Gigantism

He ulu ulu ʻole ka Gigantism ma muli o ka nui o ka hormone ulu (GH) i ka wā kamaliʻi.

Kākaʻikahi loa ʻo Gigantism. ʻO ke kumu maʻamau o ka hoʻokuʻu nui ʻana o GH he noncancerous (benign) tumo o ka pituitary gland. Nā kumu ʻē aʻe e:

• ʻO ka maʻi genetic e pili ana i ka ʻili o ka ʻili (pigmentation) a me nā kumu o nā ʻeha benign o ka ʻili, ka puʻuwai, a me ka ʻōnaehana endocrine (hormone) (Carney complex)
• ʻO ka maʻi genetic e pili ana i nā iwi a me nā ʻili pigmentation (McCune-Albright Syndrome)
• ʻO ka maʻi genetic kahi o kahi a ʻoi paha o nā gland endocrine e hana nui a hana paha i kahi tumo (he nui endocrine neoplasia ʻano 1 a ʻano 4 paha)
• ʻO ka maʻi genetic e hana ana i nā pituitary tumors
• ʻO ka maʻi kahi e kū ai nā tumors ma nā aʻa o ka lolo a me ka iwi kuamoʻo (neurofibromatosis)

Inā kū ka nui o ka GH ma hope o ka pau ʻana o ka ulu ʻana o ka iwi maʻamau (hopena o ka wā ʻōpio), ʻike ʻia ke ʻano he acromegaly.

E ulu ke keiki i ke kiʻekiʻe, a i nā mākala a me nā kino. ʻO kēia ulu nui ʻana e hoʻonui i ke keiki no kona mau makahiki.

ʻO nā ʻōuli ʻē aʻe e like me:

• Hoopaneeia ka manawa makua
• ʻIke pālua a paʻakikī paha me ka ʻaoʻao (peripheral) hihiʻo
• Kaulana ka lae (frontal bossing) a me kahi ā ʻāʻī
• Nā hakahaka ma waena o nā niho
• ʻEha poʻo
• Hoʻonui sweating
• Nā wā kūpono (menstruation)
• ʻEha hui
• Nā lima a me nā wāwae nui me nā manamana lima a me nā manamana wāwae mānoanoa
• Hoʻokuʻu i ka waiū umauma
• Pilikia hiamoe
• Mānoanoa o nā helehelena
• Nawaliwali
• Hoʻololi leo

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

ʻO nā hoʻokolohua Laboratory i kauoha ʻia e komo pū:

• Cortisol
• Estradiol (kaikamahine)
• Hōʻaʻo kāohi GH
• ʻO Prolactin
• Ke kumu ulu ulu like ʻo Insulin-I
• ʻO testosterone (keikikāne)
• Hīmona thyroid

ʻO nā hoʻokolohua kiʻi, e like me CT a MRI scan o ke poʻo, e kauoha ʻia paha e nānā no kahi tumo pituitary.

No nā pituitary tumors, hiki i ke kīpoki ke hoola i nā hihia he nui.

Ke hiki ʻole i ke ʻoki ke hoʻopau loa i ka tumo, hoʻohana ʻia nā lāʻau e ālai a hoʻēmi paha i ka hoʻokuʻu ʻana o GH a pale aku iā GH mai ka hōʻea ʻana i nā mākia pahuhopu.

I kekahi manawa hoʻohana ʻia ka hoʻomaʻamaʻa radiation e hoʻemi i ka nui o ka tumo ma hope o ke kahakaha ʻana.

Kūleʻa maʻamau ke kahakaha pituitary i ka palena ʻana i ka hana GH.

Hiki i ka mālama mua ʻana ke hoʻololi i nā loli i hana ʻia e GH ʻoi aku.

ʻO ke ʻoki a me ka mālama ʻana i ka radiation e alakaʻi i nā pae haʻahaʻa o nā hormones pituitary ʻē aʻe. Hiki i kēia ke kumu i kekahi o nā kūlana aʻe:

• ʻAʻole lawa ka adrenal (ʻaʻole hana nui nā adrenal glands i kā lākou mau hormones)
• Diabetes insipidus (make wai loa a me ka nui o ka urination; i nā manawa maʻamau)
• 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)

Kāhea i kāu mea hāʻawi inā loaʻa nā hōʻailona o kāu keiki i ka ulu nui ʻana.

ʻAʻole hiki ke pale ʻia ʻo Gigantism. Hiki i ka mālama mua ʻana ke pale i ka maʻi mai ka ʻino a kōkua i ka pale ʻana i nā pilikia.

Pilikua Pituitary; Overproduction o ka ulu ana o ka hōmona; Hone ulu - hoʻonui i ka hana

• Nānā Endocrine

Katznelson L, Laws ER Jr, Melmed S, et al; ʻAhahui Endocrine. Acromegaly: kahi papa hana hoʻomaʻamaʻa hana kaiaulu endocrine. ʻO J Clin Endocrinol Metab. 2014; 99 (11): 3933-3951. PMID: 25356808 www.ncbi.nlm.nih.gov/pubmed/25356808.

Melmed S. Acromegaly. I: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Makua a Pediatric. ʻEpekema 7 Piladelapia, PA: Elsevier Saunders; 2016: chap 12.