Lɛ wi lan bɔt sɔm prɔblɛm dɛn we de wit yu bɔdi in glandular system? - Mכltipכl εndokrin Nioplasia (MEN) .

Wi bɔdi tan lɛk wan wɔndaful mashin, nɔto so? Fɔ mek dis mashin wok fayn, ɛni pat nid fɔ wok togɛda ɛn kɔdinɛt fayn fayn wan. Wan impɔtant tin de na wi bɔdi, we dɛn kɔl di ɛndokrin sistɛm . di gland dεm na dis sistεm de mek כmon dεm we de kכntrol bכku pan di tin dεm we wi bכdi de du. Bɔt sɔntɛnde, dis sistɛm kin go bifo. Tide wi go tɔk bɔt wan rare bɔt rili impɔtant kɔndishɔn fɔ no bɔt. Dat na Multiple Endocrine Neoplasia , we dεn kכl bak `(MEN)` fכ sכt.

So wetin na dis εndokrin sistεm?

Fɔ tɔk am simpul wan, wi ɛndokrin sistɛm na wan nɛtwɔk we gɛt gland ɛn ɔgan dɛn na wi bɔdi. Dɛn wan ya de mek kemikal dɛn we dɛn kɔl ɔmon ɛn pul dɛn na di blɔd. Tink bɔt dɛn ɔmon ya as smɔl smɔl mɛsenja dɛn we de kɛr mɛsej dɛn insay wi bɔdi. Dɛn mɛsej ya kin tɛl wi ɔgan, skin, ɛn mɔsul dɛn wetin fɔ du ɛn ustɛm fɔ du am.

difrεn men gland dεm εn כgan dεm de we de insay wi εndokrin sistεm:

• Hypothalamus: Dis de na di say we wi bren de. I de kɔntrol bɔku tin dɛn na di ɛndokrin sistɛm.
• Pituitary gland: Dis smɔl gland we gɛt kɔnekshɔn to di haypothalamus, de mek ɔmon dɛn we de kɔntrol bɔku ɔda gland dɛn, lɛk di tayroyd gland, di adrenal gland dɛn, di ovaria dɛn, ɛn di tɛstikul dɛn.
• Tayroyd: Dis gland we shep lɛk bɔtaflay we de bifo di nɛk de kɔntrol wi bɔdi in mɛtabolism, we na aw wi de yuz di ɛnaji we de kɔmɔt na di it we wi de it.
• Paratayroyd gland dεm: Dis fכ sכm gland dεm we kin de nia di tayroyd gland dεm de kכntro di lεvεl dεm we di kalsiכm εn fכsfכr de insay wi bכdi.
• di adrenal gland dεm: Dis tu gland dεm we de oba di kidni dεm de kכntro di mεtabolism, bכdi prεshכn, divεlכpmεnt fכ mami εn dadi biznεs, εn di strεs rεspכns.
• Pinal gland: Dis gland de mek di ɔmon we dɛn kɔl melatonin ɛn i de manej wi slip saykl.
• Pankrias: Na dis say dɛn kin mek insulin. I rili impɔtant fɔ di mɛtabolism ɛn fɔ kɔntrol di blɔd shuga. I de pat bak pan wi dijestiv sistɛm.
• Ovaries: Na dεn de mek di uman sεks כmon dεm we dεn kכl εstrojen, prכjεstεron, εn tεstostεron.
• Testes: We i de prodyuz sεl na man, di כmon tεstostεron de prodyuz bak ya.

So wetin na Multiple Endocrine Neoplasia (MEN)?

Multiple Endocrine Neoplasia (MEN) na wan jεnεtik kכndyushכn we nכ kin apin we tכmכro de divεlכp na mכr dan wan pan di gland dεm εn tisu dεm na di εndokrin sistεm, we wi bin dכn tכk bכt. Sɔntɛnde, dɛn tumbu ya kin bi kansa.

Tu men kayn tin de fɔ dis `(MEN)` kɔndishɔn:

1. mכltipכl εndokrin niכplasia tayp 1 (MEN tayp 1): dis na kכndyushכn we mכltipכl tכmכro dεm de divεlכp na difrεn gland dεm na di εndokrin sistεm. Dɛn kin kɔl dis bak MEN-1 ɛn Wermer’s syndrome.

2. mכltipכl εndokrin niכplasia tayp 2 (MEN tayp 2): Dis na jεnεtik kεnsar kכndyushכn we de afekt sεvεra gland dεm. Pipul dɛn we gɛt MEN2 kin gɛt wan kayn tayroyd kansa we dɛn kɔl mɛdula tayroyd kansa (MTC) . dεn gεt hכy risk fכ divεlכp tכmכro dεm bak na כda gland dεm na di εndokrin sistεm. Dɛn kin kɔl dis bak MEN-2 ɛn Sipple syndrome.

Wetin mek dis `(MEN)` situeshɔn de apin?

dεn tu kayn `(MEN)` dεm ya de kכz bay chenj dεm na wi jin dεm , dat na mכtεshכn . Imajin se wi bɔdi gɛt sɔntin lɛk instrɔkshɔn buk, dat na, jin. If ivin wan lɛta na dis instrɔkshɔn buk nɔ rayt, dat min se if dɛn chenj wan jin, sɔm pan di wok dɛn we di bɔdi de du kin ambɔg.

• (MEN tayp 1) de kכz bay wan mכtεshכn na di `MEN1` jin . dis `MEN1` jin na tכmכro suprεsכr jin . Dat min se na wan jin we de ɛp fɔ kɔntrol di we aw di sɛl dɛn de sheb ɛn mek di tumbu dɛn nɔ fɔm. If dis jin nɔ wok fayn, sɔm sɛl dɛn kin gro we dɛn nɔ ebul fɔ kɔntrol ɛn mek tumbu.
• (MEN tayp 2) de kכz bay wan mכtεshכn na di `RET` jin . dis `RET` jin na jin we de sho se di kεnsar de divεlכp. we dis jin chenj, di sεl dεm na sכm כgan dεm εn gland dεm de gro we dεn nכ ebul fכ kכntrכl εn fכm tכmכro.

dis jεnεtik mכtεshכn kin kכmכt frכm di mama εn papa כ i kin apin randomly di tεm we di pikin de divεlכp. If wan mama ɔ papa gɛt MƐN, na lɛk 50% chans de fɔ mek pikin gɛt am.

Lɛ wi lan smɔl mɔ bɔt `(MEN)` tayp 1 (`MEN tayp 1`)

Pipul dεm we gεt MEN tayp 1 de divεlכp tכmכro na sεvεra gland dεm na di εndokrin sistεm. Di say dɛm wae kin gɛt dis sik pas ɔl na:

• Paratayroyd gland dɛm: Dis na di wan we kin bɔku pas ɔl.
• di gastroenteropancreatic tract: Dis min se tכmכro kin fכm na di pankrias, bεlε, εn כda pat dεm na di dijestiv sistεm lεk di duodenum.
• Pituitary gland we de na di bɔdi.

כl di tεm dεm, di lumps dεm we de divεlכp wit MEN tayp 1 n כ de kεnsar (benign) . Bɔt sɔm lumps kin bi kansa (malignant).I kin spre bak (metastasize) to ɔda pat dɛn na di bɔdi. di gland dεm we gεt tכmכro kin kכl tu mכch כmon insay di bכdi. Dis na wae kin mek yu gɛt difrɛn kayn sik ɛn wɛl bɔdi prɔblɛm.

Dɔktɔ dɛn dɔn no pas 20 kayn ɛndokrin ɛn nɔ-endokrin tɔŋ dɛn pan pipul dɛn we gɛt MEN tayp 1. Ɔda kayn tɔŋ dɛn de we nɔ kin bɔku, lɛk:

• di nyuroεndokrin tכmכro dεm we de divεlכp na di taymus (wan limf node na di chεst) εn di brכnki (aywe dεm na di lכng).
• di adrenocortical tumor dεm de fכm na di כta layεr na di adrenal gland dεm.
• Fat lumps (Lipomas) we de fכm כnda di skin.
• Brɔst kansa.
• tכmכro dεm lεk mεningioma εn εpεndimoma dεm we kin apin na di bren כ spεnal kכd.

Wetin na di simptom dɛm fɔ `(MEN type 1)`?

Di sayn dɛm fɔ MEN tayp 1 kin difrɛn bad bad wan frɔm wan pɔrsin to ɔda pɔrsin. I dipen pan us gland dɛn de afɛkt ɛn ɔmɔs ɔmon dɛn de mek. Sɔm pipul dɛn nɔ kin gɛt ɛni sayn atɔl, ɔda wan dɛn kin gɛt smɔl smɔl sayn dɛn, ɛn sɔm kin gɛt siriɔs sik, ivin we kin mek dɛn layf de pan denja. Di sayn dɛm kin difrɛn frɔm wan pɔrsin to ɔda pɔrsin, ivin insay di sem famili, ivin bitwin twin pikin dɛm.

Lɛ wi luk sɔm pan di men kayn lumps ɛn di sayn dɛm wae gɛt fɔ du wit am:

• Bikɔs ɔf prɔblɛm wit di paratayroyd gland dɛm (haypaparatayroydism):

90% pan di pipul dεm we gεt `(MEN tayp 1)` de divεlכp dis kכndyushכn we dεn rich 50. insay dis, di paratayroyd gland dεm de bi ova aktiv.

• Sɔm kayn sayn dɛm wae nɔr kin izi fɔ yu: yu jɔyn dɛn kin pen, yu mɔsul dɛn kin wik, yu taya, yu kin gɛt pwɛl hat, yu nɔr kin ebul fɔ kɔnsɛntret, yu nɔr kin want fɔ it.
• Di bad bad sayn dɛm: nɔs, vɔmit, kɔnfyushɔn, fɔgɛt, tɔsti pasmak ɛn pis ɔltɛm, kɔnstipɛshɔn, bon pen.

• biכs fכ di tכmכro dεm na di pankrias εn di fכs pat pan di sכmכl intestin (Gastrinomas):

bכt 40% pan di big pipul dεm we gεt MEN tayp 1 de gεt tכmכro dεm we dεn kכl gastrinomas. Dɛn tin ya kin mek wan ɔmon we dɛn kɔl gastrin, we kin mek di bɛlɛ mek tumɔs asid.

• Di sayn dɛm: Bɛlɛ de at, dayarɛa, at bɔn (asid riflɔks), bɛlɛ ɔlsa (pɛptik ɔlsa).
• Wan ɔda tɔŋ we dɛn kin si na dis kategori na insulinoma . Dis kin mek insulin, we kin mek di blɔd shuga nɔ bɔku (hypoglycemia).
• Di sayn dɛm: kɔnfyushɔn, shek shek, swet, angri pasmak, nɔr de rɛst, at de bit kwik kwik wan, yu de si chenj fɔ sɔm tɛm.

• Bikɔs ɔf di pituitary tumor (prolactinomas):

Na lɛk 25% pan di pipul dɛm we gɛt MEN tayp 1 kin gɛt pituitary tumor. Di wan dɛn we kin bɔku pas ɔl na prolaktinomas, we kin mek di ɔmon we dɛn kɔl prolaktin .

• di simptom dεm na uman dεm: mεnstral we nכ de rεgulεr כ sכt fכ mεnstral (amenorrhea), i at fכ bεlε pikin, milk we de kכmכt frכm di nipl dεm we dεn nכ bεlε כ we dεn de gi bεlε (galactorrhea), dεn nכ want fכ du mami εn dadi biznεs.
• di simptom dεm na man dεm: I de dכn fכ du mami εn dadi bikoz di tεstostεron lεvεl dεm dכn dכn, εrectile dysfunction (ED), εn i at fכ bεlε pikin.
• If di lump big: ed de at, nכs/vכmit, vishכn de chenj (dכbul vishכn, sayd vishכn dεn dכn dכn).

Impɔtant: Nɔto ɔlman go gɛt di sem sayn. Dis list nɔ de ɔlsay. bכku כda kayn lumps de we kin divεlכp na MEN tayp 1.

Lɛ wi lan bak bɔt `(MEN)` tayp 2 (`MEN tayp 2`)

Ɔlman we gɛt MEN tayp 2 kin gɛt wan kayn tayroyd kansa we dɛn kɔl mɛdula tayroyd kansa (MTC) . dis kayn kansa de divεlכp insay wan spεshal kayn sεl na di tayroyd gland we dεn kכl C sεl dεm. Dɛn sɛl dɛn ya kin mek wan ɔmon we dɛn kɔl kalsitɔnin. MTC kin spre to di limf no dεm εn כda כgan dεm. Di men tritmɛnt na fɔ ɔpreshɔn fɔ pul di tayroyd gland (tayroydɛktɔmi).

Dɔn bak, pipul dɛm wae gɛt `(MEN type 2)` kin gɛt wan ɔr tu pan dɛn kayn tin ya:

• Fiokromosaytoma: dis na tכmכro we nכ kin apin we de divεlכp na di midul pat pan wan כ tu di adrenal gland dεm (adrenal mεdula). Bɔku tɛm, dɛn tin ya nɔ kin gɛt kansa. Na lɛk 10%-15% pan di kes dɛm kin bi kansa ɛn i kin skata.
• haypaparatayroydism: di blכd kalsiכm lεvεl de inkrεs biכs fכ di paratayroyd כmon (PTH) we di paratayroyd gland dεm de prodyuz pasmak.

Wetin na di simptom dɛm fɔ `(MEN type 2)`?

De sayn dɛm wae de ya kin difrɛn bak. Di sayn dɛm kin kam bikɔs ɔf di ay lɛvɛl ɔf ɔmon dɛm we di kansa (MTC) ɛn sɔm tɔŋ dɛm de mek.

• Di sayn dɛm fɔ mɛdula tayroyd kansa (MTC):
• Wan lump na di frɔnt pat na di nɛk, di nɛk de pen, yu vɔys de chenj (we yu de ala lawd lawd wan), yu de kɔf, i nɔ izi fɔ swɛla, i nɔ izi fɔ blo.

• Di simptom dɛm wae de kam wit Pheochromocytoma: (i kin apin na lɛk 50% pan di kes dɛm) .
• Di sik kin apin nɔmɔ we dɛn tɔŋ ya de mek bɔku ɔmon dɛn lɛk adrenaline. Sɔm tumbu dɛn nɔ kin mek ɔmon ɛn dɛn nɔ kin sho ɛni sayn.
• Kɔmɔn sayn dɛm (bɔku tɛm dɛn kin kam ɛn go insay spɛl): ay blɔd prɛshɔn (haypa prɛshɔn), ed we de at, we yu de swet pasmak fɔ no rizin, at bit kwik ɔ we nɔ de bit ɔltɛm, we yu de shek.

• Di sayn dɛm wae kin kam wit haypaparatayroydism:
• As in `(MEN type 1)`, simptom dεm lεk jכyn pen, mכsul dεm we wik, taya, pwεl hat, at fכ kכnsantreshכn, lכs fכ it, nכs, vכmit, tכsti pasmak εn fכ pis bכku tεm, kכnstεpshכn, εn bon pen kin apin.

Udat kin divɛlɔp dis `(MEN)` kɔndishɔn? Aw i kɔmɔn?

Di kɔndishɔn `(MEN)` kin afɛkt man ɛn uman ikwal. di ej we di kכndishכn `(MEN tayp 1)` de sho de difrεn bכku. Dɛn dɔn no se i gɛt am pan pikin dɛn we ol lɛk 8 ia ɛn big pipul dɛn we ol lɛk 80 ia.

`(MEN)` na wan kɔndishɔn we nɔ kin apin so ɔltɛm .

• `(MEN type 1)` kin afɛkt lɛk wan pan 30,000 pipul dɛm.
• `(MEN type 2)` kin afɛkt lɛk wan pan 35,000 pipul dɛm.

Sɔm pipul dɛm wae de du risach biliv se di aktual nɔmba fɔ pipul dɛm wae gɛt dis sik kin bɔrku bikɔs dɛn nɔr no di sik ɔr nɔr no di sik fayn.

Aw dɔktɔ dɛn kin no di kɔndishɔn `(MEN)`? (Diagnosis) .

fכ no di kכndishכn `(MEN)` kin kכmplikt sכmtεm, biכs i de afekt difrεn gland dεm.

• Identifikeshɔn fɔ `(MEN tayp 1)`:

Dɛn kin no se pɔsin gɛt MEN tayp 1 if i gɛt at le tu pan di tri big ɛndokrin tɔŋ dɛn we wi dɔn tɔk bɔt (paratayrɔyd tɔmɔs, pituitary tɔmɔs, ɛn/ɔ tumbu dɛn na di gastrointestinal trakt), ɔ if i gɛt wan pan dɛn tɔŋ dɛn de ɛn wan famili mɛmba gɛt MEN tayp 1.

• Test dɛn:
• bכdi tεst: Chεk fכ hכy lεvεl fכ sכm כmon dεm (e.g. paratayroyd כmon (PTH), kalsiכm).
• Imej tɛst: Dɛn tin ya kin ɛp fɔ fɛn say dɛn we di lumps de, lɛk CT skan (kɔmpyuta tomografi skan) ɔ MRI (magnɛtik rɛsɔnans imej skan).
• jεnεtik tεst: I de chεk fכ mכtεshכn na di `MEN1` jin.

• Identifikeshɔn fɔ `(MEN tayp 2)`:

Dɛn kin no se pɔsin gɛt MEN tayp 2 if i gɛt mɛdula tayroyd kansa (MTC) wit fiokromosaytɔma ɛn/ɔ haypaplasia ɔ adenoma na di paratayroyd gland dɛn.

• Test dɛn:
• Blɔd tɛst: Chɛk di ɔmon lɛvɛl lɛk kalsitɔnin (fɔ MTC), paratayrɔyd ɔmon (PTH), ɛn katekolamin (fɔ fiokromosaytoma).
• Imej tɛst: Dɛn kin yuz `CT skan` ɔ `MRI skan`.
• jεnεtik tεst: I de chεk fכ mכtεshכn na di `RET` jin.

Wetin na di tritmɛnt dɛm fɔ `(MEN)`?

di tritmεnt fכ MEN dipכnt כlsay pan us εndokrin gland dεm εn כgan dεm de afekt. Bɔku tɛm, i kin gɛt fɔ du wit wan tim we gɛt bɔku bɔku dɔktɔ dɛn, lɛk di wan dɛn we de mɛn di sik dɛn we de mek pɔsin in bɔdi , di dɔktɔ dɛn we de du ɔpreshɔn , ɛn di wan dɛn we de stɔdi bɔt kansa .

Bɔku tritmɛnt dɛn kin de:

• Mɛrɛsin: Kɔntrol di sayn dɛm ɛn ridyus di ifɛkt dɛm we di ɔmon dɛm we pasmak kin gɛt.
• כpεrayshכn: Rimov di lכmp כ di כl gland we afekt (e.g., di tayroyd gland).
• Ɔmon riplesmɛnt tɛrapi: If dɛn du ɔpreshɔn fɔ pul wan ɛndokrin gland, dɛn kin gi di ɔmon dɛn we i de mek na do.
• Tritmɛnt fɔ kansa: If di kansa dɔn skata to ɔda say dɛn (we dɔn mɛtastas), tritmɛnt dɛn lɛk kemotɛrapi ɛn redyushɔn tɛrapi .

Bikɔs ɛvri `(MEN)` pasɛnt na in yon, di tritmɛnt plan we de wok fɔ ɔlman difrɛn. Nɔr frayd fɔ tɔk to yu dɔktɔ bɔt de tritmɛnt wae go fayn fɔ yu.

Yu tink se `(MEN)` kin wɛl kɔmplit wan? Yu tink se dɛn go ebul fɔ stɔp am?

Na ɔnfɔni, naw nɔr gɛt mɛrɛsin fɔ di kɔndishɔn `(MEN)`. Bɔt, dɛn kin ebul fɔ kɔntrol am . Dɔktɔ dɛn kin trit di chenj dɛn we kin apin na ɛni gland wit ɔpreshɔn ɔ mɛrɛsin lɛk aw i fɔ bi da tɛm de.

i nכ posεbul fכ mek di divεlכpmεnt fכ `(MEN)`, biכs na wan jεnεtik mכtεshכn de kכz am. dis jεnεtik mכtεshכn kin kכmכt frכm di mama εn papa כ i kin apin randomly di tεm we di εmbrayo de.

Bɔt if dɛn dɔn no se pɔsin we de nia yu fambul (mama ɔ papa, brɔda ɛn sista) gɛt MEN, i impɔtant fɔ tɔk to yu dɔktɔ bɔt aw fɔ tɛst yu jɛnɛtiks fɔ MEN. If yu du dat, dat kin ɛp fɔ no di tumbu kwik kwik wan if yu gɛt di sik.

Wetin kin apin we yu de liv wit `(MEN)`? (Prɔgnosis) .

di prכgnosis fכ MEN dipכnt pan sεvεra fכs tin dεm:

• Aw kwik fɔ no `(MEN)`.
• Us ɛndokrin gland dɛn kin afɛkt?
• If di lump gɛt kansa ɔ nɔto kansa.
• Di kayn tritmɛnt we dɛn kin yuz.
• If kansa tumor dɔn spre to ɔda pat dɛn na di bɔdi (metastasized) na in dɛn kɔl am.

If dɛn dɔn no se yu gɛt MEN, yu dɔktɔ kin gi yu di bɛst aidia bɔt yu tritmɛnt ɛn di we fɔ go bifo.

Ustɛm fɔ go to dɔktɔ ɛn impɔtant kwɛstyɔn dɛn fɔ aks

If dɛn dɔn no se yu gɛt MEN, yu go nid fɔ go to yu dɔktɔ ɔltɛm fɔ wach yu kɔndishɔn ɛn mek shɔ se yu tritmɛnt de wok fayn fayn wan.

Dɔn bak, if pɔsin we de nia yu famili na yu famili gɛt `(MEN)`, tɔk to yu dɔktɔ bɔt aw fɔ tɛst yu jɛnɛtiks, lɛk aw wi bin dɔn tɔk.

If yu gɛt `(MEN)`, i go fayn fɔ aks yu dɔktɔ kwɛstyɔn dɛn lɛk dɛn wan ya:

• Us kayn `(MEN)` a gɛt?
• Aw (MAN) de afɛkt mi bɔdi?
• Us sayn dɛn a fɔ luk fɔ?
• Us tritmɛnt opshɔn dɛn a gɛt?
• Wetin na di bɛnifit ɛn bad tin dɛn we difrɛn we dɛn fɔ trit pɔsin gɛt?
• Aw lɔng i kin tek fɔ mek di tritmɛnt go bifo?
• Yu tink se dɛn fɔ tɛst di ɔda pipul dɛn na mi famili fɔ (MEN)?

Fɔ dɔn, tin dɛn fɔ mɛmba (Take-Home Message) .

Multiple endocrine neoplasia (MEN) na wan sik we nɔ kin apin so ɔltɛm. Dɔn bak, bikɔs MEN kin mek yu gɛt bɔku difrɛn sayn dɛm ɛn nɔto ɔlman in kɔndishɔn na di sem, sɔmtɛm i kin at fɔ no if yu gɛt am.

If yu gɛt ɛni nyu sayn we de wɔri yu, ɔ if yu notis ɛni chenj na yu bɔdi, di bɛst tin fɔ du na fɔ go to dɔktɔ.

Pan ɔl we sɔm kes dɛm fɔ `(MEN)` kin apin randomly, i kin rɔn bak na famili. If wan pan yu klos fambul gɛt `(MEN)`, i rili impɔtant fɔ mek yu du jenɛtik tɛst fɔ no if yu de pan denja. Tɔk to yu dɔktɔ bɔt ɛni kwɛstyɔn we yu gɛt bɔt yu risk fɔ gɛt `(MEN)`. Dɛn de de fɔ ɛp yu. Nɔ fred, nɔ fred, ɛn nɔ fred fɔ aks kwɛstyɔn.

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