IyInI I-CushIng’s syndrome?I-Cushing’s syndrome ibangela izinguquko emzimbeni nasebuchosheni ezibangelwa ukuba ne-cortisol eningi egazini isikhathi eside. I-cortisol i-steroid hormone ekhiqizwa izindlala i-adrenal, ezitholakala phezu kwezinso. Uma iyisilinganiso esifanele, i-cortisol isiza umzimba ukuthi• ubhekane nengcindezi• ukugcinwa kwamazinga afanele omfutho wegazi, inhliziyo nemithambo

yegazi• ukwazi ukuqapha ukusebenza kwamasosha omzimba • uguqule amafutha, amakhabhohayidrethi namaphrotheni abe amandla

ngabe bewazI?I-cortisol ngesinye isikhathi iye ibizwe “ngehomoni yengcindezi” ngoba omunye wemisebenzi yayo omqoka kakhulu ukusiza umzimba ukuthi ubhekane nengcindezi.

Ibangelwa yInI I-CushIng’s syndrome? Kunezinhlobo ezimbili ze-Cushing’s syndrome: e-exogenous (ebangelwa yizimo ezingaphandle komzimba) ne-endogenous (ebangelwa yizimo ezingaphakathi komzimba). Ziyafana izimpawu zazo zombili lezi zinhlobo. Umehluko uba sekutheni zibangelwe yini kuphela.

I-exogenous Cushing’s syndrome ejwayeleke kakhulu itholakala kubantu abathatha imithi enjenge-cortisol efana ne-prednisone. Lawa maphilisi asetshenziselwa ukwelapha izifo ezivuswa izimo ezithile ezifana nokuphathwa isifuba nesifo nofehlale lwamathambo (rheumatoid arthritis). Acindezela namasosha omzimba futhi ngemuva kokuhlinzwa ufakelwe isitho somzimba. Lolu hlobo lwe-Cushing’s luba olwesikhashana kanti luyaphela uma isiguli sesiyekile ukuthatha imithi enjenge-cortisol.

I-Cushing’s syndrome

I-endogenous Cushing’s syndrome, lapho izindlala ze-adrenal zikhiqiza kakhulu i-cortisol, iwuhlobo olungavamile. Kujwayele ukuthi iqale kancane kodwa kungaba lukhuni ukuthola ukuthi umuntu unayo. Lolu hlobo lwe-Cushing’s isikhathi esiningi lubangelwa ukukhipha kwamahomoni izigaxa zendlala i-adrenal noma i-pituitary, indlala etholakala ngaphansi kobuchopho. Endlaleni i-adrenal, isigaxa (isikhathi esiningi esisuke singesona esomdlavuza) sikhiqiza i-cortisol eningi kakhulu. Isigaxa esiku-pituitary sikhiqiza i-ACTH eningi—ihomoni etshela izindlala i-adrenal ukuthi zenze i-cortisol. Uma kuba nezigaxa ku-pituitary, lolu hlobo lokugula isikhathi esiningi lubizwa nge-Cushing’s disease.

Izigaxa eziningi ezikhiqiza i-ACTH zisuka ku-pituitary kodwa ngesinye isikhathi ezigaxeni ezingaphumi ku-pituitary, okujwayele ukuthi kube amaphaphu, zingakhiqiza i-ACTH eningi kangangokuthi ingabangela i-Cushing’s syndrome.

IpHEpHA LAmApHUZU

www.hormone.orgIphepha lamaphuzu e-Cushing’s syndrome

I-hormone health network inikeza ngezinsiza zamahhala ngolwazi oluseqophelweni eliphezulu kakhulu ngokwelashwa ngokwesayensi oluthathwe ku-endocrine society (www.endocrine.org). Injongo ye-network wukusiza iziguli ekubeni ngezifundisiwe zibe ngezizibandakanyayo, nezaziyo zibe ngeziyingxenye yokwelashwa kwazo kwezempilo. Iphepha lamaphuzu nalo liyatholakala isingisi lapha www.hormone.org.

abahlelI

James w. Findling, mdwilliam F. young, Jr., md

Masingana 2012, Ushicilelo lwesi-4

Ihlolwa kanjanI I-CushIng’s syndrome?Kujwayele ukusetshenziswa izinhlobo zokuhlola ezintathu ukuze kutholakale i-Cushing’s syndrome. Enye yezinhlobo zokuhlola ezibucayi kakhulu ukukala amazinga e-cortisol ematheni phakathi kwehora le-11:00 ebusuku naphakathi kwamabili. Kuthathwa isampula lamathe ngesiqukathi seplastiki bese lithunyelwa egumbini lokwenza ucwaningo ukuze licutshungulwe. Amazinga e-cortisol aba phansi kakhulu ngalesi sikhathi sosuku. Uma kuqhathaniswa nalokhu, abantu abane-Cushing’s syndrome baba namazinga aphezulu.

Amazinga e-cortisol angakalwa futhi nasemchamweni othathwe esikhathini esingamahora angama-24.

Kolunye uhlobo lokuhlolwa, abantu abasolwa ukuthi bane-Cushing’s syndrome kuye kukalwe amazinga abo e-cortisol ekuseni ngemuva kokuthathwa isilinganiso se-dexamethasone, i-steroid eyakhiwe egunjini lokwenza ucwaningo. Ngokujwayelekile, i-dexamethasone ibangela ukwehla kwe-cortisol ibe semazingeni aphansi kakhulu, kodwa akwenzeki lokhu kubantu abane-Cushing’s syndrome.

yelashwa kanjanI I-CushIng’s syndrome?Indlela okwelashwa ngayo i-Cushing’s syndrome incika kokuyimbangela.

I-exogenous Cushing’s syndrome iyaphela ngemuva kokuba isiguli siyeke ukuthatha imithi enjenge-cortisol ebesiyisebenzisela ukwelapha esinye isifo. Udokotela wakho ozonquma ukuthi isiphi isikhathi esifanele ongehlisa ngaso bese ugcina ngokuyeka ukusebenzisa imithi.

Ku-endogenous Cushing’s syndrome, kuqale kubhekwe ukuthi akungcono yini ukuthi umuntu ahlinzwe ukuze kususwe izigaxa ezibangelwa amazinga aphezulu e-cortisol. Noma ukuhlinzwa kuvame ukuba impumelelo, abanye abantu bangadinga nemithi futhi eyehlisa i-cortisol noma ukwelashwa ngemisebe yokukhanya ukuze kubulawe amaseli ezigaxa asele. Abanye abantu kuye kudingeke ukuthi kususwe zombili izindlala ze-adrenal ukuze kulawuleke i-Cushing’s syndrome.

Imibuzo okumele uyibuze udokotela wakho• nginaluphi uhlobo lwe-Cushing’s syndrome?• yini okumele ngiyenze uma i-Cushing’s syndrome

yami ibangelwa imithi engiyithathayo?• ngabe ngizodinga imithi yokwelapha noma eziphi

izimpawu enginazo?• kuzothatha isikhathi esingakanani ngemuva

kokwelapha ukuthi izimpawu enginazo ziphele?• ngabe kumele yini ukuthi ngibonane nodokotela

osebenza ngezifo zokungasebenzi kahle kwamahomoni ukuze nginakekeleke?

ImIthombo• Thola udokotela osebenza ngezifo zokungasebenzi ngendlela efanele

kwamahomoni (Endocrinologist): www.hormone.org noma ushayele ucingo ku-1-800-HORMONE (1-800-467-6663)

• I-Cushing’s Support and Research Foundation: www.csrf.net • I-National Adrenal Diseases Foundation: www.nadf.us/diseases/

cushings.htm• I-National Endocrine and metabolic Diseases Information Service:

http://endocrine.niddk.nih.gov

IzInkomba nezImpawu ze-CushIng’s syndrome• Ukukhuluphala, ikakhulukazi kwesingenhla somzimba• Ukuba nobuso obuyindilinga kanye nokuba namafutha amaningi

maphezulu nomhlane nangaphezu kwengqwababa• Ukuba noshukela omningi egazini (isifo sikashukela)• Ukuphakama komfutho wegazi (i-hypertension)• Isifo sokuncipha kwamathambo (i-osteoporosis)• Ukulahlekelwa nokuba buthakathaka kwezicubu zomzimba• Isikhumba esizacile, esibuthakathaka nesilimala kalula• Izimpawu ezikhomba ukunwebeka kwesikhumba eziwumbala

onsomi sakubabomvu (okujwayele ukuba sesiswini nangaphansi kwezingalo)

• Ukuba nengcindezi nokuthola kulukhuni ukuthi ucabange kahle• Ukuba neziboya eziningi ebusweni kubantu besifazane• Ukungayi njalo noma kungayi esikhathini nokungatholi bantwana• Ukwehla kokulangazelela ucansi • Ukungakhuli ngethambo kanye nokukhuluphala ngokweqile

ezinganeni