Kia ako tātou mō ētahi raruraru o te pūnaha repe o tō tinana? - Ngā Mate Pūkahukahu Endocrine Maha (MEN)

He rite tō tātou tinana ki tētahi mīhini whakamiharo, kāore? Kia tika ai te mahi a tēnei mīhini, me mahi tahi, me taurite hoki ia wāhanga. He pūnaha tino nui kei roto i tō tātou tinana, e kiia nei ko te pūnaha endocrine . Ko ngā repe o tēnei pūnaha ka whakaputa i ngā homoni e whakahaere ana i ngā mahi maha o roto i tō tātou tinana. Heoi, i ētahi wā ka hē te pūnaha nei. I tēnei rā ka kōrero tātou mō tētahi āhuatanga onge engari he tino nui hei mōhio. Koia te Multiple Endocrine Neoplasia , e mōhiotia ana ko te `(MEN)`.

Nā, he aha tēnei pūnaha endocrine?

Ki te whakarapopoto, ko tā tātou pūnaha endocrine he whatunga o ngā repe me ngā okana i roto i tō tātou tinana. Koinei ngā mea e whakaputa ana i ngā matū e kiia nei ko ngā homoni , ā, e tukuna ana ki roto i te toto. Whakaarohia ēnei homoni hei karere iti e kawe ana i ngā karere i roto i ō tātou tinana. Mā ēnei karere e tohutohu ō tātou okana, kiri, me ngā uaua ki te aha me mahi, me te wā hoki me mahi ai.

He maha ngā repe me ngā whekau matua o te pūnaha endocrine:

• Hypothalamus: Kei te pūtake o tō tātou roro tēnei. He maha ngā mea e whakahaeretia ana e ia i roto i te pūnaha endocrine.
• Te repe pituitary: Ko tēnei repe iti, e hono ana ki te hypothalamus, e whakaputa ana i ngā homoni e whakahaere ana i te maha atu o ngā repe, tae atu ki te repe thyroid, ngā repe adrenal, ngā ovaries, me ngā testicles.
• Tairoiti: Ko tēnei repe āhua pūrerehua kei mua o te kaki e whakahaere ana i te pākia o te tinana, koinei te whakamahinga o te pūngao mai i te kai e kainga ana e tātou.
• Ngā repe parathyroid: Ko ēnei repe iti e whā, e tata ana ki te repe tairoi, e whakahaere ana i ngā taumata o te konupūmā me te whākōkī i roto i tō tātou tinana.
• Ngā repe adrenal: Ko ēnei repe e rua, kei runga ake i ngā whatukuhu, e whakahaere ana i te pākia o te tinana, te toto totoka, te whanaketanga ā-ira tangata, me te urupare ki te ahotea.
• Repe pineal: Ka whakaputahia e tēnei repe te homoni melatonin hei whakahaere i tā tātou huringa moe.
• Te repeure: Koinei te wāhi e hangaia ai te insulin. He mea tino nui mō te pākia o te tinana me te whakahaere i te huka toto. He wāhanga anō hoki ia o tā tātou pūnaha nakunaku.
• Ngā whekau ovary: Koinei te wāhi e hangaia ai ngā homoni ira wahine, arā, te estrogen, te progesterone, me te testosterone.
• Ngā whakamātautau: I te wā e whakaputa ana te parāoa i roto i ngā tāne, ka whakaputahia hoki te homoni testosterone ki konei.

Nā, he aha te Multiple Endocrine Neoplasia (MEN)?

Ko te Multiple Endocrine Neoplasia (MEN) he mate ira onge e puta ai ngā pukupuku i roto i ngā repe me ngā kiko o te pūnaha endocrine, i kōrerotia i mua ake nei. I ētahi wā ka huri ēnei pukupuku hei matepukupuku.

E rua ngā momo matua o tēnei mate `(MEN)`:

1. Te maha o ngā pukupuku endocrine momo 1 (MEN momo 1): He āhuatanga tēnei e puta ai ngā pukupuku maha i roto i ngā repe rerekē o te pūnaha endocrine. Ka kiia hoki tēnei ko te MEN-1 me te mate a Wermer.

2. Te maha o ngā neoplasia endocrine momo 2 (MEN momo 2): He mate pukupuku ira tēnei e pā ana ki ētahi repe. Ka pāngia te hunga whai MEN2 e tētahi momo mate pukupuku tairoi e kiia nei ko te mate pukupuku tairoi medullary (MTC) . He nui ake hoki te tūponotanga o te whakawhanake i ngā pukupuku i roto i ētahi atu repe o te pūnaha endocrine. Ka kiia hoki tēnei ko te MEN-2 me te Sipple syndrome.

He aha i puta ai tēnei āhuatanga "(TĀNE)"?

Ko ēnei momo '(MEN)' e rua, e puta mai ana i ngā huringa o ō tātou ira , arā, ngā whakarerekētanga ira . Whakaarohia he rite ki tētahi pukapuka tohutohu kei roto i tō tātou tinana, arā, ngā ira. Mēnā he hē tētahi reta i roto i tēnei pukapuka tohutohu, arā, ki te whakarerekētia tētahi ira, ka taea te whakararuraru i ētahi o ngā mahi a te tinana.

• (momo MEN 1) ka puta mai i te whakarerekētanga ira i roto i te ira `MEN1` . Ko tēnei ira `MEN1` he ira pehi pukupuku . Arā, he ira e āwhina ana ki te whakahaere i te wehenga pūtau me te ārai i te hanganga o ngā pukupuku. Ki te kore tēnei ira e mahi tika, ka taea e ētahi pūtau te tipu haere i waho o te mana whakahaere, ka hanga pukupuku.
• (MEN momo 2) ka puta mai i te whakarerekētanga ira i roto i te ira `RET` . Ko tēnei ira `RET` he ira e pā ana ki te whanaketanga o te mate pukupuku. Ina whakarerekētia tēnei ira, ka tipu haere ngā pūtau i roto i ētahi okana me ngā repe, ā, ka puta he pukupuku.

Ka taea te tuku iho i ēnei whakarerekētanga ira mai i ngā mātua, ka taea rānei te puta noa i te wā e whanake ana te kukune i roto i te kōpū. Mena he MEN tō tētahi o ngā mātua, e 50% te tūponotanga ka pāngia te tamaiti e tēnei mate.

Kia ako tātou i ētahi atu kōrero mō te momo `(MEN)` (`MEN momo 1`)

Ka puta he pukupuku i roto i ētahi repe o te pūnaha endocrine i te hunga whai MEN momo 1. Ko ngā wāhi e tino pāngia ana ko:

• Ngā repe parathyroid: Koinei te mea tino noa.
• Te ara gastrointestinal pancreatic: Ko te tikanga ka taea e ngā pukupuku te puta i roto i te pancreas, te puku, me ētahi atu wāhanga o te pūnaha nakunaku, pērā i te duodenum.
• Te repe pituitary.

I te nuinga o te wā, ko ngā puku e puta mai ana me te MEN momo 1 ehara i te matepukupuku (pai) . Heoi, ko ētahi puku ka matepukupuku (kino).Ka taea hoki te horapa (metastasize) ki ētahi atu wāhanga o te tinana. Ko ngā repe he pukupuku kei roto, ka tukuna he nui rawa o te homoni ki roto i te toto. Koinei te take e puta ai ngā momo tohu me ngā raruraru hauora.

Neke atu i te 20 ngā momo pukupuku endocrine me ngā momo pukupuku kore-endocrine kua kitea e ngā tākuta i roto i te hunga whai MEN momo 1. Tērā atu anō ngā momo pukupuku kāore i te tino kitea, pērā i:

• Ngā pukupuku neuroendocrine e whanake ana i roto i te thymus (he kōpuku lymph i roto i te uma) me te bronchi (ngā ara manawa i roto i ngā pukahukahu).
• Ka puta ngā pukupuku adrenocortical i te paparanga o waho o ngā repe adrenal.
• Ngā puku momona (Lipomas) e puta ana i raro i te kiri.
• Te mate pukupuku o te ū.
• Ko ngā pukupuku pērā i te meningioma me te ependymoma ka puta i roto i te roro, i te taurakira rānei.

He aha ngā tohu o te `(MEN momo 1)`?

Ka rerekē ngā tohu o te momo MEN 1 i ia tangata, i ia tangata. Kei ngā repe e pāngia ana, me te nui o te homoni e whakaputaina ana e rātou. Tērā pea kāore he tohu o ētahi tāngata, ko ētahi he ngawari noa iho, ā, ko ētahi he kino rawa atu, he morearea hoki. Ka rerekē ngā tohu i ia tangata, i ia tangata, ahakoa i roto i te whānau kotahi, ahakoa i waenga i ngā māhanga.

Kia tirohia ētahi o ngā momo matua o ngā puku me ō rātou tohu e pā ana:

• Nā ngā raruraru o ngā repe parathyroid (hyperparathyroidism):

E 90% o te hunga whai `(MEN momo 1)` ka pāngia e tēnei mate i te 50 tau te pakeke. I roto i tēnei, ka kaha rawa te mahi a ngā repe parathyroid.

• Ngā tohu māmā: mamae hononga, ngoikore uaua, ngenge, pouri, uaua ki te arotahi, ngaro te hiahia kai.
• Ngā tohu kino: whakapairuaki, ruaki, pōhēhē, wareware, nui te matewai me te mimi pinepine, mate kōroke, mamae wheua.

• Nā ngā pukupuku i roto i te repeure me te wāhanga tuatahi o te whekau iti (Gastrinomas):

Tata ki te 40% o ngā pakeke whai MEN momo 1 ka pāngia e ngā pukupuku e kiia nei ko ngā gastrinoma. Ka puta he homoni e kiia nei ko te gastrin, ka nui rawa te waikawa e puta mai i te puku.

• Ngā Tohu: Mamae puku, korere, ngaungau (reflux waikawa), mate puku (mate peptic).
• Ko tētahi atu pukupuku e kitea ana i tēnei kāwai ko te insulinoma . Ka puta te insulin i tēnei, ka taea ai te whakaheke i te huka toto (hypoglycemia).
• Ngā Tohu: te pōhēhē, te wiri, te werawera, te hiakai nui, te manukanuka, te tere o te pā o te ngakau, ngā huringa tirohanga mō te wā poto.

• Nā ngā pukupuku pituitary (prolactinomas):

Tata ki te 25% o te hunga whai MEN momo 1 ka pāngia e ngā pukupuku pituitary. Ko ngā mea tino kitea ko ngā prolactinomas, e whakaputa ana i te homoni prolactin .

• Ngā tohu i roto i ngā wāhine: te koretake o te paheketanga, te mutu rānei o te paheketanga (amenorrhea), te uaua ki te hapu tamariki, te rere mai i ngā uma i te wā kāore i te hapu, i te whāngai u rānei (galactorrhea), te hekenga o te hiahia moepuku.
• Ngā tohu i roto i ngā tāne: Te hekenga o te hiahia moepuku nā te hekenga o ngā taumata testosterone, te ngoikore o te ure (ED), me te uaua ki te hapu tamariki.
• Mena he nui te puku: te ānini, te whakapairuaki/te ruaki, te panoni o te tirohanga (te tirohanga takirua, te heke o te tirohanga taha).

He mea nui: Ehara i te mea ka pāngia te katoa e ngā tohumate ōrite. Kāore tēnei rārangi i te katoa. He maha atu anō ngā momo puku ka puta i roto i te `(MEN momo 1)`.

Me ako anō hoki tātou mō te momo `(MEN)` 2 (`MEN momo 2`)

Ko te hunga katoa e pāngia ana e te MEN momo 2 ka pāngia e te momo matepukupuku tairoi e kiia nei ko te matepukupuku tairoi medullary (MTC) . Ka pāngia tēnei momo matepukupuku e tētahi momo pūtau motuhake i roto i te repe tairoi e kiia nei ko ngā pūtau C. Ka whakaputahia e ēnei pūtau he homoni e kiia nei ko te calcitonin. Ka horapa te MTC ki ngā kōpū lymph me ētahi atu okana. Ko te maimoatanga matua ko te tango pokanga i te repe tairoi (thyroidectomy).

Waihoki, ko te hunga whai `(MEN momo 2)` ka pāngia pea e tētahi, e rua rānei o ngā āhuatanga e whai ake nei:

• Pheochromocytoma: He pukupuku onge tēnei e tupu ana i te wāhanga waenga o tētahi, o ngā repe adrenal rānei e rua (adrenal medulla). I te nuinga o te wā, ehara ēnei i te matepukupuku. Tata ki te 10%-15% o ngā take ka huri hei matepukupuku ka horapa.
• Hyperparathyroidism: Ka piki ake ngā taumata konupūmā toto nā te nui rawa o te homoni parathyroid (PTH) e hangaia ana e ngā repe parathyroid.

He aha ngā tohu o te `(MEN momo 2)`?

He rerekē anō hoki ngā tohu i konei. Ko te nuinga o ngā tohu ka puta mai i ngā taumata tiketike o ngā homoni e whakaputaina ana e te mate pukupuku (MTC) me ētahi pukupuku.

• Ngā tohu o te mate pukupuku tairoi waenga (MTC):
• He puku kei mua o te kaki, he mamae te kaki, he rerekē te reo (he pāorooro), he maremare, he uaua ki te horomi, he uaua ki te manawa.

• Ngā tohu i puta mai i te Pheochromocytoma: (e puta ana i te 50% o ngā take)
• Ka puta noa ngā tohu ina nui rawa ngā homoni e whakaputaina ana e ēnei pukupuku, pērā i te adrenaline. Kāore ētahi pukupuku e whakaputa homoni, ā, kāore pea e whakaatu i tētahi tohu.
• Ngā tohu noa (he maha ngā wā ka haere mai, ka haere atu): te toto toto tiketike (te toto toto tiketike), te ānini, te werawera nui, kāore he take, te tere o te ngakau, te koretake rānei o te ngakau, te wiri.

• Ngā tohu e pā ana ki te hyperparathyroidism:
• Pērā i te `(MEN momo 1)`, ka puta pea ngā tohu pēnei i te mamae o ngā hononga, te ngoikore o te uaua, te ngenge, te pouri, te uaua ki te arotahi, te kore hiahia kai, te whakapairuaki, te ruaki, te matewai nui me te mimi pinepine, te mate kōroke, me te mamae o te wheua.

Ko wai ka pāngia e tēnei mate `(MEN)`? He aha te auau o tēnei mate?

Ka pāngia ngā tāne me ngā wāhine e te mate `(MEN)`. He rerekē te tau e puta ai te mate `(MEN momo 1)`. Kua kitea tēnei mate i roto i ngā tamariki e 8 tau te pakeke me ngā pakeke e 80 tau te pakeke.

He mate onge te '(MEN)'.

• E pāngia ana te tata ki te kotahi i roto i te 30,000 tāngata e te momo `TĀNE`.
• E pāngia ana te tata ki te kotahi i roto i te 35,000 tāngata e te momo `TĀNE 2`.

E whakapono ana ētahi kairangahau tera pea ka nui ake te tokomaha o te hunga e pāngia ana e ēnei āhuatanga nā te kore e tino kitea te mate, nā te hē rānei o te tautuhi i tōna mate.

Me pēhea te tātaritanga a ngā tākuta i te mate `(MEN)`? (Tauātanga)

He uaua te tautuhi i te mate `(MEN)`, nā te mea ka pā ki ngā repe rerekē.

• Te tautuhi i te `(MEN momo 1)`:

Ko te tikanga ka kitea te tangata he MEN momo 1 mēnā kei a ia kia rua, neke atu rānei, ngā pukupuku endocrine nui e toru kua whakahuatia i runga ake nei (ngā pukupuku parathyroid, ngā pukupuku pituitary, me/ranei ngā pukupuku o te ara kai), mēnā rānei kei a ia tētahi o aua pukupuku, ā, he momo MEN momo 1 kei tētahi o te whānau.

• Ngā Whakamātautau:
• Ngā whakamātautau toto: Tirohia mēnā he nui ngā taumata o ētahi homoni (hei tauira, te homoni parathyroid (PTH), te konupūmā).
• Ngā whakamātautau whakaahua: Ka āwhina ēnei ki te kimi i ngā wāhi kei reira ngā puku, pērā i te matawai CT (matawai tomography rorohiko) te MRI rānei (matawai whakaahua aukume).
• Whakamātautau ira: Ka tirohia mēnā he whakarerekētanga ira i roto i te ira `MEN1`.

• Te tautuhi i te `(MEN momo 2)`:

Ka tāpaetia te tangata kei te mate pukupuku tairoi medullary (MTC) me te pheochromocytoma me/ranei te hyperplasia, te adenoma rānei o ngā repe parathyroid.

• Ngā Whakamātautau:
• Ngā whakamātautau toto: Tirohia ngā taumata o ngā homoni pēnei i te calcitonin (mō te MTC), te homoni parathyroid (PTH), me ngā catecholamines (mō te pheochromocytoma).
• Ngā whakamātautau whakaahua: Ka whakamahia te 'scan CT' me te 'scan MRI' rānei.
• Whakamātautau ira: Ka tirohia mēnā he whakarerekētanga ira i roto i te ira `RET`.

He aha ngā maimoatanga mō te `(MEN)`?

Ko te maimoatanga o te MEN e whakawhirinaki ana ki ngā repe endocrine me ngā whekau e pāngia ana. I te nuinga o te wā ka uru atu he rōpū tākuta maha-mātauranga, tae atu ki ngā endocrinologists , ngā taote pokanga , me ngā tohunga mate pukupuku .

Tērā pea he maha ngā kōwhiringa maimoatanga:

• Rongoā: Whakahaeretia ngā tohumate me te whakaiti i ngā pānga o te taikaha o ngā homoni.
• Pokanga: Tangohia te puku, te repe katoa rānei e pāngia ana (hei tauira, te repe tairoiti).
• Whakaora homoni: Mena ka tangohia he repe endocrine mā te pokanga, ka tukuna ki waho ngā homoni e hangaia ana e ia.
• Maimoatanga matepukupuku: Mena kua horapa te matepukupuku ki ētahi atu wāhi (kua horapa ki roto i te tinana), me whakamahi ngā maimoatanga pēnei i te chemotherapy me te radiation therapy .

Nā te mea he motuhake ia tūroro `(MEN)`, he rerekē te mahere maimoatanga e pai ana mō te katoa. Kaua e wehi ki te kōrero ki tō tākuta mō ngā kōwhiringa maimoatanga e pai ana mōu.

Ka taea te whakaora katoa i te mate `(MEN)`? Ka taea te ārai?

Engari, kāore anō kia kitea he rongoā mō te mate `(MEN)` i tēnei wā. Heoi, ka taea te whakahaere . Ka rongoatia e ngā tākuta ngā huringa o ia repe mā te pokanga, mā te rongoā rānei e tika ana i taua wā.

Kāore e taea te aukati i te whanaketanga o te `(MEN)`, nā te mea i puta mai i tētahi whakarerekētanga ira. Ka taea te tuku iho i ēnei whakarerekētanga ira mai i ngā mātua, ka puta noa rānei i te wā o te kukune.

Heoi, ki te mea kua kitea he mate MEN i roto i tētahi mema o te whānau tata (matua, teina, tuākana rānei), he mea nui kia kōrero koe ki tō tākuta mō ngā whakamātautau ira mō te MEN. Mā te mahi pera ka āwhina i te kimi wawe i ngā pukupuku mēnā kei a koe te mate.

He aha ngā mea ka puta ina noho tahi koe me `(MEN)`? (Matapae)

Ko te matapae mō te MEN e whakawhirinaki ana ki ētahi āhuatanga:

• Te tere o te tautuhi i te `(MEN)`.
• Ko ēhea ngā repe endocrine e pāngia ana?
• Ahakoa he mate pukupuku te puku, kāore rānei.
• Te momo maimoatanga i whakamahia.
• Ko te tikanga tēnei mēnā kua horapa te pukupuku ki ētahi atu wāhanga o te tinana (kua horapa ki roto i te tinana).

Mena kua tākutatia koe kei te mate MEN, ka taea e tō tākuta te hoatu ki a koe te whakaaro pai mō tō maimoatanga me te huarahi whakamua.

Āhea te wā e tika ai kia kite i te tākuta me ngā pātai nui hei pātai

Mena kua tāpaetia koe kei te mate MEN, me toro atu koe ki tō tākuta i ia wā, i ia wā, kia aroturukitia ai tō āhua, kia mōhio ai hoki kei te tika te haere o tō maimoatanga.

Waihoki, ki te mea he '(MEN)' tō tētahi o tō whānau, kōrero ki tō tākuta mō ngā whakamātautau ira, e ai ki te kōrero i mua ake nei.

Mena kei a koe te '(MEN)', he pai pea te pātai atu ki tō tākuta i ēnei pātai:

• He aha te momo `(TĀNE)` kei a au?
• He aha te pānga o (MEN) ki tōku tinana?
• He aha ngā tohu me tirotiro e au?
• He aha ngā kōwhiringa maimoatanga kei a au?
• He aha ngā painga me ngā ngoikoretanga o ngā momo tikanga maimoatanga rerekē?
• Kia pēhea te roa ka angitu ai te maimoatanga?
• Me whakamātauria te toenga o tōku whānau mō (MEN)?

Hei whakamutunga, ngā mea hei maumahara (Karere hei tango ki te kāinga)

He mate onge te maha o ngā neoplasia endocrine (MEN). Waihoki, nā te mea he maha ngā tohu ka puta mai i te MEN, ā, ehara i te mea he rite tonu te āhua o te katoa, he uaua pea te mōhio mēnā kei a koe tēnei mate.

Ki te puta mai ētahi tohu hou e āwangawanga ai koe, ki te kite rānei koe i ētahi huringa o tō tinana, ko te mea pai ko te toro atu ki te tākuta.

Ahakoa ka puta noa mai ētahi o ngā mate `(MEN)`, ka taea hoki te horapa i roto i ngā whānau. Mena kei tētahi o ō whanaunga tata te mate `(MEN)`, he mea nui kia whakamātauria ō ira kia kitea ai mēnā kei te mōrearea koe. Kōrero ki tō tākuta mō ō pātai katoa mō tō mōrearea ki te whakawhanake i te `(MEN)`. Kei reira rātou hei āwhina i a koe. Kaua e mataku, kaua e mataku, kaua hoki e wehi ki te pātai.

` Ngā mate pukupuku endocrine maha, MEN, pūnaha endocrine, ngā homoni, ngā pukupuku, te mate pukupuku, momo MEN 1, momo MEN 2, parathyroid, pituitary, repeure, tairoiti, MTC, pheochromocytoma, āhua ira, ngā tohu, te tātaritanga, te maimoatanga