Kei a koe ēnei tohu? Me kōrero tātou mō te Cushing Syndrome!

Kua rongo koe i te Cushing Syndrome? Tērā pea he ingoa hou ki a koe. He māmā noa iho, he āhuatanga tēnei e puta ana ina nui rawa te homoni cortisol e whakaputaina ana e ō tātou tinana. E kiia ana hoki e ētahi ko te hypercortisolism. Ko te "syndrome" he kohinga o ngā tohu e huihui mai ana. Tērā pea kua kite koe i tēnei e kiia nei ko te Cushing's syndrome e ētahi tāngata.

Nā, he aha tēnei cortisol?

He homoni steroid te Cortisol i roto i ō tātou tinana. He maha ngā wā ka kiia e tātou ko te "hormone ahotea" nā te mea i te wā e pāngia ana tātou e te ahotea, ka tukuna e ō tātou tinana he nui ake te cortisol. I ēnei wā, ka āwhina te cortisol i a tātou:

• Ka piki ake te tere o tō manawa.
• Kei te piki haere tō toto toto.
• Ka whakahaere i ngā taumata huka toto.
• Whakahaere i te manawa.
• Ka whakanui ake i te taumahatanga o te uaua.

Ehara i te mea koinā anake, engari ina pāngia tātou e te ahotea, ka āwhina hoki te cortisol ki te aukati i ngā pūnaha kāore e tino hiahiatia ana e tō tātou tinana i taua wā, hei tauira, te pūnaha nakunaku me te pūnaha whakaputa uri.

He homoni nui te cortisol mō ō tātou tinana. He mea nui te cortisol mō ēnei mea:

• Kia mau tonu te toto toto.
• Whakahaerehia ngā taumata huka toto.
• Whakaitihia te mumura.
• Hangaia ngā maharatanga.
• Whakahaerehia tō manawa.
• Kia mau tonu te toenga tote i roto i te tinana.
• Hurihia te kai e kainga ana e tātou hei pūngao.

Ko ngā taumata cortisol e whakahaerehia ana e ngā repe iti e rua kei runga ake i ō tātou whatukuhu, arā, ko ngā repe adrenal, ko te repe pituitary i roto i te roro, me te hypothalamus, kei runga ake i te repe pituitary.

Ko te mate Cushing te take o te mate pukupuku . E rua ngā huarahi matua e puta ai tēnei:

• Endogenous: Ko te tikanga he āhuatanga tēnei e puta mai ana i te cortisol, e whakaputaina ana i roto i ō tātou tinana.
• Ā-waho: Ko te tikanga tēnei ka puta mai tētahi āhuatanga i ngā take o waho hei pānga taha o ētahi rongoā e tangohia ana hei rongoā i ētahi atu āhuatanga hauora.

Ko wai te mea tino tūpono ka pāngia e te mate Cushing?

Ko te mate Cushing te mea tino noa i roto i ngā tamariki, ngā taiohi, me ngā pakeke. Ko te mea tino noa i roto i te hunga i waenga i te 25 me te 50 tau te pakeke. Ko te hunga e tango ana i ngā rongoā kei roto te cortisol (hei tauira, ngā rongoā mō te mate huango me te mate rumatiki) he nui ake te mōrearea ki te pāngia e te mate. Tata ki te 70% o te hunga e pāngia ana e te mate Cushing he wāhine, ā, 30% he tāne.

E hia te auau o tēnei āhuatanga?

He tino onge te mate a Cushing, e pāngia ana i waenga i te 40 me te 70 i roto i te miriona tāngata ia tau.

He aha te rerekētanga i waenga i te Cushing Syndrome me te Cushing Disease?

Ko te mate a Cushing tētahi momo o te mate a Cushing. Nā tētahi pukupuku pai i roto i te repe pituitary i puta ai. He nui rawa te homoni ACTH (adrenocorticotropic hormone) e tukuna ana e tēnei pukupuku. Nā tēnei ka nui rawa te cortisol e tukuna ana e ngā repe adrenal.

Mō te hunga e pāngia ana e te mate a Cushing, neke atu i te 70% o ngā pakeke, me te 60% me te 70% o ngā tamariki me ngā taiohi e pāngia ana e tēnei momo mate a Cushing.

He aha ngā momo tākuta e rongoā ana i te Cushing Syndrome?

Mā tō tākuta whānui koe e tuku ki tētahi tohunga e kīia nei he endocrinologist hei tātaritanga me te rongoā i tēnei mate.

Ka taea te whakamate i te mate Cushing?

Ae, ka mate pea te mate Cushing mēnā kāore e rongoatia tika. Mēnā kāore e rongoatia, ka taea e tēnei taumata cortisol teitei (hypercortisolism) te arahi ki ngā momo raruraru hauora. Hei tauira:

• Ngā mate urutā
• Ngā toto totoka, inā koa i roto i ngā pukahukahu me ngā waewae
• Te pouri
• Te whakaekenga o te ngakau
• Te pikinga o te taumaha
• Ngā raruraru mahara, ngā uauatanga rānei ki te arotahi
• Te toto toto tiketike, te cholesterol tiketike rānei
• Ngā wheua whati
• Te mate huka momo 2, te mate huka o mua, te mate huka nohopuku ngoikore rānei

Ki te kore e rongoatia, ka taea e te mate a Cushing te arahi ki te mate.

He aha ngā take o te Cushing Syndrome?

Ko te mate a Cushing te take o te nui o te cortisol i roto i te tinana. He maha ngā take pea:

• Te Whakamahinga o ngā Rongoā Glucocorticoid: Ka whakamahia ngā rongoā Glucocorticoid (hei tauira, te prednisone) hei rongoā i te mate huango mau tonu, te mate rumatiki, te lupus, te sarcoidosis, me te maha atu o ngā mate pūnaha ārai mate e puta ai te mumura mau tonu. Mēnā ka roa te tango i ēnei rongoā, ka puta pea te "iatrogenic" te mate Cushing exogenous rānei. Ko te tikanga o te kupu "iatrogenic" he mea kē atu i puta mai i tētahi maimoatanga hauora.
• Ngā pukupuku pituitary: Ko te mate Cushing ( haunga te mate Cushing iatrogenic) ka puta mai i ngā pukupuku pituitary e whakaputa nui ana i te ACTH, he homoni e kī ana ki ngā repe adrenal kia whakaputa cortisol, ā, e 8 i roto i te 10 tāngata ka pāngia. Ka kiia tēnei momo mate Cushing.
• Ngā pukupuku adrenal cortex: Ka taea e te pukupuku e tupu ana i runga i te repe adrenal te whakaputa i te nui rawa o te cortisol. He pukupuku pai ēnei i te nuinga o te wā. Heoi, i ētahi wā ka taea e tēnei pukupuku te noho hei carcinoma adrenal cortical, he momo matepukupuku adrenal tino onge.
• Ngā pukupuku o te pūkahukahu, te repe taiaki, te tairoi me te taimus: Ina puta te ACTH i ngā pukupuku i waho o te repe pituitary, ka kiia ko te mate ACTH ectopic. He pukupuku kino ēnei i te nuinga o te wā. Ko te mea tino noa ko te mate pukupuku pūkahukahu pūtau iti.

He mate tuku iho te mate Cushing?

I te nuinga o te wā, kāore . Ko te nuinga o ngā mate o te Cushing's syndrome ehara i te mea tuku iho.

He aha ngā tohu o te Cushing Syndrome?

Haunga ngā tohu e pā ana ki te mate Cushing, kei reira anō ētahi tohu e pā ana ki ngā mate maha atu. Kāore e rite ngā tohu o te katoa. Koinei ngā tohu ka puta pea:

• Te pikinga tere o te taumaha i te mata (e kiia ana tēnei e ētahi he "moon face"), te puku, te tuara o te kaki (e kiia ana tēnei e ētahi he "buffalo pump"), me te uma.
• He kanohi whero, porotaka.
• He roa te wā e ora ai ngā patunga.
• Te toto toto tiketike (te toto toto tiketike).
• Te tupu nui o ngā huruhuru i te mata, te kaki, te uma, te puku, ngā ū, me ngā huha, te ngaro rānei o te huruhuru (pakira).
• Mate huka.

Ko ētahi atu tohu pea ko:

• Te putanga mai o ngā tohu totoro papura i te puku.
• Te ngawari o te whara o ngā ringa me ngā waewae.
• Te ngoikore whānui me te ngenge.
• Te tirohanga pōuri me te whanoke.
• Te ngoikore o te uaua me te ngenge o ngā peka.
• Ngā huringa o te libido me te ngoikore o te ure i roto i ngā tāne.
• Te ngoikore o te tipu o ngā tamariki.

Kia pēhea te roa o te mate Cushing Syndrome?

Ko te roa o te mate Cushing e whakawhirinaki ana ki te āhua o tō urupare ki te maimoatanga. Ko te nuinga o te hunga he nui te taumata cortisol (hypercortisolism) ka ora i muri i ētahi wiki o te maimoatanga.

Ka pāngia rānei koe e te uauatanga o te manawa e te mate Cushing?

Kāore.Ehara te poto o te manawa i te tohu matua o te mate a Cushing.

Ka puta te osteoporosis i te Cushing Syndrome?

Āe. Ka ngoikore pea ngā wheua i te mate a Cushing. Ka whati pea ngā wheua, inā koa mēnā kua roa koe e pāngia ana e te mate. Ka mamae anō hoki ngā wheua ngoikore.

Ka puta te hypokalemia i te Cushing Syndrome?

Ko te hypokalemia he āhuatanga e iti ai te taumata o te pāhare pāporo i roto i tō toto. Ka puta pea tēnei āhuatanga mēnā kei a koe te mate Cushing.

Me pēhea te tautuhi i te mate Cushing?

Mena kei te whakapae tō tākuta he nui ngā taumata cortisol (hypercortisolism), tera ētahi aratohu ka whaihia e rātou. Ka pātai rātou, ka tangohia tō hītori hauora, ka tirotirohia tō tinana, kātahi ka tonoa ētahi whakamātautau taiwhanga. Tērā pea ka aroturukihia koe e rātou mō tētahi wā.

He uaua pea te tautuhi i te mate Cushing i ētahi wā . Ki te kōrero koe ki tō tākuta kei te ngenge koe, kei te piki haere hoki tō taumaha, tērā pea kāore rātou e whakaaro tonu ki te mate Cushing. Nā te mea he rite tonu ēnei tohu ki ngā mate maha.

Waihoki, ka taea te whakapoauau i te mate a Cushing ki te mate ovary polycystic , te mate metabolic rānei. Me whakakore e tō tākuta ētahi atu mate hei whakatau i te mate.

He aha ngā whakamātautau e mahia ana hei tautuhi i te mate Cushing Syndrome?

Tērā pea ka whakahaerehia e tō tākuta ētahi o ēnei whakamātautau:

• Whakamātautau cortisol mimi 24-hāora: Ka ine tēnei whakamātautau i te nui o te cortisol i roto i tō mimi i roto i ngā maikorokaramu (mcg). Ka tono tō tākuta kia kohia e koe tō mimi mō te wā 24-hāora.
• Whakamātautau cortisol huware waenganui pō: I te nuinga o te wā, he tino iti ngā taumata cortisol i te pō. Ka tirohia e tēnei whakamātautau ngā taumata cortisol i waenga i te 11 me te 12 i te ata. Mena kei a koe te mate a Cushing, ka tino teitei rawa ō taumata cortisol i taua wā.
• Whakamātautau pehi dexamethasone horopeta iti:He rongoā rite te Dexamethasone ki te cortisol. Mō tēnei whakamātautau, ka tangohia e koe te kotahi milligram (mg) o tēnei rongoā mā te waha i te pō, kātahi ka inehia ō taumata cortisol i waenga i te 8 me te 9 i te ata. Ka tirohia e tēnei whakamātautau toto mēnā kua aro mai ō repe adrenal ki te dexamethasone mā te whakaiti i te nui o te cortisol e tukuna ana e rātou. Mena kei a koe te mate Cushing, ka teitei ō taumata cortisol.
• Whakamātautau toto: Ka ine te whakamātautau toto i te taumata o te ACTH i roto i tō toto. Mena he iti te taumata o te ACTH, tera pea he pukupuku adrenal tōu. Mena he noa, he teitei rānei te taumata, tera pea he pukupuku pituitary tōu, he pukupuku ectopic rānei.
• Whakamātautau pehi dexamethasone horopeta teitei: He rite tēnei ki te whakamātautau pehi dexamethasone horopeta iti, engari ko te horopeta he 8 mirikaramu kaua ki te 1. Ko te tikanga ka mahia tēnei whakamātautau i muri i te whakaaturanga o te whakamātautau horopeta iti i ngā taumata cortisol teitei i te ata, ā, ko ngā whakamātautau toto e whakaatu ana i ngā taumata ACTH teitei i roto i te toto. Ka taea e tēnei whakamātautau te āwhina i te kimi i te pūtake o te mate Cushing. Ka taea e ia te āwhina ki te wehewehe i waenga i te pituitary adenoma (e mōhiotia ana ko te mate Cushing) me te pukupuku i ētahi atu wāhi o tō tinana (pērā i roto i ngā pukahukahu).

Kia whakaūtia e tō tākuta kei a koe te mate Cushing, ko te mahi e whai ake nei ko te kimi i te take o te mate. I te nuinga o te wā, he rongoā, he pukupuku rānei. Mena kei te tango koe i ngā glucocorticoids, koinei pea te take, nō reira ka whakaitihia pea e tō tākuta tō horopeta. Mena kāore koe e tango ana i ngā glucocorticoids, tera pea he tohu kei roto i ō repe adrenal, i tō repe pituitary, i tētahi atu wāhi rānei. Ka tūtohu pea tō tākuta i ngā rangahau whakaahua pēnei i ēnei hei āwhina i te kimi i te pukupuku:

• Matawai CAT (matawai CT) te MRI puku rānei: Tērā pea ka whakahaerehia e tō tākuta he matawai CT, he MRI rānei hei tirotiro mēnā he pukupuku kei roto i ō repe adrenal. Ka taea te mahi i ēnei matawai me te whakamahi, me te kore rānei i te whakamāmā i roto i te uaua (whakamāmā IV). He tino tairongo ēnei whakamātautau mō te kimi i ngā pukupuku adrenal.
• Whakaahua aukume (MRI) o te pituitary:Ka tangohia he whakaahua o tō repe pituitary mā te MRI hei rapu i tētahi pukupuku. I ētahi wā, ehara te MRI i te tātaritanga tino tika. Tata ki te 50% o te hunga e pāngia ana e te mate Cushing he MRI "noa", ko te 10% pea he pukupuku kāore e pā ana ki te mate.
• Te tango tauira i ngā ihu petrosal raro rua (BIPPS): Ka kitea e tēnei whakamātautau te pūtake o te ACTH. Ka tukuna te ACTH me ētahi atu homoni pituitary mai i te repe pituitary ki roto i te toto. Ka whakahaerehia tēnei whakamātautau e tētahi tohunga hihi-X mā roto i ngā uaua e rua e kiia nei ko ngā ihu petrosal raro. Ko te reiti tika o tēnei whakamātautau kei waenga i te 95% me te 98%.
• Matawai CT o te uma: Mena kei te whakapae tō tākuta he pukupuku ectopic, ka tono pea rātou i tētahi matawai CT o te uma hei tirotiro mō te mate pukupuku pūkahukahu pea.

Me pēhea te rongoā i te Mate Cushing?

Ko te momo maimoatanga e whakawhirinaki ana ki te pūtake o ngā taumata cortisol teitei. Mena kei te tango koe i ngā glucocorticoids, tera pea ka whakaitihia e tō tākuta tō horopeta, ka tohua rānei he rongoā ehara i te glucocorticoid.

Mena he pukupuku te take o te mate a Cushing, ka tūtohu pea tō tākuta i te pokanga, i te rongoā irahiko rānei.

Ko tētahi atu kōwhiringa ko te tuku rongoā ki tō tākuta hei whakaiti i te hanga cortisol, pērā i te ketoconazole. Me mahi tahi pea koe me ētahi tākuta rerekē hei rongoā i te pukupuku me ngā tohu o te mate Cushing.

• Te rongoā matū: Mena he mate pukupuku te pukupuku, ā, kua horapa ki ētahi atu wāhanga o te tinana, me rongoā pea te rongoā matū. Me kōrero ki tō tākuta mō ngā pānga taha.
• Ngā Rongoā: Te tāpiri i ngā rongoā hei whakaiti i te cortisol, te tango rānei i ngā rongoā ka pā mai ai te Cushing's Syndrome.
• Irahiko: Kāore pea e taea te tango i te pukupuku pituitary mā te pokanga. I roto i ēnei āhuatanga, me whai pea koe i te ono wiki o te rongoā irahiko. Tērā pea ka roa ngā tau ka hoki anō ngā taumata cortisol ki te āhua noa. Kōrero ki tō tākuta mō ngā pānga taha katoa.
• Pokanga:He angitu te tango pokanga i ngā pukupuku pituitary, ngā pukupuku adrenal, me ngā pukupuku ectopic, engari me urutau koe ki ngā taumata cortisol hou, iti iho. I tēnei wā, me tango pea koe i te rongoā cortisol i roto i te ahua o ngā pire hydrocortisone. Ka taea e koe te whakamutu i te tango i tēnei rongoā i muri i te 6 ki te 18 marama. I te nuinga o te wā, i muri i te pokanga laparoscopic, ka taea e koe te wehe atu i te hōhipera i roto i te rā, i ngā rā e rua rānei.

Ki te tika te rongoā mō te mate Cushing, ka roa pea te wā e rua ki te tekau mā waru marama hei whakaora. Me noho tata tonu ki tō tākuta i tēnei wā, me tua atu hoki.

He aha ngā mea ka taea e au te tumanako mēnā kei a au te Cushing Syndrome?

Ka taea e tō tākuta te rongoā i te mate Cushing, ā, me rongoā anō hoki. Ki te kore e rongoatia, ka mate pea. Tirohia he tākuta i te wā e taea ai hei matapaki i ō tohumate me tō tākuta.

Ka taea te kino haere te mate Cushing?

Ka kino haere pea te mate Cushing mēnā kāore e rongoatia tika. Me whakapā atu ki tō tākuta, me te whakamōhio atu ki a ia mō ngā tohu hou, ngā tohu kino, me ētahi atu raruraru rānei.

Me pēhea te whakaiti, te ārai rānei i te mōrearea o te Cushing Syndrome?

E hiahia ana tō tinana ki te cortisol i ngā wā katoa. Me whai koe i tēnei hei pupuri i tō kaha. Ka whakahaere i tō manawa, ka huri i te kai e kainga ana e koe hei pūngao, ka whakahaere i ō taumata huka toto, ka āwhina i a koe ki te whakatau i te ahotea, ā, he nui atu ngā mahi ka mahia. Ehara te cortisol i te hoariri o tō tinana, engari kāore e pai te nui rawa. Heoi, kāore e taea e koe te ora me te kore cortisol.

Mena kei te tango koe i ngā glucocorticoids, i ngā steroids rānei, me tirotiro tata e tō tākuta ō taumata cortisol. Engari, kāore he huarahi hei ārai i te mate pukupuku kei puta ai te mate Cushing (hypercortisolism).

He aha te āhua o te noho tahi me te Mate Cushing?

He uaua te noho me te mate Cushing, engari kāore e tika kia waiho hei mate morearea. He tākuta kua whakangungua hei āwhina i a koe, ā, he maimoatanga anō hoki. Ko te tikanga ka taea e ēnei maimoatanga te whakaora i te mate Cushing me te whakapai ake i ngā tohu o ngā taumata cortisol teitei (hypercortisolism).

Ka pāngia koe e ētahi raruraru kare ā-roto me ngā raruraru pāpori nā te mate Cushing. Tērā pea ka whakama ētahi tāngata i te ngaronga o te makawe, te tupu nui o te makawe, me/te pikinga taumaha rānei i te mata me te tuara o te kaki. Mā te "mata marama" me te "puku o te buffalo" ka whakaaroaro rua koe mō te whai wāhi atu ki ngā huihuinga pāpori. I roto i te wā, ka āwhina te maimoatanga ki te whakapai ake i ēnei tohu. Ka taea hoki e te mate Cushing te whakararu i te pouri me ētahi atu mate hinengaro. Mēnā e tika ana, tirohia he kaiwhakaora hinengaro mō te tohutohu me te tohunga hinengaro mō te rongoā hei āwhina i a koe ki te whakatau i ngā pānga kare ā-roto o ngā taumata cortisol teitei (hypercortisolism).

Āhea ahau me toro atu ki te tākuta?

Tirohia te tākuta mēnā kei a koe ētahi o ēnei tohu o te mate Cushing:

Ngā tohu e pā ana ki ngā wāhine:

• Te tupu o ngā huruhuru kanohi hou, nui rawa rānei.
• Te huringa o te hiahia moepuku.
• Te huringa o te huringa paheketanga.

Ngā tohu e pā ana ki te katoa:

• Te pikinga tere o te taumaha i te mata (e kiia ana tēnei e ētahi he "moon face"), te puku, te tuara o te kaki (e kiia ana tēnei e ētahi he "buffalo pump"), me te uma.
• He kanohi whero, porotaka.
• Te toto toto tiketike (te toto toto tiketike).
• Te tupu nui o ngā huruhuru i te mata, te kaki, te uma, te puku, me ngā huha.
• Mate huka.
• He hakihaki hou, he hakihaki nui rānei.
• Te putanga mai o ngā tohu totoro papura i te puku.
• Te ngawari o te whara o ngā ringa me ngā waewae.
• Te ngoikore whānui me te ngenge.
• Te tirohanga pōuri me te whanoke.
• He roa te wā e ora ai ngā patunga.
• Te ngoikore o te uaua.

He aha ngā pātai me pātai atu e au ki taku tākuta?

• He aha ngā rongoā ka taea e au te tango hei āwhina i taku mate Cushing?
• He mahi whakakori tinana kei reira hei āwhina i ōku uaua ngoikore?
• He rongoā kei reira hei āwhina i te tango i ngā tohu totoro?
• Me toro atu ahau ki tētahi tohunga mō te Cushing Syndrome?
• Me mutu taku tango i tētahi o ngā rongoā e tangohia ana e au i tēnei wā?
• He aha te maimoatanga pai rawa atu mōku?
• He aha atu anō ngā mahi ārai mate hei mahi māku?

He uaua te rongoā i te mate Cushing. Ka ngoikore pea, ka nui te toto toto, ka ngenge hoki. He uaua pea ngā maimoatanga pēnei i te pokanga, te rongoā, te rongoā irahiko, me te chemotherapy. Engari he pai te hua, nā te mea mā te maimoatanga tika, ka taea te whakaora i te mate Cushing.

Whakarāpopototanga (Karere hei tango ki te kāinga)

Ko te Cushing's Syndrome he mate e puta mai ana i te pikinga o te homoni cortisol i roto i te tinana. He ahua onge tēnei, engariKi te tika te tātaritanga me te rongoā, ka taea te whakaora . He mea nui kia rapu tohutohu hauora mēnā kei a koe ngā tohu pēnei i te pupuhi o te kanohi, te taumaha, te tupu nui o te huruhuru, te toto toto tiketike rānei. He rerekē ngā kōwhiringa maimoatanga i runga i te take. Nō reira, kōrero ki tō tākuta mō ngā mea katoa, ā, whai i āna tohutohu. Kia mahara, kāore koe i te mokemoke, ā, kei te wātea te āwhina.

Te Mate a Cushing, cortisol, homoni, repe adrenal, repe pituitary, ACTH, tohu, maimoatanga, endocrinologist