Ectopic Cushing syndrome

Ectopic Cushing syndrome waa nooc ka mid ah Cushing syndrome oo buro ka baxsan qanjirka 'pituitary gland' ay soo saarto hormoon loo yaqaan 'adrenocorticotropic hormone' (ACTH).

Cudurka 'Cushing syndrome' waa cillad dhacda marka jirkaagu leeyahay heer ka sarreeya heerka caadiga ah ee hormoonka cortisol. Hormoonkan waxaa lagu sameeyay qanjidhada adrenal. Cortisol badan ayaa sababi kara dhibaatooyin kala duwan. Mid ka mid ah sababaha ayaa ah haddii hormoonka ACTH aad ugu badan dhiigga. ACTH badanaa waxaa sameeya pituitary qadar yar kadibna calaamadaha qanjidhada adrenal si loo soo saaro cortisol. Mararka qaarkood unugyada kale ee ka baxsan pituitary-ga waxay sameyn karaan qadar badan oo ah ACTH. Tan waxaa lagu magacaabaa ectopic Cushing syndrome. Ectopic waxaa loola jeedaa in wax ku dhacayaan meel aan caadi ahayn oo jirka ah.

Ectopic Cushing syndrome waxaa sababa burooyin soo daaya ACTH. Burooyinka soo saari kara, xaalado dhif ah, sii deyn kara ACTH waxaa ka mid ah:

• Burooyinka kansarka xun ee sanbabada
• Burooyinka unugyada yar yar ee ganaca
• Kareemada Medullary ee qanjirka 'thyroid'
• Burooyinka unugyada yaryar ee sambabka
• Burooyinka qanjirka 'thymus'

Ectopic Cushing syndrome wuxuu sababi karaa calaamado badan oo kala duwan. Dadka qaarkiis waxay leeyihiin calaamado badan halka kuwa kale ay qabaan wax yar uun. Inta badan dadka qaba nooc kasta oo ah 'Cushing syndrome' waxay leeyihiin:

• Wareeg, casaan, iyo waji buuxa (wajiga dayaxa)
• Heerka koritaanka ilmaha oo gaabis ah
• Kordhinta culeyska dufanka ku urursan jirridda, laakiin dufanka oo ka lumiya gacmaha, lugaha, iyo badhida (buurnida dhexe)

Isbedelada maqaarka ee badanaa la arko:

• Caabuqyada maqaarka
• Calaamadaha fidinta oo casaan ah (1/2 inji 1 sentimitir ama ka ballaaran) oo loo yaqaan 'striae' maqaarka caloosha, bowdyaha, gacmaha sare, iyo naasaha
• Maqaar khafiif ah oo nabar fudud leh

Isbedelada murqaha iyo lafaha waxaa ka mid ah:

• Dhabar xanuun, oo ku dhaca waxqabadyada caadiga ah
• Lafa xanuun ama danqasho
• Uruurinta dufanka inta udhaxeysa garbaha iyo lafta qoorta
• Feeraha iyo jabka lafdhabarta ee ay keento khafiifinta lafaha
• Murqaha daciifka ah, gaar ahaan miskaha iyo garbaha

Dhibaatooyinka jirka oo dhan (nidaamsan) waxaa ka mid noqon kara:

• Nooca 2aad ee sonkorowga mellitus
• Dhiig kar
• Kalastarol iyo triglycerides badan
  

Haweenka waxaa laga yaabaa inay yeeshaan:

• Kordhinta timaha ee wejiga, qoorta, laabta, caloosha, iyo bowdyaha
• Muddooyinka oo noqda kuwo aan caadi ahayn ama joogsada

Ragga waxaa laga yaabaa inay leeyihiin:

• Hoos udhaca ama rabitaanka galmada
• Awood daro

Calaamadaha kale ee dhici kara waxaa ka mid ah:

• Isbeddelada maskaxda, sida niyadjabka, walwalka, ama isbeddelada dabeecadda
• Daal
• Madax xanuun
• Haraad iyo kaadi badan

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

Tijaabooyinka la qaadi karo waxaa ka mid ah:

• 24-saac tijaabo kaadi ah si loo cabiro heerarka cortisol iyo creatinine
• Tijaabooyinka dhiigga si loo hubiyo ACTH, cortisol, iyo heerarka potassium (badanaa aad ugu hooseeya ectopic Cushing syndrome)
• Imtixaanka xakamaynta Dexamethasone (qiyaasta sare iyo hoose)
• Muunad samaynta sanka oo yar (tijaabo gaar ah oo ka qiyaasisa ACTH xididdada u dhow maskaxda iyo xabadka)
• Gulukooska soonka
• MRI iyo baaritaan sare oo CT ah ayaa lagu baarayaa si loo ogaado burooyinka (mararka qaarkood baaritaano daawo nukliyeer ah ayaa loo baahan karaa)

Daaweynta ugufiican ectopic Cushing syndrome waa qalliin looga saarayo burada. Qalliinku badanaa waa suurtogal marka buradu tahay noncancerous (benign).

Xaaladaha qaarkood, burooyinka waa kansar waxayna ku faafaan aagagga kale ee jirka ka hor inta uusan dhakhtarku ogaanin dhibaatada soosaarka cortisol. Qalliin ayaan suurto gal ka ahayn kiisaskaas. Laakiin dhakhtarku wuxuu kuu qori karaa daawooyin si loo joojiyo soosaarka cortisol.

Mararka qaarkood ka saarida qanjidhada adrenal labadaba waa loo baahan yahay haddii aan la helin burooyinka oo daawooyinku aysan si buuxda u xanibin wax soo saarka cortisol.

Qalliin si looga saaro buro waxay u horseedi kartaa soo kabasho buuxda. Laakiin waxaa jira fursad ah in burada ay soo noqoto.

Buruhu wuu faafi karaa ama wuu soo laaban karaa qalitaanka ka dib. Heer sare oo kortiisol ah ayaa sii socon kara.

Wac adeeg bixiyahaaga haddii aad isku aragto astaamaha cudurka 'Cushing syndrome'.

Daaweynta degdega ah ee burooyinka ayaa yareyn kara halista xaaladaha qaarkood. Kiisas badan ayaan laga hortagi karin.

Cudurka 'Cushing syndrome' - ectopic; Ectopic ACTH syndrome

• Qanjirada 'Endocrine'

Nieman LK, Biller BM, Findling JW, iyo al. Daaweynta Cudurka 'Cushing's syndrome': tilmaamaha ku-takhasuska bulshada ee Endocrine Society. J Clin Endocrinol Metab. 2015; 100 (8): 2807-2831. PMID 26222757 www.ncbi.nlm.nih.gov/pubmed/26222757.

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.