Ðe viwòa le nu wɔm abe ɖevi gã ene hafi wòtsia? Mina míasrɔ̃ nu tso Precocious Puberty ŋu.

Ðe nèse le ɖokuiwò me kpɔ be viwònyɔnu alo viwòŋutsu le nu wɔm abe ɖevi sue ene do ŋgɔ na woƒe ɣeyiɣia, alo le ŋutilã me tɔtrɔwo ɖem fiaa? Ðevi aɖewo ate ŋu aɖe sɔhɛmenɔɣi ƒe dzesiwo afia ŋutɔŋutɔ hafi woƒe ɣeyiɣia naɖo. Egbea míele nu ƒom tso nɔnɔme sia si woyɔna be ‘precocious puberty’ alo abe alesi ɖɔktawo yɔnae ene be, `(Precocious Puberty)` ŋu. Mègatsi dzi o, míaƒo nu tso esia ŋu bɔbɔe.

Eyata nukae nye sɔhɛmenɔɣi ƒe gɔmedzedze sia?

Ƒewuimenɔɣi nye ɣeyiɣi si me ɖevi ƒe ŋutilã toa tɔtrɔ gãwo me eye vivivi la, wodzea ame tsitsi ƒe nɔnɔmewo tutuɖo gɔme. Esia nye nusi le dzɔdzɔme nu ŋutɔ. Zi geɖe la, viwòa ƒe ahɔhɔ̃ ƒe akpa sue aɖe si woyɔna be hypothalamus nɔa anyi. Afi siae hypothalamus dzea egɔme tsoe. Eɖea atike aɖewo siwo woyɔna be lãmetsiŋusẽwo dona. Emegbe lãmetsi siawo ɖoa dzesi ɖe ahɔhɔ̃meka sue bubu si le ahɔhɔ̃a me si woyɔna be pituitary gland. Emegbe lãkusia ɖea lãmetsi ƒomevi bubu si woyɔna be gonadotropins dona. Gonadotropin siawo yia ɖevia ƒe gbɔdɔdɔ ƒe lãkusi siwo woyɔna be gonads la me tẽ. Le ŋutsuviwo me la, esiawoe nye ``vidzidɔ.'' Esiawo wɔa lãmetsi si nye ``testosterone.'' Le nyɔnuviwo me la, esiawoe nye ``azigolowo.'' Esiawo wɔa lãmetsi si nye ``estrogen.''

Zi geɖe la, nyɔnuvi dzea sɔhɛmenɔɣi gɔme tso ƒe 8 va ɖo 13. Ŋutsuvi dzea sɔhɛmenɔɣi gɔme tso ƒe 9 va ɖo 14. Ke hã, le go sia me la, ``Precocious Puberty``, ɖoɖo sia dzea egɔme do ŋgɔ ŋutɔ. Eyae nye be nyɔnuvi dzea dzesi siawo ɖeɖefia gɔme hafi xɔa ƒe 8, eye ŋutsuvi dzea dzesi siawo ɖeɖefia gɔme hafi xɔa ƒe 9 .

Ðe sɔhɛmenɔɣi do ŋgɔ ƒomevi vevi aɖewo lia?

Ẽ, ƒomevi vevi evee li. Na míakpɔ nusiwo wonye ɖa.

1. Central Precocious Puberty

Esiae nye ƒomevi si bɔ wu . Nusi dzɔna le afisia enye be ɖevia ƒe ahɔhɔ̃ dzea lãmetsi aɖe si woyɔna be ‘Gonadotropin-releasing hormone (GnRH)’ dodo gɔme hafi ɣeyiɣi si wokpɔ mɔ na la ɖo. Esia nana be vidzidɔ kple azigolowo ɖea gbɔdɔdɔ ƒe lãmetsiwo abe ‘androgens’ ene doa goe kaba.

2. Ƒewuivi ƒe Ƒewuime Dodo Ðe Ŋgɔ le Peripheral

Kuxi aɖe si le ɖevia ƒe vidzidziŋutetewo, abe azigolo, vidzidɔ, alo adrenal glands ene ŋu gbɔe kuxi sia tsona. Ɣeaɖewoɣi la, lãmetsi siwo tso gota gome gena ɖe ŋutilãa me hã ate ŋu ahe nɔnɔme sia vɛ. Wogayɔa esia be gonadotropin-independent precocious puberty.

Ameka ŋue nɔnɔme sia gblẽa nu le wu? Aleke gbegbe wòbɔe?

Le nyateƒe me la, ɖevi ɖesiaɖe ate ŋu ato sɔhɛmenɔɣi ƒe gɔmedzedze ƒe nɔnɔme sia me. Ke hã, ebɔ ɖe nyɔnuviwo me wu ŋutsuviwo.

Le alesi wòbɔe gome la, dɔléle sia dzea nyɔnuvi siwo ade 20 le 10,000 ɖesiaɖe me dzi, gake mede ŋutsuvi 5 le 10,000 ɖesiaɖe me o.

Nukatae amewo ɖoa sɔhɛmenɔɣi kaba nenema gbegbe ɖo? Nukawoe nye susu siwo tae?

Susuawo toa vovo le ƒomevi si míeyɔ va yi nu.

Nusiwo Hea Central Precocious Puberty vɛ

Abe alesi míegblɔe va yi ene la, esia tsoa lãmetsi si nye `(GnRH)` ƒe dodo kaba tso ahɔhɔ̃a me gbɔ. Le go geɖe me, vevietɔ le nyɔnuviwo gome la, esesẽna be woakpɔ nusi gbɔ esia tso si me kɔ. Ke hã, ɣeaɖewoɣi la, nu siawo tɔgbe ate ŋu ahe:

• Ahɔhɔ̃ ƒe nuveviwɔame
• Ahɔhɔ̃ me dɔdzẽwo
• Ahɔhɔ̃ me dɔlélewo
• Ahɔhɔ̃ ƒe dɔmawɔmawɔ nyuie
• Wole keklẽŋusẽ ƒe atikewɔwɔ me tom

Nusiwo Hea Ƒewuivi Siwo Dona Kaŋe le Peripheral Precocious Puberty vɛ

Kuxi siwo le ɖevia ƒe vidzinuwo alo adrenal glands ŋu gbɔe esia ƒomevi tsona. Le kpɔɖeŋu me:

• Ovary, testes alo adrenal gland ƒe dɔdzẽwo
• Dɔdzẽ siwo wɔa lãmetsi aɖe si woyɔna be ``Human Chorionic Gonadotropin (HCG)``
• Domenyiŋusẽfianu aɖewo, le kpɔɖeŋu me, McCune-Albright ƒe dɔléle.
• Lãmetsiŋusẽ ƒe dɔmawɔmawɔ nyuie sesẽ
• Dɔléle siwo le adrenal glands me, le kpɔɖeŋu me, ``Congenital adrenal hyperplasia``.

Ɣeaɖewoɣi la, lãmetsiŋusẽ siwo tso ɖevia ƒe ŋutilã godo hã ate ŋu anye nusi gbɔ wòtso. Bu nuwo abe kreme, atike, alo kpeɖeŋutɔ siwo me estrogen alo testosterone, alo androgens le ŋu kpɔ.

Dzesi kawoe ɖea sɔhɛmenɔɣi kaba ƒe dzesiwo fiana? Aleke nèwɔ dea dzesii?

Dzesi siwo bɔ siwo woate ŋu akpɔ le ŋutsuwo kple nyɔnuwo siaa ŋue nye aklãdɔ, ŋutilã ƒe ʋeʋẽ si dzina ɖe edzi, kple ame ƒe kɔkɔme ƒe dzidziɖedzi kpata . Tsɔ kpe ɖe eŋu la, gbɔdɔdɔ ƒe nɔnɔmewo hã dzea egɔme doa ŋgɔ.

Bu eŋu kpɔ, kasia viwònyɔnuvi si xɔ ƒe adre la de dzesii be yeƒe nowo le tsitsim, alo viwòŋutsuvi si xɔ ƒe enyi ƒe gbe trɔ eye wòdze ɖa tsitsi gɔme. Nu siawoe míeyɔna be dzesiwo.

Dzesi siwo wokpɔna le nyɔnuviwo ŋu:

• No ƒe tsitsi
• Dzinukpɔkpɔ dzea egɔme
• Taɖa ƒe tsitsi le abɔta kple ame ŋutɔ ƒe teƒewo

Dzesi siwo wokpɔna le ŋutsuviwo ŋu:

• Gbe ƒe ɖiɖi
• Taɖa ƒe tsitsi le mo, abɔta, kple ame ŋutɔ ƒe teƒewo
• Ŋutsu ƒe vidzinu kple vidzidɔ ƒe lolome
• Lãmetsiwo ƒe tsitsi

Amekawoe le afɔku gã me be woaxɔ dɔléle sia?

Ƒuƒoƒo aɖewo le sɔhɛmenɔɣi ƒe gɔmedzedze sia ƒe afɔku me vie. Woawoe nye:

• Nyɔnuviwo
• Ðevi siwo lolo akpa alo lolo akpa
• To aɖewo me viwo (Numekukuwo ɖee fia be esia bɔ ɖe ameyibɔ ɖevi siwo le duta dome wu. Ele be woasrɔ̃ nu tso esia ŋu geɖe wu le míaƒe dukɔa me.)

Nukawoe nye kuxi siwo ate ŋu ado mo ɖa le sɔhɛmenɔɣi kaba ta?

Togbɔ be ɖevi ƒe kɔkɔme dzina ɖe edzi kasia ne woɖo sɔhɛmenɔɣi kaba hã la, ne wonya wu sɔhɛmenɔɣia nu ko la, tsitsia nu tsona. Eyata woate ŋu anɔ kpuie wu ɖevi bubu siwo xɔ ƒe ɖeka. Esia ate ŋu akpɔ ŋusẽ ɖe ɖevia dzi le susu me.

Nu bubue nye be ɖeviwo te ŋu kpea ŋu eye woƒe dzi dzea eme ne woƒe ŋutilã trɔ kabakaba wu ɖevi bubuwo. Bu alesi wòasesẽ na ɖevi be wòakpɔ yewo ŋutɔ yeƒe ŋutilã wòato tɔtrɔ gãwo me esime yewoƒe sukuhatiwo gakpɔtɔ nye ɖevi siwo le zɔzɔm ko ŋu kpɔ.

Nya siawo ate ŋu ahe nuwɔna, seselelãme, kple hadomekuxiwo vɛ na ɖeviwo. Woate ŋu akpɔ dzimaɖitsitsi kple blanuiléle. Woate ŋu anɔ afɔku gã aɖe hã me be woazã atike muamewo ahaƒo wo ɖokui ɖe nuwɔna siwo me afɔku le me.

Aleke ɖɔktawo wɔa dea dzesi dɔléle siae?

Ne èkplɔ viwòa yi ɖɔkta gbɔ la, ado ɖevia kpɔ nyuie gbã. Abia nya wò hã tso viwòa ƒe atikewɔwɔ ŋutinya kple nenye be nɔnɔme sia tɔgbe nɔ ame aɖe ŋu le wò ƒomea me hã.

Emegbe anya wɔ be woawɔ dodokpɔwo abe esia ene:

• Asi kple asibidɛ ƒe X-ray: Esia léa ŋku ɖe ɖevia ƒe ƒu ƒe ƒexɔxɔ ŋu. Ne ŋutilãa wɔ gbɔdɔdɔ ƒe lãmetsiwo fũ akpa la, ƒuawo tsina kaba wu alesi wòle. Esia nye sɔhɛmenɔɣi kaba ƒe dzesiwo dometɔ ɖeka.
• Ʋudodokpɔ: Esia léa ŋku ɖe ɖevia ƒe lãmetsiŋusẽ ƒe agbɔsɔsɔ ŋu. Etɔxɛe la, eléa ŋku ɖe lãmetsi siwo nye ``Luteinizing Hormone (LH)`` kple ``Follicle-Stimulating Hormone (FSH)``, siwo pituitary gland wɔna ƒe agbɔsɔsɔme ŋu. Esiawoe nye lãmetsiŋusẽ siwo kpɔa ŋusẽ ɖe sɔhɛmenɔɣi dzi. Eléa ŋku ɖe gbɔdɔdɔ ƒe lãmetsiwo ƒe agbɔsɔsɔ hã ŋu.
• Ahɔhɔ̃ ƒe MRI scan: Dodokpɔ sia kpena ɖe ame ŋu be woaɖe kuxi ɖesiaɖe abe ahɔhɔ̃ me dɔdzẽ ene ɖa.
• Pelvic ultrasound: Woate ŋu awɔ dodokpɔ sia ne èsusu be viwòa ƒe peripheral precocious puberty le eŋu. Dodokpɔ sia léa ŋku ɖe nyɔnuviwo ƒe azigolo alo adrenal glands me dɔdzẽ ŋu, elabena esiawo ate ŋu ana woadze sɔhɛme kaba ɣeaɖewoɣi.

Le dodokpɔ siawo me tsonu nu la, wò ɖɔkta ate ŋu aɖo wò ɖe ɖeviwo ƒe lãmenugbagbeviwo ŋuti nunyala, si nye ɖɔkta si bi ɖe dɔléle siwo do ƒome kple lãmetsiŋusẽ na ɖeviwo me.

Nukawoe nye atike siwo wozãna na esia?

Atikewɔwɔmɔnu nɔ te ɖe sɔhɛmenɔɣi si do ŋgɔ ƒe ƒomevi dzi.

Atikewɔwɔ na Central Precocious Puberty

Taɖodzinu vevitɔ si le ƒomevi sia ŋue nye be woatɔ te lãmetsiŋusẽ `LH` kple `FSH` ƒe wɔwɔ to pituitary gland dzi. Esia nana sɔhɛmenɔɣi ƒe dzesiwo dzi ɖena kpɔtɔna eye ate ŋu ahe dzinukpɔkpɔ gɔ̃ hã ɖe megbe. Zi geɖe la, wowɔa esia kple atike si woyɔna be `GnRH agonist`. Wogayɔa esia be `Puberty Blocker`. Esia nye lãmetsiŋusẽ si amegbetɔ wɔ. Wowɔa esia be woatsɔ atɔ te vidzidzi ƒe lãmetsi alo tsitsi ƒe lãmetsiwo ƒe wɔwɔ. Ðɔktaa ana atike sia ɖevia abe atike si wodo nɛ ene le ɣeyiɣi aɖewo koŋ me. Ele be woayi atikewɔwɔ sia dzi vaseɖe ɣeyiɣi nyuitɔ si me woadze sɔhɛmenɔɣi gɔme.

Atikewɔwɔ na Peripheral Precocious Puberty

Wodaa nɔnɔme sia ƒomevi to gbɔdɔdɔ ƒe lãmetsiwo ƒe dzɔtsoƒe ɖeɖeɖa me. Ðewohĩ ahiã be woawɔ dɔ na ɖevi aɖewo be woaɖe dɔdzẽ alo nu bubu aɖe si le sɔhɛmenɔɣi ƒe gɔmedzedze hem vɛ la ɖa. Ame bubuwo ate ŋu ahiã steroid-tikewo, abe glucocorticoids ene. Ɣeaɖewoɣi la, woate ŋu aɖu nɔnɔmea dzi ne woɖe gotagome lãmetsiŋusẽa, abe estrogen-tikewo ene, tsoƒe ɖa.

Ðe woate ŋu axe mɔ ɖe sɔhɛmenɔɣi kaba nua?

Zi geɖe la, esesẽna be woaxe mɔ ɖe nɔnɔme sia nu. Gake woate ŋu axe mɔ ɖe enu vaseɖe afi aɖe to ɖevia ƒe gbɔdɔdɔ ƒe lãmetsi siwo tso gota gome zazã dzi ɖeɖe kpɔtɔ me. Le kpɔɖeŋu me, ele vevie be woana kreme, ami, alo atike bubu siwo me estrogen alo testosterone le la nanɔ afisi ɖeviwo mate ŋu akpɔ o.

Aleke etsɔme anɔ na ɖevi siwo ŋu nɔnɔme sia le?

Ðevi ƒe etsɔme nɔ te ɖe nu geɖe dzi:

• Ƒu ƒe tsitsi
• Ƒe si ɖevia xɔ esime dzesiawo dze egɔme
• Aleke gbegbe nɔnɔme sia va do kabakabae nye si
• Ðevia ƒe atikewɔwɔ ƒe ɖoɖo

Gake naneke meli si woavɔ̃ o. Ne wokpɔe kaba eye wotsɔ atikewo da dɔ nɛ alo ne ehiã la, wowɔ dɔ nɛ la, zi geɖe la, woate ŋu aɖu dɔlélea dzi. Emegbe ɖevia ate ŋu atsi le ablaɖeɖe si sɔ nu eye wòaɖo tsitsime.

Ɣekaɣie wòle be maƒo nu kple ɖɔkta tso nya sia ŋu?

Ne viwòa ɖe sɔhɛmenɔɣi kaba ƒe dzesi aɖewo fia, vevietɔ ne ɖevia mexɔ ƒe 8 haɖe o (ne nyɔnuvie wònye) alo mexɔ ƒe 9 o (ne ŋutsuvie wònye) la, yi ɖɔkta gbɔ enumake.

Nya kawoe wòle be mabia ɖɔktaa?

Àte ŋu abia nya siawo tɔgbe:

• Ðe vinye le sɔhɛmenɔɣi me tom kaba nyateƒea?
• Nukatae nusia dzɔ ɖe vinyea dzi?
• Atikewɔwɔ kae nèkafu na vinyea?
• Ðe vinyea hiã atike be wòaɖu nɔnɔme sia dzia?
• Ðe kpekpeɖeŋunaha aɖewo li siwo kpena ɖe ɖevi siwo ɖoa sɔhɛmenɔɣi kaba ŋua?
• Ðe wòle be míayi ɖeviwo ƒe lãmenugbagbeviwo ƒe dɔwɔwɔ ŋuti nunyala gbɔa?

Nukatae wòdze abe nyɔnuviwo le sɔhɛmenɔɣi me tom do ŋgɔ le ŋkeke siawo me ene?

Le dukɔwo abe United States ene me la, wogblɔna be nɔnɔme aɖe li be nyɔnuviwo gena ɖe sɔhɛmenɔɣi kaba. Woate ŋu agblɔ be susu ɖeka si ta esia tso lolo akpa si le dzidzim ɖe edzi le dukɔ mawo me gbɔ. Le numekulawo ƒe nya nu la, kadodo aɖe le Body Mass Index (BMI) si sɔ gbɔ kple no ƒe tsitsi kaba dome. Dzixɔse aɖe hã li be nuɖuɖu siwo ŋu wotrɔ asi le, siwo me ami sɔ gbɔ ɖo ɖuɖu fũ akpa hã ate ŋu ana ame naɖo sɔhɛmenɔɣi kaba.

Azɔ hã, wogblɔ be to vovovo me tɔwo kpɔa ŋusẽ ɖe esia dzi. Le kpɔɖeŋu me, woka nya ta be nyɔnuvi ameyibɔ kple Hispaniatɔ siwo le United States ɖoa sɔhɛmenɔɣi kaba wu ameƒomevi bubuwo. Esi lolo akpa bɔ ɖe hatsotso siawo dome ta la, ema hã ate ŋu anye nusi gbɔ sɔhɛmenɔɣi ƒe gɔmedzedze ƒe dzidziɖedzi sia tso.

Gake zi geɖe la, esiawo nyea numekuku siwo wowɔna le dutadukɔwo me. Ðewohĩ nɔnɔme si le míaƒe dukɔa me ato vovo. Eyata , ne ɖikeke aɖe le mewò le viwòa ŋu la, nu nyuitɔ si nàwɔe nye be nàdi atikewɔlawo ƒe aɖaŋuɖoɖo.

Eyata nu vevi kawo dzie wòle be míaɖo ŋkui tso ŋutinya sia me?

Ƒewuimenɔɣi kaba ate ŋu anye agba na ɖevia kple dzilawo siaa vie. Gake ele vevie be nànya esia.

• Ne ède dzesi dzesi siwo fia be yeƒe ƒewuiwo meɖo kaba (hafi nyɔnuviwo naxɔ ƒe 8 eye ŋutsuviwo naxɔ ƒe 9) la, mègabu eŋu nu tsɛe o. Yi ɖɔkta gbɔ enumake.
• Susu geɖewo ate ŋu anɔ esia ta. Ɣeaɖewoɣi la, ɖewohĩ womate ŋu akpɔ nusi gbɔ wòtso si me kɔ o. Gake atikewɔwɔ me dodokpɔwo ate ŋu akpe ɖe ŋuwò nànya.
• Dɔdamɔnu siwo wɔa dɔ nyuie li. Ne wokpɔ ɖevia dze sii kaba eye woda dɔ nɛ la, woate ŋu alé ɖevia ƒe tsitsi ɖe te abe alesi wòle ene.
• Lé ŋku ɖe viwòa ƒe susu ƒe lãmesẽ hã ŋu. Ðewohĩ asesẽ na wo be woalɔ̃ ɖe tɔtrɔ sia dzi. Na lɔlɔ̃ kple kpekpeɖeŋu wo. Miɖo wo ɖe aɖaŋuɖoha ne ehiã.

Nu vevitɔ kekeakee nye be nànya be menye wò ɖeka koe o. Ðɔktawo li be yewoakpe ɖe mia kple viwòa ŋu. Eyata mègavɔ̃ o, eye nàdi atikewɔlawo ƒe aɖaŋuɖoɖo ɣesiaɣi ne ɖikeke le ŋuwò.

` Precocious Puberty, lãmetsiwo, ɖeviwo ƒe tsitsi, sɔhɛmenɔɣi, nyɔnuviwo, ŋutsuviwo