Hyperparathyroidism

Hyperparathyroidism ndimatenda omwe mafinya am'mitsempha mwanu amatulutsa mahomoni ochulukirapo (PTH).

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Matenda a parathyroid amathandiza kuchepetsa kugwiritsidwa ntchito kwa calcium ndi thupi. Amachita izi popanga mahomoni otchedwa parathyroid (PTH). PTH imathandiza kuchepetsa calcium, phosphorus, ndi mavitamini D m'magazi ndi mafupa.

Mlingo wa calcium ukakhala wotsika kwambiri, thupi limayankha popanga PTH yambiri. Izi zimapangitsa kuchuluka kwa calcium m'magazi kukwera.

Pamene imodzi kapena zingapo zamatenda ophatikizana zimakula, zimabweretsa PTH yochulukirapo. Nthawi zambiri, chifukwa chake ndi chotupa chosaopsa cha ma gland a parathyroid (parathyroid adenoma). Zotupa zopwetekazi ndizofala ndipo zimachitika popanda chifukwa chodziwika.

• Matendawa amapezeka kwambiri kwa anthu azaka zopitilira 60, koma amathanso kupezeka kwa achikulire. Hyperparathyroidism muubwana ndizachilendo kwambiri.
• Amayi ndi omwe amakhudzidwa kwambiri kuposa amuna.
• Kutentha kwa mutu ndi khosi kumawonjezera ngozi.
• Ma syndromes ena amtundu (angapo endocrine neoplasia I) zimapangitsa kuti akhale ndi hyperparathyroidism.
• Nthawi zambiri, matendawa amayamba chifukwa cha khansa ya parathyroid.

Zochitika zamankhwala zomwe zimayambitsa calcium yotsika kapena kuchulukitsa kwa phosphate zitha kuchititsanso hyperparathyroidism. Zomwe zimachitika ndi monga:

• Zinthu zomwe zimapangitsa kuti thupi likhale lovuta kuchotsa phosphate
• Impso kulephera
• Kalisiamu wokwanira mu zakudya
• Kashiamu wambiri amatayika mumkodzo
• Matenda a Vitamini D (amatha kupezeka mwa ana omwe samadya zakudya zosiyanasiyana, komanso kwa achikulire omwe sapeza kuwala kokwanira pakhungu lawo kapena omwe samadya vitamini D pachakudya monga pambuyo pa opaleshoni ya bariatric)
• Mavuto oyamwa zakudya

Hyperparathyroidism nthawi zambiri imapezeka ndi kuyezetsa magazi koyamba zizindikiro zisanachitike.

Zizindikiro zimayambitsidwa chifukwa cha kuwonongeka kwa ziwalo kuchokera kumtunda wa calcium m'magazi, kapena kutayika kwa calcium m'mafupa. Zizindikiro zimatha kuphatikiza:

• Kupweteka kwa mafupa kapena kukoma
• Kukhumudwa ndi kuiwala
• Kumva kutopa, kudwala, ndi kufooka
• Mafupa osalimba amiyendo ndi msana omwe amatha kuthyoka mosavuta
• Kuchuluka kwamkodzo komwe kumapangidwa ndikusowa kukodza pafupipafupi
• Miyala ya impso
• Nsautso ndi kusowa kwa njala

Wothandizira zaumoyo adzayesa thupi ndikufunsa za zizindikiro.

Mayeso omwe angachitike ndi awa:

• Kuyesa magazi kwa PTH
• Kuyesa magazi a calcium
• Zamchere phosphatase
• Phosphorus
• Kuyesa mkodzo kwa maola 24

Mayeso a mafupa x-rays ndi mafupa (DXA) angathandize kuzindikira kuti mafupa atayika, amathyoka, kapena amachepetsa mafupa.

Ma X-ray, ultrasound, kapena CT a impso kapena thirakiti amatha kuwonetsa calcium kapena kutsekeka.

Ultrasound kapena mankhwala a nyukiliya osanthula khosi (sestamibi) amagwiritsidwa ntchito kuti awone ngati chotupa chosaopsa (adenoma) m'matumbo a parathyroid chikuyambitsa hyperparathyroidism.

Ngati muli ndi calcium yowonjezeka pang'ono ndipo mulibe zizindikilo, mutha kusankha kukayezetsa pafupipafupi kapena kuchiritsidwa.

Ngati mwasankha kulandira chithandizo, atha kukhala:

• Kumwa madzi ambiri kupewa miyala ya impso
• Kuchita masewera olimbitsa thupi
• Osatenga mtundu wa mapiritsi amadzi otchedwa thiazide diuretic
• Estrogen kwa amayi omwe adutsa msambo
• Kuchita opareshoni kuti muchotse gland

Ngati muli ndi zizindikilo kapena kuti calcium yanu ndiyokwera kwambiri, mungafunike kuchitidwa opaleshoni kuti muchotse chithokomiro chomwe chimatulutsa timadzi tambiri.

Ngati muli ndi hyperparathyroidism kuchipatala, omwe amakupatsirani mankhwalawa amatha kukupatsani vitamini D, ngati muli ndi vitamini D wochepa kwambiri.

Ngati hyperparathyroidism imayamba chifukwa cha kulephera kwa impso, chithandizo chitha kuphatikizira:

• Kalasi yowonjezera ndi vitamini D
• Kupewa phosphate mu zakudya
• Mankhwala cinacalcet (Sensipar)
• Dialysis kapena kumuika impso
• Kuchita opaleshoni ya parathyroid, ngati gawo la parathyroid limakhala lokwera mosalamulirika

Chiwonetsero chimadalira chifukwa cha hyperparathyroidism.

Mavuto a nthawi yayitali omwe amatha kuchitika ngati hyperparathyroidism sakulamulidwa bwino ndi awa:

• Mafupa amafooka, kupunduka, kapena kutha
• Kuthamanga kwa magazi ndi matenda a mtima
• Miyala ya impso
• Matenda a impso a nthawi yayitali

Opaleshoni ya gland ya parathyroid imatha kubweretsa hypoparathyroidism ndikuwononga mitsempha yomwe imayendetsa zingwe zamawu.

Hypercalcemia yokhudzana ndi parathyroid; Kufooka kwa mafupa - hyperparathyroidism; Mafupa kupatulira - hyperparathyroidism; Osteopenia - hyperparathyroidism; Mlingo wa calcium - hyperparathyroidism; Matenda a impso - hyperparathyroidism; Impso kulephera - hyperparathyroidism; Opera parathyroid; Kulephera kwa Vitamini D - hyperparathyroidism

• Matenda a Parathyroid

Hollenberg A, Wersinga WM. Matenda a Hyperthyroid. Mu: Melmed S, Auchus RJ, Goldfine AB, Koenig RJ, Rosen CJ, olemba. Buku la Williams la Endocrinology. Wolemba 14th. Philadelphia, PA: Elsevier; 2020: mutu 12.

Thakker RV. Matenda a parathyroid, hypercalcemia ndi hypocalcemia. Mu: Goldman L, Schafer AI, olemba. Mankhwala a Goldman-Cecil. 26 wa. Philadelphia, PA: Elsevier; 2020: chap 232.