Hypopituitarism

Hypopituitarism mamiriro mune iyo iyo pituitary gland isingaburitse yakajairwa mamwe emamwe kana ayo ese mahormone.

Iyo pituitary gland idiki dhizaini iyo iri kungori pazasi pehuropi. Inosungirirwa ne stalk kune hypothalamus. Iyo hypothalamus inzvimbo yeuropi iyo inodzora pituitary gland basa.

Mahormone akaburitswa neiyo pituitary gland (uye nemabasa awo) ndeaya:

• Adrenocorticotropic hormone (ACTH) - inomutsa adrenal gland kuburitsa cortisol; cortisol inobatsira kuchengetedza BP uye shuga yeropa
• Antidiuretic hormone (ADH) - inodzora kurasikirwa kwemvura neitsvo
• Follicle-inosimudzira mahormone (FSH) - inodzora basa repabonde uye kubereka muvanhurume nevanhukadzi
• Kukura kwehomoni (GH) - inomutsa kukura kwemasuru uye mapfupa
• Luteinizing hormone (LH) - inodzora basa repabonde uye kubereka muvanhurume nevanhukadzi
• Oxytocin - inokurudzira chibereko kuti chibvume panguva yebasa uye mazamu kuburitsa mukaka
• Prolactin - inokurudzira kukura kwemazamu echikadzi uye kugadzirwa kwemukaka
• Thyroid-inosimudzira mahormone (TSH) - inomutsa gland yegland kuti ibudise mahormone anokanganisa metabolism yemuviri

Mune hypopituitarism, pane kushomeka kweimwe kana anopfuura mahormone epituitary. Kushaikwa kwehormone kunotungamira mukurasikirwa nebasa mune gland kana nhengo yeanodzora mahormone. Semuenzaniso, kushayikwa kweTSH kunotungamira mukurasikirwa neyakajairika mashandiro eiyo thyroid gland.

Hypopituitarism inogona kukonzerwa ne:

• Kuvhiya kwehuropi
• Bundu rebongo
• Musoro wekutambudzika (kushungurudzika kwehuropi kukuvara)
• Zvirwere kana kuzvimba kwehuropi uye zvinyama zvinotsigira uropi
• Kufa kwenzvimbo yetissue mupituitary gland (pituitary apoplexy)
• Radiation kurapa kuuropi
• Kurohwa
• Subarachnoid hemorrhage (kubva kuputika aneurysm)
• Bundu repituitary gland kana hypothalamus

Dzimwe nguva, hypopituitarism inokonzerwa neyakajairika immune immune kana chirwere che metabolic, senge:

• Yakawandisa iron mumuviri (hemochromatosis)
• Kuwedzera kusingaenzanisike kwemasero ekudzivirira anonzi histiocytes (histiocytosis X)
• Autoimmune mamiriro anokonzera kuzvimba kwepituitary (lymphocytic hypophysitis)
• Kuzvimba kwematukisi akasiyana siyana uye nhengo (sarcoidosis)
• Zvirwere zvepituitary, senge yekutanga pituitary tibhii

Hypopituitarism zvakare isingawanzo kusangana kunokonzerwa nekubuda ropa kwakanyanya panguva yekuzvitakura. Kurasikirwa kweropa kunotungamira kurufu rwenyama mune yepituitary gland. Aya mamiriro anonzi Sheehan syndrome.

Mimwe mishonga inogona zvakare kudzvinyirira pituitary basa. Mishonga yakajairika ndeyeglucocorticoids (senge prednisone uye dexamethasone), iyo inotorwa kuitira kuzvimba uye mamiriro ekudzivirira. Mishonga inoshandiswa kurapa kenza yeprostate inogona zvakare kutungamira kune yakaderera pituitary basa.

Zviratidzo zve hypopituitarism zvinosanganisira chero zvinotevera:

• Marwadzo emudumbu
• Kuderedza kudya
• Kushaikwa kwepabonde kutyaira (mune varume kana vakadzi)
• Dzungu kana kupera simba
• Kunyanyisa kuita weti uye nyota
• Kukundikana kuburitsa mukaka (mune vakadzi)
• Kuneta, kushaya simba
• Kutemwa nemusoro
• Kusabereka (mumadzimai) kana kumisa kumwedzi
• Kurasikirwa kweruoko kana bvudzi repabhawa
• Kurasikirwa kwemuviri kana bvudzi kumeso (mune varume)
• Kuderera kweropa
• Shuga shoma yeropa
• Kunzwa kutonhora
• Kureba kupfupi (asingasviki mashanu tsoka kana 1.5 mita) kana kutanga kuri panguva yekukura
• Kunonoka kukura uye kukura pabonde (muvana)
• Matambudziko ekuona
• Kuonda

Zviratidzo zvinogona kukura zvishoma uye zvinogona kusiyana zvakanyanya, zvichienderana ne:

• Huwandu hwehormone husipo uye nhengo dzavanokanganisa
• Kukura kwechirwere

Zvimwe zviratidzo zvinogona kuitika nechirwere ichi:

• Kumeso kuzvimba
• Bvudzi kurasikirwa
• Hoarseness kana kuchinja izwi
• Kuomarara kwakabatana
• Kurera huremu

Kuti uongorore hypopituitarism, panofanirwa kunge paine mashoma mahormone huwandu nekuda kwedambudziko neiyo pituitary gland. Iko kuongororwa kunofanirwa zvakare kubvisa kunze zvirwere zvemuviri zvinokanganiswa neiyi hormone.

Miedzo inogona kusanganisira:

• Ubongo CT scan
• Pituitary MRI
• ACTH
• Cortisol
• Estradiol (inonzi estrogen)
• Follicle-inosimudzira mahormone (FSH)
• Insulin-senge kukura chinhu 1 (IGF-1)
• Luteinizing mahormone (LH)
• Osmolality bvunzo zveropa uye weti
• Testosterone nhanho
• Utachiona-hunokurudzira mahormone (TSH)
• Utachiona kemikari (T4)
• Biopsy yepituitary

Chikamu chehomoni yepituitary inogona kunge yakakwira muropa kana iwe uine bundu repituitary riri kuburitsa yakawandisa iyo hormone. Bundu rinogona kupwanya mamwe maseru epituitary, zvichitungamira kune akadzika mamwe mahormone.

Kana hypopituitarism ichikonzerwa nebundu, ungangoda kuvhiyiwa kuti ubvise bundu. Radiation therapy inogona zvakare kudikanwa.

Iwe unozoda mishonga yehomoni hwese kutsiva mahormone ayo asisiri kugadzirwa nenhengo dziri pasi pehutongi hwepituitary gland. Izvi zvinogona kusanganisira:

• Corticosteroids (cortisol)
• Kukura kemikari
• Zvepabonde mahormone (testosterone yevarume uye estrogen yevakadzi)
• Uturu hwehomoni
• Desmopressin

Zvinodhaka zvinowanikwawo kurapa kushaya mbereko kune varume nevakadzi.

Kana iwe ukatora mishonga yeglucocorticoid yekushomeka kwepituitary ACTH, ita shuwa kuti unoziva nguva yekutora dhizaini yemushonga wako. Kurukurai izvi nemupi wezvehutano.

Gara uchitakura ID yekurapa (kadhi, bracelet, kana chishongo) icho chinoti une adrenal insufficiency. Chitupa chinofanirwa zvakare kutaura mhando yemushonga uye chipimo chemushonga chaunoda kana paitika njodzi inokonzereswa neadrenal insufficiency.

Hypopituitarism inowanzo gara. Zvinoda kurapwa kweupenyu hwese nemushonga mumwe kana yakawanda. Asi iwe unogona kutarisira hwakajairika hupenyu hurefu.

Muvana, hypopituitarism inogona kusimuka kana bundu rikabviswa panguva yekuvhiyiwa.

Mhedzisiro yemhedzisiro yekurapa hypopituitarism inogona kukura. Nekudaro, usamise chero mushonga uri wega pasina kutaura nemupi wako kutanga.

Fonera mupiki wako kana iwe ukaita zviratidzo zve hypopituitarism.

Muzviitiko zvakawanda, kusagadzikana hakudziviriki. Kuziva nezve njodzi, sekutora mimwe mishonga, kunogona kubvumidza kuongororwa kwekutanga uye kurapwa.

Kusakwana kwepituitary; Panhypopituitarism

• Endocrine masero
• Pituitary shwanu
• Gonadotropin
• Pituitary uye TSH

Burt MG, Ho KKY. Hypopituitarism uye kukura kwehomoni kushomeka. Muna: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Vakuru uye Chiremba. 7th ed. Philadelphia, PA: Elsevier Saunders; 2016: chits. 11.

Clemmons DR, Nieman LK. Kusvika kune murwere ane endocrine chirwere. Mune: Goldman L, Schafer AI, eds. Goldman-Cecil Mushonga. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016: chits. 221.

Fleseriu M, Hashim IA, Karavitaki N, et al. Hormonal kutsiva mu hypopituitarism muvakuru: iyo Endocrine Society kiriniki yekudzidzira nhungamiro. J Clin Endocrinol Metab. 2016; 101 (11): 3888-3921. PMID: 27736313 www.ncbi.nlm.nih.gov/pubmed/27736313.