Inkinga enkulu ye-adrenal

Inkinga enkulu ye-adrenal yisimo esisongela impilo esenzeka lapho ingekho i-cortisol eyanele. Le yihomoni ekhiqizwa yizindlala ze-adrenal.

Izindlala ze-adrenal zitholakala ngenhla nje kwezinso. Indlala ye-adrenal iqukethe izingxenye ezimbili. Ingxenye engaphandle, ebizwa nge-cortex, ikhiqiza i-cortisol. Le yihomoni ebalulekile yokulawula umfutho wegazi. Ingxenye yangaphakathi, ebizwa nge-medulla, ikhiqiza i-hormone adrenaline (ebizwa nangokuthi i-epinephrine). Kokubili i-cortisol ne-adrenaline ikhishwa ekuphenduleni ukucindezeleka.

Ukukhiqizwa kweCortisol kulawulwa yi-pituitary. Le yindlala encane engezansi ngaphansi kobuchopho. I-pituitary ikhipha i-adrenocorticotropic hormone (ACTH). Le yihomoni eyenza ukuthi izindlala ze-adrenal zikhulule i-cortisol.

Ukukhiqizwa kwe-adrenaline kulawulwa yimizwa evela ebuchosheni nakumgogodla nangokujikeleza kwamahomoni.

Inkinga ye-adrenal ingenzeka kunoma yikuphi okulandelayo:

• Indlala ye-adrenal yonakele ngenxa, isibonelo, isifo i-Addison noma esinye isifo se-adrenal gland, noma ukuhlinzwa
• I-pituitary ilimele futhi ayikwazi ukukhipha i-ACTH (hypopituitarism)
• Ukungasebenzi kahle kwe-adrenal akuphathwa kahle
• Uthathe imishanguzo yeglucocorticoid isikhathi eside, futhi ume ngokungazelelwe
• Usuphelelwe ngamanzi emzimbeni
• Ukutheleleka noma okunye ukucindezeleka komzimba

Izimpawu nezimpawu zenkinga ye-adrenal zingafaka noma yikuphi okulandelayo:

• Ubuhlungu besisu noma ubuhlungu ohlangothini
• Ukudideka, ukulahlekelwa ukwazi, noma ikhoma
• Ukuphela kwamanzi emzimbeni
• Isiyezi noma ikhanda elikhanyayo
• Ukukhathala, ubuthakathaka obukhulu
• Ubuhlungu bekhanda
• Umkhuhlane omkhulu
• Ukuphelelwa isifiso sokudla
• Umfutho wegazi ophansi
• Ushukela wegazi ophansi
• Isicanucanu, ukuhlanza
• Ukushaya kwenhliziyo okusheshayo
• Izinga lokuphefumula ngokushesha
• Ukuhamba kancane, ukuvilapha
• Ukujuluka okungajwayelekile nokudlulele ebusweni noma ezintendeni zezandla

Ukuhlolwa okungahle kuhlolwe ukusiza ukuxilonga inkinga enkulu ye-adrenal kufaka:

• Isivivinyo sokukhuthaza i-ACTH (cosyntropin)
• Izinga leCortisol
• Ushukela wegazi
• Izinga le-potassium
• Izinga le-sodium
• izinga le-pH

Esimeni esibucayi se-adrenal, udinga ukunikezwa i-hydrocortisone yesidakamizwa ngokushesha nge-vein (intravenous) noma imisipha (intramuscular). Ungathola uketshezi olufakwa emithanjeni uma unomfutho wegazi ophansi.

Uzodinga ukuya esibhedlela ukuze uthole ukwelashwa nokuqashwa. Uma ukutheleleka noma enye inkinga yezokwelapha ibangele le nkinga, ungadinga ukwelashwa okwengeziwe.

Ukushaqeka kungenzeka uma ukwelashwa kunganikezwa kusenesikhathi, futhi kungaba yingozi empilweni.

Iya egumbini labezimo eziphuthumayo noma ushayele inombolo yendawo ephuthumayo (efana ne-911) uma uba nezimpawu zesimo esibucayi se-adrenal.

Shayela umhlinzeki wakho wezokunakekelwa kwezempilo uma unesifo i-Addison noma i-hypopituitarism futhi ungakwazi ukuthatha umuthi wakho we-glucocorticoid nganoma yisiphi isizathu.

Uma unesifo i-Addison, uvame ukutshelwa ukuthi wandise okwesikhashana umthamo wemithi yakho ye-glucocorticoid uma ucindezelekile noma ugula, noma ngaphambi kokuhlinzwa.

Uma unesifo i-Addison, funda ukuqaphela izimpawu zokucindezeleka okungenzeka kubangele inkinga enkulu ye-adrenal. Uma ufundiswe udokotela wakho, lungela ukuzinika isibhamu esiphuthumayo se-glucocorticoid noma ukwandisa isilinganiso sakho semithi yomlomo ye-glucocorticoid ngezikhathi zokuxineka. Abazali kufanele bafunde ukwenza lokhu ezinganeni zabo ezinokungeneli kwe-adrenal.

Ngaso sonke isikhathi phatha i-ID yezokwelapha (ikhadi, isongo, noma umgexo) okusho ukuthi awunakho ukusebenza kahle kwe-adrenal. Umazisi kufanele futhi usho uhlobo lomuthi nomthamo owudingayo uma kunesimo esiphuthumayo.

Uma uthatha imithi ye-glucocorticoid yokushoda kwe-pituitary ACTH, qiniseka ukuthi uyazi ukuthi uzothatha nini umthamo wokucindezeleka womuthi wakho. Xoxa ngalokhu nomhlinzeki wakho.

Ungalokothi uphuthelwe ukuthatha imithi yakho.

Inkinga ye-adrenal; Inkinga ye-Addisonian; Ukungakwazi ukusebenza kahle kwe-adrenal

• Izindlala ze-Endocrine
• Uketshezi lwe-adrenal gland secretion

UBornstein SR, u-Alloliu B, u-Arlt W, et al. Ukuxilongwa kanye nokwelashwa kokungasebenzi kahle kwe-adrenal: umhlahlandlela wokusebenza emtholampilo we-Endocrine Society. UJ Clin Endocrinol Metab. 2016; 101 (2): 364-389. I-PMID: PMC4880116 www.ncbi.nlm.nih.gov/pmc/articles/PMC4880116.

UStewart PM, iNewell-Price JDC. I-adrenal cortex. Ku: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, abahleli. Incwadi kaWilliams ye-Endocrinology. Umhlaka 13. IPhiladelphia, PA: Elsevier; 2016: isahluko 15.

Thiessen MEW. Izinkinga ze-thyroid ne-adrenal. Ku: Walls RM, Hockberger RS, Gausche-Hill M, ama-eds. Imithi Ephuthumayo yaseRosen: Imiqondo kanye Nokuzijwayeza Komtholampilo. Umhlaka 9. IPhiladelphia, PA: Elsevier; 2018: isahluko 120.