Acromegaly

ʻO nā hōʻailona o ka acromegaly e komo pū ana i kahi maka a me nā lima i hoʻonui ʻia. Hiki i nā loli i ka maka ke hana i ka iwi lae a me ka iwi ʻāʻī haʻahaʻa e kūlou mai, a me ka ihu a me nā lehelehe e hoʻonui ʻia.

ʻO ka Acromegaly kahi maʻi hormonal e ulu mai ana i ka wā e hana nui ai kāu gland pituitary i ka hormone ulu i ka wā makua.

Ke nui loa kāu hormone ulu, e hoʻonui ana kāu mau iwi i ka nui. I ke wā kamaliʻi, e alakaʻi kēia i ka hoʻonui ʻana i ke kiʻekiʻe a kapa ʻia ʻo gigantism. Akā i ka wā makua, ʻaʻole e loli ke kiʻekiʻe. Ma kahi o kēlā, ua kaupalena ʻia ka hoʻonui ʻana i ka nui o ka iwi i nā iwi o kou mau lima, nā wāwae a me ka maka, a kapa ʻia ʻo acromegaly.

No ka mea he mea maʻamau ʻole ka acromegaly a ua lohi ka loli kino i nā makahiki he nui, i kekahi manawa e lōʻihi ka manawa e ʻike ai i ke kūlana. Inā ʻaʻohe lāʻau lapaʻau, hiki i nā kiʻekiʻe o ka hormone ulu ke hoʻopilikia i nā ʻāpana ʻē aʻe o ke kino, ma waho aʻe o kou mau iwi. Hiki kēia ke alakaʻi i nā pilikia olakino koʻikoʻi - i kekahi manawa hiki ke hoʻoweliweli i ke ola - Akā hiki i ka lāʻau lapaʻau ke ho'ēmi i kou pilikia o nā pilikia a hoʻomaikaʻi nui i kou mau hōʻailona, ​​e komo pū ana me ka hoʻonui ʻana o kou mau hiʻohiʻona.

He hōʻailona maʻamau o ka acromegaly ka nui ʻana o nā lima a me nā wāwae. No ka laʻana, e ʻike paha ʻoe ʻaʻole hiki iā ʻoe ke kau i nā apo i kūpono ma mua, a ua hoʻonui mau ʻia kou nui kāmaʻa. Hiki i ka acromegaly ke hoʻokumu pū i nā loli mālie i ke ʻano o kou helehelena, e like me ka ihu haʻahaʻa a me ka iwi lae, ka ihu nui, nā lehelehe mānoanoa, a me ka ākea ākea ma waena o kou mau niho. Ma muli o ka holomua mālie ʻana o ka acromegaly, ʻaʻole paha e ʻike ʻia nā hōʻailona mua no nā makahiki. I kekahi manawa, ʻike nā kānaka i nā loli kino ma o ka hoʻohālikelike ʻana i nā kiʻi kahiko me nā kiʻi hou. Ma ke ʻano holoʻokoʻa, ʻokoʻa nā hōʻailona a me nā hōʻailona o ka acromegaly mai ke kanaka a i ke kanaka, a hiki ke komo pū me kekahi o kēia mau mea: Nā lima a me nā wāwae nui. Nā hiʻohiʻona helehelena nui, me nā iwi helehelena, nā lehelehe, ka ihu a me ka alelo. ʻIli wiliwili, momona, mānoanoa. Ka hou ʻana o ka hou a me ka ʻala kino. Nā ulu liʻiliʻi o ka ʻili (nā hōʻailona ʻili). Ka luhi a me ka nāwaliwali o nā hono a i ʻole nā ​​mākala. ʻEha a me ka palena o ka neʻe ʻana o nā hono. Ka leo hohonu, husky ma muli o ka nui ʻana o nā kaula leo a me nā sinuses. Ka hanu nui ma muli o ka pale ʻana o ke ala ea kiʻekiʻe. Nā pilikia ʻike. Nā ʻeha poʻo, hiki ke mau a i ʻole koʻikoʻi. Nā loli o ka pōʻai menstrual i nā wāhine. Ka hana erectile i nā kāne. Ka nalowale o ka makemake i ka moekolohe. Inā loaʻa iā ʻoe nā hōʻailona a me nā hōʻailona e pili ana i ka acromegaly, e kelepona i kāu kauka no kahi hoʻokolokolo. Hoʻomohala pinepine ʻia ka acromegaly. ʻAʻole paha e ʻike nā lālā o kou ʻohana i nā loli kino mālie e kū mai me kēia maʻi i ka wā mua. Akā he mea nui ka ʻike mua ʻana i hiki iā ʻoe ke hoʻomaka e loaʻa ka mālama kūpono. Hiki i ka acromegaly ke alakaʻi i nā pilikia olakino koʻikoʻi inā ʻaʻole ia i mālama ʻia.

Inā loaʻa iā ʻoe nā hōʻailona a me nā ʻōuli e pili ana i ka acromegaly, e kelepona i kāu kauka no kahi hoʻokolokolo. Hoʻomohala mālie pinepine ʻia ka acromegaly. ʻAʻole paha e ʻike koke mai kou mau ʻohana i nā loli kino mālie e kū mai ana me kēia maʻi. Akā, he mea nui ka ʻike mua ʻana i mea e hiki ai iā ʻoe ke hoʻomaka i ka loaʻa ʻana o ka mālama kūpono. Hiki i ka acromegaly ke alakaʻi i nā pilikia olakino koʻikoʻi inā ʻaʻole ia i mālama ʻia.

Hoʻomaka ka acromegaly i ka wā e hoʻopuka nui ai ke kīʻaha pituitary i ka hormone ulu (GH) ma kahi manawa lōʻihi. ʻO ke kīʻaha pituitary he kīʻaha liʻiliʻi ma ke kumu o kou lolo, ma hope o ke alahaka o kou ihu. Hoʻopuka ia i ka GH a me ka nui o nā hormones ʻē aʻe. He kuleana nui ka GH i ka hoʻokele ʻana i kou ulu kino. I ka wā e hoʻokuʻu ai ke kīʻaha pituitary i ka GH i loko o kou kahe koko, e hoʻoulu ia i kou ate e hoʻopuka i ka hormone i kapa ʻia ʻo ka insulin-like growth factor-1 (IGF-1) — i kapa ʻia kekahi manawa he insulin-like growth factor-I, a i ʻole IGF-I. ʻO ka IGF-1 ka mea e hoʻoulu ai i kou mau iwi a me nā ʻiʻo ʻē aʻe e ulu. ʻO ka nui o ka GH e alakaʻi i ka nui o ka IGF-1, ka mea e hiki ai ke hoʻoulu i nā hōʻailona, nā hōʻailona a me nā pilikia o ka acromegaly. I nā mākua, ʻo ka ʻōpū ka kumu maʻamau o ka nui o ka hoʻopuka ʻana o ka GH: Nā ʻōpū pituitary. ʻO ka hapa nui o nā hihia acromegaly e hoʻokumu ʻia e kahi ʻōpū ʻaʻohe kanesa (benign) (adenoma) o ke kīʻaha pituitary. Hoʻopuka ka ʻōpū i nā nui o ka hormone ulu, e hoʻoulu ana i nā hōʻailona a me nā hōʻailona o ka acromegaly. ʻO kekahi o nā hōʻailona o ka acromegaly, e like me nā headaches a me ka ʻike maikaʻi ʻole, ua hoʻokumu ʻia e ke kaomi ʻana o ka ʻōpū i nā pūnaewele lolo kokoke. Nā ʻōpū ʻaʻole pituitary. I kekahi mau kānaka me ka acromegaly, nā ʻōpū ma nā ʻāpana ʻē aʻe o ke kino, e like me nā māmā a i ʻole ka pancreas, e hoʻokumu i ka maʻi. I kekahi manawa, hoʻopuka kēia mau ʻōpū i ka GH. I nā hihia ʻē aʻe, hoʻopuka nā ʻōpū i ka hormone i kapa ʻia ʻo ka growth hormone-releasing hormone (GH-RH), ka mea e hōʻailona ai i ke kīʻaha pituitary e hana hou i ka GH.

ʻO ka poʻe i loaʻa i kahi kūlana genetic maʻamau ʻole i kapa ʻia ʻo ka multiple endocrine neoplasia, type 1 (MEN 1), he kiʻekiʻe ko lākou pilikia o ka loaʻa ʻana o ka acromegaly. Ma ka MEN 1, ʻo nā glands endocrine — maʻamau nā parathyroid glands, pancreas a me ka pituitary gland — e ulu ana nā tumors a hoʻokuʻu i nā hormones keu. Hiki i kēlā mau hormones ke hoʻoulu i ka acromegaly.

Inā waiho ʻole ʻia me ka mālama ʻole, hiki i ka acromegaly ke alakaʻi i nā pilikia olakino nui. Hiki i nā pilikia ke komo pū me:

• Cholesterol kiʻekiʻe.
• Nā pilikia o ka naʻau, ʻo ka nui ʻana o ka naʻau (cardiomyopathy).
• Osteoarthritis.
• Ka maʻi diabetes type 2.
• Hoʻonui ʻia o ka gland thyroid (goiter).
• Nā ulu ʻaʻai ʻole (polyps) ma ka papa o kou kolona.
• Sleep apnea, kahi kūlana kahi e hoʻomaha ai a hoʻomaka hou ai ka hanu i ka wā e hiamoe ai.
• Carpal tunnel syndrome.
• Hoʻonui ʻia ka pilikia o nā tumors cancerous.
• Loli ʻana o ka ʻike a i ʻole ka nalowale o ka ʻike.

Hiki i ka mālama mua ʻana i ka acromegaly ke pale aku i kēia mau pilikia mai ka hoʻomohala ʻana a i ʻole ka hoʻopilikia ʻana. Inā waiho ʻole ʻia, hiki i ka acromegaly a me kāna mau pilikia ke alakaʻi i ka make koke.

E nīnau aku kāu kauka e pili ana i kāu mōʻaukala lapaʻau a me ka hana ʻana i kahi hoʻokolokolo kino. A laila, hiki iā ia ke ʻōlelo aku i nā hana penei: Ana ʻana o ka IGF-1. Ma hope o kou hoʻokēʻai ʻana i ka pō, e lawe mai kāu kauka i kahi laʻana koko e ana i ka pae IGF-1 i loko o kou koko. Hōʻike ka pae IGF-1 kiʻekiʻe i ka acromegaly. Hoʻokolokolo hoʻohaʻahaʻa ulu hormone. ʻO kēia ka ʻano maikaʻi loa no ka hōʻoia ʻana i kahi ʻike acromegaly. I loko o kēia hoʻokolokolo, ua ana ʻia kāu pae koko GH ma mua a ma hope o kou inu ʻana i kahi hoʻomākaukau o ke kō (glucose). I loko o nā kānaka ʻaʻohe acromegaly, hoʻemi pinepine ka inu glucose i ka pae GH. Akā inā loaʻa iā ʻoe ka acromegaly, e noho kiʻekiʻe kāu pae GH. Kiʻi. Hiki i kāu kauka ke ʻōlelo aku i kahi hoʻokolokolo kiʻi, e like me ka magnetic resonance imaging (MRI), e kōkua i ka kuhikuhi ʻana i kahi a me ka nui o kahi tumor ma kāu gland pituitary. Inā ʻaʻohe mau tumors pituitary i ʻike ʻia, hiki i kāu kauka ke kauoha i nā hoʻokolokolo kiʻi ʻē aʻe e ʻimi i nā tumors nonpituitary. ʻIke hou aku CT scan MRI

Hoʻololi ka mālama ʻana i ka acromegaly ma muli o ke kanaka. E hilinaʻi paha kāu papahana mālama ʻana ma kahi a me ka nui o kāu tumor, ka nui o kāu mau hōʻailona, a me kou makahiki a me kou olakino holoʻokoʻa. No ke kōkua ʻana e hoʻoemi i kou mau pae GH a me IGF-1, ʻo nā koho mālama ʻana e komo pinepine ana i ka ʻoki kino a i ʻole ka radiation e wehe a hoʻemi paha i ka nui o ka tumor e hoʻoulu ana i kāu mau hōʻailona, a me ka lāʻau lapaʻau e kōkua ai e hoʻoponopono i kou mau pae hormone. Inā ʻoe e ʻike ana i nā pilikia olakino ma muli o ka acromegaly, hiki i kāu kauka ke ʻōlelo aku i nā mālama hou aku e kōkua ai i ka hoʻokele ʻana i kāu mau pilikia. ʻOki Kino ʻOki kino endoscopic transnasal transsphenoidal Hoʻonui i ke kiʻi E pani ʻOki kino endoscopic transnasal transsphenoidal ʻOki kino endoscopic transnasal transsphenoidal I ka ʻoki kino endoscopic transnasal transsphenoidal, waiho ʻia kahi mea hana ʻoki kino ma o ka ihu a ma ka ʻaoʻao o ka nasal septum e komo i kahi tumor pituitary. Hiki i nā kauka ke wehe i ka hapa nui o nā tumor pituitary me kahi ʻano i kapa ʻia ʻo ka ʻoki kino transsphenoidal. I loko o kēia kaʻina hana, hana kāu kauka ma o kou ihu e wehe i ka tumor mai kou pituitary gland. Inā ʻaʻole i kau ʻia ka tumor e hoʻoulu ana i kāu mau hōʻailona ma luna o kou pituitary gland, e ʻōlelo aku kāu kauka i kahi ʻano ʻoki kino ʻē aʻe e wehe i ka tumor. I nā hihia he nui - ʻoi aku inā he liʻiliʻi kāu tumor - hoʻi ka wehe ʻana i ka tumor i kāu mau pae GH i ka maʻamau. Inā ke kau nei ka tumor i kaomi ma nā pūnaewele a puni kou pituitary gland, kōkua pū ka wehe ʻana i ka tumor e hoʻomaha i nā poʻo ʻeha a me nā loli ʻike. I kekahi mau hihia, ʻaʻole hiki i kāu kauka ke wehe i ka tumor holoʻokoʻa. Inā pēlā, hiki iā ʻoe ke loaʻa mau nā pae GH kiʻekiʻe ma hope o ka ʻoki kino. Hiki i kāu kauka ke ʻōlelo aku i kahi ʻoki kino ʻē aʻe, nā lāʻau lapaʻau a i ʻole nā ​​mālama radiation. Nā Lāʻau Lapaʻau Hiki i kāu kauka ke ʻōlelo aku i kekahi o nā lāʻau lapaʻau aʻe - a i ʻole ka hui ʻana o nā lāʻau lapaʻau - e kōkua i kou mau pae hormone e hoʻi i ka maʻamau: Nā lāʻau e hoʻemi ana i ka hana ulu hormone (somatostatin analogues). I loko o ke kino, hana kahi hormone lolo i kapa ʻia ʻo somatostatin e kūʻē (e kāohi) i ka hana GH. ʻO nā lāʻau octreotide (Sandostatin) a me lanreotide (Somatuline Depot) nā mana hana kanaka (synthetic) o somatostatin. ʻO ka lawe ʻana i kekahi o kēia mau lāʻau e hōʻailona i ka pituitary gland e hana i ka GH emi, a hiki ke hoʻemi i ka nui o kahi tumor pituitary. Ma ke ʻano maʻamau, hoʻokomo ʻia kēia mau lāʻau i nā nāʻi o kou mau puʻupuʻu (nāʻi gluteal) i hoʻokahi mahina e kahi limahana mālama ola. Nā lāʻau e hoʻoemi ai i nā pae hormone (dopamine agonists). Hiki i nā lāʻau waha cabergoline a me bromocriptine (Parlodel) ke kōkua i ka hoʻoemi ʻana i nā pae o GH a me IGF-1 i kekahi poʻe. Hiki i kēia mau lāʻau ke kōkua pū i ka hoʻemi ʻana i ka nui o ka tumor. No ka mālama ʻana i ka acromegaly, pono e lawe ʻia kēia mau lāʻau lapaʻau ma nā nui kiʻekiʻe, kahi e hoʻonui ai i ka pilikia o nā hopena ʻaoʻao. ʻO nā hopena ʻaoʻao maʻamau o kēia mau lāʻau e komo pū ana i ka nausea, ka luaʻi, ka ihu ʻā, ka luhi, ka dizziness, nā pilikia hiamoe a me nā loli manaʻo. Lāʻau e kāohi i ka hana o GH (growth hormone antagonist). Hoʻopau ka lāʻau pegvisomant (Somavert) i ka hopena o GH ma nā pūnaewele o ke kino. Hiki iā Pegvisomant ke kōkua nui no nā poʻe i loaʻa ʻole ka holomua maikaʻi me nā mālama ʻē aʻe. Hāʻawi ʻia ma ke ʻano he injection i kēlā me kēia lā, hiki i kēia lāʻau ke kōkua i ka hoʻoemi ʻana i nā pae IGF-1 a hoʻomaha i nā hōʻailona, ​​akā ʻaʻole ia e hoʻoemi i nā pae GH a hoʻemi i ka nui o ka tumor. Radiation Inā ʻaʻole hiki i kāu kauka ke wehe i ka tumor holoʻokoʻa i ka wā o ka ʻoki kino, hiki i kāu kauka ke ʻōlelo aku i ka mālama radiation. Hoʻopau ka radiation therapy i nā sela tumor i koe a hoʻemi mālie i nā pae GH. Hiki ke mau makahiki no kēia mālama e hoʻomaikaʻi maopopo i nā hōʻailona acromegaly. Hoʻoemi pinepine ka mālama radiation i nā pae o nā hormone pituitary ʻē aʻe, ʻaʻole wale GH. Inā loaʻa iā ʻoe ka mālama radiation, e pono paha iā ʻoe nā kipa hahai maʻamau me kāu kauka e hōʻoia i ka hana pono ʻana o kou pituitary gland, a e nānā i kou mau pae hormone. Hiki ke lōʻihi kēia mālama hahai no ke koena o kou ola. ʻO nā ʻano o ka radiation therapy e komo pū ana: Conventional radiation therapy. Hāʻawi pinepine ʻia kēia ʻano o ka radiation therapy i kēlā me kēia lā ma kahi manawa o ʻehā a ʻeono pule. ʻAʻole paha ʻoe e ʻike i ka hopena piha o ka radiation therapy maʻamau no 10 mau makahiki a ʻoi aku paha ma hope o ka mālama ʻana. Stereotactic radiosurgery. Hoʻohana ka Stereotactic radiosurgery i ka 3D imaging e hāʻawi i kahi nui o ka radiation i nā sela tumor, ʻoiai e kaupalena ana i ka nui o ka radiation i nā pūnaewele maʻamau a puni. Hiki ke hāʻawi ʻia i loko o hoʻokahi nui. Hiki i kēia ʻano o ka radiation ke hoʻihoʻi i nā pae GH i ka maʻamau i loko o ʻelima a ʻumi mau makahiki. ʻIke hou aku Radiation therapy Stereotactic radiosurgery Noi i kahi kūkā