Tiyeni tiphunzire za mavuto ena omwe ali ndi dongosolo la glandular la thupi lanu? - Multiple Endocrine Neoplasia (MEN)

Thupi lathu lili ngati makina odabwitsa, sichoncho? Kuti makinawa agwire ntchito bwino, gawo lililonse liyenera kugwira ntchito limodzi ndikugwirizana bwino. Pali dongosolo lofunika kwambiri m'thupi lathu, lomwe limatchedwa dongosolo la endocrine . Tizilombo ta m'dongosololi timatulutsa mahomoni omwe amalamulira zochita zambiri m'thupi lathu. Komabe, nthawi zina dongosololi limatha kusokonekera. Lero tikambirana za vuto losowa koma lofunika kwambiri loti tidziwe. Ilo ndi Multiple Endocrine Neoplasia , lomwe limadziwikanso kuti `(MEN)` mwachidule.

Ndiye kodi dongosolo la endocrine ili ndi chiyani?

Mwachidule, dongosolo lathu la endocrine ndi netiweki ya tiziwalo ndi ziwalo m'thupi lathu. Izi ndi zomwe zimapanga mankhwala otchedwa mahomoni ndikuwatulutsa m'magazi. Ganizirani mahomoni awa ngati amithenga ang'onoang'ono omwe amanyamula mauthenga mkati mwa matupi athu. Mauthenga awa amauza ziwalo zathu, khungu, ndi minofu zomwe tiyenera kuchita komanso nthawi yoti tichite.

Pali ziwalo zingapo zazikulu ndi ma gland omwe ali m'thupi lathu la endocrine:

• Hypothalamus: Iyi ili pansi pa ubongo wathu. Imalamulira zinthu zambiri mu dongosolo la endocrine.
• Pituitary gland: Kachiwalo kakang'ono aka, kolumikizidwa ndi hypothalamus, kamapanga mahomoni omwe amalamulira tiziwalo tina tambiri, kuphatikizapo chithokomiro, tiziwalo ta adrenal, mazira, ndi machende.
• Chithokomiro: Chithokomiro chooneka ngati gulugufe chomwe chili kutsogolo kwa khosi chimayang'anira kagayidwe ka thupi m'thupi lathu, momwe timagwiritsira ntchito mphamvu kuchokera ku chakudya chomwe timadya.
• Ma glands a Parathyroid: Ma glands ang'onoang'ono anayi awa, omwe nthawi zambiri amakhala pafupi ndi gland ya chithokomiro, amayang'anira kuchuluka kwa calcium ndi phosphorous m'thupi lathu.
• Ma adrenal glands: Ma adrenal glands awiriwa, omwe ali pamwamba pa impso, amalamulira kagayidwe kachakudya m'thupi, kuthamanga kwa magazi, kukula kwa kugonana, komanso kuyankha kupsinjika maganizo.
• Pineal gland: Gland iyi imapanga mahomoni otchedwa melatonin ndipo imayang'anira nthawi yathu yogona.
• Pancreas: Apa ndi pomwe insulin imapangidwira. Ndi yofunika kwambiri pa kagayidwe kachakudya ndi kuwongolera shuga m'magazi. Ndi gawo la dongosolo lathu logaya chakudya.
• Mazira: Apa ndi pomwe mahomoni achikazi otchedwa estrogen, progesterone, ndi testosterone amapangidwa.
• Mayeso: Pamene akupanga umuna mwa amuna, mahomoni otchedwa testosterone amapangidwanso pano.

Ndiye kodi Multiple Endocrine Neoplasia (MEN) ndi chiyani?

Matenda a Multiple Endocrine Neoplasia (MEN) ndi matenda osowa kwambiri omwe amapezeka m'majini omwe amakhudza ziwalo zambiri za thupi ndi minofu ya dongosolo la endocrine, zomwe takambirana kale. Nthawi zina matendawa amatha kukhala khansa.

Pali mitundu iwiri ikuluikulu ya vuto la `(MEN)` ili:

1. Multiple endocrine neoplasia type 1 (MEN type 1): Iyi ndi matenda omwe matuza angapo amakula m'matenda osiyanasiyana a endocrine system. Izi zimatchedwanso MEN-1 ndi Wermer's syndrome.

2. Multiple endocrine neoplasia type 2 (MEN type 2): Iyi ndi khansa ya majini yomwe imakhudza tiziwalo timene timatulutsa timadzi ...

N’chifukwa chiyani vuto la `(AMEN)` limachitika?

Mitundu yonse iwiri ya `(MEN)` imayambitsidwa ndi kusintha kwa majini athu, ndiko kuti, kusintha kwa majini . Tangoganizani kuti thupi lathu lili ndi chinthu chonga buku la malangizo, ndiko kuti, majini. Ngati ngakhale chilembo chimodzi m'buku la malangizoli chili cholakwika, ndiko kuti, ngati jini yasinthidwa, ntchito zina za thupi zimatha kusokonekera.

• (MEN type 1) imayamba chifukwa cha kusintha kwa majini a `MEN1` . Jini la `MEN1` ili ndi jini loletsa khansa . Ndiko kuti, jini lomwe limathandiza kulamulira kugawikana kwa maselo ndikuletsa zotupa kuti zisapangidwe. Ngati jini ili siligwira ntchito bwino, maselo ena amatha kukula mosalamulirika ndikupanga zotupa.
• (MEN type 2) imayamba chifukwa cha kusintha kwa majini a `RET` . Jini la `RET` ili ndi jini yogwirizana ndi kukula kwa khansa. Jini ili likasinthidwa, maselo m'ziwalo zina ndi m'matenda amakula mosalamulirika ndikupanga zotupa.

Kusintha kwa majini kumeneku kumatha kutengera kwa makolo kapena kungachitike mwangozi panthawi yomwe mwana wosabadwayo akukula. Ngati kholo limodzi lili ndi AMUNA, pali mwayi wa 50% kuti mwana akhale ndi vutoli.

Tiyeni tiphunzire zambiri za `(MEN)` mtundu 1 (`MEN mtundu 1`)

Anthu omwe ali ndi matenda a MEN type 1 amakhala ndi zotupa m'matenda angapo a endocrine system. Malo omwe amakhudzidwa kwambiri ndi awa:

• Matenda a parathyroid: Ichi ndi chomwe chimapezeka kwambiri.
• Njira ya m'mimba: Izi zikutanthauza kuti zotupa zimatha kupangika mu kapamba, m'mimba, ndi m'mbali zina za m'mimba, monga duodenum.
• Chiwalo cha pituitary.

Nthawi zambiri, ziphuphu zomwe zimayamba ndi mtundu woyamba wa MEN sizikhala ndi khansa (zoipa) . Komabe, ziphuphu zina zimatha kukhala khansa (zoopsa).Zingathenso kufalikira (kufalikira) ku ziwalo zina za thupi. Tizilombo toyambitsa matenda timene timakhala ndi zotupa nthawi zambiri timatulutsa mahomoni ambiri m'magazi. Izi ndi zomwe zimayambitsa zizindikiro zosiyanasiyana komanso mavuto azaumoyo.

Madokotala apeza mitundu yoposa 20 ya zotupa za endocrine ndi zomwe sizili za endocrine mwa anthu omwe ali ndi mtundu woyamba wa MEN. Palinso mitundu ina ya zotupa zomwe sizimapezeka kawirikawiri, monga:

• Zotupa za neuroendocrine zomwe zimakula mu thymus (lymph node pachifuwa) ndi bronchi (njira zopumira m'mapapo).
• Zilonda za adrenocortical zimapangidwa mu gawo lakunja la glands za adrenal.
• Matumbo amafuta (Lipomas) omwe amapangika pansi pa khungu.
• Khansa ya m'mawere.
• Zotupa monga meningiomas ndi ependymomas zomwe zingachitike mu ubongo kapena msana.

Kodi zizindikiro za `(MEN type 1)` ndi ziti?

Zizindikiro za mtundu woyamba wa MEN zimatha kusiyana kwambiri malinga ndi munthu ndi munthu. Zimatengera tinthu tating'onoting'ono tomwe takhudzidwa komanso kuchuluka kwa mahomoni omwe amatulutsa. Anthu ena sangakhale ndi zizindikiro konse, ena akhoza kukhala ndi zizindikiro zochepa, ndipo ena akhoza kukhala ndi zizindikiro zoopsa, zomwe zingawopseze moyo. Zizindikiro zimatha kusiyana malinga ndi munthu ndi munthu, ngakhale m'banja lomwelo, ngakhale pakati pa mapasa.

Tiyeni tiwone mitundu ikuluikulu ya ziphuphu ndi zizindikiro zake:

• Chifukwa cha mavuto ndi ma glands a parathyroid (hyperparathyroidism):

Anthu 90% omwe ali ndi `(MEN type 1)` amakhala ndi vutoli akafika zaka 50. Pachifukwa ichi, ma glands a parathyroid amayamba kugwira ntchito mopitirira muyeso.

• Zizindikiro zochepa: kupweteka kwa mafupa, kufooka kwa minofu, kutopa, kuvutika maganizo, kuvutika kuganizira, kusowa chilakolako cha chakudya.
• Zizindikiro zazikulu: nseru, kusanza, kusokonezeka, kuiwala, ludzu lochuluka komanso kukodza pafupipafupi, kudzimbidwa, kupweteka kwa mafupa.

• Chifukwa cha zotupa mu kapamba ndi gawo loyamba la matumbo ang'onoang'ono (Gastrinomas):

Pafupifupi 40% ya akuluakulu omwe ali ndi matenda a MEN type 1 amakhala ndi zotupa zotchedwa gastrinomas. Izi zimapanga mahomoni otchedwa gastrin, omwe amachititsa kuti m'mimba mutulutse asidi wambiri.

• Zizindikiro: Kupweteka m'mimba, kutsegula m'mimba, kutentha pamtima (acid reflux), zilonda zam'mimba (zilonda zam'mimba).
• Chotupa china chomwe chimapezeka m'gululi ndi insulinoma . Ichi chimapanga insulin, yomwe ingayambitse shuga wotsika m'magazi (hypoglycemia).
• Zizindikiro: chisokonezo, kunjenjemera, thukuta, njala yochuluka, kusakhazikika, kugunda kwa mtima mwachangu, kusintha kwa masomphenya kwakanthawi.

• Chifukwa cha zotupa za pituitary (prolactinomas):

Pafupifupi 25% ya anthu omwe ali ndi matenda a mtundu woyamba wa MEN amakhala ndi zotupa za pituitary. Zofala kwambiri ndi ma prolactinoma, omwe amapanga mahomoni otchedwa prolactin .

• Zizindikiro mwa akazi: kusayenda bwino kwa msambo kapena kusiya kusamba (amenorrhea), kuvutika kutenga pakati, kutuluka magazi ngati mkaka m'mabele a akazi akakhala opanda pakati kapena oyamwitsa (galactorrhea), kuchepa kwa chilakolako chogonana.
• Zizindikiro mwa amuna: Kuchepa kwa chilakolako chogonana chifukwa cha kuchepa kwa testosterone, kusowa mphamvu yogonana (ED), komanso kuvutika kutenga pakati.
• Ngati chotupacho chili chachikulu: mutu, nseru/kusanza, kusintha kwa masomphenya (kuona kawiri, kuchepa kwa masomphenya am'mbali).

Chofunika: Si aliyense amene adzakumana ndi zizindikiro zomwezo. Mndandandawu si wokwanira. Pali mitundu ina yambiri ya ziphuphu zomwe zingachitike mu `(MEN type 1)`.

Tiyeni tiphunzirenso za `(AMEN)` mtundu wachiwiri (`AMEN mtundu wachiwiri`)

Aliyense amene ali ndi mtundu wachiwiri wa MEN amakhala ndi mtundu wa khansa ya chithokomiro yotchedwa medullary thyroid cancer (MTC) . Mtundu uwu wa khansa umakula mu mtundu wapadera wa selo mu chithokomiro chotchedwa maselo a C. Maselo amenewa amapanga mahomoni otchedwa calcitonin. MTC imatha kufalikira ku ma lymph nodes ndi ziwalo zina. Chithandizo chachikulu ndi kuchotsa chithokomiro chotchedwa thyroidectomy kwa opaleshoni.

Komanso, anthu omwe ali ndi `(MEN type 2)` akhoza kukhala ndi chimodzi kapena zonsezi mwa izi:

• Pheochromocytoma: Ichi ndi chotupa chosowa chomwe chimayamba pakati pa gland imodzi kapena zonse ziwiri za adrenal (adrenal medulla). Nthawi zambiri, izi si khansa. Pafupifupi 10%-15% ya milandu imatha kukhala khansa ndikufalikira.
• Hyperparathyroidism: Kuchuluka kwa calcium m'magazi kumawonjezeka chifukwa cha kupanga kwambiri kwa hormone ya parathyroid (PTH) ndi ma thyroid glands.

Kodi zizindikiro za `(MEN type 2)` ndi ziti?

Zizindikiro pano ndizosiyana. Zizindikiro nthawi zambiri zimayambitsidwa ndi kuchuluka kwa mahomoni opangidwa ndi khansa (MTC) ndi zotupa zina.

• Zizindikiro za khansa ya chithokomiro ya medullary (MTC):
• Chotupa kutsogolo kwa khosi, kupweteka kwa khosi, kusintha kwa mawu (mawu omveka), chifuwa, kuvutika kumeza, komanso kuvutika kupuma.

• Zizindikiro zomwe zimayambitsidwa ndi Pheochromocytoma: (zimapezeka pafupifupi 50% ya milandu)
• Zizindikiro zimangochitika pamene zotupazi zimapanga mahomoni ambiri, monga adrenaline. Zotupa zina sizipanga mahomoni ndipo sizingasonyeze zizindikiro zilizonse.
• Zizindikiro zodziwika bwino (nthawi zambiri zimabwera ndi kutuluka ngati ma spell): kuthamanga kwa magazi (kuthamanga kwa magazi), mutu, thukuta kwambiri popanda chifukwa, kugunda kwa mtima mofulumira kapena kosakhazikika, kunjenjemera.

• Zizindikiro za hyperparathyroidism:
• Monga momwe zilili mu `(MEN type 1)`, zizindikiro monga kupweteka kwa mafupa, kufooka kwa minofu, kutopa, kuvutika maganizo, kuvutika kuganizira, kusowa chilakolako cha chakudya, nseru, kusanza, ludzu lochuluka komanso kukodza pafupipafupi, kudzimbidwa, ndi kupweteka kwa mafupa zimatha kuchitika.

Ndani angadwale vutoli la `(AMEN)`? Kodi ndi lofala bwanji?

Matenda a `(MEN)` angakhudze amuna ndi akazi mofanana. Zaka zomwe matendawa a `(MEN type 1)` amawonekera zimasiyana kwambiri. Amapezeka mwa ana aang'ono ngati zaka 8 ndi akuluakulu ngati zaka 80.

`(AMEN)` ndi vuto losowa kwambiri .

• `(MEN type 1)` imakhudza pafupifupi munthu m'modzi mwa anthu 30,000.
• `(MEN type 2)` imakhudza pafupifupi munthu m'modzi mwa anthu 35,000.

Ofufuza ena amakhulupirira kuti chiwerengero chenicheni cha anthu omwe ali ndi matendawa chikhoza kukhala chokwera chifukwa cha kusapezeka ndi matendawa kapena kusadziwika bwino.

Kodi madokotala amazindikira bwanji vuto la `(MEN)`? (Kuzindikira)

Kuzindikira matenda a `(MEN)` kungakhale kovuta pang'ono, chifukwa kumakhudza ma glands osiyanasiyana.

• Kuzindikiritsa `(mtundu wa MEN 1)`:

Munthu nthawi zambiri amapezeka ndi matenda a mtundu wa MEN 1 ngati ali ndi matenda awiri mwa atatu akuluakulu a endocrine omwe atchulidwa pamwambapa (matenda a parathyroid, matenda a pituitary, ndi/kapena matenda a m'mimba), kapena ngati ali ndi chimodzi mwa zotupazo ndipo wachibale wake ali ndi matenda a mtundu wa MEN 1.

• Mayeso:
• Kuyezetsa magazi: Yang'anani kuchuluka kwa mahomoni ena (monga parathyroid hormone (PTH), calcium).
• Mayeso ojambulira: Izi zingathandize kupeza malo omwe pali ziphuphu, monga CT scan (computed tomography scan) kapena MRI (magnetic resonance imaging scan).
• Kuyesa majini: Kufufuza kusintha kwa majini a `MEN1`.

• Kuzindikiritsa `(mtundu wa MEN 2)`:

Munthu amapezeka ndi matenda a MEN type 2 ngati ali ndi khansa ya chithokomiro ya medullary (MTC) pamodzi ndi pheochromocytoma ndi/kapena hyperplasia kapena adenoma ya parathyroid glands.

• Mayeso:
• Kuyezetsa magazi: Yang'anani kuchuluka kwa mahomoni monga calcitonin (ya MTC), parathyroid hormone (PTH), ndi catecholamines (ya pheochromocytoma).
• Mayeso ojambulira: `CT scan` kapena `MRI scan` amagwiritsidwa ntchito.
• Kuyesa majini: Kufufuza kusintha kwa majini mu jini ya `RET`.

Kodi mankhwala a `(AMEN)` ndi otani?

Chithandizo cha MEN chimadalira kwathunthu kuti ndi tiziwalo titi ta endocrine ndi ziwalo ziti zomwe zakhudzidwa. Nthawi zambiri chimakhala ndi gulu la madokotala osiyanasiyana, kuphatikizapo madokotala a endocrinologists , madokotala ochita opaleshoni , ndi madokotala a khansa .

Pakhoza kukhala njira zingapo zochiritsira:

• Mankhwala: Kuletsa zizindikiro ndi kuchepetsa zotsatira za mahomoni ochulukirapo.
• Opaleshoni: Chotsani chotupa kapena gland yonse yomwe yakhudzidwa (monga gland ya chithokomiro).
• Chithandizo chobwezeretsa mahomoni: Ngati chiwalo cha endocrine chachotsedwa opaleshoni, mahomoni opangidwa ndi icho amaperekedwa kunja.
• Chithandizo cha khansa: Ngati khansa yafalikira kumadera ena (yomwe yafalikira), mankhwala monga chemotherapy ndi radiation therapy .

Popeza wodwala aliyense wa `(AMEN)` ndi wapadera, dongosolo la chithandizo lomwe limagwirira ntchito aliyense ndi losiyana. Musaope kulankhula ndi dokotala wanu za njira zochiritsira zomwe zili zabwino kwa inu.

Kodi `(AMUNA)` angachiritsidwe kwathunthu? Kodi angapewedwe?

Tsoka ilo, pakadali pano palibe mankhwala a vutoli (MEN). Komabe, lingathe kuthandizidwa . Madokotala amachiza kusintha kwa gland iliyonse ndi opaleshoni kapena mankhwala, monga momwe ziyenera kukhalira panthawiyo.

Sizotheka kuletsa kukula kwa `(MEN)`, chifukwa kumachitika chifukwa cha kusintha kwa majini. Kusintha kwa majini kumeneku kumatha kutengera kwa makolo kapena kuchitika mwangozi panthawi ya embryonic siteji.

Komabe, ngati wachibale wapafupi (kholo, m'bale kapena mlongo) wapezeka ndi matenda a MEN, ndikofunikira kulankhula ndi dokotala wanu za kuyezetsa majini a MEN. Kuchita zimenezi kungathandize kuzindikira zotupa msanga ngati muli ndi vutoli.

Kodi chimachitika ndi chiyani mukakhala ndi `(AMUNA)`? (Zomwe zimachitika nthawi zambiri)

Kuzindikira kwa MEN kumadalira zinthu zingapo:

• Kodi `(MEN)` idadziwika mofulumira bwanji.
• Ndi matenda ati a endocrine omwe amakhudzidwa?
• Kaya chotupacho ndi khansa kapena ayi.
• Mtundu wa chithandizo chomwe chagwiritsidwa ntchito.
• Kaya chotupa cha khansa chafalikira ku ziwalo zina za thupi (chomwe chafalikira m'thupi) chimatchedwa.

Ngati mwapezeka ndi matenda a MEN, dokotala wanu angakupatseni lingaliro labwino kwambiri la chithandizo chanu komanso njira yopitira patsogolo.

Nthawi yoti mukaonane ndi dokotala komanso mafunso ofunikira oti mufunse

Ngati mwapezeka ndi matenda a MEN, muyenera kupita kwa dokotala nthawi zonse kuti muwone momwe matenda anu alili komanso kuti muwonetsetse kuti chithandizo chanu chikugwira ntchito bwino.

Komanso, ngati wachibale wapafupi m'banja mwanu ali ndi `(MEN)`, lankhulani ndi dokotala wanu za kuyezetsa majini, monga tafotokozera kale.

Ngati muli ndi `(AMEN)`, zingakhale zothandiza kufunsa dokotala wanu mafunso monga awa:

• Kodi ndili ndi mtundu wanji wa `(AMEN)`?
• Kodi (AMEN) amakhudza bwanji thupi langa?
• Ndi zizindikiro ziti zomwe ndiyenera kuyang'anitsitsa?
• Kodi ndi njira ziti zochiritsira zomwe ndili nazo?
• Kodi ubwino ndi kuipa kwa njira zosiyanasiyana zochiritsira ndi kotani?
• Kodi zimatenga nthawi yayitali bwanji kuti chithandizo chipambane?
• Kodi banja langa lonse liyenera kuyezedwa kuti lili ndi (AMEN)?

Pomaliza, zinthu zoti muzikumbukira (Uthenga Wopita Nawo Kunyumba)

Matenda a multiple endocrine neoplasia (MEN) ndi matenda osowa kwambiri. Komanso, chifukwa chakuti MEN angayambitse zizindikiro zosiyanasiyana ndipo si matenda a aliyense omwe ali ofanana, nthawi zina zimakhala zovuta kudziwa ngati muli nawo.

Ngati mukumva zizindikiro zatsopano zomwe zimakudetsani nkhawa, kapena ngati muwona kusintha kulikonse m'thupi lanu, chinthu chabwino kwambiri choti muchite ndikuwonana ndi dokotala.

Ngakhale kuti milandu ina ya `(AMEN)` imachitika mwachisawawa, imatha kuchitikanso m'mabanja. Ngati m'modzi mwa achibale anu apafupi ali ndi `(AMEN)`, ndikofunikira kwambiri kukayezetsa majini kuti mudziwe ngati muli pachiwopsezo. Lankhulani ndi dokotala wanu za mafunso aliwonse omwe muli nawo okhudza chiopsezo chanu cha `(AMEN)`. Alipo kuti akuthandizeni. Musachite mantha, musachite mantha, ndipo musachite mantha kufunsa mafunso.

` Multiple endocrine neoplasia, MEN, endocrine system, mahomoni, zotupa, khansa, MEN mtundu 1, MEN mtundu 2, parathyroid, pituitary, kapamba, chithokomiro, MTC, pheochromocytoma, majini, zizindikiro, matenda, chithandizo