Ese ufite ibi bimenyetso? Reka tuvuge kuri Cushing Syndrome!

Ese wigeze wumva ibyerekeye Cushing Syndrome? Izina rishobora kuba ari rishya kuri wewe. Mu magambo make, ni indwara ibaho iyo imibiri yacu ikora imisemburo myinshi ya cortisol . Hari n'abantu bayita hypercortisolism. "Syndrome" ni uruhurirane rw'ibimenyetso bihurirana. Hari abantu bamwe bashobora kuba barayibonye yitwa Cushing's syndrome.

None se iyi cortisol ni iki?

Cortisol ni imisemburo ya steroide mu mibiri yacu. Akenshi tuyita "imisemburo ya stress" kuko iyo turi mu stress, imibiri yacu irekura cortisol nyinshi. Muri ibi bihe, cortisol idufasha:

• Igipimo cy'umutima wawe kiriyongera.
• Umuvuduko w'amaraso yawe uri kwiyongera.
• Igenzura urugero rw'isukari mu maraso.
• Igenzura guhumeka.
• Byongera umuvuduko w'imitsi.

Si ibyo gusa, ahubwo iyo dufite stress, cortisol inafasha mu guhagarika by'agateganyo sisitemu zitari ngombwa ku mubiri wacu muri icyo gihe, urugero, sisitemu y'igogora n'iy'imyororokere.

Cortisol ni imisemburo y'ingenzi ku mibiri yacu. Cortisol ni ingenzi kuri ibi bintu:

• Gukomeza umuvuduko w'amaraso.
• Kugenzura urugero rw'isukari mu maraso.
• Kugabanya ububyimbirwe.
• Hubaka urwibutso.
• Genzura uburyo uhumeka.
• Gumana umunyu mu mubiri.
• Hindura ibiryo turya mo imbaraga.

Urugero rwa Cortisol rugenzurwa n'uturemangingo tubiri duto turi hejuru y'impyiko zacu, uturemangingo tw'intanga ngabo, uturemangingo tw'ubwonko, na hypothalamus, iri hejuru y'uturemangingo tw'ubwonko.

Indwara ya Cushing ikunze guterwa n'ikibyimba . Ibi bishobora kubaho mu buryo bubiri bw'ingenzi:

• Ikomoka ku ngirabuzimafatizo: Ibi bivuze ko ari indwara iterwa na cortisol, ikorerwa mu mibiri yacu.
• Ituruka hanze: Ibi bivuze ko indwara iterwa n'impamvu zo hanze nk'ingaruka z'imiti imwe n'imwe ifatwa kugira ngo ivure izindi ndwara.

Ni nde ushobora kurwara indwara ya Cushing Syndrome cyane?

Indwara ya Cushing ikunze kugaragara cyane mu bana, ingimbi n'abangavu. Ikunze kugaragara cyane mu bantu bari hagati y'imyaka 25 na 50. Abantu bafata imiti irimo cortisol (urugero, imiti ivura asima na rubagimpande) bafite ibyago byinshi byo kurwara iyi ndwara. Abantu bagera kuri 70% by'abafite iyi ndwara ya Cushing ni abagore naho 30% ni abagabo.

Iki kibazo gikunze kugaragara gute?

Indwara ya Cushing ni indwara idakunze kugaragara , yibasira abantu bari hagati ya 40 na 70 muri miliyoni buri mwaka.

Ni irihe tandukaniro riri hagati ya Cushing Syndrome n'indwara ya Cushing?

Indwara ya Cushing ni ubwoko bwa syndrome ya Cushing. Iterwa n'ikibyimba kitari kibi mu gasabo k'ubwonko. Iyi kibyimba isohora imisemburo myinshi ya ACTH (adrenocorticotropic hormone) . Ibi bituma imisemburo ya adrenal isohora cortisol nyinshi cyane.

Mu bafite indwara ya Cushing, abantu barenga 70% by'abantu bakuru na hagati ya 60% na 70% by'abana n'urubyiruko bafite ubwo bwoko bwa Cushing.

Ni ubuhe bwoko bw'abaganga bavura indwara ya Cushing?

Umuganga wawe mukuru azakohereza kwa muganga w’inzobere witwa inzobere mu by’ubuvuzi bw’indwara z’imitsi kugira ngo apime kandi avure iyi ndwara.

Ese indwara ya Cushing ishobora kwica?

Yego, indwara ya Cushing's Syndrome ishobora kwica iyo idavuwe neza. Iyo itavuwe, iyi cortisol iri hejuru (hypercortisolism) ishobora gutera ibibazo bitandukanye by'ubuzima. Urugero:

• Indwara zandurira mu mubiri
• Amaraso afungana, cyane cyane mu bihaha no mu maguru
• Ihungabana
• Indwara y'umutima
• Kongera ibiro
• Ibibazo byo kwibuka cyangwa kugorwa no kwibanda ku bintu
• Umuvuduko w'amaraso ukabije cyangwa cholesterol nyinshi
• Amagufwa yavunitse
• Diyabete yo mu bwoko bwa 2, prediabetes, cyangwa isukari yo mu nda idakora neza

Iyo itavuwe, indwara ya Cushing ishobora no gutuma umuntu apfa.

Ni izihe mpamvu zitera indwara ya Cushing?

Indwara ya Cushing iterwa n'urugero rwinshi rwa cortisol mu mubiri. Hari impamvu nyinshi zishobora gutera:

• Ikoreshwa ry'Imiti ya Glucocorticoid: Imiti ya Glucocorticoid (urugero, prednisone) ikoreshwa mu kuvura asima idakira, rubagimpande, lupus, sarcoidosis, n'izindi ndwara nyinshi ziterwa n'ubwiyongere bw'umubiri zitera ububyimbirwe budakira. Gufata iyi miti igihe kirekire bishobora gutera "iatrogenic" cyangwa indwara ya Cushing ituruka hanze. Ijambo "iatrogenic" risobanura ko hari ikindi kintu giterwa n'ubuvuzi.
• Ibibyimba byo mu gatuza: Indwara ya Cushing ( usibye iatrogenic Cushing syndrome) iterwa n'ibibyimba byo mu gatuza bitanga ACTH nyinshi, imisemburo ibwira imisemburo y'inkendero gukora cortisol, kandi ikagira ingaruka ku bantu 8 kuri 10. Ubwo bwoko bwitwa indwara ya Cushing.
• Ibibyimba byo mu nteruro y'intanga: Ikibyimba kigaragara hejuru y'intanga ngore gishobora gukora cortisol nyinshi cyane. Ibi akenshi ni ibibyimba bidakomeye. Ariko, rimwe na rimwe iki kibyimba gishobora kuba kanseri yo mu nteruro y'intanga ngore, ubwoko budasanzwe bwa kanseri yo mu nteruro y'intanga ngore.
• Ibibyimba by'ibihaha, pancreas, tiroyide na thymus: Iyo ACTH ikorwa n'ibibyimba bitari mu gahu k'ubwonko, byitwa ectopic ACTH syndrome. Ibi bibyimba akenshi biba ari bibi. Ikunze kugaragara cyane muri ibi ni kanseri y'ibihaha y'uturemangingo duto.

Ese indwara ya Cushing syndrome ni iy'umuragwa?

Akenshi, oya . Abantu benshi barwaye indwara ya Cushing si uko baba barayirwaye mu buryo bw'umwimerere.

Ni ibihe bimenyetso by'indwara ya Cushing?

Uretse ibimenyetso byihariye bya syndrome ya Cushing, hari n'ibimenyetso bishobora kuba bimwe mu bindi bibazo byinshi. Si abantu bose bazagira ibimenyetso bimwe. Ibi ni ibimenyetso bishobora kubaho:

• Kwiyongera ibiro vuba mu maso (bamwe babyita "ukwezi mu maso"), igifu, inyuma y'ijosi (bamwe babyita "imbogo"), n'igituza.
• Isura itukura kandi izengurutse.
• Ibikomere bifata igihe kugira ngo bikire.
• Umuvuduko ukabije w'amaraso (hypertension).
• Kumera umusatsi mwinshi mu maso, mu ijosi, mu gituza, mu nda, mu mabere no mu bibero, cyangwa mu gutakaza umusatsi (ubusatsi).
• Diyabete.

Ibindi bimenyetso bishobora kuba birimo:

• Kugaragara kw'ibisebe by'umuhengeri mu gice cyo mu nda.
• Gukomeretsa amaboko n'ibirenge byoroshye.
• Intege nke rusange n'umunaniro.
• Kutabona neza no kugira isereri.
• Intege nke z'imitsi no gutakaza amaguru n'amaboko.
• Impinduka mu mibonano mpuzabitsina no kudakora neza kw'imibonano mpuzabitsina ku bagabo.
• Imikurire mibi mu bana.

Indwara ya Cushing imara igihe kingana iki?

Igihe indwara ya Cushing imara giterwa n'uko witwara iyo uvuwe. Abantu benshi bafite urugero rwa cortisol ruri hejuru (hypercortisolism) barakira nyuma y'ibyumweru bike bamaze kuvurwa.

Ese indwara ya Cushing itera ibibazo byo guhumeka?

Oya.Guhumeka nabi si ikimenyetso kiranga indwara ya Cushing.

Ese indwara ya Cushing itera indwara yo kubura amaraso (osteoporosis)?

Yego. Indwara ya Cushing ishobora gutera intege nke z'amagufwa. Ibi bishobora gutera kuvunika, cyane cyane niba umaze igihe kinini urwaye iyo ndwara. Amagufwa adakomeye na yo ashobora gutera ububabare.

Ese indwara ya Cushing itera hypokalemia?

Hypokalemia ni indwara aho urugero rwa potasiyumu mu maraso yawe ruba ruto. Iyi ndwara ishobora kubaho iyo ufite indwara ya Cushing.

Indwara ya Cushing ipimwa ite?

Niba muganga wawe akeka ko cortisol iri hejuru (hypercortisolism), hari amabwiriza azakurikiza. Bazakubaza ibibazo, bagufate amateka y'ubuzima bwawe, bagukorere isuzuma ry'umubiri, hanyuma bagutegeke ibizamini byo muri laboratwari. Bashobora kandi kugukurikirana igihe runaka.

Indwara ya Cushing rimwe na rimwe ishobora kugorana kuyisuzuma. Iyo ubwiye muganga wawe ko unaniwe kandi ubyibushye, ashobora kudahita atekereza kuri iyo ndwara ya Cushing. Ibi biterwa nuko ibi bimenyetso bikunze kugaragara ku ndwara nyinshi zitandukanye.

Nanone, indwara ya Cushing rimwe na rimwe ishobora kwitiranywa na polycystic ovary syndrome cyangwa metabolic syndrome . Muganga wawe azakenera kwemeza izindi ndwara kugira ngo amenye niba hari ikibazo.

Ni ibihe bipimo bikorwa kugira ngo hamenyekane indwara ya Cushing Syndrome?

Muganga wawe ashobora gukora bimwe muri ibi bizamini:

• Ikizamini cya cortisol mu nkari cy'amasaha 24: Iki kizamini gipima ingano ya cortisol mu nkari zawe muri mikorogarama (mcg). Muganga wawe azagusaba gukusanya inkari zawe mu gihe cy'amasaha 24.
• Ikizamini cya cortisol yo mu macandwe yo mu gicuku: Ubusanzwe, urugero rwa cortisol ruba ruto cyane nijoro. Iki kizamini gisuzuma urugero rwa cortisol hagati ya saa tanu na saa kumi n'ebyiri za mu gitondo. Niba ufite indwara ya Cushing, urugero rwa cortisol yawe ruzaba ruri hejuru cyane muri icyo gihe.
• Ikizamini cyo kugabanya umuvuduko wa dexamethasone ku gipimo gito:Dexamethasone ni umuti usa na cortisol. Kuri iki kizamini, ufata mililigarama imwe (mg) y'uyu muti unywa nijoro, hanyuma urugero rwa cortisol yawe rugapimwa hagati ya saa mbiri na saa cyenda za mu gitondo. Iki kizamini cy'amaraso kireba niba imisemburo y'inkende yawe yakiriye dexamethasone mu kugabanya ingano ya cortisol isohora. Niba ufite indwara ya Cushing, urugero rwa cortisol yawe ruzaba ruri hejuru.
• Isuzuma ry'amaraso: Isuzuma ry'amaraso ripima urugero rwa ACTH mu maraso yawe. Niba urugero rwa ACTH ruri hasi, ushobora kuba ufite ikibyimba cyo mu ndure z'intanga. Niba urugero ruri hejuru cyangwa rusanzwe, ushobora kuba ufite ikibyimba cyo mu bwonko cyangwa ikibyimba cyo mu nda.
• Ikizamini cyo gupima dexamethasone ku rugero rwo hejuru: Iki kizamini gisa n'ikizamini cyo gupima dexamethasone ku rugero rwo hasi, ariko urugero ni miligarama 8 aho kuba 1. Iki kizamini gikunze gukorwa nyuma y'uko ikizamini cyo gupima gike kigaragaje urugero rwinshi rwa cortisol mu gitondo kandi ibizamini by'amaraso bikagaragaza urugero rwinshi rwa ACTH mu maraso. Iki kizamini gishobora gufasha kumenya icyateye indwara ya Cushing. Gishobora gufasha gutandukanya adenoma ya pituitary (izwi kandi nka Cushing's disease) n'ikibyimba ahandi mu mubiri wawe (nk'aho mu bihaha).

Iyo umuganga wawe amaze kwemeza ko ufite indwara ya Cushing, intambwe ikurikiraho ni ukumenya ikibitera. Akenshi, gishobora kuba umuti cyangwa ikibyimba. Niba ufata glucocorticoids, iyo ni yo mpamvu, bityo muganga wawe ashobora kugabanya urugero rwawe. Niba utari gufata glucocorticoids, bishobora kugaragaza ikibyimba mu ngirabuzimafatizo zawe z'inkondo y'umura, mu ngirabuzimafatizo ya pituitary, cyangwa ahandi. Muganga wawe ashobora kukugira inama yo gukora inyigo nk'izi kugira ngo agufashe kubona ikibyimba:

• Gupima CAT (CT scan) cyangwa MRI mu nda: Muganga wawe ashobora gukora CT scan cyangwa MRI kugira ngo arebe niba ufite ikibyimba mu ndurwe z'intanga. Ibi bipimo bishobora gukorwa hamwe cyangwa hatabayeho intravenous contrast (IV contrast). Ibi bipimo ni ingenzi cyane mu kumenya ibibyimba by'intanga.
• Ishusho ya magnetic resonance (MRI) y'agahu k'ubwonko bw'umuntu:MRI ifata amafoto y'agace ka pituitary kugira ngo irebe ko hari ikibyimba. Hari igihe MRI iba atari igisubizo cyuzuye. Abantu bagera kuri 50% barwaye indwara ya Cushing bagira MRI "isanzwe", mu gihe 10% bashobora kuba bafite ibibyimba bidafitanye isano n'iyi ndwara.
• Isuzuma rya Bilateral inferior petrosal sinus sampling (BIPPS): Iki kizamini gisanga isoko y’isohoka rya ACTH. ACTH n’indi misemburo ya pituitary iva mu gahu k’ubwonko ikajya mu maraso. Umuganga w’inararibonye mu by’imirasire akora iki kizamini binyuze mu mitsi ibiri yitwa inferior petrosal sinuses. Igipimo cy’ukuri cy’iki kizamini kiri hagati ya 95% na 98%.
• Igituza cya CT scan: Niba muganga wawe akeka ko hari ikibyimba cyo mu nda, ashobora gusaba ko bagupima igituza kugira ngo barebe niba hari kanseri y'ibihaha ishobora kuba ihari.

Indwara ya Cushing ivurwa ite?

Ubwoko bw'ubuvuzi buterwa n'impamvu nyamukuru ituma urugero rwa cortisol ruri hejuru. Niba ufata glucocorticoids, muganga wawe ashobora kugabanya urugero rwawe cyangwa akakwandikira umuti utari uwa glucocorticoids.

Niba indwara ya Cushing iterwa n'ikibyimba, muganga wawe ashobora kukugira inama yo kubagwa cyangwa kuvurwa hakoreshejwe imirasire.

Ubundi buryo ni uko muganga wawe akwandikira umuti ugabanya ikorwa rya cortisol, nka ketoconazole. Ushobora gukenera gukorana n'abaganga batandukanye kugira ngo bavure ikibyimba n'ibimenyetso bya syndrome ya Cushing.

• Chimiotherapie: Niba ikibyimba ari kanseri kandi kikaba cyarakwirakwiriye mu bindi bice by'umubiri, imiti ya chimiotherapie ishobora kuba ngombwa. Menya neza ko waganiriye na muganga wawe ku ngaruka mbi zose.
• Imiti: Kongeramo imiti igabanya cortisol cyangwa gukuraho imiti ishobora gutera indwara ya Cushing's Syndrome.
• Imirasire: Ikibyimba cya pituitary gishobora kutavanwaho. Muri ibyo bihe, ushobora kuba warahawe imiti ivura imirasire mu byumweru bitandatu. Bishobora gufata imyaka myinshi kugira ngo urugero rwa cortisol rusubire ku rugero rusanzwe. Vugana na muganga wawe ku ngaruka mbi zose.
• Kubaga:Kubaga gukuraho ibibyimba byo mu bwonko, ibibyimba byo mu misemburo, n'ibibyimba byo hanze y'umubiri birakora neza, ariko uzakenera kumenyera urugero rushya rwa cortisol. Muri iki gihe, ushobora gukenera gufata imiti ya cortisol mu buryo bwa hydrocortisone. Uzashobora guhagarika gufata uyu muti nyuma y'amezi 6 kugeza kuri 18. Kenshi na kenshi, nyuma yo kubagwa laparoscopic, uzabasha kuva mu bitaro mu munsi umwe cyangwa ibiri.

Iyo indwara ya Cushing ivuwe neza, bishobora gufata amezi hagati ya 2 na 18 kugira ngo ikire. Komeza uhuze na muganga wawe muri iki gihe no mu gihe kirenze icyo.

Ni iki nakwitega mu gihe mfite indwara ya Cushing Syndrome?

Muganga wawe ashobora kandi agomba kuvura indwara ya Cushing. Iyo itavuwe, ishobora kwica. Shaka muganga vuba bishoboka kugira ngo umuganirize ibimenyetso byawe na muganga wawe.

Ese indwara ya Cushing ishobora kwiyongera?

Indwara ya Cushing ishobora kwiyongera iyo idavuwe neza. Komeza kuvugana na muganga wawe umumenyeshe ibimenyetso bishya, ibimenyetso birushaho kwiyongera, cyangwa ikindi kibazo icyo ari cyo cyose.

Nigute nagabanya cyangwa ngakingira ibyago byo kurwara indwara ya Cushing Syndrome?

Umubiri wawe ukeneye cortisol igihe cyose. Urayikeneye kugira ngo ikomeze gukora. Igenzura guhumeka kwawe, igahindura ibiryo urya mo imbaraga, ikagenzura urugero rw'isukari mu maraso yawe, ikagufasha guhangana n'imihangayiko, kandi igakora byinshi kurushaho. Cortisol si umwanzi w'umubiri wawe, ariko kuyirya cyane si byiza. Ariko, ntushobora kubaho udafite cortisol.

Niba ufata glucocorticoids cyangwa steroides, hamagara muganga wawe akurikirane urugero rwa cortisol yawe neza. Ikibabaje ni uko nta buryo bwo kwirinda ko ikibyimba cyatera indwara ya Cushing's Syndrome (hypercortisolism).

Bimeze bite kubana n'indwara ya Cushing Syndrome?

Kubana na Cushing's syndrome bishobora kugorana, ariko si ngombwa ko biba ari indwara ishobora gushyira ubuzima mu kaga. Hari abaganga bahuguwe kugufasha, kandi hari n'uburyo bwo kuvura. Ubu buryo busanzwe bushobora gukiza Cushing's syndrome no kunoza ibimenyetso by'urugero ruri hejuru rwa cortisol (hypercortisolism).

Indwara ya Cushing ishobora gutuma ugira ibibazo bimwe na bimwe mu byiyumvo no mu mibanire. Hari abantu bashobora kugira isoni zo gutakaza umusatsi, gukura k'umusatsi cyane, cyangwa kwiyongera ibiro mu maso no mu ijosi. "Isura y'ukwezi" n'"ipfundo ry'inyambo" bishobora gutuma utekereza kabiri ku bijyanye no kwitabira ibikorwa byo gusabana. Uko igihe kigenda gihita, ubuvuzi bushobora gufasha kunoza ibi bimenyetso. Indwara ya Cushing ishobora kandi gutera kwiheba n'izindi ndwara zo mu mutwe. Niba bibaye ngombwa, reba umuganga w'indwara zo mu mutwe kugira ngo akugire inama n'umuganga w'indwara zo mu mutwe kugira ngo akubere imiti igufasha guhangana n'ingaruka z'amarangamutima ziterwa n'urugero rwinshi rwa cortisol (hypercortisolism).

Ni ryari ngomba kujya kwa muganga?

Shaka muganga niba ufite kimwe muri ibi bimenyetso bya syndrome ya Cushing:

Ibimenyetso byibasira abagore by’umwihariko:

• Umusatsi mushya cyangwa mwinshi wo mu maso umera.
• Impinduka mu byifuzo by'imibonano mpuzabitsina.
• Impinduka mu kwezi k'imihango.

Ibimenyetso bigira ingaruka kuri buri wese:

• Kwiyongera ibiro vuba mu maso (bamwe babyita "ukwezi mu maso"), igifu, inyuma y'ijosi (bamwe babyita "imbogo"), n'igituza.
• Isura itukura kandi izengurutse.
• Umuvuduko ukabije w'amaraso (hypertension).
• Umusatsi mwinshi mu maso, mu ijosi, mu gituza, mu nda no mu bibero.
• Diyabete.
• Indwara y'ibiheri bishya cyangwa byinshi.
• Kugaragara kw'ibisebe by'umuhengeri mu gice cyo mu nda.
• Gukomeretsa amaboko n'ibirenge byoroshye.
• Intege nke rusange n'umunaniro.
• Kutabona neza no kugira isereri.
• Ibikomere bifata igihe kugira ngo bikire.
• Intege nke z'imitsi.

Ni ibihe bibazo ngomba kubaza muganga wanjye?

• Ni iyihe miti nshobora gufata kugira ngo nyifashe mu gihe mfite indwara ya Cushing's syndrome?
• Ese hari imyitozo ngororamubiri nshobora gukora kugira ngo mfashe imitsi yanjye idakomeye?
• Ese hari imiti ishobora gukoreshwa mu gufasha kuvura ibisebe byo mu mutwe?
• Ese nkwiye kubonana n'inzobere mu ndwara ya Cushing Syndrome?
• Ese ngomba guhagarika gufata imiti iyo ari yo yose ndimo gufata ubu?
• Ni ubuhe buryo bwiza bwo kuvura kuri njye?
• Ese hari izindi ngamba zo kwirinda ngomba gufata?

Indwara ya Cushing ishobora kuba indwara igoranye guhangana nayo. Ishobora gutera intege nke, umuvuduko ukabije w'amaraso, n'umunaniro. Uburyo bwo kuvura nko kubaga, imiti, kuvurwa hakoreshejwe imirasire, na chimiotherapie bushobora kugorana. Ariko birakwiye, kuko iyo habayeho ubuvuzi bukwiye, indwara ya Cushing ishobora gukira.

Incamake (Ubutumwa bwo kujyana mu rugo)

Indwara ya Cushing ni indwara iterwa n’ubwiyongere bw’umusemburo wa cortisol mu mubiri wacu. Ibi ni gake cyane, arikoIyo igaragaye kandi ikavurwa neza, ishobora gukira . Ni ngombwa cyane gushaka inama kwa muganga niba ufite ibimenyetso nko kubyimba mu maso, kwiyongera ibiro, gukura k'umusatsi cyane, cyangwa umuvuduko ukabije w'amaraso. Uburyo bwo kuvura buratandukanye bitewe n'impamvu. Bityo rero vugana na muganga wawe kuri byose kandi ukurikize inama ze. Wibuke ko utari wenyine, kandi ubufasha burahari.

Indwara ya Cushing, cortisol, imisemburo, imisemburo y'inkende, imyakura ya pituitary, ACTH, ibimenyetso, uburyo bwo kuvura , indwara y'imiti igabanya ubukana bw'amaraso