So wobrɛ bere nyinaa? So eyi betumi ayɛ ɔhaw wɔ wo pituitary gland no ho? (Hypopituitarism) .

So ɛtɔ da bi a wote nka sɛ wo nipadua ayɛ mmerɛw, te sɛ nea biribi ayera? Ebia nea enti a ɛte saa ne ɔhaw ketewaa bi a ɛwɔ wo nipadua mu ntini nketenkete, nanso ɛho hia yiye no biako mu. Ɛnnɛ yɛrebɛka hypopituitarism , tebea bi a ɛntaa nsi a ɛba wɔ pituitary gland no mu ho asɛm . Mma ɛnhaw wo, yɛbɛka eyi ho asɛm tiawa, wɔ ɔkwan a wubetumi ate ase so.

Dɛn ne hypopituitarism?

Sɛ yɛbɛka no tiawa a, hypopituitarism yɛ bere a wo pituitary gland no ntumi nyɛ hormone a ɛdɔɔso. Seesei ebia woresusuw nea saa hormone ahorow yi yɛ ho. Hormone ahorow te sɛ nnuru abɔfo a ɛde nkrasɛm kɔ ma yɛn nipadua no yɛ adwuma yiye. Pituitary hormone ahorow di nneɛma pii so, a nea ɛka ho ne yɛn nipadua mu nneɛma a ɛsakra , nipadua nyin, nna mu nkɔso, ne awo.

Fa no sɛ ɛyɛ ahyɛde beae ketewaa bi a ɛwɔ yɛn nipadua mu, pituitary gland. Nanso ɛnyɛ ɛno nkutoo na ɛyɛ adwuma. Amemene no fã foforo a ɛho hia a wɔfrɛ no hypothalamus na ɛboa no . Hypothalamus no ka kyerɛ pituitary gland no sɛ, "Okay, gyae hormone no mprempren." Hypothalamus no nso di nneɛma te sɛ mogya mmoroso, koma bɔ, nipadua mu hyew, ne aduan a wɔyam no so. Enti, sɛ biribi asɛe anaa yare bi wɔ pituitary gland anaa hypothalamus no so a, wubetumi anya hypopituitarism.

Saa tebea yi betumi aba mpofirim, wɔ akwanhyia bi akyi mpo. Anaasɛ ebetumi anya nkɔso nkakrankakra wɔ asram anaa mfe pii mu. Mpɛn pii no, ebehia sɛ saa nkurɔfo yi nom nnuru wɔ wɔn nkwa nna nyinaa mu na ama wɔadi wɔn yare no ho sɛnkyerɛnne ahorow so. Nanso mma ɛnhaw wo, wo duruyɛfo bɛhwɛ wo yiye na ɔde ayaresa a ɛho hia ama wo.

So hypopituitarism ahorow ahorow wɔ hɔ?

Yiw, wobetumi akyekyɛ mu ayɛ no ahorow atitiriw abien. Biako gyina sɛnea hormone dodow a enni hɔ no so .

• Pituitary a atew ne ho: Wɔ eyi mu no, pituitary hormone biako pɛ na enni hɔ.
• Pituitary hormone pii a enni nipadua mu: Eyi ne bere a pituitary hormone abien anaa nea ɛboro saa nni hɔ.
• Panhypopituitarism: Eyi yɛ tebea a emu nyɛ den pii a ɛma nkwaadɔm a pituitary gland no yɛ nyinaa so tew.

Afei, wɔkyekyɛ wɔn mu sɛnea nea ɛde ba ne sɛnea ɛka pituitary gland no te :

• Primary hypopituitarism: Eyi fi ɔsɛe anaa yare a ɛka pituitary gland no tẽẽ.
• Secondary hypopituitarism: Eyi fi hypothalamus a ɛsɛe anaa yare a ɛba no so. Kae sɛ hypothalamus ne nea ɛma akwankyerɛ ma pituitary gland no.
• Idiopathic hypopituitarism: Ɛtɔ mmere bi a, wontumi nhu nea ɛde ba.

Dɛn ne Hypopituitarism ho sɛnkyerɛnne ahorow?

Nsɛnkyerɛnne no gu ahorow gyina hormone a enni mu no so . Nneɛma a edidi so yi nso di dwuma:

• Wo bɔbeasu .
• Mfe a woadi bere a tebea yi fii ase no .
• Nea ɛde hypopituitarism ba.
• Hwɛ sɛnea hormone ahorow no so tew ntɛmntɛm .

Afei ma yɛnhwɛ sɛnkyerɛnne ahorow a ɛda adi bere a hormone biara sua no.

Nsɛnkyerɛnne a Ɛkyerɛ sɛ Nkwammoaa a Ɛma Onyin (GH) a Nni Hɔ

Wɔ nkokoaa a wɔawo wɔn foforo fam no:

• Asikre dodow a ɛba fam wɔ mogya mu (Hypoglycemia) .
• Ɔbarima akyi berɛmo ketewaa a ɛnteɛ a obi wɔ (Micropenis) .

Wɔ mmofra nkumaa fam no:

• Onyin yɛ brɛoo koraa anaasɛ ɛnte saa koraa. Sɛ nhwɛso no, sɛ ɛte sɛ nea wo ba no nnyin tenten bere a wɔde toto mmofra afoforo a wɔne wɔn bɔ tipɛn ho a, eyi betumi ayɛ eyi ho sɛnkyerɛnne.
• Ɔsorokɔ tiawa .
• Nna mu nkɔso a ɛkyɛ anaasɛ enni hɔ wɔ mmerantebere ne mmabaabere mu.

Wɔ mpanyimfo fam no:

• Ɔbrɛ a ɛtra so bere nyinaa . Sɛ wote nka sɛ batere no awu.
• Sɛ́ wobɛte nka sɛ n’ani nnye pii na n’ani nnye asetra ho.
• Nna mu dwumadi ne akɔnnɔ a ɛso tew .
• Srade a ɛkɔ soro, titiriw wɔ asen ho .
• Awɔw ne ɔhyew a wotumi gyina ano a ɛso tew .
• Ntini a ɛso tew .
• Ahoɔden ne boasetɔ a ɛso tew bere a wɔreyɛ apɔw-mu-teɛteɛ no.

Nsɛnkyerɛnne a ɛkyerɛ sɛ obi nni Thyroid-Stimulating Hormone (TSH) a enni nipadua no mu

Wɔ nkokoaa a wɔawo wɔn foforo fam no:

• Ntini mu ahoɔden a ɛso tew (akwaa te nka sɛ nkwa nni mu).
• Nipadua mu hyew a ɛba fam (Hypothermia) .
• Sɛ wote nka sɛ wo ho ayɛ wo hyew .
• Su a wɔde nne a ɛyɛ den na ɛyɛ obonin .

Wɔ mmofra nkumaa ne mpanyimfo fam no:

Eyi ho sɛnkyerɛnne te sɛ hypothyroidism , efisɛ TSH hormone no kanyan thyroid ntini no ma ɛyɛ n’ankasa hormone ahorow.

• Ɔbrɛ a ɛtra so .
• Wora a ɛyɛ nwunu ne nwi a ɛyɛ mmerɛw/ɛyera .
• Ayamtim .
• Mu duru a ɛkɔ soro .
• Ntini mu mmerɛwyɛ .
• Tumi a obi tumi gyina awɔw ano a ɛso tew .
• Adwene mu tebea horow te sɛ adwenemhaw .
• Mmea betumi anya brayɛ a ɛnkɔ so daa anaasɛ mogya bɛtɔ wɔn kɛse sen sɛnea ɛte daa .

Nsɛnkyerɛnne a ɛkyerɛ sɛ Follicle-Stimulating Hormone (FSH) ne/anaasɛ Luteinizing Hormone (LH) a enni nipadua no mu

FSH ne LH yɛ nkwaadɔm a wɔfrɛ no gonadotropins . Eyinom ka yɛn awo nhyehyɛe no tẽẽ .

Wɔ nkokoaa mmarimaa a wɔawo wɔn foforo fam no:

• Ɔbarima akyi berɛmo ketewaa a ɛnteɛ a obi wɔ (Micropenis) .
• Nkwaboaa a ensi fam .

Wɔ mmofra nkumaa fam no:

• Nufu a ennya nkɔso wɔ mmeawa mu.
• Mmarimaa mmadwoa ntrɛw .
• Nipadua no nnya nkɔanim mpofirim wɔ ne tenten mu (onyin a ɛyɛ hu) wɔ mmerantebere ne mmabaabere mu.

Wɔ mmarima fam no:

• Ɔbarima ne ɔbea nna ho akɔnnɔ a ɛso tew .
• Ɔbrɛ a ɛtra so .
• Awo a wontumi nwo .
• Ɔbarima ne ɔbea nna a ɛnyɛ den .
• Anim anaa nipadua mu nhwi a ɛyera .

Wɔ mmea fam no:

• Ɔbarima ne ɔbea nna ho akɔnnɔ a ɛba fam .
• Ɔbrɛ a ɛtra so .
• Awo a wontumi nwo .
• Hot flashes - Ɔhyew a ɛba mpofirim wɔ nipadua no mu.
• Brayɛ a ɛnkɔ so daa anaasɛ brayɛ a egyae koraa (Amenorrhea) .
• Nwi a ɛyera wɔ yafunu no ase .
• Sɛ wɔantumi anwo nufusu bere a wɔawo akokoaa akyi .

Adrenocorticotropic Hormone (ACTH anaa Corticotropin) a Ɛntumi Nni Ho Nsɛnkyerɛnne

Wɔ nkokoaa a wɔawo wɔn foforo fam no:

• Asikre dodow a ɛba fam wɔ mogya mu (Hypoglycemia) .
• Mu duru a ɛkɔ soro brɛoo yiye (Failure to thrive) . Ɛte sɛ nea akokoaa no nnyɛ latching on ɛwom mpo sɛ ɔrenom nufusu a ɛdɔɔso de.
• Ntini a ɛma obi ho kyere no .
• Wora a ɛyɛ kɔkɔɔ (Jaundice) .

Wɔ mmofra nkumaa ne mpanyimfo fam no:

• Ɔbrɛ a ɛtra so .
• Mu duru a wɔtew so a ntease biara nnim .
• Mogya mmoroso a ɛba fam (Hypotension) .
• Akisikuru ne ɔfe .
• Asikre dodow a ɛba fam wɔ mogya mu (Hypoglycemia) .
• Adwene a ɛyɛ basaa, adwene a ɛyera .

Nsɛnkyerɛnne a ɛkyerɛ sɛ obi nni Prolactin

Eyi su titiriw ne nufusu a entumi mma bere a wɔawo akokoaa akyi no .

Nsɛnkyerɛnne a Ɛkyerɛ sɛ Oxytocin Nni Mu

• Nufu a wɔma ho haw bere a wɔawo akokoaa no akyi.
• Ɛyɛ den sɛ wo ne abofra no benya abusuabɔ wɔ awo akyi.
• Afoforo amanehunu ho tema a wonni .
• Ɛyɛ den sɛ wo ne afoforo bedi nkitaho.

Nsɛnkyerɛnne a ɛkyerɛ sɛ Antidiuretic Hormone (ADH anaa Vasopressin anaa Arginine Vasopressin) a enni nipadua no mu

Wɔ nkokoaa a wɔawo wɔn foforo fam no:

• Ɔfe a wɔfe .
• Atiridii a wonnim nea ɛde ba .
• Su a ɛboro so .
• Mu duru a ɛso tew .
• Ayamtim .
• Mpɛn pii a wɔde diaper gu nsu mu (Very wet diapers) .

Wɔ mmofra nkumaa fam no:

• Ɔhaw a ɛwɔ tiafi ntetee mu .
• Mpa a wɔde nsu gu mu .
• Ɔbrɛ a wobɛbrɛ ntɛmntɛm .

Wɔ mpanyimfo fam no:

• Nsu a wɔtaa tow .
• Sukɔm a ɛboro so .
• Electrolyte a ɛnkari pɛ .

Nea ɛho hia: Sɛ wowɔ saa sɛnkyerɛnne ahorow yi mu biako anaa abien a, mma ɛnhaw wo, nanso sɛ ɛkɔ so a, ɛbɛyɛ papa sɛ wobɛhwehwɛ aduruyɛfo afotu.

Dɛn ne nneɛma a ɛde hypopituitarism ba?

Nneɛma pii betumi ama tebea yi aba. Ɛtɔ mmere bi a nnuruyɛfo mpo ntumi nhu nea ɛde ba ankasa. Mpɛn pii no, nneɛma atitiriw abiɛsa na ebetumi de aba:

1. Pituitary gland anaa hypothalamus a wɔde mia so.

2. Ɔsɛe a ɛba pituitary gland anaa hypothalamus so.

3. Ayaresa tebea bi a ɛntaa nsi anaa yare foforo a ɛma obi nya hypopituitarism.

Tebea horow a ɛka pituitary gland anaa hypothalamus

Tebea horow a ebetumi de nhyɛso aba amemene no afã horow yi so na ama obi anya hypopituitarism no bi ne:

• Pituitary adenomas: Eyinom yɛ akisikuru a ɛnyɛ hu a ɛba wɔ pituitary gland no mu. Wobetumi asesa ɔkwan a wɔfa so yɛ hormone ahorow.
• Amemene mu akisikuru: Akisikuru a ɛba wɔ baabi a ɛbɛn hypothalamus anaa pituitary gland no betumi asɛe hormone a wɔyɛ no.
• Lymphocytic hypophysitis (LH): Eyi yɛ tebea a ɛntaa nsi. Ɛha no, nkwammoaa a wɔfrɛ no lymphocytes kɔhyɛ pituitary gland no mu. (Ɛnsɛ sɛ wɔde saa LH yi frafra Luteinizing Hormone a yɛadi kan aka ho asɛm no, ɛnte saa?!)
• Pituitary anaa hypothalamus sarcoidosis: Sarcoidosis yɛ yare a ɛma obi ho hyehye no.

Nsɛm a esisi a ɛsɛe pituitary gland anaa hypothalamus

• Oprehyɛn: Nsɛnnennen a ɛba bere a wɔreyɛ amemene no oprehyɛn (titiriw oprehyɛn a wɔyɛ de yi pituitary adenomas fi hɔ).
• Mframa a wɔde sa yare: Mframa a wɔde sa kokoram ayaresa anaa pituitary adenomas a wɔadi kan ayɛ.
• Ti apirakuru a emu yɛ den (Amemene mu opira a ɛyɛ hu - TBI):Nneɛma te sɛ kar akwanhyia, asehwe, ne agumadi mu opira.
• Pituitary apoplexy: Pituitary gland ntini a ɛsɛe mpofirim.

Ayaresa mu tebea horow a ɛntaa nsi

• Hemochromatosis a wonya fi awosu mu: Eyi yɛ awosu mu tebea. Ɛma dade a ɛboro so boaboa ano wɔ mogya no mu. Eyi betumi asɛe pituitary gland no.
• Mmoawa a ɛma obi ho kyere no: Ɛwom sɛ ɛntaa nsi de, nanso hypopituitarism betumi aba sɛ ɔhaw a efi ɔyare mmoawa a ɛma obi ho kyere no ba.
• Awosu mu nkwaadɔm mu nsakrae: Awosu mu tebea horow bi a wɔntaa nhu betumi ama pituitary hormone hormone aba.

Dɛn ne nneɛma a ɛde asiane ba?

Tebea anaa nsɛm a esisi a edidi so yi betumi ayɛ asiane ahorow a ɛbɛma obi anya hypopituitarism:

• Esiane sɛ wɔadi kan anya kokoram ne mframa a wɔde sa yare nti .
• Ti anaa amemene mu opira: Nnipa a wɔapirapira wɔ ti a ɛyɛ hu (TBI) no mu 27% kosi 32% nya hypopituitarism.
• Sickle cell anemia: Saa yare yi betumi ama pituitary hormone ayɛ mmerɛw.
• Asikreyare a ɛto so 1: Ntini ne mogya ntini a asikreyare a ɛto so 1 a wontumi nni so de ba no betumi ama tebea yi aba.
• Nyinsɛn ne awo: Mogya a ɛtɔ dodo wɔ awo akyi no betumi asɛe pituitary gland no. Wɔfrɛ saa tebea yi Sheehan syndrome .

Nsɛnnennen a ebetumi aba

Hormone a enni nipadua mu a ɛka hypopituitarism ho no betumi ama tebea afoforo aba. Saa nsunsuanso ahorow yi gu ahorow gyina hormone a enni mu no so. Nhwɛso ahorow bi ni:

• GH (onyin hormone) a enni nipadua mu no betumi ama obi ayɛ kɛse mmoroso , mogya mu srade a ɛdɔɔso , ne nipadua mu nneɛma a ɛsakra no mu yare .
• Estrogen hormone a enni nipadua mu (esiane FSH a enni hɔ nti) betumi ama mmea anya nnompe mu yare ( nnompe a ɛyɛ teateaa).
• ACTH a enni nipadua mu no betumi ama obi anya adrenal crisis , tebea a egye ntɛmpɛ a ɛde ne nkwa to asiane mu.

Nhwehwɛmu bɛn na wɔyɛ de hu tebea yi?

Wo duruyɛfo betumi ahyɛ sɛ wɔnyɛ nhwehwɛmu yi mu biara mfa nhu sɛ wowɔ hypopituitarism:

• Mogya mu nhwehwɛmu a ɛbɛma woahu sɛnea wo hormone dodow te: Ebia wo duruyɛfo bɛkyerɛ sɛ wɔnyɛ mogya mu nhwehwɛmu a ɛkyerɛ sɛnea wo hormone ahorow te.
• Hormone stimulation tests: Wɔ sɔhwɛ yi mu no, wo duruyɛfo bɛma wo aduru bi a ɛbɛkanyan wo pituitary gland ma hormone a wɔresɔ ahwɛ no afi mu. Afei, wɔfa mogya bi na wɔde kɔ aduruyɛdan bi mu ma wɔyɛ ho nhwehwɛmu.
• Insulin a wotumi gyina ano ho sɔhwɛ: Eyi betumi ahu onyin hormone (GH) ne ACTH a enni nipadua no mu.
• Osmolality nhwehwɛmu a wɔyɛ de hwɛ mogya ne nsu: Eyi yɛ nhwehwɛmu a ɛkyerɛ sɛ obi nni antidiuretic hormone (ADH) a enni nipadua no mu.
• MRI (Magnetic Resonance Imaging) Scan: MRI scan twa wo nipadua no mu mfonini a ɛkɔ akyiri. Wobu amemene no MRI mfonini sɛ ɔkwan a eye sen biara a wɔbɛfa so ahu akisikuru a ɛma amemene no yɛ mmerɛw.
• Brain CT (Computed Tomography) scan: Wobetumi de nhwehwɛmu yi adi dwuma de ahu sɛ ebia amemene mu akisikuru anaa pituitary adenoma bi wɔ hɔ a ɛde tebea yi ba anaa.

Ɔkwan bɛn so na wɔsa hypopituitarism?

Ɛwom sɛ wonni aduru biara de, nanso wobetumi asa . Ayaresa no gyina hormone ahorow a enni mu ne nea ɛde wo tebea no reba so . W’aduruyɛ kuw no bɛboa wo ma woayɛ ayaresa nhyehyɛe a eye ma wo. Ayaresa a wɔtaa fa so no bi ne:

• Hormone replacement therapy: Eyi botae ne sɛ ɛbɛma pituitary hormone a ɛso atew no asan akɔ nea ɛfata. Mpɛn pii no, ɛsɛ sɛ wonom nnuru wo nkwa nna nyinaa.
• Oprehyɛn: Ebia nnipa a wɔwɔ pituitary adenomas no behia oprehyɛn na wɔayi afi hɔ.
• Mframa a wɔde sa yare: Mframa a wɔde sa yare betumi aboa ma pituitary adenomas no so atew.

Ebia wo duruyɛfo nso bɛkamfo akyerɛ sɛ fa aduruyɛ ho ID krataa anaa abɔso ka wo ho bere nyinaa, sɛ biribi si ntɛm a.

Dɛn ne nkɔmhyɛ a ɛkyerɛ sɛ obi anya hypopituitarism?

Adwene a ɛwɔ hɔ no gu ahorow, na egyina nneɛma yi so:

• Mfe a woadi bere a wo sɛnkyerɛnne ahorow no fii ase no .
• Nea enti a wo tebea no te .
• Sɛnea hormone ahorow a ɛba fam no nya nkɛntɛnso no.
• Sɛnea wo nipadua yɛ n’ade wɔ ayaresa ho .

Nnipa pii a wɔwɔ hypopituitarism no bɔ asetra a ahoɔden wom. Nanso, sɛ pituitary no sɛe bere tenten a, ebia nkwa nna bɛyɛ tiaa kakra asen obi a wadi mfe koro a onni yare no. Nanso, mpɛn pii no, wɔn a wodi ayaresa nhyehyɛe a ɛfata akyi no nkwa nna so ntew .

Na sɛ asɛm bi si ntɛm nso ɛ? Sɛ hypopituitarism ba mpofirim, emu yɛ den, na wɔansa a, ebetumi ayɛ aduruyɛ mu asɛm a egye ntɛmpɛ na mpo akowie owu mu. Enti sɛ wuhu sɛnkyerɛnne ahorow a, kɔ oduruyɛfo nkyɛn ntɛm ara.

Bere bɛn na ɛsɛ sɛ mekɔ oduruyɛfo nkyɛn?

Mpɛn pii no, hypopituitarism hwehwɛ sɛ wɔhwɛ nkwaadɔm a ɛka ho no yiye wɔ wɔn nkwa nna nyinaa mu . Kɔ wo duruyɛfo nkyɛn daa na hwɛ sɛ w’ayaresa nhyehyɛe no reyɛ adwuma.Sɛ wowɔ sɛnkyerɛnne foforo anaa ɛhaw adwene a, kɔ wo duruyɛfo nkyɛn ntɛm ara sɛnea wubetumi.

Nsɛm bɛn na ɛsɛ sɛ mibisa me duruyɛfo?

Sɛ wohu sɛ wowɔ hypopituitarism a, ebia wobɛpɛ sɛ wubisa wo duruyɛfo nsɛm yi:

• Hypopituitarism bɛn na mewɔ?
• Hormone bɛn na ɛba fam wɔ me mu?
• Dɛn nti na ɛte saa?
• Ayaresa ahorow bɛn na mewɔ?
• So nsunsuanso bɔne bi wɔ m’ayaresa no mu?
• Bere tenten ahe na ɛsɛ sɛ menom aduru no?
• So eyi bɛka m’awo?
• So eyi bɛka me nyinsɛn no?
• So eyi betumi ato me mma nso?

Awiei koraa no, kae (Take-Home Message) .

Sɛ wohu yare foforo a, ebetumi ayɛ hu, nanso nsuro sɛ wubebisa wo duruyɛfo nsɛm afa hypopituitarism ho. Mpɛn pii no, ɛho hia sɛ wɔsa yare wɔ nkwa nna nyinaa mu na wɔhwɛ hormone ahorow so. Ɛno nti na ɛho hia sɛ wokɔ wo duruyɛfo nkyɛn daa no. Sɛ wowɔ sɛnkyerɛnne foforo anaa ɛhaw adwene bi a, kɔ wo duruyɛfo nkyɛn. Wɔwɔ hɔ sɛ wɔbɛboa wo. Sɛ wohwɛ so yiye a, wubetumi atra ase a ahoɔden wom na ɛyɛ nnam.

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