Pheochromocytoma

Umuhumekero wa pheochromocytoma (fee-o-kroe-moe-sy-TOE-muh) ni igisebe gito kigororoka mu mpyiko. Akenshi, igisebe ntabwo ari kanseri. Iyo igisebe atari kanseri, bitwa ko ari nta ngaruka. Ufite imikaya ibiri y'impyiko - imwe hejuru y'impyiko buri imwe. Imikaya y'impyiko ikora imisemburo ifasha mu kugenzura ibikorwa by'ingenzi mu mubiri, nko kugenzura umuvuduko w'amaraso. Ubusanzwe, pheochromocytoma iba mu mpyiko imwe gusa. Ariko ibyo bishusho bishobora gukura mu mikaya yombi y'impyiko. Hamwe na pheochromocytoma, igisebe gisohora imisemburo ishobora gutera ibimenyetso bitandukanye. Muri byo harimo umuvuduko ukabije w'amaraso, kubabara umutwe, gucana ibyuya n'ibimenyetso byo kugira ubwoba. Niba pheochromocytoma idakurikiranwe, ibihombo bikomeye cyangwa bishobora guhitana ubuzima ku zindi nzego z'umubiri bishobora kubaho. Kugira icyemezo cyo gukuraho pheochromocytoma kenshi bituma umuvuduko w'amaraso usubira mu rugero rwiza.

Pheochromocytoma ikunda gutera ibimenyetso bikurikira: Umuvuduko w'amaraso uri hejuru. Umutwe. Kunyara cyane. Gukubita k'umutima kwihuta. Bamwe mu bantu bafite pheochromocytoma bagira kandi ibimenyetso nka: Kuhagarara k'umubiri kubera ubwoba. Uruhu ruhinduka ibara ryiza, bizwi kandi nka pallor. Guhumeka nabi. Ibimenyetso nk'iby'igitero cy'ubwoba, bishobora kuba harimo ubwoba bukomeye butunguranye. Ubwoba cyangwa kumva ko hari ikintu kibi kigiye kuba. Ibibazo by'ubuhumekero. Kubabara mu nda. Gutakaza ibiro. Bamwe mu bantu bafite pheochromocytoma nta bimenyetso bagira. Ntibabimenya ko bafite uwo muntu kugeza igihe ikizamini cyo kubona amafoto cyabibonetse. Akenshi, ibimenyetso bya pheochromocytoma biraza kandi bigenda. Iyo bitangira gitunguranye kandi bikomeza kugaruka, bizwi nka spells cyangwa ibitero. Ibi bitero bishobora cyangwa bitashobora kugira ikintu kibitera gishobora kuboneka. Ibikorwa bimwe na bimwe cyangwa imimerere ishobora gutera spell, nka: Akazi gakomeye k'umubiri. Ubwoba cyangwa umunaniro. Guhindura umwanya w'umubiri, nko kwigunga, cyangwa kuva mu kwicara cyangwa kuryama ukajya guhagarara. Kubyara. Ubuvuzi n'umuti ugutera kuba mu mimerere yo gusinzira mu gihe cy'ubuvuzi, bizwi nka anesthésique. Ibiribwa birimo tyramine nyinshi, ikintu gifata umuvuduko w'amaraso, bishobora kandi gutera spells. Tyramine iboneka cyane mu biribwa byavuye, byakuze, byashyizwe muri pick, byavuwe, byakuze cyane cyangwa byononekaye. Ibi biribwa birimo: Foromaje zimwe. Umuceri n'inyama zimwe. Soybeans cyangwa ibintu byakozwe na soya. Chocolat. Inyama zumye cyangwa zometse. Imiti imwe n'ibiyobyabwenge bishobora gutera spells birimo: Imiti yo kuvura ihungabana yitwa imiti yo kuvura ihungabana ya tricyclic. Urugero rumwe rw'imiti yo kuvura ihungabana ya tricyclic ni amitriptyline na desipramine (Norpramin). Imiti yo kuvura ihungabana yitwa monoamine oxidase inhibitors (MAOIs), nka phenelzine (Nardil), tranylcypromine (Parnate) na isocarboxazid (Marplan). Icyago cy'ibitero kirakomeye cyane iyo iyi miti ifatwa hamwe n'ibiribwa cyangwa ibinyobwa birimo tyramine nyinshi. Ibinyabutabire nka kafeyin, amphetamines cyangwa cocaïne. Umuvuduko w'amaraso uri hejuru ni kimwe mu bimenyetso by'ingenzi bya pheochromocytoma. Ariko abantu benshi bafite umuvuduko w'amaraso uri hejuru ntabwo bafite uwo muntu mu mpyiko. Muganiro n'umuganga wawe niba hari imwe muri iyi mpamvu ikukurikira: Ibimenyetso by'ibimenyetso bifitanye isano na pheochromocytoma, nka umutwe, kunyara no gukubita k'umutima kwihuta, gukomeye. Kugira ikibazo cyo kugenzura umuvuduko w'amaraso uri hejuru ukoresheje ubuvuzi ubu ufite. Umuvuduko w'amaraso uri hejuru utangira mbere y'imyaka 20. Kwiyongera kenshi kw'umuvuduko w'amaraso. Amateka y'umuryango wa pheochromocytoma. Amateka y'umuryango wa genetique ifitanye isano. Ibi birimo multiple endocrine neoplasia, ubwoko bwa 2 (MEN 2), indwara ya von Hippel-Lindau, ibyago bya paraganglioma byarazwe n'indwara ya neurofibromatosis 1.

Umuvuduko ukabije w'amaraso ni kimwe mu bimenyetso by'ingenzi bya pheochromocytoma. Ariko abantu benshi bafite umuvuduko ukabije w'amaraso ntabwo bagira ibibyimba bya adrenal. Muganiro n'umuganga wawe niba hari kimwe muri ibi bikurikira bikugwiriye: Ibihe by'ibimenyetso bifitanye isano na pheochromocytoma, nka: kubabara umutwe, gucana ibyuya no gutera umutima wihuta cyane. Kugira ikibazo cyo kugenzura umuvuduko ukabije w'amaraso ukoresheje ubuvuzi ubukoresha. Umuvuduko ukabije w'amaraso utangira mbere y'imyaka 20. Izamuka rikomeye ry'umuvuduko w'amaraso risubira kugaruka. Amateka y'umuryango wa pheochromocytoma. Amateka y'umuryango wa indwara ifitanye isano na gene. Ibi birimo multiple endocrine neoplasia, ubwoko bwa 2 (MEN 2), indwara ya von Hippel-Lindau, indwara zikomoka ku muryango wa paraganglioma na neurofibromatosis 1.

Abashakashatsi ntibabizi neza icyateza pheochromocytoma. Ubu bwoko bw'ibibyimba bukaba mu mitsi yitwa chromaffin cells. Izi mitsi ziba hagati mu mpyiko. Zikaba zisohora imisemburo imwe n'imwe, cyane cyane adrenaline na noradrenaline. Iyi misemburo ifasha mu kugenzura imikorere myinshi y'umubiri, nko gutera umutima, umuvuduko w'amaraso n'isukari mu maraso. Adrenaline na noradrenaline bitera umubiri kwihangana cyangwa guhunga. Ibyo bibaho iyo umubiri utekereza ko hari ikibazo. Iyi misemburo ituma umuvuduko w'amaraso uzamuka kandi umutima ukubita cyane. Nanone itegura indi migendekere y'umubiri kugira ngo ubashe guhita ugaruka. Pheochromocytoma ituma iyi misemburo isohorwa cyane. Kandi ituma isohorwa mu gihe utari mu kaga. Icyinshi cy'imitsi ya chromaffin iba mu mpyiko. Ariko amatsinda mato y'izi mitsi aba nanone mu mutima, mu mutwe, mu ijosi, mu kibuno, mu gice cy'igifu no ku mugongo. Ibibyimba by'imitsi ya chromaffin biba hanze y'impyiko byitwa paragangliomas. Bishobora kugira ingaruka nk'izo pheochromocytoma igira ku mubiri.

Abantu bafite MEN 2B bagira uburibwe bw'imitsi mu minwa, mu kanwa, mu maso no mu buryo bw'igogorwa. Bashobora kandi kugira uburibwe kuri gland adrenal, bita pheochromocytoma, na kanseri ya thyroid medullary.

Imyaka y'umuntu n'ibibazo bimwe by'ubuzima bishobora kongera ibyago bya pheochromocytoma.

Ibyinshi muri pheochromocytomas biboneka mu bantu bari hagati y'imyaka 20 na 50. Ariko uburibwe bushobora kuvuka mu myaka yose.

Abantu bafite ibibazo bimwe by'indwara z'umurage bafite ibyago byinshi bya pheochromocytomas. Uburibwe bushobora kuba bwiza, bisobanura ko atari kanseri. Cyangwa bishobora kuba bibi, bisobanura ko ari kanseri. Akenshi, uburibwe bwiza bufite aho buhuriye n'izo ndwara z'umurage buva mu mitsi yombi ya adrenal. Ibimenyetso by'umurage bifitanye isano na pheochromocytoma birimo:

• Multiple endocrine neoplasia, ubwoko bwa 2 (MEN 2). Iki kibazo gishobora gutera uburibwe mu bice byinshi by'umubiri ukora imisemburo, bita endocrine system. Hari ubwoko bubiri bwa MEN 2 - ubwoko bwa 2A na 2B. Zombi zishobora kuba zirimo pheochromocytomas. Ubundi buribwe bufite aho buhuriye n'iki kibazo bushobora kugaragara mu bindi bice by'umubiri. Ibyo bice by'umubiri birimo thyroid, parathyroid glands, minwa, akanwa n'uburyo bw'igogorwa.
• Indwara ya Von Hippel-Lindau. Iki kibazo gishobora gutera uburibwe mu bice byinshi by'umubiri. Ahantu hashoboka harimo ubwonko n'umugongo, endocrine system, pancreas na kidneys.
• Neurofibromatosis 1. Iki kibazo gitera uburibwe ku ruhu bita neurofibromas. Gishobora kandi gutera uburibwe bw'imitsi inyuma y'ijisho rihuza n'ubwonko, bita optic nerve.
• Hereditary paraganglioma syndromes. Ibi bibazo biherwa mu miryango. Bishobora gutera pheochromocytomas cyangwa paragangliomas.

• Indwara y'umutima.
• Impuhwe.
• Gusinzira kw'impyiko.
• Kubura ubwenge.

Gake, pheochromocytoma iba kanseri, kandi ibisanzwe bya kanseri bikwirakwira mu bindi bice by'umubiri. Udukoko twa kanseri dukomoka kuri pheochromocytoma cyangwa paraganglioma akenshi ujya mu mikaya, amagufa, umwijima cyangwa mu mapapu.

Kugira ngo bamenye niba ufite pheochromocytoma, umuganga wawe ashobora gusaba ibizamini bitandukanye.

Ibi bizamini bipima urwego rw'imisemburo ya adrenaline na noradrenaline, ndetse n'ibintu bishobora guturuka kuri iyo misemburo yitwa metanephrines. Inyuguti zo hejuru za metanephrines ziramenyekanye cyane iyo umuntu afite pheochromocytoma. Inyuguti za Metanephrine ntabwo zishobora kuba ari nyinshi iyo umuntu afite ibimenyetso biterwa n'ikintu kitari pheochromocytoma.

• Isuzuma ry'amaraso. Umuganga afata igice cy'amaraso kugira ngo akore isuzuma mu igenamiterere.

Kuri ubu bwoko bwombi bw'ibizamini, baza umuganga wawe niba ukeneye gukora ikintu icyo ari cyo cyose kugira ngo witegure. Urugero, ushobora gusabwa kutagura igihe runaka mbere y'ikizamini. Ibi bita gusinya. Cyangwa ushobora gusabwa kutagura imiti runaka. Ntucikire umuti uretse niba umwe mu itsinda ry'abaganga bawe akubwiye kandi akaguha amabwiriza.

Niba ibisubizo by'ikizamini cya laboratoire bibonye ibimenyetso bya pheochromocytoma, hakenewe ibizamini byo kubona ishusho. Umuganga wawe ashobora gusaba kimwe cyangwa birenga muri ibi bizamini kugira ngo amenye niba ufite uburibwe. Ibi bizamini bishobora kuba birimo:

• CT scan, ihuza uburyo bwa X-ray bwakozwe kuva mu mpande zitandukanye z'umubiri wawe.
• MRI, ikoresha amashusho ya radiyo hamwe n'ikinyabiziga cya magnetique kugira ngo ikore amashusho arambuye.
• M-iodobenzylguanidine (MIBG) imaging, isuzuma rishobora kubona ibintu bike by'ikintu cya radioactive cyashyizwe. Icyo kintu gifatwa na pheochromocytomas.
• Positron emission tomography (PET), isuzuma rishobora kandi kubona ibintu bya radioactive bifatwa n'uburibwe.

Uburibwe muri gland ya adrenal bushobora kuboneka mu gihe cy'isuzuma ry'amashusho ryakozwe ku mpamvu zindi. Iyo bibaye, abaganga bakunze gusaba ibizamini byinshi kugira ngo bamenye niba uburibwe bukwiye kuvurwa.

Umuganga wawe ashobora kugutekerezaho ibizamini bya gene kugira ngo arebe niba pheochromocytoma ifitanye isano n'uburwayi bwa gene. Amakuru yerekeye ibintu bishoboka bya gene ashobora kuba akomeye kubera impamvu nyinshi:

• Amwe mu marwayi ya gene ashobora gutera ikibazo cy'ubuzima kirenze kimwe. Rero, ibisubizo by'ibizamini bishobora kwerekana ko hakenewe gusuzuma ibindi bibazo by'ubuzima.
• Amwe mu marwayi ya gene arashobora kubaho cyangwa kuba kanseri. Rero, ibisubizo byawe by'ibizamini bishobora kugira ingaruka ku myanzuro yo kuvura cyangwa gahunda z'igihe kirekire zo gukurikirana ubuzima bwawe.
• Ibisubizo by'ibizamini bishobora kwerekana ko abandi bagize umuryango bagomba gusuzuma pheochromocytoma cyangwa ibindi bibazo bifitanye isano.

Inama ku bijyanye na gene irashobora kugufasha kumva ibisubizo byo gusuzuma gene yawe. Irashobora kandi gufasha umuryango wawe gucunga ibibazo byose by'ubuzima bwo mu mutwe bifitanye isano n'umunaniro wo gusuzuma gene.