Hyperparathyroidism

I-Hyperparathyroidism sisiphazamiso apho amadlala e-parathyroid entanyeni yakho avelisa kakhulu ihomoni yeparathyroid (PTH).

Kukho iincindi ze-parathyroid ezincinci ezi-4 entanyeni, kufutshane okanye ziqhotyoshelwe 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 egazi kunye nethambo.

Xa inqanaba lecalcium liphantsi kakhulu, umzimba uphendula ngokwenza iPTH engaphezulu. Oku kubangela ukuba inqanaba le-calcium egazini lenyuke.

Xa idlala elinye okanye nangaphezulu le-parathyroid ikhula ngakumbi, ikhokelela kwi-PTH kakhulu. Rhoqo, unobangela sisifo esibuhlungu sedlala yeparathyroid (parathyroid adenoma). Ezi zicubu ezinobungozi ziqhelekile kwaye zenzeka ngaphandle kwesizathu esaziwayo.

• Esi sifo sixhaphake kakhulu kubantu abangaphezulu kweminyaka engama-60, kodwa sinokubakho nakubantu abadala abancinci. Hyperparathyroidism ebuntwaneni ayiqhelekanga kakhulu.
• Abasetyhini ngabona banokuchaphazeleka kunamadoda.
• Imitha yentloko kunye nentamo yonyusa umngcipheko.
• Ezinye ii-syndromes zemfuza (ii-endocrine neoplasia ezininzi) zenza ukuba kube lula ukuba ne-hyperparathyroidism.
• Kwiimeko ezinqabileyo kakhulu, esi sifo sibangelwa ngumhlaza weparathyroid.

Iimeko zonyango ezibangela i-calcium ephantsi yegazi okanye ukunyuka kwe-phosphate kunokukhokelela kwi-hyperparathyroidism. Iimeko eziqhelekileyo zibandakanya:

• Iimeko ezenza kube nzima ukuba umzimba ususe i-phosphate
• Ukungaphumeleli kwezintso
• Ayonelanga i-calcium ekutyeni
• I-calcium eninzi ilahlekile kumchamo
• Ukuphazamiseka kukaVitamin D (kunokwenzeka kubantwana abangadli kutya okwahlukeneyo, nakubantu abadala abangakufumaniyo ukukhanya kwelanga ngokwaneleyo kulusu lwabo okanye abanokungeniswa kakuhle kwe-vitamin D ekutyeni nasemva kotyando lwe-bariatric)
• Iingxaki zokufunxa izondlo ekutyeni

I-Hyperparathyroidism ihlala ichongwa kuvavanyo lwegazi oluqhelekileyo ngaphambi kokuba kuvele iimpawu.

Iimpawu zibangelwa kakhulu kukonakala kwamalungu avela kwinqanaba eliphezulu le-calcium egazini, okanye ilahleko ye-calcium emathanjeni. Iimpawu zingabandakanya:

• Intlungu yethambo okanye ukuthamba
• Uxinzelelo kunye nokulibala
• Ndiziva ndidiniwe, ndigula, kwaye ndibuthathaka
• Amathambo aqinileyo emilenzeni kunye nomqolo onokuqhekeka ngokulula
• Ukonyuka kwenani lomchamo ovelisiweyo kwaye kufuneka uchame rhoqo
• Amatye eentso
• Isicaphucaphu kunye nokuphelelwa ngumdla wokutya

Umboneleli wezempilo uya kwenza uvavanyo lomzimba kwaye abuze malunga neempawu.

Uvavanyo olunokwenziwa lunokubandakanya:

• Uvavanyo lwegazi lwe-PTH
• Uvavanyo lwegazi lweCalcium
• I-alkaline phosphatase
• Iphosphorus
• Uvavanyo lomchamo lweeyure ezingama-24

Uvavanyo lwe-Bone x-ray kunye ne-bone mineral density (DXA) inokunceda ekufumaneni ukulahleka kwethambo, ukwaphuka kwamathambo, okanye ukuthambisa kwethambo.

I-X-ray, i-ultrasound, okanye i-CT scan yeentso okanye i-urinary tract ingabonisa i-calcium deposits okanye ukuvalwa.

I-Ultrasound okanye unyango lwamayeza enyukliya entanyeni (sestamibi) isetyenziselwa ukubona ukuba ngaba isisu esibi (adenoma) kwi-parathyroid gland ibangela i-hyperparathyroidism.

Ukuba unenqanaba elinyusiweyo le-calcium kwaye awunazo iimpawu, unokukhetha ukuba uhlolwe rhoqo okanye uphathwe.

Ukuba uthatha isigqibo sokuba ufumane unyango, kunokubandakanya:

• Ukusela ulwelo oluninzi ukunqanda amatye ezintso ukuba angakheki
• Ukuzivocavoca
• Ungathathi uhlobo lwepilisi yamanzi ebizwa ngokuba yi-thiazide diuretic
• I-Estrogen yabasetyhini abadlulile kwixesha lokuyeka ukuya exesheni
• Ukwenza utyando ukususa amadlala angaphezulu

Ukuba unempawu okanye inqanaba lakho le-calcium liphezulu kakhulu, unokufuna utyando ukususa i-parathyroid gland evelisa ngaphezulu ihomoni.

Ukuba une-hyperparathyroidism evela kwimeko yonyango, umboneleli wakho unokumisela i-vitamin D, ukuba une-vitamin D esezantsi.

Ukuba i-hyperparathyroidism ibangelwa kukusilela kwezintso, unyango lunokubandakanya:

• I-calcium eyongezelelweyo kunye ne-vitamin D
• Ukuphepha i-phosphate ekudleni
• Iyeza i-cinacalcet (iSensipar)
• I-Dialysis okanye ukufakelwa kwezintso
• Utyando lweparathyroid, ukuba inqanaba lokungakhathali liphezulu ngokungalawulekiyo

Imbonakalo ixhomekeke kwisizathu sehyperparathyroidism.

Iingxaki zexesha elide ezinokuthi zenzeke xa i-hyperparathyroidism ingalawulwa kakuhle ibandakanya:

• Amathambo aba buthathaka, akhubazeke, okanye aphuke
• Uxinzelelo lwegazi kunye nesifo sentliziyo
• Amatye eentso
• Isifo sezintso sexesha elide

Utyando lwe-Parathyroid gland lunokubangela i-hypoparathyroidism kunye nomonakalo kwimithambo-luvo elawula iintambo zezwi.

I-hypercalcemia enxulumene neparathyroid; Osteoporosis - hyperparathyroidism; Ukucoca amathambo - hyperparathyroidism; Osteopenia - hyperparathyroidism; Inqanaba eliphezulu le-calcium - hyperparathyroidism; Isifo esinganyangekiyo sezintso - hyperparathyroidism; Ukusilela kwezintso - hyperparathyroidism; Ukugqithisa ngokweqile; Ukusilela kweVitamin D - hyperparathyroidism

• Izibilini zeParathyroid

IHollenberg A, iWiersinga WM. Ukuphazamiseka kwehyperthyroid. Ku: UMelmed S, uAuchus RJ, uGoldfine AB, uKoenig RJ, uRosen CJ, ii-eds. Incwadi ebhaliweyo kaWilliam ye-Endocrinology. Umhla we-14. IPhiladelphia, PA: Elsevier; 2020: isahl 12.

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.