Kei te tere rawa te tipu o tāu tamaiti? Me ako tātou mō te rahinga nui!

I ētahi wā ka tere rawa te tipu o ā tātou tamariki, kāore? Engari ehara i te mea noa kia tere ake te tipu o rātou i ētahi atu tamariki, me te nui ake o ō rātou waewae. Ko te take pea o tēnei he mate tino onge. I tēnei rā ka kōrero tātou mō tēnei mate, arā, ko te 'Gigantism'.

He aha te 'Gigantengism'?

He whakarāpopototanga noa iho, he āhuatanga onge te gigantism e nui rawa ai te homoni tipu (GH) e whakaputaina ana e te tamaiti, e te taiohi rānei. Koinei te take e roa ake ai te tipu o ēnei tamariki i ētahi atu. I te nuinga o te wā, ka whakaputaina tēnei homoni tipu (GH) e tētahi repe iti, rite ki te pī, kei te pūtake o tō tātou roro. Ka kiia ko te repe pituitary. Heoi, ki te puta he pukupuku iti i roto i tēnei repe pituitary, ka taea e ia te whakaputa i te homoni tipu (GH) nui atu i te mea e hiahiatia ana. Ko te wā tēnā ka puta ai te gigantism.

He repe iti te Repe Pituitary kei te pūtake o te roro, i raro i te Hypothalamus. E waru pea ngā homoni ka tukuna e ia. Ko te Homoni Tipu (GH) tētahi o aua homoni.

He mea nui te Homoni Tipu, e mōhiotia ana ko te Homoni Tipu Tangata (hGH), mō te tipu o ngā tamariki. Ka pā ki ngā wāhanga maha o te tinana, ā, ka āwhina i te tamaiti kia tipu tika. Heoi, kei roto i ō tātou wheua ētahi momo pereti tipu e kiia nei ko ngā Epiphyses/Growth Plates, ā, ina kati rawatia (arā, i muri i te pakeketanga), kāore te homoni tipu (GH) e whakanui ake i te teitei. Ko tāna mahi he pupuri i te hanganga me te pākia o ngā wheua, te kiriuhi, me ētahi atu okana. He hononga tata tēnei homoni tipu (GH) ki tētahi homoni e kiia nei ko te Insulin-like Growth Factor 1 (IGF1), e hangaia ana e tō tātou ate. Ka āwhina ngātahi ēnei e rua i te tipu me te pākia o te tinana.

Ko te gigantism he āhuatanga e nui rawa ai te homoni tipu (GH) e whakaputaina ana e te tinana, ka tere ai te tipu o ngā uaua, ngā wheua, me ngā kiko honohono. Ka hua ake tēnei i te teitei rerekē me ētahi huringa i roto i ngā kiko ngohengohe o te tinana. Ki te kore e rongoatia, ka taea e ētahi tāngata e pāngia ana e te gigantism te tipu ki te neke atu i te 8 putu te teitei.

Nō reira, he mea tino nui kia tātaritatia te mate, kia tīmata wawe tonu te maimoatanga i roto i ngā take o te gigantism.

He aha te rerekētanga i waenga i te 'Gigantism' me te 'Acromegaly'?

Ko te gigantism me te acromegaly he mate e puta mai ana i te nui rawa o te homoni tipu (GH). Ko te rerekētanga kei te tangata e pāngia ana. Ka puta te acromegaly i roto i ngā pakeke. Ka puta te gigantism i roto i ngā tamariki me ngā taiohi e tipu tonu ana, arā, kāore anō kia eke ki te pakeketanga.

I te whakarapopototanga, ka puta te gigantism ina piki ake ngā taumata o te homoni tipu (GH) i mua i te kati o ngā pereti tipu i roto i ngā wheua o ngā tamariki (arā, i mua i te mutunga o te pakeketanga).

Ki te piki ake ngā taumata o tō homoni tipu (GH) i muri i te katinga o ō pereti tipu, ka puta te acromegaly. Kāore koe e tipu roa, engari ka pā te nui o te GH ki te āhua o ō wheua, te rahi o ō whekau, me ētahi atu āhuatanga hauora.

He tino onge te mate gigantism i te acromegaly.

Ko wai ka pāngia e te gigantism? He pēhea te noa o tēnei?

Ahakoa he tino onge tēnei āhuatanga, ka taea e te gigantism te puta i roto i tētahi tamaiti kāore anō kia kati ōna pereti tipu (arā, kāore anō kia oti te pakeketanga). He nui ake te kitea i roto i ngā tama i ngā kōtiro.

He tino onge te mate nui rawa atu. Hei tauira, tata ki te 100 noa iho ngā keehi kua pūrongohia i te Hononga o Amerika tae noa mai ki tēnei wā. Nō reira, ka taea e koe te whakaaro he aha te onge o tēnei mate.

He aha te rerekētanga o te tipu noa o ngā tamariki i te gigantism?

Ko te homoni tipu (GH) te mea e whakahaere ana i te tipu i te wā tamarikitanga. Arā, e whakahaere ana i te pākia o te tinana, me te whakatupu i te tipu ka taea te ine i roto i ngā wheua, ngā uaua, me ngā kiko. I te nuinga o te wā, he tukanga pumau te tipu tae noa ki te pakeketanga o te tamaiti.

I te wā o te pakeketanga, ka tino piki ake te whakaputanga o ngā homoni ira tangata (te estrogen me te testosterone). Mā tēnei ka āta kati ngā epiphyses (ngā pereti tipu) i ngā pito o ngā wheua roa o te tamaiti. Ina kati katoa ngā epiphyses, arā, ina oti te pakeketanga, ka mutu te tipu teitei.

Ko te tere o te tipu o te tamaiti me tōna teitei whakamutunga i muri i te pakeketanga ka whakatauhia e te huinga o ngā ira maha i riro mai i ō rātou mātua, ngā āhuatanga taiao, me te ira tangata.

Mēnā he nui te rahi o te tinana, ka tere te tipu o te tamaiti, ā, he roa ake i ētahi atu tamariki o te tau me te ira tangata. Heoi, i te tīmatanga, ka rite ngā tohu o te nui o te tinana ki te tere tipu noa o te tamarikitanga, ā, ka uaua ki ngā mātua te kite.

Mena he pātai, he āwangawanga rānei āu mō te tere o te tipu o tāu tamaiti, me kōrero ki tā rātou tākuta.

He aha ngā tohu o te gigantism?

Ko te nui rawa o te homoni tipu (GH) ka puta mai i te gigantism. Waihoki, ka taea e te pukupuku i roto i te repe pituitary te pēhi i te roro me te kiko io e tata ana, ka puta ai ētahi tohu. Ko te tohu matua o te gigantism ko te tipu nui rawa.Ka tere rawa te tipu o ngā tamariki e pāngia ana e te gigantism.

Haunga te roa rawa atu/rahi atu i tōna tau, ko ngā āhuatanga ā-tinana e kitea ana i te gigantism ko:

• He rae tino pū ake, me te kauae tino pū ake.
• He āputa i waenganui i ngā niho.
• Te matotoru o ngā āhuatanga o te mata.
• He nui ngā ringaringa me ngā waewae, me ngā maihao matotoru.

Ko ētahi atu tohu ka kitea pea ko:

• Te whakanui ake i ngā whekau o roto, inā koa te ngākau o te tamaiti.
• Te werawera nui (hyperhidrosis).
• Te tirohanga takirua, te uaua rānei ki te tirohanga taha.
• Te mamae o te upoko.
• Mamae hononga.
• Te pakeketanga kua roa.
• Te paheketanga koretake.
• Ngā raruraru moe, hei tauira, te mate moe pōrearea.
• Te ngoikore o te uaua.

Mena kei tō tamaiti ēnei tohu, he mea tino nui kia kōrero wawe tonu koe ki te tākuta.

He aha ngā take o te gigantism?

He maha ngā wā ka puta te gigantism i te pukupuku pai (adenoma pituitary) i roto i te repe pituitary o te tamaiti. Ka nui rawa te tukunga o te homoni tipu (GH) i tēnei. Ina kitea he gigantism ngā tamariki, he nui tonu te adenoma pituitary (he pukupuku 10 mm te rahi, nui ake rānei), e kiia nei ko te macroadenoma. Ka taea hoki te puta te gigantism i te whakanuinga o te repe pituitary, e kiia nei ko te pituitary hyperplasia.

He maha ngā tamariki e pāngia ana e te gigantism he whakarerekētanga ira e puta ai he pukupuku pituitary. Ko te whakarerekētanga ira e pā ana ki te gigantism ko te whakarerekētanga, te mukunga rānei o te ira AIP. E pāngia ana tēnei e te 29% o te hunga e pāngia ana e te gigantism.

Ka puta anō hoki te gigantism hei wāhanga o ētahi mate ira tino onge e whakanui ana i te mōrearea o te whakawhanake i te pukupuku pituitary e whakaputa ana i te homoni tipu (GH). Ko ētahi o ēnei mate ko:

• Carney complex: He āhuatanga ira tēnei e pā ana ki te tae kiri, ā, ka puta he pukupuku pai o te kiri, te ngākau, me te pūnaha endocrine. Tata ki te 10% ki te 13% o te hunga whai Carney complex ka whanakehia he adenomas pituitary e whakaputa ana i te homoni tipu (GH), e tipu puhoi ana i te nuinga o te wā.
• Te mate McCune-Albright:He mate ira tēnei e pā ana ki ngā wheua, te kiri, me te pūnaha endocrine. Ka puta he ira café-au-lait i runga i te kiri, he kiko whara i roto i ngā wheua, me te pakeketanga wawe. E 20% ki te 30% o te hunga whai mate McCune-Albright he nui rawa te homoni tipu (GH). He maha ngā wā ka puta mai tēnei i te whakanui (hyperplasia) o te repe pituitary, i te pituitary adenoma rānei.
• Ngā momo mate endocrine maha (MEN) momo 1, momo 4 rānei: He mate ira ēnei. I tēnei wā, ka kaha rawa te mahi a tētahi, ētahi rānei o ō repe endocrine, ka puta rānei he pukupuku. Kei roto pea i tēnei he pukupuku pituitary e whakaputa ana i te homoni tipu (GH).
• Neurofibromatosis: He mate ira tēnei e kiia nei ko ngā mate neurocutaneous. Ka pāngia te kiri me te pūnaha io e ēnei mate. Ka puta ēnei mate i te pikinga rerekē o te tipu pūtau. Ka taea e tēnei te arahi ki te hanganga o ngā pukupuku puta noa i te tinana. Kei roto pea i ēnei he pukupuku e whakaputa ana i te homoni tipu (GH).
• Ngā Adenoma Pituitary Motuhake ā-Whānau (FIPA): He āhuatanga tuku iho tēnei. Kei roto ko te whanaketanga o ngā adenoma pituitary. Kei roto pea i ēnei ko ngā adenoma e whakaputa ana i te homoni tipu (GH).

Me pēhea te tautuhi i te gigantism?

He uaua te tautuhi i te kapia nui nā te mea he tino onge te mate, ā, nā te mea ka rerekē te tere tipu o ngā tamariki nā ngā āhuatanga ira me te taiao.

Ko te tikanga, ka whakapae ngā tākuta he nui rawa te rahi o te tinana ina e toru ngā paerewa rerekētanga teitei ake o te teitei o te tamaiti i te teitei toharite mō tōna ira tangata me tōna tau, e rua rānei ngā paerewa rerekētanga teitei ake i te teitei toharite i tatauhia mai i ngā teitei o ngā mātua o te tamaiti.

Ki te whakapae te tākuta o tāu tamaiti he gigantism tāu tamaiti, tera pea ka tukuna koe e ia ki tētahi endocrinologist (he tākuta e tohunga ana ki ngā mate e pā ana ki ngā homoni). Ka whakatauhia e te tākuta he tātaritanga i runga i te hītori hauora o tāu tamaiti, te hītori hauora whānau, te whakamātautau tinana whānui, me ngā whakamātautau motuhake pēnei i ngā whakamātautau toto me ngā whakamātautau whakaahua.

He aha ngā whakamātautau e whakamahia ana hei tautuhi i te gigantism?

Mena kei te whakapae te tākuta o tāu tamaiti he gigantism tōna, ka taea te whakahaere i ngā whakamātautau e whai ake nei hei whakaū i te mate:

• Ngā whakamātautau toto mō te Homoni Tipu me te IGF-1 (Insulin-like Growth Factor 1): Ka ine ēnei whakamātautau i ngā taumata o ngā homoni rerekē i roto i te tauira toto i tangohia mai i te uaua o te tamaiti. Mena he teitei ake ngā taumata i te tikanga, he tohu pea tēnei o te gigantism.
• Whakamātautau Manawanui Huka: Ka ine tēnei whakamātautau i te pai o te urupare a ngā taumata homoni tipu o te tamaiti ki te huka. Mō tēnei whakamātautau, ka tangohia e te tākuta he tauira toto mai i te uaua i ngā wā rerekē i muri i te inu a te tamaiti i te otinga huka (huka).
• Ngā whakamātautau whakaahua: Mena ka whakaūtia e ngā whakamātautau toto he gigantism tō tamaiti, ka tūtohu pinepine tō tākuta i tētahi matawai MRI (Magnetic Resonance Imaging) i tētahi matawai CT (Computed Tomography) rānei. Ka taea e ēnei te kite mārama i te rahi me te wāhi o te pukupuku pituitary. Ka taea hoki e rātou te āwhina ki te whakatau i te maimoatanga tika e hiahiatia ana.

Mena kua tāpaetia tō tamaiti he gigantism, ka whakahaerehia pea e te tākuta ētahi atu whakamātautau hei tirotiro mēnā kua pāngia ētahi atu wāhanga o te tinana e te mate. Kei roto i ēnei whakamātautau ko:

• He echocardiogram hei tirotiro i ngā raruraru o te ngākau.
• Ngā whakamātautau moe hei tirotiro mēnā kei te pāngia koe e te mate moe pōrearea.
• Ngā hihi-X, he matawai DEXA/DXA rānei hei tirotiro i te hauora o ō wheua.

Me pēhea te rongoā i te gigantism?

Ko ngā whāinga matua o te maimoatanga o te gigantism ko:

• Te whakahaere haumaru i ngā taumata o te 'hormone tipu' (GH) me te 'insulin-like growth factor 1' (IGF1).
• Te whakahaere i te tipu o te 'puku pituitary'.
• Te whakaiti i te pānga o te pukupuku pituitary ki te kiko roro e tata ana me te io whatu.
• Te rongoā, te whakaiti rānei i ngā pānga o te homoni tipu (GH) ki ētahi atu pūnaha tinana.

He maha ngā maimoatanga e whakamahia ana e ngā tākuta mō te nunui o te kiri , ko te pokanga me te rongoā irahiko ngā maimoatanga matua.

Ahakoa he rongoā whai hua hei rongoā i te nui rawa o te homoni tipu (GH) i roto i ngā pakeke (acromegaly), kāore anō kia tino rangahaua ngā pānga o ēnei rongoā ki ngā tamariki.

Pokanga mō te Gigantism

Ko te pokanga te rongoā tino noa mō te gigantism. Ko te whāinga he tango i te pukupuku pituitary, he whakaiti rānei i tōna rahi. Nā te mea he nui te pukupuku pituitary e puta ai te gigantism, me maha ngā pokanga e hiahiatia ana mō te tamaiti kia pai ai te whakahaere i ngā taumata o te homoni tipu (GH).

Tērā pea ka whakamahia e te taote pokanga o tāu tamaiti tētahi tikanga pokanga e kīia nei ko te pokanga transsphenoidal hei tango i tētahi pukupuku pituitary. Ko tēnei ko te mahi i te pokanga mā te ihu o tāu tamaiti, mā te sphenoid sinus (he kōhao i roto i te angaanga i muri i te kōhao ihu, i raro i te roro).

Te Whakaora Irahiko mō te Gigantism

Ki te kore e taea e te pokanga te whakaiti i ngā taumata o te homoni tipu, tera pea ka āwhina te rongoā irahiko. Kei roto i tēnei ko te whakamahi i ngā taputapu motuhake hei arotahi i ngā hihi irahiko ki te puku. He puhoi te mahi a tēnei maimoatanga. Tērā pea ka hiahiatia he maha ngā maimoatanga, me te roa o ngā wā okiokinga i waenganui. Tērā pea ka roa pea he maha ngā tau ka kitea ngā hua katoa.

He aha ngā raruraru o te maimoatanga?

Nā te pokanga me/ranei te rongoā irahiko, tata ki te 60% o te hunga e pāngia ana e te gigantism ka pāngia e te mate e kiia nei ko te hypopituitarism i muri i te maimoatanga. Koinei te wā ka iti te hanga o tētahi, ētahi, katoa rānei o ngā homoni e hangaia ana e te repe pituitary. Ka rongoatia te hypopituitarism ki ngā rongoā whakakapinga homoni.

Ko ngā raruraru ka puta mai i te pokanga hei tango i te pukupuku pituitary ko:

• Te toto.
• Te turuturu o te Wai Cerebrospinal (CSF).
• Te mate kiriuhi roro (meningitis).
• Te ngaronga o te konutai (tote) me te taurite wai i roto i te tinana.

Ko ngā pānga taha pea o te rongoā irahiko ko:

• Te Whakararuraru i te Huarahi Whakaputa.
• Te ngaronga o te tirohanga me te kino o te roro (he onge).
• Te hanganga o te pukupuku i muri i ētahi tau o te maimoatanga (he onge).

Ka taea te ārai i te kanuimaha? He aha te matapae?

Engari, kāore he mea ka taea e koe te mahi hei ārai i te nunui rawa o te tinana. Heoi, he mea nui te kite wawe. Ka taea e te maimoatanga wawe te āwhina ki te ārai, ki te whakakore rānei i ngā huringa e take ai te roa rawa o tāu tamaiti.

Ko te matapae mō ngā tamariki me ngā taiohi kua tātaitia ki te gigantism e whakawhirinaki ana ki ētahi āhuatanga:

• Te wawe, te mutunga rānei o te tautuhi i te mate.
• He pēhea te whai huatanga o ngā maimoatanga hei whakahaere i ngā taumata o te homoni tipu?
• Mena he raruraru e pā ana ki te gigantism.

I te nuinga o te wā, he nui ake ngā raruraru o te hunga kaumātua i te wā e kitea ai te mate i ērā i kitea i te wā taitamariki. Tērā pea nā te roa o te pānga ki te homoni tipu me te insulin-like growth factor 1 (IGF1) tēnei.

Nō reira, ki te kite koe i ngā huringa rerekē, ohorere rānei o te tipu me/ngā āhuatanga tinana rānei o tāu tamaiti, he mea nui kia kōrero wawe tonu koe ki tā rātou tākuta.

He aha te roanga o te oranga o te tangata e pāngia ana e te gigantism? He aha ngā raruraru mō te wā roa?

He mea nui te kitenga wawe me te rongoā i te gigantism hei ārai i te teitei rawa me ōna raruraru, ā, hei whakanui ake i te roa o te oranga.

Ki te kore e rongoatia, ka pāngia te kapia nui e ngā raruraru nui, ā, ka piki ake te maha o ngā mate i te nuinga o te wā.

Ko ngā raruraru roa e pā ana ki ētahi tāngata he nui rawa te rahi o te tinana nā te roa rawa me te pānga whānui o te nui rawa o te homoni tipu:

• Te uaua ki te neke haere (Nekenekehanga) nā te ngoikore o te uaua.
• Te mumura o ngā hononga (te mate wheua o te hononga).
• Te Neuropathy Peripheral (ngā mate o te io peripheral).
• 'Te mate moe'.
• Te nui haere o te ngākau (cardiomegaly) me ngā raruraru o te takirere ngākau.
• Ngā raruraru pākia o te pūnaha io pērā i te mate huka momo 2.

Hei tāpiritanga, ka taea te whakaiti i te kounga o te oranga o te hunga e pangia ana e te gigantism kāore i te rongoatia nā ngā raruraru o ngā mahi o ia rā pēnei i te hokohoko kākahu me te haereere nā te roa rawa.

Āhea koe me toro atu ki te tākuta o tāu tamaiti mō te gigantism?

Mena kua tāpaetia tāu tamaiti he mate nui rawa te tinana, me toro atu ia ki tā rātou tākuta, ki te tākuta endocrinologist rānei, kia aroturukihia ai te ahunga whakamua o te maimoatanga, kia tika ai hoki te taumata o ngā homoni.

Ki te kite koe i ētahi huringa o te tere tipu o tāu tamaiti, me/ranei ngā āhuatanga tinana, he mea nui kia kōrero wawe tonu ki te tākuta o tāu tamaiti. Ahakoa kāore pea te gigantism te take, he mea tika kia tirotirohia ngā huringa whakapae. Ko te mea pai ko te tautuhi wawe i te gigantism, ā, ko te hunga e pāngia ana e te gigantism he hunga ora hauora. Ki te mea he pātai āu mō te tipu o tāu tamaiti, kaua e wehi ki te pātai ki tō tākuta. Kei reira rātou hei āwhina i a koe.

Ngā mea tino nui hei maumahara (Karere hei kawe ki te kāinga)

He mate onge te rahinga nui o te tinana engari he mate kino pea. Ko te mea nui ko te rapu tohutohu hauora tonu mēnā ka kite koe i tētahi mea rerekē, whakapae rānei mō te whanaketanga o tāu tamaiti, pērā i te tere o te tipu teitei atu i te mea i whakaarohia, te nui ake rānei o ngā waewae.

Kia maumahara, mā te tātaritanga wawe me te maimoatanga ka nui ake te tūponotanga o tāu tamaiti kia ora hauora, kia ora noa. Kaua e manukanuka, kei reira ngā tākuta hei āwhina i a koe me tāu tamaiti. Kōrero ki a rātou mō ō āwangawanga katoa.

` Te nui o te rahi, te homoni tipu, te repe pituitary, te tipu o ngā tamariki, te pikinga o te teitei, te acromegaly