Cutar Cushing

Cutar Cushing wani yanayi ne wanda gland shine yake fitar da adrenocorticotropic hormone da yawa (ACTH). Glanden pituitary gabobi ne na tsarin endocrine.

Cutar Cushing wani nau'i ne na ciwon Cushing. Sauran nau'ikan cututtukan Cushing sun hada da cututtukan Cushing mai banƙyama, ciwon Cushing wanda lalacewa ta haifar da ciwan kansa, da kuma ciwon kumburin mahaifa.

Cutar Cushing tana faruwa ne sakamakon ƙari ko yawan girma (hyperplasia) na gland. Glandar bakin ciki tana kasa da gindin kwakwalwa. Wani nau'in cututtukan pituitary da ake kira adenoma shine mafi yawan dalilin. Adenoma cuta ce mai illa (ba ciwon daji ba).

Tare da cutar Cushing, gland din pituitary yana sakin ACTH da yawa. ACTH tana ƙarfafa samarwa da sakin cortisol, hormone damuwa. Yawan ACTH da yawa yana haifar da gland don yin cortisol mai yawa.

Cortisol yawanci ana sake shi yayin yanayin damuwa. Hakanan yana da sauran ayyuka da yawa, gami da:

• Gudanar da amfani da jiki na carbohydrates, fats, da sunadarai
• Rage tsarin garkuwar jiki kan busa (kumburi)
• Daidaita hawan jini da daidaiton ruwan jiki

Kwayar cutar Cushing ta hada da:

• Kiba na sama (sama da kugu) da siraran hannaye da kafafu
• Zagaye, ja, cike da fuska (fuskar wata)
• Saurin girma cikin yara

Canje-canje na fata waɗanda ake gani sau da yawa sun haɗa da:

• Acne ko cututtukan fata
• Alamar madaidaiciya mai tsayi (inci 1/2 ko inci 1 ko mafi faɗi), ana kiranta striae, akan fatar ciki, cinyoyi, hannuwan hannu na sama, da ƙirjin
• Fata mai laushi tare da rauni mai sauƙi, galibi akan makamai da hannaye

Muscle da kashi canje-canje sun hada da:

• Ciwon baya, wanda ke faruwa tare da ayyukan yau da kullun
• Ciwon ƙashi ko taushi
• Tarin kitse tsakanin kafadu (bawon bulo)
• Raunin kasusuwa, wanda ke haifar da haƙarƙari da kashin baya
• Musclesananan tsokoki da ke haifar da haƙuri rashin motsa jiki

Mata na iya samun:

• Ci gaban gashi da yawa a fuska, wuya, kirji, ciki, da cinyoyi
• Halin jinin haila wanda ya zama mara tsari ko tsayawa

Maza na iya samun:

• Rage ko babu sha'awar yin jima'i (low libido)
• Matsalar tashin hankali

Sauran cututtuka ko matsaloli na iya haɗawa da:

• Canje-canjen tunani, kamar ɓacin rai, damuwa, ko canje-canje a ɗabi'a
• Gajiya
• Yawaitar cututtuka
• Ciwon kai
• Thirstarin ƙishirwa da fitsari
• Hawan jini
• Ciwon suga

Mai ba da sabis na kiwon lafiya zai yi gwajin jiki kuma ya yi tambaya game da alamunku.

Ana yin gwaje-gwaje da farko don tabbatar akwai cortisol da yawa a jiki, sannan don tantance dalilin.

Wadannan gwaje-gwajen suna tabbatar da cortisol da yawa:

• 24-fitsari cortisol
• Dexamethasone danniya gwajin (low kashi)
• Matakan salsalar cortisol (da sanyin safiya da kuma dare)

Wadannan gwaje-gwajen suna tantance dalilin:

• Jinin matakin ACTH
• Brain MRI
• Gwajin kwayar Corticotropin-sakewa, wanda ke aiki akan gland shine zai haifar da sakin ACTH
• Dexamethasone danniya gwajin (babban kashi)
• Samfurin sinadarin ƙananan ƙwayar cuta (IPSS) - matakan matakan ACTH a cikin jijiyoyin da suke ɗora ƙwayar cuta ta jiki idan aka kwatanta da jijiyoyin da ke cikin kirji

Sauran gwaje-gwajen da za'a iya yi sun haɗa da ɗayan masu zuwa:

• Azumin glucose na jini da A1C don gwada ciwon sukari
• Lipid da cholesterol gwajin
• Binciken ƙananan ma'adinai don bincika osteoporosis

Ana iya buƙatar gwajin gwaji sama da ɗaya don tantance cutar Cushing. Mai ba ku sabis na iya tambayar ku don ganin likita wanda ya ƙware a cikin cututtukan cututtukan zuciya.

Jiyya ya haɗa da tiyata don cire ƙwayar pituitary, idan zai yiwu. Bayan tiyata, glandon na pituitary na iya sake fara aiki sannu a hankali ya koma yadda yake.

Yayin aiwatar da aikin daga tiyata, zaku iya buƙatar maganin maye gurbin cortisol saboda pituitary yana buƙatar lokaci don fara sake ACTH.

Hakanan za'a iya amfani da maganin fitila na gland na pituitary idan ba a cire kumburin gaba ɗaya ba.

Idan ƙari ba ya amsawa ga tiyata ko radiation, kuna iya buƙatar magunguna don hana jikinku yin cortisol.

Idan waɗannan jiyya ba su yi nasara ba, za a iya cire ƙwayoyin adrenal don dakatar da samar da matakan cortisol masu yawa. Cire glandon adrenal na iya haifar da ciwon pituitary don yayi girma sosai (Nelson syndrome).

Rashin magani, Cutar Cushing na iya haifar da ciwo mai tsanani, har da mutuwa. Cire ƙwayar cutar na iya haifar da cikakken dawowa, amma ƙari zai iya girma.

Matsalolin kiwon lafiya waɗanda zasu iya haifar da cutar Cushing sun haɗa da:

• Ressionarfafawa a cikin kashin baya
• Ciwon suga
• Hawan jini
• Cututtuka
• Dutse na koda
• Yanayi ko wasu matsalolin hauka

Kira mai ba ku sabis idan kun ci gaba da alamun cutar Cushing.

Idan an cire kumburin pituitary, kira mai ba da sabis idan kuna da alamun rikitarwa, gami da alamun cewa ciwon ya dawo.

Pituitary Cushing cuta; Adenoma mai ɓoye ACTH

• Endocrine gland
• Striae a cikin popliteal fossa
• Striae a kafa

Juszczak A, Morris DG, Grossman AB, Nieman LK. Ciwon ciwo na Cushing. A cikin: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Manya da Yara. 7th ed. Philadelphia, PA: Elsevier Saunders; 2016: babi na 13.

Molitch NI. Ciwon baya. A cikin: Goldman L, Schafer AI, eds. Magungunan Goldman-Cecil. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016: babi na 224.

Stewart PM, Newell-Price JDC. Tsarin adrenal. A cikin: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. Littafin Williams na Endocrinology. 13th ed. Philadelphia, PA: Elsevier; 2016: babi na 15.