e-cholesterol, kunye nokuncipha kwethambo okanye i-osteoporosis kufuneka kujongwe kwaye unyangwe.

Nge-Cushing syndrome ebangelwa yipituitary okanye ithumba ekhupha i-ACTH (Cushing disease), unokufuna:

• Utyando lokususa ithumba
• Imitha emva kokususwa kwesisu sepituitary (kwezinye iimeko)
• Unyango lwe-Cortisol emva kotyando
• Amayeza okutshintsha iihomoni zepituitary eziye zazisilela
• Amayeza okuthintela umzimba ekwenzeni i-cortisol eninzi kakhulu

Ukuba ne-Cushing syndrome ngenxa yesifo sepituitary, ithumba le-adrenal, okanye amanye amathumba:

• Unokufuna utyando ukususa ithumba.
• Ukuba ithumba alinakususwa, unokufuna amayeza anokukunceda ukhuphe i-cortisol.

Ukususa ithumba kungakhokelela ekuvuseleleni ngokupheleleyo, kodwa kukho ithuba lokuba imeko ibuye.

Ukusinda kwabantu abane-Cushing syndrome ebangelwa ngamathumba kuxhomekeke kuhlobo lwethumba.

Ukunganyangwa, i-Cushing syndrome inokubusongela ubomi.

Iingxaki zempilo ezinokubangelwa yi-Cushing syndrome zibandakanya nayiphi na kwezi zilandelayo:

• Seswekile
• Ukwandiswa kwethumba le-pituitary
• Amathambo aqhekeka ngenxa ye-osteoporosis
• Igazi elonyukayo
• Amatye eentso
• Usulelo olubi

Tsalela umnikezeli wakho ukuba unempawu zeCushing 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.

Hypercortisolism; Ukugqithisa kweCortisol; Ukugqithisa kweglucocorticoid-Cushing syndrome

• Amadlala endocrine

UNieman LK, uBiller BM, u-Findling JW, et al; Umbutho we-Endocrine. Unyango lwe-Cushing's syndrome: Isikhokelo sonyango se-Endocrine Society. J Ikliniki ye-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 ebhaliweyo kaWilliam ye-Endocrinology. Umhla we-13. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 15.