{"id":71283,"date":"2017-11-06T20:45:15","date_gmt":"2017-11-06T20:45:15","guid":{"rendered":"http:\/\/humanitasnet-new.local\/malattie\/feohromocitom\/"},"modified":"2025-01-13T02:55:52","modified_gmt":"2025-01-13T02:55:52","slug":"feohromocitom","status":"publish","type":"disease","link":"https:\/\/humanitas-net.humweb.webiz.team\/sr\/diseases\/feohromocitom\/","title":{"rendered":"Feohromocitom"},"content":{"rendered":"

Definicija<\/h2>\n

Feohromocitom predstavlja retku, obi\u010dno nekanceroznu (benignu) tumorsku promenu nadbubre\u017enog tkiva. Kod svake individue prisutne su dve nadbubre\u017ene \u017elezde, po jedna iznad svakog bubrega. U nadbubre\u017enim \u017elezdama produkuju se hormoni \u010dija je uloga u kontrolisanju svakog organa i organskog sistema u organizmu.<\/p>\n

Usled prisustva feohromocitoma, nadbubre\u017ene \u017elezde produkuju prekomernu koli\u010dinu epinefrina i norepinefrina, hormona koji kontroli\u0161u sr\u010danu frekvencu, metabolizam i krvni pritisak. Ve\u0107ina osoba sa feohromocitomom uzrasta su od 20 do 50 godina. Ipak, feohromocitom se mo\u017ee javiti\u00a0 bilo kom uzrastu.<\/p>\n

U slu\u010daju nele\u010denja, feohromocitom mo\u017ee rezultovati te\u017eim ili \u010dak \u017eivotno ugro\u017eavaju\u0107im o\u0161te\u0107enjem organskih sistema, pogotovo kardiovaskulanog sistema. Hirur\u0161ki tretman je preporu\u010den u cilju odstranjivanja feohromocitoma kao i normalizacije vrednosti krvnog pritiska.<\/p>\n

 <\/p>\n

Simptomi<\/h2>\n

Znaci i simptomi feohromocitoma naj\u010de\u0161\u0107e podrazumevaju:<\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Visok krvni pritisak<\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Bol u grudima<\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Ubrzan sr\u010dani rad<\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Znojenje<\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Te\u0161ke glavobolje<\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Tremor<\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Bledilo facijalne regije<\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Gubitak daha<\/p>\n

 <\/p>\n

Re\u0111i znaci i simptomi mogu uklju\u010divati slede\u0107e:<\/p>\n

Iritabilnost<\/p>\n

Abdominalni bol<\/p>\n

Konstipaciju (zatvor)<\/p>\n

Gubitak telesne te\u017eine<\/p>\n

 <\/p>\n

Navedeni znaci i simptomi \u010desto se javljaju u kra\u0107im periodima trajanja od 15 do 20 minuta. Epizode se mogu javiti par puta tokom dana ili re\u0111e. Faktori koji uslovljavaju nastanak navedene simptomatologije uklju\u010duju<\/p>\n

Prekomernu upotrebu muskulature\u00a0 tokom fizi\u010dkog napora\/ve\u017ebi<\/p>\n

Anksioznost ili stres<\/p>\n

Posturalne promene organizma<\/p>\n

Peristalti\u010dke pokrete<\/p>\n

Ro\u0111enje deteta<\/p>\n

Hrana bogata tiraminom (odre\u0111ene vrste sireva, suvo ili dimljeno meso, avokado, banane, kisela riba, boranija, drugo)<\/p>\n

Odre\u0111ena medikamentozna terapija (dekongestivi, inhibitori monoamino oksidaze (MAOI), stimulansi kao \u0161to su amfetamini ili kokain)<\/p>\n

 <\/p>\n

Uzroci<\/h2>\n

Iako ta\u010dan etiopatogenetski mehanizam nastanka feohromocitoma jo\u0161 uvek nije definisan, poznato je da se solitarni tumor naj\u010de\u0161\u0107e razvija u specijalizovanim \u0107elijama (hromafilnim \u0107elijama) lokalizovanim u centru jedne ili obe nadbubre\u017ene \u017elezde. Ove \u0107elije produkuju i osloba\u0111aju odre\u0111ene hormone, primarno adrenalin (epinefrin) kao i\u00a0 noradrenalin (norepinefrin) koji se primenjuju u cilju stimulacije odgovora organizma na potencijalni stresni faktor. Ipak, u slu\u010daju iregularnog ili prekomernog osloba\u0111anja ovih hormona, nastaju povi\u0161ene vrednosti krvnog pritiska kao i ubrzana sr\u010dana radnja. To stanje poznato je kao feohromocitom.<\/p>\n

 <\/p>\n

\u00a0Faktori rizika<\/h2>\n

Faktori koji pove\u0107avaju rizik za nastanak i progresiju feohromocitoma mogu biti evidentni kod osoba sa retkim naslednim poreme\u0107ajima kao i tumorima udru\u017eenim sa ovim poreme\u0107ajima. Ova genetska stanja podrazumevaju slede\u0107e:<\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0 \u00a0\u00a0\u00a0\u00a0Multiplu endokrinu neoplaziju, tip II (MEN II) : poreme\u0107aj koji rezultuje nastankom tumora u vi\u0161e hormonskih sistema organizma (endokrinim sistemima)<\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Von Hipel-Lindau bolest: oboljenje koje rezultuje nastankom tumora na multiplim mestima, kao \u0161to je centralni nervni sistem, endokrini sistem, pankreas i bubrezi<\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Neurofibromatoza 1 (NF1): nasledni neurolo\u0161ki poreme\u0107aj koji rezultuje nastankom multiplih tumora ko\u017ee (neurofibromatoza), pigmentisanih ta\u010daka na ko\u017ei kao i tumorom opti\u010dkog nerva<\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Hereditarni paraganglionarni sindrom: grupa naslednih poreme\u0107aja koji rezultuju nastankom bilo feohromocitoma bilo paraganglioma<\/p>\n

 <\/p>\n

Komplikacije<\/h2>\n

Feohromocitom rezultuje nastankom povi\u0161enih vrednosti krvnog pritiska kod obolele individue. Postojanje visokih vrednosti krvnog pritiska mo\u017ee rezultovati o\u0161te\u0107enjem multiplih organa, pogotovo tkiva kardiovaskualarnog sistema, bubrega i mozga. U slu\u010daju nepru\u017eanja medicinske pomo\u0107i, komplikacije koje mogu nastati rezultuju brojnim medicinskim stanjima kao \u0161to su:<\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Sr\u010dana oboljenja<\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Infarkt<\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Insuficijencija bubrega<\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Akutni respiratorni distres sindrom<\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 O\u0161te\u0107enje nerava o\u010diju<\/p>\n

 <\/p>\n

\u00a0Le\u010denje<\/h2>\n

Primarni vid le\u010denja feohromocitoma jeste hirur\u0161ko uklanjanje tumorske promene. Pre podvrgavanja bilo kojoj hirur\u0161koj intervenciji, lekar \u0107e ordinirati medikamentoznu terapiju u cilju kontrole nivoa krvnog pritiska kao i smanjivanje rizika za nastanak postoperativnih komplikacija. Medikamenti koji se primenjuju u le\u010denju podrazumevaju:<\/p>\n

Alfa blokatore: farmakolo\u0161ke agense \u010dija je funkcija prevencija noradrenalinskih stimulativnih efekata na mi\u0161i\u0107e zida manjih arterija i vena. Budu\u0107i da ovi krvni sudovi ostaju dilatirani i relaksirani, krvni protok se pobolj\u0161ava i krvni pritisak vra\u0107a na fiziolo\u0161ke granice.<\/p>\n

Beta blokatori: grupa lekova koja se koristi sa ciljem regulisanja i kontrole sr\u010danih aritmija, sa protektivnim dejstvom na srce i prevencijom sr\u010danih napada i hipertenzije.<\/p>\n

Ostali medikamenti u cilju sni\u017eavanja vrednosti krvnog pritiska<\/p>\n

Dodatna medikamentozna terapija mo\u017ee podrazumevati:<\/p>\n

Hirur\u0161ki pristup: hirur\u0161ko uklanjanje kompletne nadbubre\u017ene \u017elezde zajedno sa feohromocitomom. Ostatak zdravog nadbubre\u017enog tkiva preuzima funkciju nedostaju\u0107eg nadbubrega, \u010dime se vrednosti krvnog pritiska vra\u0107aju na normalne vrednosti.<\/p>\n

Terapeutski pristup kod le\u010denja malignih tumora i metastatskih depozita usled feohromocitoma mogu uklju\u010divati slede\u0107e postupke:<\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Radionuklidni tretman: upotrebu radioaktivnih lekova koji se nazivaju radiofarmaceutici u cilju eliminacije kanceroznih \u0107elija<\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Hemoterapija: upotreba izuzetno jakih lekova u cilju uni\u0161tavanja brzorastu\u0107ih kanceroznih \u0107elija<\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0Ciljana terapija karcinoma:\u00a0 upotreba specifi\u010dnih lekova koji interferiraju sa odre\u0111enim molekulima neophodnim za rast i progresiju kanceroznih \u0107elija.<\/p>\n","protected":false},"featured_media":0,"template":"","class_list":["post-71283","disease","type-disease","status-publish","hentry"],"yoast_head":"\nFeohromocitom - Humanitas.net<\/title>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"sr_RS\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Feohromocitom - Humanitas.net\" \/>\n<meta property=\"og:description\" content=\"Definicija Feohromocitom predstavlja retku, obi\u010dno nekanceroznu (benignu) tumorsku promenu nadbubre\u017enog tkiva. Kod svake individue prisutne su dve nadbubre\u017ene \u017elezde, po jedna iznad svakog bubrega. 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