I-pituitary apoplexy

I-pituitary apoplexy yisimo esingavamile, kodwa esibi sendlala ye-pituitary.

I-pituitary iyindlala encane engxenyeni yobuchopho. I-pituitary ikhiqiza amahomoni amaningi alawula izinqubo zomzimba ezibalulekile.

I-pituitary apoplexy ingabangelwa ukuphuma kwegazi ku-pituitary noma ngokugeleza kwegazi okuvinjelwe ku-pituitary. I-Apoplexy isho ukopha esithweni noma ukulahleka kokugeleza kwegazi kuye esithweni.

I-pituitary apoplexy ivame ukubangelwa ukopha ngaphakathi kwesimila esingenalo umdlavuza (esibi) se-pituitary. Lezi zicubu zivame kakhulu futhi kaningi azitholakali. I-pituitary iyalimala lapho isimila sikhula ngokuzumayo. Kuphuma igazi ku-pituitary noma kuvimbele ukunikezwa kwegazi ku-pituitary. Lapho isimila sikhulu, kukhuphuka ingozi yokuba ne-pituitary apoplexy yesikhathi esizayo.

Lapho ukopha kwe-pituitary kwenzeka kowesifazane ngesikhathi noma ngemuva kokubeletha, kubizwa ngokuthi yi-Sheehan syndrome. Lesi yisimo esingajwayelekile kakhulu.

Izici zobungozi ze-pituitary apoplexy kubantu abangakhulelwe abangenaso isimila zifaka:

• Izinkinga zokopha
• Isifo sikashukela
• Ukulimala ekhanda
• Kushisa bhé kule ndawo ngendlala ye-pituitary
• Ukusetshenziswa komshini wokuphefumula

I-pituitary apoplexy kulezi zimo ayivamile kakhulu.

I-pituitary apoplexy ivame ukuba nesikhathi esifushane sezimpawu (acute), ezingasongela impilo. Izimpawu zivame ukufaka:

• Ikhanda elibuhlungu (impilo yakho imbi kakhulu)
• Ukukhubazeka kwemisipha yamehlo, kudala ukubona kabili (i-ophthalmoplegia) noma izinkinga zokuvula ijwabu leso
• Ukulahleka kombono wokuzungeza noma ukulahleka kwawo wonke umbono kwelinye noma womabili amehlo
• Umfutho wegazi ophansi, isicanucanu, ukulahlekelwa isifiso sokudla, nokuhlanza ngenxa yokungakwazi ukusebenza kahle kwe-adrenal
• Izinguquko zobuntu ngenxa yokuncipha okungazelelwe komunye wemithambo ebuchosheni (umthambo wangaphakathi wobuchopho)

Ngaphansi kokujwayelekile, ukungasebenzi kahle kwepituitary kungavela kancane. Ku-Sheehan syndrome, isibonelo, uphawu lokuqala kungaba ukwehluleka ukukhiqiza ubisi olubangelwa ukuntuleka kwe-hormone prolactin.

Ngokuhamba kwesikhathi, izinkinga ezinamanye ama-pituitary hormone zingakhula, zidale izimpawu zale mibandela elandelayo:

• Ukukhula kwe-hormone yokukhula
• Ukungakwazi ukusebenza kahle kwe-adrenal (uma kungenjalo sekuvele kukhona noma kuyelashwa)
• I-Hypogonadism (izindlala zocansi lomzimba zikhiqiza ama-hormone amancane noma awekho nhlobo)
• I-Hypothyroidism (indlala yegilo ayenzi i-hormone yegilo eyanele)

Ezimweni ezingavamile, lapho okubandakanyeka ngemuva (ingxenye engemuva) ye-pituitary, izimpawu zingafaka:

• Ukwehluleka kwesibeletho ukwenza isivumelwano sokubeletha ingane (kwabesifazane)
• Ukwehluleka ukukhiqiza ubisi lwebele (kwabesifazane)
• Ukuchama kaningi nokoma okukhulu (isifo sikashukela insipidus)

Umhlinzeki wezokunakekelwa kwempilo uzokwenza ukuhlolwa komzimba abuze ngezimpawu zakho.

Izivivinyo ezinga-odwa zifaka:

• Ukuhlolwa kwamehlo
• Iskena se-MRI noma se-CT

Ukuhlolwa kwegazi kuzokwenziwa ukuhlola amazinga alandelayo:

• I-ACTH (i-adrenocorticotropic hormone)
• ICortisol
• I-FSH (i-hormone evuselelayo)
• Ozokusebenzisa
• I-LH (i-luteinizing hormone)
• Iprolactin
• I-TSH (i-hormone evuselela i-thyroid)
• Ukukhula okufana ne-insulin-1 (IGF-1)
• Sodium
• I-Osmolarity egazini nasemchameni

I-apoplexy enamandla ingadinga ukuhlinzwa ukuze kuncishiswe ingcindezi ku-pituitary futhi kuthuthukise izimpawu zombono. Amacala abucayi adinga ukuhlinzwa okuphuthumayo. Uma umbono ungathinteki, ukuhlinzeka kaningi akudingekile.

Ukwelashwa ngokushesha ngamahomoni angena esikhundleni se-adrenal (i-glucocorticoids) kungadingeka. La mahomoni avame ukunikezwa ngomthambo (nge-IV). Amanye ama-hormone ekugcineni angafakwa esikhundleni, kufaka phakathi:

• Ozokusebenzisa
• Amahomoni ezocansi (estrogen / testosterone)
• Indlala yegilo
• IVasopressin (ADH)

I-pituitary apoplexy enamandla ingaba yingozi empilweni. Umbono muhle kubantu abanesifo sesikhathi eside (esingapheli) sokutholwa kwamathambo okutholakala nokwelashwa.

Izinkinga ze-pituitary apoplexy engalashwa ingafaka:

• Inkinga ye-Adrenal (isimo esenzeka lapho ingekho i-cortisol eyanele, i-hormone ekhiqizwa yizindlala ze-adrenal)
• Ukulahleka kombono

Uma amanye ama-hormone alahlekile engashintshwa, izimpawu ze-hypothyroidism ne-hypogonadism zingakhula, kufaka phakathi ukungazali.

Shayela umhlinzeki wakho uma unezinye izimpawu zokunganeleki okungapheli kwesifo.

Iya egumbini labezimo eziphuthumayo noma ushayele inombolo yendawo ephuthumayo (efana ne-911) uma unezimpawu ze-pituitary apoplexy, okubandakanya:

• Ubuthakathaka bemisipha yamehlo noma ukulahleka kombono
• Kungazelelwe, ikhanda elibi kakhulu
• Umfutho wegazi ophansi (ongadala ukuquleka)
• Isicanucanu
• Ukuhlanza

Uma uba nalezi zimpawu futhi usuvele utholakale ukuthi unesifo se-pituitary, funa usizo lwezokwelapha khona manjalo.

I-pituitary infarction; I-pituitary tumor apoplexy

• Izindlala ze-Endocrine

UHannoush ZC, Weiss RE. I-pituitary apoplexy. Ku: Feingold KR, Anawalt B, Boyce A, et al, ama-eds. I-Endotext [Internet]. ENingizimu Dartmouth, MA: MDText.com. 2000-. www.ncbi.nlm.nih.gov/books/NBK279125. Kubuyekezwe u-Ephreli 22, 2018. Kufinyelelwe ngoMeyi 20, 2019.

I-Melmed S, i-Kleinberg D. Izixuku zamapayipi nezicubu. Ku: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, abahleli. Incwadi kaWilliams ye-Endocrinology. Umhlaka 13. IPhiladelphia, PA: Elsevier; 2016: isahluko 9.