Exogenous Cushing chirwere

Exogenous Cushing syndrome chimiro cheCushing syndrome inoitika muvanhu vanotora glucocorticoid (inonziwo corticosteroid, kana steroid) mahormone.

Cushing syndrome idambudziko rinoitika kana muviri wako uine yakakwira kupfuura yakajairwa chikamu chehomoni cortisol. Iyi hormone inowanzo gadzirwa mune adrenal glands.

Exogenous zvinoreva zvinokonzerwa nechimwe chinhu chiri kunze kwemuviri. Exogenous Cushing syndrome inoitika kana munhu akatora mishonga inogadzirwa nevanhu (synthetic) glucocorticoid kurapa chirwere.

Glucocorticoids inopihwa hosha zhinji, dzakadai sehosha dzemapapu, mamiriro eganda, chirwere chinoputira ura, gomarara, mamota europi uye chirwere chejoini. Iyi mishonga inouya nenzira dzakasiyana, kusanganisira mapiritsi, intravenous (IV), jekiseni mujoini, enema, mafuta ekuzora, inhalers, uye madonhwe eziso.

Vazhinji vanhu vane Cushing syndrome vane:

• Denderedzwa, tsvuku, izere kumeso (kumeso kwemwedzi)
• Inononoka kukura mwero (muvana)
• Kurema kwekurema nemafuta kuwanda padanda, asi kurasikirwa kwemafuta kubva pamaoko, makumbo, uye magaro (wepakati kufutisa)

Kuchinja kweganda kunowanzoonekwa kunosanganisira:

• Zvirwere zveganda
• Purple yakatambanudza mamaki (1/2 inch kana 1 sentimita kana kupfuura yakafara), inonzi striae, paganda redumbu, zvidya, kumusoro maoko, uye mazamu
• Ganda rakatetepa nekupwanya kuri nyore

Tsandanyama uye pfupa shanduko dzinosanganisira:

• Backache, inoitika nemabasa enguva dzose
• Kurwadziwa kwepfupa kana hunyoro
• Unganidzo yemafuta pakati pemapfudzi uye pamusoro pekora pfupa
• Ribvu uye musana kutsemuka kunokonzerwa nekuonda kwemapfupa
• Misungo isina kusimba, kunyanya yehudyu nemapendekete

Muviri-wakapamhama (systemic) matambudziko anogona kusanganisira:

• Nyora 2 chirwere cheshuga
• Kuwedzera kweropa
• Yakakwira cholesterol uye triglycerides

Vakadzi vanogona kuva:

• Nguva dzinova dzisina kujairika kana kumira

Varume vanogona kuva:

• Yakadzikira kana isina chishuwo chebonde (yakaderera libido)
• Matambudziko ekugadzirisa

Zvimwe zviratidzo zvinogona kuitika zvinosanganisira:

• Pfungwa shanduko, senge kushushikana, kushushikana, kana shanduko mumaitiro
• Kuneta
• Kutemwa nemusoro
• Kuwedzera nyota uye kuita weti

Anopa hutano anoita bvunzo dzepanyama uye obvunza nezvezviratidzo zvako nemishonga yauri kutora. Udza mupiki nezve mishonga yese yawanga uchinwa kwemwedzi yakati wandei yapfuura. Uyezve udza mupi nezve mapfuti awakatambira kuhofisi yemupi.

Kana iwe ukashandisa cortisone, prednisone, kana imwe corticosteroids, inotevera mhedzisiro mhedzisiro inogona kuratidza exogenous Cushing syndrome:

• Yakadzika ACTH mwero
• Yakadzika cortisol level (kana yakakwira cortisol nhanho) muropa kana weti, zvinoenderana nemushonga wauri kutora
• Kusanzwisisika kupindura kune cosyntropin (ACTH) yekusimudzira bvunzo
• Yakakwirira kupfuura zvakajairwa kutsanya glucose
• Ropa rakaderera potasiamu
• Yakaderera mapfupa kuwanda, sekuyerwa nemapfupa emamineral density bvunzo
• Yakakwira cholesterol, kunyanya yakakwira triglycerides uye yakadzika yakakwira-density lipoprotein (HDL)

Imwe nzira inonzi yakakwira kuita kwemvura chromatography (HPLC) inogona kuratidza yakakwira mwero weanofungidzirwa mushonga mune weti.

Kurapa ndiko kuderera uye pakupedzisira kurega kutora chero corticosteroids. Izvi zvinogona kuitwa zvishoma nezvishoma kana nekukurumidza, zvinoenderana nekuti nei uri kurapwa nekorticosteroid. Usarega kutora chero mushonga usati watanga kutaura nemupi wako. Kamwe kamwe kumisa corticosteroids mushure mekuvatora kwenguva yakareba kunogona kukonzera mamiriro anotyisidzira ehupenyu anonzi adrenal dambudziko.

Kana iwe usingakwanise kurega kutora mushonga nekuda kwechirwere (semuenzaniso, iwe unoda glucocorticoid mushonga kuti ubate asthma yakaoma), tevedzera rairo dzemupi wako kuti ungaderedze sei mukana wekuvandudza matambudziko, kusanganisira

• Kurapa yakakwira shuga yeropa nekudya, mishonga yemumuromo, kana insulin.
• Kurapa yakakwira cholesterol nekudya kana mishonga.
• Kutora mishonga kudzivirira kurasikirwa kwemabhonzo. Izvi zvinogona kubatsira kudzikisa njodzi yekutyoka kana iwe ukaita osteoporosis.
• Kutora mimwe mishonga kudzikisa huwandu hweglucocorticoid mushonga waunoda.

Zvishoma nezvishoma tapering mushonga urikukonzera mamiriro acho unogona kubatsira kudzoreredza mhedzisiro yeadrenal gland shrinkage (atrophy). Izvi zvinogona kutora mwedzi kusvika pagore. Munguva ino, ungangoda kutangazve kana kuwedzera chipimo chemushonga wako panguva yekunetseka kana kurwara.

Matambudziko ehutano anogona kukonzeresa kubva kune exogenous Cushing syndrome inosanganisira chero eanotevera:

• Yakadzika immune immune, iyo inogona kutungamira kune kazhinji hutachiona
• Kukuvara kumeso, itsvo, uye tsinga nekuda kwekusarapwa shuga yepamusoro yeropa
• Chirwere cheshuga
• Yakakwira cholesterol mazinga
• Kuwedzera njodzi yekurwadziwa kwemoyo kubva kuchirwere cheshuga chisina kurapwa uye cholesterol yakawanda
• Kuwedzera njodzi yekuvhara ropa
• Mapfupa asina kusimba (osteoporosis) uye yakawedzera njodzi yekutyoka

Aya matambudziko anogona kazhinji kudzivirirwa nekurapwa kwakakodzera.

Sheedza musangano pamwe nemupi wako kana iwe uri kutora corticosteroid uye iwe ukava nezviratidzo zveCushing syndrome.

Kana iwe ukatora corticosteroid, ziva zviratidzo nezviratidzo zveCushing syndrome. Kurapwa nekukurumidza kunogona kubatsira kudzivirira chero mhedzisiro yenguva refu yeCushing syndrome. Kana iwe ukashandisa inhaled steroids, iwe unogona kudzikisa kuratidzwa kwako kune iyo steroid nekushandisa spacer uye nekushambidza muromo wako mushure mekufema mune iyo steroids.

Cushing syndrome - corticosteroid inosimudzira; Corticosteroid-inosimudzira Cushing syndrome; Iatrogenic Cushing chirwere

• Hypothalamus kugadzirwa kwehomoni

Nieman LK, Biller BM, Kutsvaga JW, et al.Kurapa kweCushing's syndrome: iyo Endocrine Society kiriniki yekudzidzira nhungamiro.J Clin Endocrinol Metab. 2015; 100 (8): 2807-2831. PMID: 26222757 www.ncbi.nlm.nih.gov/pubmed/26222757.

Stewart PM, Newell-Mutengo JDC. Iyo adrenal cortex. Mune: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. Williams Chinyorwa cheEndocrinology. 13 ed. Philadelphia, PA: Elsevier; 2016: chits.