Cushing syndrome ngenxa isimila adrenal

I-Cushing syndrome ngenxa yesimila i-adrenal iyindlela yeCushing syndrome. Kwenzeka lapho isimila se-adrenal gland sikhipha inani elingaphezulu kwe-hormone cortisol.

I-Cushing syndrome yisifo esenzeka lapho umzimba wakho unezinga eliphakeme kunelijwayelekile le-hormone cortisol. Le hormone yenziwa kwizindlala ze-adrenal. I-cortisol eningi kakhulu ingabangelwa izinkinga ezahlukahlukene. Enye yezinkinga ezinjalo isimila kwesinye sezindlala ze-adrenal. Izicubu ze-adrenal zikhipha i-cortisol.

Izimila ze-adrenal azivamile. Zingaba ezingenomdlavuza (ezinobungozi) noma ezinomdlavuza (ezimbi).

Izicubu ezingenomdlavuza ezingadala i-Cushing syndrome zifaka:

• I-adrenal adenomas, isimila esivamile esingajwayelekile ukwenza i-cortisol eyeqile
• I-Macronodular hyperplasia, ebangela ukuthi izindlala ze-adrenal zikhulise futhi zenze i-cortisol eyeqile

Izicubu zomdlavuza ezingadala i-Cushing syndrome zifaka i-adrenal carcinoma. Lesi isimila esingavamile, kepha ngokuvamile senza i-cortisol eyeqile.

Iningi labantu abane-Cushing syndrome bane:

• Round, obomvu, ubuso obugcwele (ubuso benyanga)
• Izinga lokukhula kancane ezinganeni
• Ukuzuza kwesisindo ngokunqwabelana kwamafutha esiqwini, kepha ukulahleka kwamafutha ezandleni, emilenzeni nasezinqeni (ukukhuluphala okuphakathi)

Izinguquko zesikhumba ezivame ukubonwa:

• Ukutheleleka kwesikhumba
• Amamaki anombala onsomi (1/2 intshi noma isentimitha elilodwa noma ngaphezulu ububanzi), okuthiwa i-striae, esikhunjeni sesisu, emathangeni, ezingalweni ezingaphezulu, nasemabeleni
• Isikhumba esizacile esinokulimazeka okulula

Izinguquko zemisipha namathambo zifaka:

• Ubuhlungu beqolo, obenzeka ngemisebenzi ejwayelekile
• Ubuhlungu bamathambo noma isisa
• Ukuqoqwa kwamafutha phakathi kwamahlombe nangaphezulu kwethambo lekhola
• Ubambo kanye nokuqhekeka komgogodla okubangelwa ukuncipha kwamathambo
• Imisipha ebuthakathaka, ikakhulukazi okhalweni nasemahlombe

Izinguquko zomzimba wonke (systemic) zifaka:

• Thayipha i-2 yesifo sikashukela
• Umfutho wegazi ophezulu
• Ukwandisa i-cholesterol ne-triglycerides

Abesifazane bavame ukuba:

• Ukukhula kwezinwele okweqile ebusweni, entanyeni, esifubeni, esiswini nasemathangeni (okuvame kakhulu kunezinye izinhlobo zeCushing syndrome)
• Izikhathi eziba ngokungajwayelekile noma ukuma

Amadoda angaba:

• Ukunciphisa noma ukungabi nesifiso sobulili (i-libido ephansi)
• Izinkinga zokwakhiwa

Ezinye izimpawu ezingenzeka zibandakanya:

• Izinguquko zengqondo, njengokucindezeleka, ukukhathazeka, noma izinguquko ekuziphatheni
• Ukukhathala
• Ubuhlungu bekhanda
• Ukwanda ukoma nokuchama

Umhlinzeki wezokunakekelwa kwempilo uzokwenza ukuhlolwa komzimba abuze ngezimpawu zakho.

Ukuhlolwa kokuqinisekisa i-Cushing syndrome:

• Isampula lomchamo wamahora angama-24 ukukala amazinga e-cortisol ne-creatinine
• Ukuhlolwa kwegazi ukuhlola amazinga we-ACTH, i-cortisol, ne-potassium
• Isivivinyo sokucindezela i-Dexamethasone
• Amazinga we-cortisol yegazi
• Izinga le-DHEA yegazi
• Izinga le-cortisol yamathe

Ukuhlolwa kokuthola imbangela noma izinkinga kufaka:

• I-CT yesisu
• ACTH
• Ubuningi bamathambo
• Cholesterol
• Ukuzila ukudla kweglucose

Ukuhlinzwa kwenziwa ukuze kususwe isimila se-adrenal. Imvamisa, yonke indlala ye-adrenal iyasuswa.

Ukwelashwa kokufakwa esikhundleni se-Glucocorticoid kuvame ukudingeka kuze kube yilapho enye indlala ye-adrenal ilulama ekuhlinzweni. Ungadinga lokhu kwelashwa izinyanga ezintathu kuya kwezingu-12.

Uma ukuhlinzeka kungenzeki, njengasesimweni somdlavuza we-adrenal osakazekile (i-metastasis), imithi ingasetshenziswa ukumisa ukukhishwa kwe-cortisol.

Abantu abane-tumor adrenal abahlinzwa banombono omuhle kakhulu. Ngomdlavuza we-adrenal, ukuhlinzwa kwesinye isikhathi akunakwenzeka. Lapho kwenziwa ukuhlinzwa, akuwelaphi njalo umdlavuza.

Izimila ezinomdlavuza ezingadlulela esibindini noma emaphashini.

Shayela umhlinzeki wakho uma uba nezimpawu ze-Cushing syndrome.

Ukwelashwa okufanele kwezicubu ze-adrenal kunganciphisa ubungozi bezinkinga kwabanye abantu abane-Cushing syndrome ehlobene nesimila.

Isimila se-Adrenal - Cushing syndrome

• Izindlala ze-Endocrine
• I-adrenal metastases - i-CT scan
• I-Adrenal Tumor - CT

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UNieman LK, uBiller BM, uTholeling JW, et al. Ukwelashwa kwe-Cushing's syndrome: umhlahlandlela wokusebenza komtholampilo we-Endocrine Society. UJ Clin Endocrinol Metab. 2015; 100 (8): 2807-2831. I-PMID: 26222757 www.ncbi.nlm.nih.gov/pubmed/26222757.

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.