Nukae nye Glucagonoma? Mina míaƒo nu tso nɔnɔme sia si mebɔ o ŋu!

Dɔgbo nye ŋutinu sue aɖe gake wòle vevie ŋutɔ le wò ŋutilã me. Ewɔa lãmetsiŋusẽ vovovo siwo míaƒe ŋutilã hiã. Eyata ɣeaɖewoɣi la, kansa ƒomevi aɖe si mebɔ o si dona le dɔgboa me ate ŋu ahe kuxiwo vɛ. Emae woyɔna be nɔnɔme sia be Glucagonoma . Ðewohĩ suklidɔ dze dziwò kasia, alo nane si le abe ʋuʋudedi wɔnuku aɖe ene va le wò ŋutigbalẽ ŋu, ele vevie ŋutɔ be nànya esia.

Nukae nye glucagonoma? Kpuie ko la,...

Glucagonoma nye kansadɔ si mebɔ kura o si dona le wò dɔgbo me. Dɔdzẽ sia naa lãmetsi aɖe si woyɔna be glucagon la sɔ gbɔ akpa. Fifia ɖewohĩ èle eŋu bum be nukae nye glucagon sia hã.

Glucagon nye lãmetsi vevi aɖe ŋutɔ si kpena ɖe mía ŋu míeɖua sukli ƒe agbɔsɔsɔ si le míaƒe ŋutilã me, si fia be sukli ƒe agbɔsɔsɔ le ʋu me dzi. Alpha cells, si nye lãmenugbagbevi tɔxɛ aɖe si le wò dɔgboa me ye wɔe. Bu eŋu kpɔ ne mèɖu nu o hena ɣeyiɣi aɖe, ne èdea kame vevie ŋutɔŋutɔ, alo ne èɖua nuɖuɖu si me protein sɔ gbɔ ɖo la, sukli si le ʋu me ate ŋu aɖiɖi, alo? Ɣemaɣie sukli sia gena ɖe eme, eɖea sukli si wodzra ɖo ɖe wò aklã me, si nye glycogen , ɖe go, eye wònaa sukli si le ʋu me la gadzina ɖe edzi. Ele abe ame aɖe si kpena ɖe mía ŋu be sukli nada asɔ le míaƒe ŋutilã me ene.

Gake ne suklidɔ aɖe li la, suklidɔlékui sia wɔa nu wògbɔa eme. Ekema míaƒe ŋutilã mate ŋu akpɔ egbɔ o. Woyɔa dzesi siwo dona le esia ta ƒe ƒuƒoƒo be Glucagonoma Syndrome . Esia ate ŋu ahe kuxi geɖe abe ŋutigbalẽ ƒe kuxiwo kple suklidɔ ene vɛ.

Kansa sia ƒomevi si woyɔna be glucagonoma la le dɔdzẽ ƒe hatsotso si nye pancreatic neuroendocrine tumors , alo islet cell tumors . Zi geɖe la, esiawo dona le dɔgboa ƒe asike alo titina.

Ðe esia nye kansa nyateƒea?

Ẽ, zi geɖe la, suklidɔ nyea kansa . Nublanuinyae nye be, ne wokpɔe gɔ̃ hã la, le dɔléle siwo ade 50% me, si fia be anɔ abe ɖeka le eve ɖesiaɖe me ene la, kansa sia ate ŋu akaka (akaka) ɖe ŋutilã ƒe akpa bubuwo, vevietɔ aklã .

Aleke gbegbee nɔnɔme sia bɔe?

Le nyateƒe me la, glucagonoma nye dɔléle si mebɔ kura o . Ame yeye siwo mede ɖeka le miliɔn ɖeka me o ye wokpɔna ƒe sia ƒe. Zi geɖe la , edzea amesiwo xɔ tso ƒe 50 va ɖo ƒe 70 dzi .

Nukae nye esia ƒe dzesiwo?

Zi geɖe la, glucagonomas tsina vivivi . Eyata negbe ɖe wò ŋutilã wɔ sukli si sɔ gbɔ be wòahe kuxiwo vɛ ko hafi la, ɖewohĩ dzesi aɖeke madze le ŋuwò o.

Gake ne glucagonoma na glucagon sɔ gbɔ akpa eye ŋutilãa mete ŋu le egbɔ o la, glucagonoma ƒe dɔléle si míeyɔ va yi la dzɔna.Edzɔna. Emegbe, àkpɔ dzesi siwo me kɔ. Ne dzesi siawo le ŋuwò la, ele vevie ŋutɔ be nàkpɔ ɖɔkta kaba ale si nàte ŋui.

Ŋutilã ƒe ʋuʋudedi (Necrolytic Migratory Erythema - NME) .

Esiae nye suklidɔ ƒe dzesi vevitɔ kple esi bɔ wu . Ame siwo ŋu dɔléle sia le ƒe 90% lɔƒo xɔa ŋutigbalẽ ƒe kuxi sia. Woyɔa esia be necrolytic migratory erythema (NME) .

Kpɔe ɖa le susu me be wò ŋutigbalẽ, vevietɔ le ame ŋutɔ ƒe ŋutinuwo, akɔta, kple afɔwo ƒe akpa si le ete la, dzea teƒe siwo biã, ƒoƒo, eye ɣeaɖewoɣi wòsea veve gɔme. Emegbe esiawo trɔna zua ʋuʋudedi, wogbãna, eye wogbãna. Ne woda gbe le wo ŋu vɔ gɔ̃ hã la, teƒe aɖe si ƒe amadede nye aŋutiɖiɖi ate ŋu anɔ anyi. Esia ate ŋu adzɔ le teƒe ɖeka, ada gbe le eŋu, eye emegbe wòagadze le teƒe bubu. Ele abe ʋuʋudedi si le ʋuʋum tso teƒe yi teƒe ene.

NME ƒe nɔnɔme bubuwo:

• Esia ate ŋu ava eye wòadzo, eye ate ŋu aʋuʋu le ŋutilãa me .
• Ate ŋu avivi ŋutɔ eye wòase veve le gɔmedzedzea me.
• Aɖuɖɔtoea trɔna biãna eye emegbe wòzua ʋuʋudedi eye wòzua ƒuƒu. Ne ehaya vɔ la, teƒe aɖe si ƒe amadede nye aŋutiɖiɖi ate ŋu anɔ anyi.
• Esia ate ŋu ana woaxɔ nuwo abe aɖe ƒe abi (glossitis ), nu me abi, nuyi siwo me vuvu, kple dzogoe ƒe abi .
• Ŋku ƒe ʋuʋu ( blepharitis ), ɖa ƒe vuvu, kple ɖa ƒe kuxiwo hã ate ŋu ado mo ɖa.

Suklidɔ ƒe dzesiwo

Dɔléle sia nana sukli sɔa gbɔ ɖe ʋu me ( hyperglycemia ), si ate ŋu ana ame naxɔ suklidɔ. Suklidɔ ƒe dzesiwo dometɔ aɖewoe nye:

• Be woanye ame tsɛ le susu aɖeke manɔmee.
• Tsikɔwuame si gbɔ eme enuenu (Polydipsia) .
• Aɖuɖɔtoe enuenu ( polyuria ), vevietɔ le zã me.
• Dɔwuame si gbɔ eme ( Polyphagia ).

(glucagonoma syndrome) ƒe dzesi bubuwo .

Dzesi bubu geɖewo hã li:

• Aɖuɖɔtoe si nɔa anyi didi .
• Hemoglobin si bɔbɔ ɖe ʋu me (ʋusɔgbɔdɔ ). Esia ate ŋu ahe ɖeɖiteameŋu kple taɖuame vɛ.
• Ʋu ƒe sisi, vevietɔ le afɔwo ƒe ʋuka goglowo me ( Deep Vein Thrombosis (DVT) ).

Dzesi siwo do ƒome kple susu kple lãmekawo ƒe dɔwɔwɔ

Ɣeaɖewoɣi la, àte ŋu akpɔ dzesi siwo do ƒome kple susu kple lãmekawo hã, abe:

• Teteɖeanyi
• Tagbɔdɔléle
• Zitɔtɔ
• Hyperreflexia (ŋutilã ƒe dɔwɔwɔ kabakaba) .
• Azɔlizɔzɔ si wɔa nuku (ataxia ) .
• Tagbɔdɔléle ( Psychosis) .) .
• Vɔvɔ̃ kple ɖikeke siwo me susu mele o ( Paranoid Delusions ) .

Nukae hea glucagonoma vɛ?

Zi geɖe la, ɖɔktawo menya nusi tututu gbɔ suklidɔ tsona o . Gake le dɔléle siwo ade 10% me la, kansa sia do ƒome kple domenyiŋusẽfianu ƒe nɔnɔme aɖe si woyɔna be Multiple Endocrine Neoplasia type 1 (MEN type 1) .

Gake menye amesiame si ŋu MEN ƒomevi 1 le ye xɔa glucagonoma o. Ema hã nye alafa memamã sue aɖe ŋutɔ.

Aleke nèwɔ de dzesi esia?

Ne ŋutigbalẽ ƒe nɔnɔme si nye necrolytic migratory erythema (NME) si míeyɔ va yi le ŋuwò la, ɖɔkta ate ŋu asusui be suklidɔ le ŋuwò. Emegbe woate ŋu awɔ dodokpɔwo abe:

• Nutsitsidɔ le Ʋu me Sukli Dodokpɔ: Ne sukli sɔ gbɔ la, woate ŋu ake ɖi be suklidɔ le ame ŋu eye woate ŋu aɖo kpe suklidɔ si do ƒome kplii dzi.
• Nutsitsidɔ Glucagon Ʋudodokpɔ: Glucagon ƒe agbɔsɔsɔ sɔ gbɔ le mɔ si mesɔ o nu le glucagonoma me – zi geɖe la, ewua picogram 500 le mililita ɖeka me (pg/mL). Glucagon ƒe agbɔsɔsɔ si sɔ le nutsitsidɔ me mede 150 pg/mL o.
• Amino Acid Ʋudodokpɔ: Zi geɖe la, glucagonoma nana amino acids ƒe agbɔsɔsɔ si le ʋua me dzi ɖena kpɔtɔna ( hypoaminoacidemia ).
• Ʋu Xexlẽme Blibo (CBC): Esia léa ŋku ɖe ʋusɔgbɔdɔ ŋu , elabena ʋusɔgbɔdɔ ate ŋu adzɔ kple glucagonoma.

Nɔnɔmetatawo dodokpɔ abe esiawo ene ate ŋu akpe ɖe ŋuwò nàɖo kpe edzi nenye be ƒunukpeƒetetedɔ aɖe le eme:

• CT Scan ƒe dɔwɔwɔ
• MRI Scan ƒe Dɔwɔɖoɖo
• Endoscopic Ultrasound ƒe dɔwɔwɔ

Aleke wowɔa atike nɛ?

Glucagonoma dada nɔ te ɖe nenye be dɔdzẽa le dɔgboa me (si le teƒe ɖeka) alo kaka ɖe ŋutilã ƒe akpa bubuwo (si kaka ɖe teƒe bubuwo) dzi koŋ .

Alesi woaɖu dzesiwo dzi gbã

Afɔɖeɖe gbãtɔe nye be woaɖu dzesiwo kple kuxi siwo sukli si sɔ gbɔ ɖe lãme na ame hena vɛ dzi. Wowɔa nu ɖe ​​esia ŋu ale:

• Atike siwo woatsɔ aɖu sukli si sɔ gbɔ wu dzi: Atike siwo woyɔna be Octreotide kple Lanreotide kpena ɖe ame ŋu be sukli si sɔ gbɔ wu ƒe ŋusẽkpɔɖeamedziwo dzi ɖena kpɔtɔna eye wodzudzɔa suklidɔ ƒe wɔwɔ. Atike siawo ate ŋu ana dɔdzẽ ƒe tsitsi gɔ̃ hã nagbɔdzɔ. Wonana gbɔdzɔe hã tso NME, suklidɔ, aɖuɖɔtoe, kple lãmekawo ƒe dɔmawɔmawɔ nyuie ƒe dzesiwo me.
• Suklidɔ dzi kpɔkpɔ: Ðewohĩ ahiã be nàno suklidɔtike alo insulin dodo be wò ʋumesukli ƒe agbɔsɔsɔ nanɔ agbɔsɔsɔ si sɔ me.
• Nunyiame ƒe kpekpeɖeŋu:Woate ŋu ana Total Parenteral Nutrition (TPN) , amino acid kple zinc kpeɖeŋutɔ be woaɖe nunyuimakpɔɖu ƒe nugbegblẽwo dzi akpɔtɔ.
• NME ŋutigbalẽdɔdada: Dɔlékuiwutikewo kple corticosteroids ate ŋu ana NME nanyo ɖe edzi.
• Ʋumenugbagbeviɣitikewo: Ʋumenugbagbeviɣitikewo abe heparin ene kpena ɖe ame ŋu be woaxe mɔ ɖe ʋuka me ʋu ƒe sisi (DVT) nu .

Nenye be eƒe dɔgbo me koe...

Ne dɔdzẽa le dɔgboa me ko la, amekokoe nye atike vevitɔ . Ne amekolaa te ŋu ɖe dɔdzẽa ɖa keŋkeŋ la, zi geɖe la, wodaa dɔlélea . Ne woɖe glucagonoma la ɖa vɔ la, ele be wò glucagon ƒe agbɔsɔsɔ natrɔ ava nɔ abe tsã ene. Ele be wò dzesiwo hã nu nayi.

Ne ekaka ɖe teƒe bubuwo (metastasized)...

Ɣesiaɣi si wòanya wɔ la, ɖɔktawo kafui be woawɔ dɔ na wo be woaɖe dɔdzẽwo ɖa. Esia ate ŋu alɔ dɔdzẽ siwo le dɔgboa, ʋuka siwo te ɖe wo ŋu, kple aklã me ɖeɖeɖa ɖe eme.

Gake ne amekolaa mete ŋu ɖe ƒunukpeƒea ƒe ɖeke alo wo katã ɖa o la, wò atikewɔlawo ate ŋu aɖo aɖaŋu na wò be nàwɔ atike siawo dometɔ ɖeka alo esi wu nenema:

• Atikewɔmɔnu: Dɔdamɔnu sia wɔa dɔ to kansa lãmenugbagbeviwo tsɔtsrɔ̃ kple mɔxexe ɖe woƒe tsitsi nu me.
• Radiofrequency Ablation: Esia zãa dzoxɔxɔ si tso radio ƒutsotsoewo me tsɔ wua kansa lãmenugbagbeviwo.
• Cryosurgical Ablation: Esia zãa atike siwo fa miamiamia ŋutɔ, abe nitrogen si nye tsi ene, tsɔ tsrɔ̃a kansa lãmenugbagbeviwo.
• Chemoembolisization: Atikewɔwɔ sia xea mɔ na ʋu ƒe sisi na kansa la.

Nukae nye nyagblɔɖi si woatsɔ ahaya tso nɔnɔme sia me?

Mɔkpɔkpɔ na amesi ŋu glucagonoma le nɔ te ɖe nu geɖe dzi:

• Wò ƒexɔxɔ kple wò lãmesẽ bliboa .
• Kansa ƒe dɔdzẽ ƒe lolome .
• Eɖanye be kansa la kaka alo mekaka o .

Ne dɔdzẽa le dɔgboa me ko la, zi geɖe la, nukpɔsusua nyona . Zi geɖe la, amekoko be woaɖe dɔdzẽa ɖa la daa gbe le ame ŋu, gake esia le alea le glucagonoma dɔnɔ siwo ade 20% ko gome.

Esi wònye be glucagonoma mebɔ o ta la, nyatakaka siwo sɔ gbɔ be woagblɔ ɣeyiɣi didi si tututu nàte ŋu anɔ agbe alo nusi ado tso eme ne kansa la kaka o. Wò atikewɔlawo ƒe ƒuƒoƒoa ate ŋu ana nyatakaka bubuwo le wò nɔnɔme tɔxɛa nu.

Ðe woate ŋu axe mɔ ɖe esia nua?

Esi dzɔdzɔmeŋutinunyalawo menya nusi gbɔ suklidɔ akpa gãtɔ tsona o ta la, le nyateƒe me la, naneke meli nàte ŋu awɔ atsɔ axe mɔ ɖe enu o .

Gake ne wokpɔe be MEN (Multiple Endocrine Neoplasia) le wò ƒometɔ siwo le ɖoƒe gbãtɔ dometɔ ɖeka (dzila ŋutɔŋutɔwo kple nɔviwòwo) ŋu la, ƒo nu kple wò ɖɔkta tso domenyiŋusẽfianu dodokpɔ ŋu. Ne MEN hã le asiwò la, domenyiŋusẽfianu dodokpɔ ate ŋu akpe ɖe ŋuwò nàde dzesi kansawo le woƒe gɔmedzedze.

Esi wokpɔ kansa le ŋuwò la, enye nusi doa dziku na ame ŋutɔ. Ne enye nusi mebɔ o abe glucagonoma ene la, egasesẽna wu. Gake ɖo ŋku edzi be wò atikewɔlawo ƒe ƒuƒoƒoa li be woaɖo wò biabiawo ŋu ahakpe ɖe ŋuwò. Ne èse le ɖokuiwò me be ye ɖeka koe suklidɔ le susu kple seselelãme gome la, bia wò ɖɔkta tso ɖoɖo kple dɔwɔna siwo ate ŋu akpe ɖe ŋuwò ŋu.

Mlɔeba la, nusiwo dzi wòle be woaɖo ŋkui (Take-Home Message) .

Eyata togbɔ be glucagonoma nye dɔléle si mebɔ kura o hã la, ele vevie be nànyae. Vevietɔ ne kasia dzesi siwo ɖi suklidɔ kpe ɖe ŋutigbalẽ ƒe ʋuʋudedi wɔnuku aɖe (NME) ŋu, abe alesi míegblɔe ene la, yi ɖɔkta gbɔ kaba. Ne wokpɔe dze sii kaba la, woate ŋu adae. Togbɔ be esia mebɔ o hã la, atikewɔmɔnu aɖewo li.

Mègatsi dzi o, menye wò ɖeka koe o. Wò ɖɔkta kple atikewɔlawo ƒe ƒuƒoƒo akpe ɖe ŋuwò le mɔzɔzɔ sia me. Misẽ ŋu eye nàwɔ ɖe aɖaŋuɖoɖo siwo wona wò dzi.

` Glucagonoma, dɔdzẽ si le dɔgboa me, glucagon, suklidɔ, ŋutigbalẽ ƒe dzesiwo, lãmetsiwo, kansa siwo mebɔ o