Lefu la Addison

Boloetse ba Addison ke boloetse bo hlahang ha litšoelesa tsa adrenal li sa hlahise lihormone tse lekaneng.

Litšoelesa tsa adrenal ke litho tse nyane tse hlahisang lihormone tse kaholimo ho liphio ka seng. Li entsoe ka karolo e kantle, e bitsoang cortex, le karolo e kahare, e bitsoang medulla.

Cortex e hlahisa lihormone tse 3:

• Lihormone tsa Glucocorticoid (joalo ka cortisol) li boloka taolo ea tsoekere (tsoekere), e fokotsa (hatella) karabelo ea 'mele ea ho itšireletsa mafung, hape e thusa' mele ho sebetsana le khatello ea maikutlo.
• Lihormone tsa Mineralocorticoid (joalo ka aldosterone) li laola botsitso ba sodium, metsi le potasiamo.
• Lihormone tsa thobalano, androgens (e motona) le estrogens (basali), li ama kholo ea kholo ea thobalano le thobalano.

Lefu la Addison le bakoa ke tšenyo ea adrenal cortex. Tšenyo e baka hore cortex e hlahise lihormone tse tlase haholo.

Tšenyo ena e ka bakoa ke tse latelang:

• Ts'ireletso ea mmele e hlasela ka phoso litšoelesa tsa adrenal (lefu la autoimmune)
• Matšoao a kang lefuba, HIV kapa tšoaetso ea fungal
• Ho tsoa mali ka har'a litšoelesa tsa adrenal
• Lihlahala

Lisosa tse kotsi tsa mofuta oa "Addison" o ikemetseng li kenyelletsa maloetse a mang a autoimmune:

• Ho ruruha (ho ruruha) ha qoqotho ea qoqotho e atisang ho fella ka ho fokotsa ts'ebetso ea qoqotho (chronic thyroiditis)
• Tšoelesa ea qoqotho e hlahisa lihomone tse ngata tsa qoqotho (qoqotho e feteletseng, lefu la mabitla)
• Ho phatloha ho hlohlona le maqhubu le machachetsi (dermatitis herpetiformis)
• Litšoelesa tsa parathyroid molaleng ha li hlahise hormone e lekaneng ea parathyroid (hypoparathyroidism)
• Tšoelesa ea pituitary ha e hlahise lihormone tse ling tse tloaelehileng kapa lihormone tsohle tsa eona (hypopituitarism)
• Ho itšireletsa mafung ka boithaopo ho amang methapo le mesifa eo ba e laolang (myasthenia gravis)
• 'Mele ha o na lisele tse khubelu tsa mali tse phetseng hantle (phokolo ea mali e kotsi)
• Likokoana-hloko ha li khone ho hlahisa peō ea botona kapa ea banna (testicular failure)
• Mofuta oa I lefu la tsoekere
• Ho lahleheloa ke 'mala o sootho (pigment) libakeng tsa letlalo (vitiligo)

Mefokolo e meng e sa tloaelehang ea liphatsa tsa lefutso le eona e ka baka khaello ea adrenal.

Matšoao a lefu la Addison a ka kenyelletsa tse latelang:

• Bohloko ba mpeng
• Letšollo le sa foleng, ho nyekeloa ke pelo le ho hlatsa
  
• Ho fifala ha letlalo
• Ho felloa ke metsi 'meleng
• Botsoa ha u ema
• Feberu e tlaase
• Tsoekere e tlase maling
• Khatello ea mali e tlase
• Bofokoli bo feteletseng, mokhathala, le ho tsamaea butle, ho noaboloha
• Letlalo le lefifi kahare marameng le melomong (buccal mucosa)
• Takatso ea letsoai (ho ja lijo ka letsoai le lengata)
• Ho fokotsa boima ba 'mele ka ho fokotsa takatso ea lijo

Matšoao a kanna a se be teng ka linako tsohle. Batho ba bangata ba na le a mang a matšoao ana kaofela ha ba na le tšoaetso kapa khatello ea maikutlo 'meleng. Ka linako tse ling, ha ba na matšoao.

Mofani oa tlhokomelo ea bophelo o tla etsa tlhahlobo ea 'mele mme a botse ka matšoao.

Liteko tsa mali li kanna tsa laeloa mme li ka bonts'a:

• Eketseha potasiamo
• Khatello ea mali e tlase, haholoholo ka phetoho ea boemo ba mmele
• Boemo ba cortisol e tlase
• Boemo ba sodium e tlase
• PH e tlaase
• Maemo a tloaelehileng a testosterone le estrogen, empa boemo bo tlase ba DHEA
• Palo e phahameng ea eosinophil

Liteko tse ling tsa laboratori li ka laeloa.

Liteko tse ling li ka kenyelletsa:

• X-ray ea mpeng
• Tlhaloso ea mpa ea mpa
• Teko ea ho hlohlelletsa Cosyntropin (ACTH)

Kalafo e nang le li-corticosteroids le li-mineralocorticoids e tla laola matšoao a lefu lena. Hangata meriana ena e hloka ho nooa bophelo bohle.

Le ka mohla u se ke ua tlōla tekanyetso ea meriana ea hau bakeng sa boemo bona hobane liphetoho tse sokelang bophelo li ka hlaha.

Mofani oa hau a ka u joetsa hore u eketse litekanyetso tsa hau nako e khuts'oane ka lebaka la:

• Tšoaetso
• Kotsi
• Khatello ea maikutlo
• Phekolo

Nakong ea mofuta o fetelletseng oa ho haella ha adrenal, o bitsoang mathata a adrenal, o tlameha ho kenya hydrocortisone hanghang. Kalafo ea khatello e tlase ea mali le eona ea hlokahala.

Batho ba bang ba nang le lefu la Addison ba rutoa ho ipha ente ea tšohanyetso ea hydrocortisone nakong ea khatello. 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 bolela mofuta oa moriana le litekanyetso tseo u li hlokang haeba ho le kotsi.

Ka kalafo ea lihormone, batho ba bangata ba nang le lefu la Addison ba khona ho phela bophelo bo tloaelehileng.

Mathata a ka hlaha haeba o nka hormone e nyane haholo kapa e ngata haholo ea adrenal.

Bitsa mofani oa hau haeba:

• Ha o khone ho boloka meriana ea hau e le tlase ka lebaka la ho hlatsa.
• U na le khatello ea maikutlo joalo ka ts'oaetso, kotsi, ho sithabela maikutlo, kapa ho felloa ke metsi 'meleng. U kanna ua hloka hore meriana ea hau e fetoloe.
• Boima ba hau boa eketseha ha nako e ntse e feta.
• Maqaqailana a hao a qala ho ruruha.
• U hlahisa matšoao a macha.
• Ha u phekoloa, u ba le matšoao a lefu le bitsoang Cushing syndrome

Haeba u e-na le matšoao a mathata a adrenal, ipehele ente ea tšohanyetso ea meriana eo u e filoeng. Haeba e sa fumanehe, e-ea kamoreng e haufi ea maemo a tšohanyetso kapa letsetsa 911.

Matšoao a koluoa ​​ea adrenal a kenyelletsa:

• Bohloko ba mpeng
• Ho phefumoloha ho thata
• Botsoa kapa hlooho e bobebe
• Khatello ea mali e tlase
• Boemo bo fokotsehileng ba tsebo

Boikaketsi ba adrenocortical; Ho hloleha ho sa foleng ha adrenocortical; Ho haella ha adrenal ea mantlha

• Litšoelesa tsa endocrine

Barthel A, Benker G, Berens K, et al. Nchafatso ea lefu la Addison. Exp Clin Endocrinol lefu la tsoekere. 2019; 127 (2-03): 165-175. PMID: 30562824 www.ncbi.nlm.nih.gov/pubmed/30562824.

Bornstein SR, Allolio B, Arlt W, le al. Ho lemoha le kalafo ea khaello ea mantlha ea adrenal: Tataiso ea boits'oaro ea Mokhatlo oa Endocrine. J Kliniki ea Endocrinol Metab. 2016; 101 (2): 364-389. PMID: PMC4880116 www.ncbi.nlm.nih.gov/pmc/articles/PMC4880116.

Nieman LK. Cortex ea Adrenal. Ka: Goldman L, Schafer AI, li-eds. Phekolo ea Goldman-Cecil. La 25th ed. Philadelphia, PA: Elsevier Saunders; 2016: khaolo ea 227.