Maʻi maʻi kupapaʻu

ʻO ka maʻi Graves kahi maʻi autoimmune e alakaʻi i kahi gland thyroid overactive (hyperthyroidism). ʻO kahi maʻi autoimmune kahi ʻano i kū ke kuhi hewa ka ʻōnaehana pale pale i nā mea olakino olakino.

ʻO ka gland thyroid kahi mea nui o ka ʻōnaehana endocrine. Aia ke gland ma ke alo o ka ʻāʻī ma luna kahi e hui ai nā iwi iwi. Hoʻokuʻu kēia gland i nā hormones thyroxine (T4) a me triiodothyronine (T3), ka mea e kaohi i ka metabolism o ke kino. He mea nui ka kaohi ʻana i ka metabolism no ka hoʻoponopono ʻana i ka naʻau, ke kaupaona, a me nā pae ikehu a me ka noʻonoʻo.

Ke hana ke kino i ka nui o ka hormone thyroid, kapa ʻia ke ʻano he hyperthyroidism. (ʻO kahi thyroid underactive e alakaʻi i ka hypothyroidism.)

ʻO ka maʻi Graves ke kumu maʻamau o hyperthyroidism. Loaʻa ia ma muli o kahi pane ʻōnaehana pale ʻole e hoʻoulu i ka thyroid gland e hana i ka nui o ka hormone thyroid. ʻO ka maʻi Graves ka mea maʻamau i nā wahine ma mua o nā makahiki 20. Akā hiki ke maʻi i kēlā me kēia makahiki a hiki ke hoʻopili i nā kāne pū kekahi.

Loaʻa paha i ka poʻe ʻōpio kēia mau ʻōuli:

• Ka pīhoihoi a hopohopo paha, a me nā pilikia e hiamoe ana
• Hoʻonui i ka umauma i nā kāne (hiki)
• Hoʻopilikia i nā pilikia
• Ka luhi
• ʻO ka neʻe pinepine ʻana o ka ʻōpū
• Lilo ka lauoho
• Heat intolerance a hoʻonui i ka sweating
• Hoʻonui i ka makemake, ʻoiai ka hōʻemi ʻana i ke kaumaha
• Nā wā maʻamau o ka wā maʻamau i nā wahine
• Nāwaliwali o nā mākala o nā hiʻupuʻu a me nā poʻohiwi
• Moodiness, me ka huhū a me ka huhū
• Palpitations (sensation o kahi puʻuwai puʻuwai ikaika a kū ʻole paha)
  
• ʻO ke kuʻi puʻuwai wikiwiki a i ʻole kaulike ʻole
• Ka hanu ʻana me ka hana
• Tremor (haʻalulu o nā lima)

Nui nā poʻe me ka maʻi Graves i pilikia me ko lākou mau maka.

• E ʻōhū mai ana paha nā maka maka a ʻeha paha.
• Hiki i nā maka ke huhū, makaʻu a haehae pinepine paha.
• Aia paha ka hihiʻo pālua.
• Hiki ke ʻike ʻia ka hōʻemi ʻana o ka ʻike a me ka hōʻino ʻana i ke kole i nā hihia koʻikoʻi.

Loaʻa paha i ka poʻe ʻelemakule kēia mau ʻōuli:

• ʻO ke kuʻi puʻuwai wikiwiki a i ʻole kaulike ʻole
• ʻEha ʻeha
• Lilo ka hoʻomanaʻo ʻana a i ʻole hoʻemi ʻia ka manaʻo nui
• Nāwaliwali a luhi hoʻi

E hana ka mea mālama ola i kahi hoʻokolohua kino a ʻike paha ʻoe ua hoʻonui ʻia ka helu o kou puʻuwai. Hiki i kahi hoʻokolohua o kou ʻāʻī ke ʻike ua hoʻonui ʻia kou gland thyroid (goiter).

ʻO nā hōʻike ʻē aʻe kekahi:

• Nā ho'āʻo koko e ana i nā pae o TSH, T3, a me T4 manuahi
• Lawe ʻia ka iodine radioactive a nānā

Hiki paha i kēia maʻi ke hoʻopili i nā hopena hōʻike aʻe:

• ʻO Orbit CT scan a i ʻole ultrasound
• ʻO ka thyroid stimulate immunoglobulin (TSI)
• ʻO ka kinetona thyroid peroxidase (TPO)
• Anati-TSH receptor antibody (TRAb)

Kūpono ka mālama ʻana i ka kaohi ʻana i kāu thyroid overactive. Hoʻohana pinepine ʻia nā lāʻau i kapa ʻia beta-blockers e mālama i nā hōʻailona o ka wikiwiki o ka puʻuwai, ka hou ʻana, a me ka hopohopo a hiki i ke kaohi ʻia ʻana o ka hyperthyroidism.

Mālama ʻia ʻo Hyperthyroidism me hoʻokahi a ʻoi paha o kēia mau mea:

• Hiki i nā lāʻau antithyroid ke ālai a hoʻololi paha i ka hoʻohana ʻana o ka iodine i ka iodine. Hoʻohana ʻia kēia mau mea e kaohi ai i ka momona o ka thyroid ma mua o ke kaha ʻana a i ʻole ka radioiodine therapy a i ʻole he lapaʻau lōʻihi.
• ʻO Radioiodine therapy i hāʻawi ʻia ai ka iodine radioactive e ka waha. Hoʻopili ia a laila i ka nui o ka pepa thyroid a hana i nā mea i hōʻino ʻia.
• Hana ʻia paha ke kaha e hemo ai ka thyroid.

Inā loaʻa iā ʻoe ka lāʻau iodine radioactive a i ʻole ke ʻoki ʻana, pono ʻoe e lawe i nā homone thyroid i ke koena o kou ola. ʻO kēia no ka mea e luku a hemo paha kēia mau hana i ka momona.

LAAU ANA I NA MAKA

ʻO kekahi o nā pilikia o ka maka e pili ana i ka maʻi Graves e hoʻomaikaʻi pinepine ma hope o ka mālama ʻana me nā lāʻau, radiation, a i ʻole ke ʻoki ʻana e mālama ai i ka thyroid overactive. Hiki i ka radioiodine therapy ke hōʻino i nā pilikia o ka maka. ʻOi aku ka maikaʻi o ka pilikia o ka maka i ka poʻe puhipaka, ʻoiai ma hope o ka mālama ʻia ʻana o ka hyperthyroidism.

I kekahi manawa, pono ka prednisone (kahi lāʻau lāʻau steroid e kaomi i ka ʻōnaehana pale) e hōʻemi i ka huhū o ka maka a me ka pehu.

Pono ʻoe e kāpili i kou mau maka i ka pō e pale i ka maloʻo ʻana. Hiki i nā aniani aniani a me nā kulu maka ke hōʻemi i ka huhū o ka maka. I nā hanana maʻamau, pono paha ke kīpoki a i ʻole radiation radiation (ʻokoʻa i ka iodine radioactive) e pale aku ai i ka hōʻino hou ʻana i ka maka a me ka nalo ʻana o ka ʻike.

ʻO ka maʻi Graves e pane maikaʻi i ka lāʻau. ʻO ke kahakaha thyroid a iodine radioaktif paha e hoʻoulu pinepine i kahi thyroid underactive (hypothyroidism). Me ka loaʻa ʻole o ke kaulike pololei o ka hoʻowili hormonone thyroid, hiki i ka hypothyroidism ke alakaʻi i:

• Kaumaha
• Ka lohi o ka noʻonoʻo a me ke kino
• Kaumaha hoʻonui
• ʻIli maloʻo
• Konipōpō
• Ka hoʻomanawanui ʻole ʻana
• Nā wā maʻamau o nā wahine

Kāhea i kāu mea hāʻawi inā loaʻa nā hōʻailona o ka maʻi Graves. Kāhea pū kekahi inā eʻoi aku ka maikaʻi o ka pilikia o kou maka a i ʻole nā ​​hōʻailona ʻē aʻe a hoʻomaikaʻi ʻole paha me ka lāʻau.

E hele i ka lumi pilikia a kāhea paha i ka helu kūloko kūloko (e like me 911) inā loaʻa nā ʻōuli o hyperthyroidism me:

• Hoʻoemi i ka ʻike
• Fiva
• Wikiwiki, pākuʻi puʻuwai ʻole
• Hānu koke ka hanu

Hoʻolahalaha i ka goiter thyrotoxic; Hyperthyroidism - Luakupapau; Thyrotoxicosis - Luakupapau; Exophthalmos - Luakupapau; Ophthalmopathy - Nā ilina; Exophthalmia - Luakupapau; Exorbitism - Luakupapau

• Nānā Endocrine
• Hoʻonui ka thyroid - scintiscan
• Maʻi maʻi kupapaʻu
• Kelepaʻi thyroid

ʻO Hollenberg A, Wiersinga WM. Nā maʻi Hyperthyroid. I: Melmed S, Auchus RJ, Golfine AB, Koenig RJ, Rosen CJ, eds. ʻO Williams Textbook of Endocrinology. 14th ed. Piladelapia, PA: Elsevier; 2020: chap 12.

ʻO Jonklaas J, ʻo Cooper DS. ʻOhana. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier; 2020: chap 213.

Marcdante KJ, Kleigman RM. Maʻi thyroid. I: Marcdante KJ, Kliegman RM, hua. Nā Pono Nui o Pediatrics. 8th ed. Elsevier; 2019: chap 175.

ʻO Marino M, Vitti P, Chiovato L. maʻi ʻo Graves. I: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Makua a Pediatric. ʻEpekema 7 Piladelapia, PA: Elsevier Saunders; 2016: chap 82.

Ross DS, Burch HB, Cooper DS, et al. Nā ʻōkuhi ʻo 2016 American Tyroid Association no ka hōʻoia a me ka hoʻokele o hyperthyroidism a me nā kumu ʻē aʻe o thyrotoxicosis. ʻOhana. 2016; 26 (10): 1343-1421. PMID: 27521067 pubmed.ncbi.nlm.nih.gov/27521067/.