I-Hypoparathyroidism

I-Hypoparathyroidism yisifo lapho izindlala ze-parathyroid entanyeni zingakhiqizi i-hormone eyanele ye-parathyroid (PTH).

Kunezinhlayiya ezine ezincane ze-parathyroid entanyeni, eseduze noma enamathiselwe ohlangothini olungemuva lwendlala yegilo.

Izindlala ze-parathyroid zisiza ukulawula ukusetshenziswa kwe-calcium nokususwa ngumzimba. Benza lokhu ngokukhiqiza i-hormone ye-parathyroid (PTH). I-PTH isiza ukulawula amazinga e-calcium, i-phosphorus, ne-vitamin D egazini nasethanjeni.

I-Hypoparathyroidism yenzeka lapho izindlala zikhiqiza i-PTH encane kakhulu. Izinga le-calcium egazini lehla, nezinga le-phosphorus liyakhuphuka.

Isizathu esivame kakhulu se-hypoparathyroidism ukulimala kwezindlala ze-parathyroid ngesikhathi sokuhlinzwa kwegilo noma kwentamo. Kungabangelwa noma yikuphi okulandelayo:

• Ukuhlasela ngokuzenzakalela kwezindlala ze-parathyroid (ezivamile)
• Izinga eliphansi kakhulu le-magnesium egazini (eliguquguqukayo)
• Ukwelashwa kwe-iodine enemisebe ye-hyperthyroidism (kuyaqabukela)

I-DiGeorge syndrome yisifo lapho kwenzeka khona i-hypoparathyroidism ngoba zonke izindlala ze-parathyroid azikho lapho kuzalwa. Lesi sifo sifaka ezinye izinkinga zempilo ngaphandle kwe-hypoparathyroidism. Ngokuvamile kutholakala ebuntwaneni.

I-hypoparathyroidism ejwayelekile yenzeka nezinye izifo ze-endocrine ezinjengokungakwazi ukusebenza kahle kwe-adrenal ku-syndrome ebizwa nge-type I polyglandular autoimmune syndrome (PGA I).

Ukuqala kwalesi sifo kuhamba kancane futhi izimpawu zingaba mnene. Abantu abaningi abatholakala ukuthi bane-hypoparathyroidism bebenezimpawu zeminyaka ngaphambi kokuba batholwe. Izimpawu zingaba mnene kangako ukuthi ukuxilongwa kwenziwa ngemuva kokuhlolwa kwegazi okukhombisa i-calcium ephansi.

Izimpawu zingafaka noma yikuphi okulandelayo:

• Izindebe zeminwe, iminwe nezinzwane (ezivame kakhulu)
• Amajaqamba emisipha (avame kakhulu)
• Ukuphazamiseka kwemisipha okubizwa ngokuthi yi-tetany (kungathinta umphimbo, kubangele ubunzima bokuphefumula)
• Ubuhlungu besisu
• Isigqi senhliziyo esingajwayelekile
• Izipikili eziphukile
• Isifo senkwethu
• Ukufakwa kwe-calcium kwezinye izicubu
• Ukwehla kokuqonda
• Izinwele ezomile
• Isikhumba esomile nesomile
• Ubuhlungu ebusweni, emilenzeni nasezinyaweni
• Ukuya esikhathini okubuhlungu
• Ukuquleka
• Amazinyo angakhuli ngesikhathi, noma nhlobo
• Uqweqwe lwawo lwamazinyo olubuthakathaka (ezinganeni)

Umhlinzeki wezokunakekelwa kwempilo uzokwenza ukuhlolwa komzimba abuze ngezimpawu.

Ukuhlolwa okuzokwenziwa kufaka phakathi:

• Ukuhlolwa kwegazi kwe-PTH
• Ukuhlolwa kwegazi kweCalcium
• Magnesium
• Ukuhlolwa komchamo wamahora angama-24

Ezinye izivivinyo ezinga-odwa zifaka:

• I-ECG ukuhlola isigqi senhliziyo esingajwayelekile
• I-CT scan ukuhlola ama-calcium deposits ebuchosheni

Inhloso yokwelashwa ukunciphisa izimpawu nokubuyisela ibhalansi ye-calcium namaminerali emzimbeni.

Ukwelashwa kubandakanya izithasiselo ze-calcium carbonate kanye ne-vitamin D. Lokhu imvamisa kufanele kuthathwe impilo yonke. Amazinga egazi alinganiswa njalo ukuqinisekisa ukuthi umthamo ulungile. Kunconywa ukudla okunekhalsiyamu ephezulu, okuphansi kwe-phosphorus.

Imijovo ye-PTH inganconywa kwabanye abantu. Udokotela wakho angakutshela ukuthi lo muthi ukulungele yini.

Abantu abanokuhlaselwa okusongela impilo kwamazinga aphansi e-calcium noma izicubu zemisipha ezinde banikezwa i-calcium ngomthambo (IV). Izinyathelo zokuqapha ziyathathwa ukuvimbela ukuquleka noma ukuqubuka komphimbo. Inhliziyo ibhekwe isigqi esingajwayelekile kuze kube yilapho umuntu esezinzile. Lapho ukuhlaselwa okusongela impilo sekulawuliwe, ukwelashwa kuyaqhubeka ngemithi ethathwe ngomlomo.

Umphumela kungenzeka ube muhle uma ukuxilongwa kwenziwa kusenesikhathi. Kepha ushintsho emazinyweni, ezinkalweni, nasekubalweni kobuchopho alunakubuyiselwa emuva ezinganeni ezingatholanga i-hypoparathyroidism ngesikhathi sokukhula.

I-Hypoparathyroidism ezinganeni ingaholela ekukhuleni okungekuhle, emazinyweni angajwayelekile, nasekukhuleni kwengqondo kancane.

Ukwelashwa okuningi nge-vitamin D ne-calcium kungadala i-calcium ephezulu yegazi (i-hypercalcemia) noma i-calcium yomchamo ephezulu (hypercalciuria). Ukwelashwa ngokweqile kwesinye isikhathi kungaphazamisa ukusebenza kwezinso, noma kubangele nokwehluleka kwezinso.

I-Hypoparathyroidism yandisa ubungozi be:

• Isifo i-Addison (kuphela uma imbangela ingeyokuzimela)
• Isifo senkwethu
• Isifo se-Parkinson
• I-anemia enamandla (kuphela uma imbangela ingumzimba ozenzakalelayo)

Shayela umhlinzeki wakho uma uthuthukisa noma yiziphi izimpawu ze-hypoparathyroidism.

Izinkinga zokubanjwa noma zokuphefumula ziphuthumayo. Shayela ku-911 noma inombolo ephuthumayo yendawo ngokushesha.

I-hypocalcemia ehlobene ne-Parathyroid

• Izindlala ze-Endocrine
• Nezindlala Parathyroid

UClarke BL, uBrown EM, uCollins MT, et al. I-Epidemiology nokuxilongwa kwe-hypoparathyroidism. UJ Clin Endocrinol Metab. 2016; 101 (6): 2284-2299. I-PMID: 26943720 pubmed.ncbi.nlm.nih.gov/26943720/.

Reid LM, Kamani D, Randolph GW. Ukuphathwa kokuphazamiseka kwe-parathyroid. Ku: IFlint PW, uFrancis HW, uHaughey BH, et al, eds. I-Cummings Otolaryngolog: Ukuhlinzwa Kwekhanda Nentamo. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2021: isahluko 123.

I-Thakker RV.Izindlala ze-parathyroid, i-hypercalcemia ne-hypocalcemia. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 232.