Yintoni iGlucagonoma? Makhe sithethe ngale meko ingaqhelekanga!

I-pancreas sisitho esincinci kodwa esibaluleke kakhulu emzimbeni wakho. Sivelisa iihomoni ezininzi ezifunekayo emzimbeni wethu. Ngoko ke, ngamanye amaxesha, uhlobo olungaqhelekanga lomhlaza oluvela kwi-pancreas lunokubangela iingxaki. Yiyo le nto le meko ibizwa ngokuba yiGlucagonoma . Mhlawumbi ngequbuliso unesifo seswekile, okanye uphuhlise into efana nokurhawuzelelwa okungaqhelekanga eluswini lwakho, kubaluleke kakhulu ukuqaphela oku.

Yintoni i-glucagonoma? Ngamafutshane...

I-Glucagonoma sisimila esingaqhelekanga esinomhlaza esikhula kwi-pancreas yakho. Esi simila sivelisa i-hormone eninzi kakhulu ebizwa ngokuba yi-glucagon. Ngoku usenokuba uyazibuza ukuba yintoni le glucagon.

I-Glucagon yi-hormone ebaluleke kakhulu enceda ekulawuleni amanqanaba eswekile emzimbeni wethu, oko kukuthi, amanqanaba eswekile egazini . Yenziwa zii -alpha cells, uhlobo olukhethekileyo lweseli kwi-pancreas yakho. Khawucinge ukuba awukatyi ixesha elide, ukuba uzilolonga kakhulu, okanye ukuba utya isidlo esineeproteni ezininzi, amanqanaba eswekile egazini lakho anokwehla, akunjalo? Kulapho ke le glucagon ingena khona, ikhuphe iswekile egcinwe kwisibindi sakho, oko kukuthi, i-glycogen , ize ibuyisele amanqanaba eswekile egazini. Kufana nomntu onceda ekugcineni ibhalansi yeswekile emzimbeni wethu.

Nangona kunjalo, xa kukho i-glucagonoma, le hormone ye-glucagon iveliswa ngokugqithisileyo. Emva koko umzimba wethu awukwazi ukuyinyamezela. Ukudibana kweempawu ezibangelwa koku kubizwa ngokuba yi -Glucagonoma Syndrome . Oku kunokukhokelela kwiingxaki ezininzi ezifana neengxaki zolusu kunye nesifo seswekile.

Olu hlobo lomhlaza, olubizwa ngokuba yi-glucagonoma, lukwiqela lee-pancreatic neuroendocrine tumors , okanye ii-islet cell tumors . Amaxesha amaninzi, ezi zivela emsileni okanye embindini we-pancreas.

Ingaba lo ngumhlaza ngenene?

Ewe, uninzi lwexesha, i-glucagonoma ngumhlaza . Into ebuhlungu kukuba, nokuba ifunyenwe, malunga ne-50% yamatyala, oko kukuthi, malunga nenye kwababini, lo mhlaza usenokuba usasazeke (wasasazeka) kwamanye amalungu omzimba, ingakumbi isibindi .

Ixhaphake kangakanani le meko?

I-Glucagonoma yimeko engaqhelekanga kakhulu . Ngaphantsi kwesinye kwisigidi seemeko ezintsha ezifunyaniswayo minyaka le. Ihlala ichaphazela abantu abaphakathi kweminyaka engama-50 ukuya kwengama-70 ubudala .

Zithini iimpawu zoku?

Iiglucagonomas zihlala zikhula kancinci . Ngoko ke, ngaphandle kokuba umzimba wakho uvelisa iglucagon eyaneleyo ukubangela iingxaki, usenokungabi nazo naziphi na iimpawu.

Nangona kunjalo, xa i-glucagonoma ivelisa i-glucagon eninzi kwaye umzimba ungakwazi ukuyinyamezela, i-glucagonoma syndrome ekhankanyiweyo ngaphambili iyenzeka.Kuyenzeka. Emva koko, uza kubona iimpawu ezicacileyo. Ukuba unale mpawu, kubaluleke kakhulu ukubona ugqirha ngokukhawuleza.

Ukuqhambuka kolusu (Necrolytic Migratory Erythema - NME)

Olu lolona phawu luphambili noluqhelekileyo lwe-glucagonoma syndrome. Malunga nama-90% abantu abanale syndrome bahlakulela le ngxaki yolusu. Ibizwa ngokuba yi -necrolytic migratory erythema (NME) .

Khawucinge nje, ulusu lwakho, ingakumbi kwiindawo zangasese, ezinqeni, nasemilenzeni esezantsi, luqala ukuba namabala abomvu, arhawuzelelayo, kwaye ngamanye amaxesha abuhlungu. La mabala kamva ajika abe ngamadyungudyungu, aqhekeke, kwaye abe lukhuni. Nokuba sele epholile, ibala elimdaka lisenokuhlala. Oku kunokwakheka kwenye indawo, kuphole, kuze kuphinde kuvele kwenye indawo. Kufana nokurhawuzelela okuhamba ukusuka kwenye indawo ukuya kwenye.

Ezinye iimpawu ze-NME:

• Oku kunokufika kudlule, kwaye kunokuhambahamba emzimbeni .
• Kunokuba buhlungu kakhulu ekuqaleni.
• Irhashalala liba bomvu lize libe namadyungudyungu lize libe luqweqwe. Emva kokuphola, kusenokusala ibala elimdaka.
• Oku kunokukhokelela kwizinto ezifana nezilonda zolwimi (glossitis ), izilonda zomlomo, imilebe eqhekekileyo, kunye ne -angular cheilitis .
• Ukudumba kwamehlo ( i-blepharitis ), ukulahleka kweenwele, kunye neengxaki zezipikili nako kunokubakho.

Iimpawu zesifo seswekile

Esi sifo sibangela amazinga aphezulu eswekile egazini ( i-hyperglycemia ), nto leyo enokubangela isifo seswekile. Iimpawu zesifo seswekile ziquka:

• Ukuba mncane ngaphandle kwesizathu.
• Ukunxanwa okugqithisileyo rhoqo (i-Polydipsia) .
• Ukuchama rhoqo ( i-polyuria ), ingakumbi ebusuku.
• Indlala egqithisileyo ( i-Polyphagia ).

Ezinye iimpawu ze (i-glucagonoma syndrome)

Kukho nezinye iimpawu ezininzi:

• Urhudo olungapheliyo .
• I-hemoglobin ephantsi egazini (i-anemia ). Oku kunokubangela ukudinwa kunye nesiyezi.
• Amahlwili egazi, ingakumbi kwimithambo enzulu yemilenze ( Deep Vein Thrombosis (DVT) ).

Iimpawu ezinxulumene nenkqubo yengqondo neyengqondo

Ngamanye amaxesha, ungabona neempawu ezinxulumene nenkqubo yengqondo neyemithambo-luvo, ezinje ngezi:

• Uxinzelelo
• Isifo sengqondo esixhalabisayo
• Ukuphazamiseka
• I-Hyperreflexia (ukukhawulezisa iimpendulo zomzimba)
• Ukuhamba okungaqhelekanga (ataxia )
• Izifo zengqondo ( Psychosis))
• Uloyiko olungenangqondo kunye nokurhanela ( iiParanoid Delusions )

Yintoni ebangela i-glucagonoma?

Uninzi lwexesha, oogqirha abazi unobangela ochanekileyo we-glucagonoma. Nangona kunjalo, malunga ne-10% yamatyala, lo mhlaza unxulunyaniswa nesifo semfuza esibizwa ngokuba yi-Multiple Endocrine Neoplasia type 1 (MEN type 1) .

Nangona kunjalo, ayinguye wonke umntu one-MEN type 1 ofumana i-glucagonoma. Naleyo yipesenti encinci kakhulu.

Uyibona njani le nto?

Ukuba une- necrolytic migratory erythema (NME) ekhankanyiweyo ngaphambili, ugqirha unokurhanela ukuba kukho i-glucagonoma. Emva koko banokwenza uvavanyo olufana nolu:

• Uvavanyo lweswekile egazini lokuzila ukutya: Ukuba iswekile iphezulu, i-glucagonoma inokurhanelwa kwaye isifo seswekile esihambelanayo sinokuqinisekiswa.
• Uvavanyo lweGazi lweGlucagon yokuzila ukutya: Amanqanaba eGlucagon aphezulu ngokungaqhelekanga kwi-glucagonoma – adla ngokuba ngaphezulu kwama-500 picograms nge-milliliter (pg/mL). Amanqanaba aqhelekileyo e-glucagon yokuzila ukutya angaphantsi kwe-150 pg/mL.
• Uvavanyo lweGazi lwe-Amino Acid: I-Glucagonoma idla ngokubangela amanqanaba aphantsi e-amino acid egazini ( i-hypoaminoacidemia ).
• Ubalo lweGazi olupheleleyo (CBC): Oku kuhlola i -anemia , njengoko i-anemia inokwenzeka nge-glucagonoma.

Uvavanyo lokujonga olu hlobo lunokunceda ukuqinisekisa ukuba kukho iqhuma:

• Iskena se-CT
• Iskeni yeMRI
• I-Endoscopic Ultrasound

Iphathwa njani?

Unyango lwe-glucagonoma luxhomekeke kakhulu ekubeni umhlaza ukhawulelwe kwi-pancreas (ubekwe kwindawo ethile) okanye usasazeke kwezinye iindawo zomzimba (usususwe kwi-metastasized) .

Indlela yokulawula iimpawu kuqala

Inyathelo lokuqala kukulawula iimpawu kunye neengxaki ezibangelwa kukugqithisa kwe-glucagon. Oku kuphathwa ngolu hlobo lulandelayo:

• Amayeza okulawula i-glucagon egqithisileyo: Iinaliti ezibizwa ngokuba yi -Octreotide kunye ne-Lanreotide zinceda ekunciphiseni imiphumo ye-glucagon egqithisileyo kwaye ziyeke ukuveliswa kwe-glucagon. La mayeza anokunciphisa nokukhula kweethumba. Akwanceda kwiimpawu ze-NME, isifo seswekile, isifo sohudo, kunye neengxaki zenkqubo yemithambo-luvo.
• Ulawulo lwesifo seswekile: Usenokufuna amayeza eswekile aselwayo okanye inaliti ye-insulin ukuze ugcine amanqanaba eswekile egazini lakho ekwinqanaba elifanelekileyo.
• Inkxaso yesondlo:I-Total Parenteral Nutrition (TPN) , i-amino acid kunye nezongezo ze-zinc zinokunikwa ukunciphisa imiphumo yokungondleki kakuhle.
• Unyango lwesifo sesikhumba se-NME: Ii-antibiotics kunye ne -corticosteroids zinokuphucula i-NME.
• Unyango lwe-Anticoagulant: Izinto zokunciphisa igazi ezifana ne -heparin zinceda ekuthinteleni i-deep vein thrombosis (DVT) .

Ukuba ikhawulelwe kwi-pancreas...

Ukuba umhlaza ukwipancreas kuphela, unyango oluphambili lolona lunyango . Ukuba ugqirha wotyando unokulisusa ngokupheleleyo ithumba, isifo sihlala sinyangeka . Emva kokuba i-glucagonoma isusiwe, amanqanaba akho e-glucagon kufuneka abuyele kwisiqhelo. Iimpawu zakho nazo kufuneka ziphele.

Ukuba isasazeke nakwezinye iindawo (i-metastasized)...

Nanini na xa kunokwenzeka, oogqirha bacebisa ukuba kususwe iithumba ngotyando. Oku kungabandakanya ukususwa kweethumba kwi-pancreas, ii-lymph nodes ezikufutshane, kunye nesibindi.

Kodwa ukuba ugqirha akakwazi ukususa naliphi na okanye lonke iqhuma, iqela lakho lezonyango linokucebisa olunye okanye ngaphezulu kwezi ndlela zonyango:

• Unyango lweKhemotherapy: Olu nyango lusebenza ngokutshabalalisa iiseli zomhlaza kwaye luthintele ukukhula kwazo.
• Ukususwa kweRadiofrequency: Oku kusebenzisa ubushushu obuvela kumaza erediyo ukubulala iiseli zomhlaza.
• Ukususwa kweCryosurgical: Oku kusebenzisa iikhemikhali ezibandayo kakhulu, ezifana ne-nitrogen engamanzi, ukutshabalalisa iiseli zomhlaza.
• Unyango lweChemoembolization: Olu nyango luthintela ukuhanjiswa kwegazi kumhlaza.

Ithini ingqikelelo yokuchacha kule meko?

Imeko yomntu one-glucagonoma ixhomekeke kwizinto ezininzi:

• Ubudala bakho kunye nempilo yakho iyonke .
• Ubungakanani bethumba lomhlaza .
• Nokuba umhlaza usasazekile okanye awusasazekanga .

Ukuba umhlaza uphelela kwi-pancreas, ikamva lihlala lilungile . Utyando lokususa ithumba ludla ngokuba lonyango, kodwa oku kunjalo kwi-20% kuphela yezigulane ezine-glucagonoma.

Ngenxa yokuba i-glucagonoma inqabile, akukho datha yaneleyo yokuchaza ukuba ungaphila ixesha elingakanani okanye isiphumo siya kuba yintoni ukuba umhlaza usasazeka. Iqela lakho lezonyango liya kukwazi ukubonelela ngolwazi oluthe kratya ngokusekelwe kwimeko yakho ethile.

Ngaba oku kungathintelwa?

Ngenxa yokuba izazinzulu aziyazi imbangela yeemeko ezininzi ze-glucagonoma, akukho nto unokuyenza ukuyithintela .

Nangona kunjalo, ukuba omnye wezalamane zakho ezikwinqanaba lokuqala (abazali bokuzalwa kunye nabantakwenu) ufunyaniswe ene -MEN (Multiple Endocrine Neoplasia) , thetha nogqirha wakho malunga novavanyo lwemfuza. Ukuba nawe une-MEN, uvavanyo lwemfuza lunokunceda ekufumaneni umhlaza kwisigaba sawo sokuqala.

Ukufunyaniswa ukuba unomhlaza yinto ecaphukisayo kakhulu. Xa kuyinto engaqhelekanga efana ne-glucagonoma, kuba nzima nangakumbi. Kodwa khumbula, iqela lakho lezonyango likho ukuze liphendule imibuzo yakho kwaye likuxhase. Ukuba uziva wedwa ngengqondo nangokweemvakalelo nge-glucagonoma, buza ugqirha wakho ngeenkqubo kunye neenkonzo ezinokukunceda.

Okokugqibela, izinto ekufuneka uzikhumbule (Umyalezo Wokuya Ekhaya)

Ngoko ke, nangona i-glucagonoma ingaqhelekanga kakhulu, kubalulekile ukuba uyiqaphele. Ingakumbi ukuba ngequbuliso ubonakalisa iimpawu ezifana nesifo seswekile kunye nokuqhambuka kolusu okungaqhelekanga (NME), njengoko kukhankanyiwe, bona ugqirha ngaphandle kokulibazisa. Ukuba iqatshelwe kwangethuba, inokunyangeka. Nangona oku kunqabile, kukho unyango.

Ungakhathazeki, awuwedwa. Ugqirha wakho kunye neqela lezonyango baya kukunceda kulo lonke olu hambo. Hlala uqinile kwaye ulandele icebiso abakunika lona.

I- Glucagonoma, umhlaza wepancreatic, i-glucagon, isifo seswekile, iimpawu zolusu, iihomoni, umhlaza ongaqhelekanga