Ectopic Cushing chirwere

Ectopic Cushing syndrome chimiro cheCushing syndrome umo bundu riri kunze kwepituitary gland rinoburitsa hormone inonzi adrenocorticotropic hormone (ACTH).

Cushing syndrome idambudziko rinoitika kana muviri wako uine yakakwira kupfuura yakajairwa chikamu chehomoni cortisol. Iyi hormone inogadzirwa mune adrenal gland. Yakawandisa cortisol inogona kunge yakakonzerwa nematambudziko akasiyana siyana. Chimwe chezvikonzero ndechekuti kana paine yakawandisa mahormone ACTH muropa. ACTH inowanzo gadzirwa nepituitary mune zvidiki uye zvobva zvaratidza maadrenal glands kuti abudise cortisol. Dzimwe nguva mamwe masero ari kunze kwepituitary anogona kuita huwandu hwakawanda hwe ACTH. Izvi zvinonzi ectopic Cushing syndrome. Ectopic zvinoreva kuti chimwe chinhu chiri kuitika munzvimbo isina kujairika mumuviri.

Ectopic Cushing syndrome inokonzerwa nemamota anosunungura ACTH. Mamota anogona, mune zvisingawanzoitika zviitiko, kuburitsa ACTH anosanganisira:

• Benign carcinoid mamota emapapu
• Islet maseru mamota epancreas
• Medullary carcinoma yehutachiona
• Diki maseru mamota emapapu
• Mamota eiyo thymus gland

Ectopic Cushing syndrome inogona kukonzera akawanda akasiyana zviratidzo. Vamwe vanhu vane zviratidzo zvakawanda nepo vamwe vane mashoma chete. Vazhinji vanhu vane chero mhando yeCushing syndrome vane:

• Denderedzwa, tsvuku, uye 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:

• Zvirwere zveganda
• Purple yakatambanudza mamaki (1/2 inch 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 mellitus
• Kuwedzera kweropa
• Yakakwira cholesterol uye triglycerides
  

Vakadzi vanogona kuva:

• Bvudzi rakawandisa kukura kumeso, mutsipa, chifuva, dumbu, uye zvidya
• Nguva dzinova dzisina kujairika kana kumira

Varume vanogona kuva:

• Yakadzikira kana isina chishuwo chebonde
• Kushaya simba

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 nezve zviratidzo zvako.

Miedzo inogona kuitwa inosanganisira:

• Maawa makumi maviri nemasere weti muyero kuyera cortisol uye creatinine mazinga
• Ropa bvunzo kutarisa ACTH, cortisol, uye potasiamu mazinga (kazhinji akanyanya kuderera muectopic Cushing syndrome)
• Dexamethasone kudzvanyirira bvunzo (zvese zvakakwira uye zvakaderera dosi)
• Yakaderera petrosal sinus sampling (chaiyo bvunzo inoyera ACTH kubva mutsinga padhuze nepfungwa uye muchipfuva)
• Kutsanya glucose
• MRI uye yakakwirira resolution CT inoongorora kuti iwane bundu (dzimwe nguva mishonga yenyukireya inogona kuongororwa)

Mushonga wakanakisa weectopic Cushing syndrome kuvhiyiwa kubvisa bundu. Kuvhiya kunowanzoitika kana bundu racho risinganzwisisike (benign).

Mune zvimwe zviitiko, bundu iri rine gomarara uye rinopararira kune dzimwe nzvimbo dzemuviri chiremba asati awana dambudziko nekugadzirwa kwecortisol. Kuvhiya kunogona kusakwanisika mune idzi kesi. Asi chiremba anogona kupa mishonga yekuvhara cortisol kugadzirwa.

Dzimwe nguva kubviswa kwese adrenal gland kunodiwa kana bundu risingakwanise kuwanikwa uye mishonga isingavharise zvakakwana kugadzirwa kwecortisol.

Kuvhiya kubvisa bundu kunogona kutungamira mukuzorora zvizere. Asi pane mukana wekuti bundu richadzoka.

Bundu rinogona kupararira kana kudzoka mushure mekuvhiyiwa. Chikamu chepamusoro checortisol chinogona kuenderera.

Fonera mupiki wako kana iwe ukaita zviratidzo zveCushing syndrome.

Kukurumidza kurapwa kwemamota kunogona kudzikisa njodzi mune dzimwe nguva. Zviitiko zvakawanda hazvidzivirike.

Cushing chirwere - ectopic; Ectopic ACTH chirwere

• Endocrine masero

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.