Cushing mob vim muaj cov qog adrenal

Cushing mob vim yog qog adrenal yog ib hom mob Cushing syndrome. Nws tshwm sim thaum lub qog ntshav ntawm lub qog adrenal tso cov tshuaj hormones cortisol ntau dhau.

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 teeb meem zoo li no yog qog ua ib ntawm cov qog adrenal. Cov qog adrenal tso cov cortisol.

Cov qog adrenal yog qhov tsawg. Lawv tuaj yeem yog cov mob tsis huv (benign) lossis mob qog nqaij hlav (malignant).

Cov hlav tsis muaj pob uas tuaj yeem ua rau Cushing syndrome muaj xws li:

• Adrenal adenomas, uas yog ib qho hlav uas ua rau tsis tshua muaj cortisol ntau dhau lawm
• Macronodular hyperplasia, uas ua rau cov qog adrenal ua haujlwm loj thiab ua kom cortisol ntau dhau

Mob qog yuav ua rau kom tus mob Cushing muaj xws li adrenal carcinoma. Qhov no yog ib qho mob qog, tab sis feem ntau nws ua rau cortisol ntau dhau.

Feem coob cov neeg muaj tus mob Cushing muaj:

• Hloov, liab, 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 ua xim daj (1/2 nti lossis 1 centimeter lossis ntau dua), hu ua striae, ntawm daim tawv nqaij ntawm lub plab, ncej puab, 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 (hloov raws chaw) muaj xws li:

• Yam 2 ntshav qab zib mellitus
• Ntshav siab
• Cov cholesterol thiab triglycerides ntau ntxiv

Cov poj niam feem ntau muaj:

• Dhau ntawm cov plaub hau kev loj hlob ntawm lub ntsej muag, caj dab, hauv siab, plab thiab hauv ncej (feem ntau muaj dua lwm yam mob Cushing syndrome)
• Lub sijhawm ua haujlwm tsis meej lossis nres

Tus txiv neej yuav muaj:

• Tsawg lossis tsis muaj siab rau kev sib deev (tsis tshua muaj libido)
• Teeb meem Erection

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 kuaj mob kom paub meej cov mob Cushing:

• Kev kuaj zis 24 teev kom ntsuas cov qib cortisol thiab creatinine
• Kev kuaj ntshav mus kuaj ACTH, cortisol, thiab theem potassium
• Kev Tshuaj Ntsuam Kev Tshuaj Ntsuam Dexamethasone
• Cov ntshav cortisol theem
• Ntshav DHEA qib
• Qaub cortisol qib

Kev ntsuam xyuas los txiav txim qhov ua rau lossis teeb meem yog:

• Hauv plab CT
• ACTH
• Cov pob txha ua haujlwm
• Cov roj khov ua tiav
• Yoo Pleev Cov Phaj Ej

Kev phais mob tas tau tshem tawm cov qog adrenal. Feem ntau, tag nrho cov qog adrenal yog tshem tawm.

Glucocorticoid hloov kho yog feem ntau xav tau kom txog thaum lwm qhov mob adrenal rov qab los ntawm kev phais. Koj tuaj yeem xav tau cov tshuaj no rau 3 mus rau 12 hlis.

Yog tias kev phais mob tsis tuaj yeem, xws li muaj mob qog nqaij hlav adrenal uas tau kis (metastasis), cov tshuaj tuaj yeem siv los txiav kev tso tawm cortisol.

Cov neeg muaj qog hlav qog ntshav uas tau txais kev phais muaj qhov pom kev zoo. Rau mob qog nqaij hlav adrenal, kev phais mob qee zaum tsis tuaj yeem. Thaum kev phais mob ua, nws tsis kho tus mob qog nqaij hlav tas mus li.

Mob qog adrenal hlav yuav kis mus rau lub siab lossis ntsws.

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

Kev kho zoo los ntawm kev mob qog tuaj yeem txo cov kev pheej hmoo ntawm cov teeb meem rau qee tus neeg nrog adrenal hlav ntsig txog Cushing syndrome.

Mob qog adrenal - Cushing syndrome

• Cov qog endocrine
• Adrenal metastases - CT scan
• Cov tshuaj qog Adrenal - CT

Asban A, Patel AJ, Reddy S, Wang T, Balentine CJ, Chen H. Cancer ntawm endocrine system. Hauv: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, eds. Abeloff's Clinical OncologyCov. 6 tus ed. Philadelphia, PA: Elsevier; 2020: chap 68.

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.