Yonke into ekufuneka uyazi malunga neCushing's Syndrome

Umxholo

• Ushwankathelo
• Iimpawu zesifo sikaCushing
• Ebantwaneni
• Kwabafazi
• Emadodeni
• Isifo sikaCushing's syndrome sibangela
• ICorticosteroids
• Amathumba
• Isifo sikaCushing
• Unyango lwe-Cushing's syndrome
• Ukuxilongwa kwe-Cushing's syndrome
• Ukuchonga unobangela we-Cushing's syndrome
• Ukutya kwesifo sikaCushing's syndrome
• Iimpawu zomngcipheko wesifo sikaCushing
• Ulawulo lwe-Cushing's syndrome
• Imbonakalo yeCushing's syndrome

Ushwankathelo

I-Cushing's syndrome okanye i-hypercortisolism, yenzeka ngenxa yamanqanaba aphezulu ngokungaqhelekanga e-hormone ye-cortisol. Oku kunokwenzeka ngenxa yezizathu ezahlukeneyo.

Kwiimeko ezininzi, ukufumana unyango kunokukunceda ulawule amanqanaba akho e-cortisol.

Iimpawu zesifo sikaCushing

Ezona mpawu zixhaphakileyo zale meko zezi:

• ukutyeba kwakho
• iidipozithi ezinamanqatha, ngakumbi phakathi embindini, ubuso (obubangela ukujikeleza, ubuso obunenyanga), naphakathi kwamagxa kunye nomqolo ongaphezulu (kubangela inyongo)
• Iimpawu ezimfusa ezisesifubeni, ezingalweni, esiswini nasemathangeni
• ulusu olucekethekileyo olukruquka ngokulula
• ukwenzakala kolusu okucothayo ukunyanga
• induna
• ukudinwa
• ubuthathaka bemisipha

Ukongeza kwiimpawu eziqhelekileyo apha ngasentla, kukho ezinye iimpawu ezinokuthi ngamanye amaxesha zibonwe kubantu abane-Cushing's syndrome.

Oku kunokubandakanya:

• iswekile ephezulu yegazi
• ukwanda kokoma
• ukwanda komchamo
• osteoporosis
• uxinzelelo lwegazi (uxinzelelo lwegazi)
• intloko ebuhlungu
• ukuhamba kweemvakalelo
• ixhala
• ukucaphuka
• ukudakumba
• ukwanda kweziganeko zosulelo

Ebantwaneni

Abantwana banokuba nesifo sikaCushing's, nabo, nangona bekhula kancinci kunabantu abadala. Ngokophando lwe-2019, malunga neemeko ezintsha ze-Cushing's syndrome minyaka le zenzeka ebantwaneni.

Ukongeza kwiimpawu ezingentla, abantwana abane-Cushing's syndrome banokuba nazo:

• ukutyeba kakhulu
• ukukhula kancinci
• uxinzelelo lwegazi (uxinzelelo lwegazi)

Kwabafazi

I-Cushing's syndrome ixhaphake kakhulu kubafazi kunamadoda. NgokweZiko lezeMpilo leSizwe (i-NIH), amatyeli amathathu abasetyhini abaphuhlisa i-Cushing's syndrome xa kuthelekiswa namadoda.

Abasetyhini abane-Cushing's syndrome banokukhulisa iinwele zobuso kunye nezomzimba.

Oku kuhlala kwenzeka rhoqo kwi:

• ubuso nentamo
• isifuba
• isisu
• amathanga

Ukongeza, abasetyhini abane-Cushing's syndrome banokuba namava ngokungaqhelekanga. Ngamanye amaxesha, ukuya exesheni akukho kwaphela. Ukunganyangwa kwe-Cushing's syndrome kwabasetyhini kunokukhokelela kubunzima bokukhulelwa.

Emadodeni

Njengakwimeko yabafazi nabantwana, amadoda ane-Cushing's syndrome nawo anokufumana ezinye iimpawu ezongezelelweyo.

Amadoda ane-Cushing's syndrome anokuba nawo:

• Ukungasebenzi kakuhle kwe-erectile
• ukulahleka komdla wesondo
• kunciphise ukuzala

Isifo sikaCushing's syndrome sibangela

Isifo sikaCushing's syndrome sibangelwa kukudlulwa kwehomoni cortisol. Amadlala akho eadrenal avelisa icortisol.

Inceda ngemisebenzi emininzi yomzimba wakho, kubandakanya:

• ukumisela uxinzelelo lwegazi kunye nenkqubo yentliziyo
• ukunciphisa ukuphendula okuvuthayo kwamajoni omzimba
• ukuguqula ii-carbohydrate, amafutha, kunye neeproteni kumandla
• Ukulinganisa iziphumo ze-insulin
• Ukuphendula kuxinzelelo

Umzimba wakho unokuvelisa amanqanaba aphezulu e-cortisol ngezizathu ezahlukeneyo, kubandakanya:

• amanqanaba aphezulu oxinzelelo, kubandakanya uxinzelelo olunxulumene nokugula kakhulu, utyando, ukwenzakala, okanye ukukhulelwa, ngakumbi kwikota yokugqibela
• uqeqesho lweembaleki
• ukungondleki
• utywala
• uxinzelelo, ukuphazamiseka, okanye amanqanaba aphezulu oxinzelelo lweemvakalelo

ICorticosteroids

Unobangela oqhelekileyo we-Cushing's syndrome kukusetyenziswa kwamayeza e-corticosteroid, anje nge-prednisone, kwiidosi eziphezulu ixesha elide. Ababoneleli ngezempilo banokuyalela oku ukuba banyange izifo ezinokutsha, ezinje nge-lupus, okanye ukuthintela ukwaliwa kwelungu elifakelweyo.

Iidosi eziphezulu ze-steroids ezitofwayo zokunyanga iintlungu zangasemva nazo zinokubangela isifo sikaCushing. Nangona kunjalo, i-dose ephantsi ye-steroids ngohlobo lwe-inhalants, ezinjengezo zisetyenziselwa i-asthma, okanye i-creams, njengalezo ezimiselwe i-eczema, ngokuqhelekileyo azanele ngokwaneleyo ukuba zibangele imeko.

Amathumba

Iindidi ezininzi zamathumba zinokukhokelela kwimveliso ephezulu yecortisol.

Ezinye zezi ziquka:

• Amathumba endlala yebhinqa. Idlala lengqula likhupha iadrenocorticotropic hormone (ACTH) eninzi, evuselela imveliso yecortisol kwincindi yeadrenal. Oku kubizwa ngokuba sisifo sikaCushing.
• Izidumba ze-Ectopic. Ezi ngamathumba angaphandle kwendawo yokuvelisa i-ACTH. Ngokuqhelekileyo zivela kwimiphunga, i-pancreas, i-thyroid, okanye i-thymus gland.
• Ukungaqhelekanga kwe-adrenal gland okanye i-tumor. Ukungaqhelekanga kwe-adrenal okanye ithumba kunokukhokelela kwiipateni ezingaqhelekanga zemveliso yecortisol, enokubangela isifo sikaCushing.
• Isifo sikaCushing's syndrome. Nangona i-Cushing's syndrome ingaqhelekanga njengelifa, kunokwenzeka ukuba ube nelifa lokuthambekela ekuphuhliseni izicubu zamadlala endocrine.

Isifo sikaCushing

Ukuba i-Cushing's syndrome ibangelwa yidlala yebhinqa evelisa i-ACTH ethi yona ibe yi-cortisol, ibizwa ngokuba sisifo sikaCushing.

Njengakwi-Cushing's syndrome, isifo sikaCushing sichaphazela abafazi abaninzi kunamadoda.

Unyango lwe-Cushing's syndrome

Injongo iyonke yonyango lwe-Cushing's syndrome kukunciphisa amanqanaba e-cortisol emzimbeni wakho. Oku kunokufezekiswa ngeendlela ezininzi. Unyango olufumanayo luya kuxhomekeka kwinto ebangela imeko yakho.

Umboneleli wakho wezempilo unokuyalela amayeza ukunceda ukulawula amanqanaba e-cortisol. Amanye amayeza anciphisa ukuveliswa kwe-cortisol kwiincindi ze-adrenal okanye ukunciphisa imveliso ye-ACTH kwi-pituitary gland. Amanye amayeza athintela ukusebenza kwecortisol kwizicubu zakho.

Imizekelo ibandakanya:

• ketoconazole (Nizoral)
• mitotane (iLysodren)
• iMetyrapone (iMetopirone)
• ipasireotide (uphawu)
• mifepristone (Korlym, Mifeprex) kubantu abane-2 yeswekile okanye ukunganyamezelani kwe-glucose

Ukuba usebenzisa i-corticosteroids, utshintsho kunyango okanye kumthamo kunokuba yimfuneko. Ungazami ukutshintsha idosi ngokwakho. Kuya kufuneka wenze oku phantsi kolawulo olusondeleyo lonyango.

Izidumba zinokuba zibi, oko kuthetha ukuba unomhlaza, okanye ubungozi, oko kuthetha ukuba awunomdlavuza.

Ukuba imeko yakho ibangelwa yithumba, umboneleli wakho wezempilo unokufuna ukususa ithumba ngotyando. Ukuba ithumba alinakususwa, umboneleli wakho wokhathalelo lwempilo unokucebisa ngonyango lwe-radiation okanye ichemotherapy.

Ukuxilongwa kwe-Cushing's syndrome

Isifo sikaCushing's kunokuba nzima ngakumbi ukusixilonga. Kungenxa yokuba uninzi lweempawu, njengokufumana ubunzima okanye ukudinwa, zinokuba nezinye izizathu. Ukongeza, i-Cushing's syndrome ngokwayo inokuba nezizathu ezininzi ezahlukeneyo.

Umboneleli wakho wezempilo uya kuyiphonononga imbali yakho yonyango. Baza kubuza imibuzo malunga neempawu, naziphi na iimeko zempilo onokuba nazo, kunye nawaphi na amayeza onokuthi umiselwe.

Kananjalo baya kwenza uvavanyo lomzimba apho baya kujonga iimpawu ezinjenge-hump yenyathi, kunye namanqaku olulekileyo kunye nemivimbo.

Okulandelayo, banoku-odola iimvavanyo zaselebhu, kubandakanya:

• Uvavanyo lwe-cortisol yasimahla yeeyure ezingama-24: Kolu vavanyo, uya kucelwa ukuba uqokelele umchamo wakho ngaphezulu kweeyure ezingama-24. Kuya kuvavanywa amanqanaba e-cortisol.
• Umlinganiso we-Salivary cortisol: Kubantu abangenayo i-Cushing's syndrome, amanqanaba e-cortisol ehla ngokuhlwa. Olu vavanyo lilinganisa inqanaba le-cortisol kwisampulu yamathe eye yaqokelelwa ebusuku kakhulu ukubona ukuba amanqanaba e-cortisol aphezulu kakhulu.
• Uvavanyo lokucinezelwa lwedosi ephantsi: Kolu vavanyo, uya kunikwa idosi ye-dexamethasone ngorhatya. Igazi lakho liya kuvavanywa amanqanaba e-cortisol kusasa. Ngokwesiqhelo, i-dexamethasone ibangela amanqanaba e-cortisol ukuba ehle. Ukuba une-Cushing's syndrome, oku ngekhe kwenzeke.

Ukuchonga unobangela we-Cushing's syndrome

Emva kokuba ufumene isifo se-Cushing's syndrome, umboneleli wakho wezempilo kufuneka aqonde unobangela wemveliso yecortisol egqithisileyo.

Uvavanyo lokunceda ukumisela unobangela unokubandakanya:

• Uvavanyo lwehomoni yeadrenocorticotropin hormone (ACTH): Amanqanaba e-ACTH egazini ayalinganiswa. Amanqanaba asezantsi e-ADTH kunye namanqanaba aphezulu e-cortisol anokubonisa ubukho be-tumor kwiincindi ze-adrenal.
• I-Corticotropin-ekhulula i-hormone (CRH) yovavanyo lokukhuthaza: Kolu vavanyo, kunikezelwa umpu weCRH. Oku kuyonyusa amanqanaba e-ACTH kunye ne-cortisol kubantu abanezilonda zepituitary.
• Uvavanyo lokucinezelwa lweedosi ephezulu: Oku kuyafana novavanyo lwedosi esezantsi, ngaphandle kokuba kusetyenziswa idosi ephezulu ye-dexamethasone. Ukuba amanqanaba e-cortisol ehla, unokuba nethumba lesifo. Ukuba abanako unganethumba le-ectopic.
• Isampulu yesono sikaPetrosal: Igazi litsalwa emthanjeni kufutshane ne-pituitary nakwimithambo ekude ne-pituitary. Ukudubula kweCRH kunikwa. Amanqanaba aphezulu e-ACTH egazini kufutshane ne-pituitary anokubonisa ithumba lelungu. Amanqanaba afanayo avela kuzo zombini iisampulu abonisa ithumba le-ectopic.
• Izifundo zokulinganisa: Oku kunokubandakanya izinto ezinje nge-CT kunye neMRI scan. Zisetyenziselwa ukujonga ngeso lengqondo iadrenal kunye nedlala lengqula ukujonga amathumba.

Ukutya kwesifo sikaCushing's syndrome

Nangona utshintsho ekutyeni alunakuyinyanga imeko yakho, banokukunceda ukugcina amanqanaba akho e-cortisol ekunyukeni nangaphezulu okanye ekuncedeni ukuthintela ezinye iingxaki.

Ezinye iingcebiso ngokutya kwabo bane-Cushing's syndrome zibandakanya:

• Ukubeka iliso kwindlela otya ngayo ikhalori. Ukugcina umkhondo wekhalori yakho oyifunayo kubalulekile kuba ukutyeba kobunzima yenye yezona mpawu ziphambili zesifo sikaCushing.
• Zama ukunqanda ukusela utywala. Ukusetyenziswa kotywala kunxulunyaniswe nokunyuka kwamanqanaba e-cortisol, ngakumbi, ngokokufunda kuka-2007.
• Jonga iswekile yegazi lakho. I-Cushing's syndrome inokukhokelela kwi-glucose ephezulu yegazi, ke zama ukungakutyi ukutya okunokubangela ukunyuka kweswekile yegazi. Imizekelo yokutya ekugxilwe kuyo kukutya kubandakanya imifuno, iziqhamo, ukutya okuziinkozo kunye nentlanzi.
• Sika kwakhona kwi-sodium. Isifo sikaCushing's sikwanxulunyaniswa noxinzelelo lwegazi (uxinzelelo lwegazi). Ngenxa yoku, zama ukunciphisa umda we-sodium. Ezinye iindlela ezilula zokwenza oku kubandakanya ukungafaki ityuwa kukutya kunye nokufunda ngononophelo iilebheli zokutya ukujonga umxholo wesodium.
• Qinisekisa ukufumana i-calcium eyaneleyo kunye ne-vitamin D. ICushing’s syndrome inokuwenza buthathaka amathambo akho, ikwenze uthambekele ekuqhekekeni. Zombini i-calcium kunye nevithamin D zinokunceda ukomeleza amathambo akho.

Iimpawu zomngcipheko wesifo sikaCushing

Eyona nto iphambili ekuphuhliseni i-Cushing's syndrome kukuthatha idosi ephezulu yecorticosteroids ixesha elide. Ukuba umboneleli wakho wezempilo umisele i-corticosteroids ukuba inyange imeko yempilo, babuze malunga nedosi kunye nokuba uza kubathatha ixesha elingakanani.

Eminye imingcipheko inokubandakanya:

• uhlobo-2 lweswekile olungalawulwa kakuhle
• uxinzelelo lwegazi (uxinzelelo lwegazi)
• ukutyeba kakhulu

Ezinye iimeko ze-Cushing's syndrome zibangelwa kukudumba kwethumba. Nangona kunokubakho imeko yemfuza yokuphuhlisa amathumba endocrine (usapho lweCushing's syndrome), akukho ndlela yokuthintela amathumba ekubeni abumbe.

Ulawulo lwe-Cushing's syndrome

Ukuba une-Cushing's syndrome, kubalulekile ukuba ilawulwe ngokufanelekileyo. Ukuba awufumani nyango ngayo, i-Cushing's syndrome inokukhokelela kubunzima bempilo obunokubakho.

Oku kunokubandakanya:

• i-osteoporosis, enokunyusa umngcipheko wokuqhekeka kwethambo
• ukulahleka kwemisipha (atrophy) kunye nobuthathaka
• uxinzelelo lwegazi (uxinzelelo lwegazi)
• uhlobo lwe-2 yeswekile
• usulelo rhoqo
• isifo sentliziyo okanye ukubetha
• uxinzelelo okanye uxinzelelo
• ubunzima bokuqonda njengengxaki yokugxila okanye iingxaki kwimemori
• ukwandiswa kwethumba esele likho

Imbonakalo yeCushing's syndrome

Ngokukhawuleza uqala unyango, ngcono isiphumo esilindelekileyo. Kubalulekile ukuba uqaphele ukuba imbonakalo yakho ixhomekeke kwisizathu esithile kunye nonyango olufumanayo.

Kungathatha ixesha ukuba iimpawu zakho ziphuculwe. Qiniseka ukuba ubuza umboneleli wakho wezempilo ngezikhokelo zokutya ezisempilweni, ugcine ukuqeshwa, kunye nokwandisa inqanaba lomsebenzi wakho kancinci.

Amaqela enkxaso anokukunceda ukumelana nesifo sikaCushing. Isibhedlele sakho okanye umboneleli wezempilo angakunika ulwazi malunga namaqela ahlangana kwindawo yakho.