Isifo samathuna

Isifo se-Graves yisifo sokuzilimaza esiholela ekuguleni kwe-thyroid okungaphezu kwamandla (hyperthyroidism). Isifo sokuzivikela komzimba yisimo esenzeka lapho amasosha omzimba ehlasela ngephutha izicubu ezinempilo.

Indlala yegilo iyisitho esibalulekile sohlelo lwe-endocrine. Le ndlala itholakala ngaphambili entanyeni ngenhla lapho kuhlangana khona amathambo ekhololo. Le ndlala ikhipha ama-hormone thyroxine (T4) kanye ne-triiodothyronine (T3), elawula imetabolism yomzimba. Ukulawula imetabolism kubalulekile ekulawuleni imizwa, isisindo, namazinga engqondo nangokomzimba.

Lapho umzimba wenza i-hormone yegilo eningi kakhulu, lesi simo sibizwa ngokuthi yi-hyperthyroidism. (I-thyroid engasebenzi iholela ku-hypothyroidism.)

Isifo samathuna yisona sizathu esivame kakhulu se-hyperthyroidism. Kungenxa yempendulo yesistimu yomzimba engajwayelekile edala ukuthi indlala yegilo ikhiqize i-hormone yegilo eningi kakhulu. Isifo samathuna sivame kakhulu kwabesifazane abaneminyaka engaphezu kwengama-20. Kodwa lesi sifo singenzeka noma ngasiphi isikhathi futhi singathinta nabesilisa.

Abantu abasha bangaba nalezi zimpawu:

• Ukukhathazeka noma ukwethuka, kanye nezinkinga zokulala
• Ukukhuliswa kwamabele emadodeni (kungenzeka)
• Izinkinga ukugxila
• Ukukhathala
• Ukuhamba kwamathumbu kaningi
• Ukulahleka kwezinwele
• Ukungabekezelelani kokushisa nokujuluka okwandayo
• Ukwanda kwesifiso, yize ulahlekelwe isisindo
• Isikhathi esingajwayelekile sokuya esikhathini kwabesifazane
• Ubuthakathaka bemisipha yezinqulu namahlombe
• Isimo sengqondo, kufaka phakathi ukucasuka nentukuthelo
• Ukushaya ngonyawo (ukuzwa ukushaya kwenhliziyo okuqinile noma okungavamile)
  
• Ukushaya kwenhliziyo okusheshayo noma okungajwayelekile
• Ukuphefumula ngomsebenzi
• Ukuqhaqhazela (ukuthuthumela kwezandla)

Abantu abaningi abanezifo ze-Graves banezinkinga ngamehlo abo:

• Izinhlamvu zamehlo zingabonakala sengathi ziyaxhuma futhi zingaba buhlungu.
• Amehlo angazizwa ecasukile, eluma noma eklebhuka kaningi.
• Umbono ophindwe kabili kungenzeka ubekhona.
• Ukwehla kombono nokulimala kwe-cornea nakho kungenzeka ezimweni ezinzima.

Abantu asebekhulile bangaba nalezi zimpawu:

• Ukushaya kwenhliziyo okusheshayo noma okungajwayelekile
• Ubuhlungu besifuba
• Ukulahleka kwememori noma ukuncipha kokuhlushwa
• Ubuthakathaka nokukhathala

Umhlinzeki wezokunakekelwa kwempilo uzokwenza ukuhlolwa komzimba futhi angathola ukuthi unenhliziyo eyandayo. Ukuhlolwa kwentamo yakho kungathola ukuthi indlala yakho yegilo ikhulisiwe (goiter).

Ezinye izivivinyo zifaka:

• Ukuhlolwa kwegazi ukukala amazinga we-TSH, T3, ne-T4 yamahhala
• Ukuthathwa nokuskena kwe-iodine enemisebe

Lesi sifo singathinta nemiphumela yokuhlolwa elandelayo:

• I-Orbit CT scan noma i-ultrasound
• I-immunoglobulin evuselela indlala yegilo (TSI)
• Igciwane lesandulela ngculazi i-peroxidase (TPO)
• I-anti-TSH receptor antibody (TRAb)

Ukwelashwa kuhloswe ukulawula i-thyroid yakho engasebenzi ngokweqile. Imithi ebizwa nge-beta-blockers ivame ukusetshenziselwa ukwelapha izimpawu zokushaya kwenhliziyo okusheshayo, ukujuluka nokukhathazeka kuze kube yilapho i-hyperthyroidism ilawulwa.

I-Hyperthyroidism iphathwa ngokulandelayo noma ngaphezulu kokulandelayo:

• Imithi ye-Antithyroid ingavimba noma iguqule ukuthi indlala yegilo isebenzisa iodine kanjani. Lokhu kungasetshenziselwa ukulawula indlala yegilo engasebenzi ngokweqile ngaphambi kokuhlinzwa noma ukwelashwa kwe-radioiodine noma njengokwelashwa kwesikhathi eside.
• Ukwelashwa kwe-radioiodine lapho iodine enemisebe inikezwa ngomlomo. Bese igxila kwizicubu ze-thyroid ezedlulele futhi idale umonakalo.
• Ukuhlinzwa kungenziwa ukususa i-thyroid.

Uma uke welashwa noma wahlinzwa iodine enemisebe, kuzodingeka uthathe ama-hormone e-thyroid esikhundleni sempilo yakho yonke. Lokhu kungenxa yokuthi lezi zindlela zokwelapha zibulala noma zisuse indlala.

UKWELASHWA KWamehlo

Ezinye zezinkinga zamehlo ezihlobene nesifo i-Graves zivame ukuba ngcono ngemuva kokwelashwa ngemithi, ngemisebe, noma ngokuhlinzwa ukwelapha i-thyroid engasebenzi ngokweqile. Ukwelashwa kwe-Radioiodine kwesinye isikhathi kungenza izinkinga zamehlo zibe zimbi kakhulu. Izinkinga zamehlo zimbi kakhulu kubantu ababhemayo, noma ngabe selashwa i-hyperthyroidism.

Kwesinye isikhathi, i-prednisone (umuthi we-steroid ocindezela amasosha omzimba) uyadingeka ukunciphisa ukucasuka kwamehlo nokuvuvukala.

Ungadinga ukuthinta amehlo akho uvale ebusuku ukuvimbela ukoma. Izibuko zelanga namaconsi wamehlo kunganciphisa ukucasuka kwamehlo. Ezimweni ezingavamile, ukuhlinzwa noma ukwelashwa ngemisebe (okungafani ne-iodine enemisebe) kungadingeka ukuvimbela ukulimala okuqhubekayo esweni nokulahleka kombono.

Isifo samathuna sivame ukuphendula kahle ekwelashweni. Ukuhlinzwa kwendlala yegilo noma iodine enemisebe ngokuvamile kuzodala i-thyroid engasebenzi kahle (i-hypothyroidism). Ngaphandle kokuthola isilinganiso esifanele sokushintshwa kwehomoni ye-thyroid, i-hypothyroidism ingaholela ku:

• Ukucindezeleka
• Ubuvila ngokwengqondo nangokomzimba
• Ukuzuza kwesisindo
• Isikhumba esomile
• Ukuqunjelwa
• Ukungabekezelelani okubandayo
• Izikhathi ezingavamile zokuya esikhathini kwabesifazane

Shayela umhlinzeki wakho uma unezimpawu zesifo se-Graves. Fonela futhi uma izinkinga zamehlo akho noma ezinye izimpawu ziba zimbi kakhulu noma zingathuthuki ngokwelashwa.

Iya egumbini labezimo eziphuthumayo noma ushayele inombolo yendawo ephuthumayo (efana ne-911) uma unezimpawu ze-hyperthyroidism nge:

• Nciphisa ukwazi
• Imfiva
• Ngokushesha, ukushaya kwenhliziyo okungajwayelekile
• Ukuphefumula okungazelelwe

Ukusabalalisa i-goiter ye-thyrotoxic; Hyperthyroidism - Amathuna; I-Thyrotoxicosis - Amathuna; Ama-Exophthalmos - Amathuna; I-Ophthalmopathy - Amathuna; I-Exophthalmia - Amathuna; Ukushiswa ngokweqile - Amathuna

• Izindlala ze-Endocrine
• Ukwandiswa kwe-thyroid - i-scintiscan
• Isifo samathuna
• Indlala yegilo

IHollenberg A, iWiersinga WM. Izinkinga ze-Hyperthyroid. Ku: Melmed S, Auchus RJ, Golfine AB, Koenig RJ, Rosen CJ, abahleli. Incwadi kaWilliams ye-Endocrinology. Umhlaka 14. IPhiladelphia, PA: Elsevier; 2020: isahluko 12.

UJonklaas J, Cooper DS. Indlala yegilo. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 213.

UMarcdante KJ, uKleigman RM. Isifo se-thyroid. Ku: UMarcdante KJ, uKliegman RM, ama-eds. UNelson Essentials Pediatrics. Umhlaka 8. Elsevier; 2019: isahluko 175.

UMarino M, uVitti P, isifo sikaChiovato L. Amathuna. Ku: Jameson JL, De Groot LJ, de Kretser DM, et al, abahleli. I-Endocrinology: Eyabantu Abadala Neyengane. Umhla wesi-7. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 82.

URoss DS, uBurch HB, uCooper DS, et al. Imihlahlandlela ye-2016 American Thyroid Association yokuxilongwa nokuphathwa kwe-hyperthyroidism nezinye izimbangela ze-thyrotoxicosis. Indlala yegilo. 2016; 26 (10): 1343-1421. I-PMID: 27521067 pubmed.ncbi.nlm.nih.gov/27521067/.