Hoʻokumu ʻia ʻo Gigantism e kahi huna nui o ka hormone ulu i ka wā kamaliʻi, a ʻo ia ka hopena i kahi kiʻekiʻe loa. Hoʻohui pinepine ʻia kēia ʻano maʻamau loa i ka hoʻomohala ʻana i kahi tumo benign o ka pituitary gland, ka pituitary adenoma. I nā makahiki i hala iho nei, ua wehe ka noiʻi i ka komo pinepine ʻana o nā kumu kūlohelohe. He paʻakikī ka hoʻomaʻamaʻa a pinepine pinepine i ka multimodal.

ʻO Gigantism kahi ʻano laha loa o ka acromegaly, kahi ʻano i hoʻokumu ʻia e ka hune nui o ka hormone ulu, i kapa ʻia ʻo GH (no Ka hormone ulu), aiʻole ka hormone somatotrope (STH). 

Ke kū ʻia ma mua o ka ʻōpio (ʻōpio a me ke keiki liʻiliʻi), ke hui pū ʻole ʻia nā iwi iwi, pili pū kēia hormonal me ka ulu nui ʻana o nā iwi i ka lōʻihi a me ke kino holoʻokoʻa. a alakaʻi i ka gigantism.

ʻO nā keiki me ke ʻano he kiʻekiʻe ke kiʻekiʻe, me nā keikikāne e piʻi ana i 2 mau mika a ʻoi paha i ko lākou mau makahiki ʻōpio.

ʻO ka maʻamau, hoʻokuʻu ʻia ka hormone ulu i loko o ke koko e kahi gland liʻiliʻi ma ke kumu o ka lolo i kapa ʻia ka pituitary gland. I nā keiki, ʻo kāna hana nui ka hāpai i ka ulu ʻana. ʻO ka hana ʻana o ka hormone ulu e ka pituitary gland e hoʻoponopono ʻia e GHRH (hōmona hoʻoiho ulu), kahi hōmona i hana ʻia e ka hypothalamus kokoke.

ʻO ka hypersecretion hormone ulu i nā keiki me gigantism ka mea pinepine ma muli o ke ʻano o kahi tumo benign i ka pituitary gland, i kapa ʻia pituitary adenoma: ka hoʻolaha ʻana o nā hunaola hana huaʻōlelo e wehewehe i kona kiʻekiʻe kiʻekiʻe kiʻekiʻe.

Ma lalo o 1% o nā hihia, overactive ka pituitary gland no ka mea hoʻonāukiuki ʻia e GHRH, kahi i hana ʻia e kahi tumo i hiki ke loaʻa ma nā wahi āpau o ke kino.

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Manaʻo ʻia ʻo Gigantism i ke alo o ka ulu wikiwiki i hoʻohālikelike ʻia (hoʻohālikelike ʻia ka piʻo o ke kiʻekiʻe me ka awelika awelika), ke kiʻekiʻe ke keiki ke hoʻohālikelike ʻia me nā lālā ʻē aʻe o kona ʻohana. Hōʻike ka hoʻokolohua hoʻokolohua i nā mea ʻē aʻe e pili ana i ka gigantism (e ʻike i nā ʻōuli).

Hōʻoia ʻia ka hōʻailona e nā hoʻokolohua koko, e hoʻopili ana i nā ana pinepine o ka ulu ʻana o ka hormone a ʻo ka hoʻāʻo ʻana hoʻi o ka glucose - ke piʻi nei ke kiʻekiʻe o ka glucose koko ma hope o ka omo ʻia ʻana o kahi mea inu kō e hoʻoliʻiliʻi i ka huna o ka hormone ulu, ʻaʻole i ʻike ʻia i nā kumuhana me gigantism.

Hana ʻia nā hoʻokolohua kiʻi ʻana e loaʻa ai i ka tumo i kumu o gigantism:

• MRI (magnetic resonance imaging) ʻo ia ka hoʻokolokolo ʻana i ke koho e ʻike ai i kahi adenoma pituitary;
• Hoʻohana nui ʻia ka scanner e nānā no nā ʻōpuʻu e hūnā ana i ka GHRH i nā pancreas, nā ovaries a i ʻole nā ​​adrenal glands;
• hiki i ka radiography ke kuhikuhi i nā mea kūpono ʻole o ka ulu ʻana o ka iwi.

Hiki i ke alo o ka pituitary adenoma ke hoʻopili i ka hana o ka pituitary i nā kekelē ʻokoʻa. Ma waho aʻe o ka hōmona ulu, hoʻopuka ia i ka prolactin (lactation hormone) a me nā hormones ʻē aʻe nona ka kuleana e hoʻoulu i nā huna mai nā adrenal glands, ka thyroid gland a me nā genital glands. No laila pono ka loiloi hormonal piha.

Hiki i ke tumo ke ʻomi i nā aʻa optic a hoʻonāukiuki i nā haunaele ʻike, no laila ka pono no ka hoʻokolokolo pono ophthalmologic.

Noi ʻia nā hoʻokolokolo ʻē aʻe e loiloi i nā disfunction like ʻole e pili pū me ka gigantism.

Pili ka poʻe

ʻOi aku ka nui o ka Gigantism ma mua o ka acromegaly e pili ana i nā mākua, ʻoiai pinepine ʻole kēia ʻano (3 a 5 mau hihia hou i kēlā me kēia miliona poʻe i kēlā me kēia makahiki). Ma ʻAmelika Hui Pū ʻIa, hoʻokahi haneli mau hihia o gigantism i ʻike ʻia.

Hoʻonui ka Gigantism i ka nui ma nā keikikāne, akā ʻo kekahi o nā ʻano mua loa he wahine ka nui

Nā mea pilikino

Hōʻike maʻamau ʻo Gigantism iā ia iho ma ke ʻano he kaʻawale a sporadic hormonal pathology, ʻo ia ka mea e ʻōlelo ʻia ma waho o nā ʻano hoʻoilina. Akā aia kekahi mau hihia maʻamau o ka famenial pituitary adenomas, gigantism hiki ke lilo i hoʻokahi o nā ʻāpana o nā hoʻoilina multitumor hereditary, e like me McCune-Albrigh Syndrome, ʻano 1 neoplasia endocrine (NEM1) a i ʻole neurofibromatosis. .

ʻO kekahi mau ʻano ʻē aʻe a me nā genomic e pili ana i ka gigituism pituitary, hoʻoilina a ʻaʻole hoʻi, i ʻike ʻia i nā makahiki i hala iho nei. ʻO kahi noiʻi kūwaho kūwaho nui i hoʻonohonoho ʻia e ka endocrinologist Belgian Albert Beckers, e uhi ana i nā hihia 208 o gigantism, no laila ua kahakaha ʻia ke komo ʻana o nā kumu kūlohelohe i 46% o nā hihia. 

Ma waho aʻe o ko lākou kino nunui, hiki i nā keiki a me nā ʻōpio me ka gigantism ke hōʻike i nā hōʻike ʻē aʻe e pili ana i kā lākou pathology.

• kaulike (pinepine) momona,
• kahi hoʻonui hoʻonui ʻia o ka nui o ka iwi poʻo (macrocephaly), pili a ʻaʻole paha me nā hiʻohiʻona o ka helehelena (prognathism, frontal bumps, etc.)
• nā haunaele ʻike e like me ka loli i ke kahua o ka hihiʻo a i ʻole ka ʻike pālua.
• nui nā lima a me nā wāwae nui ʻole, me nā manamana lima lahilahi,
• nā neuropathy ākea,
• nā maʻi maʻi ʻōpū,
• tumors maikaʻi,
• nā maʻi hormonal…

Hoʻolālā ka mālama ʻana o nā keiki me gigantism i ka mālama ʻana i kā lākou mea huna nui o ka hormone ulu, kahi e koi ai i ka hoʻokomo ʻana i nā ʻano hana maʻamau.

ʻO keʻano maʻamau

ʻOi aku ka ʻoki ʻana o ka adituoma pituitary ma ke ʻano he lapaʻau mua. He hana paʻakikī kēia, hiki ke hana pinepine ʻia me ka nasally ʻoiai pono e wehe i ka cranium ke nui ka adenoma (macroadenoma).

Ke nui loa ka tumo a kokoke loa paha i nā hanana nui i ka lolo, ʻaʻole hiki ke hoʻohana ʻia.

ʻO ke kelepona

Kono ʻia paha ka irradiation X-ray ma ka hoʻohui o ke kahakaha ʻana e luku i nā koena tumo residual a mālama i nā tumal recalcitrant (ma kahi o kanakolu mau kau). He ʻeha ʻole kēia ʻano hana akā hiki ke kumu i kahi hormonal imbalance kuleana no nā ʻano maʻi.

I kēia mau lā, ua hoʻokumu ʻia ka ʻenehana radiosurgery Gamma Knife. Ma kahi o ka scalpel, hoʻohana ia i ka radiation gamma, ʻoi aku ka ikaika a me ka ʻoi loa o ka pololei ma mua o nā kukuna x, e luku ai i ka tumo i kahi noho hoʻokahi. Mālama ʻia ia no nā tumors liʻiliʻi.

Hoʻopaʻa ʻia nā molecules i ka hoʻohaʻahaʻa ʻana i ka huna ʻana o ka hormone ulu me ka ʻoki pū ʻana a me ka radiation radiation, ʻoiai inā ʻaʻole lawa ka hemo ʻana o ka tumo. Hoʻopili ka arsenal therapeutic i nā analogues o somatostatin a me ka dopamine, maikaʻi loa akā hiki ke loaʻa nā hopena ʻaoʻao nui.