Hypogonadotropic hypogonadism

Hypogonadism ke boemo boo liteko tsa banna kapa mae a bomme a hlahisang lihormone tse nyane tsa thobalano.

Hypogonadotropic hypogonadism (HH) ke mofuta oa hypogonadism o bakoang ke bothata ba tšoelesa ea pituitary kapa hypothalamus.

HH e bakoa ke khaello ea lihormone tse atisang ho tsosa mae a bomme kapa li-testes. Lihormone tsena li kenyelletsa gonadotropin-release hormone (GnRH), follicle e hlohlelletsang hormone (FSH) le luteinizing hormone (LH).

Ka tloaelo:

• Hypothalamus bokong e lokolla GnRH.
• Hormone ena e hlohlelletsa tšoelesa ea pituitary ho lokolla FSH le LH.
• Lihormone tsena li bolella mae a bomme kapa li-testes tsa banna hore li ntše lihormone tse lebisang kholisong e tloaelehileng ea thobalano nakong ea bohlankana, linako tse tloaelehileng tsa ho ilela khoeli, maemo a estrogen le kemolo ho basali ba baholo, le tlhahiso e tloaelehileng ea testosterone le tlhahiso ea peo ho banna ba baholo.
• Phetoho efe kapa efe ea ketane ena ea tokollo ea "hormone" e baka khaello ea lihormone tsa thobalano. Sena se thibela kholo e tloaelehileng ea thobalano ho bana le ts'ebetso e tloaelehileng ea lisosa kapa mae a bomme ho batho ba baholo.

Ho na le lisosa tse 'maloa tsa HH:

• Tšenyo ea tšoelesa ea pituitary kapa hypothalamus ea ho buuoa, ho tsoa kotsi, hlahala, tšoaetso kapa radiation
• Liphoso tsa lefutso
• Tekanyetso e phahameng kapa ts'ebeliso ea nako e telele ea meriana ea opioid kapa steroid (glucocorticoid)
• Tekanyetso e phahameng ea prolactin (hormone e ntšitsoeng ke pituitary)
• Ho imeloa kelellong haholo
• Mathata a phepo e nepahetseng (ka bobeli ba ho nona kapele kapa ho theola boima ba 'mele)
• Maloetse a nako e telele (a sa foleng) a bongaka, ho kenyelletsa ho ruruha ho sa foleng kapa tšoaetso
• Ts'ebeliso ea lithethefatsi, joalo ka heroine kapa ts'ebeliso e mpe ea meriana e fanoang ke ngaka
• Maemo a itseng a bongaka, joalo ka ts'ebetsong ea tšepe

Lefu la Kallmann ke mofuta o futsitsoeng oa HH. Batho ba bang ba nang le boemo bona le bona ba na le anosmia (tahlehelo ea kutlo ea monko).

Bana:

• Ho hloka kholo nakong ea bocha (kholo e kanna ea ba morao haholo kapa e sa phethahala)
  
• Ho banana, khaello ea kholo ea matsoele le linako tsa ho ilela khoeli
• Ho bashemane, ha ho na nts'etsopele ea litšobotsi tsa thobalano, joalo ka ho holisa li-testes le botona, ho teba ha lentsoe le moriri oa sefahleho
• Ho se khone ho fofonela (maemong a mang)
• Nako e khuts'oane (maemong a mang)

Batho ba baholo:

• Ho felloa ke thahasello ho tsa thobalano (libido) ho banna
• Ho lahleheloa ke nako ea ho ilela khoeli (amenorrhea) ho basali
• Ho fokotsa matla le thahasello mesebetsing
• Ho lahleheloa ke boima ba mesifa ho banna
• Boima ba 'mele
• Maemo a fetoha
• Ho hloka thari
  

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

Liteko tse ka etsoang li kenyelletsa:

• Liteko tsa mali ho lekanya maemo a lihormone joalo ka FSH, LH, le TSH, prolactin, testosterone le estradiol
• Karabelo ea LH ho GnRH
• MRI ea pituitary gland / hypothalamus (ho batla hlahala kapa kholo e ngoe)
• Ho etsa liteko tsa lefutso
• Liteko tsa mali ho lekola boemo ba tšepe

Kalafo e ipapisitse le mohloli oa bothata, empa e ka kenyelletsa:

• Liente tsa testosterone (ho banna)
• Patch ea letlalo la testosterone e liehang butle (ho banna)
• Li-gells tsa testosterone (ka banna)
• Lipilisi tsa Estrogen le progesterone kapa liphahlo tsa letlalo (ho basali)
• Liente tsa GnRH
• Liente tsa HCG
  

Kalafo e nepahetseng ea lihormone e tla etsa hore bohlankana bo qale ho bana mme e ka khutlisa tsoalo ho batho ba baholo. Haeba boemo bo qala kamora ho kena bohlankaneng kapa boroetsaneng kapa botsofaling, hangata matšoao a tla ntlafala ka kalafo.

Mathata a bophelo bo botle a ka bakoang ke HH a kenyelletsa:

• Ho lieha ho kena bonneng kapa bosaling
• Ho khaotsa ho ilela khoeli (ka basali)
• Ho hloka thari
• Ho fokola ha masapo le ho robeha hamorao bophelong
• Ho itšepa ho tlisoang ke ho kena bohlankaneng kapa boroetsaneng kamora nako (tšehetso ea maikutlo e ka ba molemo)
• Mathata a thobalano, joalo ka libido tse tlase

Bitsa mofani oa hau haeba:

• Ngoana oa hau ha a qale ho kena bohlankaneng kapa boroetsaneng ka nako e loketseng.
• U mosali ea ka tlase ho lilemo tse 40 'me nako ea hau ea ho ilela khoeli ea emisa.
• U lahlehetsoe ke boea bo ka mokokotlong kapa bo pepang.
• U monna 'me u fokotse thahasello ea thobalano.

Ho haella ha Gonadotropin; Hypogonadism ea bobeli

• Litšoelesa tsa endocrine
• Tšoelesa ea pituitary
• Li-gonadotropin

Bhasin S, Brito JP, Cunningham GR, le al. Phekolo ea testosterone ho banna ba nang le hypogonadism: e leng tataiso ea litloaelo tsa bongaka tsa Endocrine Society. J Kliniki ea Endocrinol Metab. 2018; 103 (5): 1715-1744. PMID: 29562364 www.ncbi.nlm.nih.gov/pubmed/29562364.

Styne DM, Grumbach MM. Physiology le mathata a ho kena bohlankaneng kapa boroetsaneng. Ka: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, bahlophisi. Buka ea Williams ea Endocrinology. 13th ed. Philadelphia, PA: Elsevier; 2016: khaolo ea 25.

PC e tšoeu. Nts'etsopele ea thobalano le boits'oaro. Ka: Goldman L, Schafer AI, li-eds. Phekolo ea Goldman-Cecil. La 26th. Philadelphia, PA: Elsevier; 2020: khaolo ea 220.