Ke luhi mau nei ʻoe, manaʻo ʻole i ke ola, a ke loli mālie nei ke kala o kou ʻili? Malia paha he makemake ʻē kou no ka paʻakai. Hoʻowahāwahā pinepine mākou i kēlā mau hōʻailona e like me ka mea maʻamau. Eia nō naʻe, hiki i kēia ke lilo i mau hōʻailona o kahi maʻi i loko o ko mākou kino i ʻike ʻole ʻia, akā he mea nui loa ia e ʻike pololei. I kēia lā ke kamaʻilio nei mākou e pili ana i kahi maʻi laha ʻole, akā inā mālama pono ʻia, hiki iā ʻoe ke ola i kahi ola maʻamau. ʻO ia ka maʻi ʻo Addison .
I ka ʻōlelo maʻalahi, he aha ka maʻi ʻo Addison?
ʻAe, e wehewehe maʻalahi kākou i kēia. Loaʻa iā mākou ʻelua mau kelepa liʻiliʻi, ʻano huinakolu, e like me ka pāpale, ma luna o ko mākou mau puʻupaʻa. Kāhea mākou i kēia mau mea he mau kelepa adrenal . He ʻāpana koʻikoʻi loa kēia o kā mākou ʻōnaehana endocrine.
ʻO ka maʻi ʻo Addison kahi kūlana i hana ʻole ai nā kelepa adrenal i ka lawa o ʻelua mau hormones koʻikoʻi, cortisol a me aldosterone .
No ke aha mākou e pono ai i kēia mau hormones ʻelua?
- Cortisol: He hormone kēia e pono ai ke ola. Kōkua ia i ko mākou kino e hoʻomanawanui i ke kaumaha, e like me ka wā e maʻi ai mākou, loaʻa i kahi ulia, a i ʻole ke ʻoki kino ʻana. Kōkua pū ia i ka hoʻoponopono ʻana i ke koko, ka helu o ka puʻuwai, ka hana o ka ʻōnaehana pale, a me nā pae glucose koko.
- ʻAldosterone: Kōkua kēia hormone i ke kaulike ʻana i nā minelala sodium (paʻakai) a me ka potassium i loko o ko kākou kino. Hoʻomalu pū ia i ka nui o ka wai e hoʻokuʻu ʻia e ko kākou mau puʻupaʻa ma ke ʻano he mimi. Hoʻopilikia pololei kēia i ko kākou koko.
Ua ʻike ʻia hoʻi ka maʻi ʻo Addison ʻo ka hemahema adrenal mua . Aia kekahi ʻano pili, i kapa ʻia ʻo ka hemahema adrenal lua . Ma kēia ʻano, ʻaʻole hoʻokuʻu ka pituitary gland i loko o ka lolo i ka nui o ka hormone ACTH , ka mea e hoʻoulu ai i nā kelepa adrenal e hana i ka cortisol. Akā i kēia lā ke kamaʻilio nui nei mākou e pili ana i ka pilikia e kū mai ana i loko o nā kelepa adrenal ponoʻī.
ʻO ka ʻokoʻa ma waena o ka maʻi ʻo Addison a me ka maʻi ʻo Cushing
E huikau paha ʻoe i kēia mau inoa ʻelua. He mau kūlana ʻokoʻa loa kēia mau mea ʻelua.
| ʻAno | ʻO ka maʻi o Addison | ʻO ka maʻi Cushing |
|---|---|---|
| Pilikia nui | ʻAʻole lawa ka cortisol (a me ka aldosterone) i loko o ke kino. | Hoʻonui ʻia ka cortisol i loko o ke kino (hypercortisolism). |
| Nā hiʻohiʻona maʻamau | Ka emi ʻana o ke kaumaha, ka ʻeleʻele o ka ʻili, ke koko haʻahaʻa. | Piʻi ke kaumaha, helehelena poepoe, koko kiʻekiʻe. |
ʻO wai ka mea i loaʻa pinepine i kēia maʻi? Pehea ka maʻamau?
ʻOiai hiki i ka maʻi ʻo Addison ke hoʻopilikia i nā kānaka o kēlā me kēia makahiki, ʻoi aku ka maʻamau o ia i nā kānaka ma waena o 30 a me 50 mau makahiki .
He maʻi laha ʻole kēia. No ka laʻana, ma ʻAmelika, hoʻopilikia kēia maʻi i hoʻokahi i loko o hoʻokahi haneli tausani kānaka. Akā aia kekahi poʻe me kēia maʻi ma ko mākou ʻāina.
Aia kekahi poʻe i ʻoi aku ka nui o ka pilikia o ka loaʻa ʻana o kēia maʻi. ʻO ia ka poʻe i loaʻa i nā maʻi autoimmune ʻē aʻe. ʻO ia hoʻi, nā maʻi kahi e hoʻouka ai ka ʻōnaehana pale ponoʻī o ko mākou kino i kā mākou mau cell ponoʻī. Inā loaʻa iā mākou kēlā mau maʻi, ʻoi aku ka kiʻekiʻe o ka pilikia o ka loaʻa ʻana o ka maʻi ʻo Addison.
- ʻAno I diabetes
- ʻO ka anemia ʻino
- Maʻi Graves
- ʻO ka thyroiditis mau loa
- Vitiligo - nā ʻāpana keʻokeʻo ma ka ʻili
- ʻO ka maʻi ʻaʻai
He aha nā hōʻailona o ka maʻi ʻo Addison?
I ka maʻi ʻo Addison, lohi pinepine ka hōʻino ʻana i nā kelepa adrenal, i ka hala ʻana o ka manawa. No laila, ʻike mālie ʻia nā hōʻailona. Hiki ke ʻokoʻa kēia mau hōʻailona mai kēlā kanaka a kēia kanaka.
| Nā hōʻailona maʻamau e ʻike mālie ʻia | |
|---|---|
| ʻO ka hiʻohiʻona maʻamau | Ka luhi mau loa a me ka luhi e piʻi mālie ana, me ka wehewehe ʻole ʻia. |
| Nā loli ʻili | Ka loli ʻana o ke ʻili me ka ʻeleʻele/ʻeleʻele, ʻoiai ma nā wahi me nā ʻeha, nā pelu ʻili (e like me nā armpits, groin), a me nā ʻāʻī (Hyperpigmentation). |
| ʻŌnaehana hoʻoheheʻe | ʻEha ka ʻōpū, ka nausea, ka luaʻi ʻana, ka maʻi pākīkī, ka nele o ka makemake e ʻai, a me ka pohō kaumaha. |
| Nā hiʻohiʻona ʻē aʻe | ʻEha nā ʻiʻo a me nā hono, maloʻo ka wai, poniuniu i ke kū ʻana (ma muli o ke koko haʻahaʻa), huhū, kaumaha, makemake nui i ka paʻakai, a me ke kō koko haʻahaʻa (hypoglycemia). |
Hiki i nā wāhine ke ʻike i nā hōʻailona e like me ka menstruation kūpono ʻole, ka nalowale o ka lauoho kino, a me ka emi ʻana o ka makemake i ka moekolohe.
Kūlana pilikia e pono ai ka nānā ʻana: Pilikia Addisonian
I kekahi manawa, ʻoi aku hoʻi ma hope o kahi maʻi koʻikoʻi, ulia, a i ʻole ke kaumaha nui, hiki i kēia mau hōʻailona ke lilo koke i mea koʻikoʻi loa. Ua kapa ʻia kēia he Addisonian Crisis a i ʻole ka hemahema adrenal acute . He pilikia olakino kēia e pono ai ka mālama koke ʻana a hiki ke hoʻoweliweli i ke ola!
Nā hōʻailona o ka pilikia Addisonian:
- He nāwaliwali kupaianaha a hiki ʻole ke hoʻomanawanui.
- ʻEha koke a nui ma ke kua i lalo, ka ʻōpū, a i ʻole nā wāwae.
- Nā loli noʻonoʻo e like me ka hoʻomaha ʻole, ka huikau, a me nā manaʻo makaʻu.
- ʻO ka luaʻi nui a me ka maʻi pākī (hiki i kēia ke alakaʻi i ka maloʻo koke).
- Ke emi nei ke koko haʻahaʻa loa.
- Ka nalowale o ka ʻike.
Inā ʻike ʻoe a i ʻole kekahi āu i ʻike ai i kēia mau hōʻailona, e lawe koke iā lākou i ka ʻOihana Pilikia (ETU) o ka haukapila kokoke loa.
He aha nā kumu o ka maʻi ʻo Addison?
ʻO ke kumu nui a me ke kumu maʻamau o ka maʻi ʻo Addison he pane autoimmune.I ka ʻōlelo maʻalahi, hoʻouka hewa kā mākou ʻōnaehana pale ponoʻī (ʻōnaehana pale) a luku i ka ʻaoʻao o waho o kā mākou mau kelepa adrenal (adrenal cortex). ʻAʻole ʻike ʻia ke kumu pololei o kēia. Hoʻomaka ka ʻike ʻia ʻana o nā hōʻailona ma hope o ka luku ʻia ʻana o kahi 90% o kēia mau kelepa. Hiki i kēia ke hala i nā mahina, a i ʻole nā makahiki.
ʻO kēia ke kumu o 75% o nā maʻi o Addison.
Nā kumu kakaikahi ʻē aʻe:
- ʻO ka maʻi puʻupuʻu: He kumu nui kēia i ka wā ma mua. He kumu koʻikoʻi nō ia ma nā ʻāina e ulu ana.
- Nā maʻi i hana hou ʻia: Nā maʻi e pili ana i ka maʻi HIV/AIDS a me nā maʻi fungal.
- Kanesa: Ka laha ʻana o nā hunaola kanesa mai nā wahi ʻē aʻe a i nā kelepa adrenal.
- Ke kahe koko i loko o nā kelepa adrenal.
- Wehe ʻoki kino ʻana i nā kelepa adrenal.
- ʻAmyloidosis: He maʻi kahi e waiho ai kekahi ʻano protein i loko o nā ʻōpū a hōʻino iā lākou.
Pehea e ʻike ai i kēia maʻi? (Diagnosis)
Ma muli o ka lohi loa o ka hele ʻana mai o nā hōʻailona a he mea maʻamau ia i nā maʻi ʻē aʻe he nui, hiki ke paʻakikī ke ʻike i ka maʻi ʻo Addison i nā pae mua. I ka manawa pinepine, ʻike ʻia ka maʻi "ma ke ʻano ulia." Hiki i nā kauka ke kānalua i kēia inā ʻike lākou i nā pae sodium haʻahaʻa a me nā pae potassium kiʻekiʻe i loko o ke koko i ka wā o kahi hoʻāʻo koko maʻamau no kekahi kūlana ʻē aʻe. Eia kekahi, ʻo ka hyperpigmentation o ka ʻili kahi hōʻailona nui e alakaʻi ai i ka kānalua o kēia maʻi.
Inā kānalua kāu kauka i kēia ma muli o kāu mau hōʻailona, e kauoha lākou i kekahi mau hoʻokolohua hou aʻe e hōʻoia i ka maʻi.
Nā hoʻokolohua hōʻoia:
- Nā hoʻāʻo koko: Ke ana nei nā hoʻāʻo koko i nā pae o ka sodium, potassium, cortisol, a me nā hormones ACTH. I ka maʻi ʻo Addison, haʻahaʻa ka cortisol a kiʻekiʻe nā pae ACTH.
- Hoʻāʻo hoʻoulu ACTH: ʻO kēia ka hoʻāʻo nui i hoʻohana ʻia e hōʻoia i ka hōʻailona. Ma kēia hoʻāʻo, hāʻawi ʻia ka hormone ACTH synthetic ma ke ʻano he injection, a ana ʻia ka pae cortisol i loko o kou koko ma kahi o hoʻokahi hola ma hope. Inā olakino kou mau kelepa adrenal, pono e piʻi aʻe kou pae cortisol. Eia naʻe, inā ʻaʻole, hōʻoia ia ʻaʻole hana pono kāu mau kelepa adrenal.
- Hoʻāʻo hypoglycemia i hoʻokomo ʻia e ka insulin: Hana ʻia kēia hoʻāʻo e ʻike ai inā loaʻa kāu mau hōʻailona i kahi pilikia me ka pituitary gland.
- CT scan: Hiki ke hana ʻia kahi CT scan e nānā inā ua hōʻino ʻia kāu mau kelepa adrenal, ua maʻi ʻia, a ua emi paha ka nui.
Pehea e mālama ʻia ai?
ʻO ke ʻano nui o ka mālama ʻana i ka maʻi ʻo Addison, ʻo ia kēia:ʻO ka Hormone Replacement Therapy (HRT) ke kaʻina hana o ka hoʻololi ʻana i nā hormones nele o ke kino ma ke ʻano o nā pila synthetic.
No ka mea he maʻi mau kēia, pono ʻoe e lawe i kēia lāʻau lapaʻau no ke koena o kou ola .
- Hāʻawi ʻia kahi lāʻau i kapa ʻia ʻo hydrocortisone ma kahi o ka hormone cortisol .
- Hāʻawi ʻia kahi lāʻau i kapa ʻia ʻo fludrocortisone ma kahi o ka hormone aldosterone .
ʻOkoʻa ka nui o kēia mau lāʻau lapaʻau mai kēlā kanaka a kēia kanaka. Eia kekahi, hiki i kāu kauka ke hoʻonui i kāu nui no kekahi manawa e pale aku i kahi pilikia Addisonian inā loaʻa iā ʻoe kahi hanana kaumaha, e like me ka maʻi, kahi ulia, a i ʻole ke ʻoki kino.
Inā ʻoe e lawe ana i ka fludrocortisone, e aʻo aku kāu kauka iā ʻoe e hoʻohui i kahi paʻakai hou i kāu meaʻai, ʻoiai i ka wā wela, ka hou a ma hope o ka hoʻoikaika kino.
Ke noho nei me ka maʻi a me nā mea āu e hana ai
Me ka mālama kūpono, hiki i kekahi me ka maʻi ʻo Addison ke ola i kahi ola maʻamau a olakino . Eia nō naʻe, he mea nui loa ka mālama ʻana i ka nui kūpono o ka lāʻau lapaʻau.
Inā kiʻekiʻe loa ka nui o ka lāʻau lapaʻau, hiki ke loaʻa nā hopena ʻaoʻao e like me ka momona, ka maʻi diabetes type 2, ka osteoporosis, a me ke koko kiʻekiʻe. No laila, he mea nui e ʻike mau i kāu kauka (pinepine he endocrinologist) a hana i nā hoʻokolohua e pono ai e mālama i ka nui kūpono o ka lāʻau lapaʻau.
Nā mea āu e hana ai no kou palekana ponoʻī:
- E komo mau i kahi kāleka ID a i ʻole ke kūpeʻe lima/lei lei makaʻala lapaʻau. E kōkua kēia i nā limahana lapaʻau e ʻike ua loaʻa iā ʻoe ka maʻi ʻo Addison inā nalowale kou ʻike i kahi pilikia.
- E kamaʻilio me kāu kauka e pili ana i ka mālama ʻana i kahi pana cortisol i ka lima inā he pilikia. Eia kekahi, e aʻo i kahi lālā o ka ʻohana a i ʻole kahi mea aloha pehea e hāʻawi ai i ka pana iā ʻoe.
- E nīnau i kāu kauka i ka mea e hana ai ke manaʻo ʻoe he maʻi a i ʻole ke kaumaha nui nei. I ia mau hihia, pono paha e hoʻoponopono ʻia ka nui o kāu lāʻau lapaʻau.
- E hoʻomau i ka ʻike ʻana i kāu kauka.
Hiki ke hoʻopilikia i ka naʻau ka ʻike ʻana he maʻi mau kou. Akā ʻo ka nūhou maikaʻi, ua kāohi maikaʻi ʻia ka maʻi ʻo Addison me ka lāʻau lapaʻau. ʻO ka mea nui loa, ʻo ia ka launa mau ʻana me kāu kauka a loaʻa ka lāʻau lapaʻau āu e pono ai.
Leka Lawe-Home
- ʻO ka maʻi ʻo Addison kahi maʻi i hana ʻole ai nā kelepa adrenal i ka lawa o nā hormones cortisol a me aldosterone.
- ʻO nā hōʻailona nui e komo pū ana me ka luhi mau loa me ke kumu ʻole, ka ʻeleʻele ʻana o ka ʻili a me nā ʻāʻī, a me ka makemake nui i nā meaʻai paʻakai.
- ʻO ka "pilikia Addisonian" he pilikia hoʻoweliweli i ke ola e pono ai ka mālama koke ʻia.
- ʻO ka lāʻau lapaʻau, ʻo ia ka lawe ʻana i nā pila hormone haʻahaʻa no ke ola a pau.
- Me ka lāʻau kūpono, hiki iā ʻoe ke ola i kahi ola maʻamau a olakino hoʻi, akā he mea nui e noho mau me kāu kauka.
- Inā loaʻa iā ʻoe kēia maʻi, he mea nui loa ia no kou palekana e kau mau i kahi kāleka hoʻomaopopo lapaʻau a i ʻole ke kūpeʻe lima a loaʻa kahi hoʻolālā ulia pōpilikia.
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