Apituxy pituitary

ʻO ka pituitary apoplexy kahi mea laha ʻole, akā ʻo ke kūlana koʻikoʻi o ka pituitary gland.

ʻO ka pituitary kahi gland liʻiliʻi ma ke kumu o ka lolo. Hoʻopuka ka pituitary i nā hormoni he nui e kaohi i nā hana o ke kino.

Hiki ke kumu ʻia ka pituitary apoplexy e ke kahe ʻana i ka pituitary a i ʻole ke kahe ʻia o ke kahe i ka pituitary. ʻO ka Apoplexy ke kumu o ke kahe ʻana i loko o kahi ʻokena a i ʻole ka nalo ʻana o ke kahe o ke koko i kahi meaola.

Hoʻokumu pinepine ʻia ka pituitary apoplexy e ke kahe ʻana o ke koko ma loko o kahi tumo noncancerous (benign) o ka pituitary. Kūleʻa kēia mau tumors a ʻaʻole ʻike pinepine ʻia. Pōʻino ka pituitary ke hoʻonui nui ka tumo. E hoʻokahe ke koko i loko o ka pituitary a i ʻole nā ​​palaka i ka lako o ke koko i ka pituitary. ʻO ka nui o ka tumo, ʻo ke kiʻekiʻe ka makaʻu no ka apoplexy pituitary i ka wā e hiki mai ana.

Ke hiki mai ke kahe pituitary i ka wahine i ka manawa a ma hope paha o ka hānau ʻana, kapa ʻia ʻo Sheehan Syndrome. He kūlana kakaʻī loa kēia.

Nā kumuhana kūpilikiʻi no ka pituitary apoplexy i ka poʻe hāpai ʻole me ka ʻole o kahi tumo pū:

• Nā maʻi hōʻeha
• Diabetes
• Poino poʻo poʻo
• ʻO ka uila i ka pituitary gland
• Hoʻohana o ka mīkini hanu

Kākaʻikahi ka pituitary apoplexy i kēia mau hanana.

ʻO ka pituitary apoplexy kahi manawa pōkole o nā ʻōuli (koʻikoʻi), a hiki ke hoʻoweliweli i ke ola. Hoʻopili pinepine nā ʻōuli i:

• ʻEha poʻo poʻo (ʻoi loa o kou ola)
• ʻO ka palapū ʻana o nā mākala maka, ke kumu o ka ʻike lua (ophthalmoplegia) a i ʻole nā ​​pilikia e wehe ana i kahi kuʻemaka
• Ka nalowale ʻana o ka hihi ākea a i ʻole ka nalo ʻana o nā hihiʻo āpau i hoʻokahi a ʻelua paha mau maka
• Ke kahe haʻahaʻa, kaho, pau ka makemake, a me ka luaʻi mai ka lawa ʻole o ka adrenal
• Hoʻololi ke kanaka ma muli o ka hikikii o kekahi o nā aʻa i ka lolo (anterior cerebral artery)

ʻOi aku ka liʻiliʻi, ʻike mālie ʻia ka hana pituitary. I ka Sheehan Syndrome, no ka laʻana, he hemahema paha ka hōʻailona mua e hana i ka waiū i hoʻokumu ʻia e ka nele o ka hormone prolactin.

I ka hala ʻana o ka manawa, ulu paha nā pilikia me nā hormones pituitary ʻē aʻe, e hana ana i nā ʻōuli o ke ʻano aʻe.

• ʻO ka hemahema o ka hormone ulu
• Ka lawa ʻole o ka adrenal (inā ʻaʻole ma mua a mālama ʻia paha)
• Hypogonadism (hana nā kino wahine o ke kino i ka liʻiliʻi a ʻaʻohe paha o nā homona)
• Hypothyroidism (ʻaʻole lawa ka nui o ka nui o kouoneoneoneone)

I nā hihia maʻamau, ke pili ka hope (ʻaoʻao hope) o ka pituitary, e hoʻopili ʻia nā ʻōuli:

• Ka hana ʻole ʻana o ka kōpū e ʻaelike e hānau i kahi pēpē (i nā wahine)
• Ka hana ʻole ʻana i ka waiū umauma (i nā wahine)
• ʻO ka urination pinepine a me ka make wai koʻikoʻi (diabetes insipidus)

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

ʻO nā hoʻokolohua i kauoha ʻia e komo pū:

• Nā hoʻāʻo maka
• MRI a i ʻole CT scan

E hana ʻia nā hoʻokolohua koko e nānā i nā pae o:

• ACTH (adrenocorticotropic hormone)
• Cortisol
• FSH (follicle-stimulate hōmona)
• Hone ulu
• LH (luteinizing hōmona)
• ʻO Prolactin
• TSH (hormonone hoʻōla thyroid)
• Ke kumu ulu ulu like ʻo Insulin-1 (IGF-1)
• Sodoma
• Osmolarity i ke koko a me ka mimi

Pono paha ka apoplexy koʻikoʻi i ke ʻoki e hoʻomaha i ke kaomi ma ka pituitary a hoʻomaikaʻi i nā hōʻailona ʻike. Pono nā hihia koʻikoʻi i kahi ʻoki kūloko. Inā ʻaʻole pili ka hihi, pono pinepine ʻole ke ʻoki.

ʻO ka mālama koke ʻana me nā homone pani adrenal (glucocorticoids) e pono ai. Hāʻawi pinepine ʻia kēia mau homoniola ma o ke aa (e IV). Hiki ke hoʻololi ʻia i kekahi mau hormones ʻē aʻe, me:

• Hone ulu
• Nā homone wahine (estrogen / testosterone)
• Hīmona thyroid
• Vasopressin (ADH)

Hiki ke hoʻoweliweli i ka pommitary apituxy pituitary. Maikaʻi ka kuanaʻike no ka poʻe i loaʻa ka hemahema pituitary wā lōʻihi (mau) e ʻike ʻia a mālama ʻia.

Nā pilikia o ka aprexy pituitary pituitary hiki ʻole ke hoʻopili ʻia:

• ʻO ka pilikia adrenal (ke ʻano e kū ana ke lawa ʻole ka cortisol, kahi hormone i hana ʻia e nā adrenal glands)
• Lilo hihio

Inā ʻaʻole pani ʻia kekahi mau homone e nalo ana, ulu paha nā ʻōuli o hypothyroidism a me hypogonadism, me ka infertility.

Kāhea i kāu mea hāʻawi inā loaʻa iā ʻoe nā hōʻailona o ka lawa ʻole o ka pituitary.

E hele i ka lumi pilikia a kāhea paha i ka helu pilikia kūloko (e like me 911) inā loaʻa nā ʻōuli o ka apituxy pituitary ʻoi loa, e like me:

• Nāwaliwali nā mākala o ka maka a i ʻole ka nalo ʻana o ka hihi
• Kū koke, ʻeha ke poʻo
• Ke kaomi haʻahaʻa (hiki ke hoʻonāwaliwali)
• Nusea
• ʻO ka luaʻi

Inā hoʻomohala ʻoe i kēia mau ʻōuli a ua ʻike ʻia ʻoe me kahi tumo pituitary, e ʻimi koke i ke kōkua lapaʻau.

Infarction Pituitary; Apituxy pituitary tumo

• Nānā Endocrine

ʻO Hannoush ZC, Weiss RE. Apituxy pituitary. I: Feingold KR, Anawalt B, Boyce A, et al, eds. Endotext [Pūnaewele]. South Dartmouth, MA: MDText.com. 2000-. www.ncbi.nlm.nih.gov/books/NBK279125. Hoʻohou ʻia ʻApelila 22, 2018. Loaʻa iā Mei 20, 2019.

Melmed S, Kleinberg D. Pituitary masses a me nā tumors. I: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. ʻO Williams Textbook of Endocrinology. 13th ed. Piladelapia, PA: Elsevier; 2016: chap 9.