Mmekọrịta

Intersex bụ otu ọnọdụ nke ọdịiche dị n'etiti akụkụ mpụga na akụkụ ahụ dị n'ime (ule na ovaries).

Ochie okwu maka ọnọdụ a bụ hermaphroditism. Agbanyeghi na agbakwunyere okwu ochie n’isiokwu a maka ntughari aka, otutu ndi okacha amara, ndi oria na ezin’ulo dochie ha. Na-arịwanye elu, a na-akpọ otu ọnọdụ a nsogbu nke mmepe mmekọahụ (DSDs).

Enwere ike ịkekọrịta Intersex na edemede 4:

• 46, XX njikọ
• 46, XY intersex
• Ezi gonadal intersex
• Mgbagwoju anya ma ọ bụ inteterexed a na-akụwaghị achịkwa

A tụlere nke ọ bụla na nkọwa zuru ezu n'okpuru.

Mara: N’ọtụtụ ụmụaka, enwere ike ghara ịchọpụta ihe kpatara nsogbu mmekọrịta nwoke na nwanyị, ọbụlagodi na usoro nyocha ọhụụ.

46, XX INTERSEX

Onye ahu nwere chromosom nke nwanyi, ovaries nke nwanyi, ma na mpụga (n’èzí) ihe eji amu nwoke ma obu nwoke. Nke a na - abụkarị nsonaazụ nke nwa ebu n'afọ nke nwanyị ekpughere na oke homonụ nwoke tupu amụọ ya. Ejiri labia ("egbugbere ọnụ" ma ọ bụ okpukpu akpụkpọ anụ nke ụmụ nwanyị na-apụ apụ) fuse, na nwanyị na-agba ume na-ebuwanye ibu dị ka amụ. N’ọtụtụ ọnọdụ, onye a na-enwekarị akpanwa na tubes. A na-akpọkwa ọnọdụ a 46, XX with virilization. A na-akpọbu ya pseudohermaphroditism ụmụ nwanyị. Enwere ọtụtụ ihe kpatara ya:

• Congenital adrenal hyperplasia (ihe kacha ebute).
• Hụmonụ nwoke (dị ka testosterone) nke nne na-ewere ma ọ bụ zutere ya n'oge afọ ime.
• Nwa nwoke na-emepụta hormone nwoke na nne: Ndị a na-abụkarị etuto ovarian. Ndi nne nwere umu 46, XX intersex kwesiri ka enyocha ha belụsọ na onwere ihe ozo doro anya.
• Aromatase erughi: Onye a nwere ike ọ gaghị ahụta ruo mgbe ọ ga-etolite. Aromatase bụ enzyme nke na-agbanwekarị homonụ nwoke na homonụ nwanyị. Ọrụ aromatase nke ukwuu nwere ike iduga estrogen (hormone nwanyi); pere mpe na 46, XX intersex. N'oge uto, ụmụaka iri abụọ na abụọ a, ndị a zụlitere dị ka ụmụ agbọghọ, nwere ike ịmalite ịkpa àgwà nwoke.

46, XY INTERSEX

Onye nwere chromosome nke nwoke, mana akụkụ ahụ dị na mpụga etoliteghi ma ọ bụ bụrụ nwanyị doro anya. N'ime, ule nwere ike ịbụ nke nkịtị, emezighị emezi, ma ọ bụ na anọghị. A na-akpọkwa ọnọdụ a 46, XY with undervirilization. A na-akpọbu ya pseudohermaphroditism nke nwoke. Mepụta akụkụ nwoke na nwanyị na-abụghị nwoke na nwanyị na-adabere na nguzozi kwesịrị ekwesị n'etiti homonụ nwoke na nwanyị. Ya mere, ọ na-achọ mmepụta zuru oke na ọrụ nke homonụ nwoke. 46, XY intersex nwere ọtụtụ ihe nwere ike ịkpata:

• Nsogbu nke ule: Ule a na - eweputa homonụ nwoke. Ọ bụrụ na testes adịghị etolite nke ọma, ọ ga - eduga na enweghị ike. Enwere ọtụtụ ihe nwere ike ịkpata nke a, gụnyere XY ezigbo gonadal dysgenesis.
• Nsogbu banyere ịkpụzi testosterone: etolitere Testosterone site na usoro usoro. Usoro nke ọ bụla chọrọ enzyme dị iche. Enweghị ike na nke ọ bụla n'ime enzymes ndị a nwere ike ịkpata testosterone na-ezughị ezu ma mepụta ọrịa dị iche nke 46, XY intersex. Dị dị iche iche nke adrenal hyperplasia nke nwere ike ịdaba na ụdị a.
• Nsogbu na iji testosterone: peoplefọdụ ndị nwere ule nkịtị ma mee ezigbo testosterone, mana ha nwere 46, XY intersex n'ihi ọnọdụ dịka ụkọ 5-alpha-reductase ma ọ bụ ọrịa etrogen insensitivity (AIS).
• Ndị nwere ụkọ 5-alpha-reductase enweghị enzyme dị mkpa iji tọghata testosterone ka dihydrotestosterone (DHT). Enwere ma ọ dịkarịa ala ụdị 5 dị iche iche nke 5-alpha-reductase. Fọdụ n'ime ụmụaka ahụ nwere nsogbu nwoke na nwanyị, ụfọdụ nwere usoro ọmụmụ nwanyị, ọtụtụ nwere ihe dị n'etiti. Ihe ka ọtụtụ na-agbanwe na akụkụ nwoke na nwanyị na mpụga n'oge oge.
• AIS bụ ihe kachasị akpata 46, XY intersex. Ọ na-akpọ ya testicular feminization. N'ebe a, homonụ ahụ niile bụ ihe dị mma, mana ndị nabatara homonụ nwoke anaghị arụ ọrụ nke ọma. Enwere ntụpọ dị iche iche dị iche iche 150 ka achọpụtara ruo ugbu a, na nke ọ bụla na-ebute ụdị AIS dị iche.

EZIOKWU GONADAL INTERSEX

Onye ahu aghaghi inwe ovarian na testicular tissue. Nke a nwere ike ịdị n'otu gonad (ovotestis), ma ọ bụ onye ahụ nwere ike nwee 1 ovary na 1 testis. Onye ahụ nwere ike ịnwe chromosome XX, ma ọ bụ chromosomes nke XY, ma ọ bụ ha abụọ. Mkpụrụ akụkụ ahụ dị na mpụga nwere ike bụrụ ihe edoghị anya ma ọ bụ nwee ike iyi nwanyị ma ọ bụ nwoke. A na-akpọ ọnọdụ a ezi hermaphroditism. N'ọtụtụ ndị mmadụ nwere ezigbo gonadal intersex, a maghị ihe kpatara ya, ọ bụ ezie na n'ọmụmụ anụmanụ ụfọdụ, ejikọtara ya na ikpughe na pesticides ugbo nkịtị.

Ihe mgbagwoju anya ma obu ihe omuma nke INTERSEX nke mmekorita nwoke na nwanyi

Ọtụtụ nhazi chromosome ndị ọzọ na-abụghị 46, XX ma ọ bụ 46, XY nwere ike ịkpata nsogbu nke mmepe mmekọahụ. Ndị a gụnyere 45, XO (naanị otu X chromosome), na 47, XXY, 47, XXX - okwu abụọ a nwere nmekọ nwoke na nwanyị, ma X ma ọ bụ Y. Nsogbu ndị a anaghị ebute ọnọdụ ebe enwere nghọtahie n'etiti ime. na mpụga genitalia. Agbanyeghị, enwere ike ịnwe nsogbu na ogo agụụ mmekọahụ, mmekorita nwoke na nwanyị na ọnụ ọgụgụ mgbanwe nke chromosomes mmekọahụ.

Ihe mgbaàmà ndị metụtara intersex ga-adabere na ihe kpatara ya. Ha nwere ike ịgụnye:

• Okpukpo genitalia na amu
• Micropenis
• Clitoromegaly (nke gbasara)
• Nlekọta ihu na labial
• O doro anya na ule a na-achọghị (nke nwere ike bụrụ ovaries) na ụmụ nwoke
• Igwe umu mmadu ma obu inguinal (ukwu) (nke nwere ike ibu ule) n'ime umuaka
• Hypospadias (oghere nke amụ bụ ebe ọzọ na-abụghị n'ọnụ; na nwanyị, urethra [urinal canal] ga-emepe n’ime ikpu)
• Ma ọ bụghị na-ahụkarị-egosi genitalia na nwa
• Ọdịdị electrolyte
• Na-egbu oge ma ọ bụ na-anọghị oge
• Mgbanwe ndị a na-atụghị anya ha n’oge uto

Enwere ike ịme ule na ule ndị a:

• Nyocha Chromosome
• Akụkụ homonụ (dịka ọmụmaatụ, ọkwa testosterone)
• Ọnwụnwa na-akpali akpali
• Nyocha Electrolyte
• Specific molekụla ule
• Endoscopic exam (iji nyochaa enweghị ma ọ bụ ọnụnọ nke ikpu ma ọ bụ cervix)
• Ultrasound ma ọ bụ MRI iji nyochaa ma akụkụ anụ ahụ dị n'ime (dịka ọmụmaatụ, akpanwa)

Dika odi, otu ndi okacha amara nke aru aru na intersex kwesiri ijiko aka nghota ma ghota nwata ya na intersex ma kwado ezinulo.

Ndị nne na nna kwesịrị ịghọta esemokwu na mgbanwe n'ịgwọ intersex n'afọ ndị na-adịbeghị anya.N'oge gara aga, echiche e nwere ebe nile bụ na ọ kachasị mma ịkọwa nwoke na nwanyị ngwa ngwa o kwere mee. Nke a na-adaberekarị na akụkụ ahụ nke akụkụ karịa na okike chromosomal. Agwara ndi nne na nna ka ha ghara inwe obi ojoo n’uche ha gbasara okike nwata. A na-atụkarị aro ịwa ahụ ngwa ngwa. A ga-ewepụ ovarian ma ọ bụ testicular anụ ahụ site na nwoke ma ọ bụ nwanyị ọzọ. N'ozuzu, e lere ya anya ka ọ dị mfe ịmaliteghachi akụkụ nwanyị karịa ọrụ nwoke na nwanyị na-arụ ọrụ, yabụ ọ bụrụ na nhọrọ "ziri ezi" edoghị anya, a na-ekenye nwata ahụ ka ọ bụrụ nwa agbọghọ.

N'oge na-adịbeghị anya, echiche ọtụtụ ndị ọkachamara agbanweela. Nkwanye ugwu dị ukwuu maka ihe mgbagwoju anya nke inwe mmekọahụ na-eduga ha ime ka ha kwubie na akụkụ ụmụ nwanyị kachasị mma nwere ike ọ gaghị abụ ihe okike karịa akụkụ nwoke na nwanyị kachasị mma, ọbụlagodi na nwughari ahụ "dị mfe." Tụkwasị na nke a, ihe ndị ọzọ nwere ike ịdị mkpa karịa afọ ojuju okike karịa ịrụ ọrụ nke akụkụ ahụ. Chromosomal, neural, hormonal, psychological, na omume nwere ike imetụta njirimara nwoke na nwanyị.

Ọtụtụ ndị ọkachamara ugbu a na-agba ume igbu oge ịwa ahụ doro anya maka ogologo oge ahụike, na itinye aka na nwatakịrị ahụ na mkpebi okike.

N'ụzọ doro anya, mmekọrịta nwoke na nwanyị bụ nsogbu dị mgbagwoju anya, usoro ọgwụgwọ ya na-arụpụta ihe dị nkenke na ogologo oge. Azịza kachasị mma ga-adabere n'ọtụtụ ihe, gụnyere ihe kpatara kpatara intersex. Ọ kasị mma iwepụta oge iji ghọta ihe ndị ahụ tupu ị gbaba ngwa ngwa n'ime mkpebi. Otu nkwado nkwado intersex nwere ike inyere aka mee ka ezinụlọ mara nchọpụta ọhụrụ, ma nwee ike inye obodo nke ezinụlọ ndị ọzọ, ụmụaka, na ndị okenye tozuru otu nsogbu ahụ.

Ndị otu nkwado dị ezigbo mkpa maka ezinụlọ na-emekọ ihe na intersex.

Dị iche iche na-akwado iche iche nwere ike iche na echiche ha banyere nke a dị ezigbo mwute isiokwu. Chọọ nke na-akwado echiche gị na mmetụta gị na isiokwu ahụ.

Organizationstù ndị a na-enye ozi ndị ọzọ:

• Association for X na Y chromosome ọdịiche - genetic.org
• Ebumnuche CARES - www.caresfoundation.org/
• Intersex Society nke North America - isna.org
• Society Turner Syndrome nke United States - www.turnersyndrome.org/
• 48, XXYY - XXYY Project - genetic.org/variations/about-xxyy/

Biko lee ozi gbasara ọnọdụ onye ọ bụla. Ihe prognosis na-adabere na ihe kpatara intersex. Site na nghọta, nkwado, na ọgwụgwọ kwesịrị ekwesị, echiche zuru oke dị oke mma.

Ọ bụrụ n’ịchọpụta na nwa gị nwere nsogbu akụkụ ahụ ọzọ ma ọ bụ mmepe mmekọrịta nwoke na nwanyị, gị na onye nlekọta ahụike gị kwulite ya.

Ọgba aghara nke inwe mmekọahụ; DSDs; Pseudohermaphroditism; Matù Hermaphroditism; Hermaphrodite

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Donohoue PA. Nsogbu nke inwe mmekọahụ. Na: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Akwụkwọ ọgụgụ nke Ọrịa edimụaka. 21nke. Philadelphia, PA: Elsevier; 2020: isi 606.

Nnenna Onwuka Bịakwute nwa ọhụrụ nwere nsogbu a na-enyo enyo nke mmepe mmekọahụ. Pediatr Ọrịa North Am. 2015; 62 (4): 983-999. PMID: 26210628 www.ncbi.nlm.nih.gov/pubmed/26210628.