Multiple endocrine neoplasia (MEN) II

Multiple endocrine neoplasia, mofuta II (MEN II) ke boloetse bo fetisoang ke malapa ao ho 'ona litšoelesa tsa endocrine li leng matla haholo kapa li hlahisang hlahala. Litšoelesa tsa endocrine tse atisang ho ameha li kenyelletsa:

• Sefuba sa adrenal (hoo e ka bang halofo ea nako)
• Tšoelesa ea parathyroid (20% ea nako)
• Tšoelesa ea qoqotho (hoo e ka bang ka linako tsohle)

Multiple endocrine neoplasia (MEN I) ke boemo bo amanang.

Lebaka la MEN II ke bofokoli liphatseng tsa lefutso tse bitsoang RET. Bothata bona bo etsa hore lihlahala tse ngata li hlahe ho motho a le mong, empa eseng ka nako e le 'ngoe.

Ho kenella ha tšoelesa ea adrenal hangata ho bakoa ke hlahala e bitsoang pheochromocytoma.

Ho ameha ha qoqotho ea qoqotho hangata ho bakoa ke hlahala e bitsoang medullary carcinoma ea qoqotho.

Lihlahala tsa qoqotho, adrenal kapa litšoelesa tsa parathyroid li ka hlaha lilemo tse arohaneng.

Boloetse bona bo ka ba teng ka lilemo tsohle, 'me bo ama banna le basali ka ho lekana. Lebaka le ka sehloohong la kotsi ke nalane ea lelapa ea MEN II.

Ho na le likaroloana tse peli tsa MEN II. Ke BATHO IIa le IIb. MEN IIb ha e tloaelehe haholo.

Matšoao a ka fapana. Leha ho le joalo, li tšoana le tsa:

• Medullary carcinoma ea qoqotho
• Pheochromocytoma
• Parathyroid adenoma
• Parathyroid hyperplasia

Ho fumana boemo bona, mofani oa tlhokomelo ea bophelo o batla phetoho liphatseng tsa lefutso tsa RET. Sena se ka etsoa ka tlhahlobo ea mali. Liteko tse ling li etsoa ho fumana hore na ke lihormone life tse hlahisoang haholo.

Tlhahlobo ea 'mele e ka senola:

• Lymph nodes e atolositsoeng molaleng
• Feberu
• Khatello ea mali e phahameng
• Ho otla ha pelo ka potlako
• Maqhutsu a qoqotho

Ho nahana ka liteko tse sebelisetsoang ho khetholla lihlahala ho ka kenyelletsa:

• Tlhaloso ea mpa ea mpa
• Ho nahana ka liphio kapa li-ureters
• MIBG scintiscan
• MRI ea mpa
• Sesepa sa qoqotho
• Ultrasound ea qoqotho

Ho sebelisoa liteko tsa mali ho bona hore na litšoelesa tse itseng 'meleng li sebetsa hantle hakae. Li ka kenyelletsa:

• Boemo ba Calcitonin
• Phosphatase ea mali a alkaline
• K'halsiamo ea mali
• Boemo ba li-hormone tsa parathyroid
• Phosphorus ea mali
• Lik'hatholine tsa moroto
• Metinephrine ea moroto

Liteko tse ling kapa lits'ebetso tse ka etsoang li kenyelletsa:

• Boitsebiso ba Adrenal
• Electrocardiogram (ECG)
• Biopsy ea qoqotho

Ho hlokahala hore ho etsoa opereishene ho tlosa pheochromocytoma, e ka bang kotsi bophelong ka lebaka la lihormone tse e etsang.

Bakeng sa medullary carcinoma ea qoqotho, qoqotho ea qoqotho le li-lymph node tse haufi li tlameha ho tlosoa ka botlalo. Phekolo ea "hormone" ea "thyroid" e fuoa kamora ho buuoa.

Haeba ngoana a tsejoa hore o na le phetoho ea liphatsa tsa lefutso tsa RET, ho buuoa ho tlosa qoqotho pele e ba mofets'e ho nahanoa. Sena se lokela ho tšohloa le ngaka e tsebang boemo bona haholo. E ne e tla etsoa a sa le monyane (pele ho lilemo tse 5) ho batho ba tsejoang ke MEN IIa, le pele ho lilemo tse 6 ho batho ba nang le MEN IIb.

Hangata Pheochromocytoma ha e na mofetše (o kotsi). Medullary carcinoma ea qoqotho ke mofetše o matla haholo ebile o ka bolaeang, empa ho hlahlojoa le ho buuoa kapele ho ka baka pheko. Ho buoa ha ho phekole MEN II ea mantlha.

Ho ata ha lisele tse nang le mofetše ke bothata bo ka bang teng.

Bitsa mofani oa hau haeba u hlokomela matšoao a MEN II kapa haeba motho e mong lelapeng la hau a fumana tšoaetso e joalo.

Ho hlahloba beng ka motho ba haufi le MEN II ho ka lebisa tlhokomelong ea pele ea lefu lena le mefuta e meng e amanang le mofetše. Sena se ka lumella mehato ea ho thibela mathata.

Lefu la Sipple; BANNA II; Pheochromocytoma - BATHO II; Kankere ea qoqotho - pheochromocytoma; Kankere ea Parathyroid - pheochromocytoma

• 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.

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