Tus Sau: Gregory Harris
Hnub Kev Tsim: 11 Lub Plaub Hlis Ntuj 2021
Hloov Hnub: 17 Lub Kaum Ib Hli Ntuj 2024
Anonim
Cushing Syndrome Diagnostic Workup
Daim Duab: Cushing Syndrome Diagnostic Workup

Ectopic Cushing syndrome yog ib hom mob Cushing syndrome uas nyob rau cov qog sab nraud ua lub qog ua rau lub qog hu ua adrenocorticotropic hormone (ACTH).

Cushing syndrome yog ib qho kev tsis sib haum xeeb uas tshwm sim thaum koj lub cev muaj qib siab dua li theem ntawm cov tshuaj hormones cortisol. Qhov tshuaj hormones no yog tsim nyob rau hauv cov qog adrenal. Ntau dhau cortisol tuaj yeem yog vim muaj ntau yam teeb meem. Ib qho ntawm cov laj thawj yog tias muaj ntau ntawm cov tshuaj hormones ACTH nyob rau hauv cov ntshav. ACTH feem ntau yog ua los ntawm cov pituitary hauv qee qhov me me thiab tom qab ntawd taw qhia tias cov qog adrenal los tsim cortisol. Qee zaum lwm lub hlwb sab nraum lub pituitary tuaj yeem ua rau kom muaj ACTH ntau. Qhov no yog hu ua ectopic Cushing syndrome. Ectopic txhais tau tias qee yam tau tshwm sim hauv qhov chaw txawv txav hauv lub cev.

Ectopic Cushing syndrome yog mob los ntawm cov qog uas tso ACTH. Cov hlav uas tuaj yeem, hauv qee zaus, tso ACTH muaj xws li:

  • Cov qog nqaij hlav hlav hauv lub ntsws
  • Islet hlav qog ntawm lub txiav
  • Lub cev nqaij daim tawv mob cancer ntawm lub qog
  • Cov hlav me me ntawm lub ntsws
  • Cov qog ntawm cov thymus caj pas

Ectopic Cushing syndrome tuaj yeem ua rau ntau qhov tsos mob sib txawv. Qee tus neeg muaj ntau cov tsos mob thaum lwm tus tsuas muaj qee qhov xwb. Cov neeg feem ntau uas muaj yam mob Cushing muaj:


  • Hloov, liab, thiab tag nrho lub ntsej muag (lub ntsej muag lub hli)
  • Kev loj hlob qeeb hauv cov menyuam yaus
  • Lub cev hnyav nrog cov rog ntau nyob rau ntawm pob tw, tab sis rog rog los ntawm caj npab, ceg, thiab pob tw (nruab nrab rog)

Cov tawv nqaij hloov uas feem ntau pom:

  • Cov kab mob ntawm daim tawv nqaij
  • Ntshav daj xim (1/2 nti 1 centim los yog dav dua) hu ua striae ntawm daim tawv nqaij ntawm lub plab, ncej, sab caj npab, thiab ob lub mis
  • Tawv nqaij tawv nrog doog yooj yim

Hloov nqaij thiab pob txha muaj xws li:

  • Mob caj pas, uas tshwm sim nrog cov kev ua ub no
  • Mob leeg los yog rhiab
  • Sau cov rog ntawm lub xwb pwg thiab sab saud dab tshos
  • Cib thiab txha nraub qaum ua rau pob txha lov
  • Cov leeg tsis muaj zog, tshwj xeeb ntawm lub duav thiab lub xub pwg nyom

Lub cev thoob plaws (txheej txheem) muaj xws li:

  • Yam 2 ntshav qab zib mellitus
  • Ntshav siab
  • Cov roj (cholesterol) thiab triglycerides

Cov poj niam yuav muaj:

  • Kev hle plaub hau ntau dhau ntawm lub ntsej muag, caj dab, hauv siab, plab, thiab ncej puab
  • Lub sijhawm ua haujlwm tsis meej lossis nres

Tus txiv neej yuav muaj:


  • Tsawg lossis tsis muaj siab rau kev sib deev
  • Cuam meem txom

Lwm cov tsos mob uas yuav tshwm sim suav nrog:

  • Hloov pauv hlwb, xws li kev nyuaj siab, ntxhov siab lossis hloov tus cwj pwm
  • Nkees
  • Mob taub hau
  • Nce nqhis dej thiab tso zis

Tus kws kho mob yuav kuaj ib ce thiab nug txog koj cov tsos mob.

Kev ntsuam xyuas uas yuav ua tau muaj xws li:

  • Kev kuaj zis 24 teev kom ntsuas cov qib cortisol thiab creatinine
  • Kev kuaj ntshav los kuaj ACTH, cortisol, thiab theem poov tshuaj (feem ntau muaj qis hauv pob txha caj qaum Cushing syndrome)
  • Kev tshuaj ntsuam Dexamethasone (ob qho tshuaj siab thiab qis)
  • Txoj kev kuaj ntshav tsis zoo (kuaj tshwj xeeb uas ntsuas ACTH los ntawm cov leeg ze ntawm lub hlwb thiab hauv siab)
  • Yoo Pleev Cov Phaj Ej
  • MRI thiab kev ntsuas siab siab CT scans kom pom cov qog ntshav (qee zaum tshuaj tua kabmob nuclear xav tau)

Txoj kev kho mob zoo tshaj plaws rau ectopic Cushing syndrome yog kev phais mob kom tshem tawm cov qog. Kev phais feem ntau yog ua tau thaum lub qog tsis mob (benign).


Hauv qee kis, lub qog ua rau mob qog thiab kis mus rau lwm qhov ntawm lub cev ua ntej tus kws kho mob tuaj yeem tshawb pom qhov teeb meem nrog cortisol ntau lawm. Phais tej zaum yuav tsis muaj peev xwm ua tau hauv cov kis no. Tab sis tus kws kho mob tuaj yeem sau tshuaj los txhaws cortisol ntau lawm.

Qee zaum kev tshem tawm ob lub qog adrenal yog tias lub qog nrhiav tsis tau thiab cov tshuaj tsis tuaj yeem thaiv cortisol ntau lawm.

Kev phais tawm mus tshem tawm cov qog tuaj yeem ua rau tag nrho rov qab. Tab sis muaj txoj hmoo tias qhov qog yuav rov qab los.

Cov qog yuav kis tawm lossis rov qab los tom qab kev phais mob. Cortisol theem siab kuj tseem yuav txuas ntxiv.

Hu rau koj tus kws kho mob yog tias koj muaj cov tsos mob ntawm Cushing syndrome.

Kev kho tus mob qog sai yuav txo qis kev phom sij hauv qee kis. Ntau rooj plaub tiv thaiv tsis tau.

Cushing syndrome - ectopic; Mob Ectopic ACTH syndrome

  • Cov qog endocrine

Nieman LK, Biller BM, Tshawb JW, li al. Kev Kho Mob ntawm Cushing's syndrome: ib qho ntawm Endocrine Society cov chaw coj los soj ntsuam. J Clin Endocrinol MetabCov. Xyoo 2015; 100 (8): 2807-2831. PMID 26222757 www.ncbi.nlm.nih.gov/pubmed/26222757.

Stewart PM, Newell-Nqe JDC. Lub adrenal cortex. Hauv: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. Williams Phau Ntawv ntawm EndocrinologyCov. 13th ed. Philadelphia, PA: Elsevier; 2016: chap 15.

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