Tulina kwogera ku kizimba ekitali kya bulijjo ekiyitibwa Pheochromocytoma leero?

Oluusi olina puleesa ey’amangu? Oba otuuyana butuuyo? Ofuna omutwe ng’omutima gukuba? Toyanguwa nnyo kulowooza nti ebintu bino ebitonotono bulwadde bwa maanyi. Wabula singa obubonero buno busigalawo naddala nga puleesa enzibu okugifuga, kiba kirungi n’ofaayo katono. Leero tugenda kwogera ku mbeera etali ya bulijjo katono, naye singa ezuulibwa bulungi, esobola okujjanjabibwa obulungi ennyo. Ekyo kiyitibwa pheochromocytoma.

Pheochromocytoma kye ki? Ka tukitegeere mu ngeri ennyangu.

Mu ngeri ennyangu, pheochromocytoma kizimba ekikula mu kitundu eky’omu makkati eky’endwadde z’ekibumba, ekiyitibwa adrenal medulla. Ebizimba bino bikolebwa ekika ky’obutoffaali eky’enjawulo ekiyitibwa chromaffin cells. Obutoffaali buno bukola era ne bufulumya obusimu mu musaayi obwetaagisa omubiri gwaffe okuddamu "okulwana oba okudduka". Lowooza ku kino, bw’otya amangu oba ng’oyolekagana n’okunyigirizibwa kungi, enkyukakyuka ezibeerawo mu mubiri gwo - omutima gwo gweyongera, otuuyana, omubiri gwo gukankana - obusimu buno bwe buvunaanyizibwa ku kino.

Pheochromocytoma etera okukula mu nseke emu yokka ey’ekibumba. Kyokka oluusi kiyinza okukula mu nseke zombi. Kisoboka okuba n’ebizimba ebisukka mu kimu mu nseke emu.

Ekikulu, pheochromocytomas ezisinga obungi tezirina bulabe (si za bulabe) . Kino kitegeeza nti tezisaasaana mu bitundu by’omubiri ebirala. Wabula wakati w’ebitundu 10% ne 15% bisobola okuba kookolo. Singa eno embeera ya kookolo, enyonyolwa mu biti ebikulu ebiwerako, okusinziira ku ngeri gye yasaasaanaamu:

• Localized pheochromocytoma: Ekizimba kisangibwa mu nseke emu yokka oba zombi.
• Regional pheochromocytoma: Kookolo ono asaasaanidde mu nnywanto eziriraanye endwadde z’ekibumba oba mu bitundu ebirala.
• Metastatic pheochromocytoma: Kookolo ono asaasaanidde mu bitundu by’omubiri eby’ewala ng’ekibumba, amawuggwe oba amagumba.
• Recurrent pheochromocytoma: Kookolo akomyewo oluvannyuma lw’okujjanjabibwa. Kiyinza okuba mu kifo kye kimu kye kyali edda oba mu kifo eky’enjawulo.

Endwadde zino eziyitibwa adrenal glands mu mubiri gwaffe ze ziruwa? Omulimu gwazo guli gutya?

Tulina endwadde bbiri eziyitibwa adrenal glands. Zisangibwa emabega w’olubuto lwaffe, waggulu w’ensigo zaffe, ng’enkoofiira. Zino kitundu ku nkola yaffe ey’omubiri (endocrine system). Buli nnywanto ya adrenal erina ebitundu bibiri ebikulu. Oluwuzi olw’ebweru luyitibwa ekitundu ky’omubiri ekiyitibwa adrenal cortex, ate ekitundu ekiri wakati kiyitibwa adrenal medulla.

Adrenal medulla yaffe ekola ekibinja ky’obusimu obuyitibwa catecholamines. Obusimu buno bufuga enkola eziwerako ezikulu ennyo mu mubiri gwaffe:

• Omutima okukuba
• Puleesa
• Omutindo gwa sukaali mu musaayi `(Glucose mu musaayi)`
• Engeri omubiri gwaffe gye guddamu situleesi (okuddamu "okulwana oba okudduka") .

Ebika bya catecholamines ebikulu bye bino:

• Ekirungo kya Dopamine
• Epinephrine (Adrenaline) `(Eddagala ly’omubiri / Adrenaline)`
• Eddagala lya Norepinephrine (Noradrenaline) `(Eddagala lya Norepinephrine / Noradrenaline)`

Pheochromocytoma bw’ebaawo, esobola okufulumya obusimu buno bungi, adrenaline ne noradrenaline, mu musaayi okusinga bwe kyetaagisa. Wano obubonero obw’enjawulo we butandikira okulabika.

Njawulo ki eriwo wakati wa Pheochromocytoma ne Paraganglioma?

Bino bika bya bizimba bibiri ebifaanagana ennyo, ebitali bimu. Zombi zisibuka mu butoffaali bwa chromaffin bwe bumu bwe twayogeddeko emabegako. Kyokka, pheochromocytoma ejja mu kitundu eky’omu makkati eky’endwadde z’ekibumba (adrenal medulla), ate paraganglioma ejja mu bifo ebirala ebweru w’endwadde z’ekibumba .

Ani asinga okulwala embeera eno? Kitera kitya?

Pheochromocytoma esobola okukula ku myaka gyonna, naye esinga kubeera mu bantu abali wakati w’emyaka 30 ne 50. Ebitundu nga 10% ku balwadde baloopebwa mu buto.

Kino kizimba ekitatera kulabika nnyo . Kizibu okwogera ddala abantu bameka abalina embeera eno. Olw’okuba abantu abamu tebalaga bubonero bwonna, obulwadde buno buyinza obutazuulibwa. Kiteeberezebwa nti abantu abatakka wansi wa 1% abalina puleesa balina obulwadde bwa pheochromocytoma.

Bubonero ki omuntu alina obulwadde bwa pheochromocytoma bw’alaga?

Obubonero bwa Pheochromocytoma bubaawo ng’ekizimba kifulumya obusimu obuyitiridde obuyitibwa adrenaline (epinephrine) oba noradrenaline (norepinephrine) mu musaayi. Wabula ebizimba ebimu tebikola nnyo busimu buno era biyinza obutaba na bubonero.

Obubonero obusinga okulabibwa bwe buno:

• Puleesa (Hypertension): Buno bwe bubonero obukulu. Oluusi kiba kizibu okufuga.
• Omutwe: Kiyinza okuba omutwe ogw’amaanyi era ogw’amangu.
• Okutuuyana ekisusse awatali nsonga.
• Okukuba kw’omutima kwe kuwulira ng’omutima gukuba amangu, nga tegukuba bulijjo oba nga gukuba.
• Okuwulira ng’omubiri gwo gukankana.

Obubonero obutatera kulabika:

• Obulumi mu kifuba ne/oba mu lubuto.
• Olususu lufuuka lwa bbululu mangu okusinga bulijjo.
• Okuziyira ne/oba okusiiyibwa.
• Embiro.
• Obuteeyabya.
• Puleesa (Orthostatic hypotension) ye puleesa okukka amangu ng’oyimiridde. Kino kitegeeza nti owulira ng’oziyira ng’oyimiridde mu bwangu ng’otudde.
• Okugejja awatali nsonga.

Obubonero buno buyinza okulabika oba okweyongera oluvannyuma lw’ebintu ebimu. Okugeza nga:

• Okukola emirimu gy’omubiri egy’amaanyi.
• Obuvune mu mubiri oba situleesi ey’amaanyi mu birowoozo.
• Okuzaala.
• Okufuna eddagala eribudamya.
• Okukola okulongoosa.
• Okulya emmere erimu ekirungo kya tyramine (e.g. red wine, chocolate, cheese).

Obubonero bubaawo bulijjo? Oba bajja ne bagenda?

Omuntu alina obulwadde bwa pheochromocytoma ayinza okuba ne puleesa etaggwaawo, oba eyinza okujja n’egenda .

Abantu abamu bayinza okufuna "paroxysmal attacks," oba okulumbibwa okw'amangu okw'obubonero. Kino kitegeeza nti wabaawo puleesa okweyongera mu bwangu, nga kuwerekerwako obubonero ng’okulumwa omutwe ennyo, omutima okweyongera, n’okutuuyana ennyo. "Okulumba" kuno kuyinza okubaawo emirundi egiwerako olunaku, oba wadde omulundi gumu oba ebiri mu mwezi.

Ekikulu: Bw’oba ​​olina ekimu ku bubonero buno naddala puleesa ey’amangu, okulumwa omutwe, okutuuyana n’okukuba emiggo, kikulu nnyo okugenda ew’omusawo.

Lwaki obulwadde bwa pheochromocytoma bukula? Biki ebivaako?

Ebiseera ebisinga, tewali nsonga ntongole eyinza kuzuulibwa ku pheochromocytoma. Kibaawo mu ngeri ya kimpowooze.

Wabula mu bitundu 25% ku 35%, embeera eno ekwatagana n’embeera z’obuzaale. Ebimu ku bikulu bye bino:

• Obulwadde bwa multiple endocrine neoplasia 2, ebika A ne B (MEN2A ne MEN2B) .
• Obulwadde bwa Von Hippel-Lindau (VHL).
• Obulwadde bw’obusimu obuyitibwa neurofibromatosis ekika kya 1 (NF1) .
• Obulwadde bwa paraganglioma obusibuka
• Carney-Stratakis dyad [paraganglioma n’ekizimba ky’omu lubuto (GIST)].
• Carney triad (paraganglioma, GIST ne obulwadde bw’amawuggwe) .

Ng’oggyeeko embeera zino ez’obuzaale, pheochromocytoma nayo esobola okukula olw’enkyukakyuka mu buzaale obutakka wansi wa 10 obw’enjawulo.

Obulwadde buno buzuulibwa butya? (Okuzuula obulwadde)

Pheochromocytoma eyinza okuba enzibu okuzuula kubanga kizimba ekitatera kulabika era oluusi tekireeta bubonero bwonna. Oluusi, ekizimba kizuulibwa mu butanwa mu kukeberebwa okukolebwa olw’ensonga endala.

Waliwo ensonga eziwerako lwaki omusawo ayinza okuteebereza obulwadde buno:

• EbibyoEbyafaayo by’obujjanjabi mu bujjuvu naddala oba waliwo omuntu yenna mu maka eyafuna obulwadde bwa pheochromocytoma emabegako.
• Okukeberebwa omubiri n’abasawo mu bujjuvu.
• Some specific symptoms , okugeza "paroxysmal attacks" ze twayogeddeko ne puleesa etafugibwa bujjanjabi bwa bulijjo.

Ebigezo bya ngeri ki ebikolebwa?

Omusawo ayinza okukuwa amagezi okukebera bino wammanga okukakasa oba olina pheochromocytoma:

• Okukebera omusulo okumala essaawa 24: Kino kizingiramu okukung’aanya omusulo gwo olunaku lwonna n’okupima obungi bwa catecholamines ezigulimu. Era epima ebintu ebikolebwa nga obusimu buno bumenyese. Singa emiwendo gino giba waggulu okusinga ku gya bulijjo, kiyinza okuba akabonero ka pheochromocytoma.
• Okukebera catecholamine mu musaayi: Bino bipima emiwendo gya catecholamines mu musaayi. Okufaananako n’okukebera omusulo, era banoonya ebintu ebikolebwa obusimu obusasika.
• CT scan (Computer Tomography scan): Kino kitwala ebifaananyi bya X-ray ebiwerako okukola ebifaananyi ebikwata ku mubiri gwo munda. Omusawo ayinza okukuwa amagezi kino okutunuulira endwadde zo ez’omu kibumba.
• MRI scan (MRI - Magnetic Resonance Imaging): Kino kikozesa magineeti, amayengo ga leediyo, ne kompyuta okukola ebifaananyi ebikwata ku mubiri mu bujjuvu. Era ekozesebwa okwekenneenya endwadde z’ekibumba.

Obulwadde bwe bumala okukakasibwa, okwongera okukeberebwa kuyinza okukolebwa okuzuula oba ekizimba kiri kya kookolo (ekizibu) oba tekirina bulabe (benign), era oba kyasaasaana mu bitundu by’omubiri ebirala.

Lwaki Okukebera Obuzaale Kikulu?

Singa ozuulibwa nti olina obulwadde bwa pheochromocytoma, omusawo ajja kukuwa amagezi okukubuulirira ku buzaale n’okukeberebwa okuzuula oba olina obulwadde obusikira obukuteeka mu bulabe bw’okufuna kookolo omulala.

Okukebera obuzaale kuyinza okusemba mu mbeera nga zino:

• Singa ggwe oba omuntu mu maka go alina obubonero obukwatagana n’obulwadde bwa heditary pheochromocytoma oba paraganglioma syndrome.
• Bw’oba ​​olina ebizimba mu nseke zo zombi ez’ekibumba.
• Singa wabaawo ebizimba ebisukka mu kimu mu nseke emu ey’ekibumba.
• Singa wabaawo obubonero obulaga nti catecholamines zeeyongedde mu musaayi.
• Singa pheochromocytoma ezuulibwa nga tannaweza myaka 40.

Singa okukebera obuzaale kuzuula enkyukakyuka mu buzaale, omuwabuzi ku buzaale ayinza okukuwa amagezi nti abantu abalala mu maka go (abo abatalina bubonero naye nga bali mu bulabe) nabo bakeberebwe.

Bujjanjabi ki obw’obulwadde bwa Pheochromocytoma?

Obujjanjabi obusinga obulungi ku kino kwe kulongoosa okuggyamu ekizimba, bwe kiba kisoboka .

Okulonda obujjanjabi kisinziira ku bintu ebiwerako:

• Enkula y’ekizimba.
• Oba ekizimba kya kookolo (malignant) oba benign (benign).
• Oba waliwo obubonero obuva ku busimu bwa catecholamine okweyongera.
• Ekizimba kiri mu kifo kimu kyokka, oba kibunye mu bitundu by’omubiri ebirala? (Ekisaasaana mu bitundu ebirala) .
• Oba obulwadde buno bwazuulibwa omulundi ogwasooka, oba buzzeemu oluvannyuma lw’okujjanjabibwa emabegako.

Bw’oba ​​olina obubonero olw’obusimu bw’omu kibumba okweyongera, omusawo ayinza okukuwa eddagala okufuga obubonero obwo. Okugeza nga:

• Eddagala erikuuma puleesa ku mutindo ogwa bulijjo, gamba nga alpha-blockers.
• Eddagala erikuuma omutima nga gukuba ku mutindo ogwa bulijjo, gamba nga beta-blockers.
• Eddagala eriziyiza ebikolwa by’obusimu obufulumizibwa ekisusse okuva mu nseke z’omu lubuto.

Enzijanjaba enkulu ez’okujjanjaba obulwadde bwa pheochromocytoma ze zino:

• Okuloongoosa
• Obujjanjabi bw’amasannyalaze (radiation therapy).
• Obujjanjabi bw’eddagala
• Obujjanjabi bw’okuggyamu ebitundu by’omubiri
• Obujjanjabi bw’okuzimba omubiri (embolization therapy).
• Obujjanjabi obugendereddwamu

Ggwe ne ttiimu yo ey’abasawo nga muli wamu mujja kusalawo enteekateeka y’obujjanjabi ekusinga obulungi.

Enkola enkulu ez’obujjanjabi

• Okuloongoosa:

Eno y’obujjanjabi obukulu obw’obulwadde bwa pheochromocytoma. Ebizimba nga 90% bisobola okuggyibwamu obulungi nga bilongoosebwa .

Omusawo ayinza okukuwa amagezi okulongoosebwa okuggyamu endwadde zo emu oba zombi (adrenalectomy). Mu kiseera ky’okulongoosebwa, omusawo ajja kwekenneenya ebitundu ebigyetoolodde n’ennywanto z’omusaayi okulaba oba ekizimba kisaasaanye. Bwe kiba nga kifunye, bajja kuggyawo ekitundu ekyo, bwe kiba kisoboka.

Oluvannyuma lw’okulongoosebwa, omusaayi oba omusulo gwo gujja kukeberebwa okulaba oba gulimu catecholamine. Singa emiwendo gidda mu mbeera eya bulijjo, kitegeeza nti obutoffaali bwonna obwa pheochromocytoma buggyiddwawo.

Singa endwadde zombi ziggyibwamu, ojja kuba olina okumira obujjanjabi bw’obusimu obulamu bwo bwonna okudda mu kifo ky’obusimu obukolebwa endwadde z’ekibumba.

• Obujjanjabi bw’amasannyalaze (radiation therapy):

Buno bujjanjabi obukozesebwa okutta obutoffaali bwa kookolo oba okubulemesa okukula. Kino kikolebwa mu ngeri etakosa bitundu biramu nga bwe kisoboka.

Waliwo ebika bibiri eby’obujjanjabi obw’amasannyalaze (radiation therapy):

• Obujjanjabi bw’amasannyalaze ag’ebweru: Obusannyalazo butuusibwa mu kifo kya kookolo okuva mu kyuma ekiri ebweru w’omubiri.
• Enzijanjaba y’obusannyalazo obw’omunda: Ekintu ekikola obusannyalazo kipakiddwa mu mpiso, ensigo, waya oba emisuwa ne kiyingizibwa omusawo mu kifo oba okumpi n’ekifo kookolo w’ali.

Ekika ky’obujjanjabi obw’amasannyalaze kisinziira ku oba kookolo ali mu kitundu, mu kitundu, agenda mu bitundu ebirala oba azzeemu. Malignant pheochromocytoma esinga kujjanjabwa n’obujjanjabi obw’obusannyalazo obw’ebweru ne/oba obujjanjabi bwa 131I-MIBG. 131I-MIBG kintu kya radioactive ekikwatagana ku butoffaali bwa kookolo obumu ne butta.

• Obujjanjabi bw’eddagala:

Kino kikozesa eddagala okutta obutoffaali bwa kookolo, okubulemesa okwawukana n’okukula oba okukomya okukula kwa kookolo. Eddagala lino litera okuweebwa mu misuwa. Wadde nga buno bujjanjabi bulungi, buyinza okuvaako ebizibu.

• Obujjanjabi bw’okuggyamu ebitundu by’omubiri:

Buno bujjanjabi obutaliimu nnyo kuyingirira. Ekozesa ebbugumu eriyitiridde oba ennyonta ennyo okusaanyaawo ebizimba.

• Radiofrequency ablation: Radiofrequency ablation ekozesa amayengo ga radio okubugumya n’okusaanyaawo obutoffaali bwa kookolo n’obutoffaali obutali bwa bulijjo.
• Cryoablation: Ekozesa nayitrojeni ow’amazzi oba kaboni dayokisayidi ow’amazzi okufuuka bbugumu n’okusaanyaawo obutoffaali bwa kookolo n’obutoffaali obutali bwa bulijjo.

• Obujjanjabi bw’okuggyamu embuto:

Mu kino, omusuwa ogugabira omusaayi mu nseke z’ekibumba guzibikira. Kino kiyimiriza omusaayi okutambula mu nseke, ne kitta obutoffaali bwa kookolo obukula eyo.

• Obujjanjabi obugendereddwamu:

Kino kikozesa eddagala oba ebintu ebirala ebilumba mu ngeri ey’enjawulo obutoffaali bwa kookolo bwokka awatali bulabe ku butoffaali bulamu. Obujjanjabi buno bukozesebwa ku bulwadde bwa pheochromocytoma obusaasaana n’okuddirira.

Ekirungo ekiziyiza tyrosine kinase ekiyitibwa sunitinib kinoonyezebwa ku bulwadde bwa metastatic pheochromocytoma. Eddagala lino liziyiza ebizimba okukula.

Obulwadde buno busobola okuziyizibwa?

Ebyembi, tewali ngeri yonna gye tuyinza kuziyiza pheochromocytoma. Wabula bw’oba ​​oli mu bulabe bw’okufuna obulwadde buno olw’obulwadde bw’obuzaale n’obuzaale, okubudaabudibwa ku buzaale kuyinza okuyamba mu kukebera n’okuzuula amangu.

Singa omuntu yenna ku ba famire yo ey’oku lusegere (baganda bo, abazadde) abadde n’obulwadde bwa pheochromocytoma, oba bw’oba ​​olina embeera y’obuzaale ng’ezo ze twayogeddeko emabegako (Multiple endocrine neoplasia 2 syndrome, Von Hippel-Lindau (VHL) disease, Neurofibromatosis type 1 (NF1), Hereditary paraganglioma syndrome, Carney-Stratakis dyad, Carney triad), kikulu nnyo okwogera n’omusawo wo ku nsonga eno.

Omukisa guli gutya ogw’okuwona oluvannyuma lw’okujjanjabibwa? (Okuteebereza)

Entunula ya pheochromocytoma okutwalira awamu nnungi nnyo singa ejjanjabwa.Twagamba dda nti ebizimba nga 90% bisobola okuggyibwamu obulungi nga bilongoosebwa.

Kyokka, singa tebujjanjabwa, embeera eno eyinza okuvaako ebizibu eby’amaanyi, n’ebiyinza okutta omuntu . Okugeza nga:

• Obulwadde bw’emisuwa gy’omutima
• Obulwadde bw’emisuwa gy’omutima
• Okuvaamu omusaayi mu bwongo nga tofugibwa (Cerebral hemorrhaging) .
• Okukuŋŋaanyizibwa kw’amazzi mu mawuggwe (Pulmonary edema) .

Abalwadde abamu aba pheochromocytoma nabo bali mu bulabe bwa stroke oba myocardial infarction.

Ddi lwe nnina okulaba omusawo?

• Bw’ozuulibwa nti olina obulwadde bwa pheochromocytoma n’ofuna obubonero bwonna obukutawaanya, laba omusawo mu bwangu.
• Bw’oba ​​olina obubonero bwa pheochromocytoma, gamba nga puleesa n’okulumwa omutwe, yogerako n’omusawo wo. Wadde nga pheochromocytoma tatera kubaawo, kikulu okujjanjaba puleesa.
• Bw’oba ​​okimanyi nti omu ku b’eŋŋanda zo ez’oku lusegere (baganda bo, abazadde) alina embeera y’obuzaale nga `Multiple endocrine neoplasia 2 syndrome` oba `Von Hippel-Lindau (VHL) disease`, era oyinza okuba mu bulabe obw’amaanyi obw’okufuna pheochromocytoma, kale laba omusawo oyogere ku kukebera obuzaale.

Bibuuzo ki bye nnina okubuuza omusawo?

Bw’oba ​​ozuuliddwa nti olina obulwadde bwa pheochromocytoma, kiyinza okukuyamba okubuuza omusawo wo ebibuuzo bino:

• Lwaki nnafuna obulwadde bwa pheochromocytoma?
• Abaana bange ne/oba ab’eŋŋanda zange basobola okulwala obulwadde bwa pheochromocytoma?
• Bujjanjabi ki bwe nnina?
• Biki ebiva mu bujjanjabi obw’enjawulo?
• Nnyinza ntya okuddukanya obubonero bwange?

N’ekisembayo, ebintu ebikulu by’olina okujjukira (Obubaka bw’okutwala awaka) .

Okay, kale, wadde nga pheochromocytoma kizimba ekitali kya bulijjo, kitera okuba ekitali kya bulabe era nga kijjanjabibwa . Ekirala, kiyinza okutambulira mu maka, kale singa ggwe oba omuntu mu maka go azuuliddwa ng’olina embeera eno, kikulu okwekebeza obuzaale. Kino era kiyinza okuyamba okuzuula oba oli mu bulabe bw’okufuna ebizibu ebirala eby’obulamu.

Jjukira nti bw’oba ​​olina ekibuuzo kyonna ku bulabe bw’okufuna obulwadde bwa pheochromocytoma oba ku bulwadde buno, totya kwogera na musawo wo. Bali wano okukuyamba. Sigala nga oli mulamu bulungi!

Pheochromocytoma , endwadde z’ekibumba, catecholamines, puleesa, okulumwa omutwe, okutuuyana, ekizimba, enkola y’endocrine