Boikaketsi

Hypopituitarism ke boemo boo ho lona tšoelesa ea pituitary e sa hlahiseng bongata bo itseng ba lihomone tsa eona.

Tšoelesa ea pituitary ke moaho o monyane o ka tlase ho boko. E khomaretsoe ke lehlaka ho hypothalamus. Hypothalamus ke sebaka sa boko se laolang tšebetso ea tšoelesa ea pituitary.

Lihormone tse hlahisoang ke tšoelesa ea pituitary (le mesebetsi ea tsona) ke:

• Adrenocorticotropic hormone (ACTH) - e hlohlelletsa tšoelesa ea adrenal ho lokolla cortisol; cortisol e thusa ho boloka khatello ea mali le tsoekere maling
• Antidiuretic hormone (ADH) - e laola tahlehelo ea metsi ke liphio
• Follicle-stimulating hormone (FSH) - e laola tšebetso ea thobalano le kemolo ho ba batona le ba batšehali
• Hormone ea kholo (GH) - e tsosa kholo ea lisele le masapo
• Luteinizing hormone (LH) - e laola tšebetso ea thobalano le kemolo ho banna le basali
• Oxytocin - e hlohlelletsa popelo ho sebetsa ka nako ea pelehi le matsoele ho ntša lebese
• Prolactin - e tsosa nts'etsopele ea matsoele a basali le tlhahiso ea lebese
• Hormone e susumetsang qoqotho (TSH) - e hlohlelletsa tšoelesa ea qoqotho ho ntša lihomone tse amang metabolism ea 'mele

Ho hypopituitarism, ho na le khaello ea hormone e le 'ngoe kapa ho feta ea pituitary. Ho haella ha hormone ho lebisa ho lahleheloeng ke tšebetso ho tšoelesa kapa setho sa taolo ea lihormone. Ka mohlala, ho haelloa ke TSH ho lebisa ho lahleheloa ke mosebetsi o tloaelehileng oa qoqotho ea qoqotho.

Hypopituitarism e ka bakoa ke:

• Ho buuoa ka boko
• Hlahala ea boko
• Ho sithabela hlooho (kotsi e bohloko ea boko)
• Ho tšoaetsoa kapa ho ruruha ha boko le lisele tse tšehetsang boko
• Ho shoa ha sebaka sa lisele ka har'a pituitary gland (pituitary apoplexy)
• Phekolo ea mahlaseli bokong
• Leqeba
• Ho tsoa mali ha subarachnoid (ho tsoa ho aneurysm e phatlohileng)
• Lihlahala tsa tšoelesa ea pituitary kapa hypothalamus

Ka linako tse ling, hypopituitarism e bakoa ke boits'ireletso ba mmele bo sa tloaelehang kapa maloetse a ts'oaetso, joalo ka:

• Tšepe e ngata haholo 'meleng (hemochromatosis)
• Keketseho e sa tloaelehang ea lisele tsa 'mele ea ho itšireletsa mafung e bitsoang li-histiocytosis X (histiocytosis X)
• Boemo bo ikemetseng bo bakang ho ruruha ha pituitary (lymphocytic hypophysitis)
• Ho ruruha ha lisele le litho tse fapaneng (sarcoidosis)
• Ts'oaetso ea pituitary, joalo ka lefuba le ka sehloohong la lefuba

Hypopituitarism le eona ke bothata bo sa tloaelehang bo bakoang ke ho tsoa mali haholo nakong ea bokhachane. Ho lahleheloa ke mali ho lebisa lefung la pituitary. Boemo bona bo bitsoa Sheehan syndrome.

Meriana e meng e ka hatella ts'ebetso ea pituitary. Lithethefatsi tse atileng haholo ke glucocorticoids (joalo ka prednisone le dexamethasone), tse nkeloang maemo a ho ruruha le boits'ireletso. Lithethefatsi tse sebelisetsoang ho alafa mofetše oa senya le tsona li ka baka ts'ebetso e tlase ea pituitary.

Matšoao a hypopituitarism a kenyelletsa tse latelang:

• Bohloko ba mpeng
• Ho fokotsa takatso ea lijo
• Ho hloka thobalano (ho banna kapa basali)
• Ho tsekela kapa ho akheha
• Ho ntša metsi haholo le lenyora
• Ho hloleha ho lokolla lebese (ho basali)
• Mokhathala, bofokoli
• Ho opeloa ke hlooho
• Ho hloka thari (ho basali) kapa ho emisa ho ilela khoeli
• Ho lahleheloa ke boea ba sephakeng kapa ba pepeng
• Ho lahleheloa ke moriri kapa moriri oa sefahleho (ka banna)
• Khatello ea mali e tlase
• Tsoekere e tlase maling
• Ho utloahala ho bata
• Bolelele bo khuts'oane (bo ka tlase ho limithara tse 5 kapa limithara tse 1,5) haeba bo qala ke nakong ea kholo
• Kholo e liehang le kholo ea thobalano (ho bana)
• Mathata a pono
• Ho fokotsa boima ba 'mele

Matšoao a ka hlaha butle mme a ka fapana haholo ho latela:

• Palo ea lihormone tse haellang le litho tseo li li amang
• Boima ba lefu lena

Matšoao a mang a ka hlahang ka lefu lena:

• Ho ruruha ha sefahleho
• Ho hlotheha ha moriri
• Ho honotha kapa ho fetola lentsoe
• Ho satalla ho kopaneng
• Boima ba 'mele

Ho lemoha hypopituitarism, ho tlameha hore ho be le li-hormone tse tlase ka lebaka la bothata ba tšoelesa ea pituitary. Tlhahlobo e tlameha ho hlakola le mafu a setho a anngoeng ke hormone ena.

Liteko li ka kenyelletsa:

• Sesepa sa Brain CT
• MRI ea pituitary
• ACTH
• Cortisol
• Estradiol (estrogen)
• Hormone e susumetsang follicle (FSH)
• Khōlo ea 1 e tšoanang le insulin (IGF-1)
• Hormone ea Luteinizing (LH)
• Liteko tsa Osmolality bakeng sa mali le moroto
• Tekanyo ea testosterone
• Hormone e susumetsang qoqotho (TSH)
• Hormone ea qoqotho (T4)
• Biopsy ea pituitary

Tekanyo ea hormone ea pituitary e kanna ea phahama maling haeba o na le hlahala ea pituitary e hlahisang hormone eo haholo. Hlahala e ka silafatsa lisele tse ling tsa pituitary, e lebisang maemong a tlase a lihormone tse ling.

Haeba hypopituitarism e bakoa ke hlahala, o kanna oa hloka ho buuoa ho tlosa hlahala. Phekolo ea radiation le eona e ka hlokahala.

U tla hloka meriana ea hormone ea bophelo bohle ho nka sebaka sa lihormone tse seng li sa etsoa ke litho tse tlas'a taolo ea tšoelesa ea pituitary. Tsena li ka kenyelletsa:

• Corticosteroids (cortisol)
• Hormone ea kholo
• Lihormone tsa thobalano (testosterone bakeng sa banna le estrogen bakeng sa basali)
• Hormone ea qoqotho
• Tsebang

Lithethefatsi le tsona lia fumaneha ho phekola ho hloka thari ho amanang ho banna le basali.

Haeba u nka meriana ea glucocorticoid bakeng sa khaello ea pituitary ACTH, etsa bonnete ba hore u tseba nako ea ho noa lethal dose la moriana oa hau. Buisanang ka sena le mofani oa tlhokomelo ea bophelo.

Kamehla jara ID ea bongaka (karete, sefaha sa letsoho, kapa sefaha sa sefaha) se reng ha u na matla a adrenal. ID e boetse e lokela ho re mofuta oa moriana le litekanyo tseo u li hlokang haeba ho ka hlaha ts'ohanyetso e bakiloeng ke ho se lekane ha adrenal.

Hypopituitarism hangata e lula e le teng. E hloka kalafo ea bophelo bohle ka moriana o le mong kapa ho feta. Empa u ka lebella nako e tloaelehileng ea bophelo.

Ho bana, hypopituitarism e ka ntlafala haeba hlahala e tlosoa nakong ea ts'ebetso.

Litla-morao tsa meriana ea ho phekola hypopituitarism li ka hlaha. Leha ho le joalo, u se ke ua emisa moriana o le mong ntle le ho bua le mofani oa hau pele.

Bitsa mofani oa hau haeba u ba le matšoao a hypopituitarism.

Maemong a mangata, bothata bona ha bo qojoe. Ho lemoha kotsi, joalo ka ho noa meriana e itseng, ho ka lumella ho hlahlojoa le kalafo kapele.

Ho se tšoanelehe ha pituitary; Panhypopituitarism

• Litšoelesa tsa endocrine
• Tšoelesa ea pituitary
• Li-gonadotropin
• Pituitary le TSH

M Burt MG, Ho KKY. Hypopituitarism le khaello ea li-hormone tsa kholo. Ka: Jameson JL, De Groot LJ, oa Kretser DM, et al, eds. Endocrinology: Batho ba baholo le bana. La 7th. Philadelphia, PA: Elsevier Saunders; 2016: khaolo ea 11.

Clemmons DR, Nieman LK. Atamela mokuli ea nang le lefu la endocrine. Ka: Goldman L, Schafer AI, li-eds. Phekolo ea Goldman-Cecil. La 25th ed. Philadelphia, PA: Elsevier Saunders; 2016: khaolo ea 221.

Fleseriu M, Hashim IA, Karavitaki N, et al. Phetoho ea Hormonal ho hypopituitarism ho batho ba baholo: Tataiso ea boits'oaro ea Mokhatlo oa Endocrine. J Kliniki ea Endocrinol Metab. 2016; 101 (11): 3888-3921. PMID: 27736313 www.ncbi.nlm.nih.gov/pubmed/27736313.