Dɛn ne Glucagonoma? Momma yɛnka tebea a ɛntaa nsi yi ho asɛm!

Pancreas yɛ akwaa ketewaa bi nanso ɛho hia yiye wɔ wo nipadua mu. Ɛma hormone ahorow pii a yɛn nipadua hia. Enti, ɛtɔ mmere bi a, kokoram bi a wɔntaa nhu a ɛba dwensɔtwaa mu no betumi de ɔhaw ahorow aba. Ɛno ne nea wɔfrɛ tebea yi Glucagonoma . Ebia woanya asikreyare mpofirim, anaasɛ woanya biribi te sɛ akisikuru a ɛyɛ nwonwa wɔ wo honam ani, ɛho hia yiye sɛ wuhu eyi.

Dɛn ne glucagonoma? Sɛ yɛbɛka no tiawa a...

Glucagonoma yɛ kokoram a ɛntaa nsi koraa a ɛba wo dwensɔtwaa mu. Saa akisikuru yi ma hormone bi a wɔfrɛ no glucagon dɔɔso dodo. Afei ebia woresusuw nea glucagon yi yɛ ho.

Glucagon yɛ hormone a ɛho hia yiye a ɛboa ma yɛhwɛ asikre dodow a ɛwɔ yɛn nipadua mu, kyerɛ sɛ, mogya mu glucose dodow so. Alpha nkwammoaa, nkwammoaa soronko bi a ɛwɔ wo dwensɔtwaa mu na ɛyɛ. Fa no sɛ sɛ wunnidi bere tiaa bi, woteɛteɛ w’apɔw mu denneennen ankasa, anaasɛ wudi aduan a protein pii wom a, asikre dodow a ɛwɔ wo mogya mu betumi akɔ fam, ɛnte saa? Ɛno na glucagon yi ba mu, yi asikre a wɔde asie wo mmerɛbo mu, kyerɛ sɛ, glycogen , no fi adi, na ɛma asikre dodow a ɛwɔ wo mogya mu no san kɔ soro. Ɛte sɛ obi a ɔboa ma asikre kari pɛ wɔ yɛn nipadua mu.

Nanso, sɛ glucagonoma bi wɔ hɔ a, wɔyɛ saa glucagon hormone yi boro so. Afei yɛn nipadua no ntumi nni ho dwuma. Wɔfrɛ sɛnkyerɛnne ahorow a ɛka bom a ɛba esiane eyi nti no Glucagonoma Syndrome . Eyi betumi de nsɛnnennen pii te sɛ honam ani haw ne asikreyare aba.

Saa kokoram yi a wɔfrɛ no glucagonoma no ka pancreatic neuroendocrine tumors , anaa islet cell tumors . Mpɛn pii no, eyinom sɔre wɔ dwensɔtwaa no dua anaa mfinimfini fã.

So eyi yɛ kokoram ankasa?

Yiw, mpɛn pii no, glucagonoma yɛ kokoram . Awerɛhosɛm ne sɛ, sɛ wohu mpo a, wɔ bɛyɛ 50% mu, kyerɛ sɛ, bɛyɛ abien biara mu biako, ebia kokoram yi atrɛw (atrɛw) akɔ nipadua no afã afoforo, titiriw mmerɛbo no mu .

Saa tebea yi abu so dɛn?

Glucagonoma yɛ tebea a ɛntaa nsi koraa ankasa. Afe biara wohu nnipa foforo ɔpepem biako biara mu biako. Ɛtaa ka nnipa a wɔadi fi mfe 50 kosi 70 .

Dɛn ne eyi ho sɛnkyerɛnne?

Glucagonomas taa nyin nkakrankakra . Enti, gye sɛ wo nipadua no yɛ glucagon a ɛdɔɔso a ɛde ɔhaw ahorow ba, ebia worennya yare no ho sɛnkyerɛnne biara.

Nanso, sɛ glucagonoma ma glucagon dɔɔso dodo na nipadua no ntumi nni ho dwuma a, glucagonoma syndrome a yɛadi kan aka ho asɛm no ba.Ɛba. Afei, wubehu sɛnkyerɛnne ahorow a emu da hɔ. Sɛ wowɔ saa nsɛnkyerɛnne yi a, ɛho hia paa sɛ wobɛkɔ oduruyɛfo nkyɛn ntɛm ara sɛnea wubetumi.

Wora a ɛyɛ mmerɛw (Necrolytic Migratory Erythema - NME) .

Eyi ne glucagonoma yare no ho sɛnkyerɛnne titiriw ne nea ɛtaa ba . Nnipa a wɔwɔ saa yare yi mu bɛyɛ 90% nya honam ani haw yi. Wɔfrɛ no necrolytic migratory erythema (NME) .

Fa no sɛ, wo honam ani, titiriw wɔ wo kokoam akwaa, wo nan ase, ne wo nan ase, fi ase yɛ kɔkɔɔ, ɛyɛ wo yaw, na ɛtɔ mmere bi a ɛyɛ yaw. Akyiri yi eyinom dan akisikuru, ɛpaapae, na ɛyɛ kurukuruwa. Sɛ wɔsa wie mpo a, ebia baabi a ɛyɛ bruu bɛkɔ so atra hɔ. Eyi betumi ayɛ beae biako, asa yare, na afei asan ada adi wɔ baabi foforo. Ɛte sɛ akisikuru a efi baabi kɔ baabi.

NME no mu nneɛma afoforo:

• Eyi betumi aba na akɔ, na ebetumi adi akɔneaba wɔ nipadua no mu .
• Ebetumi ayɛ wo yaw kɛse na ayɛ yaw mfiase no.
• Akisikuru no dan kɔkɔɔ na afei ɛyɛ akisikuru na ɛyɛ kurukuruwa. Sɛ ɛsa wie a, ebia baabi a ɛyɛ bruu bɛkɔ so atra hɔ.
• Eyi betumi ama obi anya nneɛma te sɛ tɛkrɛma mu akuru (glossitis ), ano a akuru, anofafa a apaapae, ne anim a ɛyɛ ahinanan .
• Aniwa a ɛho ahonhon ( blepharitis ), nhwi a ɛbɛtɔ, ne nnadewa mu haw nso betumi aba.

Asikreyare ho sɛnkyerɛnne ahorow

Saa yare yi ma asikre dodow kɔ soro wɔ mogya mu ( hyperglycemia ), na ebetumi ama obi anya asikreyare. Asikreyare ho sɛnkyerɛnne ahorow bi ne:

• Sɛ́ wobɛyɛ teateaa a ntease biara nnim.
• Sukɔm a ɛtaa de obi boro so (Polydipsia) .
• Nsu a wɔtaa tow ( polyuria ), titiriw anadwo.
• Ɔkɔm a ɛboro so ( Polyphagia ).

Nsɛnkyerɛnne afoforo a ɛkyerɛ sɛ (glucagonoma syndrome) .

Nsɛnkyerɛnne afoforo pii wɔ hɔ:

• Atiridiinini a enni sabea .
• Hemoglobin a ɛba fam wɔ mogya mu (nemia ). Eyi betumi ama obi abrɛ na wayɛ basaa.
• Mogya a ɛtɔ, titiriw wɔ nan no ntini a emu dɔ no mu ( Deep Vein Thrombosis (DVT) ).

Nsɛnkyerɛnne a ɛfa adwene ne ntini nhyehyɛe ho

Ɛtɔ da bi a, wobɛtumi nso ahunu yareɛ no ho nsɛnkyerɛnneɛ a ɛfa adwene ne ntini nhyehyɛeɛ ho, te sɛ:

• Hahaahayɔ
• Adwene mu yare
• Basabasayɛ
• Hyperreflexia (nipadua no mmuae ntɛmntɛm) .
• Nantew a ɛyɛ nwonwa (ataxia ) .
• Adwene mu haw ( Psychosis) .) .
• Ehu ne adwenem naayɛ a ntease nnim ( Paranoid Delusions ) .

Dɛn na ɛde glucagonoma ba?

Mpɛn pii no, nnuruyɛfo nnim nea ɛde glucagonoma ba ankasa . Nanso, wɔ bɛyɛ 10% mu no, kokoram yi ne awosu mu tebea bi a wɔfrɛ no Multiple Endocrine Neoplasia type 1 (MEN type 1) wɔ abusuabɔ .

Nanso, ɛnyɛ obiara a ɔwɔ MEN type 1 na onya glucagonoma. Ɛno nso yɛ ɔha biara mu nkyem ketewaa bi pɛ.

Wobɛyɛ dɛn ahu eyi?

Sɛ wowɔ honam ani yare a wɔfrɛ no necrolytic migratory erythema (NME) a ​​yɛadi kan aka ho asɛm no a, ebia oduruyɛfo bi besusuw sɛ glucagonoma. Afei wobetumi ayɛ sɔhwɛ ahorow te sɛ:

• Mogya mu Asikre Ho Nhwehwɛmu a Wɔyɛ wɔ Mmuadadi Mu: Sɛ asikre dodow dɔɔso a, wobetumi asusuw sɛ glucagonoma wɔ hɔ na wɔakyerɛ sɛ asikreyare a ɛbata ho no wɔ hɔ.
• Mmuadadi Glucagon Mogya mu Nhwehwɛmu: Glucagon dodow kɔ soro wɔ ɔkwan a ɛnteɛ so wɔ glucagonoma mu – mpɛn pii no ɛboro picogram 500 wɔ mililita biara mu (pg/mL). Glucagon dodow a ɛfata wɔ mmuadadi mu no nnu 150 pg/mL.
• Amino Acid Mogya mu Nhwehwɛmu: Glucagonoma taa ma amino acid dodow a ɛwɔ mogya no mu no sua ( hypoaminoacidemia ).
• Mogya Dodow a Edi Mu (CBC): Eyi hwɛ sɛ mogya a ɛtɔ kɔ nipadua mu anaa , efisɛ mogya a ɛtɔ kɔ nipadua mu betumi aba wɔ glucagonoma ho.

Mfoninitwa sɔhwɛ ahorow te sɛ eyinom betumi aboa ma wɔahu sɛ ebia akuru bi wɔ hɔ anaa:

• CT Scan a wɔde yɛ nhwehwɛmu
• MRI Scan a Wɔde Yɛ Adwuma
• Endoscopic Ultrasound a Wɔde Yɛ Adwuma

Ɔkwan bɛn so na wɔsa?

Glucagonoma ayaresa gyina sɛ ebia kokoram no wɔ dwensɔtwaa no nkutoo mu (ɛwɔ baabi) anaasɛ atrɛw akɔ nipadua no afã afoforo (ɛkɔ mmeae afoforo) so kɛse .

Sɛnea wobedi kan adi sɛnkyerɛnne ahorow so

Ade a edi kan ne sɛ wobedi sɛnkyerɛnne ne nsɛnnennen a glucagon a ɛboro so de ba no so. Wɔdi eyi ho dwuma sɛnea edidi so yi:

• Nnuru a wɔde siw glucagon a ɛboro so ano: Nnuru a wɔde twitwiw nipadua mu a wɔfrɛ no Octreotide ne Lanreotide boa ma glucagon a ɛboro so no nkɛntɛnso so tew na ɛma glucagon a wɔyɛ no gyae. Saa nnuru yi tumi ma akisikuru no nyin brɛoo mpo. Wɔma ahotɔ nso fi NME, asikreyare, akisikuru, ne ntini mu yare ho sɛnkyerɛnne ahorow ho.
• Asikreyare ano aduru: Ebia wubehia asikreyare aduru a wɔnom anaa insulin a wɔde twitwiw wo mu na ama asikre dodow a ɛwɔ wo mogya mu no akɔ so ayɛ nea ɛfata.
• Aduan pa ho mmoa:Wobetumi de Total Parenteral Nutrition (TPN) , amino acid ne zinc a wɔde ka aduan ho ama de atew nea efi aduan pa a wonnya nni mu ba no so.
• NME honam ani yare a wɔsa: Nnuru a ekum ɔyare mmoawa ne corticosteroids betumi ama NME atu mpɔn.
• Anticoagulant Therapy: Nnuru a ɛma mogya yɛ mmerɛw te sɛ heparin boa ma wosiw deep vein thrombosis (DVT) ano .

Sɛ ɛyɛ dwensɔtwaa no nkutoo a...

Sɛ kokoram no wɔ dwensɔtwaa mu nkutoo a, oprehyɛn ne ayaresa titiriw . Sɛ oduruyɛfo a ɔyɛ oprehyɛn no tumi yi akisikuru no koraa a, wɔtaa sa yare no . Sɛ woyi glucagonoma no fi hɔ wie a, ɛsɛ sɛ wo glucagon dodow san kɔ sɛnea na ɛte kan no. Ɛsɛ sɛ wo yare no ho sɛnkyerɛnne nso fi hɔ.

Sɛ atrɛw akɔ mmeae afoforo (metastasized)...

Bere biara a ɛbɛyɛ yiye no, nnuruyɛfo kamfo kyerɛ sɛ wɔnyɛ oprehyɛn yi akisikuru no. Ebia nea ɛka eyi ho ne akisikuru a ɛwɔ dwensɔtwaa, ntini a ɛbɛn, ne mmerɛbo mu a wobeyi afi hɔ.

Nanso sɛ oduruyɛfo a ɔyɛ oprehyɛn no ntumi nyi akisikuru no biara anaa ne nyinaa a, w’aduruyɛfo kuw no betumi akamfo ayaresa yi biako anaa nea ɛboro saa akyerɛ:

• Nnuru a wɔde sa yare: Saa ayaresa yi yɛ adwuma denam kokoram nkwammoaa a ɛsɛe no na esiw ano no so.
• Radiofrequency Ablation: Eyi de ɔhyew a efi radio asorɔkye mu di dwuma de kunkum kokoram nkwammoaa.
• Cryosurgical Ablation: Eyi de nnuru a ɛyɛ nwini kɛse te sɛ nitrogen a ɛyɛ nsu di dwuma de sɛe kokoram nkwammoaa.
• Chemoembolisation: Saa ayaresa yi siw mogya a ɛkɔ kokoram no mu no kwan.

Dɛn ne nkɔmhyɛ a ɛkyerɛ sɛ obi bɛsan anya ahoɔden afi tebea yi mu?

Anidaso a obi a ɔwɔ glucagonoma betumi anya no gyina nneɛma pii so:

• Wo mfe a woadi ne w’akwahosan nyinaa .
• Kokoram akisikuru no kɛse .
• Sɛ́ ebia kokoram no atrɛw anaasɛ ɛntrɛwee .

Sɛ kokoram no wɔ dwensɔtwaa no nkutoo mu a, mpɛn pii no, nea ɛbɛba no ye . Oprehyɛn a wɔyɛ de yi akisikuru no taa yɛ ayaresa, nanso eyi te saa wɔ ayarefo a wɔwɔ glucagonoma no mu bɛyɛ 20% pɛ mu.

Esiane sɛ glucagonoma ho yɛ na nti, nsɛm a ɛdɔɔso nni hɔ a ɛbɛkyerɛ bere tenten pɔtee a wubetumi atra ase anaa nea ebefi mu aba sɛ kokoram no trɛw a. Wo nnuruyɛfo kuw no betumi agyina wo tebea pɔtee no so de nsɛm pii ama.

So wobetumi asiw eyi ano?

Esiane sɛ nyansahufo nnim nea ɛde glucagonoma dodow no ara ba nti, biribiara nni hɔ a wubetumi ayɛ ankasa de asiw ano .

Nanso, sɛ wɔahu sɛ w’abusuafo a wodi kan no mu biako (awofo a wɔwoo wo ne wo nuanom) anya MEN (Multiple Endocrine Neoplasia) , a, wo ne wo duruyɛfo nkasa mfa awosu mu nhwehwɛmu ho. Sɛ wowɔ MEN nso a, awosu mu nhwehwɛmu betumi aboa ma wɔahu kokoram wɔ ne mfiase.

Sɛ wohu sɛ ɔwɔ kokoram a, ɛyɛ osuahu a ɛhaw adwene kɛse. Sɛ ɛyɛ biribi a ɛntaa nsi te sɛ glucagonoma a, ɛyɛ den kɛse mpo. Nanso kae sɛ, w’aduruyɛfo kuw no wɔ hɔ sɛ wobebua wo nsɛmmisa na wɔaboa wo. Sɛ wote nka sɛ wo nkutoo na wowɔ glucagonoma wɔ adwene ne nkate fam a, bisa wo duruyɛfo nhyehyɛe ne nnwuma a ebetumi aboa wo ho asɛm.

Nea etwa to no, nneɛma a ɛsɛ sɛ wokae (Take-Home Message) .

Enti, ɛwom mpo sɛ glucagonoma yɛ tebea a ɛntaa nsi koraa de, nanso ɛho hia sɛ wohu. Titiriw sɛ mpofirim ara wunya sɛnkyerɛnne ahorow a ɛte sɛ asikreyare ka honam ani akisikuru a ɛyɛ nwonwa (NME) ho, sɛnea yɛaka no, kɔ oduruyɛfo nkyɛn ntɛm. Sɛ wohu no ntɛm a, wobetumi asa. Ɛwom sɛ eyi ntaa mma de, nanso ayaresa ahorow wɔ hɔ.

Mma ɛnhaw wo, ɛnyɛ wo nko ara. Wo duruyɛfo ne aduruyɛ kuw no bɛboa wo wɔ akwantu yi mu. Kɔ so yɛ den na di afotu a wɔde ma wo no akyi.

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