Ingabe unalezi zimpawu? Ake sixoxe nge-Cushing Syndrome!

Wake wezwa nge-Cushing Syndrome? Leli gama lingase libe lisha kuwe. Kalula nje, yisimo esenzeka lapho imizimba yethu ikhiqiza i- cortisol eningi kakhulu. Abanye abantu baphinde bakubize ngokuthi i-hypercortisolism. "I-syndrome" iqoqo lezimpawu ezihlanganayo. Kungenzeka ukuthi uke wayibona ibizwa ngokuthi i-Cushing's syndrome ngabanye abantu.

Ngakho-ke iyini le cortisol?

I-Cortisol iyi-hormone ye-steroid emizimbeni yethu. Sivame ukuyibiza ngokuthi "i-hormone yokucindezeleka" ngoba uma singaphansi kokucindezeleka, imizimba yethu ikhipha i-cortisol eyengeziwe. Phakathi nalezi zikhathi, i-cortisol iyasisiza:

• Isilinganiso senhliziyo yakho siyakhuphuka.
• Umfutho wegazi lakho uyakhuphuka.
• Ilawula amazinga kashukela egazini.
• Ilawula ukuphefumula.
• Kwandisa ukucindezeleka kwemisipha.

Akukhona lokho kuphela, kodwa uma sicindezelekile, i-cortisol iyasiza nasekuvaleni okwesikhashana izinhlelo ezingabalulekile emizimbeni yethu ngaleso sikhathi, isibonelo, uhlelo lokugaya ukudla kanye nohlelo lokuzala.

I-Cortisol iyi-hormone ebalulekile emizimbeni yethu. I-Cortisol ibalulekile kulezi zinto:

• Gcina umfutho wegazi.
• Lawula amazinga kashukela egazini.
• Nciphisa ukuvuvukala.
• Yakha izinkumbulo.
• Lawula ukuphefumula kwakho.
• Gcina ibhalansi kasawoti emzimbeni.
• Guqula ukudla esikudlayo kube amandla.

Amazinga e-cortisol alawulwa yizindlala ezimbili ezincane phezu kwezinso zethu, izindlala ze-adrenal, indlala ye-pituitary ebuchosheni, kanye ne-hypothalamus, etholakala ngaphezu kwendlala ye-pituitary.

I-Cushing's syndrome ivame ukubangelwa isimila . Lokhu kungenzeka ngezindlela ezimbili eziyinhloko:

• Okungokwemvelo: Lokhu kusho ukuthi kuyisimo esibangelwa yi-cortisol, ekhiqizwa emizimbeni yethu.
• Okungaphandle: Lokhu kusho ukuthi isimo sibangelwa izimbangela zangaphandle njengomphumela ongemuhle wemithi ethile ethathwa ukwelapha ezinye izimo zezokwelapha.

Ubani okungenzeka kakhulu ukuthi athole i-Cushing Syndrome?

I-Cushing's syndrome ivame kakhulu ezinganeni, kubantu abadala abasebasha, nakubantu abadala. Ivame kakhulu kubantu abaneminyaka ephakathi kuka-25 no-50. Abantu abaphuza imithi equkethe i-cortisol (isibonelo, imithi ye-asthma kanye ne-rheumatoid arthritis) basengozini enkulu yokuthola lesi simo. Cishe abantu abangu-70% abane-Cushing's syndrome ngabesifazane kanti abangu-30% ngabesilisa.

Sivame kangakanani lesi simo?

I-Cushing's syndrome iyisimo esingavamile kakhulu , esithinta abantu abaphakathi kuka-40 no-70 kwabayisigidi ngonyaka.

Uyini umehluko phakathi kwe-Cushing Syndrome kanye ne-Cushing Disease?

Isifo sikaCushing siwuhlobo lwe-Cushing's syndrome. Sibangelwa isimila esingesona esibi endlaleni ye-pituitary. Lesi simila sikhipha i-hormone i- ACTH (adrenocorticotropic hormone) eningi kakhulu. Lokhu kubangela ukuthi izindlala ze-adrenal zikhiphe i-cortisol eningi kakhulu.

Kulabo abane-Cushing's syndrome, abantu abadala abangaphezu kuka-70% kanye nezingane eziphakathi kuka-60% no-70% kanye nabantu abadala abasebasha banalolu hlobo lwesifo sikaCushing.

Hlobo luni lodokotela abaphatha i-Cushing Syndrome?

Udokotela wakho uzokudlulisela kuchwepheshe obizwa ngokuthi i-endocrinologist ukuze ahlole futhi aphathe lesi simo.

Ingabe i-Cushing Syndrome ingaba yingozi?

Yebo, i-Cushing's Syndrome ingaba yingozi uma ingelashwa kahle. Uma ingelashwa, leli zinga eliphezulu le-cortisol (i-hypercortisolism) lingaholela ezinkingeni eziningi zempilo. Isibonelo:

• Izifo
• Amahlule egazi, ikakhulukazi emaphashini nasemilenzeni
• Ukucindezeleka
• Isifo senhliziyo
• Ukwanda kwesisindo
• Izinkinga zememori noma ubunzima bokugxilisa ingqondo
• Umfutho wegazi ophezulu noma i-cholesterol ephezulu
• Amathambo aphukile
• Uhlobo lwesibili lwesifo sikashukela, i-prediabetes, noma i-glucose yokuzila ukudla engasebenzi kahle

Uma ingelashwa, i-Cushing's syndrome ingaholela ngisho nasekufeni.

Yiziphi izimbangela ze-Cushing Syndrome?

I-Cushing's syndrome ibangelwa amazinga aphezulu e-cortisol emzimbeni. Kunezimbangela eziningana ezingaba khona:

• Ukusetshenziswa Kwemithi Ye-Glucocorticoid: Imithi ye-Glucocorticoid (isibonelo, i-prednisone) isetshenziselwa ukwelapha i-asthma engapheli, i-rheumatoid arthritis, i-lupus, i-sarcoidosis, kanye nezinye izifo eziningi zokuzivikela komzimba ezibangela ukuvuvukala okungapheli. Ukuthatha le mithi isikhathi eside kungabangela i-"iatrogenic" noma i-exogenous Cushing syndrome. Igama elithi "iatrogenic" lisho ukuthi kukhona okunye okubangelwa ukwelashwa kwezokwelapha.
• Izimila zepituitary: I-Cushing syndrome ( ngaphandle kwe-iatrogenic Cushing syndrome) ibangelwa izimila zepituitary ezikhiqiza i-ACTH eningi kakhulu, i-hormone etshela izindlala ze-adrenal ukuthi zikhiqize i-cortisol, futhi ithinta abantu abangu-8 kwabayi-10. Lolu hlobo lubizwa ngokuthi isifo se-Cushing.
• Izimila ze-adrenal cortical: Isimila esikhula phezu kwe-adrenal gland singakhiqiza i-cortisol eningi kakhulu. Lezi zivame ukuba izimila ezingengozini. Kodwa-ke, ngezinye izikhathi lesi simila singaba yi-adrenal cortical carcinoma, uhlobo olungavamile kakhulu lomdlavuza we-adrenal.
• Izimila zamaphaphu, ama-pancreas, i-thyroid kanye ne-thymus: Uma i-ACTH ikhiqizwa izimila ezingaphandle kwe-pituitary gland, ibizwa ngokuthi i-ectopic ACTH syndrome. Lezi zimila zivame ukuba yingozi. Ezivame kakhulu kulezi umdlavuza wamaphaphu wamaseli amancane.

Ingabe i-Cushing Syndrome idluliselwa ngofuzo?

Ngokuvamile, cha . Iningi lamacala e-Cushing's syndrome awaveli ku-genetic.

Ziyini izimpawu ze-Cushing Syndrome?

Ngaphezu kwezimpawu eziqondene ngqo ne-Cushing's syndrome, kunezimpawu ezingaba yinto evamile kwezinye izimo eziningi. Akuwona wonke umuntu ozoba nezimpawu ezifanayo. Lezi yizimpawu ezingase zivele:

• Ukukhuluphala okusheshayo ebusweni (abanye bakubiza ngokuthi "ubuso benyanga"), indawo yesisu, ngemuva kwentamo (abanye bakubiza ngokuthi "i-buffalo hump"), kanye nesifuba.
• Ubuso obomvu, obuyindilinga.
• Amanxeba athatha isikhathi ukuphola.
• Umfutho wegazi ophezulu (umfutho wegazi ophakeme).
• Ukukhula kwezinwele ngokweqile ebusweni, entanyeni, esifubeni, esiswini, emabeleni, nasemathangeni, noma ekulahlekelweni izinwele (ubumpandla).
• Isifo sikashukela.

Ezinye izimpawu zingase zihlanganise:

• Ukuvela kwamabala okwelula onsomi endaweni yesisu.
• Ukuphuka kalula kwezandla nezinyawo.
• Ubuthakathaka obujwayelekile kanye nokukhathala.
• Ukubona okufiphele kanye nesiyezi.
• Ubuthakathaka bemisipha kanye nokulahlekelwa yimilenze.
• Ukushintsha kwe-libido kanye nokungasebenzi kahle kwe-erectile emadodeni.
• Ukukhula okuphazamisekile ezinganeni.

I-Cushing Syndrome ihlala isikhathi esingakanani?

Ukuthi i-Cushing's syndrome ihlala isikhathi esingakanani kuncike endleleni osabela ngayo ekwelashweni. Iningi labantu abanamazinga aphezulu e-cortisol (hypercortisolism) liyalulama ngemva kwamasonto ambalwa okwelashwa.

Ingabe i-Cushing Syndrome ibangela ubunzima bokuphefumula?

Cha.Ukuphelelwa umoya akuyona uphawu oluyisici se-Cushing's syndrome.

Ingabe i-Cushing Syndrome ibangela i-osteoporosis?

Yebo. I-Cushing's syndrome ingabangela amathambo abuthakathaka. Lokhu kungabangela ukuphuka kwamathambo, ikakhulukazi uma usunesikhathi eside unalesi simo. Amathambo abuthakathaka nawo angabangela ubuhlungu.

Ingabe i-Cushing Syndrome ibangela i-hypokalemia?

I-Hypokalemia yisimo lapho izinga le-potassium egazini lakho liphansi. Lesi simo singavela uma une-Cushing's syndrome.

Itholakala kanjani i-Cushing Syndrome?

Uma udokotela wakho esola amazinga aphezulu e-cortisol (i-hypercortisolism), kuneziqondiso ezithile azolandela. Bazobuza imibuzo, bathathe umlando wakho wezokwelapha, benze ukuhlolwa ngokomzimba, bese be-oda ezinye izivivinyo zelebhu. Bangase futhi bakuqaphe isikhathi esithile.

I-Cushing's syndrome ngezinye izikhathi ingaba nzima ukuyixilonga. Uma utshela udokotela wakho ukuthi ukhathele futhi uyakhuluphala, bangase bangacabangi ngokushesha nge-Cushing's syndrome. Lokhu kungenxa yokuthi lezi zimpawu zivamile ezifweni eziningi ezahlukene.

Futhi, i-Cushing's syndrome ngezinye izikhathi ingadidaniswa ne- polycystic ovary syndrome noma i-metabolic syndrome . Udokotela wakho kuzodingeka akhiphe ezinye izimo ukuze athole ukuthi unesifo yini.

Yiziphi izivivinyo ezenziwayo ukuze kutholakale i-Cushing Syndrome?

Udokotela wakho angenza ezinye zalezi zivivinyo:

• Ukuhlolwa kwe-cortisol yomchamo kwamahora angama-24: Lokhu kuhlolwa kulinganisa inani le-cortisol emchameni wakho ngama-microgram (mcg). Udokotela wakho uzokucela ukuthi uqoqe umchamo wakho esikhathini samahora angama-24.
• Ukuhlolwa kwe-cortisol yamathe phakathi kwamabili: Ngokuvamile, amazinga e-cortisol aphansi kakhulu ebusuku. Lokhu kuhlolwa kuhlola amazinga e-cortisol phakathi kuka-11 no-12 ekuseni. Uma une-Cushing's syndrome, amazinga akho e-cortisol azoba phezulu ngendlela engavamile ngaleso sikhathi.
• Ukuhlolwa kokunciphisa i-dexamethasone ngomthamo ophansi:I-Dexamethasone iyimithi efana ne-cortisol. Kulolu vivinyo, uthatha i-milligram eyodwa (mg) yalo muthi ngomlomo ebusuku, bese amazinga akho e-cortisol elinganiswa phakathi kuka-8 no-9 ekuseni. Lokhu kuhlolwa kwegazi kubheka ukuthi izindlala zakho ze-adrenal zisabela yini ku-dexamethasone ngokunciphisa inani le-cortisol eziyikhiphayo. Uma une-Cushing's syndrome, amazinga akho e-cortisol azoba phezulu.
• Ukuhlolwa kwegazi: Ukuhlolwa kwegazi kulinganisa izinga le-ACTH egazini lakho. Uma izinga le-ACTH liphansi, ungase ube nesimila se-adrenal. Uma izinga lijwayelekile noma liphezulu, ungase ube nesimila se-pituitary noma isimila se-ectopic.
• Ukuhlolwa kokucindezela i-dexamethasone ngomthamo ophezulu: Lokhu kufana nokuhlolwa kokucindezela i-dexamethasone ngomthamo ophansi, kodwa umthamo ungama-milligram angu-8 esikhundleni se-1. Lokhu kuhlolwa kuvame ukwenziwa ngemuva kokuba ukuhlolwa komthamo ophansi kubonise amazinga aphezulu e-cortisol ekuseni kanti ukuhlolwa kwegazi kubonise amazinga aphezulu e-ACTH egazini. Lokhu kuhlolwa kungasiza ekutholeni imbangela ye-Cushing's syndrome. Kungasiza ekuhlukaniseni phakathi kwe-pituitary adenoma (eyaziwa nangokuthi isifo sikaCushing) kanye nesimila kwenye indawo emzimbeni wakho (njengasemaphashini).

Uma udokotela wakho eseqinisekisile ukuthi une-Cushing's syndrome, isinyathelo esilandelayo ukuthola ukuthi yini ebangela lokhu. Ezimweni eziningi, kungaba umuthi noma isimila. Uma uthatha ama-glucocorticoids, cishe yisona imbangela, ngakho udokotela wakho angase anciphise umthamo wakho. Uma ungawasebenzisi ama-glucocorticoids, kungabonisa isimila kuma-adrenal glands akho, i-pituitary gland, noma kwenye indawo. Udokotela wakho angase ancome izifundo zezithombe ezifana nalezi ukusiza ukuthola isimila:

• Ukuskena kwe-CAT (CT scan) noma isisu se-MRI: Udokotela wakho angenza ukuskena kwe-CT noma i-MRI ukuze abone ukuthi unesimila yini ezindlaleni zakho ze-adrenal. Lokhu kuskena kungenziwa ngokuqhathanisa kwe-intravenous (IV contrast) noma ngaphandle kwayo. Lokhu kuhlolwa kubucayi kakhulu ekutholeni izimila ze-adrenal.
• Ukuthwebula izithombe ze-magnetic resonance (MRI) ze-pituitary:I-MRI ithatha izithombe ze-pituitary gland yakho ukuze ibheke isimila. Kwezinye izimo, i-MRI ayisona isifo esiphelele. Cishe abantu abangu-50% abane-Cushing's syndrome bane-MRI "ejwayelekile", kuyilapho abangu-10% bengase babe nezimila ezingahlobene nalesi sifo.
• Ukuhlolwa kwe-Bilateral inferior petrosal sinus sampling (BIPPS): Lokhu kuhlolwa kuthola umthombo wokukhishwa kwe-ACTH. I-ACTH namanye ama-hormone e-pituitary akhishwa endlaleni ye-pituitary aye egazini. Udokotela we-radiologist onolwazi wenza lokhu kuhlolwa ngemithambo emibili ebizwa ngokuthi ama-inferior petrosal sinuses. Izinga lokunemba kwalokhu kuhlolwa liphakathi kuka-95% no-98%.
• Isifuba se-CT scan: Uma udokotela wakho esola ukuthi kukhona isimila esingaphandle kwesisu, angase acele i-CT scan yesifuba ukuze ahlole ukuthi kungenzeka yini ukuthi kukhona umdlavuza wamaphaphu.

Iphathwa kanjani i-Cushing Syndrome?

Uhlobo lokwelashwa luncike embangela eyinhloko yamazinga aphezulu e-cortisol. Uma uthatha ama-glucocorticoids, udokotela wakho cishe uzonciphisa umthamo wakho noma akunikeze umuthi ongeyona i-glucocorticoid.

Uma i-Cushing's syndrome ibangelwa isimila, udokotela wakho angase asikisele ukuhlinzwa noma ukwelashwa ngemisebe.

Enye indlela iwukuba udokotela wakho akunikeze umuthi onciphisa ukukhiqizwa kwe-cortisol, njenge-ketoconazole. Kungase kudingeke ukuthi usebenzisane nodokotela abaningana abahlukene ukuze welaphe isimila kanye nezimpawu ze-Cushing's syndrome.

• Ukwelashwa ngamakhemikhali: Uma isimila sinomdlavuza futhi sesisakazekele kwezinye izingxenye zomzimba, ukwelashwa ngamakhemikhali kungadingeka. Qiniseka ukuthi ukhuluma nodokotela wakho nganoma yimiphi imiphumela emibi.
• Imithi: Ukwengeza imithi eyehlisa i-cortisol noma ukususa imithi engabangela i-Cushing's Syndrome.
• Ukukhishwa kwemisebe: Isimila se-pituitary singase singasuswa ngokuhlinzwa. Ezimweni ezinjalo, kungadingeka ukuthi welashwe ngemisebe amasonto ayisithupha. Kungathatha iminyaka ukuthi amazinga e-cortisol abuyele esimweni esijwayelekile. Khuluma nodokotela wakho nganoma yimiphi imiphumela emibi.
• Ukuhlinzwa:Ukususwa kwezimila ze-pituitary, izimila ze-adrenal, kanye nezimila ze-ectopic kuphumelele, kodwa kuzodingeka ujwayele amazinga amasha e-cortisol aphansi. Phakathi nalesi sikhathi, kungadingeka ukuthi uthathe umuthi we-cortisol ngesimo samaphilisi e-hydrocortisone. Uzokwazi ukuyeka ukuthatha lo muthi ngemva kwezinyanga eziyi-6 kuya kweziyi-18. Ezimweni eziningi, ngemva kokuhlinzwa kwe-laparoscopic, uzokwazi ukuphuma esibhedlela ngosuku olulodwa noma ezimbili.

Uma i-Cushing's syndrome yelashwa kahle, kungathatha noma yikuphi kusukela ezinyangeni ezimbili kuya kweziyi-18 ukululama. Hlala useduze nodokotela wakho phakathi nalesi sikhathi nangale kwalokho.

Yini engingayilindela uma ngine-Cushing Syndrome?

Udokotela wakho angayilapha futhi kufanele ayiphathe i-Cushing's syndrome. Uma ingelashwa, ingaba yingozi. Bonana nodokotela ngokushesha okukhulu ukuze uxoxe ngezimpawu zakho nodokotela wakho.

Ingabe i-Cushing Syndrome ingaba yimbi kakhulu?

I-Cushing's syndrome ingaba yimbi kakhulu uma ingelashwa kahle. Hlala uthintana nodokotela wakho futhi ubazise nganoma yiziphi izimpawu ezintsha, izimpawu eziya ziba zimbi, noma ezinye izinkinga.

Ngingayinciphisa noma ngiyivimbele kanjani ingozi ye-Cushing Syndrome?

Umzimba wakho udinga i-cortisol ngaso sonke isikhathi. Uyayidinga ukuze uhlale usebenza. Ilawula ukuphefumula kwakho, iguqula ukudla okudlayo kube amandla, ilawula amazinga kashukela egazini lakho, ikusize ubhekane nokucindezeleka, futhi yenza okuningi kakhulu. I-Cortisol ayisona isitha somzimba wakho, kodwa okuningi kakhulu kwayo akukuhle. Kodwa-ke, awukwazi ukuphila ngaphandle kwe-cortisol.

Uma uthatha ama-glucocorticoids noma ama-steroid, cela udokotela wakho ukuthi aqaphe amazinga akho e-cortisol eduze. Ngeshwa, ayikho indlela yokuvimbela isimila ekubangeleni i-Cushing's Syndrome (hypercortisolism).

Kunjani ukuphila ne-Cushing Syndrome?

Ukuphila ne-Cushing's syndrome kungaba nzima, kodwa akudingeki kube yisimo esisongela impilo. Kukhona odokotela abaqeqeshwe ukukusiza, futhi kukhona ukwelashwa. Lokhu kwelashwa ngokuvamile kungalapha i-Cushing's syndrome futhi kuthuthukise izimpawu zamazinga aphezulu e-cortisol (i-hypercortisolism).

I-Cushing's syndrome ingabangela ukuthi ubhekane nezinkinga ezithile ezingokomzwelo nezingokwenhlalo. Abanye abantu bangase bazizwe benamahloni ngokulahlekelwa izinwele, ukukhula kwezinwele ngokweqile, kanye/noma ukukhuluphala ebusweni nangemuva kwentamo. "Ubuso benyanga" kanye "ne-buffalo hump" kungakwenza ucabange kabili ngokuhlanganyela ezimweni zenhlalo. Ngokuhamba kwesikhathi, ukwelashwa kungasiza ekuthuthukiseni lezi zimpawu. I-Cushing's syndrome ingabangela nokucindezeleka kanye nezinye izifo zengqondo. Uma kudingeka, bona udokotela wezokwelapha ukuze akunike ukwelulekwa kanye nodokotela wezifo zengqondo ukuze akunike imithi yokukusiza ukubhekana nemiphumela engokomzwelo yamazinga aphezulu e-cortisol (hypercortisolism).

Kufanele ngimbone nini udokotela?

Bona udokotela uma unezinye zalezi zimpawu ze-Cushing's syndrome:

Izimpawu ezithinta ngqo abesifazane:

• Ukukhula kwezinwele zobuso ezintsha noma eziningi ngokweqile.
• Ushintsho ekuthandweni kocansi.
• Ushintsho emjikelezweni wokuya esikhathini.

Izimpawu ezithinta wonke umuntu:

• Ukukhuluphala okusheshayo ebusweni (abanye bakubiza ngokuthi "ubuso benyanga"), indawo yesisu, ngemuva kwentamo (abanye bakubiza ngokuthi "i-buffalo hump"), kanye nesifuba.
• Ubuso obomvu, obuyindilinga.
• Umfutho wegazi ophezulu (umfutho wegazi ophakeme).
• Ukukhula kwezinwele ngokweqile ebusweni, entanyeni, esifubeni, esiswini nasemathangeni.
• Isifo sikashukela.
• Induna entsha noma eningi kakhulu.
• Ukuvela kwamabala okwelula onsomi endaweni yesisu.
• Ukuphuka kalula kwezandla nezinyawo.
• Ubuthakathaka obujwayelekile kanye nokukhathala.
• Ukubona okufiphele kanye nesiyezi.
• Amanxeba athatha isikhathi ukuphola.
• Ubuthakathaka bemisipha.

Yimiphi imibuzo okufanele ngiyibuze udokotela wami?

• Yimiphi imithi engingayithatha ukuze ngisize nge-Cushing's syndrome yami?
• Ingabe kukhona ukuvivinya umzimba engingakwenza ukusiza imisipha yami ebuthakathaka?
• Ingabe ikhona imithi engasetshenziswa ukusiza ngama-stretch marks?
• Ingabe kufanele ngibone uchwepheshe we-Cushing Syndrome?
• Ingabe kudingeka ngiyeke ukuthatha noma yimiphi imithi engiyisebenzisayo njengamanje?
• Yikuphi ukwelashwa okungcono kakhulu kimi?
• Ingabe kukhona ezinye izindlela zokuvimbela okufanele ngizithathe?

I-Cushing's syndrome ingaba yisimo esinzima ukubhekana naso. Ingabangela ubuthakathaka, umfutho wegazi ophakeme, kanye nokukhathala. Ukwelashwa okufana nokuhlinzwa, imithi, ukwelashwa ngemisebe, kanye ne-chemotherapy kungaba nzima. Kodwa kuyafaneleka, ngoba ngokwelashwa okufanele, i-Cushing's syndrome ingelapheka.

Isifinyezo (Umyalezo Wokuya Nawe Ekhaya)

I-Cushing's Syndrome yisimo esibangelwa ukwanda kwe-cortisol ye-hormone emizimbeni yethu. Lokhu kuyinto engavamile, kodwaUma itholakale futhi yelashwa kahle, ingelapheka . Kubaluleke kakhulu ukufuna iseluleko sezokwelapha uma unezimpawu ezifana nokuvuvukala kobuso, ukukhuluphala, ukukhula kwezinwele ngokweqile, noma umfutho wegazi ophakeme. Izinketho zokwelapha ziyahlukahluka kuye ngembangela. Ngakho-ke khuluma nodokotela wakho ngakho konke bese ulandela iseluleko sakhe. Khumbula, awuwedwa, futhi usizo luyatholakala.

I- Cushing's Syndrome, i-cortisol, ama-hormone, izindlala ze-adrenal, indlala ye-pituitary, i-ACTH, izimpawu, ukwelashwa, i-endocrinologist