Hyperparathyroidism

I-Hyperparathyroidism yisifo lapho izindlala ze-parathyroid entanyeni yakho zikhiqiza khona i-hormone eningi kakhulu (PTH).

Kunezindlala ezine ezincane ze-parathyroid entanyeni, eduzane 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.

Lapho izinga le-calcium liphansi kakhulu, umzimba uphendula ngokwenza i-PTH eningi. Lokhu kubangela ukuthi izinga le-calcium egazini likhuphuke.

Lapho eyodwa noma eziningi zezindlala ze-parathyroid zikhula, ziholela ku-PTH eningi kakhulu. Ngokuvamile, imbangela yisisu esibuhlungu sezindlala ze-parathyroid (parathyroid adenoma). Lezi zicubu ezinobungozi zivamile futhi zenzeka ngaphandle kwesizathu esaziwayo.

• Lesi sifo sivame kakhulu kubantu abangaphezu kweminyaka engama-60, kodwa singenzeka nakubantu abadala abasebasha. I-Hyperparathyroidism ebuntwaneni ayijwayelekile kakhulu.
• Abesifazane banamathuba amaningi okuthi bathinteke kunabesilisa.
• Imisebe ekhanda nasentanyeni inyusa ingozi.
• Amanye ama-syndromes ezakhi zofuzo (ama-endocrine neoplasia I amaningi) enza kube nokwenzeka ukuthi kube ne-hyperparathyroidism.
• Ezimweni ezingavamile kakhulu, lesi sifo sibangelwa umdlavuza we-parathyroid.

Izimo zezokwelapha ezibangela i-calcium ephansi yegazi noma i-phosphate eyandisiwe nayo ingaholela ku-hyperparathyroidism. Izimo ezivamile zifaka:

• Izimo ezenza kube nzima emzimbeni ukukhipha i-phosphate
• Ukuhluleka kwezinso
• Ayanele i-calcium ekudleni
• I-calcium eningi ilahlekile emchameni
• Ukuphazamiseka kuka-Vitamin D (kungahle kwenzeke ezinganeni ezingadli ukudla okuhlukahlukene, nakubantu abadala asebekhulile abangakutholi ukukhanya kwelanga okwanele esikhunjeni sabo noma abanokumunceka okungatheni kwe-vitamin D ekudleni okufana nangemva kokuhlinzwa nge-bariatric)
• Izinkinga zokumunca izakhamzimba ekudleni

I-Hyperparathyroidism ivame ukutholakala ngokuhlolwa kwegazi okuvamile ngaphambi kokuba kuvele izimpawu.

Izimpawu zidalwa kakhulu ukulimala kwezitho ezisuka ezingeni eliphezulu le-calcium egazini, noma ngokulahleka kwe-calcium emathanjeni. Izimpawu zingafaka:

• Ubuhlungu bamathambo noma isisa
• Ukudangala nokukhohlwa
• Ukuzizwa ngikhathele, ngigula, futhi ngibuthaka
• Amathambo aqinile wezitho nomgogodla ongaphuka kalula
• Kukhuphuke inani lomchamo futhi lidinga ukuchama kaningi
• Amatshe ezinso
• I-nausea nokulahlekelwa isifiso sokudla

Umhlinzeki wezokunakekelwa kwempilo uzokwenza ukuhlolwa komzimba abuze ngezimpawu.

Ukuhlolwa okungenziwa kufaka phakathi:

• Ukuhlolwa kwegazi kwe-PTH
• Ukuhlolwa kwegazi kweCalcium
• I-alkaline phosphatase
• I-Phosphorus
• Ukuhlolwa komchamo wamahora angama-24

Ukuhlolwa kwe-Bone x-rays kanye ne-bone mineral density (DXA) kungasiza ekutholeni ukulahleka kwethambo, ukuqhekeka, noma ukuthambisa kwamathambo.

I-X-ray, i-ultrasound, noma i-CT scan yezinso noma i-urinary tract ingakhombisa ukufakwa kwe-calcium noma ukuvinjelwa.

I-Ultrasound noma ukuskena kwemithi yenuzi entanyeni (sestamibi) kusetshenziselwa ukubona ukuthi ngabe isimila esibi (adenoma) esiswini se-parathyroid sidala i-hyperparathyroidism.

Uma unezinga le-calcium elinyuke kancane futhi ungenazo izimpawu, ungakhetha ukuhlolwa njalo noma ukwelashwa.

Uma uthatha isinqumo sokwelashwa, kungabandakanya:

• Ukuphuza uketshezi oluningi ukuvimbela ukwakheka kwamatshe ezinso
• Ukuzivocavoca umzimba
• Ukungathathi uhlobo lwephilisi lamanzi elibizwa nge-thiazide diuretic
• I-Estrogen yabesifazane abadlule esikhathini sokuya esikhathini
• Ukuhlinzwa ukuze ususe izindlala ezingasebenzi ngokweqile

Uma unezimpawu noma izinga lakho le-calcium liphakeme kakhulu, ungadinga ukuhlinzwa ukuze ususe indlala ye-parathyroid ekhiqiza ngokweqile i-hormone.

Uma une-hyperparathyroidism evela esimweni sezokwelapha, umhlinzeki wakho angakunikeza uvithamini D, uma unezinga eliphansi levithamini D.

Uma i-hyperparathyroidism ibangelwa ukwehluleka kwezinso, ukwelashwa kungafaka:

• I-calcium eyengeziwe nevithamini D
• Ukugwema i-phosphate ekudleni
• Umuthi i-cinacalcet (iSensipar)
• I-Dialysis noma ukufakelwa izinso
• Ukuhlinzwa kwe-Parathyroid, uma izinga le-parathyroid liba phezulu ngokungalawuleki

I-Outlook incike embangela ye-hyperparathyroidism.

Izinkinga zesikhathi eside ezingenzeka lapho i-hyperparathyroidism ingalawulwa kahle ifaka:

• Amathambo aba buthakathaka, akhubazeke, noma angaphuka
• Umfutho wegazi ophakeme nesifo senhliziyo
• Amatshe ezinso
• Isifo sezinso sesikhathi eside

Ukuhlinzwa kwe-parathyroid gland kungaholela ku-hypoparathyroidism futhi kulimaze izinzwa ezilawula izintambo zezwi.

I-hypercalcemia ehlobene ne-Parathyroid; Ukukhumuzeka kwamathambo - hyperparathyroidism; Ukunciphisa amathambo - i-hyperparathyroidism; I-osteopenia - i-hyperparathyroidism; Izinga eliphezulu le-calcium - hyperparathyroidism; Isifo sezinso esingapheliyo - hyperparathyroidism; Ukwehluleka kwezinso - hyperparathyroidism; I-parathyroid esebenzayo; Ukushoda kukavithamini D - hyperparathyroidism

• Nezindlala Parathyroid

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

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.