He aha te Pheochromocytoma? Tohutohu, Take, me te Maimoatanga

He pūngāwerewere onge te pheochromocytoma e tupu ana i roto i ngā whatukuhu adrenal, ngā kōpū iti kei runga i ō whatukuhu. Ka whakaputa enei pūngāwerewere i te nui o ngā homoni e kiia nei ko ngā catecholamines, tae atu ki te adrenaline me te noradrenaline.

Whakaarohia he rite ki te pūnaha whakatūpato o tō tinana e mau ana i te tere rawa. Ahakoa ko te nuinga o ngā pheochromocytomas he pai (kāore i te mate pukupuku), ka taea e rātou te whakaputa i ngā raruraru hauora nui nā te mea ka whakakiia tō pūnaha ki ngā homoni ahotea. Ko te rongo pai, mā te whakatau tika me te maimoatanga, ka taea te whakahaere pai i tēnei āhuatanga.

He aha ngā tohu o te pheochromocytoma?

Ka puta mai ngā tohu nā te mea ka whakakiia tonu tō tinana ki ngā homoni ahotea, e hanga ana i te mea e rite ana ki te noho tonu i roto i te āhua whawhai-rerenga. Ka taea e ēnei tohu te haere mai me te haere atu kaore i te tūpono, e whakawehi pinepine ana i te whakatau.

Ko ngā tohu tino noa ka pā atu ki a koe:

• Te toto teitei e uaua ana ki te whakahaere mā te rongoā
• Ngā mamae o te upoko nui e rerekē ana i ō mamae o te upoko noa
• Te wera nui, ahakoa kāore koe e wera ana, kāore rānei e mahi
• Te ngākau tere, te kore ranei e tika
• Te manukanuka, te whakaeke ranei
• Te wiri, te wiri ranei
• Te kiri ma
• Te ngaro o te taumaha kaore i te whakamārama

Ka wheako etahi i te mea e kiia ana e ngā tākuta he "wāhanga" he "whakaeke" rānei, ka kaha ake te kino o ēnei tohu. Ka roa ēnei wāhanga mai i etahi meneti ki ngā haora maha. I waenganui i ngā wāhanga, ka rongo pea koe he noa, koia te take i uaua ai te hopu i tēnei āhuatanga.

I etahi wā onge, ka pā pea ki a koe te ruaki, te ruaki, ngā raruraru tirohanga, te mamae o te uma rānei. Ahakoa ka wehi ēnei tohu, kia mahara kei reira ngā maimoatanga whai hua ina kitea tika te āhuatanga.

He aha ngā take o te pheochromocytoma?

Kāore i te marama tonu te take tika o te pheochromocytoma, engari e mohio ana tātou ka tupu ina tīmata ngā pūtau motuhake i roto i ō whatukuhu adrenal ki te tipu kaore i te noa. Ko ēnei pūtau, e kiia nei ko ngā pūtau chromaffin, ko te tikanga kei te whakahaere i te iti o ngā homoni ahotea.

E 40% te tata o ngā pheochromocytomas e hono ana ki ngā āhuatanga ira tuku iho. Ki te whai koe i te hītori whānau o ētahi atu āhuatanga ira, ka nui ake pea tō tūponotanga. Kei roto i ēnei ngā āhuatanga penei i te multiple endocrine neoplasia (MEN) momo 2A me te 2B, te mate von Hippel-Lindau, me te neurofibromatosis momo 1.

Mō ngā take toenga, ka puta mai ngā pūngāwerewere kaore he hononga ira mārama. Kei te ako tonu ngā kairangahau i te aha e whakaoho ana i tēnei tipu pūtau kaore i te noa i roto i te hunga kaore he whakawhānautanga ira.

He mea nui kia mohio kei te kore he mea i mahia e koe, kāore rānei i mahia e koe i puta ai tēnei āhuatanga. Ka taea e ēnei pūngāwerewere te tupu i roto i te tangata, ahakoa ngā whiringa oranga, ngā tikanga hauora rānei.

Nōhea te haere ki te taakuta mō te pheochromocytoma?

Me whakapiri atu koe ki tō kaiwhakarato hauora ki te wheako koe i te huinga o ngā mamae o te upoko nui, te wera nui, me te ngākau tere, ina koa ki te puta mai ēnei tohu i roto i ngā wāhanga. Ko tēnei toru o ngā tohu, ina koa ka puta tahi anō rātou, he mea nui kia whakarongohia.

Rapua te tiaki hauora tere ki te whai koe i te toto teitei rawa (i runga ake i te 180/120) me ngā tohu penei i te mamae o te upoko nui, te mamae o te uma, te uaua ki te manawa, te rerekētanga ranei o te tirohanga. Ka taea e ēnei te tohu i te mate toto nui, e hiahia ana ki te maimoatanga tere.

Whakapa atu hoki ki tō taakuta ki te pēnei te toto i teitei rawa atu i te whakahaere mā ō rongoā noa, ki te wheako ranei koe i ngā whakaeke hou, kaore i te whakamārama, me ngā tohu tinana.

Ki te whai koe i te hītori whānau o te pheochromocytoma, ngā āhuatanga ira e pā ana rānei, he whakaaro nui kia kōrero mō ngā whiringa whakamātautau me tō kaiwhakarato hauora, ahakoa kāore koe e whai tohu.

He aha ngā take tūponotanga mō te pheochromocytoma?

Ko te mārama ki ō take tūponotanga ka taea te awhina i a koe me tō taakuta kia tupato ki ngā tohu pea o tēnei āhuatanga. Ko te take tūponotanga nui rawa ko te whai i ētahi āhuatanga ira tuku iho e rere ana i roto i ngā whānau.

Ka nui ake pea tō tūponotanga ki te whai koe i:

• Multiple endocrine neoplasia (MEN) momo 2A, 2B rānei
• Te mate von Hippel-Lindau
• Neurofibromatosis momo 1
• Hereditary paraganglioma syndrome
• Te hītori whānau o te pheochromocytoma

He mea nui hoki te tau, me te nuinga o ngā pheochromocytomas i whakatauhia i roto i te hunga i waenga i te 40 me te 60 tau te pakeke. Heoi, ka taea te puta i tetahi tau, tae atu ki ngā tamariki me ngā tāne taitamariki, ina koa ka hono atu ki ngā āhuatanga ira.

Kāore i rite ki te maha atu o ngā āhuatanga, ngā take oranga penei i te kai, te whakakori tinana, te ahotea rānei kāore e pā nui ki tō tūponotanga ki te whanake i te pheochromocytoma. Ko te tikanga kāore koe e whakahe ki a koe ano ki te whakatauhia koe ki tēnei āhuatanga.

He aha ngā raruraru pea o te pheochromocytoma?

Kaore he maimoatanga, ka taea e te pheochromocytoma te arahi ki ngā raruraru nui nā te mea ka whakaputahia e ngā homoni nui te ahotea nui ki tō pūnaha toto. Ko te raruraru tino awangawanga ko te mate toto nui, ka piki haere te toto ki teitei rawa.

Ko ngā raruraru pea:

• Ngā raruraru ngākau, tae atu ki ngā āhuatanga kore e tika, te ngākau rānei, te kore ranei o te ngākau
• Te pōkaikaha mai i te toto teitei rawa
• Te kino o te whatukuhu mai i te toto teitei roa
• Ngā raruraru kanohi, tae atu ki te ngaro o te tirohanga mai i te kino o ngā oko toto
• Te mate huka mai i ngā pānga homoni ki te huka toto
• Te wai i roto i ngā ngā paru (pulmonary edema)

I etahi wā onge, ki te kino te pūngāwerewere (mate pukupuku), ka taea te horapa ki ētahi atu wāhanga o tō tinana. Heoi, ko te nuinga o ngā pheochromocytomas he pai.

Ko te rongo whakamārama ko te maimoatanga tika, ka taea te aukati i ēnei raruraru. Ko te whakatau wawe me te whakahaere tika ka whakaiti nui i tō tūponotanga ki te wheako i ēnei hua kino.

Me pēhea te whakatau i te pheochromocytoma?

Ko te whakatau i te pheochromocytoma ka tīmata mā ngā whakamātautau toto me te mimi e ine ana i ngā taumata o ngā catecholamines me ō hua pakaru i roto i tō pūnaha. Ka tono pea tō taakuta kia kohikohi koe i te mimi i te 24 haora, kia hoatu rānei ngā tauira toto.

Ki te tohu ēnei whakamātautau i te pheochromocytoma, ka tono tō taakuta i ngā rangahau whakaahua kia kimi i te pūngāwerewere. Ka taea e ngā tirohanga CT, MRI rānei te tohu i te wahi o te pūngāwerewere kei roto i ō whatukuhu adrenal, i etahi atu wāhi rānei o tō tinana.

I etahi wā ka whakamahi ngā tākuta i te momo tirohanga motuhake e kiia nei ko te MIBG scintigraphy, e whakamahi ana i te matū pūkaha e kukume ana ki ngā pūtau pheochromocytoma. Ka taea e tēnei whakamātautau te awhina motuhake ki te kimi i ngā pūngāwerewere pea kei te huna i ngā wāhi kaore i te noa.

Ka tono pea tō taakuta i te whakamātautau ira, ina koa ki te whakatauhia koe i te tau iti, ki te whai rānei koe i te hītori whānau o ngā āhuatanga e pā ana. Ka taea te whai hua o tēnei mōhiohio mō tō mahere maimoatanga me mō ngā mema whānau pea e whai hua ana i te whakamātautau.

He aha te maimoatanga mō te pheochromocytoma?

Ko te pokanga hei tango i te pūngāwerewere ko te maimoatanga matua mō te pheochromocytoma, a he maha tonu te whakaora. Heoi, me whakarite tika tō rōpū hauora i a koe mō te pokanga, nā te mea ka taea e te tango i te pūngāwerewere te whakaputa i ngā taumata homoni ki te rereke nui.

I mua i te pokanga, ka inu pea koe i ngā rongoā e kiia nei ko ngā alpha-blockers mō ngā wiki maha. Ka awhina ēnei rongoā ki te whakahaere i tō toto me tō tere ngākau mā te aukati i ētahi o ngā pānga o ngā homoni nui. Ko ngā rongoā noa ko te phenoxybenzamine, doxazosin rānei.

Ka tono pea tō taakuta i ngā beta-blockers, engari i muri i te tīmatanga o ngā alpha-blockers. Me nui ake hoki tō kai tote me te wai i tēnei wā whakarite kia awhina i te whakawhānui i tō nui toto.

Ko te pokanga anō he maha te mahi laparoscopically (iti te whakauru) ina taea, ko te tikanga ngā tapa iti me te tere ake te ora. I etahi wā, ina koa ki ngā pūngāwerewere nui, pea ka hiahiatia te pokanga tuwhera.

Mō ngā take onge ka kino te pheochromocytoma, kua horapa, pea ka uru te maimoatanga ki te chemotherapy, te rongoā radiation, ngā rongoā whāinga rānei. Ka mahi tahi tō rōpū oncology ki a koe hei whakawhanake i te huarahi pai mō tō āhuatanga motuhake.

Me pēhea te whakahaere i ngā tohu i te kāinga i te wā o te maimoatanga?

I a koe e whakarite ana mō te maimoatanga, te ora rānei mai i te pokanga, kei reira ngā mea maha ka taea e koe te mahi i te kāinga hei awhina i te whakahaere i ō tohu me te tautoko i tō oranga whānui. Ko te matua ko te karo i ngā mea pea ka whakaoho i ngā wāhanga tohu.

Whakamātauria te karo i ngā mea whakaoho e mohiotia ana e taea te whakaiti i ō tohu:

• Ētahi kai penei i ngā mīti kōti, te tiakarete, ngā kai nui rānei i te tyramine
• Te waiū me te caffeine
• Ētahi rongoā, ina koa ngā decongestants
• Te whakapau kaha tinana, te whakarerekētanga o te tūnga rānei
• Te ahotea nui ina taea

Arotake ki ngā mahi ngawari, noa e whakatairanga ana i te whakahāwea. Ka taea e te hikoi māori, ngā mahi manawa hohonu, te whakaaroaro rānei te awhina i te whakahaere i te manukanuka me ngā taumata ahotea. Kia tino okioki koe, i te mea ka taea e te ngenge te whakaiti i ngā tohu.

Tūhonohia he pukapuka tohu hei aroturuki i te wā e puta mai ana ngā wāhanga me te aha pea i whakaoho ai. Ka taea te whai hua nui o tēnei mōhiohio mō tō rōpū hauora i te whakahaere i tō āhuatanga.

Tangohia ō rongoā i whakaritea tika i te ara i tohua, ina koa ngā rongoā toto teitei. Kaua e mutu, kaua e whakarerekē i ngā horoinga kaore i te kōrero ki tō taakuta tuatahi, i te mea ka taea e tēnei te arahi ki ngā rereketanga o te toto kino.

Me pēhea te whakarite mō tō hui taakuta?

Ko te whakarite pai mō tō hui ka awhina i te whakarite kei a tō taakuta ngā mōhiohio katoa e hiahiatia ana hei whakarato i te tiaki pai. Tīmata mā te tuhi i ō tohu katoa, tae atu ki te wā i tīmata ai rātou me te auau o te puta.

Kawe mai he rārangi katoa o ngā rongoā katoa e tangohia ana e koe, tae atu ki ngā rongoā-ā-te-kaute me ngā taapiri. Ka taea e ētahi rongoā te whakakore i ngā hua whakamātautau, te whakaiti rānei i ngā tohu, no reira e hiahia ana tō taakuta ki tēnei whakaahua katoa.

Whakaritehia ngā mōhiohio mō tō hītori hauora whānau, ina koa ngā whānau tata kua whai pheochromocytoma, ngā pūngāwerewere kaore i te noa, ngā āhuatanga ira e pā ana rānei. Ka taea te tino nui o tēnei mōhiohio mō tō whakatau me te mahere maimoatanga.

Tuhia ngā pātai e hiahia ana koe ki te ui ki tō taakuta. Kaua e manukanuka ki te maha rawa o ngā pātai. Ko tō hauora tēnei, a he mea nui te mārama ki tō āhuatanga mō tō rangimarie hinengaro me te angitu o te maimoatanga.

Whakaarohia te kawe mai i tētahi hoa whakawhirinaki, mema whānau rānei ki tō hui. Ka taea e rātou te awhina i a koe ki te mahara ki ngā mōhiohio nui me te whakarato i te tautoko ngākau i te wā pea e rongohia ana he wā nui.

He aha te tango matua mō te pheochromocytoma?

He āhuatanga onge engari ka taea te whakaora te pheochromocytoma e pā ana ki ngā whatukuhu adrenal e whakaputa homoni ana o tō tinana. Ahakoa ka wehi, ka whakararuraru ngā tohu, ko te nuinga o ēnei pūngāwerewere he pai, ka taea te whakaora pai mā te pokanga.

Ko te mea nui rawa kia mahara ko te whakatau wawe me te maimoatanga tika ka arahi ki ngā hua pai mō te nuinga o te iwi. Mā te tiaki hauora tika, ka tumanako koe ki te hoki ki te oranga noa i muri i te maimoatanga.

Ki te wheako koe i te huinga tino nui o ngā mamae o te upoko nui, te wera nui, me te ngākau tere, ina koa i roto i ngā wāhanga, kaua e whakaroa ki te rapu whakamātautau hauora. Ahakoa he onge te pheochromocytoma, ko te hopu wawe ka ngāwari ake te maimoatanga.

Noho hono atu ki tō rōpū hauora i te wā o tō haerenga maimoatanga. Ko rātou tō puna pai mō te whakahaere i tēnei āhuatanga me te whakarite i te hua pai rawa mō tō hauora me tō kounga o te ora.

Ngā pātai uiui noa mō te pheochromocytoma

Ka taea te aukati i te pheochromocytoma?

Ko te nuinga o ngā pheochromocytomas kaore e taea te aukati nā te mea ka tupu pinepine mai i ngā take ira, ngā take kaore i te mohiotia rānei. Heoi, ki te whai koe i te āhuatanga ira e mohiotia ana e whakanui ana i tō tūponotanga, ka taea e te whakamātautau noa te awhina i te kite i ngā pūngāwerewere wawe ina tino taea te whakaora. Ko te pupuri i te hauora whānui pai me te karo i ngā mea whakaoho tohu e mohiotia ana ka taea te awhina i te whakahaere i te āhuatanga ina whakatauhia.

Me whai maimoatanga ora tonu ahau i muri i te pokanga?

Ko te nuinga o te iwi kāore e hiahia ki te maimoatanga haere tonu i muri i te tango pokanga angitu o te pheochromocytoma pai. Ka aroturuki tō taakuta i a koe mā ngā whakamātautau toto waatea me ngā tirotiro kia whakarite kia kaua e hoki mai te pūngāwerewere. Pea ka hiahia etahi ki te rongoā toto teitei tonu, engari he mea waatea tēnei i te nuinga o te wā i te whakatika o tō tinana i muri i te pokanga.

Ka hoki mai te pheochromocytoma i muri i te maimoatanga?

He mea onge te hokinga mai i muri i te tango pokanga katoa, e puta ana i raro i te 10% o ngā take. He iti te nui o te tūponotanga ki te whai koe i te āhuatanga ira, ki te kino rānei te pūngāwerewere taketake. Koia te take ka tūtohutia e tō taakuta ngā hui whakarite noa me ngā whakamātautau waatea hei aroturuki i ngā tohu o te hokinga mai.

He mate pukupuku tonu te pheochromocytoma?

Kāo, e 90% te tata o ngā pheochromocytomas he pai, ko te tikanga kāore e horapa ki ētahi atu wāhanga o te tinana. Ahakoa ngā pūngāwerewere pai e hiahia ana ki te maimoatanga nā te mea ka whakaputahia e rātou ngā homoni nui e taea te whakaputa i ngā raruraru hauora nui. E 10% anake te kino (mate pukupuku), ā, ahakoa ēnei ka taea te whakahaere pai mā te maimoatanga tika.

Ka taea e te ahotea te whakaoho i ngā wāhanga pheochromocytoma?

Ahakoa kāore te ahotea e whakaoho i te pheochromocytoma anō, ka taea e ia te whakaoho i ngā wāhanga tohu i roto i te hunga kua whai i te āhuatanga. Ka whakaputa tonu te pūngāwerewere i ngā homoni ahotea, ā, ka taea e te ahotea atu te pēhi i ēnei taumata ki teitei ake, ka arahi ki ngā tohu nui ake. Ko te whakahaere i te ahotea mā ngā tikanga whakahāwea ka taea te awhina i te whakaiti i te auau me te kaha o ngā wāhanga.