Cutar ciwo ta Cushing

Exogenous Cushing syndrome wani nau'i ne na ciwon Cushing wanda ke faruwa a cikin mutanen da ke shan maganin glucocorticoid (wanda kuma ake kira corticosteroid, ko steroid).

Cutar ciwo ta Cushing cuta ce da ke faruwa yayin da jikinka ya sami matakin da ya fi na al'ada na hormone cortisol. Wannan hormone yawanci ana yin sa ne a cikin gland adrenal.

Meansaramar hanya ta haifar da wani abu a waje da jiki. Exogenous Cushing syndrome yana faruwa ne yayin da mutum ya sha magungunan roba na mutum (roba) don magance wata cuta.

Glucocorticoids ana ba su don cututtuka da yawa, irin su cututtukan huhu, yanayin fata, cututtukan hanji mai kumburi, ciwon daji, ciwan kwakwalwa, da haɗin gwiwa. Wadannan magunguna sun zo ta hanyoyi daban-daban, ciki har da kwaya, intravenous (IV), allura a cikin hadin gwiwa, enema, mayukan fatar jiki, masu shakar iska, da digon ido.

Yawancin mutane da ke fama da cutar Cushing suna da:

• Zagaye, ja, cike da fuska (fuskar wata)
• Saurin girma (a cikin yara)
• Rage nauyi tare da tara kitse a jikin akwati, amma asarar mai daga hannu, kafafu, da gindi (tsakiyar kiba)

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

• 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 raunin rauni

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 da sama da abin wuya
• Rib da kasusuwa na kashin baya wanda aka samu sakamakon siririn kasusuwa
• Musclesarfin tsokoki, musamman na kwatangwalo da kafaɗu

Matsalolin jiki (na tsari) na iya haɗawa da:

• Rubuta ciwon sukari na 2
• Hawan jini
• Babban cholesterol da triglycerides

Mata na iya samun:

• Lokutan da suka zama marasa tsari ko tsayawa

Maza na iya samun:

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

Sauran cututtukan da za su iya faruwa sun haɗa da:

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

Mai ba da sabis na kiwon lafiya zai yi gwajin jiki kuma ya yi tambaya game da alamun ku da magungunan da kuke sha. Faɗa wa mai bayarwa game da duk magungunan da kuka sha na watanni da suka gabata. Har ila yau gaya wa mai bayarwa game da harbe-harben da kuka karɓa a ofishin mai bayarwa.

Idan kayi amfani da cortisone, prednisone, ko wasu corticosteroids, sakamakon gwajin da ke gaba na iya ba da shawarar rashin lafiyar Cushing:

• ACananan matakin ACTH
• Levelananan matakin cortisol (ko babban matakin cortisol) a cikin jini ko fitsari, ya dogara da maganin da kuke sha
• Amsar da ba ta dace ba ga gwajin haɓaka cosyntropin (ACTH)
• Mafi girma fiye da al'ada glucose mai azumi
• Bloodananan matakin potassium
• Boneananan ƙananan ƙashi, kamar yadda aka auna ta gwajin ƙimar ma'adinai
• Babban cholesterol, musamman babban triglycerides da ƙananan ƙananan lipoprotein (HDL)

Wata hanyar da ake kira chromatography mai saurin yin ruwa (HPLC) na iya nuna babban maganin da ake zargi a cikin fitsari.

Jiyya shine ragewa kuma ƙarshe dakatar da shan kowace corticosteroids. Ana iya yin wannan a hankali ko da sauri, gwargwadon dalilin da ya sa ake kula da ku tare da corticosteroid. Kada ka daina shan kowane magani ba tare da fara magana da mai ba ka ba. Ba zato ba tsammani tsayawa corticosteroids bayan shan su na dogon lokaci na iya haifar da yanayin barazanar rai da ake kira adrenal rikicin.

Idan ba za ku iya dakatar da shan magani ba saboda cuta (alal misali, kuna buƙatar maganin glucocorticoid don kula da asma mai tsanani), bi umarnin mai ba ku kan yadda za a rage yiwuwar ɓarkewar rikice-rikice, gami da:

• Kula da hawan jini da abinci, magungunan baka, ko insulin.
• Yin maganin babban cholesterol da abinci ko magunguna.
• Shan magunguna dan hana zubar kashi. Wannan na iya taimakawa rage haɗarin karaya idan kun sami ciwan kashi.
• Shan wasu magunguna don rage adadin maganin glucocorticoid da kuke buƙata.

Sannu a hankali shafa maganin da ke haifar da yanayin na iya taimakawa baya sakamakon illar gusar adrenal gland (atrophy). Wannan na iya ɗaukar watanni har tsawon shekara. A wannan lokacin, zaku iya sake farawa ko ƙara sashin maganin ku na steroid a lokacin damuwa ko rashin lafiya.

Matsalolin kiwon lafiya waɗanda zasu iya haifar da cututtukan Cushing sun haɗa da ɗayan masu zuwa:

• Immunearancin garkuwar jiki, wanda na iya haifar da cututtuka da yawa
• Lalacewa ga idanu, koda, da jijiyoyi saboda yawan hawan jini
• Ciwon suga
• Babban matakan cholesterol
• Riskarin haɗarin kamuwa da ciwon zuciya daga cutar sikari da ba a kula da ita da kuma babban cholesterol
• Riskarin haɗarin jinin jini
• Kasusuwa marasa ƙarfi (osteoporosis) da kuma haɗarin karaya

Wadannan rikitarwa ana iya kiyaye su gaba ɗaya tare da magani mai kyau.

Kira don alƙawari tare da mai ba da sabis idan kuna shan corticosteroid kuma kuna ci gaba da bayyanar cututtukan Cushing.

Idan ka ɗauki corticosteroid, san alamomi da alamomin cutar Cushing. Yin jiyya da wuri na iya taimakawa hana duk wani tasirin cikin dogon lokaci na ciwon Cushing. Idan kayi amfani da magungunan inha, zaku iya rage tasirin ku ga masu amfani da kwayoyi ta hanyar amfani da wata cuta da kuma kurkurar bakinku bayan numfashi a cikin kwayar.

Ciwon Cushing - corticosteroid ya haifar; Corticosteroid-haifar da ciwo na Cushing; Ciwan Iatrogenic Cushing

• Hypothalamus samar da hormone

Nieman LK, Biller BM, Findling JW, et al.Jiyya na cututtukan Cushing: jagorar aikin likita na 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. 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.