Cushing's Disease In Dev: Ua Rau, Tsos Mob, Thiab Kho

2024 Tus sau: Daisy Haig | [email protected]. Kawg hloov kho: 2023-12-17 03:09

Cushing's disease-tseem muaj lub npe hu ua hypercortisolism thiab hyperadrenocorticism-yog ib tus kabmob hnyav uas cuam tshuam rau cov tib neeg nruab nrab thiab cov laus. Nws tuaj yeem yog qhov hnyav yog tias tsis kho.

Nov yog yam koj yuav tsum paub txog Cushing's disease nyob hauv dev-los ntawm hom thiab cov tsos mob los kho thiab tu.

Cushing's Disease in Cov dev Yog Dab Tsi?

Cushing's disease (hyperadrenocorticism) tshwm sim thaum lub qog adrenal ua haujlwm zais rau ntau dhau lawm ntau hauv kev nyuaj siab, lossis cortisol.

Dab tsi ua rau Cushing tus mob hauv dev?

Cushing's disease nyob hauv cov dev feem ntau pom nyob rau hauv nruab nrab-hnub nyoog rau cov dev laus-txog li 7 txog 12 xyoos.

Muaj peb hom Cushing's Disease hauv dev:

Pituitary-qee Tus Cushing's Disease

Tus mob Pituitary dependant Cushing's mob tshwm sim thaum lub qog ua rau lub qog pituitary nyob rau hauv lub hauv paus ntawm lub hlwb zais cia ntau dhau ntawm cov hormone uas ua rau cov qog adrenal ua rau cortisol.

Cov qog no feem ntau yog benign thiab me; txawm li cas los xij, 15-20% ntawm cov neeg mob qog ua rau qog nqaij hlav yuav nyob rau thaum kawg ua rau cov leeg mob hlwb thaum cov qog loj tuaj. Cov qog Pituitary ua lub luag haujlwm rau 80-85% ntawm Cushing's mob tus kab mob.

Kev Mob Hlwb Ntshav Adrenal

Cov qog adrenal tsim cov tshuaj hormones kev ntxhov siab thiab nyob ze rau ntawm lub raum. Kev mob qog ua haujlwm tuaj yeem yog benign (tsis yog mob qog nqaij hlav) lossis mob qog (mob qog nqaij hlav). Cov qog adrenal ua rau 15-20% ntawm Cushing's mob tus kab mob.

Iatrogenic Cushing's Disease

Iatrogenic Cushing's disease hauv cov dev yog tshwm sim los ntawm kev siv tshuaj steroids ntau dhau los lossis siv sijhawm ntev.

Cushing's Disease puas zoo li cas rau dev?

Thaum uas tsis pheej mob, Cushing's disease nyob hauv dev (tshwj xeeb yog tias tswj tsis tau) tuaj yeem cuam tshuam nrog:

• Ntshav siab
• Mob raum
• Lub pob zeb tso zis
• Mob ntshav qab zib
• Cov tawv nqaij muaj mob ntsws thiab mob txeeb zig
• Hloov pauv lub siab (vacuolar hepatopathy)
• Kev pheej hmoo ntawm txhaws

Ntshav siab thiab cov protein poob ntawm cov zis yog qhov ncaj ncees nrog hyperadrenocorticism thiab tuaj yeem ua rau mob raum.

Tsis tas li ntawd, 15-20% ntawm cov dev nrog cov qog nqaij hlav hauv plab ua rau muaj cov leeg mob siab vim tias cov qog loj tuaj thiab 5-10% ntawm Cushing's cov neeg mob yuav tseem mob ntshav qab zib.

Txawm tias tsawg, Cushing's cov neeg mob kuj tseem muaj feem yuav ua tau ntshav txhaws uas hu ua pulmonary thromboembolisms.

Puas Muaj Ib Yam Kab Nquag Uas Raug Cushing's Disease?

Cushing's disease no feem ntau raug kuaj pom hauv cov tsiaj no:

• Poodles, tshwj xeeb tshaj yog Miniature Poodles
• Dachshunds
• Lub thawv
• Boston Kev Nyab Xeeb
• Yorkshire Cov Kev Thauj Khoom
• Staffordshire Cov Khoom Muaj

Cov tsos mob ntawm tus mob Cushing hauv cov dev zoo li cas?

Muaj ntau cov tsos mob uas tuaj yeem tshwm sim hauv dev nrog Cushing's disease. Nov yog qee qhov tsos mob tshwm sim tshaj plaws ntawm Cushing's disease hauv cov dev:

• Haus dej ntau
• Nce tso zis
• Muaj ntau yam qab los noj mov
• Cov plaub hau poob los yog rov qab ua dua tshiab
• Rau nkawv
• Lauj kaub-plab tsos
• Cov tawv nqaij nyias
• Cawv Dub
• Rov ua cov tawv nqaij
• Cov mob txeeb zig mus tso zis
• Dheev dig muag
• Qaug zog
• Kev tso zis tsis tso zis
• Seborrhea lossis oily tawv nqaij

• Cov chaw ruaj khov thiab tawv nqaij ntawm cov tawv nqaij (hu ua calcinosis cutis)

Caum li cas thiaj paub hais tias muaj tus kab mob hauv dev?

Txawm hais tias tsis muaj ib qho kev sim uas yuav kuaj tau 100% tus neeg mob, koj tus kws kho tsiaj yuav yuav pom zoo kom qee yam kev sib txuas nrog cov hauv qab no:

• Lub hauv paus ntshav ntshav (CBC / Chemistry)
• Urinalysis +/- zis kab lis kev cai (txhawm rau ua kom mob txeeb zig)
• Kev kuaj ntshav ACTH (tuaj yeem muaj qhov tsis zoo)
• Kev ntsuam xyuas qis dexamethasone qis (tuaj yeem cuam tshuam los ntawm lwm yam mob)
• High-koob tshuaj dexamethasone rau kev tsuj
• Zis cortisol rau creatinine piv
• Ultrasound hauv plab (tuaj yeem paub cov kev hloov pauv hauv lub siab thiab qog cov qog lossis cov qog)
• Khoos phib tawj tomography scan lossis cov duab tshav ua suab nrov (tuaj yeem kuaj cov qog ntxig)

Dab Tsi Kho Mob Cushing Hauv Cov Tsiaj?

Kev Kho Mob Cushing's disease hauv cov dev feem ntau ua rau ntawm qhov pib. Cov kev kho mob suav nrog:

• Kev phais mob
• Cov tshuaj noj
• Kev tawg

Yog tias Cushing's mob yog tshwm sim los ntawm kev siv tshuaj steroids ntau dhau lawm, cov tshuaj steroid yuav tsum ua tib zoo kaw thiab tsis txiav txuas ntxiv. Qhov no tuaj yeem ua rau rov ua dua li ntawm thawj hom kab mob steroid thaum xub thawj siv los kho.

Kev phais mob

Cov qog Pituitary thiab qog tuaj yeem phais, thiab yog tias benign, phais yuav curative.

Cov tshuaj noj

Yog tias kev phais mob tsis yog qhov kev xaiv, kev tswj hwm kev kho mob nrog lub trilostane lossis mitotane tuaj yeem ua kom tiav. Cov tshuaj no cuam tshuam nrog kev tsim cov cortisol, tab sis kev saib xyuas zoo heev yog qhov tsim nyog los xyuas kom meej tias adrenal ua haujlwm tsis cuam tshuam ntau dhau sai.

Nyob ntawm seb cov tshuaj twg yog pib, koj tus kws kho tsiaj yuav tsim ib lub tswv yim los saib xyuas koj tus dev cov ntshav thiab mus txog qhov tsim nyog (qhov no yuav sib txawv raws tus neeg mob, lub sijhawm nyob ntawm kev siv tshuaj, thiab lwm yam).

Thaum tus tsiaj vet tau txiav txim siab koj tus dev txoj kev noj tshuaj kom raug, kuaj ACTH cov kev sim yuav tsum tau ua ib qho txhua peb lossis rau lub hlis lossis yog tias koj pom cov cim ntawm Cushing pib tshwm sim dua. Raws li kev mob qog nqaij hlav thiab qog hlav tuaj, lawv yuav xav tau cov tshuaj ntau ntxiv los tswj cov tsos mob.

Thaum pib noj tshuaj lossis hloov cov tshuaj, thov nco ntsoov saib xyuas koj tus tsiaj txhawm chim, ntuav, tsis qab los, lossis muaj teeb meem ua pa, thiab hu rau tus kws kho tsiaj sai yog tias muaj cov cim no

Kev tawg

Kev kho mob hluav taws xob rau tus mob pituitary-dependant Cushing's disease hauv cov dev tau pom tias muaj kev txhim kho lossis tshem tawm cov kev mob puas siab ntsws thiab txhim kho qhov pom, tshwj xeeb tshaj yog thaum kho thaum ntxov. Cov sij hawm nruab nrab txoj sia nyob hauv cov rooj plaub no yog 743 hnub.

Ntev li cas Cov dev nrog Cushing's Disease Live?

Kev kuaj mob rau cov dev nrog Cushing's disease yog nyob ntawm pituitary vs. tsis-pituitary-Cushing's thiab seb lub qog tsis ua haujlwm lossis mob hnyav.

Pituitary Tumors

Yog tias tshwm sim los ntawm cov qog ntxig me me, kev tswj hwm kev kho mob tuaj yeem muab kev tswj kom ntev ntev nrog lub neej zoo. Rau cov mob caj dab pituitary Cushing's, lub sij hawm nyob nruab nrab ntawm cov neeg mob kho nrog trilostane lossis mitotane muaj li ob rau ob thiab ib nrab xyoo.

Yog tias lub qog pituitary loj thiab cuam tshuam rau lub hlwb thiab cov puag ncig ib puag ncig, kev kuaj mob tsis zoo.

Cov qog Pob adrenal

Kwv yees li 50% ntawm cov qog adrenal yog benign, thiab phais mob yog curative. Lwm 50 feem pua ntawm cov qog adrenal yog cov neeg ua txhaum thiab coj tus mob tsis zoo, tshwj xeeb tshaj yog tias lawv twb tau metastasized thaum lub sijhawm kuaj mob.

Lub sijhawm muaj sia nyob nruab nrab yog kwv yees li ib xyoos thaum kho nrog trilostane. Qhov kev mob loj zuj zus hauv cov neeg mob nrog metastasis ntawm thawj cov qog, cov neeg hauv zos ntxeem tau ntawm cov hlab ntsha, lossis lub qog loj dua 5 cm ntev.

Koj puas tuaj yeem Tiv Thaiv Cushing Tus Kab Mob Hauv Cov dev?

Hmoov tsis zoo, koj tsis tuaj yeem tiv thaiv tus mob Cushing yog tias nws tshwm sim los ntawm lub qog pituitary lossis qog adrenal.

Txawm li cas los xij, koj tuaj yeem zam qhov kev siv tshuaj steroids mus sij hawm ntev los txo txoj kev pheej hmoo ntawm kev tsim mob iatrogenic Cushing's disease.