Maʻi Addison

ʻO ka maʻi Addison kahi maʻi e hiki ke hana ʻole nā ​​adrenal glands i nā hormona.

ʻO nā momona adrenal he mau mea hoʻokuʻu hoʻokuʻu liʻiliʻi i hoʻonohonoho ʻia ma luna o kēlā me kēia puʻupaʻa. Hana ʻia lākou i kahi ʻāpana i waho, i kapa ʻia ʻo Cortex, a me kahi ʻāpana o loko, i kapa ʻia ʻo medulla.

Hana ka cortex i 3 mau homone:

• Mālama nā homone Glucocorticoid (e like me ka cortisol) i ke kaohi kō (glucose), hoʻoliʻiliʻi (kāohi) i ka pane ʻōnaehana, a kōkua i ke kino e pane i ke kaumaha.
• ʻO nā hormones Mineralocorticoid (e like me aldosterone) hoʻoponopono i ka sodium, ka wai a me ke kaulike potassium.
• ʻO nā homone wahine, androgens (kāne) a me estrogens (wahine), e hoʻopili i ka ulu ʻana o ka moekolohe a me ka hoʻokele wahine.

Loaʻa nā maʻi Addison mai ka hōʻino ʻana i ka adrenal cortex. ʻO ka hōʻino ke kumu o ka cortex e hana i nā pae hormone i haʻahaʻa loa.

ʻO kēia mau kumu i kumu ʻia e kēia mau mea:

• Ke hoʻouka kuhi hewa nei ka ʻōnaehana pale i nā ʻōpū adrenal (maʻi autoimmune)
• ʻO nā maʻi e like me ka maʻi puʻupuʻu, HIV, a me nā maʻi fungal paha
• Hemorrhage i loko o nā adrenal glands
• Nā Tumors

ʻO nā kumu pilikia no ka maʻi autoimmune o ka maʻi Addison me nā maʻi autoimmune ʻē aʻe:

• ʻO ka pehu (ka mumū) o ka pona thyroid e hopena pinepine ai i ka hoʻoemi ʻia o ka hana thyroid (thyroiditis mau).
• Hana ka thyroid gland i ka nui o ka hormone thyroid (ka nui o ka thyroid, ka maʻi Graves)
• ʻIke ka huehue me nā puʻupuʻu a me nā palapū (dermatitis herpetiformis)
• ʻAʻole hana nā ʻōpala Parathyroid i ka ʻāʻī i ka nui o ka hormone parathyroid (hypoparathyroidism)
• ʻAʻole hana ka pituitary gland i nā huina maʻamau o kekahi a i ʻole o kāna mau hormones (hypopituitarism)
• ʻO ka maʻi Autoimmune e hoʻopili i nā aʻa a me nā mākala a lākou e kaohi ai (myasthenia gravis)
• ʻAʻohe o ke kino i lawa i nā hunaola ʻulaʻula olakino (anemia anemia)
• ʻAʻole hiki i nā testicle ke hana i ka sperm a i ʻole nā ​​kāne kāne (testicular failed)
• ʻAno I diabetes
• Ka nalowale ʻana o ke kala ʻeleʻele (pigment) mai nā wahi o ka ʻili (vitiligo)

Hiki i kekahi mau ʻano kīnā ʻole laha ʻole ke kumu o ka lawa ʻole o adrenal.

Nā hōʻailona o ka maʻi Addison i loko o kēia mau mea:

• Abdominal eha
• ʻO ka maʻi diarrhea, nausea, a me ka luaʻi
  
• ʻEleʻele o ka ʻili
• Make wai
• Pōpōpō ke kū ʻana i luna
• Kaha wela
• Koko kōpaʻa haʻahaʻa
• Kaomi haʻahaʻa
• ʻO ka nāwaliwali loa, ka luhi, a me ka neʻe, lohi
• ʻIli ʻeleʻele i loko o ka pāpālina a me nā lehelehe (buccal mucosa)
• Makemake nui i ka paʻakai (ʻai i ka meaʻai me ka paʻakai nui)
• ʻO ka hōʻemi kaumaha me ka makemake nui i hoʻemi ʻia

ʻAʻole paha nā ʻōuli i nā manawa āpau. Nui nā poʻe i kekahi a i ʻole o kēia mau ʻōuli āpau ke loaʻa lākou i ka maʻi a i ʻole ke koʻikoʻi ʻē aʻe i ke kino. I kekahi mau manawa, ʻaʻohe o lākou hōʻailona.

E hana ka mea mālama ola i kahi hoʻokolohua kino a nīnau e pili ana i nā ʻōuli.

E kauoha ʻia paha nā hōʻike koko a hōʻike paha:

• Hoʻonui i ka potassium
• Ke kahe haʻahaʻa, ʻoi loa me ka loli o ke kūlana o ke kino
• Pākuʻi liʻiliʻi kortisol
• Pae paʻakai haʻahaʻa
• PH haʻahaʻa
• Nā pae testosterone a me nā estrogen maʻamau, akā haʻahaʻa ka pae DHEA
• Helu eosinophil kiʻekiʻe

Kauoha ʻia paha nā hoʻokolohua hoʻokolohua hou aʻe.

Hiki i nā hoʻokolohua ʻē aʻe ke:

• Hihi x ʻōpū
• Scanner CT ʻōpū
• Hōʻike hoʻonāukiuki ʻo Cosyntropin (ACTH)

ʻO ka mālama ʻana me nā corticosteroids a me nā mineralocorticoids e kaohi i nā ʻōuli o kēia maʻi. Pono e lawe i kēia mau lāʻau i ke ola.

Mai hōʻalo wale i nā lāʻau o kāu lāʻau no kēia ʻano no ka mea e hiki ke hana i nā hopena hoʻoweliweli.

E haʻi paha kāu mea hāʻawi iā ʻoe e hoʻonui i kāu mea hana no kahi manawa pōkole ma muli o:

• Maʻi kīnā
• ʻEhaʻeha
• Kaumaha
• ʻOki kino

I loko o kahi ʻano nui o ka lawa ʻole o adrenal, i kapa ʻia ʻo adrenal crisis, pono ʻoe e hoʻopili koke i ka hydrocortisone. ʻO ka mālama ʻana no ke kaomi haʻahaʻa e pono pū kekahi.

Ua aʻo ʻia kekahi poʻe me ka maʻi ʻo Addison e hāʻawi iā lākou iho i kahi kuʻi pilikia o ka hydrocortisone i nā manawa pilikia. Lawe mau i ka ID olakino (kāleka, kūpeʻe lima, a i ʻole ka lei) i ʻōlelo e loaʻa ka lawa ʻole o ka adrenal. Pono e ʻōlelo ka ID i ke ʻano o ka lāʻau a me nā mea pono āu e pono ai i ka wā pilikia.

Me ka hoʻomaʻamaʻa hormone, hiki i nā poʻe he nui me ka maʻi Addison ke alakaʻi i kahi ola maʻamau.

Hiki ke hana i nā pilikia inā lawe ʻoe i ka liʻiliʻi a i ʻole ka nui o ka adrenal hormone.

Kāhea i kāu mea hāʻawi inā:

• ʻAʻole hiki iā ʻoe ke mālama i kāu lāʻau ma muli o ka luaʻi.
• Loaʻa iā ʻoe ke koʻikoʻi e like me ka maʻi, ʻeha, ʻeha, a me ka make wai. Pono paha ʻoe e hoʻoponopono i kāu lāʻau.
• Hoʻonui ka hoʻonui o kou kaumaha i ka manawa.
• Hoʻomaka ka pehu o kou kuʻekuʻe wāwae.
• Hoʻokumu ʻoe i nā ʻōuli hou.
• Ma ka mālama ʻana, hoʻomohala ʻoe i nā hōʻailona o kahi maʻi i kapa ʻia ʻo Cushing Syndrome

Inā loaʻa iā ʻoe nā ʻōuli o ka pilikia adrenal, e hāʻawi iā ʻoe iho i kahi kuʻikuʻi pilikia o kāu lāʻau i kuhikuhi ʻia. Inā ʻaʻole loaʻa, e hele i kahi lumi pilikia kokoke a kāhea paha iā 911.

ʻO nā ʻōuli o ka pilikia adrenal me:

• Abdominal eha
• Hanu paʻakikī
• ʻO ka puʻupuʻu a i ʻole ka uila
• Kaomi haʻahaʻa
• Hoʻoemi i ka pae o ka ʻike

Hypofunction Adrenocortical; Ka lawa adrenocortical lawa; ʻO ka lawa ʻole adrenal kumu

• Nānā Endocrine

ʻO Barthel A, Benker G, Berens K, et al. Hoʻohou i kahi maʻi o Addison. Exp ʻO Clin Endocrinol Diabetes. 2019; 127 (2-03): 165-175. PMID: 30562824 www.ncbi.nlm.nih.gov/pubmed/30562824.

Bornstein SR, Allolio B, Arlt W, et al. ʻIke a me ka mālama ʻana i ka pono adrenal kumu mua: kahi papa hana hoʻomaʻamaʻa ʻo Endocrine Society. ʻO J Clin Endocrinol Metab. 2016; 101 (2): 364-389. PMID: PMC4880116 www.ncbi.nlm.nih.gov/pmc/articles/PMC4880116.

Nieman LK. ʻO adrenal Cortex. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 25th hua. Piladelapia, PA: Elsevier Saunders; 2016: chap 227.