Isifo i-Addison

Isifo i-Addison yisifo esenzeka lapho izindlala ze-adrenal zingakhiqizi amahomoni anele.

Izindlala ze-adrenal yizitho ezincane ezikhipha ama-hormone ezibekwe ngaphezulu kwenso ngalinye. Zakhiwa yingxenye engaphandle, ebizwa nge-cortex, nengxenye engaphakathi, ebizwa nge-medulla.

I-cortex ikhiqiza ama-hormone amathathu:

• Ama-hormone e-Glucocorticoid (njenge-cortisol) agcina ukulawula ushukela (i-glucose), anciphise (ukucindezela) ukuphendula komzimba, futhi asize umzimba uphendule ekucindezelekeni.
• Ama-hormone e-Mineralocorticoid (njenge-aldosterone) alawula ibhalansi ye-sodium, amanzi ne-potassium.
• Ama-hormone ocansi, ama-androgens (owesilisa) nama-estrogens (abesifazane), athinta ukukhula kwezocansi nokushayela ucansi.

Isifo i-Addison sibangelwa ukulimala kwe-adrenal cortex. Umonakalo ubangela ukuthi i-cortex ikhiqize amazinga ama-hormone aphansi kakhulu.

Lo monakalo ungadalwa yilokhu okulandelayo:

• Amasosha omzimba ahlasela ngephutha izindlala (isifo somzimba)
• Ukutheleleka okufana nesifo sofuba, i-HIV, noma izifo zokukhunta
• Ukopha ngaphakathi kwezindlala ze-adrenal
• Izimila

Izici zobungozi bohlobo oluzenzakalelayo lwesifo i-Addison zifaka ezinye izifo ezizimele:

• Ukuvuvukala (ukuvuvukala) kwendlala yegilo evame ukuholela ekunciphiseni ukusebenza kwe-thyroid (chronic thyroiditis)
• Indlala yegilo ikhiqiza i-hormone yegilo eningi kakhulu (i-thyroid engasebenzi ngokweqile, isifo se-Graves)
• Ukuqhuma okunamaqhubu namabhamuza (i-dermatitis herpetiformis)
• Izindlala zeParathyroid entanyeni azivezi i-hormone eyanele ye-parathyroid (hypoparathyroidism)
• Indlala ye-pituitary ayikhiqizi amanani ajwayelekile amanye noma wonke amahomoni ayo (i-hypopituitarism)
• I-autoimmune disorder ethinta izinzwa nemisipha abayilawulayo (myasthenia gravis)
• Umzimba awunawo amangqamuzana egazi abomvu anele anele (i-anemia eyingozi)
• Amasende awakwazi ukukhiqiza isidoda noma ama-hormone wesilisa (ukuhluleka kwamasende)
• Thayipha I isifo sikashukela
• Ukulahleka kombala onsundu (i-pigment) kusuka ezindaweni zesikhumba (vitiligo)

Ukukhubazeka okuthile kwezakhi zofuzo okungavamile nakho kungadala ukungasebenzi kahle kwe-adrenal.

Izimpawu zesifo i-Addison zingafaka noma yikuphi okulandelayo:

• Ubuhlungu besisu
• Uhudo olungapheli, isicanucanu, nokuhlanza
  
• Ukwenza mnyama kwesikhumba
• Ukuphela kwamanzi emzimbeni
• Isiyezi lapho usukuma
• Umkhuhlane osezingeni eliphansi
• Ushukela wegazi ophansi
• Umfutho wegazi ophansi
• Ubuthakathaka obukhulu, ukukhathala, nokuhamba kancane, okuvilaphayo
• Isikhumba esimnyama ngaphakathi kwezihlathi nezindebe (i-buccal mucosa)
• Ukulangazelela usawoti (ukudla ukudla nosawoti omningi owengeziwe)
• Ukwehla kwesisindo ngokunciphisa ukudla

Izimpawu kungenzeka zingabi khona ngaso sonke isikhathi. Abantu abaningi banezinye noma zonke lezi zimpawu lapho benesifo noma okunye ukucindezeleka emzimbeni. Ngezinye izikhathi, abanazo izimpawu.

Umhlinzeki wezokunakekelwa kwempilo uzokwenza ukuhlolwa komzimba abuze ngezimpawu.

Ukuhlolwa kwegazi kungenzeka ku-odwe futhi kungakhombisa:

• Ukwenyuka kwe-potassium
• Umfutho wegazi ophansi, ikakhulukazi ngokushintsha kwesimo somzimba
• Izinga le-cortisol eliphansi
• Izinga eliphansi le-sodium
• I-pH ephansi
• Izinga elijwayelekile le-testosterone ne-estrogen, kepha izinga eliphansi le-DHEA
• Isibalo se-eosinophil esiphakeme

Ukuhlolwa okwengeziwe kwelabhorethri kunga-odwa.

Ezinye izivivinyo zingafaka:

• I-x-ray yesisu
• Iskena se-CT esiswini
• Ukuhlolwa kokukhuthaza kweCosyntropin (ACTH)

Ukwelashwa ngokufakwa esikhundleni se-corticosteroids kanye ne-mineralocorticoids kuzolawula izimpawu zalesi sifo. Le mithi imvamisa idinga ukuphuzwa impilo yonke.

Ungalokothi weqe imithamo yemithi yakho ngenxa yalesi simo ngoba kungenzeka ukusabela okusongela impilo.

Umhlinzeki wakho angakutshela ukuthi ukhuphule umthamo wakho okwesikhashana ngenxa ye:

• Ukutheleleka
• Ukulimala
• Ukucindezeleka
• Ukuhlinzwa

Ngesikhathi sokudlulela ngokweqile kwe-adrenal, okuthiwa i-adrenal crisis, kufanele ujove i-hydrocortisone ngaso leso sikhathi. Ukwelashwa kwengcindezi yegazi ephansi kuyadingeka futhi.

Abanye abantu abanesifo i-Addison bafundiswa ukuzinika umjovo ophuthumayo we-hydrocortisone phakathi nezimo ezicindezelayo. 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.

Ngokwelashwa kwehomoni, abantu abaningi abanesifo i-Addison bayakwazi ukuphila impilo ejwayelekile.

Izinkinga zingenzeka uma uthatha i-adrenal hormone encane kakhulu noma eningi kakhulu.

Shayela umhlinzeki wakho uma:

• Awukwazi ukugcina umuthi wakho uphansi ngenxa yokuhlanza.
• Unengcindezi efana nokutheleleka, ukulimala, ukuhlukumezeka, noma ukoma. Ungadinga ukuthi umuthi wakho ulungiswe.
• Isisindo sakho siyakhula ngokuhamba kwesikhathi.
• Amaqakala akho aqala ukuvuvukala.
• Uba nezimpawu ezintsha.
• Ekwelashweni, uba nezimpawu zesifo okuthiwa yiCushing syndrome

Uma unezimpawu zenkinga ye-adrenal, zinike umjovo ophuthumayo womuthi owunikeziwe. Uma ingatholakali, iya egumbini lezimo eziphuthumayo eliseduze noma ushayele ku-911.

Izimpawu zenkinga ye-adrenal zifaka:

• Ubuhlungu besisu
• Kunzima ukuphefumula
• Isiyezi noma ikhanda elikhanyayo
• Umfutho wegazi ophansi
• Izinga elehlisiwe lokuqonda

Ukuzenzisa kwe-Adrenocortical; Ukungasebenzi kahle okungapheli kwe-adrenocortical; Ukwehluleka okuyinhloko kwe-adrenal

• Izindlala ze-Endocrine

UBarthel A, uBenker G, uBerens K, et al. Ukuvuselelwa kwesifo i-Addison. I-Exp Clin Endocrinol Isifo Sikashukela. 2019; 127 (2-03): 165-175. I-PMID: 30562824 www.ncbi.nlm.nih.gov/pubmed/30562824.

UBornstein SR, u-Allolio 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.

UNieman LK. I-adrenal cortex. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-25. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 227.