Hypopituitarism

Hypopituitarism wani yanayi ne wanda gland pituitary baya samar da adadi na yau da kullun na wasu ko duk hormones.

Glandan pituitary karamin tsari ne wanda yake kasa da kwakwalwa. Ana haɗa shi da tsini zuwa ga hypothalamus. Hypothalamus yanki ne na kwakwalwa wanda ke sarrafa aikin gland na pituitary.

Hanyoyin da kwayar cuta ta pituitary ta fitar (da ayyukansu) sune:

• Adrenocorticotropic hormone (ACTH) - yana motsa glandon adrenal don sakin cortisol; cortisol na taimakawa wajen kiyaye hawan jini da suga
• Antidiuretic hormone (ADH) - yana sarrafa asarar ruwa ta koda
• Hormone-stimulating hormone (FSH) - yana sarrafa aikin jima'i da haihuwa cikin maza da mata
• Hormone na girma (GH) - yana haifar da haɓakar kyallen takarda da ƙashi
• Luteinizing hormone (LH) - yana sarrafa aikin jima'i da haihuwa cikin maza da mata
• Oxytocin - yana kara karfin mahaifa yayin kwanciya da nono su saki madara
• Prolactin - yana karawa mace ci gaban nono da samar da madara
• Hormone-stimulating hormone (TSH) - yana motsa glandar thyroid don saki hormones wanda ke shafar metabolism na jiki

A cikin hypopituitarism, akwai ƙarancin homonin pituitary daya ko fiye. Rashin hormone yana haifar da asarar aiki a cikin gland ko sashin jikin hormone. Misali, rashin TSH yana haifar da asarar aiki na al'ada na glandar thyroid.

Hypopituitarism na iya haifar da:

• Yin tiyatar kwakwalwa
• Ciwon kwakwalwa
• Ciwon kai (raunin ƙwaƙwalwar ƙwaƙwalwa)
• Cututtuka ko kumburin kwakwalwa da kyallen takarda masu tallafawa kwakwalwa
• Mutuwar wani yanki na nama a cikin gland (pituitary apoplexy)
• Radiation far zuwa kwakwalwa
• Buguwa
• Zubar da jini na subarachnoid (daga fashewar jijiyoyin jiki)
• Tumurai na pituitary gland ko hypothalamus

Wani lokaci, hypopituitarism yana faruwa ne saboda tsarin garkuwar jiki wanda ba a sani ba ko cututtuka na rayuwa, kamar su:

• Iron da yawa a jiki (hemochromatosis)
• Rashin haɓaka a cikin ƙwayoyin rigakafi da ake kira histiocytes (histiocytosis X)
• Yanayin autoimmune wanda ke haifar da kumburi na pituitary (lymphocytic hypophysitis)
• Kumburi na nau'ikan kyallen takarda da gabobi (sarcoidosis)
• Cututtuka na pituitary, kamar su tarin fuka na farko na pituitary

Hypopituitarism shima matsala ce mai saurin lalacewa sakamakon tsananin zubar jini yayin daukar ciki. Rashin jini yana haifar da mutuwar nama a cikin gland. Ana kiran wannan yanayin Sheehan syndrome.

Hakanan wasu magunguna na iya dakatar da aikin pituitary. Mafi yawan kwayoyi sune glucocorticoids (kamar su prednisone da dexamethasone), waɗanda ake ɗauka don yanayin kumburi da na rigakafi. Magungunan da ake amfani da su don magance cutar sankarar mafitsara kuma na iya haifar da rashin aikin pituitary.

Kwayar cututtukan hypopituitarism sun haɗa da ɗayan masu zuwa:

• Ciwon ciki
• Rage ci
• Rashin sha'awar jima'i (a cikin maza ko mata)
• Dizizness ko suma
• Yawan fitsari da kishirwa
• Rashin sakin madara (a cikin mata)
• Gajiya, rauni
• Ciwon kai
• Rashin haihuwa (a cikin mata) ko tsaida lokacin al'ada
• Raguwar hamata ko gashin kai
• Rashin jiki ko gashin fuska (a cikin maza)
• Pressureananan hawan jini
• Sugararancin sukarin jini
• Hankali ga sanyi
• Gajeren tsawo (ƙasa da ƙafa 5 ko mita 1.5) idan farawa ya kasance a lokacin lokacin girma
• Rage girma da haɓaka jima'i (a cikin yara)
• Matsalar hangen nesa
• Rage nauyi

Kwayar cututtuka na iya haɓaka a hankali kuma na iya bambanta ƙwarai, dangane da:

• Yawan homonin da suka bata da gabobin da suke shafar su
• Tsananin cutar

Sauran alamun da zasu iya faruwa tare da wannan cuta:

• Fuskar fuska
• Rashin gashi
• Sandarewa ko sauya murya
• Iffarfin haɗin gwiwa
• Karuwar nauyi

Don bincika hypopituitarism, dole ne a sami ƙananan matakan hormone saboda matsala tare da gland din pituitary. Dole ne ganewar asali ya kawar da cututtukan gabobin da wannan kwayar ta shafa.

Gwaje-gwaje na iya haɗawa da:

• Brain CT scan
• Matsayi na MRI
• ACTH
• Cortisol
• Estradiol (estrogen)
• Hormone-mai motsa motsa jiki (FSH)
• Growtharfin haɓakar insulin 1 (IGF-1)
• Luteinizing hormone (LH)
• Gwajin Osmolality don jini da fitsari
• Matakan testosterone
• Hormone-stimulating hormone (TSH)
• Hormone na thyroid (T4)
• Biopsy na pituitary

Matsayi na kwayar cutar pituitary na iya zama mai girma a cikin jini idan kuna da ciwon kumburi wanda yake samar da yawancin wannan hormone. Cutar ƙari na iya murkushe sauran ƙwayoyin pituitary, wanda ke haifar da ƙananan matakan sauran kwayoyin.

Idan hypopituitarism ya haifar da ƙari, kuna iya buƙatar tiyata don cire kumburin. Hakanan ana iya buƙatar maganin kashe hasken rana.

Kuna buƙatar magungunan homon har tsawon rai don maye gurbin homonin waɗanda ba sassan jikin da ke ƙarƙashin ikon glandon pituitary ba su. Waɗannan na iya haɗawa da:

• Corticosteroids (cortisol)
• Ci gaban hormone
• Jima'i na jima'i (testosterone ga maza da estrogen ga mata)
• Hormone na thyroid
• Desmopressin

Hakanan akwai magunguna don magance rashin haihuwa da ke da nasaba da maza da mata.

Idan kun sha magungunan glucocorticoid don rashi ACTH na rashi, ku tabbata kun san lokacin da zaku sha matsin lamba na maganin ku. Tattauna wannan tare da mai kula da lafiyar ku.

Koyaushe ka ɗauki ID na likita (kati, munduwa, ko abun wuya) wanda ya ce kana da ƙarancin adrenal. ID ɗin ya kamata ya faɗi irin magani da sashin da kuke buƙata idan akwai gaggawa da aka haifar da ƙarancin adrenal.

Hypopituitarism yawanci dindindin ne. Yana buƙatar magani na rayuwa tare da ɗaya ko fiye da magunguna. Amma zaka iya tsammanin tsawon rayuwar yau da kullun.

A cikin yara, hypopituitarism na iya inganta idan aka cire kumburin lokacin aikin tiyata.

Illolin magunguna don magance hypopituitarism na iya haɓaka. Koyaya, kar a dakatar da kowane magani a kanku ba tare da yin magana da mai ba ku ba tukuna.

Kira mai ba ku sabis idan kun ci gaba bayyanar cututtukan hypopituitarism.

A mafi yawan lokuta, ba a hana rigakafin. Sanin haɗari, kamar daga shan wasu magunguna, na iya ba da izinin ganewar asali da magani.

Rashin isasshen yanayi; Panhypopituitarism

• Endocrine gland
• Pituitary gland shine yake
• Gonadotropins
• Matsayi da TSH

Burt MG, Ho KKY. Hypopituitarism da rashi girma na hormone. A cikin: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Manya da Yara. 7th ed. Philadelphia, PA: Elsevier Saunders; 2016: sura 11.

Clemmons DR, Nieman LK. Gabatarwa ga mai haƙuri tare da cututtukan endocrine. A cikin: Goldman L, Schafer AI, eds. Magungunan Goldman-Cecil. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016: babi na 221.

Fleseriu M, Hashim IA, Karavitaki N, et al. Canjin maye gurbi a cikin hypopituitarism a cikin manya: jagorar aikin likita na Endocrine Society. J Clin Endocrinol Metab. 2016; 101 (11): 3888-3921. PMID: 27736313 www.ncbi.nlm.nih.gov/pubmed/27736313.