He aha ka Congenital Adrenal Hyperplasia? Nā hōʻailona, nā kumu, a me ka mālama

ʻO ka Congenital adrenal hyperplasia (CAH) kahi hui o nā kūlana hoʻoilina e pili ana i kou mau kīʻaha adrenal. Aia kēia mau kīʻaha liʻiliʻi ma luna o kou mau puʻupaʻa a hana i nā hormones nui e pono ai kou kino e hana pono.

Ke loaʻa iā ʻoe ka CAH, ʻaʻole hiki i kou mau kīʻaha adrenal ke hana i ka hormone i kapa ʻia ʻo cortisol. Hana kēia no ka mea nele kāu kino a i ʻole he liʻiliʻi loa o kahi enzyme e pono ai e hana i ka cortisol. E noʻonoʻo i nā enzyme e like me nā limahana liʻiliʻi i loko o kou kino e kōkua i nā hana kemika e holo mālie.

He aha nā hōʻailona o ka congenital adrenal hyperplasia?

Hiki i nā hōʻailona o ka CAH ke ʻokoʻa loa ma muli o ke ʻano āu e loaʻa ai a me ka nui o kona koʻikoʻi. Hoʻomaopopo kekahi poʻe i nā hōʻailona ma hope koke o ka hānau ʻana, ʻoiai ʻaʻole paha e ʻike kekahi i nā hōʻailona a hiki i ko lākou wā ʻelemakule.

Eia nā hōʻailona maʻamau loa āu e ʻike ai i nā pēpē hou a me nā pēpē:

• Nā genitalia ambiguous i nā kaikamahine pēpē (nā genitalia ʻaʻole i ʻike maopopo ʻia he kāne a wahine paha)
• Nā genitalia nui i nā keikikāne pēpē
• Ka maloʻo nui a me ka luaʻi i nā hebedoma mua o ke ola
• Nā manawa haʻahaʻa o ke kō koko
• Ka nalowale nui o ka paʻakai ma o ka mimi
• Ka hānai ʻino a me ka nele o ka loaʻa ʻana o ke kaupaona
• Ka luhi a i ʻole ka hiamoe maʻamau ʻole

Hana kēia mau hōʻailona mua no ka mea ke paio nei ke kino o kāu pēpē e mālama i ke kaulike kūpono o ka paʻakai, ke kō, a me nā wai me ka lawa ʻole o ka cortisol.

I ka wā e ulu ai nā keiki me ka CAH, hiki iā ʻoe ke ʻike i nā hōʻailona ʻē aʻe e ulu ana:

• Ka puka ʻana o ka wā ʻōpio mua loa (i kekahi manawa i ka wā ʻōpio 2-4 makahiki)
• Nā ulu wikiwiki i hahai ʻia e ka lōʻihi hope loa ma mua o ka manaʻo
• Ka ulu nui o ka lauoho kino
• Ka ʻāʻī nui
• Nā manawa menstrual maʻamau ʻole a i ʻole ka nele o nā manawa i nā kaikamāhine
• Ka leo hohonu i nā kaikamāhine
• Ka hoʻomohala ʻana o nā ʻiʻo e like me ka holomua no ko lākou makahiki

Loaʻa i kekahi poʻe kahi ʻano palupalu o ka CAH ʻaʻole e ʻike ʻia a hiki i ka wā makua. Hiki i nā hōʻailona makua ke komo pū me nā pilikia hānau, nā manawa maʻamau ʻole, ka ulu nui o ka lauoho, a me ka ʻāʻī nui ʻaʻole e pane i nā mālama maʻamau.

He aha nā ʻano o ka congenital adrenal hyperplasia?

Aia ʻelua ʻano nui o ka CAH, a ʻo ka hoʻomaopopo ʻana i ka ʻokoʻa hiki ke kōkua iā ʻoe e ʻike i ka mea e manaʻo ai. ʻO ke ʻano āu e loaʻa ai ke hilinaʻi nei i ka nui o ka hana enzyme i kāu kino.

ʻO ka CAH Classic ka ʻano koʻikoʻi loa e ʻike pinepine ʻia i nā pēpē hou. Ma kahi o 75% o nā kānaka me ka CAH classic loaʻa pū kekahi i ka mea a nā kauka i kapa ai ʻo "salt-wasting," ʻo ia hoʻi ke nalowale nui nei ko lākou kino i ka paʻakai a hiki ke maloʻo loa. ʻO ke 25% ʻē aʻe he "simple virilizing" CAH classic, kahi e hoʻopōʻino ai nā pilikia hormone i ka wā ʻōpio mua a me nā loli hoʻomohala ʻē aʻe akā ʻaʻole pinepine e hoʻopōʻino i ka nalowale o ka paʻakai e weliweli ai i ke ola.

ʻOi aku ka palupalu o ka CAH Non-classic a pinepine ʻaʻole e hōʻike i nā hōʻailona a hiki i ka wā ma hope o ke kamaliʻi, ka wā ʻōpio, a i ʻole ka wā makua. Loaʻa pinepine i nā kānaka me kēia ʻano ka hana enzyme lawa e pale aku ai i nā pilikia koʻikoʻi i ka wā pēpē, akā hiki iā lākou ke ʻike i nā pilikia hormone i ko lākou ulu ʻana.

He aha ka mea e hoʻokumu ai i ka congenital adrenal hyperplasia?

Hoʻokumu ʻia ka CAH e nā loli (mutations) i kāu mau gene e pili ana i ka hana ʻana o kou mau kīʻaha adrenal. Hoʻoilina ʻoe i kēia mau loli genetic mai kou mau mākua, ʻo ia ke kumu i kapa ʻia ai ʻo "congenital" - ʻo ia hoʻi ke kū mai i ka hānau ʻana.

ʻO ke kumu maʻamau loa kahi gene e hana i kahi enzyme i kapa ʻia ʻo 21-hydroxylase. Ma kahi o 90-95% o nā kānaka me ka CAH loaʻa nā mutations i kēia gene kūikawā. Me ka lawa ʻole o kēia enzyme, ʻaʻole hiki i kou mau kīʻaha adrenal ke hana pono i ka cortisol, akā ke hoʻāʻo mau nei lākou ma ka hana ʻana i ka nui o nā hormones ʻē aʻe i kapa ʻia ʻo androgens.

ʻAʻole pinepine, hiki ke hoʻokumu ʻia ka CAH e nā mutations i nā gene e hana i nā enzyme ʻē aʻe e like me 11-beta-hydroxylase, 17-hydroxylase, a i ʻole 3-beta-hydroxysteroid dehydrogenase. Hoʻokumu kēlā me kēia o kēia i nā hōʻailona ʻokoʻa iki, akā hoʻopōʻino lākou a pau i ka hana hormone maʻamau i kou mau kīʻaha adrenal.

Hahai ka CAH i ka mea a nā geneticists i kapa ai ʻo kahi ʻano "autosomal recessive." ʻO ia hoʻi, pono ʻoe e hoʻoilina i kahi gene mutated mai kou mau mākua ʻelua e loaʻa ai ke kūlana. Inā hoʻoilina wale ʻoe i hoʻokahi gene mutated, he "carrier" ʻoe akā ʻaʻole pinepine e loaʻa iā ʻoe nā hōʻailona.

I ka wā hea e ʻike ai i ke kauka no ka congenital adrenal hyperplasia?

Pono ʻoe e ʻimi i ka mālama ola kino koke inā ʻike ʻoe i kekahi mau hōʻailona hoʻomaopopo, ʻoi aku hoʻi i nā pēpē hou a me nā keiki ʻōpio. Hiki i kēia mau hōʻailona ke hōʻike i kahi pilikia hormonal koʻikoʻi e pono ai ka mālama pilikia.

Kāhea koke i kāu kauka inā ʻike ʻoe i ka luaʻi, ka maloʻo nui, ka luhi nui, a i ʻole nā hōʻailona o ke kō koko haʻahaʻa i kahi pēpē hou. Hiki i kēia ke lilo i nā hōʻailona o kahi pilikia salt-wasting, kahi e weliweli ai i ke ola inā ʻaʻole mālama koke ʻia.

Pono ʻoe e hoʻokaʻaʻike pū i kāu mea mālama ola inā ʻike ʻoe i nā hōʻailona o ka wā ʻōpio mua i nā keiki ʻōpio, e like me ka ulu ʻana o ka lauoho kino, ka ulu wikiwiki ʻana, a i ʻole nā loli genital ma mua o 8 makahiki i nā kaikamāhine a i ʻole 9 makahiki i nā keikikāne. ʻOiai ʻaʻole weliweli koke, hiki i ka mālama mua ke kōkua i ka pale ʻana i nā pilikia.

No nā mākua, e noʻonoʻo e ʻike i ke kauka inā ʻike ʻoe i nā pilikia hānau i wehewehe ʻole ʻia, nā manawa maʻamau ʻole loa, ka ulu nui o ka lauoho i nā wahi maʻamau ʻole, a i ʻole ka ʻāʻī nui ʻaʻole e hoʻomaikaʻi me nā mālama maʻamau. Hiki i kēia ke lilo i nā hōʻailona o ka CAH non-classic i ʻike ʻole ʻia ma mua i ke ola.

He aha nā mea pilikia no ka congenital adrenal hyperplasia?

ʻOiai hiki ke mālama maikaʻi ʻia ka CAH me ka mālama kūpono, he mea nui e hoʻomaopopo i nā pilikia hiki ke loaʻa iā ʻoe e hiki ai iā ʻoe ke hana pū me kāu hui mālama ola e pale aku ai iā lākou. Hiki ke pale ʻia a emi iki ʻia ka hapa nui o nā pilikia me ka ʻike mua a me ka mālama mau.

ʻO nā pilikia pōkole loa koʻikoʻi loa e komo pū me:

• Ka pilikia adrenal (ka maloʻo nui, ka haʻalulu, a me nā pilikia electrolyte)
• Nā pae kō koko haʻahaʻa weliweli
• Ka maloʻo nui e hiki ke alakaʻi i nā pilikia puʻupaʻa
• Ka nele o ka ulu i nā pēpē i mālama ʻole ʻia

ʻOi aku ka maʻamau o kēia mau pilikia ʻoi aku i nā kānaka me ka CAH classic, ʻoi aku hoʻi ke ʻano salt-wasting, a maʻamau e kū mai i ka wā i ʻike ʻole ʻia ai ke kūlana a i ʻole i nā manawa o ke kaumaha a i ʻole ka maʻi.

Hiki i nā pilikia lōʻihi ke hoʻopilikia i ka ulu a me ka hoʻomohala ʻana:

• Ka lōʻihi hope loa o ka makua ma muli o ka wā ʻōpio mua a me ka hui mua ʻana o nā papa ulu
• Nā pilikia hānau i nā kāne a me nā wahine
• Nā manawa menstrual maʻamau ʻole a i ʻole ka nele o nā manawa
• Nā pilikia noʻonoʻo e pili ana i nā genitalia ambiguous a i ʻole ka ʻike kāne
• Ka hoʻonui ʻia o ka pilikia o ka osteoporosis mai ka mālama steroid lōʻihi
• Ka hoʻonui ʻia o ka pilikia o ka momona a me nā pilikia metabolic

Me ka mālama lapaʻau kūpono a me ka mālama hormone pani, hiki i ka hapa nui o nā kānaka me ka CAH ke ola i nā ola olakino, maʻamau a pale aku i kēia mau pilikia. Kūkulu nā nānā mau a me nā hoʻoponopono mālama i ka hoʻemi ʻana i nā pilikia ʻoiai e mālama ana i ka maikaʻi o ke ola.

Pehea e hiki ai ke pale ʻia ka congenital adrenal hyperplasia?

ʻOiai he kūlana genetic ka CAH, ʻaʻole hiki iā ʻoe ke pale aku iā ia mai ka loaʻa ʻana inā hoʻoilina ʻoe i nā gene mai kou mau mākua ʻelua. Eia naʻe, hiki i ka ʻōlelo aʻo genetic a me ka hoʻokolohua ke kōkua iā ʻoe e hoʻomaopopo i kāu mau pilikia a hana i nā hoʻoholo hoʻolālā ʻohana naʻauao.

Inā loaʻa iā ʻoe kahi moʻolelo ʻohana o ka CAH a i ʻole ʻoe i kahi hui ethnic kiʻekiʻe-pilikia, hiki i ka ʻōlelo aʻo genetic ke kōkua iā ʻoe e hoʻomaopopo inā he mea hāpai ʻoe. Hoʻokomo ka hoʻokolohua hāpai i kahi hoʻokolohua koko maʻalahi e hiki ke ʻike inā loaʻa iā ʻoe hoʻokahi kope o ka gene mutated.

Inā he mau mea hāpai nā hoa pili ʻelua, loaʻa iā ʻoe kekahi mau koho e noʻonoʻo ai. Hiki i ka hoʻokolohua prenatal i ka wā hāpai ke ʻike i ka CAH i loko o ka pēpē e ulu ana. Koho kekahi mau kāne i ka fertilization in vitro me ka hoʻokolohua genetic o nā embryos (i kapa ʻia ʻo preimplantation genetic diagnosis) e koho i nā embryos me ka ʻole o ke kūlana.

No nā ʻohana me kahi moʻolelo o ka CAH, he mea nui ka nānā ʻana i nā pēpē hou. Loaʻa i ka hapa nui o nā ʻāina i kēia manawa ka CAH i kā lākou mau papahana nānā pēpē hou maʻamau, kahi e hiki ai ke hopu i ke kūlana ma mua o ka ulu ʻana o nā hōʻailona a ʻae i ka mālama koke.

Pehea ka ʻike ʻia o ka congenital adrenal hyperplasia?

Hoʻokomo pinepine ka ʻike ʻana i ka CAH i nā hoʻokolohua koko e ana i nā pae hormone, a pili ka manawa o kēia mau hoʻokolohua i ka wā e ʻike ʻia ai nā hōʻailona. Loaʻa ka hapa nui o nā hihia i kēia manawa ma o nā papahana nānā pēpē hou maʻamau ma mua o ka ulu ʻana o nā hōʻailona.

Hoʻokomo ka nānā ʻana i nā pēpē hou i ka lawe ʻana i kahi laʻana koko liʻiliʻi mai ka kuʻekuʻe o kāu pēpē i loko o nā lā mua o ke ola. Ana ka hoʻokolohua i nā pae o ka hormone i kapa ʻia ʻo 17-hydroxyprogesterone, kahi i hoʻonui pinepine ʻia i nā pēpē me ka CAH.

Inā he maʻamau ʻole ka hoʻokolohua nānā, e kauoha kāu kauka i nā hoʻokolohua koko kikoʻī hou aku e hōʻoia i ka ʻike. Ana kēia mau hoʻokolohua hōʻoia i nā hormones he nui e komo pū me ka cortisol, aldosterone, a me nā androgens like ʻole e hoʻoholo i ke ʻano o ka CAH āu keiki.

No nā keiki kahiko a me nā mākua, hoʻomaka pinepine ka ʻike ʻana i ka wā e ʻike ʻia ai nā hōʻailona. Hiki i kāu kauka ke kauoha i nā hoʻokolohua hormone like, pinepine i hana ʻia i kakahiaka nui i ka wā e kiʻekiʻe loa ai nā pae cortisol. I kekahi manawa pono kahi hoʻokolohua hoʻoulu, kahi e loaʻa ai iā ʻoe kahi inikini o ka synthetic ACTH (kahi hormone e hoʻoulu i nā kīʻaha adrenal) a laila e hoʻokolohua ʻia kāu koko e ʻike i ka pane ʻana o kāu mau adrenals.

I kekahi mau hihia, hiki i ka hoʻokolohua genetic ke ʻike i nā mutations kūikawā e hoʻokumu ana i ka CAH. Hiki ke kōkua kēia ʻike no ka hoʻolālā ʻohana a me ka hoʻoholo ʻana i ke ʻano kūikawā o ka nele enzyme āu e loaʻa ai.

He aha ka mālama no ka congenital adrenal hyperplasia?

Kūkulu ka mālama no ka CAH i ka pani ʻana i nā hormones ʻaʻole hiki i kou kino ke hana pono a me ka mālama ʻana i nā hōʻailona i kou ola holoʻokoʻa. Me ka mālama mau, hiki i ka hapa nui o nā kānaka me ka CAH ke ola i nā ola maʻamau, olakino.

Hoʻokomo ka mālama nui i ka lawe ʻana i nā lāʻau corticosteroid e pani i ka cortisol ʻaʻole e hana ana kou kino. Lawe ka hapa nui o nā kānaka i ka hydrocortisone, kahi like me ka cortisol e hana maoli ana kou kino. E lawe pinepine ʻoe i kēia lāʻau ʻelua a ʻekolu paha manawa i kēlā me kēia lā, me nā nui kiʻekiʻe i nā manawa o ka maʻi a i ʻole ke kaumaha.

Inā loaʻa iā ʻoe ke ʻano salt-wasting o ka CAH, pono pū ʻoe i kahi lāʻau i kapa ʻia ʻo fludrocortisone e kōkua i kou mau puʻupaʻa e paʻa i ka paʻakai a mālama i ke kaulike wai kūpono. Pono kekahi poʻe i ka paʻakai hou aku i ko lākou ʻai, ʻoi aku hoʻi i ka wā wela a i ʻole ka hoʻoikaika kino.

No nā kānaka me nā genitalia ambiguous, hiki ke kuhikuhi ʻia ka hoʻoponopono ʻana i ka ʻoki. He paʻakikī kēia mau hoʻoholo a pono e komo pū me kahi hui o nā loea e komo pū me nā pediatric endocrinologists, urologists, a me nā psychologists. ʻO ka manawa a me ke ʻano o ka ʻoki e ʻokoʻa ma muli o nā kūlana pilikino a me nā makemake ʻohana.

Pono pinepine ka mālama i nā hoʻoponopono i kou ulu ʻana a me ka loli ʻana o nā pono o kou kino. Hiki i nā keiki ke pono i nā hoʻonui nui i ko lākou nui ʻana, a hiki i nā wahine ke pono i nā hoʻoponopono i ka wā hāpai. Kūkulu nā nānā mau me nā hoʻokolohua koko i kāu kauka e hoʻomaikaʻi i kāu mālama.

Pehea e mālama ai i ka congenital adrenal hyperplasia ma ka home?

Hoʻokomo ka mālama ʻana i ka CAH ma ka home i ka hoʻomohala ʻana i nā hana maikaʻi e pili ana i ka lāʻau lapaʻau, ka mālama ʻana i ke kaumaha, a me ka ʻike ʻana i ka wā e ʻimi ai i ka mālama lapaʻau hou aku. Me ke ala kūpono, hiki iā ʻoe ke mālama i ke olakino maikaʻi a pale aku i nā pilikia.

ʻO ka lawe mau ʻana i kāu mau lāʻau lapaʻau ka mea nui loa o ka mālama home. E hoʻonohonoho i kahi papa hana i kēlā me kēia lā e maʻalahi ai ke hoʻomanaʻo i kāu mau nui, e like me ka lawe ʻana iā lākou me nā meaʻai a i ʻole ka hoʻohana ʻana i kahi mea hoʻonohonoho pila. Mai haʻalele i nā nui a mai hoʻōki i ka lawe ʻana i kāu lāʻau lapaʻau me ka ʻole o ka kamaʻilio mua ʻana me kāu kauka.

I ka wā o ka maʻi, ka hōʻeha, a i ʻole ke kaumaha nui, pono kāu kino i ka cortisol hou aku. E aʻo kāu kauka iā ʻoe pehea e hoʻonui ai i kāu mau nui lāʻau lapaʻau i kēia mau manawa. E mālama i kahi papa hana kākau e haʻi pololei iā ʻoe i ka nui o ka lāʻau lapaʻau hou aku e lawe a i ka wā hea e hoʻokaʻaʻike ai i kāu hui mālama ola.

E lawe mau i ka ʻike ola kino e wehewehe ana iā ʻoe he CAH a helu i kāu mau lāʻau lapaʻau. I kahi pilikia, hiki i kēia ʻike ke ola ola. E noʻonoʻo e komo i kahi kūpeʻe hoʻomaopopo ola a mālama paha i kahi kāleka pilikia i loko o kāu ʻeke.

E makaʻala i nā hōʻailona o kou kino a aʻo e ʻike i nā hōʻailona e hōʻike ana paha ʻoe e pono ai ka mālama lapaʻau. Hoʻokomo kēia i ka luaʻi mau, ka luhi nui, ka dizziness, a i ʻole kekahi mau hōʻailona e like me ka maʻamau ʻole no ʻoe.

Pehea ʻoe e hoʻomākaukau ai no kāu kauka appointment?

Hiki i ka hoʻomākaukau ʻana no kāu mau CAH appointments ke kōkua iā ʻoe e loaʻa ka nui loa mai kāu kipa a hōʻoia i kāu kauka i nā ʻike a pau e pono ai e hāʻawi i ka mālama maikaʻi loa. Hana ka hoʻomākaukau maikaʻi i kēia mau kipa ʻoi aku ka maikaʻi a me ka hua.

E mālama i kahi diary hōʻailona ma waena o nā appointments, e hoʻomaopopo ana i nā hōʻailona maʻamau ʻole, nā hopena lāʻau lapaʻau, a i ʻole nā manawa āu i pono ai e hoʻonui i kāu mau nui ma muli o ka maʻi a i ʻole ke kaumaha. Kūkulu kēia ʻike i kāu kauka e hoʻomaopopo i ka maikaʻi o kāu mālama i kēia manawa.

E lawe mai i kahi papa inoa piha o nā lāʻau lapaʻau āu e lawe nei, e komo pū me nā nui a me ka manawa pololei. E komo pū me nā lāʻau lapaʻau over-the-counter, nā mea hoʻohui, a i ʻole nā mea hoʻōla lāʻau, ʻoiai hiki i kēia ke launa pū me kāu mau lāʻau lapaʻau CAH.

E kākau i nā nīnau a i ʻole nā manaʻo hopohopo āu e loaʻa ai ma mua o kāu appointment. Hiki i nā kumuhana maʻamau ke komo pū me nā hoʻoponopono nui, ka mālama ʻana i nā hopena, ka hoʻolālā ʻana no ka huakaʻi a i ʻole nā hanana kūikawā, a i ʻole nā manaʻo hopohopo e pili ana i ka ulu a me ka hoʻomohala ʻana i nā keiki.

No nā keiki me ka CAH, e lawe mai i nā pakuhi ulu a me nā ʻike hana kula inā loaʻa iā ʻoe nā manaʻo hopohopo e pili ana i ka hoʻomohala ʻana. Makemake kāu kauka e nānā pono i ka ulu kino a me nā hōʻailona hoʻomohala.

He aha ka mea nui e lawe ai e pili ana i ka congenital adrenal hyperplasia?

ʻO ka mea nui loa e hoʻomaopopo ai e pili ana i ka CAH ʻo ia ʻoiai he kūlana ola lōʻihi ia, hiki ke mālama maikaʻi ʻia me ka mālama kūpono a me ka mālama lapaʻau. Hiki i ka hapa nui o nā kānaka me ka CAH ke ola i nā ola maʻamau loa ke lawe mau lākou i kā lākou mau lāʻau lapaʻau a hana pili pono me kā lākou hui mālama ola.

Hana ka ʻike mua a me ka mālama ʻana i kahi ʻokoʻa nui i nā hopena. Mahalo i nā papahana nānā pēpē hou, loaʻa ka hapa nui o nā hihia i kēia manawa ma mua o ka ulu ʻana o nā pilikia koʻikoʻi. ʻAe kēia ʻike mua i ka mālama koke a pale aku i nā pilikia koʻikoʻi e hiki ke kū mai inā hele ʻole ka CAH i ka ʻike ʻole.

ʻO ke kī i ka mālama holomua ka hoʻomaopopo ʻana i kou kūlana, ka lawe ʻana i nā lāʻau lapaʻau e like me ka kuhikuhi ʻia, a me ka ʻike ʻana i ka wā e ʻimi ai i ka mālama lapaʻau hou aku. Me kēia mau kumu ma kahi, hiki iā ʻoe ke manaʻo e ola i kahi ola olakino, piha ʻoiai loaʻa iā ʻoe ka CAH.

E hoʻomanaʻo e hoʻopilikia ka CAH i nā kānaka āpau i nā ʻano like ʻole, a pono e hoʻopilikino ʻia kāu papahana mālama i kāu mau pono kūikawā. Kūkulu ka kamaʻilio mau ʻana me kāu hui mālama ola i ka mālama ʻana i kāu mālama e hoʻomau ana i ka maikaʻi i ka wā e loli ai nā pono o kou kino i ka manawa.

Nā nīnau i nīnau pinepine ʻia e pili ana i ka congenital adrenal hyperplasia

Hiki i nā kānaka me ka CAH ke loaʻa nā keiki?

ʻAe, hiki i nā kānaka he nui me ka CAH ke loaʻa nā keiki, ʻoiai hiki ke hoʻopilikia ʻia ka hānau ʻana i kekahi mau hihia. Hiki i nā wahine me ka CAH ke loaʻa nā manawa maʻamau ʻole a pono paha i ka mālama e hoʻomaikaʻi i ka hānau ʻana. Loaʻa pinepine i nā kāne me ka CAH ka hānau maʻamau. Hiki ke kōkua ka hana pū ʻana me kahi reproductive endocrinologist inā pilikia ʻoe i ka hāpai ʻana.

Hoʻokumu anei nā lāʻau lapaʻau CAH i ka loaʻa kaupaona?

ʻIke kekahi poʻe i ka loaʻa kaupaona me ka mālama corticosteroid, akā ʻaʻole kēia he mea hiki ʻole. ʻO ke kī ka loaʻa ʻana o ka nui kūpono e pani ana i ka mea e pono ai kou kino me ka ʻole o ka nui loa. Hiki i ka hoʻoikaika kino mau, ka ʻai olakino, a me ka hana pū ʻana me kāu kauka e hoʻomaikaʻi i kāu mau nui ke kōkua i ka mālama ʻana i nā manaʻo hopohopo kaupaona.

Hiki ke hoʻōki ʻia nā lāʻau lapaʻau CAH inā hoʻomaikaʻi nā hōʻailona?

ʻAʻole, ʻaʻole pono e hoʻōki ʻia nā lāʻau lapaʻau CAH ʻoiai inā ʻoluʻolu ʻoe. Ke pani nei kēia mau lāʻau lapaʻau i nā hormones ʻaʻole hiki i kou kino ke hana iā ia iho, no laila hiki i ka hoʻōki ʻana iā lākou ke alakaʻi i nā pilikia koʻikoʻi e komo pū me ka pilikia adrenal. E kamaʻilio mau me kāu kauka ma mua o ka hana ʻana i nā loli i kāu papahana lāʻau lapaʻau.

Pehea ka hoʻopilikia ʻana o ke kaumaha i ka CAH?

Hoʻonui ka kaumaha kino a me ka noʻonoʻo i ka pono o kou kino no ka cortisol. ʻOiai ʻaʻole hiki i nā kānaka me ka CAH ke hana i ka cortisol hou aku ma ke ʻano maoli, pono paha ʻoe e hoʻonui i kāu mau nui lāʻau lapaʻau i ka manawa pōkole i nā manawa kaumaha e like me ka maʻi, ka ʻoki, a i ʻole nā hanana ola nui. E aʻo kāu kauka iā ʻoe pehea e hoʻoponopono pono ai i kāu mau nui.

ʻOi aku ka maʻamau o ka CAH i loko o kekahi mau ʻohana a i ʻole nā hui ethnic?

ʻAe, ʻoi aku ka maʻamau o ka CAH i loko o kekahi mau heluna kanaka e komo pū me nā kānaka o Ashkenazi Jewish, Hispanic, Slavic, a me Italian descent. Eia naʻe, hiki ke kū mai i loko o kekahi hui ethnic. Inā loaʻa iā ʻoe kahi moʻolelo ʻohana o ka CAH a i ʻole ʻoe i kahi hui kiʻekiʻe-pilikia, hiki i ka ʻōlelo aʻo genetic ke kōkua iā ʻoe e hoʻomaopopo i kāu mau pilikia a me nā koho.