Cudurka cushing

Cudurka Cushing waa xaalad qanjirka 'pituitary gland' uu sii daayo hormoon aad u badan oo loo yaqaan 'adrenocorticotropic hormone' (ACTH). Qanjirka 'pituitary gland' waa xubin ka mid ah nidaamka 'endocrine system'.

Cudurka Cushing waa nooc ka mid ah xanuunka 'Cushing syndrome'. Noocyada kale ee xanuunka 'Cushing syndrome' waxaa ka mid ah 'Cushing syndrome' oo ka baxsan, Cushing syndrome oo ay sababaan burooyinka 'adrenal buro', iyo ectopic Cushing syndrome.

Cudurka 'Cushing' waxaa sababa buro ama koritaan saaid ah (hyperplasia) ee qanjirka 'pituitary gland'. Qanjirka 'pituitary gland' wuxuu ku yaal meel ka hooseysa salka maskaxda. Nooc ka mid ah burooyinka pituitary ee loo yaqaan adenoma ayaa ah sababta ugu badan. Adenoma waa buro aan dhib lahayn (ma aha kansar).

Cudurka Cushing, qanjirka 'pituitary gland' wuxuu soo daayaa ACTH badan. ACTH waxay kicisaa wax soo saarka iyo sii deynta cortisol, hormoon walbahaar. ACTH aad u badan ayaa keenta qanjidhada adrenal inay sameyso cortisol aad u tiro badan.

Cortisol caadi ahaan waa la sii daayaa inta lagu jiro xaaladaha walaaca leh. Waxay kaloo leedahay hawlo kale oo badan, oo ay ka mid yihiin:

• Xakamaynta isticmaalka jidhka ee karbohaydraytyada, dufanka, iyo borotiinnada
• Yaraynta jawaabta habka difaaca jirka ee bararka (caabuq)
• Nidaaminta cadaadiska dhiigga iyo isu dheelitirka biyaha jirka

Calaamadaha lagu garto cudurka 'Cushing' waxaa ka mid ah:

• Cayilka jidhka sare (oo ka sarreeya dhexda) iyo gacmaha iyo lugaha oo dhuuban
• Wareeg, casaan, waji buuxa (wajiga dayaxa)
• Heerka koritaanka ilmaha oo gaabis ah

Isbedelada maqaarka ee badanaa la arko waxaa ka mid ah:

• Cudurka finanka ama maqaarka
• Calaamadaha fidinta (guduudka ah) (1/2 inji ama 1 sentimitir ama ka ballaaran), oo loo yaqaan 'striae', maqaarka caloosha, bowdyaha, gacmaha kore, iyo naasaha
• Maqaar khafiif ah oo nabar fudud leh, badiyaa gacmaha iyo gacmaha

Isbedelada murqaha iyo lafaha waxaa ka mid ah:

• Dhabar xanuun, oo ku dhaca waxqabadyada caadiga ah
• Lafa xanuun ama danqasho
• Uruurinta dufanka garbaha dhexdooda (buffalo hump)
• Daciifinta lafaha, taas oo keenta feeraha iyo jabka lafdhabarta
• Murqaha daciifka ah ee keena dulqaad la'aanta jimicsiga

Haweenka waxaa laga yaabaa inay yeeshaan:

• Kordhinta timaha ee wejiga, qoorta, laabta, caloosha, iyo bowdyaha
• Wareegga caadada oo noqda wax aan caadi ahayn ama istaaga

Ragga waxaa laga yaabaa inay leeyihiin:

• Hoos udhaca ama rabitaanka galmada (libido hoose)
• Dhibaatooyinka kacsiga

Calaamadaha kale ama dhibaatooyinka waxaa ka mid noqon kara:

• Isbeddelada maskaxda, sida niyadjabka, walwalka, ama isbeddelada dabeecadda
• Daal
• Infekshanno isdaba joog ah
• Madax xanuun
• Haraad iyo kaadi badan
• Dhiig kar
• Sonkorowga

Bixiyaha xanaanada caafimaadka ayaa sameyn doona baaritaan jireed wuxuuna weydiin doonaa astaamahaaga.

Tijaabooyinka waxaa la sameeyaa marka hore si loo xaqiijiyo in jirka ku badan yahay cortisol, ka dibna si loo ogaado sababta.

Imtixaanadani waxay xaqiijinayaan cortisol aad u badan:

• 24-saac kaadida cortisol
• Imtixaanka xakamaynta Dexamethasone (qadar yar)
• Heerarka cortisol ee salivary (subaxa hore iyo goor dambe habeenkii)

Imtixaanadani waxay go'aamiyaan sababta:

• Dhiigga heerka ACTH
• Maskaxda MRI
• Tijaabada hormoonka-sii deynta Corticotropin, ee ka shaqeysa qanjirka 'pituitary gland' si ay u keento sii deynta ACTH
• Imtixaanka xakamaynta Dexamethasone (qadar sare)
• Sampling-ka sanbabada petrosal sinus (IPSS) - waxay cabiraysaa heerarka ACTH ee xididdada ka daadanaya qanjirka 'pituitary gland' marka la barbar dhigo xididdada xabadka

Tijaabooyinka kale ee la qaadi karo waxaa ka mid ah kuwa soo socda:

• Soonka gulukooska dhiigga iyo A1C si loo baaro sonkorowga
• Baaritaanka xaydha iyo dufanka
• Baadhitaanka cufnaanta macdanta lafaha si loo hubiyo lafo-beelka

In ka badan hal baaris baaris ayaa loo baahan karaa si loo ogaado cudurka Cushing. Bixiyahaaga ayaa laga yaabaa inuu ku weydiiyo inaad aragto dhakhtar ku takhasusay cudurrada pituitary.

Daaweyntu waxay ku lug leedahay qalliin looga saarayo burooyinka pituitary, haddii ay suurtagal tahay. Qalliinka ka dib, qanjirka 'pituitary gland' ayaa si tartiib tartiib ah u bilaabi kara inuu mar kale shaqeeyo oo caadi ku soo noqdo.

Inta lagu guda jiro howsha ka soo kabashada qalliinka, waxaad u baahan kartaa daaweynta cortisol beddelka maxaa yeelay pituitary wuxuu u baahan yahay waqti uu ku bilaabo inuu sameeyo ACTH markale.

Daaweynta shucaaca ee qanjirka 'pituitary gland' sidoo kale waa la isticmaali karaa haddii aan si buuxda looga soo bixin burada.

Haddii burooyinka aysan ka jawaabin qalliinka ama shucaaca, waxaad u baahan kartaa daawooyin kaa celiya jirkaaga sameynta cortisol.

Haddii daaweyntani aysan guuleysan, qanjidhada adrenal waxay u baahan kartaa in laga saaro si loo joojiyo heerarka sare ee cortisol in la soo saaro. Ka saarida qanjidhada adrenal waxay sababi kartaa burooyinka pituitary inay aad u sii weynaadaan (Nelson syndrome).

Cudurka Cushing ee aan la daaweyn wuxuu sababi karaa cudur daran, xitaa dhimasho. Ka soo bixida burada waxay u horseedi kartaa soo kabasho buuxda, laakiin burooyinka ayaa dib u kori kara.

Dhibaatooyinka caafimaad ee ka dhalan kara cudurka Cushing waxaa ka mid ah:

• Jabka jajaban ee lafdhabarta
• Sonkorowga
• Dhiig kar
• Caabuqyada
• Dhagaxaanta kilyaha
• Niyadda ama dhibaatooyinka kale ee maskaxda

Wac adeeg bixiyahaaga haddii aad isku aragto astaamaha cudurka Cushing.

Haddii lagaa saaray buro pituitary, wac dhakhtarkaaga haddii aad leedahay calaamado dhibaatooyin ah, oo ay ku jiraan calaamado muujinaya in buro soo noqotay.

Cudurka 'Pituitary Cushing'; AC-qarsoodi ah adenoma

• Qanjirada 'Endocrine'
• Striae ee fossa popliteal
• Striae lugta

Juszczak A, Morris DG, Grossman AB, Nieman LK. Cushing’s syndrome. Gudaha: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Dadka waaweyn iyo carruurta. 7aad ed. Philadelphia, PA: Elsevier Saunders; 2016: cutubka 13.

Molitch ME. Pituitary hore. Gudaha: Goldman L, Schafer AI, eds. Daawada Goldman-Cecil. 25aad. Philadelphia, PA: Elsevier Saunders; 2016: cutubka 224.

Stewart PM, Newell-Price JDC. Kiliyaha adrenal. Gudaha: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. Williams Buugga Buugga Endocrinology. 13aad. Philadelphia, PA: Elsevier; 2016: cutubka 15.