Iprolactinoma

Iprolactinoma iyisimila esingalapheki esinomdlavuza esikhiqiza i-hormone ebizwa ngeprolactin. Lokhu kubangela iprolactin eningi egazini.

Iprolactin yihomoni eyenza amabele akhiqize ubisi (i-lactation).

I-Prolactinoma uhlobo oluvame kakhulu lwe-pituitary tumor (adenoma) ekhiqiza i-hormone. Kwakha cishe i-30% yawo wonke ama-pituitary adenomas. Cishe zonke izicubu zepituitary azinomdlavuza (benign). I-prolactinoma kungenzeka njengengxenye yesimo esizuzwe njengefa esibizwa nge-endocrine neoplasia type 1 (MEN 1).

Ama-prolactinomas avela kakhulu kubantu abangaphansi kweminyaka engama-40. Avamile kakhulu kwabesifazane kunabesilisa, kodwa ayivelakancane ezinganeni.

Okungenani uhhafu wawo wonke ama-prolactinomas mancane kakhulu (angaphansi kwesentimitha elilodwa noma u-3/8 we-intshi ububanzi). Lezi zicubu ezincane zenzeka kaningi kwabesifazane futhi zibizwa ngama-microprolactinomas.

Izimila ezinkulu zivame kakhulu emadodeni. Zivame ukwenzeka lapho sezikhulile. Isimila singakhula sibe ngosayizi omkhulu ngaphambi kokuba kuvele izimpawu. Izicubu ezinkulu kuno-1/8 intshi (1 cm) ububanzi zibizwa ngokuthi ama-macroprolactinomas.

Isimila sivame ukutholwa ekuqaleni kwabesifazane kunakubesilisa ngenxa yezikhathi zokuya esikhathini ezingajwayelekile.

Kwabesifazane:

• Ubisi olungavamile lugeleza lusuka ebeleni kowesifazane ongakhulelwe noma onakekela (galactorrhea)
• Ubumnene besifuba
• Ukwehla kwezintshisekelo zocansi
• Ukwehla kombono wangaphandle
• Ubuhlungu bekhanda
• Ukungabi nenzalo
• Ukuyeka ukuya esikhathini akuhlobene nokunqamuka kokuya esikhathini, noma ukuya esikhathini okungajwayelekile
• Umbono uyashintsha

Emadodeni:

• Ukwehla kwezintshisekelo zocansi
• Ukwehla kombono wangaphandle
• Ukwandiswa kwezicubu zesifuba (gynecomastia)
• Ubuhlungu bekhanda
• Izinkinga zokwakhiwa (ukungabi namandla)
• Ukungabi nenzalo
• Umbono uyashintsha

Izimpawu ezibangelwa ingcindezi evela ku-tumor enkulu zingafaka:

• Ubuhlungu bekhanda
• Imikhuba emibi
• Umsele wamanzi
• Isicanucanu nokuhlanza
• Izinkinga ngomuzwa wokuhogela
• Ubuhlungu besinus noma ingcindezi
• Izinguquko zombono, ezinjengokubona kabili, amajwabu amehlo alengayo noma ukulahleka kwenkundla okubukwayo

Kungase kungabikho zimpawu, ikakhulukazi emadodeni.

Umhlinzeki wezokunakekelwa kwempilo uzokwenza ukuhlolwa komzimba abuze ngezimpawu zakho. Uzobuzwa futhi ngemithi nezinto oziphuzayo.

Izivivinyo ezinga-odwa zifaka:

• I-Pituitary MRI noma i-CT CT scan
• Izinga le-testosterone emadodeni
• Izinga leprolactin
• Ukuhlolwa komsebenzi we-thyroid
• Olunye uvivinyo lomsebenzi we-pituitary

Imithi ivame ukuphumelela ekwelapheni i-prolactinoma. Abanye abantu kufanele bathathe le mithi impilo yabo yonke. Abanye abantu bangayeka ukuthatha imishanguzo ngemuva kweminyaka embalwa, ikakhulukazi uma isimila sabo besisincane ngenkathi sitholwa noma sesinyamalele kwi-MRI. Kodwa kunengozi yokuthi isimila singakhula futhi siveze i-prolactin futhi, ikakhulukazi uma bekuyisigaxa esikhulu.

I-prolactinoma enkulu kwesinye isikhathi ingakhula ngesikhathi sokukhulelwa.

Ukuhlinzwa kungenziwa nganoma yikuphi okulandelayo:

• Izimpawu zinzima, njengokuwohloka okungazelelwe kombono
• Awukwazi ukubekezelela imithi yokwelapha isimila
• Isimila asiphenduli emithini

Imisebe imvamisa isetshenziswa kuphela kubantu abane-prolactinoma eqhubeka nokukhula noma iba yimbi kakhulu ngemuva kokuzama umuthi nokuhlinzwa. Imisebe inganikezwa ngendlela:

• Imisebe ejwayelekile
• Ummese weGamma (stereotactic radiosurgery) - uhlobo lokwelashwa ngemisebe okugxila ama-x-ray anamandla amakhulu endaweni encane ebuchosheni.

Umbono uvame ukuba muhle, kepha kuya ngempumelelo yokwelashwa noma ukuhlinzwa. Ukuhlolelwa ukuhlola ukuthi isimila sesibuyile ngemuva kokwelashwa kubalulekile.

Ukwelashwa kwe-prolactinoma kungashintsha amazinga amanye ama-hormone emzimbeni, ikakhulukazi uma kwenziwa ukuhlinzwa noma imisebe.

Izinga eliphakeme le-estrogen noma i-testosterone lingabandakanyeka ekukhuleni kwe-prolactinoma. Abesifazane abane-prolactinomas kufanele balandelwe eduze ngesikhathi sokukhulelwa. Kufanele baxoxe ngalesi sifo nomhlinzeki wabo ngaphambi kokuthatha amaphilisi okulawula ukubeletha anokuqukethwe kwe-estrogen okuphezulu kunokujwayelekile.

Bona umhlinzeki wakho uma unezimpawu ze-prolactinoma.

Uma uke waba ne-prolactinoma esikhathini esedlule, shayela umhlinzeki wakho ngokulandela okujwayelekile, noma uma izimpawu zakho zibuya.

Adenoma - ukufihla; Iprolactin - i-adenoma yokufihla i-pituitary

• Izindlala ze-Endocrine

Bronstein MD. Ukuphazamiseka kwemfihlo ye-prolactin kanye ne-prolactinomas. Ku: Jameson JL, De Groot LJ, de Kretser DM, et al, abahleli. I-Endocrinology: Eyabantu Abadala Neyengane. Umhla wesi-7. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 7.

UTirosh A, Shimon I. Indlela yamanje yokwelashwa kwama-prolactinomas. IMinerva Endocrinol. 2016; 41 (3): 316-323. I-PMID: 26399371 www.ncbi.nlm.nih.gov/pubmed/26399371.