Cudurka Addison: Addison’s disease

 Cudurka Addison waa waxtar la'aanta Qanjirka Adrenal Cortex ka Waana xaalad xanuun oo daba-dheeraata taas oo Qanjirka Adrenal Cortex ee ku yaala kelyaha korkoodu uu ku guuldareysto inuu soo saaro hoormonada cortisol iyo aldosterone ku filan. 

Cortisol (glucocorticoid): waxaa uu  muhiim u yahay maaraynta Tamarta Jirka, la qabsiga Xaladaha walbahaarka(stress), habaynta difaaca jirka, iyo ilaalinta Shaqada caadiga ah ee xubnaha Jirka(homeostasis).

Aldosterone (mineralocorticoid): waa hoormoon kamid ah kuwa ugu muhiimsan kaas oo door muhiim ah ka qaata ilaalinta isku dheeli tirka qaar kamid ah Macdanaha jirka Sida sodium, potassium, dheelitirka biyaha, iyo cadaadiska dhiigga ee Caadiga ah (homeostasis) ee jirka iyada oo loo marayo falcelinada kelyaha iyo xubnaha kale.

Sababaha:

1. Difaaca jirka oo si khaldan u dhibaateeya qanjirka Adrenal waana kan ugu badan(Autoimmune adrenalitis)
2. TB ( Aduunka oo dhan waa lagu arkaa)
3. kansar ku Soofaafay qanjirka(Metastasis)
4. Infekshannada (sida HIV, fungal)
5. Dhiigbaxa adrenal (Tusaale Waterhouse-Friderichsen)-waa xaalad aad khatar u ah oo lagu garto shaqo gab ku timaada qanjirada adrenal-ka oo ay ugu wacan tahay dhiigbaxa labada qanjir (Adrenal Cortex) waxaana  keena caabuqyo ba'an oo ay sababto bakteeriyo.

Sidee u dhacaa Xanuunkan:

1. La'aanta Aldosterone(Mineralocorticoid) waxay keentaa reebidii sodium-ta baxaysay oo daciifta iyo saaristii  potassium-ta oo yaraata, taas oo keenta macdanta sodium ee dhiiga oo hooseysa (hyponatremia), macdanta potassium-ta dhiiga oo sareysa(hyperkalemia), fuuq-bax, dhiig-yaraan, iyo suurtagalnimo in wareegii dhiiggu istaago.
2. Yaraanta Cortisol(Glucocorticoid) waxay yaraynaysaa dheef-shiidka kiimikaad ee Carbohydrates-ka, taas oo keenta sonkortii dhiiga oo hoos u dhacda(hypoglycemia), daciifnimo, caabuq iyo daciifnimada wadnaha, taas oo keenta xadaadiska dhiiga oo hooseyseeya(hypotension).
3. La'aanta cortisol waxay meesha  ka saartaa jawaab celinti tabnayd ee uu  heli lahaa qanjirka pituitary, waxayna kordhisaa ACTH iyo wax soo saarka beta-lipotropin, taas oo keenta haaro ama baro madow oo  maqaarka ah sababtoo ah kicinta melanocyte.
4. Cilladaha hoormoonadaan oo la isku daray waxay soo saaraan calaamado ay ka mid yihiin daciifnimo, daal, miisaan lumis, calool xanuun, waxayna ku dhammaan karaan carqalada adrenal ee ba'an(Adrenal Crisis) oo ay calaamad u tahay Caadiska dhiiga oo aad u hooseeya (severe hypotension) iyo shoog(shick).

• ↓ Cortisol → jawaab celinti pituitary heli lahaa oo daciif ah, Sonkorta dhiiga oo hooseysa(hypoglycemia) 
• ↓ Aldosterone → sodium hoose, potassium sare, BP hooseeya 
• ↑ ACTH →baro madow oo maqaarka ah (hyperpigmentation) 

Calaamadaha:

• Daal, miisaanka oo yaraada, murqaha oo daciifa
• Dhiigbax (gaar ahaan xuubka maqaarka, cirridka)
• Dhiig kar iyo dawakhaad
• Damcida cusbada 
• Labo, matag iyo calool xanuun
• Sonkorta dhiiga oo hooseysa

Ogaanshaha:

1. Electrolytes: Macdanta sodium-ta dhiiga oo hooseysa (Hyponatremia) iyo Macdanta potassium-ta dhiiga oo saysa hyperkalemia.
2. Subaxda hore  serum cortisol: hooseeya
3. Tijaabada kicinta ACTH (Synacthen test): Haddii aanu Kor u kac ku imaan cortisol-ka  waa Xaalada Addison's disease oo Asaasi ah, laakiin haddii sare kac sameeyo dhibaatadu meel kale ayey ka jirtaa Sida Hypothalamus ama Pituitary.
4. Plasma ACTH : waa koraysaa Cudurka asaasiga ah (Addison’s disease)
5. Kahortagaha difaaca jirka(Antibodies): Anti-21 hydroxylase antibodies waa marka Difaaca Jirku Sababay(autoimmune).

Daawaynta:

1. Hydrocortisone Beddelka Glucocorticoid 
2. Fludrocortisone Beddelka Mineralocorticoid
3. Waxaa Kor loo qaadaya dose-ka daawada marka bukaanku xanuunsan yahay ama walbahaar iyo culeys heysto.

Xaalada Cudurka Addison Ee Daran 

Waxaa dhacaya in Cadaadiska dhiigu aad hoos guy dhaco(Severe hypotension), fuuqbax(dehydration), iyo shoog(shock). Xaaladaan Waxa ka keena 
jirro, qaliin ama dawooyinkii oo bukaanku seegay

daweeynta Xaaladaan: 

IV hydrocortisone
Dareere xididka laga soonayo (IV fluid)
Macdanaha Jirka(Electrolytes ) oo la saxo