Hyperparathyroidism

Hyperparathyroidism ke boloetse boo litšoelesa tsa parathyroid tse molaleng oa hau li hlahisang hormone e ngata haholo ea parathyroid (PTH).

Ho na le litšoelesa tse 4 tse nyane tsa parathyroid molaleng, haufi kapa tse hokeletsoeng ka lehlakoreng le ka morao la tšoelesa ea qoqotho.

Litšoelesa tsa parathyroid li thusa ho laola ts'ebeliso ea khalsiamo le ho tlosoa ke 'mele. Ba etsa sena ka ho hlahisa hormone ea parathyroid (PTH). PTH e thusa ho laola maemo a calcium, phosphorus le vithamine D maling le masapong.

Ha boemo ba calcium bo le tlase haholo, 'mele o arabela ka ho etsa PTH e eketsehileng. Sena se etsa hore khalsiamo e maling e phahame.

Ha e le 'ngoe kapa tse ling tsa litšoelesa tsa parathyroid li hola, e lebisa ho PTH e ngata haholo. Hangata, sesosa ke hlahala e kotsi ea litšoelesa tsa parathyroid (parathyroid adenoma). Lihlahala tsena tse kotsi li tloaelehile 'me li etsahala ntle le lebaka le tsejoang.

• Lefu lena le atile haholo bathong ba ka holimo ho lilemo tse 60, empa le ka hlaha le ho batho ba baholo. Hyperparathyroidism bongoaneng e sa tloaelehang haholo.
• Basali ba kotsing ea ho ameha ho feta banna.
• Mahlaseli a kotsi hloohong le molaleng a eketsa kotsi.
• Li-syndromes tse ling tsa lefutso (multiple endocrine neoplasia I) li etsa hore ho be bonolo ho ba le hyperparathyroidism.
• Maemong a sa tloaelehang haholo, lefu lena le bakoa ke mofetše oa parathyroid.

Maemo a bongaka a bakang khalsiamo e tlase ea mali kapa phosphate e eketsehang le ona a ka lebisa ho hyperparathyroidism. Maemo a tloaelehileng a kenyelletsa:

• Maemo a etsang hore ho be thata ho 'mele ho tlosa phosphate
• Ho hloleha ha liphio
• Ha ho na calcium e lekaneng lijong
• Kalsiamo e ngata e lahlehile morotong
• Mathata a vithamine D (a ka hlaha ho bana ba sa jeng lijo tse fapaneng, le ho batho ba baholo ba sa fumaneng khanya ea letsatsi letlalong la bona kapa ba nang le vithamine D e fokolang lijong tse kang kamora 'opereishene ea bariatric)
• Mathata a monya limatlafatsi lijong

Hyperparathyroidism hangata e fumanoa ke liteko tse tloaelehileng tsa mali pele matšoao a hlaha.

Matšoao a bakoa haholo ke tšenyo ea litho tsa mmele tse tsoang khalsiamo e phahameng maling, kapa ke tahlehelo ea khalsiamo masapong. Matšoao a ka kenyelletsa:

• Ho opeloa ke masapo kapa bonolo
• Ho sithabela maikutlo le ho lebala
• Ho ikutloa ke khathetse, ke kula ebile ke fokola
• Masapo a fokolang a maoto le matsoho a mokokotlo a ka robehang habonolo
• Ho eketseha ha moroto o hlahisoang mme o hloka ho ntša metsi khafetsa
• Majoe a liphio
• Ho nyekeloa ke pelo le ho lahleheloa ke takatso ea lijo

Mofani oa tlhokomelo ea bophelo o tla etsa tlhahlobo ea 'mele mme a botse ka matšoao.

Liteko tse ka etsoang li kenyelletsa:

• Teko ea mali ea PTH
• Teko ea mali ea calcium
• Alkaline phosphatase
• Phosphorus
• Teko ea moroto oa lihora tse 24

Liteko tsa Bone x-rays le bone mineral density (DXA) li ka thusa ho lemoha ho senyeha ha masapo, ho robeha ha masapo kapa ho nolofatsa masapo.

Lisebelisoa tsa X-ray, ultrasound kapa CT tsa liphio kapa pampitšana ea ho ntša metsi li ka bontša li-calcium calcium kapa blockage.

Ultrasound kapa sesebelisoa sa nyutlelie sa molala (sestamibi) se sebelisetsoa ho bona hore na hlahala e nang le kotsi (adenoma) e tšoeroeng ke parathyroid e baka hyperparathyroidism.

Haeba u na le khalsiamo e eketsehang ka bonolo ’me u se na matšoao, u ka khetha ho ea hlahlojoa khafetsa kapa ho phekoloa.

Haeba u nka qeto ea ho fumana kalafo, e ka kenyelletsa:

• Ho noa maro a mangata ho thibela majoe a liphio ho theha
• Ho ikoetlisa
• Ho se noe mofuta oa pilisi ea metsi e bitsoang thiazide diuretic
• Estrogen bakeng sa basali ba seng ba fetile nako ea ho ilela khoeli
• Ho etsoa opereishene ho tlosa litšoelesa tse feteletseng

Haeba u na le matšoao kapa boemo ba calcium bo phahame haholo, o kanna oa hloka ho buuoa ho tlosa tšoelesa ea parathyroid e hlahisang hormone haholo.

Haeba u na le hyperparathyroidism ho tloha boemong ba bongaka, mofani oa hau a ka fana ka vithamine D, haeba u na le vithamine D e tlase.

Haeba hyperparathyroidism e bakoa ke ho hloleha ha liphio, kalafo e ka kenyelletsa:

• K'halsiamo e eketsehileng le vithamine D
• Ho qoba phosphate lijong
• Meriana cinacalcet (Sensipar)
• Dialysis kapa ho kenyelletsa liphio
• Ho buuoa ka parathyroid, haeba boemo ba parathyroid bo phahama ka mokhoa o sa laoleheng

Ponahalo e ipapisitse le sesosa sa hyperparathyroidism.

Mathata a nako e telele a ka bang teng ha hyperparathyroidism e sa laoloe hantle a kenyelletsa:

• Masapo a fokola, a holofala kapa a ka robeha
• Khatello ea mali e phahameng le lefu la pelo
• Majoe a liphio
• Lefu la nako e telele la liphio

Ho buuoa ka parathyroid gland ho ka baka hypoparathyroidism le tšenyo ea methapo e laolang methapo ea lentsoe.

Hypercalcemia e amanang le parathyroid; Lefu la ho fokola ha masapo - hyperparathyroidism; Ho fokotsa masapo - hyperparathyroidism; Lefu la osteopenia - hyperparathyroidism; Boemo bo phahameng ba calcium - hyperparathyroidism; Lefu le sa foleng la liphio - hyperparathyroidism; Ho hloleha ha liphio - hyperparathyroidism; Feteletseng parathyroid; Ho haella ha vithamine D - hyperparathyroidism

• Litšoelesa tsa Parathyroid

Hollenberg A, Wersinga WM. Mathata a Hyperthyroid. Ka: Melmed S, Auchus RJ, Goldfine AB, Koenig RJ, Rosen CJ, bahlophisi. Buka ea Williams ea Endocrinology. La bo14 la ed. Philadelphia, PA: Elsevier; 2020: khaolo ea 12.

Thakker RV. Litšoelesa tsa parathyroid, hypercalcemia le hypocalcemia. Ka: Goldman L, Schafer AI, li-eds. Phekolo ea Goldman-Cecil. La 26th. Philadelphia, PA: Elsevier; 2020: khaolo ea 232.