Isifo samangcwaba

Isifo se-Graves sisifo sokuzimela komzimba esikhokelela kwi-thyroid gland (hyperthyroidism). Ukuphazamiseka komzimba yimeko eyenzekayo xa amajoni omzimba ehlasela ngempazamo izicwili ezisempilweni.

Idlala lengqula lilungu elibalulekileyo lenkqubo yonyango. Le ndlala ibekwe ngaphambili entanyeni apho kudibana khona amathambo eekhola. Eli dlala likhupha iihomoni i-thyroxine (T4) kunye ne-triiodothyronine (T3), elawula imetabolism yomzimba. Ukulawula imetabolism kubalulekile ekulawuleni imeko, ubunzima, kunye namandla engqondo nawomzimba.

Xa umzimba wenza i-hormone ye-thyroid eninzi, imeko ibizwa ngokuba yi-hyperthyroidism. (Ukungasebenzi kwe-thyroid kukhokelela kwi-hypothyroidism.)

Isifo samangcwaba sesona sizathu siqhelekileyo sehyperthyroidism. Kungenxa yempendulo yesistim yomzimba engaqhelekanga ebangela ukuba idlala lengqula livelise ihomoni eninzi kakhulu. Isifo samangcwaba sixhaphake kakhulu kubafazi abangaphezulu kweminyaka engama-20.

Abantu abancinci banokuba nezi mpawu:

• Ixhala okanye uvalo, kunye neengxaki zokulala
• Ukwandiswa kwebele emadodeni (kunokwenzeka)
• Iingxaki zokugxila
• Ukudinwa
• Ukuhamba kwamathumbu rhoqo
• Ukulahleka kweenwele
• Ukunganyamezelani kobushushu kunye nokubila okukhulayo
• Ukonyusa umdla wokutya, ngaphandle kokunciphisa umzimba
• Ukuya exesheni ngokungaqhelekanga kwabasetyhini
• Ubuthathaka bemisipha esinqeni nasemagxeni
• Ukuziphatha, kubandakanya ukuba nochuku kunye nomsindo
• Iipilpitations (imvakalelo yokubetha kwentliziyo eyomeleleyo okanye engaqhelekanga)
  
• Ukukhawuleza okanye ukungahambi kakuhle kwentliziyo
• Ukuphefumla okufutshane kunye nomsebenzi
• Ukungcangcazela (ukungcangcazela kwezandla)

Abantu abaninzi abanezifo zamangcwaba baneengxaki ngamehlo abo:

• Iibhola zamehlo zinokubonakala ngathi ziyaphuma kwaye kunokuba buhlungu.
• Amehlo anokuziva ecaphukile, erhawuzelele okanye ekrazula rhoqo.
• Umbono ophindwe kabini unokubakho.
• Ukwehla kombono kunye nomonakalo kwi-cornea nako kunokwenzeka kwiimeko ezinzima.

Abantu abadala banokuba nezi mpawu:

• Ukukhawuleza okanye ukungahambi kakuhle kwentliziyo
• Iintlungu zesifuba
• Ukuphulukana nenkumbulo okanye ukunciphisa uxinzelelo
• Ubuthathaka kunye nokudinwa

Umboneleli wezempilo uya kwenza uvavanyo lomzimba kwaye unokufumanisa ukuba unenqanaba lentliziyo elonyukayo. Uvavanyo lwentamo yakho lunokufumanisa ukuba i-thyroid gland iyandisiwe (goiter).

Olunye uvavanyo lubandakanya:

• Uvavanyo lwegazi ukulinganisa amanqanaba e-TSH, T3, kunye ne-T4 yasimahla
• Ukuthathwa kwe-iodine ye-radioactive kunye nokuskena

Esi sifo sinokuchaphazela iziphumo zovavanyo ezilandelayo:

• I-Orbit CT scan okanye i-ultrasound
• I-thyroid evuselela i-immunoglobulin (TSI)
• Idlala lengqula ye-Thyroxidase (TPO)
• Unyango lwe-anti-TSH receptor antibody (TRAb)

Unyango lujolise ekulawuleni i-thyroid engasebenzi. Amayeza abizwa ngokuba yi-beta-blockers ahlala esetyenziselwa ukunyanga iimpawu zokukhawuleza kwentliziyo, ukubila kunye noxinzelelo kude kube kulawulwa i-hyperthyroidism.

Hyperthyroidism iphathwa ngendlela enye okanye nangaphezulu kwezi zilandelayo:

• Amayeza eAntithyroid anokuthintela okanye atshintshe indlela idlala lengqula elisebenzisa ngayo iodine. Ezi zinokusetyenziselwa ukulawula i-thyroid gland engaphezulu kokuhlinzwa okanye unyango lwe-radioiodine okanye njengonyango olude.
• Unyango lwe-radioiodine apho iodine enemisebe inikwa ngomlomo. Emva koko igxila kwizicubu ze-thyroid kwaye ibangela umonakalo.
• Utyando lunokwenziwa ukususa i-thyroid.

Ukuba unayo unyango lwe-iodine okanye utyando, kuya kufuneka uthathe iihomoni ze-thyroid ebomini bakho bonke. Kungenxa yokuba olu nyango lutshabalalisa okanye lususe idlala.

UKUNYANGWA KWAMEHLO

Ezinye zeengxaki zamehlo ezinxulumene nesifo seGraves zihlala ziphucula emva konyango ngamayeza, ngemitha, okanye ngotyando ukunyanga idlala lengqula eligqithisileyo. Unyango lweRadioiodine ngamanye amaxesha lunokwenza iingxaki zamehlo zibe mbi. Iingxaki zamehlo zimbi kakhulu kubantu abatshayayo, kwanasemva kokuba unyango lwe-hyperthyroidism lunyango.

Ngamanye amaxesha, i-prednisone (iyeza le-steroid elicinezela amajoni omzimba) liyimfuneko ukunciphisa ukucaphuka kwamehlo kunye nokudumba.

Ungadinga ukuwafaka amehlo akho kuvaleke ebusuku ukuthintela ukomisa. Izibuko zelanga kunye namaconsi wamehlo anokunciphisa ukucaphuka kwamehlo. Kwiimeko ezinqabileyo, utyando okanye unyango ngemitha (eyahlukileyo kwi-iodine ene-radioactive) kunokufuneka ukuthintela ukonakaliswa okungaphezulu kweliso kunye nokulahleka kombono.

Isifo samangcwaba sisoloko siphendula kakuhle kunyango. Utyando lwe-thyroid okanye iodine ye-radioactive iya kubangela i-thyroid engasebenzi (hypothyroidism). Ngaphandle kokufumana idosi echanekileyo yokutshintshwa kwehomoni ye-thyroid, i-hypothyroidism inokukhokelela ku:

• Uxinzelelo
• Ukonqena kwengqondo kunye nokwasemzimbeni
• Ukutyeba kwakho
• Ulusu olomileyo
• Ukuqunjelwa
• Ukunyamezelana okubandayo
• Ukuya exesheni ngokungaqhelekanga kwabasetyhini

Tsalela umnikezeli wakho ukuba uneempawu zesifo seMangcwaba. Fowunela kwakhona ukuba iingxaki zamehlo okanye ezinye iimpawu ziba mandundu okanye aziphucuki kunyango.

Yiya kwigumbi likaxakeka okanye fowunela inombolo yongxamiseko yendawo (enje nge-911) ukuba uneempawu zehyperthyroidism:

• Ukunciphisa ukuqonda
• Ifiva
• Ukukhawuleza, ukubetha kwentliziyo ngokungaqhelekanga
• Ukuphefumla ngokukhawuleza

Ukusasaza i-gorotoxic goiter; Hyperthyroidism - amangcwaba; Thyrotoxicosis - Amangcwaba; Exophthalmos - amangcwaba; I-Ophthalmopathy - Amangcwaba; Exophthalmia - Amangcwaba; Ukugqithisa - Amangcwaba

• Amadlala endocrine
• Ukwandiswa kwe-thyroid-scintiscan
• Isifo samangcwaba
• Idlala lengqula

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UJonklaas J, Cooper DS. Idlala lengqula. Ku: IGoldman L, iSchafer AI, ii-eds. Amayeza eGoldman-Cecil. Ngomhla wama-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 213.

UMarcdante KJ, uKleigman RM. Isifo se-thyroid. Ku: UMarcdante KJ, uKliegman RM, ii-eds. UNelson oBalulekileyo kwiPediatrics. Ngomhla we-8. Elsevier; I-2019: isahluko 175.

UMarino M, uVitti P, isifo sikaChiovato L. Amangcwaba. Ku: Jameson JL, De Groot LJ, de Kretser DM, et al, ii-eds. Endocrinology: Abantu abadala kunye nabantwana. Umhla wesi-7. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 82.

Ross DS, Burch HB, Cooper DS, okqhubekayo. Izikhokelo zoMbutho we-Thyroid ye-2016 yokufumanisa isifo kunye nolawulo lwe-hyperthyroidism kunye nezinye izizathu zethrotoxicosis. Idlala lengqula. Ngo-2016; 26 (10): 1343-1421. IINKCUKACHA: 27521067 pubmed.ncbi.nlm.nih.gov/27521067/.