Hypercalcemia

ʻO ka hypercalcemia ka nui o kāu calcium i kou koko.

ʻO ka hormone Parathyroid (PTH) a me ka Wikamina D e kōkua i ka mālama ʻana i ke kaulike calcium i ke kino.

• Hana ʻia ʻo PTH e nā gland parathyroid. ʻO kēia mau ʻāpana liʻiliʻi ʻehā i loko o ka ʻāʻī ma hope o ka gland thyroid.
• Loaʻa ka wikamina D ke hōʻike ʻia ka ʻili i ka lā o ka lā, a mai nā kumuʻai a i ʻole nā ​​mea hoʻopili.

ʻO ke kumu maʻamau o ke kiʻekiʻe o ke kōkō kiʻekiʻe ʻoi aku ka nui o ka PTH i hoʻokuʻu ʻia e nā aʻa parathyroid. Loaʻa kēia mea ma muli o:

• Hoʻonui i kahi o hoʻokahi a ʻoi paha o nā gland parathyroid.
• ʻO kahi ulu ma kekahi o nā glands. ʻO ka hapanui o ka manawa, maikaʻi kēia mau ulu ʻana (ʻaʻole ka maʻi ʻaʻai.

Hiki ke kiʻekiʻe ke kiʻekiʻe o ke kōpiʻomaʻa inā haʻahaʻa kou kino i nā wai a wai paha.

Hiki i nā kūlana ʻē aʻe ke kumu i ka hypercalcemia:

• ʻO kekahi ʻano o nā maʻi ʻaʻai, e like me ka maʻi ʻaʻai a me ka umauma umauma, a i ʻole ke kanesa i pālahalaha aʻe i kāu mau lālā.
• Nui ka wikamina D i loko o kou koko (hypervitaminosis D).
• ʻO ka neʻe ʻole i kahi moe no nā lā a i ʻole mau pule (ʻo ka hapanui o nā keiki).
• Nui loa ka calcium i kāu papaʻai. Kapa ʻia kēia ʻo ka waiū-alkali maʻi maʻi. Kū pinepine ia ke lawe nei kekahi kanaka ma mua o 2000 milligrams o ka calcium bicarbonate kumukanawai i ka lā me nā kaha kiʻekiʻe o ka Vitamin D.
• Kelepona thyroid overactive.
• ʻO ka maʻi maʻi kōkō ʻole a i ʻole ke kō ʻana o ka hakuʻala.
• ʻO nā lāʻau e like me lithium a me thiazide diuretics (nā wai wai).
• ʻO kekahi mau maʻi a i ʻole nā ​​pilikia olakino e like me, maʻi Paget, tuberculosis a me sarcoidosis.
• ʻO kahi kūlana hoʻoili e hoʻopili i ka hiki i ke kino ke hoʻokele i ka calcium.

Hiki i nā kāne a me nā wahine o nā makahiki āpau ke loaʻa i ke kiʻekiʻe o ka calcium kiʻekiʻe. Eia nō naʻe, maʻa mau i nā wahine ma mua o 50 mau makahiki (ma hope o ka menopause). I ka hapanui o nā hihia, pili kēia i kahi gland parathyroid overactive.

Hoʻomaopopo pinepine ʻia ke ʻano i ka wā mua e hoʻohana ana i nā hoʻokolohua koko maʻamau. ʻAʻohe o ka hapanui o ka poʻe.

Hiki ke hoʻololi ʻia nā ʻōuli ma muli o ke kiʻekiʻe o ka calcium, ma muli o ke kumu a me ka lōʻihi o ka pilikia. Pākuʻi ʻia lākou:

• Nā hōʻailona Digestive, e like me ka nausea a i ʻole ka luaʻi, ʻai maikaʻi ʻole, a i ʻole ka constipation
• Hoʻonui i ka make wai a i ʻole ka urination pinepine, ma muli o nā loli i nā puʻupaʻa
• Nāwaliwali o ka mākala a i ʻole twitches paha
• Nā loli i ka hana ʻana o kou lolo, e like me ka luhi a luhi paha a huikau paha
• ʻO ka ʻeha iwi a me nā iwi palupalu e haki maʻalahi

Pono kahi ʻike pololei i ka hypercalcemia. Pono nā kānaka me nā pōhaku hakuʻala e hōʻoia no ka hypercalcemia.

• Kalipuna serum
• Serum PTH
• Serum PTHrP (PTH pili i ka protein)
• ʻO ka pae vitamin D serum
• Kāmiwa mimi

Hoʻopaʻa ʻia ka mālama ʻana i ke kumu o hypercalcemia ke hiki. Pono paha ka poʻe me ka hyperparathyroidism mua (PHPT) i kahi ʻoki e wehe ai i ka gland parathyroid abnormal. E hoʻōla kēia i ka hypercalcemia.

Hiki i nā poʻe me ka hypercalcemia mālie ke nānā pono i ke ʻano kokoke i ka manawa me ka ʻole o ka lāʻau.

I nā wahine i ka menopause, hiki i ka mālama ʻana me ka estrogen ke hoʻololi i kekahi manawa i ka hypercalcemia mālie.

ʻO hypercalcemia koʻikoʻi e kumu i nā ʻōuli a koi i kahi noho haukapila e mālama ʻia me kēia mau mea:

• Nā Fluids ma o kahi aa -ʻO kēia ka lāʻau lapaʻau koʻikoʻi nui.
• Kalepona
• Dialysis, inā pili ka ʻino puʻupaʻa.
• ʻO ka lāʻau Diuretic, e like me furosemide.
• Nā lāʻau e hōʻoki ana i ka haʻihaʻi iwi a lawe ʻia e ka kino (bisphosphonates).
• ʻO Glucocorticoids (steroid).

Maikaʻi kāu hilinaʻi ʻana i ke kumu o kāu kiʻekiʻe calcium. Maikaʻi ka kuanaʻike no ka poʻe me ka hyperparathyroidism akahai a i ʻole hypercalcemia i loaʻa i kahi kumu kūpono. ʻO ka hapa nui o ka manawa, ʻaʻohe pilikia.

ʻO nā kānaka me ka hypercalcemia ma muli o nā kūlana e like me ke kanesa a i ʻole sarcoidosis ʻaʻole maikaʻi. ʻO kēia pinepine ma muli o ka maʻi ponoʻī, ma mua o ke kiʻekiʻe o ka calcium.

GASTROINTESTINAL

• ʻO Pancreatitis
• Maʻi maʻi peptic

KIDNEY

• Nā waihona kalipuna i loko o ka puʻupaʻa (nephrocalcinosis) i kumu i ka hopena maikaʻi ʻole o ka hakuʻala
• Make wai
• Piʻi koko kiʻekiʻe
• Hewa ʻole nā ​​hakuʻala
• Pohaku hakuʻala

PSYCHOLOGICAL

• Kaumaha
• Paʻa ka noʻonoʻo ʻana a i ʻole ka noʻonoʻo ʻana

SKELETAL

• ʻAlohā iwi
• Nā haki
• Osteoporosis

ʻO kēia mau pilikia o ka hypercalcemia lōʻihi lōʻihi i ʻike ʻole ʻia i kēia mau lā i nā ʻāina he nui.

Kāhea aku i kāu kahu mālama ola inā loaʻa iā ʻoe:

• ʻO ka moʻolelo ʻohana o hypercalcemia
• ʻO ka moʻolelo ʻohana o hyperparathyroidism
• Nā ʻōuli o hypercalcemia

ʻAʻole hiki ke pale ʻia ka hapa nui o nā kumu hypercalcemia. Pono nā wahine ma luna o 50 mau makahiki e ʻike mau i kā lākou mea lawelawe a hōʻoia i ko lākou pae calcium i nānā ʻia inā loaʻa iā lākou nā ʻōuli o hypercalcemia.

E kamaʻilio i kāu mea hoʻolako e pili ana i ka lāʻau kūpono inā ʻoe e lawe i nā mea hoʻopiha calcium a me ka wikamina D.

Kalipuna - hoʻokiʻekiʻe ʻia; Kiʻekiʻe pae kalipuna; Hyperparathyroidism - hypercalcemia

• Hypercalcemia - hoʻokuʻu

• Nānā Endocrine

Aronson JK. Nā Huahana analog D I: Aronson JK, hoʻoponopono. Nā hopena a Meyler o nā lāʻau. 16th ed. Waltham, MA: Elsevier B.V.; 2016: 487-487.

Coleman RE, Brown J, Holen I. ʻO nā metastases iwi. I: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, eds. ʻO Oncology Clinical ʻo Abboff. ʻElua huaʻōlelo Piladelapia, PA: Elsevier; 2020: chap 56.

ʻO Darr EA, Sritharan N, Pellitteri PK, Sofferman RA, Randolph GW. Ka mālama ʻana i nā maʻi parathyroid. I: Flint PW, Haughey BH, Lund V, et al, eds. Cummings Otolaryngology: Ke poʻo poʻo a me ka ʻāʻī. ʻElua huaʻōlelo Piladelapia, PA: Elsevier Saunders; 2015: chap 124.

ʻO Thakker RV. ʻO nā gland parathyroid, hypercalcemia, a me hypocalcemia. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier; 2020: chap 232.