Ngaba unazo ezi mpawu? Masithethe ngeCushing Syndrome!

Ngaba wakha weva ngeCushing Syndrome? Eli gama lisenokuba litsha kuwe. Ngamafutshane, yimeko eyenzeka xa imizimba yethu ivelisa i- cortisol eninzi kakhulu. Abanye abantu bayibiza ngokuba yi-hypercortisolism. "I-syndrome" yingqokelela yeempawu ezidibanayo. Kusenokwenzeka ukuba abanye abantu bayibonile ibizwa ngokuba yiCushing's syndrome.

Ngoko ke yintoni le cortisol?

I-Cortisol yi-hormone ye-steroid emizimbeni yethu. Sidla ngokuyibiza ngokuba yi-"stress hormone" kuba xa siphantsi koxinzelelo, imizimba yethu ikhupha i-cortisol engakumbi. Ngala maxesha, i-cortisol isinceda:

• Isantya sentliziyo yakho siyanda.
• Uxinzelelo lwakho lwegazi luyanda.
• Ilawula amanqanaba eswekile egazini.
• Ilawula ukuphefumla.
• Iyandisa uxinzelelo lwemisipha.

Ayisiyiyo loo nto kuphela, kodwa xa sixinezelekile, i-cortisol ikwanceda ekuvaleni okwethutyana iinkqubo ezingabalulekanga emizimbeni yethu ngelo xesha, umzekelo, inkqubo yokugaya ukutya kunye nenkqubo yokuzala.

I-Cortisol yi-hormone ebalulekileyo emizimbeni yethu. I-Cortisol ibalulekile kwezi zinto:

• Gcina uxinzelelo lwegazi.
• Lawula amanqanaba eswekile egazini.
• Nciphisa ukudumba.
• Yakha iinkumbulo.
• Lawula ukuphefumla kwakho.
• Gcina ibhalansi yetyuwa emzimbeni.
• Guqula ukutya esikutyayo kube ngamandla.

Amanqanaba eCortisol alawulwa ziindlala ezimbini ezincinci phezu kwezintso zethu, iindlala zeadrenal, indlala yepituitary ebuchotsheni, kunye nehypothalamus, ekwindawo engaphezulu kwendlala yepituitary.

I-Cushing's syndrome idla ngokubangelwa sisimila . Oku kunokwenzeka ngeendlela ezimbini eziphambili:

• Ezivela ngaphandle: Oku kuthetha ukuba yimeko ebangelwa yi-cortisol, eveliswa emizimbeni yethu.
• Engaphandle: Oku kuthetha ukuba imeko ibangelwa zizizathu zangaphandle njengesiphumo esingesihle samayeza athile athathwayo ukunyanga ezinye iimeko zonyango.

Ngubani onokuthi abe neCushing Syndrome?

I-Cushing's syndrome ixhaphake kakhulu ebantwaneni, kubantu abadala abaselula, nakubantu abadala. Ixhaphake kakhulu kubantu abaphakathi kweminyaka engama-25 nama-50 ubudala. Abantu abasebenzisa amayeza aqulethe i-cortisol (umzekelo, amayeza e-asthma kunye ne-rheumatoid arthritis) basengozini enkulu yokuhlaselwa yile meko. Malunga nama-70% abantu abane-Cushing's syndrome ngabafazi kwaye ama-30% ngamadoda.

Ixhaphake kangakanani le meko?

I-Cushing's syndrome yimeko engaqhelekanga kakhulu , echaphazela abantu abaphakathi kwama-40 nama-70 kwisigidi ngonyaka.

Yintoni umahluko phakathi kweCushing Syndrome kunye neCushing Disease?

Isifo sikaCushing luhlobo lwe-Cushing's syndrome. Sibangelwa sisimila esingenobungozi kwi-pituitary gland. Esi simila sikhupha i-hormone eninzi kakhulu ye- ACTH (adrenocorticotropic hormone) . Oku kubangela ukuba ii-adrenal glands zikhuphe i-cortisol eninzi kakhulu.

Kwabo banesifo sikaCushing, abantu abadala abangaphezu kwama-70% kunye nabantwana abaselula abaphakathi kwama-60% nama-70% banalo olu hlobo lwesifo sikaCushing.

Ngabaphi oogqirha abanyanga iCushing Syndrome?

Ugqirha wakho uza kukuthumela kwingcali ebizwa ngokuba yi-endocrinologist ukuze ayixilonge aze ayinyange le meko.

Ngaba iCushing Syndrome ingabulala?

Ewe, iCushing's Syndrome inokubulala ukuba ayinyangwa ngokufanelekileyo. Ukuba ayinyangwa, eli nqanaba liphezulu le-cortisol (hypercortisolism) linokubangela iingxaki ezahlukeneyo zempilo. Umzekelo:

• Iintsholongwane
• Amahlwili egazi, ingakumbi emiphungeni nasemilenzeni
• Uxinzelelo
• Ukuhlaselwa yintliziyo
• Ukutyeba kwakho
• Iingxaki zememori okanye ubunzima bokugxila
• Uxinzelelo lwegazi oluphezulu okanye i-cholesterol ephezulu
• Amathambo aphukileyo
• Uhlobo lwesibini lwesifo seswekile, isifo seswekile esingaphambi kwesifo seswekile, okanye i-glucose yokuzila ukutya engasebenzi kakuhle

Ukuba ayinyangwa, isifo sikaCushing sinokukhokelela ekufeni.

Zithini izizathu zeCushing Syndrome?

I-Cushing's syndrome ibangelwa ngamanqanaba aphezulu e-cortisol emzimbeni. Kukho izizathu ezininzi ezinokubakho:

• Ukusetyenziswa kwamayeza eGlucocorticoid: Amayeza eGlucocorticoid (umzekelo, i-prednisone) asetyenziselwa ukunyanga isifo sombefu esingapheliyo, isifo samathambo esibizwa ngokuba yi-rheumatoid arthritis, i-lupus, i-sarcoidosis, kunye nezinye izifo ezininzi ezibangela ukudumba okungapheliyo. Ukusebenzisa la mayeza ixesha elide kunokubangela i-"iatrogenic" okanye i-exogenous Cushing syndrome. Igama elithi "iatrogenic" lithetha ukuba kukho enye into ebangelwa lunyango lwezonyango.
• Iithumba zepituitary: I-Cushing syndrome ( ngaphandle kwe-iatrogenic Cushing syndrome) ibangelwa ziithumba zepituitary ezivelisa i-ACTH eninzi, i-hormone exelela amadlala e-adrenal ukuba avelise i-cortisol, kwaye ichaphazela abantu abasi-8 kwabali-10. Olu hlobo lubizwa ngokuba yi-Cushing disease.
• Ii-Adrenal cortical tumors: I-tumor ekhula phezu kwe-adrenal gland inokuvelisa i-cortisol eninzi kakhulu. Ezi zihlala ziyi-benign tumors. Nangona kunjalo, ngamanye amaxesha le tumor inokuba yi-adrenal cortical carcinoma, uhlobo olungaqhelekanga lomhlaza we-adrenal.
• Iithumba zemiphunga, ipancreas, i-thyroid kunye ne-thymus: Xa i-ACTH iveliswa ziithumba ezingaphandle kwe-pituitary gland, ibizwa ngokuba yi-ectopic ACTH syndrome. Ezi thumba zihlala ziyingozi. Ezona zixhaphakileyo kwezi ngumhlaza wemiphunga weseli encinci.

Ingaba iCushing Syndrome idluliselwa kwilifa?

Ngokwesiqhelo, hayi . Uninzi lweemeko zeCushing's syndrome azizuzisi njengelifa.

Zithini iimpawu zeCushing Syndrome?

Ukongeza kwiimpawu ezithile ze-Cushing's syndrome, kukwakho neempawu ezinokuthi zifane nezinye iimeko ezininzi. Ayingabo bonke abantu abaya kuba neempawu ezifanayo. Nazi iimpawu ezinokubakho:

• Ukwanda ngokukhawuleza kobunzima ebusweni (abanye bathi oku "bubuso benyanga"), indawo yesisu, umva wentamo (abanye bathi oku "yi-buffalo hump"), kunye nesifuba.
• Ubuso obomvu, obungqukuva.
• Amanxeba athatha ixesha ukuphola.
• Uxinzelelo lwegazi oluphezulu (uxinzelelo lwegazi oluphezulu).
• Ukukhula kweenwele ngokugqithisileyo ebusweni, entanyeni, esifubeni, esiswini, emabeleni, nasemathangeni, okanye ekulahlekelweni ziinwele (impandla).
• Isifo seswekile.

Ezinye iimpawu zingabandakanya:

• Ukubonakala kweempawu zokunwebeka ezimfusa kwindawo yesisu.
• Ukutyumza okulula kwezandla neenyawo.
• Ubuthathaka kunye nokudinwa ngokubanzi.
• Umbono ofipheleyo kunye nesiyezi.
• Ubuthathaka bemisipha kunye nokuphelelwa ngamandla kwamalungu omzimba.
• Utshintsho kwi-libido kunye nokungasebenzi kakuhle kwe-erectile kumadoda.
• Ukukhula okungahambi kakuhle ebantwaneni.

Ihlala ixesha elingakanani iCushing Syndrome?

Ixesha elithathayo le-Cushing's syndrome lixhomekeke kwindlela osabela ngayo kunyango. Uninzi lwabantu abanamanqanaba aphezulu e-cortisol (hypercortisolism) bayaphola emva kweeveki ezimbalwa zonyango.

Ngaba iCushing Syndrome ibangela ubunzima bokuphefumla?

Hayi.Ukuphefumla nzima akulona uphawu olubonakalayo lwe-Cushing's syndrome.

Ngaba iCushing Syndrome ibangela i-osteoporosis?

Ewe. I-Cushing's syndrome inokubangela amathambo abuthathaka. Oku kunokubangela ukwaphuka kwamathambo, ingakumbi ukuba ubunale meko ixesha elide. Amathambo abuthathaka nawo anokubangela iintlungu.

Ngaba iCushing Syndrome ibangela i-hypokalemia?

I-Hypokalemia yimeko apho inqanaba le-potassium egazini lakho liphantsi. Le meko inokwenzeka ukuba une-Cushing's syndrome.

Ifunyanwa njani iCushing Syndrome?

Ukuba ugqirha wakho ukrokrela ukuba amanqanaba aphezulu e-cortisol (hypercortisolism), kukho izikhokelo aza kuzilandela. Baza kubuza imibuzo, bathathe imbali yakho yezonyango, benze uvavanyo lomzimba, baze ba-odole ezinye iimvavanyo zelebhu. Banokukujonga ixesha elithile.

I-Cushing's syndrome ngamanye amaxesha inokuba nzima ukuyifumanisa. Ukuba uxelela ugqirha wakho ukuba udiniwe kwaye uyatyeba, usenokungacingi kwangoko nge-Cushing's syndrome. Oku kungenxa yokuba ezi mpawu ziqhelekile kwizifo ezininzi ezahlukeneyo.

Kwakhona, i-Cushing's syndrome ngamanye amaxesha inokubhidaniswa ne- polycystic ovary syndrome okanye i-metabolic syndrome . Ugqirha wakho kuya kufuneka akhuphe ezinye iimeko ukuze enze uxilongo.

Zeziphi iimvavanyo ezenziwayo ukuze kufunyaniswe iCushing Syndrome?

Ugqirha wakho angenza ezinye zezi mvavanyo:

• Uvavanyo lwe-cortisol yomchamo oluthatha iiyure ezingama-24: Olu vavanyo lulinganisa ubungakanani be-cortisol kumchamo wakho kwii-micrograms (mcg). Ugqirha wakho uza kukucela ukuba uqokelele umchamo wakho kwixesha leeyure ezingama-24.
• Uvavanyo lwe-cortisol yamathe phakathi kobusuku: Ngokwesiqhelo, amanqanaba e-cortisol aphantsi kakhulu ebusuku. Olu vavanyo lujonga amanqanaba e-cortisol phakathi kwe-11 ne-12 kusasa. Ukuba une-Cushing's syndrome, amanqanaba akho e-cortisol aya kuba phezulu ngendlela engaqhelekanga ngelo xesha.
• Uvavanyo lokuncitshiswa kwe-dexamethasone oluphantsi:I-Dexamethasone liyeza elifana ne-cortisol. Kolu vavanyo, uthatha i-milligram enye (mg) yale mayeza ngomlomo ebusuku, uze emva koko amanqanaba akho e-cortisol alinganiswe phakathi kwentsimbi yesi-8 neyesi-9 kusasa. Olu vavanyo lwegazi lujonga ukuba amadlala akho e-adrenal aphendule na kwi-dexamethasone ngokunciphisa ubungakanani be-cortisol abayikhuphayo. Ukuba une-Cushing's syndrome, amanqanaba akho e-cortisol aya kuba phezulu.
• Uvavanyo lwegazi: Uvavanyo lwegazi lulinganisa inqanaba le-ACTH egazini lakho. Ukuba inqanaba le-ACTH liphantsi, usenokuba nethumba le-adrenal. Ukuba inqanaba liqhelekile okanye liphezulu, usenokuba nethumba le-pituitary okanye ithumba elingaphandle kwesisu.
• Uvavanyo lokunciphisa i-dexamethasone enedosi ephezulu: Olu vavanyo lufana novavanyo lokunciphisa i-dexamethasone enedosi ephantsi, kodwa idosi yi-8 milligrams endaweni ye-1. Olu vavanyo ludla ngokwenziwa emva kokuba uvavanyo lokunciphisa i-dexamethasone lubonise amanqanaba aphezulu e-cortisol kusasa kwaye uvavanyo lwegazi lubonisa amanqanaba aphezulu e-ACTH egazini. Olu vavanyo lunokunceda ekufumaneni unobangela we-Cushing's syndrome. Lunokunceda ukwahlula phakathi kwe-pituitary adenoma (ekwaziwa ngokuba sisifo sikaCushing) kunye nethumba elikwenye indawo emzimbeni wakho (njengakwimiphunga).

Nje ukuba ugqirha wakho aqinisekise ukuba une-Cushing's syndrome, inyathelo elilandelayo kukufumanisa ukuba yintoni ebangela oku. Kwiimeko ezininzi, isenokuba liyeza okanye ithumba. Ukuba uthatha i-glucocorticoids, kusenokwenzeka ukuba yiyo loo nto ibangela oku, ngoko ugqirha wakho unokunciphisa umthamo wakho. Ukuba awusebenzisi i-glucocorticoids, oku kunokubonisa ithumba kwi-adrenal glands yakho, kwi-pituitary gland, okanye kwenye indawo. Ugqirha wakho unokucebisa izifundo zomfanekiso ezifana nezi ukuze akuncede ufumane ithumba:

• I-CAT scan (CT scan) okanye i-MRI esiswini: Ugqirha wakho angenza i-CT scan okanye i-MRI ukuze abone ukuba unethumba kwi-adrenal glands yakho. Ezi scan zinokwenziwa nge-intravenous contrast okanye ngaphandle kwayo. Ezi vavanyo zinobuthathaka kakhulu ekufumaneni izimila ze-adrenal.
• I-Magnetic resonance imaging (MRI) ye-pituitary:I-MRI ithatha imifanekiso ye-pituitary gland yakho ukuze ikhangele ithumba. Kwezinye iimeko, i-MRI ayiloxilongo olupheleleyo. Malunga nama-50% abantu abane-Cushing's syndrome bane-MRI "eqhelekileyo", ngelixa i-10% isenokuba neethumba ezingahambelaniyo ne-syndrome.
• Isampuli ye-Bilateral inferior petrosal sinus sampling (BIPPS): Olu vavanyo lufumana umthombo wokukhutshwa kwe-ACTH. I-ACTH kunye nezinye iihomoni ze-pituitary zikhutshwa kwi-pituitary gland ziye egazini. Ingcali ye-radiologist enamava yenza olu vavanyo ngemithambo emibini ebizwa ngokuba yi-inferior petrosal sinuses. Izinga lokuchaneka kolu vavanyo liphakathi kwe-95% kunye ne-98%.
• Isifuba se-CT scan: Ukuba ugqirha wakho urhanela ukuba kukho ithumba eliphuma etyhini, banokuyalela ukuba kwenziwe i-CT scan yesifuba ukuze kuhlolwe ukuba kukho umhlaza wemiphunga onokubakho na.

Inyangwa njani iCushing Syndrome?

Uhlobo lonyango luxhomekeke kwisizathu esiyintloko samanqanaba aphezulu e-cortisol. Ukuba uthatha ii-glucocorticoids, ugqirha wakho usenokunciphisa umthamo wakho okanye akunike amayeza angengo-glucocorticoid.

Ukuba i-Cushing's syndrome ibangelwa sisimila, ugqirha wakho unokucebisa utyando okanye unyango lwemitha.

Enye indlela kukuba ugqirha wakho akunike iyeza elinciphisa ukuveliswa kwe-cortisol, njenge-ketoconazole. Kusenokufuneka usebenzisane noogqirha abahlukeneyo ukunyanga ithumba kunye neempawu ze-Cushing's syndrome.

• Unyango lweKhemotherapy: Ukuba ithumba lingumhlaza kwaye lisasazeke kwamanye amalungu omzimba, unyango lwekhemotherapy lunokufuneka. Qiniseka ukuba uthetha nogqirha wakho ngayo nayiphi na imiphumo emibi.
• Amayeza: Ukongeza amayeza anciphisa i-cortisol okanye ukususa amayeza anokubangela i-Cushing's Syndrome.
• Ukusasazwa kwemitha: Ithumba le-pituitary lisenokungasuswa ngotyando. Kwiimeko ezinjalo, kunokufuneka ukuba udlule kwiiveki ezintandathu zonyango lwemitha. Kungathatha iminyaka ukuba amanqanaba e-cortisol abuyele esiqhelweni. Thetha nogqirha wakho malunga nazo naziphi na iziphumo ebezingalindelekanga.
• Utyando:Ukususwa kweethumba zepituitary, iithumba zeadrenal, kunye neethumba eziphuma etyhini kuphumelele, kodwa kuya kufuneka uhlengahlengise amanqanaba amatsha e-cortisol aphantsi. Ngeli xesha, kunokufuneka uthathe amayeza e-cortisol ngohlobo lweepilisi ze-hydrocortisone. Uya kukwazi ukuyeka ukusebenzisa la mayeza emva kweenyanga ezi-6 ukuya kwezi-18. Kwiimeko ezininzi, emva kotyando lwe-laparoscopic, uya kukwazi ukuphuma esibhedlele emva kosuku okanye ezimbini.

Ukuba i-Cushing's syndrome inyangwa ngokufanelekileyo, kungathatha naphi na ukusuka kwiinyanga ezi-2 ukuya kwezili-18 ukuba iphile. Hlala unxibelelana nogqirha wakho ngeli xesha nangaphaya.

Yintoni endinokuyilindela ukuba ndineCushing Syndrome?

Ugqirha wakho unako kwaye ufanele ukunyanga i-Cushing's syndrome. Ukuba ayinyangwa, ingabulala. Bonana nogqirha ngokukhawuleza ukuze uxoxe ngeempawu zakho nogqirha wakho.

Ngaba iCushing Syndrome ingaba mandundu?

Isifo sikaCushing sinokuba mandundu ukuba asinyangwa kakuhle. Hlala unxibelelana nogqirha wakho kwaye umxelele ngazo naziphi na iimpawu ezintsha, iimpawu eziya zisiba mandundu, okanye naziphi na ezinye iingxaki.

Ndingayinciphisa okanye ndiyithintele njani ingozi yeCushing Syndrome?

Umzimba wakho udinga i-cortisol ngalo lonke ixesha. Uyayidinga ukuze uhlale usebenza. Ilawula ukuphefumla kwakho, iguqula ukutya okutyayo kube ngamandla, ilawula amanqanaba eswekile egazini lakho, ikunceda ukujongana noxinzelelo, kwaye yenza okungakumbi. I-Cortisol ayilotshaba lomzimba wakho, kodwa ukuba ininzi kakhulu ayilunganga. Nangona kunjalo, awunakuphila ngaphandle kwe-cortisol.

Ukuba usebenzisa ii-glucocorticoids okanye ii-steroids, cela ugqirha wakho ukuba ajonge amanqanaba akho e-cortisol ngokusondeleyo. Ngelishwa, akukho ndlela yokuthintela ithumba ukuba libangele i-Cushing's Syndrome (hypercortisolism).

Kunjani ukuphila neCushing Syndrome?

Ukuphila ne-Cushing's syndrome kunokuba nzima, kodwa akufuneki ukuba ibe yimeko esongela ubomi. Kukho oogqirha abaqeqeshwe ukukunceda, kwaye kukho unyango. Olu nyango lunokuphelisa i-Cushing's syndrome kwaye luphucule iimpawu zamanqanaba aphezulu e-cortisol (hypercortisolism).

I-Cushing's syndrome inokubangela ukuba ube neengxaki ezithile ngokweemvakalelo nangokwentlalo. Abanye abantu banokuziva beneentloni ngokulahlekelwa ziinwele, ukukhula kakhulu kweenwele, kunye/okanye ukutyeba ebusweni nangasemva kwentamo. "Ubuso benyanga" kunye "ne-buffalo hump" kunokukwenza ucinge kabini malunga nokuthatha inxaxheba kwiimeko zentlalo. Ekuhambeni kwexesha, unyango lunokunceda ukuphucula ezi mpawu. I-Cushing's syndrome inokubangela nokudakumba kunye nezinye izifo zengqondo. Ukuba kuyimfuneko, bona ingcali yezonyango ukuze ufumane iingcebiso kunye nogqirha wengqondo ukuze ufumane amayeza okukunceda ujongane nemiphumo yeemvakalelo yamanqanaba aphezulu e-cortisol (hypercortisolism).

Ndifanele ndimbone nini ugqirha?

Bona ugqirha ukuba unayo nayiphi na kwezi mpawu zeCushing's syndrome:

Iimpawu ezichaphazela ngokukodwa abasetyhini:

• Ukukhula kweenwele zobuso ezintsha okanye ezigqithisileyo.
• Utshintsho kwinkanuko yesini.
• Utshintsho kumjikelo wokuya exesheni.

Iimpawu ezichaphazela wonke umntu:

• Ukwanda ngokukhawuleza kobunzima ebusweni (abanye bathi oku "bubuso benyanga"), indawo yesisu, umva wentamo (abanye bathi oku "yi-buffalo hump"), kunye nesifuba.
• Ubuso obomvu, obungqukuva.
• Uxinzelelo lwegazi oluphezulu (uxinzelelo lwegazi oluphezulu).
• Ukukhula kweenwele ngokugqithisileyo ebusweni, entanyeni, esifubeni, esiswini nasemathangeni.
• Isifo seswekile.
• I-acne entsha okanye egqithisileyo.
• Ukubonakala kweempawu zokunwebeka ezimfusa kwindawo yesisu.
• Ukutyumza okulula kwezandla neenyawo.
• Ubuthathaka kunye nokudinwa ngokubanzi.
• Umbono ofipheleyo kunye nesiyezi.
• Amanxeba athatha ixesha ukuphola.
• Ubuthathaka bemisipha.

Ndingayibuza yiphi imibuzo ugqirha wam?

• Ngawaphi amayeza endingawasebenzisa ukunceda nge-Cushing's syndrome yam?
• Ngaba kukho imithambo endinokuyenza ukunceda izihlunu zam ezibuthathaka?
• Ngaba kukho amayeza anokusetyenziswa ukunceda kwiimpawu zokunwebeka?
• Ngaba kufuneka ndidibane nengcali yeCushing Syndrome?
• Ngaba kufuneka ndiyeke ukusebenzisa amayeza endiwasebenzisayo ngoku?
• Yeyiphi indlela engcono yonyango kum?
• Ngaba kukho naziphi na ezinye iindlela zokuthintela ekufuneka ndizithathe?

Isifo sikaCushing sinokuba yimeko enzima ukujongana nayo. Sinokubangela ubuthathaka, uxinzelelo lwegazi oluphezulu, kunye nokudinwa. Unyango olufana notyando, amayeza, unyango lwemitha, kunye ne-chemotherapy lunokuba nzima. Kodwa zifanelekile, kuba ngonyango olufanelekileyo, isifo sikaCushing sinokunyangeka.

Isishwankathelo (Umyalezo Wokuya Ekhaya)

I-Cushing's Syndrome yimeko ebangelwa kukwanda kwe-hormone cortisol emizimbeni yethu. Oku kunqabile kancinci, kodwaUkuba ifunyenwe kwaye inyangwa ngokufanelekileyo, inokunyangeka . Kubaluleke kakhulu ukufuna ingcebiso kagqirha ukuba uneempawu ezinje ngokudumba kobuso, ukutyeba, ukukhula kweenwele ngokugqithisileyo, okanye uxinzelelo lwegazi oluphezulu. Iindlela zonyango ziyahluka ngokuxhomekeke kwisizathu. Ngoko ke thetha nogqirha wakho ngayo yonke into kwaye ulandele icebiso lakhe. Khumbula, awuwedwa, kwaye uncedo luyafumaneka.

Isifo sikaCushing, i-cortisol, iihomoni, ii-adrenal glands, i-pituitary gland, i-ACTH, iimpawu, unyango, i-endocrinologist