Kodi Glucagonoma ndi chiyani? Tiyeni tikambirane za vuto losowa ili!

Pancreas ndi chiwalo chaching'ono koma chofunikira kwambiri m'thupi lanu. Chimapanga mahomoni angapo omwe thupi lathu limafunikira. Chifukwa chake, nthawi zina, mtundu wosowa wa khansa womwe umayamba mu kapamba ungayambitse mavuto. Ndicho chimene vutoli limatchedwa Glucagonoma . Mwina mwadzidzidzi mwadwala matenda a shuga, kapena mwayamba kutupa kwachilendo pakhungu lanu, ndikofunikira kwambiri kudziwa izi.

Kodi glucagonoma ndi chiyani? Mwachidule...

Glucagonoma ndi chotupa cha khansa chomwe sichipezeka kawirikawiri chomwe chimayamba mu kapamba wanu. Chotupachi chimapanga mahomoni ambiri otchedwa glucagon. Tsopano mwina mukudabwa kuti glucagon iyi ndi chiyani.

Glucagon ndi mahomoni ofunikira kwambiri omwe amathandiza kulamulira kuchuluka kwa shuga m'thupi lathu, kutanthauza kuchuluka kwa shuga m'magazi . Amapangidwa ndi maselo a alpha, mtundu wapadera wa selo mu kapamba wanu. Tangoganizirani ngati simunadye kwa nthawi yayitali, ngati mukuchita masewera olimbitsa thupi kwambiri, kapena ngati mudya chakudya chokhala ndi mapuloteni ambiri, kuchuluka kwa shuga m'magazi anu kumatha kutsika, sichoncho? Pamenepo ndi pomwe glucagon iyi imabwera, imatulutsa shuga wosungidwa m'chiwindi chanu, ndiko kuti, glycogen , ndikubwezeretsa kuchuluka kwa shuga m'magazi. Zili ngati munthu amene amathandiza kusunga shuga m'thupi lathu.

Komabe, pakakhala glucagonoma, hormone iyi ya glucagon imapangidwa mopitirira muyeso. Kenako thupi lathu silingathe kupirira. Kuphatikiza kwa zizindikiro zomwe zimachitika chifukwa cha izi kumatchedwa Glucagonoma Syndrome . Izi zingayambitse mavuto ambiri monga mavuto a pakhungu ndi matenda a shuga.

Mtundu uwu wa khansa, wotchedwa glucagonoma, uli m'gulu la zotupa za pancreatic neuroendocrine , kapena zotupa za islet cell . Nthawi zambiri, izi zimachitika m'chimake kapena pakati pa kapamba.

Kodi iyi ndi khansadi?

Inde, nthawi zambiri, glucagonoma ndi khansa . Chomvetsa chisoni n'chakuti, ngakhale itapezeka, pafupifupi 50% ya milandu, kutanthauza kuti, pafupifupi munthu m'modzi mwa awiri, khansa iyi ikhoza kufalikira (kufalikira) ku ziwalo zina za thupi, makamaka chiwindi .

Kodi vutoli ndi lofala bwanji?

Matenda a glucagonoma ndi matenda osowa kwambiri . Anthu ochepa pa miliyoni imodzi amapezeka ndi matendawa chaka chilichonse. Nthawi zambiri amakhudza anthu azaka zapakati pa 50 ndi 70 .

Kodi zizindikiro za izi ndi ziti?

Ma glucagonoma nthawi zambiri amakula pang'onopang'ono . Chifukwa chake, pokhapokha ngati thupi lanu lipanga glucagon yokwanira kuyambitsa mavuto, simungakhale ndi zizindikiro zilizonse.

Komabe, pamene glucagonoma imapanga glucagon yochuluka kwambiri ndipo thupi silingathe kupirira, matenda a glucagonoma omwe atchulidwa kale amayamba.Zimachitika. Kenako, mudzawona zizindikiro zomveka bwino. Ngati muli ndi zizindikirozi, ndikofunikira kwambiri kupita kwa dokotala mwachangu momwe mungathere.

Kutupa pakhungu (Necrolytic Migratory Erythema - NME)

Ichi ndiye chizindikiro chachikulu komanso chodziwika bwino cha matenda a glucagonoma. Pafupifupi 90% ya anthu omwe ali ndi matendawa amakhala ndi vuto la khungu. Amatchedwa necrolytic migratory erythema (NME) .

Tangoganizirani, khungu lanu, makamaka m'malo obisika, matako, ndi miyendo yapansi, limayamba kukhala ndi mawanga ofiira, oyabwa, komanso nthawi zina opweteka. Pambuyo pake izi zimasanduka matuza, ming'alu, ndi kutumphuka. Ngakhale zitachira, banga lofiirira lingakhalebe. Izi zimatha kupangika pamalo amodzi, kuchira, kenako nkubwereranso pamalo ena. Zili ngati ziphuphu zomwe zimasuntha kuchokera pamalo ena kupita kwina.

Zina mwa zinthu za NME:

• Izi zimatha kubwera ndi kupita, ndipo zimatha kuyendayenda m'thupi lonse .
• Poyamba zimatha kuyabwa kwambiri komanso kupweteka .
• Ziphuphuzo zimasanduka zofiira kenako matuza n’kupanga kutumphuka. Pambuyo pochira, dothi la bulauni limatha kukhalapo.
• Izi zingayambitse zinthu monga zilonda za lilime (glossitis ), zilonda za pakamwa, milomo yosweka, ndi angular cheilitis .
• Kutupa kwa zikope ( blepharitis ), kutayika kwa tsitsi, ndi mavuto a misomali kungachitikenso.

Zizindikiro za matenda a shuga

Matendawa amayambitsa kuchuluka kwa shuga m'magazi ( hyperglycemia ), zomwe zingayambitse matenda a shuga. Zizindikiro za matenda a shuga ndi izi:

• Kukhala woonda popanda chifukwa.
• Ludzu lochuluka pafupipafupi (polydipsia) .
• Kukodza pafupipafupi ( polyuria ), makamaka usiku.
• Njala yochuluka ( Polyphagia ).

Zizindikiro zina za (glucagonoma syndrome)

Pali zizindikiro zina zingapo:

• Kutsegula m'mimba kosatha .
• Kuchepa kwa hemoglobin m'magazi (anemia ). Izi zingayambitse kutopa ndi chizungulire.
• Magazi amaundana, makamaka m'mitsempha yakuya ya miyendo ( Deep Vein Thrombosis (DVT) ).

Zizindikiro zokhudzana ndi dongosolo la ubongo ndi mitsempha

Nthawi zina, mungaonenso zizindikiro zokhudzana ndi dongosolo la ubongo ndi mitsempha, monga:

• Kuvutika maganizo
• Matenda amisala
• Kukwiya
• Hyperreflexia (kufulumizitsa mayankho a thupi)
• Kuyenda modabwitsa (ataxia )
• Matenda amisala ( Psychosis))
• Mantha ndi kukayikira kopanda nzeru ( Paranoid Delusions )

Kodi chimayambitsa glucagonoma ndi chiyani?

Nthawi zambiri, madokotala sadziwa chomwe chimayambitsa glucagonoma. Komabe, pafupifupi 10% ya milandu, khansa iyi imalumikizidwa ndi matenda a majini otchedwa Multiple Endocrine Neoplasia type 1 (MEN type 1) .

Komabe, si aliyense amene ali ndi matenda a MEN type 1 amene amadwala glucagonoma. Nawonso ndi ochepa kwambiri.

Kodi mumazindikira bwanji izi?

Ngati muli ndi vuto la khungu lotchedwa necrolytic migratory erythema (NME) lomwe latchulidwa kale, dokotala angaganize kuti muli ndi glucagonoma. Kenako angachite mayeso monga:

• Kuyesa Shuga M'magazi Osala Kusala: Ngati shuga ali wokwera, glucagonoma ikhoza kukayikiridwa ndipo matenda a shuga ogwirizana nawo angatsimikizidwe.
• Kuyesa Magazi a Glucagon Yosala Kudya: Milingo ya Glucagon imakhala yokwera kwambiri mu glucagonoma - nthawi zambiri imakhala yoposa ma picogram 500 pa milliliter (pg/mL). Milingo ya glucagon yosala kudya nthawi zonse imakhala yochepera 150 pg/mL.
• Kuyesa Magazi a Amino Acid: Glucagonoma nthawi zambiri imayambitsa kuchuluka kwa amino acid m'magazi ( hypoaminoacidemia ).
• Kuchuluka kwa Magazi Okwanira (CBC): Izi zimayang'ana kuchepa kwa magazi m'thupi , chifukwa kuchepa kwa magazi m'thupi kumatha kuchitika ndi glucagonoma.

Mayeso ojambulira zithunzi ngati awa angathandize kutsimikizira ngati pali chotupa:

• Kujambula kwa CT
• Kujambula kwa MRI
• Endoscopic Ultrasound

Kodi imachiritsidwa bwanji?

Chithandizo cha glucagonoma chimadalira kwambiri ngati khansayo imapezeka kokha ku kapamba (komwe kali m'derali) kapena yafalikira ku ziwalo zina za thupi (yomwe yafalikira) .

Momwe mungayang'anire zizindikiro poyamba

Gawo loyamba ndikuwongolera zizindikiro ndi mavuto omwe amayamba chifukwa cha kuchuluka kwa glucagon m'magazi. Izi zimachitidwa motere:

• Mankhwala oletsa glucagon wochuluka: Majakisoni otchedwa Octreotide ndi Lanreotide amathandiza kuchepetsa zotsatira za glucagon wochuluka ndikuletsa kupanga glucagon. Mankhwalawa amathanso kuchepetsa kukula kwa zotupa. Amathandizanso kuchepetsa zizindikiro za NME, matenda a shuga, kutsegula m'mimba, ndi matenda a mitsempha.
• Kusamalira matenda a shuga: Mungafunike mankhwala a shuga opangidwa mkamwa kapena jakisoni wa insulin kuti shuga m'magazi anu akhalebe m'magazi oyenera.
• Thandizo la zakudya:Zakudya zonse za Parenteral Nutrition (TPN) , amino acid ndi zinc zowonjezera zingaperekedwe kuti zichepetse zotsatira za kusowa kwa zakudya m'thupi.
• Kuchiza matenda a khungu a NME: Maantibayotiki ndi corticosteroids amatha kusintha NME.
• Mankhwala Oletsa Kutsekeka kwa Magazi: Mankhwala ochepetsa magazi monga heparin amathandiza kupewa kutsekeka kwa magazi m'mitsempha yakuya (DVT) .

Ngati ndi kokha ku kapamba...

Ngati khansa ili mu kapamba kokha, opaleshoni ndiyo njira yaikulu yothandizira . Ngati dokotala atha kuchotsa chotupacho kwathunthu, matendawa nthawi zambiri amachiritsidwa . Glucagonoma ikachotsedwa, kuchuluka kwa glucagon yanu kuyenera kubwerera mwakale. Zizindikiro zanu ziyeneranso kutha.

Ngati yafalikira kumadera ena (yomwe yafalikira)...

Nthawi iliyonse ikatheka, madokotala amalangiza kuti opaleshoni ichotse zotupa. Izi zingaphatikizepo kuchotsa zotupa mu kapamba, ma lymph nodes apafupi, ndi chiwindi.

Koma ngati dokotala sangathe kuchotsa chotupa chilichonse kapena chotupa chonsecho, gulu lanu lachipatala lingakulangizeni chimodzi kapena zingapo mwa njira izi:

• Chemotherapy: Mankhwalawa amagwira ntchito powononga maselo a khansa ndikuletsa kukula kwawo.
• Kutulutsa kwa Ma Radiofrequency: Izi zimagwiritsa ntchito kutentha kuchokera ku mafunde a wailesi kupha maselo a khansa.
• Kuchotsa Cryosurgical: Izi zimagwiritsa ntchito mankhwala ozizira kwambiri, monga nayitrogeni yamadzimadzi, kuti awononge maselo a khansa.
• Chemoembolization: Mankhwalawa amaletsa magazi kupita ku khansa.

Kodi chiyembekezo cha kuchira ku vutoli ndi chiyani?

Chiyembekezo cha munthu amene ali ndi glucagonoma chimadalira zinthu zingapo:

• Zaka zanu ndi thanzi lanu lonse .
• Kukula kwa chotupa cha khansa .
• Kaya khansa yafalikira kapena ayi .

Ngati khansayo imangopezeka m'chifuwa cha kapamba, nthawi zambiri imakhala yabwino . Opaleshoni yochotsa chotupa nthawi zambiri imakhala yochiritsa, koma izi zimachitika kwa odwala pafupifupi 20% okha a glucagonoma.

Popeza glucagonoma ndi yosowa kwambiri, palibe deta yokwanira yoti mudziwe nthawi yeniyeni yomwe mungakhale ndi moyo kapena zotsatira zake ngati khansayo ifalikira. Gulu lanu lachipatala lidzatha kupereka zambiri kutengera momwe mulili.

Kodi izi zingapewedwe?

Popeza asayansi sadziwa chomwe chimayambitsa matenda ambiri a glucagonoma, palibe chomwe mungachite kuti mupewe vutoli .

Komabe, ngati m'modzi mwa achibale anu oyamba (makolo anu enieni ndi abale anu) apezeka ndi matenda a MEN (Multiple Endocrine Neoplasia) , lankhulani ndi dokotala wanu za kuyezetsa majini. Ngati mulinso ndi MEN, kuyezetsa majini kungathandize kuzindikira khansa pachiyambi.

Kupezeka ndi khansa n'kokhumudwitsa kwambiri. Ngati ndi chinthu chosowa monga glucagonoma, zimakhala zovuta kwambiri. Koma kumbukirani kuti gulu lanu lachipatala lilipo kuti liyankhe mafunso anu ndikukuthandizani. Ngati mukumva kuti muli nokha m'maganizo ndi m'maganizo ndi glucagonoma, funsani dokotala wanu za mapulogalamu ndi mautumiki omwe angakuthandizeni.

Pomaliza, zinthu zoti muzikumbukira (Uthenga Wopita Nawo Kunyumba)

Chifukwa chake, ngakhale kuti glucagonoma ndi vuto losowa kwambiri, ndikofunikira kudziwa za matendawa. Makamaka ngati mwadzidzidzi muyamba zizindikiro zofanana ndi matenda a shuga pamodzi ndi ziphuphu za pakhungu zachilendo (NME), monga tafotokozera, pitani kwa dokotala nthawi yomweyo. Ngati zadziwika msanga, zitha kuchiritsidwa. Ngakhale izi sizichitika kawirikawiri, pali mankhwala.

Musadandaule, simuli nokha. Dokotala wanu ndi gulu lachipatala adzakuthandizani paulendowu. Khalani olimba mtima ndipo tsatirani malangizo omwe akukupatsani.

Glucagonoma , khansa ya kapamba, glucagon, matenda a shuga, zizindikiro za khungu, mahomoni, khansa zosowa