ʻO Cushing syndrome ma muli o ka tumeke adrenal

ʻO Cushing syndrome ma muli o ka tumeke adrenal kahi ʻano o Cushing syndrome. Hana ia i ka manawa e hoʻokuʻu ai kahi tumo o ka adrenal gland i nā nui o ka hormone cortisol.

ʻO Cushing Syndrome kahi maʻi e kū i ka wā i kiʻekiʻe ai kou kino ma mua o ka pae maʻamau o ka hormone cortisol. Hana ʻia kēia hormona i loko o nā adrenal glands. Hiki i ka nui o ka cortisol ma muli o nā pilikia like ʻole. ʻO kekahi pilikia e like me ka tumo ma kekahi o nā adrenal glands. Hoʻokuʻu nā kūpuna adrenal i ka cortisol.

ʻAʻohe laha nā hikoko adrenal. Hiki iā lākou ke noncancerous (benign) a i ʻole cancerous (malignant).

ʻO nā tumors noncancerous i hiki ke kumu i ka maʻi Cushing pū me:

• Adrenal adenomas, kahi tumo maʻamau i hana iki ʻole i ka nui o ka cortisol
• ʻO ka hyperplasia Macronodular, ka mea e hoʻonui ai a hoʻonui i ka nui o ka cortisol

Hiki i nā tumors cancerous ke kumu i ka maʻi ʻo Cushing me kahi carcinoma adrenal. He tumo kakaikahi kēia, akā hana maʻamau i ka nui o ka cortisol.

ʻO ka hapanui o ka poʻe me Cushing Syndrome he:

• Poepoe, ʻulaʻula, helehelena piha (maka maka)
• Lohi ka ulu ʻana o nā keiki
• Loaʻa kaupaona me ka hōʻiliʻili momona ma ke kumu, akā lilo ka momona mai nā lima, nā wāwae, a me nā puʻupuʻu (ka momona nui)

Hoʻololi ka ʻili i ʻike pinepine ʻia:

• Nā maʻi ʻili
• Nā māka poni (1/2 iniha a 1 kenimika a ʻoi ākea paha), i kapa ʻia ʻo striae, ma ka ʻili o ka ʻōpū, nā ʻūhā, nā lima luna, a me nā umauma
• ʻIli lahilahi me ka palapū maʻalahi

Hoʻololi kaʻiʻo a me ka iwi i:

• Backache, i kū me nā hana maʻamau
• ʻEha iwi a palupalu paha
• ʻOhi o ka momona ma waena o nā poʻohiwi a ma luna o ka iwi kola
• Nā ʻiwi a me nā iwi o ka iwi i hana ʻia e ka lahilahi o nā iwi
• Nā nāwaliwali nāwaliwali, ʻo ka puhaka a me nā poʻohiwi

ʻO ke hoʻololi ākea o ke kino (ʻōnaehana):

• ʻAno 2 diabetes mellitus
• Piʻi koko kiʻekiʻe
• Hoʻonui i ka cholesterol a me nā triglycerides

Loaʻa pinepine i nā wahine:

• ʻO ka ulu nui ʻana o ka lauoho ma ka maka, ka ʻāʻī, ka umauma, ʻōpū, a me nā ʻūhā (ʻoi aku ka maʻamau ma mua o nā ʻano ʻē aʻe o Cushing Syndrome)
• Nā wā i kūleʻa a kū hoʻi

Loaʻa paha i nā kāne:

• Hoemi a ʻaʻohe makemake i ka moekolohe (libido haʻahaʻa)
• Nā pilikia kūkulu

ʻO nā ʻōuli ʻē aʻe e kū pū paha me:

• Hoʻololi manaʻo, e like me ke kaumaha, hopohopo, a i ʻole nā ​​loli i ka lawena
• Ka luhi
• ʻEha poʻo
• Hoʻonui i ka make wai a me ka urination

E hana ka mea mālama ola i kahi hoʻokolohua kino a nīnau e pili ana i kāu mau hōʻailona.

Nā ho'āʻo e hōʻoia iā Cushing Syndrome:

• 24-hola mimi laʻana e ana i ka pae o ka cortisol a me ka creatinine
• Nā ho'āʻo koko e nānā iā ACTH, cortisol, a me nā pae potassium
• ʻO ka hoʻāʻo suppression Dexamethasone
• Nā pae cortisol koko
• Papa DHEA pae
• ʻO ka pae saliva cortisol

Nā hoʻāʻo e hoʻoholo ai i ke kumu a i ʻole nā ​​pilikia i:

• ʻO CT ʻōpū
• KANAWAI
• Ka mānoanoa o ka iwi
• Kolesterol
• Hoʻouka kōmiʻo

Hana ʻia ke ʻoki e wehe i ka tumenal adrenal. ʻO ka manawa pinepine, hemo ka gland adrenal holoʻokoʻa.

Pono e mālama maʻamau ʻo Glucocorticoid a hiki i ka hoʻi ʻana o ka momona adrenal ʻē aʻe mai ke ʻoki kino. Pono ʻoe i kēia lāʻau no 3 a 12 mau mahina.

Inā hiki ʻole ke ʻoki, e like me nā hihia o ka maʻi ʻaʻai adrenal i pālahalaha (metastasis), hiki i nā lāʻau ke hoʻohana i mea e hōʻoki ai i ka hoʻokuʻu ʻia o ka cortisol.

ʻO ka poʻe me kahi tumo adrenal i loaʻa i ka ʻoki kino he nānā maikaʻi loa. No ka maʻi ʻaʻai adrenal, ʻaʻole hiki ke kaha ʻana i kekahi manawa. Ke hana ʻia ke ʻoki, ʻaʻole ia e hoʻōla mau i ka maʻi ʻaʻai.

Hiki i nā tumors adrenal cancerous ke pālahalaha i ke ake a i ʻole nā ​​ake māmā.

Kāhea i kāu mea hāʻawi inā hoʻomohala ʻoe i nā hōʻailona o Cushing syndrome.

Hiki i ka mālama kūpono ʻana i nā hikoko adrenal ke hoʻemi i ka makaʻu o nā pilikia i kekahi poʻe me ka maʻi adrenal Cushing Syndrome e pili ana i ka tumora.

Tumo adrenal - Cushing maʻi maʻi

• Nānā Endocrine
• Nā metastases Adrenal - CT scan
• Tumena Adrenal - CT

ʻO Asban A, Patel AJ, Reddy S, Wang T, Balentine CJ, Chen H. Cancer o ka ʻōnaehana endocrine. I: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, eds. ʻO Oncology Clinical ʻo Abboff. ʻElua huaʻōlelo Piladelapia, PA: Elsevier; 2020: chap 68.

Nieman LK, Biller BM, Findling JW, a me al. Hoʻomaʻamaʻa ʻana i ka maʻi o Cushing: kahi papa hana hoʻomaʻamaʻa ʻo Endocrine Society. ʻO J Clin Endocrinol Metab. 2015; 100 (8): 2807-2831. PMID: 26222757 www.ncbi.nlm.nih.gov/pubmed/26222757.

ʻO Stewart PM, Newell-Kumukūʻai JDC. ʻO ka Cortex adrenal. I: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. ʻO Williams Textbook of Endocrinology. 13th ed. Piladelapia, PA: Elsevier; 2016: chap 15.