I-Parathyroid hyperplasia

I-Parathyroid hyperplasia kukunyusa kwazo zonke iincindi ezi-4 zeparathyroid. Amadlala abangelwa kukungalungelelani abekwe entanyeni, kufutshane okanye ancanyathiselwe kwicala elingasemva le-thyroid gland.

Amadlala e-parathyroid anceda ukulawula ukusetyenziswa kwe-calcium kunye nokususwa komzimba. Benza oku ngokuvelisa ihomoni yeparathyroid (PTH). I-PTH inceda ukulawula i-calcium, i-phosphorus, kunye ne-vitamin D kumanqanaba egazini kwaye kubalulekile kumathambo asempilweni.

I-Parathyroid hyperplasia inokwenzeka kubantu ngaphandle kwembali yosapho yesi sifo, okanye njengenxalenye ye-syndromes ezi-3 ezizuzwe njengelifa:

• Uninzi lwe-endocrine neoplasia I (MEN I)
• AMADODA IIA
• Isolated family hyperparathyroidism

Kubantu abane-syndrome ezuzwe njengelifa, utshintsho oluye lwatshintshwa lusapho. Kufuneka ufumane kuphela ufuzo kumzali omnye ukuze uphuhlise imeko.

• Kwi-MEN I, iingxaki kwiincindi ze-parathyroid zenzeka, kunye nezilonda kwi-pituitary gland kunye ne-pancreas.
• Kwi-MEN IIA, ukusebenza ngaphezulu kwamadlala okubamba imeko ye-parathyroid kuyenzeka, kunye nezilonda kwi-adrenal okanye kwi-thyroid gland.

Iparathyroid hyperplasia engeyonxalenye yesifo esizuze ilifa ixhaphake kakhulu. Kwenzeka ngenxa yezinye iimeko zonyango. Ezona meko zixhaphakileyo ezinokubangela i-parathyroid hyperplasia sisifo sezintso esinganyangekiyo kunye nokusilela okungapheliyo kwe-vitamin D. Kuzo zombini iimeko, iincindi ze-parathyroid ziyanda ngenxa yokuba i-vitamin D kunye namanqanaba e-calcium aphantsi kakhulu.

Iimpawu zingabandakanya:

• Ukuqhekeka kwamathambo okanye iintlungu zethambo
• Ukuqunjelwa
• Ukungabikho kwamandla
• Intlungu yezihlunu
• Isicaphucaphu

Kuya kwenziwa uvavanyo lwegazi ukujonga amanqanaba:

• Ikhalsiyam
• Iphosphorus
• Magnesium
• PTH
• Vitamin D
• Umsebenzi wezintso (i-Creatinine, i-BUN)

Uvavanyo lomchamo lweeyure ezingama-24 lunokwenziwa ukumisela ukuba ingakanani i-calcium ecocwayo ngaphandle komzimba ukuya kumchamo.

I-Bone x-ray kunye novavanyo lokuxinana kwethambo (i-DXA) lunokunceda ekuboneni ukwaphuka, ukulahleka kwethambo kunye nokuthanjiswa kwethambo. Ukuskena kwe-Ultrasound kunye ne-CT kunokwenziwa ukujonga amadlala afanayo entanyeni.

Ukuba i-parathyroid hyperplasia ingenxa yesifo sezintso okanye inqanaba eliphantsi le-vitamin D kwaye ifunyenwe kwangethuba, umboneleli wakho unokucebisa ukuba uthathe i-vitamin D, iziyobisi ezifana ne-vitamin D, kunye namanye amayeza.

Ugqirha luqhele ukwenziwa xa iingqaqambo ze-parathyroid zivelisa i-PTH kakhulu kwaye zibangela iimpawu. Ngokwesiqhelo ama-3/2 amadlala ayasuswa. Izicubu ezishiyekileyo zinokufakwa kwingalo okanye umsipha wentamo. Oku kuvumela ukufikelela ngokulula kwezicubu ukuba iimpawu zibuya. Esi sihlunu sifakelwe ukukhusela umzimba ekubeni ne-PTH encinci, enokubangela amanqanaba asezantsi e-calcium (ukusuka kwi-hypoparathyroidism).

Emva kotyando, inqanaba eliphezulu le-calcium linokuqhubeka okanye libuye. Utyando ngamanye amaxesha kunokubangela i-hypoparathyroidism, eyenza inqanaba legazi le-calcium liphantsi kakhulu.

Parathyroid hyperplasia kunokubangela hyperparathyroidism, nto leyo ekhokelela ekwandeni kwinqanaba calcium.

Iingxaki zibandakanya ukwanda kwecalcium kwizintso, ezinokubangela amatye ezintso, kunye neosteitis fibrosa cystica (ithambile, indawo ebuthathaka emathanjeni).

Utyando ngamanye amaxesha lunokonakalisa imithambo-luvo elawula imithambo yezwi. Oku kunokuchaphazela ukomelela kwelizwi lakho.

Iingxaki zinokubangelwa ngamanye amathumba ayinxalenye ye-MEN syndromes.

Fowunela umnikezeli wakho ukuba:

• Unayo nayiphi na impawu yehypercalcemia
• Unembali yosapho yesifo seMEN

Ukuba unembali yosapho kwii-MEN syndromes, unokufuna ukuvavanywa kofuzo ukukhangela uhlobo olungalunganga. Abo bane-gene engalunganga banokuba novavanyo lokuhlola rhoqo ukufumana naziphi na iimpawu zokuqala.

Ukwandiswa kwamadlala e-parathyroid; Osteoporosis - hyperplasia parathyroid; Ukucuthwa kwethambo - parathyroid hyperplasia; Osteopenia - hyperplasia parathyroid; Inqanaba eliphezulu le-calcium - i-parathyroid hyperplasia; Isifo esinganyangekiyo sezintso - parathyroid hyperplasia; Ukusilela kwezintso - parathyroid hyperplasia; Ukusebenza ngokweqile kweparathyroid - hyperplasia parathyroid

• Amadlala endocrine
• Izibilini zeParathyroid

Ukuthatha i-LM, Kamani D, iRandolph GW. Ukulawulwa kokuphazamiseka kwengqondo. Ku: IFlint PW, uFrancis HW, uHaughey BH, et al, ii-eds. I-Cummings Otolaryngology: Utyando lweNtloko kunye neNtamo. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2021: isahluko 123.

I-Thakker RV. Amadlala parathyroid, hypercalcemia kunye hypocalcemia. Ku: IGoldman L, iSchafer AI, ii-eds. Amayeza eGoldman-Cecil. Ngomhla wama-26. IPhiladelphia, PA: Elsevier; 2020: isahl 232.