Reka twige ku bibazo bimwe na bimwe biri mu mubiri wawe? - Multiple Endocrine Neoplasia (MEN)

Umubiri wacu umeze nk'imashini itangaje, si byo se? Kugira ngo iyi mashini ikore neza, buri gice kigomba gukorana neza no guhuza neza. Hari sisitemu y'ingenzi cyane mu mubiri wacu, yitwa sisitemu y'imisemburo . Ingirabuzimafatizo muri iyi sisitemu zikora imisemburo igenzura ibikorwa byinshi mu mubiri wacu. Ariko, rimwe na rimwe iyi sisitemu ishobora kugenda nabi. Uyu munsi tugiye kuvuga ku kibazo kidasanzwe ariko cy'ingenzi cyane tugomba kumenya. Iyo ni Multiple Endocrine Neoplasia , izwi kandi nka `(MEN)` mu magambo ahinnye.

None se iyi sisitemu y'imisemburo ni iki?

Mu magambo make, sisitemu yacu y’imisemburo ni urusobe rw’uturemangingo n’ingingo mu mubiri wacu. Izi ni zo zikora imiti yitwa imisemburo ikayirekura mu maraso. Tekereza ko izi misemburo ari intumwa nto zitwara ubutumwa mu mibiri yacu. Izi misemburo zibwira ingingo zacu, uruhu, n’imitsi icyo gukora n’igihe cyo kubikora.

Hari imisemburo n'ingingo nyinshi z'ingenzi bigize sisitemu yacu y'imisemburo:

• Hypothalamus: Iyi iri mu nsi y'ubwonko bwacu. Igenzura ibintu byinshi mu misemburo y'imisemburo.
• Impyiko y'ubwonko: Iyi mpyiko nto, ihujwe na hypothalamus, ikora imisemburo igenzura izindi mpyiko nyinshi, harimo impyiko ya tiroyide, impyiko z'intanga ngabo, intanga ngabo n'intanga ngabo.
• Tiroyide: Iyi mvubura imeze nk'ikinyugunyugu iri imbere mu ijosi igenzura imikorere y'umubiri wacu, ari na yo ikoresha imbaraga ziva mu byo turya.
• Udukoko twa Parathyroid: Utu dukoko tune duto, dukunze kuba hafi y’udukoko twa tiroyide, tugenzura urugero rwa kalisiyumu na fosifore mu mubiri wacu.
• Udukoko tw’impyiko: Utu dukoko tubiri, duherereye hejuru y’impyiko, tugenzura imikorere y’umubiri, umuvuduko w’amaraso, iterambere ry’imibonano mpuzabitsina, n’uburyo umuntu ahangana n’imihangayiko.
• Ingirabuzimafatizo: Iyi ngirabuzimafatizo ikora imisemburo ya melatonine kandi igacunga imikorere yacu yo gusinzira.
• Pancreas: Aha niho insuline ikorerwa. Ni ingenzi cyane mu mikorere y'umubiri no kugenzura isukari mu maraso. Ni kimwe mu bigize uturemangingo tw'igogora.
• Intanga ngabo: Aha niho imisemburo y'igitsina gore yitwa estrogen, progesterone, na testosterone ikorerwa.
• Teste: Mu gihe cyo gukora intanga mu bagabo, imisemburo ya testosterone nayo ikorerwa hano.

None se, indwara ya Multiple Endocrine Neoplasia (MEN) ni iki?

Indwara ya Multiple Endocrine Neoplasia (MEN) ni indwara idakunze kugaragara mu buryo bw’uturemangingo aho ibibyimba bikura mu turemangingo n’uturemangingo turenze kamwe, nk’uko twabivuze mbere. Hari igihe ibi bibyimba bishobora kuba kanseri.

Hari ubwoko bubiri bw'ingenzi bw'iyi ndwara ya `(MEN)`:

1. Indwara nyinshi zo mu misemburo y'amaraso mu bwoko bwa 1 (MEN type 1): Iyi ni indwara ituma habaho ibibyimba byinshi mu misemburo itandukanye y'isesemi y'amaraso. Ibi kandi byitwa MEN-1 na Wermer's syndrome.

2. Indwara nyinshi zo mu bwoko bwa 2 bw’imisemburo (MEN type 2): Iyi ni kanseri y’uturemangingo ifata imyakura myinshi. Abantu barwaye MEN2 barwara ubwoko bwa kanseri ya tiroyide yitwa kanseri ya tiroyide ya medullary (MTC) . Bafite kandi ibyago byinshi byo kurwara ibibyimba mu zindi myakura zo mu bwoko bwa endocrine. Ibi kandi byitwa MEN-2 na Sipple syndrome.

Kuki iki kibazo cya `(ABAGABO)` kibaho?

Ubwo bwoko bwombi bwa `(MEN)` buterwa n'impinduka mu ngirabuzimafatizo zacu, ni ukuvuga impinduka . Tekereza ko umubiri wacu ufite ikintu gisa n'igitabo cy'amabwiriza, ni ukuvuga ngirabuzimafatizo. Niba hari inyuguti imwe muri iki gitabo cy'amabwiriza itari yo, ni ukuvuga ko iyo ngirabuzimafatizo yahinduwe, imikorere imwe n'imwe y'umubiri ishobora guhungabana.

• (ubwoko bwa 1 bwa MEN) buterwa n'impinduka mu ngirabuzimafatizo ya `MEN1` . Iyi ngirabuzimafatizo ya `MEN1` ni ngirabuzimafatizo igabanya kanseri . Ni ukuvuga ngirabuzimafatizo ifasha kugenzura igabanyuka ry'uturemangingo no gukumira ko turemangingo zibaho. Iyo iyi ngirabuzimafatizo idakora neza, hari uturemangingo dushobora gukura tudashoboye kugenzura no gukora ibibyimba.
• (MEN type 2) iterwa n'impinduka mu ngirabuzimafatizo ya `RET` . Iyi ngirabuzimafatizo ya `RET` ni ngirabuzimafatizo ifitanye isano n'iterambere rya kanseri. Iyo iyi ngirabuzimafatizo ihindutse, uturemangingo two mu ngingo zimwe na zimwe no mu ngirabuzimafatizo dukura mu buryo butunguranye kandi tugakora ibibyimba.

Izi mpinduka mu ngirabuzimafatizo zishobora kuragwa n'ababyeyi cyangwa zishobora kubaho mu buryo butunguranye mu gihe umwana akura. Iyo umubyeyi umwe afite MEN, hari amahirwe agera kuri 50% ko umwana azayikuramo.

Reka twige byinshi kuri `(MEN)` ubwoko bwa 1 (`MEN ubwoko bwa 1`)

Abantu barwaye indwara ya MEN yo mu bwoko bwa 1 barwara ibibyimba mu ngirabuzimafatizo nyinshi zo mu misemburo y'amaraso. Ahantu hakunze kwibasirwa cyane ni:

• Udukoko twa parathyroid: Iyi ni yo ikunze kugaragara cyane.
• Uburyo bwo mu gifu: Ibi bivuze ko ibibyimba bishobora kuvuka mu igogora, mu gifu, no mu bindi bice by'igogora, nka duodenum.
• Indwara y'umuyoboro w'amaraso.

Akenshi, ibibyimba bivuka ku bwoko bwa MEN type 1 ntabwo ari kanseri (ntibyiza) . Ariko, bimwe mu bibyimba bishobora kuba kanseri (ibibi).Ishobora kandi gukwirakwira (metastasize) no mu bindi bice by'umubiri. Uturemangingo dufite ibibyimba akenshi dusohora imisemburo myinshi mu maraso. Ibi nibyo bitera ibimenyetso bitandukanye n'ibibazo by'ubuzima.

Abaganga bavumbuye ubwoko burenga 20 bw'ibibyimba byo mu misemburo n'ibitari byo mu misemburo ku bantu bafite ubwoko bwa MEN 1. Hari ubundi bwoko bw'ibibyimba bidakunze kugaragara, nka:

• Ibibyimba byo mu misemburo y'ubwonko bikura muri thymus (umuyoboro w'amaraso mu gituza) no muri bronchi (imiyoboro y'umwuka mu bihaha).
• Utubyimba tw’inkondo y’umura tuba mu gice cyo hanze cy’uturemangingo tw’inkondo y’umura.
• Utubyimba tw'ibinure (Lipomas) twibasira munsi y'uruhu.
• Kanseri y'ibere.
• Ibibyimba nka meningiomas na ependymomas bishobora kugaragara mu bwonko cyangwa mu ruti rw'umugongo.

Ni ibihe bimenyetso bya `(MEN type 1)`?

Ibimenyetso bya MEN type 1 bishobora gutandukana cyane bitewe n'umuntu ku giti cye. Biterwa n'uturemangingo tw'umubiri twagizweho ingaruka n'ingano y'imisemburo dukora. Hari abantu bashobora kutagira ibimenyetso na gato, abandi bashobora kugira ibimenyetso byoroheje, abandi bashobora kugira ibimenyetso bikomeye ndetse bishobora no gushyira ubuzima bwabo mu kaga. Ibimenyetso bishobora gutandukana bitewe n'umuntu ku wundi, ndetse no mu muryango umwe, ndetse no hagati y'impanga.

Reka turebe ubwoko bumwe bw'ingenzi bw'ibibyimba n'ibimenyetso bijyana nabyo:

• Bitewe n'ibibazo by'uturemangingo twa parathyroid (hyperparathyroidism):

90% by'abantu bafite `(MEN type 1)` barwara iyi ndwara bafite imyaka 50. Muri ibi, ingirabuzimafatizo za parathyroid zikora cyane.

• Ibimenyetso byoroheje: kubabara ingingo, intege nke z'imitsi, umunaniro, kwiheba, kugorwa no kwibanda ku bintu, kubura ubushake bwo kurya.
• Ibimenyetso bikomeye: isesemi, kuruka, urujijo, kwibagirwa, kugira inyota nyinshi no kwihagarika kenshi, kuribwa mu nda, kubabara mu magufwa.

• Bitewe n'ibibyimba mu ipanjisi no mu gice cya mbere cy'amara mato (Gastrinomas):

Abantu bakuru bagera kuri 40% barwaye indwara ya MEN yo mu bwoko bwa 1 barwara ibibyimba byitwa gastrinomas. Ibi bibyara imisemburo yitwa gastrin, ituma igifu gikora aside nyinshi cyane.

• Ibimenyetso: Kubabara mu gifu, impiswi, kuribwa mu gifu (aside reflux), ibisebe byo mu gifu (ibisebe byo mu gifu).
• Indi kanseri igaragara muri iki cyiciro ni insulinoma . Iyi kanseri ikora insuline, ishobora gutera isukari nke mu maraso (hypoglycemia).
• Ibimenyetso: urujijo, guhinda umushyitsi, kubira ibyuya, inzara ikabije, kubura amahoro, umutima utera vuba, impinduka z'igihe gito mu kureba.

• Bitewe n'ibibyimba byo mu bwonko bw'umura (prolactinomas):

Abantu bagera kuri 25% barwaye indwara ya MEN yo mu bwoko bwa 1 barwara ibibyimba byo mu bwonko. Ibikunze kugaragara cyane ni prolactinomas, zikora imisemburo ya prolactine .

• Ibimenyetso ku bagore: imihango idakora neza cyangwa guhagarika imihango (amenorrhea), kugorwa no gusama, kuva amaraso mu mabere nk'amata iyo utari utwite cyangwa wonsa (galactorrhea), kugabanuka k'ubushake bw'imibonano mpuzabitsina.
• Ibimenyetso ku bagabo: Kugabanuka k'ubushake bw'imibonano mpuzabitsina bitewe no kugabanuka k'urugero rwa testosterone, kudakora neza k'uburemba (ED), no kugorwa no gusama.
• Iyo ikibyimba ari kinini: kuribwa umutwe, isesemi/kuruka, impinduka mu kureba (kubona kabiri, kugabanuka mu kureba ku ruhande).

Icy'ingenzi: Si abantu bose bazagira ibimenyetso bimwe. Uru rutonde ntirurimo ubwinshi. Hariho ubundi bwoko bwinshi bw'ibibyimba bishobora kugaragara muri `(MEN type 1)`.

Reka kandi twige ku bwoko bwa `(MEN)` (`MEN ubwoko bwa 2`)

Umuntu wese urwaye indwara ya MEN yo mu bwoko bwa 2 arwara ubwoko bwa kanseri ya tiroyide yitwa kanseri ya tiroyide ya medullary (MTC) . Ubu bwoko bwa kanseri bukura mu bwoko bwihariye bw'uturemangingo muri tiroyide yitwa uturemangingo twa C. Utu turemangingo dukora imisemburo yitwa calcitonin. MTC ishobora gukwirakwira mu turemangingo twa lymph nodes no mu zindi ngingo z'umubiri. Uburyo bw'ingenzi bwo kuvura ni ukubaga gukuraho imisemburo ya tiroyide (thyroidectomy).

Nanone, abantu bafite `(MEN type 2)` bashobora kugira kimwe cyangwa byombi muri ibi bikurikira:

• Pheochromocytoma: Iki ni ikibyimba kidasanzwe gikura hagati mu gice kimwe cyangwa byombi by'agace k'intanga ngabo (adrenal medulla). Akenshi, ibi si kanseri. Abagera kuri 10%-15% by'abarwayi bashobora kurwara kanseri no gukwirakwira.
• Hyperparathyroidism: Igipimo cya kalisiyumu mu maraso kiriyongera bitewe n'ikorwa ryinshi rya hormone ya parathyroid (PTH) ikorwa n'udukoko twa parathyroid.

Ni ibihe bimenyetso bya `(MEN type 2)`?

Ibimenyetso hano nabyo biratandukanye. Ibimenyetso akenshi biterwa n'urugero ruri hejuru rw'imisemburo ikorwa na kanseri (MTC) hamwe na bimwe mu bibyimba.

• Ibimenyetso bya kanseri ya tiroyide ifata imitsi (MTC):
• Ikibyimba kiri imbere mu ijosi, ububabare mu ijosi, guhindura ijwi (gushwanyagurika), inkorora, kugorwa no kumira, no guhumeka bigoranye.

• Ibimenyetso biterwa na Pheochromocytoma: (igaragara hafi 50% by'abayirwaye)
• Ibimenyetso bibaho gusa iyo ibi bibyimba bitanga imisemburo myinshi cyane, nka adrenaline. Hari ibibyimba bidatanga imisemburo kandi bishobora kutagira ibimenyetso bigaragaza.
• Ibimenyetso bisanzwe (bikunze kuza no kugenda mu buryo bw'imiziririzo): umuvuduko ukabije w'amaraso (umuvuduko ukabije w'amaraso), kuribwa umutwe, kubira ibyuya byinshi nta mpamvu, gutera k'umutima cyane cyangwa kutari ku murongo, guhinda umushyitsi.

• Ibimenyetso biterwa na hyperparathyroidism:
• Nkuko bigaragara muri `(MEN type 1)`, ibimenyetso nko kubabara ingingo, intege nke z'imitsi, umunaniro, kwiheba, kugorwa no kwibanda ku bintu, kubura ubushake bwo kurya, isesemi, kuruka, inyota nyinshi no kwihagarika kenshi, kuribwa mu nda, no kubabara mu magufwa bishobora kubaho.

Ni nde ushobora kugira iyi ndwara ya `(ABAGABO)`? Ni mu rugero rungana iki?

Iyi ndwara `(MEN)` ishobora kugira ingaruka ku bagabo n'abagore kimwe. Imyaka iyo ndwara `(MEN type 1)` igaragaramo iratandukanye cyane. Yagaragaye ku bana bafite imyaka 8 n'abantu bakuru bafite imyaka 80.

`(ABAGABO)` ni indwara idakunze kugaragara .

• `(ABAGABO bo mu bwoko bwa 1)` bibasira hafi umuntu umwe mu bantu 30.000.
• `(ABAGABO bo mu bwoko bwa 2)` bibasira umuntu umwe kuri 35.000.

Abashakashatsi bamwe bemeza ko umubare nyakuri w'abantu bafite izi ndwara ushobora kuba uri hejuru bitewe no kudasuzuma neza indwara cyangwa kwibeshya ko barwaye indwara.

Ni gute abaganga basuzuma indwara `(MEN)`? (Isuzuma)

Gusuzuma indwara ya `(MEN)` bishobora kugorana gato, kuko bigira ingaruka ku ngirabuzimafatizo zitandukanye.

• Kumenya `(ubwoko bwa 1 bw'ABAGABO)`:

Ubusanzwe umuntu afatwa nk'umuntu ufite ubwoko bwa MEN type 1 iyo afite nibura bibiri muri bitatu by'ingenzi byavuzwe haruguru (ibibyimba bya parathyroid, ibibyimba bya pituitary, na/cyangwa ibibyimba byo mu nzira y'igifu), cyangwa niba afite kimwe muri ibyo bibyimba kandi umwe mu bagize umuryango we afite ubwoko bwa MEN type 1.

• Ibizamini:
• Gupima amaraso: Reba urugero ruri hejuru rw'imisemburo imwe n'imwe (urugero: hormone ya parathyroid (PTH), calcium).
• Ibizamini byo gupima: Ibi bishobora gufasha kubona ahantu hari ibibyimba, nka CT scan (computed tomography scan) cyangwa MRI (magnetic resonance imaging scan).
• Gupima imiterere y'uturemangingo: Igenzura niba hari impinduka mu ngirabuzimafatizo ya `MEN1`.

• Kumenya `(ubwoko bwa 2 bw'ABAMEN)`:

Umuntu apimwa indwara ya MEN type 2 iyo arwaye kanseri ya tiroyide ifata imitsi (MTC) hamwe na pheochromocytoma na/cyangwa hyperplasia cyangwa adenoma y’udukoko twa parathyroid.

• Ibizamini:
• Gupima amaraso: Reba urugero rw'imisemburo nka calcitonin (kuri MTC), hormone ya parathyroid (PTH), na catecholamines (kuri pheochromocytoma).
• Ibizamini byo gushushanya: `CT scan` cyangwa `MRI scan` birakoreshwa.
• Gupima imiterere y'uturemangingo: Igenzura niba hari impinduka mu ngirabuzimafatizo ya `RET`.

Ni ubuhe buryo bwo kuvura `(ABANA)`?

Uburyo bwo kuvura MEN buterwa gusa n’uturemangingo tw’imisemburo n’ingingo bigizweho ingaruka. Ubusanzwe bukoreshwa n’itsinda ry’abaganga b’inzobere mu by’imiti, harimo abaganga b’inzobere mu by’imiti , ababaga , n’abaganga b’inzobere mu by’imiti .

Hashobora kubaho uburyo butandukanye bwo kuvura:

• Imiti: Kugenzura ibimenyetso no kugabanya ingaruka z'imisemburo myinshi.
• Kubagwa: Kuraho ikibyimba cyangwa ingirabuzimafatizo yose yangiritse (urugero: ingirabuzimafatizo ya tiroyide).
• Uburyo bwo gusimbuza imisemburo: Iyo imiterere y'imisemburo ikuweho, imisemburo ikorwa nayo itangwa hanze.
• Kuvura kanseri: Iyo kanseri yakwirakwiriye mu tundi duce (ifite ibice bya metastases), uburyo bwo kuvura kanseri nka chemotherapy na radiation therapy .

Kubera ko umurwayi wese `(ABANA)` ari umwihariko, gahunda yo kuvura ikora kuri buri wese iratandukanye. Ntutinye kuvugana na muganga wawe ku buryo bwo kuvura bukubereye.

Ese `(ABAGABO)` bashobora gukira burundu? Ese bashobora kwirindwa?

Ikibabaje ni uko nta muti uhari kuri ubu w’iyi ndwara `(MEN)`. Ariko, irashobora gukemurwa . Abaganga bafata impinduka muri buri ngirangingo bakoresheje uburyo bwo kubaga cyangwa imiti uko bikwiye icyo gihe.

Ntibishoboka gukumira iterambere rya `(MEN)`, kuko riterwa n'impinduka mu ngirabuzimafatizo. Izi mpinduka mu ngirabuzimafatizo zishobora kuragwa n'ababyeyi cyangwa zikabaho ku buryo butunguranye mu gihe cy'uruhinja.

Ariko, niba umuntu wo mu muryango wa hafi (umubyeyi, umuvandimwe) yanduye MEN, ni ngombwa kuvugana na muganga wawe ku bijyanye no gupima imiterere y’umubiri w’umugabo. Kubikora bishobora gufasha kumenya ibibyimba hakiri kare niba ufite iyo ndwara.

Bigenda bite iyo ubana na `(ABAGABO)`? (Ibisobanuro)

Igipimo cy’indwara ya MEN giterwa n’ibintu byinshi:

• Uburyo `(ABANA)` bamenyekanye vuba.
• Ni izihe ngirabuzimafatizo z'imisemburo zibangamirwa?
• Niba ikibyimba ari kanseri cyangwa atari yo.
• Ubwoko bw'ubuvuzi bwakoreshejwe.
• Niba ikibyimba cya kanseri cyarakwirakwiriye mu bindi bice by'umubiri (cyarangiritse).

Niba waranduye indwara ya MEN, muganga wawe ashobora kuguha igitekerezo cyiza ku bijyanye n'ubuvuzi bwawe n'uburyo bwo kubyitaho.

Igihe cyo kujya kwa muganga n'ibibazo by'ingenzi ugomba kubaza

Niba waranduye MEN, uzakenera kujya kwa muganga wawe buri gihe kugira ngo akurikirane uko umeze kandi arebe neza ko ubuvuzi bwawe bukora neza.

Nanone, niba umuntu wo mu muryango wawe wa hafi afite `(MEN)`, vugana na muganga wawe ku bijyanye no gupima imiterere y'uturemangingo, nk'uko byavuzwe mbere.

Niba ufite `(ABANA)`, byaba byiza ubajije muganga wawe ibibazo nk'ibi:

• Ni ubuhe bwoko bwa `(ABAGABO)` mfite?
• Ni gute (ABANA) bagira ingaruka ku mubiri wanjye?
• Ni ibihe bimenyetso ngomba kwitondera?
• Ni ubuhe buryo bwo kuvura mfite?
• Ni izihe nyungu n'ibibi by'uburyo butandukanye bwo kuvura?
• Bifata igihe kingana iki kugira ngo ubuvuzi bugire icyo bugeraho?
• Ese abandi bo mu muryango wanjye bagomba gupimwa (ABAGABO)?

Amaherezo, ibintu byo kwibuka (Ubutumwa bwo kujyana mu rugo)

Indwara ya multiple endocrine neoplasia (MEN) ni indwara idakunze kugaragara. Nanone, kubera ko MEN ishobora gutera ibimenyetso bitandukanye kandi indwara ya buri wese atari imwe, rimwe na rimwe bishobora kugorana kumenya niba uyifite.

Niba ugaragaje ibimenyetso bishya biguhangayikishije, cyangwa niba ubonye impinduka mu mubiri wawe, ikintu cyiza cyo gukora ni ukujya kwa muganga.

Nubwo hari ubwo `(ABANA)` bugaragara ku buryo butunguranye, bushobora no kugaragara mu miryango. Niba umwe mu bavandimwe bawe ba hafi afite `(ABANA)`, ni ngombwa cyane gupima imiterere y'umubiri kugira ngo umenye niba uri mu kaga. Vugana na muganga wawe ku bibazo ufite ku bijyanye n'ibyago byawe byo kurwara `(ABANA)`. Barahari kugira ngo bagufashe. Ntutinye, ntutinye, kandi ntutinye kubaza ibibazo.

` Indwara nyinshi z'imisemburo, MEN, sisitemu y'imisemburo, imisemburo, ibibyimba, kanseri, MEN ubwoko bwa 1, MEN ubwoko bwa 2, parathyroid, pituitary, pancreas, tiroyide, MTC, pheochromocytoma, imiterere y'uturemangingo, ibimenyetso, isuzuma, uburyo bwo kuvura