Multiple endocrine neoplasia (MEN) I

Mofuta oa I oa endocrine neoplasia (MEN) ke lefu leo ​​ho lona e 'ngoe kapa tse ling tsa litšoelesa tsa endocrine li sebetsang haholo kapa li hlahisang hlahala. E fetisoa ka malapa.

Litšoelesa tsa endocrine tse atisang ho ameha li kenyelletsa:

• Mekhanya
• Parathyroid
• Pituitary

BATHO Ke bakoa ke bofokoli liphatseng tsa lefutso bo jereng khoutu ea protheine e bitsoang menin. Boemo bona bo etsa hore lihlahala tsa litšoelesa tse fapaneng li hlahe ho motho a le mong, empa eseng ka nako e le 'ngoe.

Boloetse bona bo ka ba teng ka lilemo tsohle, 'me bo ama banna le basali ka ho lekana. Nalane ea lelapa ea lefu lena e hlahisa kotsi ea hau.

Matšoao a fapana ho ea ka batho, 'me ho latela hore na ho tšoaroa tšoelesa efe. Li ka kenyelletsa:

• Bohloko ba mpeng
• Ho tšoenyeha
• Lefifi, litulo tse salang morao
• Ho ikutloa ho tsoa mali ka mor'a lijo
• Ho chesa, ho opa kapa ho lapa ka mpeng e kaholimo kapa sefubeng se tlase se imetsoeng ke li-antacids, lebese kapa lijo
• Ho fokotsa thahasello ea thobalano
• Mokhathala
• Ho opeloa ke hlooho
• Ho hloka nako ea ho ilela khoeli (ho basali)
• Ho felloa ke takatso ea lijo
• Ho lahleheloa ke moriri kapa moriri oa sefahleho (ka banna)
• Liphetoho tsa kelello kapa pherekano
• Bohloko ba mesifa
• Ho nyekeloa le ho hlatsa
• Ho nahanela serame
• Ho theola boima ba 'mele ka boomo
• Mathata a pono
• Bofokoli

Mofani oa tlhokomelo ea bophelo o tla etsa tlhahlobo ea 'mele mme a botse lipotso mabapi le nalane le matšoao a hau a bongaka. Liteko tse latelang li ka etsoa:

• Boemo ba cortisol ea mali
• CT scan ea mpa
• Tlhatlhobo ea hlooho ea CT
• Ho itima lijo tsoekere ea mali
• Ho etsa liteko tsa lefutso
• Teko ea insulin
• MRI ea mpa
• MRI ea hlooho
• Serum adrenocorticotropic hormone
• Khalase ea serum
• Serum follicle e susumetsang li-hormone
• Serum gastrin
• Serum glucagon
• Serame ea luteinizing hormone
• Serum hormone ea parathyroid
• Serum prolactin
• Serum thyroid e susumetsang li-hormone
• Ultrasound ea molala

Ho buoa ho tlosa tšoelesa e kulang hangata ke kalafo ea khetho. Ho ka sebelisoa moriana o bitsoang bromocriptine sebakeng sa ho buuoa bakeng sa lihlahala tsa pituitary tse lokollang hormone prolactin.

Litšoelesa tsa parathyroid, tse laolang tlhahiso ea calcium, li ka tlosoa. Leha ho le joalo, ho thata hore 'mele o laole maemo a khalsiamo ntle le litšoelesa tsena, ka hona, ho tlosa parathyroid ka botlalo ha ho etsoe pele maemong a mangata.

Meriana e teng ho fokotsa tlhahiso e feteletseng ea asiti ea mala e bakoang ke lihlahala tse ling (gastrinomas), le ho fokotsa kotsi ea liso.

Kalafo ea Phetolo ea Hormone e fanoa ha litšoelesa tsohle li tlosoa kapa li sa hlahise lihormone tse lekaneng.

Lihlahala tsa pituitary le parathyroid hangata ha li na mofets'e (benign), empa lihlahala tse ling tsa pancreatic li ka fetoha mofets'e (tse mpe) ebe li namela sebeteng. Tsena li ka fokotsa nako ea bophelo.

Matšoao a lefu la peptic ulcer, tsoekere e tlase maling, calcium e ngata maling le ho se sebetse hantle ha pituitary hangata li arabela hantle kalafong e nepahetseng.

Lihlahala li ka lula li khutla. Matšoao le mathata li ipapisitse le litšoelesa tse amehang. Ho hlahlojoa khafetsa ke mofani oa hau ho bohlokoa.

Bitsa mofani oa hau haeba u bona matšoao a MEN I kapa u na le nalane ea lelapa ea boemo bona.

Ho khothaletsoa ho hlahloba beng ka uena ba nang le ts'oaetso ena.

Lefu la Wermer; BANNA I

• Litšoelesa tsa endocrine

Webosaete ea National Comprehensive Cancer Network. Litataiso tsa litloaelo tsa bongaka litabeng tsa oncology (litataiso tsa NCCN): lihlahala tsa neuroendocrine. Mofuta oa 1.2019. www.nccn.org/professionals/physician_gls/pdf/neuroendocrine.pdf. E ntlafalitsoe ka la 5 Hlakubele 2019. E fihlile ka la 8 Hlakubele 2020.

Potso ea Newey, Thakker RV. Mefuta e mengata ea endocrine neoplasia. Ka: Melmed S, Auchus RJ, Goldfine AB, Koenig RJ, Rosen CJ, bahlophisi. Buka ea Williams ea Endocrinology. La bo14 la ed. Philadelphia, PA: Elsevier; 2020: khaolo ea 42.

Ke Nieman LK, Spiegel AM. Mathata a Polyglandular. Ka: Goldman L, Schafer AI, li-eds. Phekolo ea Goldman-Cecil. La 26th. Philadelphia, PA: Elsevier; 2020: khaolo ea 218.

Thakker RV. Mefuta e mengata ea endocrine neoplasia mofuta oa 1. Ho: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Batho ba baholo le bana. La 7th. Philadelphia, PA: Elsevier Saunders; 2016: khaolo ea 148.