Cushing syndrome ka lebaka la hlahala ea adrenal

Cushing syndrome ka lebaka la hlahala ea adrenal ke mofuta oa Cushing syndrome. E etsahala ha hlahala ea adrenal gland e ntša bongata bo fetelletseng ba "cortisol" ea "hormone".

Cushing syndrome ke lefu le hlahang ha 'mele oa hau o na le "cortisol" e phahameng ho feta e tloaelehileng. Hormone ena e entsoe ka litšoelesa tsa adrenal. Cortisol e ngata haholo e ka bakoa ke mathata a fapaneng. Bothata bo bong bo joalo ke hlahala ho e 'ngoe ea litšoelesa tsa adrenal. Lihlahala tsa adrenal li ntša cortisol.

Lihlahala tsa adrenal ha li fumanehe hangata. E ka ba tse sa tsoeleng kankere (tse kotsi) kapa tse nang le mofetše (tse kotsi).

Lihlahala tse se nang mofets'e tse ka bakang Cushing syndrome li kenyelletsa:

• Adrenal adenomas, hlahala e tloaelehileng e atisang ho etsa cortisol e feteletseng
• Macronodular hyperplasia, e etsang hore litšoelesa tsa adrenal li atolose le ho etsa cortisol e feteletseng

Lihlahala tsa mofetše tse ka bakang Cushing syndrome li kenyelletsa adrenal carcinoma. Sena ke hlahala e sa tloaelehang, empa hangata e etsa cortisol e fetelletseng.

Batho ba bangata ba nang le Cushing syndrome ba na le:

• Ho potoloha, bofubelu, sefahleho se tletseng (sefahleho sa khoeli)
• Sekhahla sa kholo ea bana
• Boima ba 'mele ka ho bokella mafura ka kutu, empa tahlehelo ea mafura matsohong, maotong le marameng (botenya bo bohareng)

Liphetoho tsa letlalo tse atisang ho bonoa:

• Tšoaetso ea letlalo
• Matšoao a pherese (1/2 cm kapa 1 cm kapa bophara ho feta), a bitsoang striae, letlalong la mpa, lirope, matsoho a kaholimo le matsoele
• Letlalo le lesesaane le ho longoa habonolo

Liphetoho tsa mesifa le masapo li kenyelletsa:

• Ho opeloa ke mokokotlo, ho etsahalang ka mesebetsi e tloahelehileng
• Ho opeloa ke masapo kapa bonolo
• Pokello ea mafura lipakeng tsa mahetla le kaholimo ho lesapo la molaleng
• Ho robeha likhopo le mokokotlo ho bakoang ke ho sohla masapo
• Mesifa fokola, haholo-holo ea letheka le mahetleng

Liphetoho tsa 'mele (systemic) li kenyelletsa:

• Mofuta oa 2 oa lefu la tsoekere
• Khatello ea mali e phahameng
• Ho eketsa k'holeseterole le triglycerides

Basali ba atisa ho ba le:

• Ho hola ha moriri ka ho feteletseng sefahlehong, molaleng, sefubeng, mpeng le liropeng (ho tloaelehileng ho feta mefuta e meng ea Cushing syndrome)
• Linako tse sa fetoheng kamehla kapa tse emisang

Banna ba kanna ba ba le:

• Ho fokotsa kapa ho se na takatso ea thobalano (low libido)
• Mathata a ho emisa

Matšoao a mang a ka bang teng a kenyelletsa:

• Liphetoho tsa kelello, joalo ka khatello ea maikutlo, ho tšoenyeha kapa ho fetoha ha boitšoaro
• Mokhathala
• Ho opeloa ke hlooho
• Nyora e eketsehileng le ho ntša metsi

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

Liteko tsa ho netefatsa lefu la Cushing:

• Sampula ea lihora tse 24 ea ho ntša metsi ho lekanya maemo a cortisol le creatinine
• Liteko tsa mali ho lekola maemo a ACTH, cortisol le potasiamo
• Teko ea khatello ea Dexamethasone
• Maemo a cortisol ea mali
• Tekanyetso ea mali ea DHEA
• Tekano ea saliva cortisol

Liteko tsa ho fumana sesosa kapa mathata li kenyelletsa:

• Mpeng CT
• ACTH
• Boima ba masapo a masapo
• Cholesterol
• Ho itima lijo ka tsoekere

Ho etsoa opereishene ho tlosa hlahala ea adrenal. Khafetsa, tšoelesa eohle ea adrenal ea tlosoa.

Kalafo ea Phekolo ea Glucocorticoid hangata e ea hlokahala ho fihlela tšoelesa e 'ngoe ea adrenal e fola ho tloha opereisheneng. U kanna ua hloka kalafo ena likhoeli tse 3 ho isa ho tse 12.

Haeba opereishene e sa khonehe, joalo ka maemong a mofets'e oa adrenal o nameng (metastasis), meriana e ka sebelisoa ho emisa ho tsoa ha cortisol.

Batho ba nang le hlahala ea adrenal ba buuoang ba na le pono e ntle. Bakeng sa mofetše oa adrenal, ka linako tse ling ho buuoa ha ho khonehe. Ha ho etsoa opereishene, ha se kamehla e phekolang mofetše.

Lihlahala tsa kankere ea adrenal li ka fetela sebeteng kapa matšoafong.

Bitsa mofani oa hau haeba u ba le matšoao a Cushing syndrome.

Kalafo e nepahetseng ea lihlahala tsa adrenal e ka fokotsa kotsi ea mathata ho batho ba bang ba nang le lefu la Cushing le amanang le hlahala ea adrenal.

Lefu la adrenal - Cushing syndrome

• Litšoelesa tsa endocrine
• Adrenal metastases - CT scan
• Adrenal Tumor - CT

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Nieman LK, Biller BM, Findling JW, le al. Kalafo ea Cushing's syndrome: Tataiso ea litloaelo tsa bongaka tsa Endocrine Society. J Kliniki ea Endocrinol Metab. 2015; 100 (8): 2807-2831. PMID: 26222757 www.ncbi.nlm.nih.gov/pubmed/26222757.

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