Ngaba umntwana wakho ukhula ngokukhawuleza kakhulu? Masifunde nge-gigantism!

Ngamanye amaxesha abantwana bethu bakhula ngokukhawuleza kakhulu, akunjalo? Kodwa akuqhelekanga ukuba ngequbuliso bakhule babe bade kakhulu kunabanye abantwana, benemilenze emikhulu. Oku kusenokuba kungenxa yemeko engaqhelekanga. Namhlanje siza kuthetha ngemeko enjalo, eyi-'Gigantism'.

Yintoni 'iGigantism'?

Ngamafutshane, i-gigantism yimeko engaqhelekanga apho umntwana okanye umntu oselula evelisa i-growth hormone (GH) eninzi kakhulu. Yiyo loo nto aba bantwana bekhula bebade kakhulu kunabanye. Ngokwesiqhelo, le hormone yokukhula (GH) iveliswa yi-gland encinci, enobukhulu be-pea ekwisiseko sobuchopho bethu. Ibizwa ngokuba yi-pituitary gland. Nangona kunjalo, ukuba kuvela ithumba elincinci kule gland ye-pituitary, inokuvelisa i-growth hormone engaphezulu (GH) kunokuba kufuneka. Kulapho ke kwenzeka i-gigantism.

I-Pituitary Gland yindlala encinci ekwisiseko sobuchopho, ngaphantsi kweHypothalamus. Enyanisweni ikhupha malunga neehomoni ezisi-8. I-Growth Hormone (GH) yenye yazo.

I-Growth Hormone, eyaziwa ngokuba yi-Human Growth Hormone (hGH), ibalulekile ekukhuleni kwabantwana. Ichaphazela amalungu amaninzi omzimba kwaye inceda umntwana akhule kakuhle. Nangona kunjalo, kukho iintlobo ezithile zee-growth plates emathanjeni ethu ezibizwa ngokuba yi-Epiphyses/Growth Plates, kwaye xa zivaliwe ngokupheleleyo (oko kukuthi emva kokufikisa), i-growth hormone (GH) ayinyusi ubude. Eyenzayo kukugcina ulwakhiwo kunye ne-metabolism yamathambo, i-cartilage, kunye nezinye izitho. Le hormone yokukhula (GH) inxulumene ngokusondeleyo ne-hormone ebizwa ngokuba yi-Insulin-like Growth Factor 1 (IGF1), eveliswa sisibindi sethu. Zimbini, ezi zimbini zinceda ekukhuleni nasekusetyenzisweni kwe-metabolism.

I-Gigantism yimeko apho umzimba uvelisa i-growth hormone eninzi (GH), nto leyo ebangela ukuba izihlunu, amathambo, kunye nezicubu ezidityanisiweyo zikhule ngokukhawuleza. Oku kubangela ukuphakama okungaqhelekanga kunye notshintsho oluninzi kwizicubu ezithambileyo zomzimba. Ukuba azinyangwa, abanye abantu abane-gigantism banokukhula babe ngaphezu kweenyawo ezili-1.5 ubude.

Kungoko ke, kubaluleke kakhulu ukufumanisa isifo kwaye uqale unyango ngokukhawuleza xa kukho i-gigantism.

Yintoni umahluko phakathi kwe-'Gigantism' kunye ne-'Acromegaly'?

I-Gigantism kunye ne-acromegaly zombini ziimeko ezibangelwa yi-excess growth hormone (GH). Umahluko kukuba ngubani oyifumanayo. I-Acromegaly ichaphazela abantu abadala. I-Gigantism ichaphazela abantwana kunye nabantu abadala abancinci abasakhula, oko kukuthi, abangakafiki kwixesha lokufikisa.

Ngamafutshane, i-gigantism yenzeka xa amanqanaba e-growth hormone (GH) enyuka ngaphambi kokuba ii-growth plates emathanjeni abantwana zivaleke (oko kukuthi, ngaphambi kokuba ukufikisa kuphele).

Ukuba amanqanaba e-hormone yakho yokukhula (GH) ayanda emva kokuba ii-growth plates zakho zivaliwe, oko kunokubangela i-acromegaly. Awuyi kukhula ube mde, kodwa i-GH engaphezulu inokuchaphazela ukuma kwamathambo akho, ubungakanani bamalungu akho, kunye nezinye iimeko zempilo.

I-Gigantism yimeko engaqhelekanga kakhulu kune-acromegaly.

Ngubani ofumana ubuqhophololo? Kuxhaphake kangakanani oku?

Nangona le yimeko engaqhelekanga, i-gigantism inokukhula nakuwuphi na umntwana onama-growth plates angekavali (oko kukuthi, akakagqibi ukufikisa). Ixhaphake kakhulu kubafana kunakumantombazana.

I-Gigantism yimeko engaqhelekanga kakhulu. Umzekelo, zimalunga ne-100 kuphela iimeko ezibikiweyo eMelika ukuza kuthi ga ngoku. Ngoko unokucinga ukuba inqabile kangakanani loo nto.

Ukukhula okuqhelekileyo kwenzeka njani ebantwaneni? Yintoni umahluko phakathi kwe-gigantism?

Ihomoni yokukhula (GH) yiyo elawula ukukhula ngexesha lobuntwana. Oko kukuthi, ilawula imetabolism ngelixa ibangela ukukhula okunokulinganiswa emathanjeni, kwizihlunu, nakwizicwili. Ngokwesiqhelo, ukukhula yinkqubo ezinzileyo de umntwana afikelele ekufikiseni.

Ngexesha lokufikisa, ukukhutshwa kweehomoni zesini (i-estrogen kunye ne-testosterone) kuyanda kakhulu. Oku kubangela ukuba ii-epiphyses (iiplate zokukhula) eziphelweni zamathambo amade omntwana zivale kancinci kancinci. Xa ii-epiphyses zivala ngokupheleleyo, oko kukuthi, xa ukufikisa kugqityiwe, ukukhula kobude kuyayeka.

Indlela umntwana akhula ngokukhawuleza ngayo kunye nobude bakhe bokugqibela emva kokufikelela ekufikiseni kuxhomekeka kukudibana kwezakhi zofuzo ezininzi azizuza kubazali bakhe, izinto ezingqongileyo, kunye nesini sakhe.

Kwimeko ye-gigantism, umntwana ukhula ngokukhawuleza kakhulu, kwaye mde kakhulu kunabanye abantwana abaneminyaka efanayo nabesini esifanayo. Nangona kunjalo, iimpawu ze-gigantism ekuqaleni zinokubonakala ngathi kukukhula okuqhelekileyo kobuntwana, okwenza kube nzima kubazali ukuqaphela.

Ukuba unemibuzo okanye iinkxalabo malunga nokukhula komntwana wakho, qiniseka ukuba uthetha nogqirha wakhe.

Zithini iimpawu ze-gigantism?

I-Gigantism ibangelwa kukwanda kwe-hormone yokukhula (GH). Kwakhona, ithumba kwi-pituitary gland linokubangela uxinzelelo kwingqondo ekufutshane kunye nezicubu zemithambo-luvo, nto leyo ebangela ezinye iimpawu. Uphawu oluphambili lwe-gigantism kukukhula kakhulu.Abantwana abane-gigantism bakhula ngokukhawuleza kakhulu.

Ukongeza ekubeni mde/mkhulu kakhulu kuneminyaka yomntu, iimpawu zomzimba ezibonakala kwi-gigantism ziquka:

• Ibunzi elibonakalayo kakhulu kunye nomhlathi obonakalayo.
• Ukuba nezikhewu phakathi kwamazinyo.
• Ukutyeba kweempawu zobuso.
• Izandla neenyawo ezinkulu, kunye neminwe etyebileyo.

Ezinye iimpawu ezinokubonwa ziquka:

• Ukwanda kwamalungu angaphakathi, ingakumbi intliziyo yomntwana.
• Ukubila okugqithisileyo (hyperhidrosis).
• Ukubona kabini okanye ubunzima ngokubona okusecaleni.
• Intloko ebuhlungu.
• Intlungu yamalungu.
• Ukufikisa okulibazisekileyo.
• Ukuya exesheni okungaqhelekanga.
• Iingxaki zokulala, umzekelo, i-sleep apnea.
• Ubuthathaka bemisipha.

Ukuba umntwana wakho unezi mpawu, kubaluleke kakhulu ukuthetha nogqirha ngokukhawuleza.

Zithini izizathu ze-gigantism?

I-Gigantism idla ngokubangelwa sisimila esingenobungozi (i-pituitary adenoma) kwi-pituitary gland yomntwana. Oku kubangela ukukhululwa okugqithisileyo kwe-growth hormone (GH). Xa abantwana abane-gigantism befunyaniswa ukuba banayo, phantse bahlala bene-pituitary adenoma enkulu (isimila esingama-10 mm okanye ngaphezulu), esibizwa ngokuba yi-macroadenoma. I-Gigantism inokubangelwa kukwanda kwe-pituitary gland, ebizwa ngokuba yi-pituitary hyperplasia.

Abantwana abaninzi abane-gigantism banotshintsho lwemfuza olubangela ithumba le-pituitary. Utshintsho lwemfuza oluqhelekileyo olunxulunyaniswa ne-gigantism kukuguquka okanye ukususwa kwe-AIP gene. Oku kuchaphazela malunga nama-29% abantu abane-gigantism.

I-Gigantism inokwenzeka njengenxalenye yeengxaki ezininzi zemfuza ezingaqhelekanga ezinyusa umngcipheko wokuba nethumba le-pituitary elikhupha i-growth hormone (GH). Ezinye zezi ngxaki ziquka:

• I-Carney complex: Le yimeko yemfuza echaphazela umbala wesikhumba kwaye ibangela iithumba ezingengobungozi zesikhumba, intliziyo, kunye nenkqubo ye-endocrine. Malunga ne-10% ukuya kwi-13% yabantu abane-Carney complex baphuhlisa ii-pituitary adenomas ezikhupha i-hormone yokukhula (GH), ezihlala zikhula kancinci.
• Isifo sikaMcCune-Albright:Le yimeko yemfuza echaphazela amathambo, ulusu, kunye nenkqubo ye-endocrine. Ibangela amabala e-café-au-lait eluswini, izicubu ezibomvu emathanjeni, kunye nokufikisa ngaphambi kwexesha. Ama-20% ukuya kuma-30% abantu abane-McCune-Albright syndrome bane-hormone yokukhula engaphezulu (GH). Oku kudla ngokubangelwa kukwanda (hyperplasia) kwe-pituitary gland, okanye i-pituitary adenoma.
• Iindidi ezininzi ze-Endocrine Neoplasias (MEN) 1 okanye 4: Ezi ziimeko zemfuza. Kwimeko enjalo, elinye okanye ngaphezulu kwamadlala akho e-endocrine asebenza kakhulu, okanye kuvela ithumba. Oku kungabandakanya ithumba le-pituitary elikhupha i-growth hormone (GH).
• I-Neurofibromatosis: Le yimeko yemfuza ebizwa ngokuba zii-neurocutaneous disorders. Ezi zichaphazela ulusu kunye nenkqubo yemithambo-luvo. Ezi meko zibangelwa kukwanda okungaqhelekanga kokukhula kweeseli. Oku kunokukhokelela ekwakhiweni kweethumba emzimbeni wonke. Ezi zinokubandakanya ithumba elikhupha i-growth hormone (GH).
• Ii-Familial Isolated Pituitary Adenomas (FIPA): Le yimeko yelifa. Ibandakanya ukuphuhliswa kwee-pituitary adenomas. Ezi zinokubandakanya ii-growth hormone (GH)-secreting adenomas.

Ifunyaniswa njani i-gigantism?

I-Gigantism inokuba nzima ukuyifumanisa kuba yimeko engaqhelekanga, kwaye kuba izinga lokukhula kwabantwana linokwahluka kakhulu ngenxa yemfuza kunye neemeko zokusingqongileyo.

Ngokwesiqhelo, oogqirha barhanela ukuba ukuphakama komntwana kukuphambuka okuqhelekileyo okuthathu ngaphezu kokuphakama okuqhelekileyo ngokwesini nangobudala bakhe, okanye ukuphambuka okuqhelekileyo okubini ngaphezu kokuphakama okuqhelekileyo okubalwa ukusuka kubude babazali bomntwana.

Ukuba ugqirha womntwana wakho ukrokrela ukuba umntwana wakho une-gigantism, mhlawumbi uza kukuthumela kwi-endocrinologist (ugqirha ogxile kwizifo ezinxulumene namahomoni). Ugqirha uza kwenza uxilongo ngokusekelwe kwimbali yezonyango yomntwana wakho, imbali yezonyango yosapho, uvavanyo olupheleleyo lomzimba, kunye novavanyo olukhethekileyo olufana novavanyo lwegazi kunye novavanyo lwemifanekiso.

Zeziphi iimvavanyo ezisetyenziselwa ukuxilonga i-gigantism?

Ukuba ugqirha womntwana wakho ukrokrela ukuba une-gigantism, kunokwenziwa ezi mvavanyo zilandelayo ukuqinisekisa imeko:

• Uvavanyo lwegazi lwe-Growth Hormone kunye ne-IGF-1 (Insulin-like Growth Factor 1): Olu vavanyo lulinganisa amanqanaba eehomoni ezahlukeneyo kwisampuli yegazi ethathwe kumthambo womntwana. Ukuba amanqanaba aphezulu kunesiqhelo, oko kungaba luphawu lwe-gigantism.
• Uvavanyo Lokunyamezela Iswekile: Olu vavanyo lulinganisa indlela amanqanaba ehomoni yokukhula komntwana asabela ngayo kwiswekile. Kolu vavanyo, ugqirha uthatha iisampuli zegazi kumthambo ngamaxesha ahlukeneyo emva kokuba umntwana esele isisombululo seswekile.
• Uvavanyo lwemifanekiso: Ukuba uvavanyo lwegazi luqinisekisa ukuba umntwana wakho une-gigantism, ugqirha wakho uya kucebisa ukuba ahlolwe nge-MRI (Magnetic Resonance Imaging) okanye nge-CT (Computed Tomography). Ezi zinokubona ngokucacileyo ubungakanani kunye nendawo yethumba le-pituitary. Zinokunceda nasekumiseleni unyango olufunekayo.

Ukuba umntwana wakho ufunyaniswe ene-gigantism, ugqirha angenza ezinye iimvavanyo ukuze abone ukuba imeko ichaphazele amanye amalungu omzimba. Ezi mvavanyo zingabandakanya:

• I-echocardiogram yokujonga iingxaki zentliziyo.
• Uvavanyo lovavanyo lokulala ukuze kubonwe ukuba unayo na i-sleep apnea.
• Ii-X-reyi okanye i-DEXA/DXA scan ukujonga impilo yamathambo akho.

Iphathwa njani i-gigantism?

Iinjongo eziphambili zokunyanga i-gigantism zezi:

• Ukulawula ngokukhuselekileyo amanqanaba 'okukhula' (GH) kunye 'ne-insulin-like growth factor 1' (IGF1).
• Ukulawula ukukhula 'kwesimila sepituitary'.
• Ukunciphisa impembelelo yethumba le-pituitary kwizicubu zobuchopho ezikufutshane kunye ne-optic nerve.
• Ukunyanga okanye ukunciphisa imiphumo ye-growth hormone (GH) kwezinye iinkqubo zomzimba.

Oogqirha badla ngokusebenzisa indibaniselwano yonyango lwe-gigantism , apho unyango oluphambili lutyando kunye nonyango lwe-radiation.

Nangona kukho amayeza asebenzayo okunyanga i-growth hormone (GH) excess kubantu abadala (acromegaly), iziphumo zala mayeza ebantwaneni azikafundwa kakuhle.

Utyando lweGigantism

Utyando lolona nyango luqhelekileyo lwe-gigantism. Injongo kukususa i-pituitary tumor okanye ukunciphisa ubukhulu bayo. Ngenxa yokuba i-pituitary tumor ebangela i-gigantism idla ngokuba nkulu, umntwana unokufuna utyando oluninzi ukuze alawule ngokufanelekileyo amanqanaba e-growth hormone (GH).

Ugqirha womntwana wakho angasebenzisa inkqubo yotyando ebizwa ngokuba yi-transsphenoidal surgery ukususa ithumba le-pituitary. Oku kuquka ukwenza utyando ngempumlo yomntwana wakho nange-sphenoid sinus (umngxuma osekhakhayini emva komngxuma wempumlo, ngaphantsi kwengqondo).

Unyango lweMisebe yeGigantism

Ukuba utyando aluphumeleli ukunciphisa amanqanaba e-growth hormone, unyango lwe-radiation lunokunceda. Oku kubandakanya ukusebenzisa izixhobo ezikhethekileyo ukujolisa imisebe ye-radiation kwi-tumor. Olu nyango lusebenza kancinci. Lunokufuna unyango oluninzi, kunye nexesha elide lokuphumla phakathi. Kungathatha iminyaka eliqela ukubona iziphumo ezipheleleyo.

Zithini iingxaki zonyango?

Ngenxa yotyando kunye/okanye unyango lwemitha, malunga nama-60% abantu abane-gigantism baba nesifo esibizwa ngokuba yi-hypopituitarism emva konyango. Oku kwenzeka xa i-hormone enye, ezininzi, okanye zonke eziveliswa yi-pituitary gland zingaveliswanga ngokwaneleyo. I-Hypopituitarism inyangwa ngamayeza okutshintsha ii-hormone.

Iingxaki ezinokubakho emva kotyando lokususa ithumba le-pituitary ziquka:

• Ukopha.
• Ukuvuza kweCerebrospinal Fluid (CSF).
• I-Meningitis (umkhuhlane wobuchopho).
• Ukulahlekelwa yi-sodium (ityuwa) kunye nokulinganisela kwamanzi emzimbeni.

Iziphumo ebezingalindelekanga zonyango lwe-radiation zingabandakanya:

• Ukungakwazi Ukuzala.
• Ukulahlekelwa kukubona kunye nokonakala kwengqondo (kunqabile).
• Ukwakheka kwethumba emva kweminyaka eliqela emva konyango (kunqabile).

Ngaba i-gigantism ingathintelwa? Ithini ingqikelelo?

Ngelishwa, akukho nto unokuyenza ukuthintela i-gigantism. Nangona kunjalo, ukubonwa kwangoko kubalulekile. Unyango lwasekuqaleni lunokunceda ukuthintela okanye ukuguqula utshintsho olubangela ukuba umntwana wakho abe mde kakhulu.

Ukuqikelela kwangaphambili kwabantwana kunye nabantu abadala abancinci abaxilongwe nge-gigantism kuxhomekeke kwizinto ezininzi:

• Ukuba esi sifo safunyanwa kwangethuba okanye emva kwexesha kangakanani.
• Zisebenza kangakanani unyango lokulawula amanqanaba e-hormone yokukhula?
• Ingaba kukho iingxaki ezinxulumene ne-gigantism.

Ngokubanzi, abantu abadala abaxilongwayo badla ngokuba neengxaki ezingaphezulu kunabo baxilongwa besebancinci. Oku kusenokwenzeka ukuba kungenxa yokuba bechitha ixesha elide besebenzisa i-growth hormone kunye ne-insulin-like growth factor 1 (IGF1).

Ngoko ke, ukuba ubona utshintsho olungaqhelekanga nolungalindelekanga ekukhuleni komntwana wakho kunye/okanye kwiimpawu zakhe zomzimba, kubalulekile ukuthetha nogqirha wakhe ngokukhawuleza.

Ingakanani iminyaka yobomi bomntu one-gigantism? Zithini iingxaki ezihlala ixesha elide?

Ukufunyanwa kwangethuba kunye nonyango lwe-gigantism kubalulekile ukuthintela ubude obugqithisileyo kunye neengxaki ezinxulumene nayo kunye nokwandisa ixesha lokuphila.

Ukuba ayinyangwa, i-gigantism inxulunyaniswa neengxaki ezinkulu kwaye izinga lokufa linokuphindwe kabini kuneliqhelekileyo.

Iingxaki zexesha elide abanye abantu abane-gigantism abahlangabezana nazo ngenxa yobude babo obugqithisileyo kunye nesiphumo sokuba ne-growth hormone eninzi ziquka:

• Ubunzima bokuhambahamba (Ukuhambahamba) ngenxa yobuthathaka bemisipha.
• I-Osteoarthritis (ukudumba kwamalungu).
• I-Peripheral Neuropathy (iingxaki zemithambo-luvo ejikeleze i-peripheral).
• 'Ukuphelelwa yi-Apnea yokulala'.
• Iingxaki zentliziyo ekhulisiweyo (i-cardiomegaly) kunye neevalvu zentliziyo.
• Iingxaki zemetabolism ezifana ne-Type 2 Diabetes.

Ukongeza, umgangatho wobomi babantu abane-gigantism enganyangwanga unokuncipha ngenxa yeengxaki zemisebenzi yemihla ngemihla efana nokuthenga impahla kunye nokuhamba ngenxa yokuba bade kakhulu.

Ufanele ubonane nini nogqirha womntwana wakho malunga ne-gigantism?

Ukuba umntwana wakho ufunyaniswe ene-gigantism, kuya kufuneka abone ugqirha wakhe kunye/okanye i-endocrinologist rhoqo ukuze ajonge inkqubela yonyango kwaye aqinisekise ukuba amanqanaba akhe e-hormone alungile.

Ukuba ubona naluphi na utshintsho kwizinga lokukhula komntwana wakho kunye/okanye iimpawu zomzimba, kubalulekile ukuthetha nogqirha womntwana wakho ngokukhawuleza. Nangona i-gigantism ingenakuba yimbangela, kufanelekile ukuphanda naluphi na utshintsho olungathandabuzekiyo. I-Gigantism ingcono ukuchongwa kwangethuba, kwaye abantu abane-gigantism badla ngokuphila ubomi obusempilweni. Ukuba unemibuzo malunga nokukhula komntwana wakho, ungoyiki ukubuza ugqirha wakho. Bakho ukuze bakuncede.

Izinto ezibalulekileyo ekufuneka uzikhumbule (Umyalezo Wokuya Ekhaya)

I-Gigantism yimeko engaqhelekanga kodwa enokuba yingozi. Eyona nto ibalulekileyo kukufuna ingcebiso kagqirha ngokukhawuleza ukuba ubona nantoni na engaqhelekanga okanye erhanelekayo malunga nokukhula komntwana wakho, njengokukhula ngokukhawuleza kunokuba bekulindelwe okanye ukuba namalungu amakhulu.

Khumbula, ukuxilongwa kwangoko kunye nonyango kwandisa kakhulu amathuba okuba umntwana wakho aphile ubomi obusempilweni nobuqhelekileyo. Ungakhathazeki, oogqirha bakhona ukunceda wena nomntwana wakho. Thetha nabo ngayo nayiphi na into enokubaxhalabisa.

I- Gigantism, iHormone yoKhula, iGland yePituitary, Ukukhula kwabantwana, Ukunyuka koBude, i-Acromegaly