He aha ka Pheochromocytoma? Nā Hōʻailona, Nā Kumu, a me ka Lapaʻau

ʻO ka pheochromocytoma he ʻano maʻi ʻaʻai liʻiliʻi e ulu ana i loko o nā kīʻaha adrenal, nā ʻāpana liʻiliʻi e noho ana ma luna o kou mau puʻupaʻa. Hoʻopuka kēia mau ʻaʻai i ka nui o nā hormones i kapa ʻia ʻo catecholamines, e komo pū ana me ka adrenaline a me ka noradrenaline.

E noʻonoʻo iā ia e like me kāu ʻōnaehana hoʻomaopopo o ke kino e paʻa ana i ka overdrive. ʻOiai ʻo ka hapa nui o nā pheochromocytomas he benign (ʻaʻole maʻi ʻaʻai), hiki iā lākou ke hoʻopuka i nā pilikia olakino koʻikoʻi no ka mea e hoʻopiha ana i kāu ʻōnaehana me nā hormones pilikia. ʻO ka mea maikaʻi, me ka hōʻoia pololei a me ka lapaʻau, hiki ke hoʻokele pono ʻia kēia maʻi.

He aha nā hōʻailona o ka pheochromocytoma?

Hiki mai nā hōʻailona no ka mea e hoʻopiha mau ʻia ana kou kino me nā hormones pilikia, e hana ana i ka mea e like me ka noho mau ʻana i kahi kūlana hakakā-a-holo. Hiki i kēia mau hōʻailona ke hele mai a hele aku me ka manaʻo ʻole, kahi e paʻakikī ai ka hōʻoia pinepine.

ʻO nā hōʻailona maʻamau āu e ʻike ai, ʻo ia:

• Ke koko kiʻekiʻe e paʻakikī ke kaohi me ka lāʻau lapaʻau
• Nā poʻo ʻeha nui e ʻokoʻa mai kāu mau poʻo ʻeha maʻamau
• Ka ʻōhule nui, ʻoiai ʻaʻole ʻoe wela a hana paha
• Ka puʻuwai wikiwiki a i ʻole kūpono ʻole
• Ka hopohopo a i ʻole nā ​​​​hopena panic
• Ke haʻalulu a i ʻole ke kūlou
• ʻIli palupalu
• Ka nalowale kaumaha wehe ʻole

ʻIke kekahi poʻe i ka mea i kapa ʻia e nā kauka he "mau hanana" a i ʻole "mau hoouka kaua" kahi e lilo koke ai kēia mau hōʻailona i ʻoi aku ka ʻino. Hiki i kēia mau hanana ke lōʻihi mai kekahi mau minuke a i kekahi mau hola. Ma waena o nā hanana, hiki iā ʻoe ke manaʻo maʻamau, ʻo ia ke kumu e paʻakikī ai ke hopu ʻia kēia maʻi.

I nā hihia liʻiliʻi, hiki iā ʻoe ke ʻike pū i ka nausea, ka luaʻi, nā pilikia ʻike, a i ʻole ka ʻeha umauma. ʻOiai hiki i kēia mau hōʻailona ke hopohopo, e hoʻomanaʻo he mau lapaʻau maikaʻi loa e loaʻa ana ke ʻike pono ʻia ka maʻi.

He aha ka mea e hoʻokumu ai i ka pheochromocytoma?

ʻAʻole maopopo mau ke kumu pololei o ka pheochromocytoma, akā ʻike mākou e ulu ana ia ke hoʻomaka nā sela i loko o kou mau kīʻaha adrenal e ulu kūpono ʻole. ʻO kēia mau sela, i kapa ʻia ʻo nā sela chromaffin, ʻo ia ka mea kuleana maʻamau no ka hoʻopuka ʻana i kahi liʻiliʻi o nā hormones pilikia.

Ma kahi o 40% o nā pheochromocytomas e pili ana i nā kūlana genetic hoʻoilina. Inā loaʻa iā ʻoe kahi mōʻaukala ʻohana o kekahi mau syndromes genetic, hiki ke kiʻekiʻe kou pilikia. ʻO kēia mau mea e komo pū ana i nā kūlana e like me ka multiple endocrine neoplasia (MEN) ʻano 2A a me 2B, ka maʻi von Hippel-Lindau, a me ka neurofibromatosis ʻano 1.

No nā hihia i koe, me he mea lā e ulu kūʻokoʻa nā ʻaʻai me ka pilina genetic maopopo ʻole. Ke noiʻi nei nā mea noiʻi i ka mea e hoʻoulu ai i kēia ulu ʻana o nā sela kūpono ʻole i nā poʻe me ka ʻole o nā predispositions genetic.

He mea nui e ʻike ʻaʻole ʻoe i hana a i ʻole ʻaʻole i hana i kēia maʻi. Hiki i kēia mau ʻaʻai ke ulu i kekahi, me ka nānā ʻole i nā koho ola a i ʻole nā ​​​​ʻano olakino.

I ka wā e ʻike ai i ke kauka no ka pheochromocytoma?

Pono ʻoe e hoʻokaʻaʻike i kāu mea mālama ola inā ʻike ʻoe i ka hui ʻana o nā poʻo ʻeha nui, ka ʻōhule nui, a me ka puʻuwai wikiwiki, ʻoi aku inā hele mai kēia mau hōʻailona i nā hanana. ʻO kēia hui o nā hōʻailona, ʻoi aku ka nui ke hele pū lākou i nā manawa hou, pono e nānā ʻia e ke kauka.

E ʻimi i ka mālama ola kino koke inā loaʻa iā ʻoe ke koko kiʻekiʻe loa (ma luna o 180/120) me nā hōʻailona e like me ka poʻo ʻeha nui, ka ʻeha umauma, ka pilikia hanu, a i ʻole nā ​​​​hoʻololi ʻike. Hiki i kēia ke hōʻike i kahi pilikia hypertensive, kahi e pono ai ka mālama pilikia.

E hoʻokaʻaʻike pū i kāu kauka inā loaʻa iā ʻoe ke koko kiʻekiʻe i lilo koke i mea paʻakikī ke kaohi me kāu mau lāʻau maʻamau, a i ʻole inā ʻoe e ʻike ana i nā hopohopo hou a i ʻole nā ​​​​hopena panic me nā hōʻailona kino.

Inā loaʻa iā ʻoe kahi mōʻaukala ʻohana o ka pheochromocytoma a i ʻole nā ​​​​kūlana genetic pili, he mea akamai ke kūkākūkā i nā koho hōʻoia me kāu mea mālama ola, ʻoiai inā ʻaʻole ʻoe i loaʻa nā hōʻailona.

He aha nā mea pilikia no ka pheochromocytoma?

ʻO ka hoʻomaopopo ʻana i kāu mau mea pilikia hiki ke kōkua iā ʻoe a me kāu kauka e makaʻala no nā hōʻailona hiki o kēia maʻi. ʻO ka mea pilikia nui loa ka loaʻa ʻana o kekahi mau kūlana genetic hoʻoilina e holo ana i nā ʻohana.

Hiki ke kiʻekiʻe kou pilikia inā loaʻa iā ʻoe:

• Multiple endocrine neoplasia (MEN) ʻano 2A a i ʻole 2B
• Ka maʻi Von Hippel-Lindau
• Neurofibromatosis ʻano 1
• Hereditary paraganglioma syndrome
• Kahi mōʻaukala ʻohana o ka pheochromocytoma

He kuleana pū ke ʻano, me ka hapa nui o nā pheochromocytomas i hōʻoia ʻia i nā poʻe ma waena o 40 a me 60 mau makahiki. Eia naʻe, hiki iā lākou ke loaʻa i kēlā me kēia makahiki, e komo pū ana i nā keiki a me nā ʻōpio, ʻoi aku ka nui ke pili i nā kūlana genetic.

ʻAʻole like me nā maʻi ʻē aʻe, ʻaʻole nā ​​​​mea pili ola e like me ka ʻai, ka hoʻoikaika kino, a i ʻole nā ​​​​pae koʻikoʻi e hoʻopilikia nui i kou pilikia o ka hoʻomohala ʻana i ka pheochromocytoma. ʻO ia hoʻi, ʻaʻole pono ʻoe e hewa iā ʻoe iho inā hōʻoia ʻia ʻoe me kēia maʻi.

He aha nā pilikia hiki o ka pheochromocytoma?

Me ka ʻole o ka lapaʻau, hiki i ka pheochromocytoma ke alakaʻi i nā pilikia koʻikoʻi no ka mea e kau ana nā hormones nui i ka ukana nui ma kāu ʻōnaehana cardiovascular. ʻO ka pilikia koʻikoʻi loa kahi pilikia hypertensive, kahi e piʻi koke ai ke koko kiʻekiʻe loa.

ʻO nā pilikia hiki ke komo pū:

• Nā pilikia puʻuwai, e komo pū ana i nā rhythms kūpono ʻole, ka puʻuwai puʻuwai, a i ʻole ka puʻuwai puʻuwai
• Ka hahau mai ke koko kiʻekiʻe loa
• Ka hōʻino ʻana i nā puʻupaʻa mai ke koko kiʻekiʻe lōʻihi
• Nā pilikia maka, e komo pū ana i ka nalowale ʻike mai ka hōʻino ʻana i nā kīʻaha koko
• Ka maʻi diabetes mai nā hopena hormonal ma ke kō koko
• Ka wai i loko o nā māmā (pulmonary edema)

I nā hihia liʻiliʻi, inā he malignant (maʻi ʻaʻai) ka ʻaʻai, hiki iā ia ke pālahalaha i nā ʻāpana ʻē aʻe o kou kino. Eia naʻe, ʻo ka hapa nui o nā pheochromocytomas he benign.

ʻO ka lono hoʻoikaika, ʻo ia me ka lapaʻau kūpono, hiki ke pale ʻia kēia mau pilikia. Hoʻemi nui ka hōʻoia mua a me ka hoʻokele kūpono i kou pilikia o ka ʻike ʻana i kēia mau hopena koʻikoʻi.

Pehea ka hōʻoia ʻana o ka pheochromocytoma?

Hoʻomaka ka hōʻoia ʻana o ka pheochromocytoma me nā ho'āʻo koko a me ka mimi e ana i nā pae o nā catecholamines a me kā lākou mau huahana hoʻokaʻawale i loko o kāu ʻōnaehana. E noi paha kāu kauka iā ʻoe e hōʻiliʻili i ka mimi ma kahi o 24 hola a i ʻole e hāʻawi i nā hāpana koko.

Inā hōʻike kēia mau ho'āʻo i ka pheochromocytoma, e kauoha kāu kauka i nā haʻawina kiʻi e ʻimi i ka ʻaʻai. Hiki i nā scans CT a i ʻole MRI ke kuhikuhi i kahi o ka ʻaʻai i loko o kou mau kīʻaha adrenal a i ʻole, i nā hihia liʻiliʻi, ma nā wahi ʻē aʻe o kou kino.

I kekahi manawa, hoʻohana nā kauka i kahi ʻano scan kūikawā i kapa ʻia ʻo MIBG scintigraphy, kahi e hoʻohana ai i kahi mea radioactive e huki ʻia i nā sela pheochromocytoma. Hiki i kēia ho'āʻo ke kōkua nui i ka ʻimi ʻana i nā ʻaʻai e hūnā ana ma nā wahi maʻamau ʻole.

Hiki i kāu kauka ke kuhikuhi i ka ho'āʻo genetic, ʻoi aku inā hōʻoia ʻia ʻoe i kahi ʻōpio a i ʻole loaʻa iā ʻoe kahi mōʻaukala ʻohana o nā kūlana pili. Hiki i kēia ʻike ke waiwai nui no kāu hoʻolālā lapaʻau a no nā lālā ʻohana e pōmaikaʻi paha mai ka hōʻoia.

He aha ka lapaʻau no ka pheochromocytoma?

ʻO ka ʻoki ʻana e wehe i ka ʻaʻai ka lapaʻau nui no ka pheochromocytoma, a he mea ho'ōla pinepine ia. Eia naʻe, pono e hoʻomākaukau pono kāu hui lapaʻau iā ʻoe no ka ʻoki ʻana no ka mea hiki i ka wehe ʻana i ka ʻaʻai ke hoʻoulu koke i nā pae hormone.

Ma mua o ka ʻoki ʻana, e lawe maʻamau ʻoe i nā lāʻau lapaʻau i kapa ʻia ʻo nā alpha-blockers no kekahi mau pule. Kūkulu kēia mau lāʻau lapaʻau i kāu koko kiʻekiʻe a me ka puʻuwai puʻuwai ma ka pale ʻana i kekahi o nā hopena o nā hormones nui. ʻO nā lāʻau lapaʻau maʻamau e komo pū ana me ka phenoxybenzamine a i ʻole doxazosin.

Hiki i kāu kauka ke kuhikuhi i nā beta-blockers, akā ma hope wale nō o ka hoʻomaka ʻana i nā alpha-blockers mua. Pono ʻoe e hoʻonui i kāu paʻakai a me ka wai i loko o kēia manawa hoʻomākaukau e kōkua i ka hoʻonui ʻana i kāu nui koko.

Hoʻokō pinepine ʻia ka ʻoki ʻana iho ma ke ʻano laparoscopically (liʻiliʻi invasive) i ka hiki, ʻo ia hoʻi nā ʻoki liʻiliʻi a me ka hoʻōla wikiwiki. I kekahi mau hihia, ʻoi aku ka nui o nā ʻaʻai nui, pono paha ka ʻoki ʻana ākea.

No nā hihia liʻiliʻi kahi i malignant a ua pālahalaha ai ka pheochromocytoma, hiki i ka lapaʻau ke komo pū me ka chemotherapy, ka radiation therapy, a i ʻole nā ​​​​lāʻau lapaʻau i kuhikuhi ʻia. E hana pū kāu hui oncology me ʻoe e hoʻomohala i ke ala maikaʻi loa no kāu kūlana kūikawā.

Pehea e hoʻokele ai i nā hōʻailona ma ka home i ka wā lapaʻau?

ʻOiai ʻoe e hoʻomākaukau ana no ka lapaʻau a i ʻole e ho'ōla mai ka ʻoki ʻana, aia kekahi mau mea hiki iā ʻoe ke hana ma ka home e kōkua i ka hoʻokele ʻana i kāu mau hōʻailona a kākoʻo i kou olakino holoʻokoʻa. ʻO ke kī ka pale ʻana i nā mea e hoʻoulu ai i nā hanana hōʻailona.

E ho'āʻo e pale i nā mea hoʻoulu i ʻike ʻia e hiki ke hoʻopilikia i kāu mau hōʻailona:

• Nā meaʻai kekahi e like me nā cheese kahiko, ke kokoleka, a i ʻole nā ​​​​meaʻai kiʻekiʻe i ka tyramine
• Ka waiʻona a me ka caffeine
• Nā lāʻau lapaʻau kekahi, ʻoi aku nā decongestants
• Ka hoʻoikaika kino a i ʻole nā ​​​​hoʻololi kūlana koke
• Ke kaumaha nui i ka hiki

E nānā i nā hana māmā, mau e hoʻoikaika i ka hoʻomaha. Hiki i ka hele wāwae māmā, nā hana hanu hohonu, a i ʻole ka noʻonoʻo ke kōkua i ka hoʻokele ʻana i ka hopohopo a me nā pae koʻikoʻi. E hōʻoia e loaʻa iā ʻoe ka hoʻomaha kūpono, ʻoiai hiki i ka luhi ke hoʻopilikia i nā hōʻailona.

E mālama i kahi puke hōʻailona e hahai i ka wā e hele mai ai nā hanana a me ka mea i hoʻoulu ai iā lākou. Hiki i kēia ʻike ke kōkua nui i kāu hui mālama ola i ka hoʻokele ʻana i kāu maʻi.

E lawe i kāu mau lāʻau lapaʻau i kuhikuhi ʻia e like me ke kuhikuhi ʻia, ʻoi aku nā lāʻau lapaʻau koko kiʻekiʻe. Mai hoʻōki a hoʻololi i nā doses me ka ʻole o ke kamaʻilio ʻana me kāu kauka mua, ʻoiai hiki i kēia ke alakaʻi i nā hoʻololi koko kiʻekiʻe weliweli.

Pehea ʻoe e hoʻomākaukau ai no kāu hālāwai kauka?

ʻO ka hoʻomākaukau maikaʻi no kāu hālāwai e kōkua i ka hōʻoia ʻana i loaʻa i kāu kauka nā ʻike āpau e pono ai e hāʻawi i ka mālama maikaʻi loa. E hoʻomaka ma ka kākau ʻana i kāu mau hōʻailona āpau, e komo pū ana i ka wā i hoʻomaka ai lākou a me ka pinepine o ka hele ʻana.

E lawe mai i kahi papa inoa piha o nā lāʻau lapaʻau āpau āu e lawe nei, e komo pū ana i nā lāʻau lapaʻau ma luna o ka counter a me nā mea hoʻohui. Hiki i kekahi mau lāʻau lapaʻau ke hoʻopilikia i nā hopena ho'āʻo a i ʻole hoʻopilikia i nā hōʻailona, ​​no laila pono i kāu kauka kēia kiʻi piha.

E hoʻomākaukau i ka ʻike e pili ana i ka mōʻaukala olakino ʻohana, ʻoi aku ka nui o nā hoahānau i loaʻa i ka pheochromocytoma, nā ʻaʻai maʻamau ʻole, a i ʻole nā ​​​​kūlana genetic pili. Hiki i kēia ʻike ke koʻikoʻi no kāu hōʻoia a me ka hoʻolālā lapaʻau.

E kākau i nā nīnau āu e makemake ai e nīnau i kāu kauka. Mai hopohopo e loaʻa nā nīnau he nui. ʻO kēia kāu olakino, a ʻo ka hoʻomaopopo ʻana i kāu maʻi he mea nui ia no kou maluhia a me ka holomua o ka lapaʻau.

E noʻonoʻo e lawe mai i kahi hoaaloha a i ʻole lālā ʻohana hilinaʻi i kāu hālāwai. Hiki iā lākou ke kōkua iā ʻoe e hoʻomanaʻo i nā ʻike nui a hāʻawi i ke kākoʻo manaʻo i ka wā e manaʻo paha he manawa nui.

He aha ka mea nui e pili ana i ka pheochromocytoma?

ʻO ka pheochromocytoma he maʻi liʻiliʻi akā hiki ke mālama ʻia e hoʻopilikia ana i nā kīʻaha adrenal hormone-producing o kou kino. ʻOiai hiki i nā hōʻailona ke hopohopo a hoʻopilikia, ʻo ka hapa nui o kēia mau ʻaʻai he benign a hiki ke mālama ʻia me ka ʻoki ʻana.

ʻO ka mea nui loa e hoʻomanaʻo ai, ʻo ia ka hōʻoia mua a me ka lapaʻau kūpono e alakaʻi i nā hopena maikaʻi loa no ka hapa nui o nā poʻe. Me ka mālama ola kūpono, hiki iā ʻoe ke manaʻo e hoʻi i ke ola maʻamau ma hope o ka lapaʻau.

Inā ʻoe e ʻike ana i ka hui maʻamau o nā poʻo ʻeha nui, ka ʻōhule nui, a me ka puʻuwai wikiwiki, ʻoi aku i nā hanana, mai kānalua e ʻimi i ka loiloi lapaʻau. ʻOiai he liʻiliʻi ka pheochromocytoma, ʻo ka hopu ʻana iā ia i ka wā mua e maʻalahi loa ai ka lapaʻau.

E noho pili me kāu hui mālama ola i kou huakaʻi lapaʻau. ʻO lākou kāu kumuwaiwai maikaʻi loa no ka hoʻokele ʻana i kēia maʻi a me ka hōʻoia ʻana i ka hopena maikaʻi loa no kou olakino a me kou maikaʻi o ke ola.

Nā nīnau i nīnau pinepine ʻia e pili ana i ka pheochromocytoma

Hiki ke pale ʻia ka pheochromocytoma?

ʻAʻole hiki ke pale ʻia ka hapa nui o nā pheochromocytomas no ka mea e ulu pinepine ana lākou ma muli o nā kumu genetic a i ʻole nā ​​​​kumu ʻike ʻole. Eia naʻe, inā loaʻa iā ʻoe kahi kūlana genetic i ʻike ʻia e hoʻonui i kou pilikia, hiki i ka hōʻoia mau ke kōkua i ka ʻike ʻana i nā ʻaʻai i ka wā mua ke mālama ʻia loa lākou. Hiki i ka mālama ʻana i ka olakino maikaʻi holoʻokoʻa a me ka pale ʻana i nā mea hoʻoulu hōʻailona i ʻike ʻia ke kōkua i ka hoʻokele ʻana i ka maʻi ke hōʻoia ʻia.

Pono anei iaʻu ka lapaʻau ola lōʻihi ma hope o ka ʻoki ʻana?

ʻAʻole pono ka hapa nui o nā poʻe i ka lapaʻau mau ma hope o ka wehe ʻana i ka pheochromocytoma benign. E nānā kāu kauka iā ʻoe me nā ho'āʻo koko manawa a me nā nānā e hōʻoia ʻaʻole e hoʻi hou mai ka ʻaʻai. Hiki i kekahi poʻe ke pono i ka lāʻau koko kiʻekiʻe mau, akā he mea manawa pōkole kēia i ka hoʻoponopono ʻana o kou kino ma hope o ka ʻoki ʻana.

Hiki i ka pheochromocytoma ke hoʻi hou ma hope o ka lapaʻau?

ʻAʻole maʻamau ka hoʻi hou ʻana ma hope o ka wehe ʻana i ka ʻoki ʻana, e loaʻa ana ma lalo o 10% o nā hihia. ʻOi aku ka nui o ka pilikia inā loaʻa iā ʻoe kahi kūlana genetic a i ʻole inā he malignant ka ʻaʻai mua. ʻO ia ke kumu e kuhikuhi ai kāu kauka i nā hālāwai hahai mau a me nā ho'āʻo manawa e nānā no nā hōʻailona o ka hoʻi hou ʻana.

He maʻi ʻaʻai mau anei ka pheochromocytoma?

ʻAʻole, ma kahi o 90% o nā pheochromocytomas he benign, ʻo ia hoʻi ʻaʻole lākou e pālahalaha i nā ʻāpana ʻē aʻe o ke kino. Pono nō hoʻi ka lapaʻau ʻana i nā ʻaʻai benign no ka mea e hoʻopuka ana lākou i nā hormones nui e hiki ke hoʻopuka i nā pilikia olakino koʻikoʻi. Ma kahi o 10% wale nō ka malignant (maʻi ʻaʻai), a hiki ke mālama ʻia kēia mau mea me ka lapaʻau kūpono.

Hiki i ke kaumaha ke hoʻoulu i nā hanana pheochromocytoma?

ʻOiai ʻaʻole hoʻokumu ke kaumaha i ka pheochromocytoma iho, hiki iā ia ke hoʻoulu i nā hanana hōʻailona i nā poʻe i loaʻa mua ka maʻi. Hoʻopuka mau ka ʻaʻai i nā hormones pilikia, a hiki i ke kaumaha hou ke hoʻokuʻi i kēia mau pae i ʻoi aku ka kiʻekiʻe, e alakaʻi ana i nā hōʻailona ʻoi aku ka ʻino. Hiki i ka hoʻokele ʻana i ke kaumaha ma o nā ʻano hoʻomaha ke kōkua i ka hoʻemi ʻana i ka pinepine a me ka ʻino o nā hanana.