Hypoparathyroidism

ʻO ka Hypoparathyroidism kahi maʻi kahi a nā parathyroid glands i hana ʻole ai i ka nui o ka hormone parathyroid (PTH).

Aia he 4 mau puʻuwai parathyroid liʻiliʻi i ka ʻāʻī, aia ma kahi kokoke a hoʻopili ʻia paha i ka ʻaoʻao hope o ka pona thyroid.

Kōkua nā palahalaha parathyroid e kāohi i ka hoʻohana ʻana o ka calcium i ke kino. Hana lākou i kēia ma ka hana ʻana i ka hormone parathyroid (PTH). Kōkua ʻo PTH i ka mālama ʻana i ka pae o ka pākika, phosphorus, a me ka wikamina D i loko o ke koko a me ka iwi.

Hana ʻia ka hypoparathyroidism ke hana ka pākē liʻiliʻi i ka PTH liʻiliʻi. Hāʻule ke kiʻekiʻe o ke kōkō o ke kōkō, a piʻi aʻe ka pae phosphore.

ʻO ke kumu maʻamau o ka hypoparathyroidism ka hōʻeha i nā gland parathyroid i ka wā o ke kiroid a me ka ʻāʻī. ʻO kekahi o kēia mau mea ke kumu.

• ʻO ka hoʻouka kaua Autoimmune ma nā gland parathyroid (maʻamau)
• Ka pae mākika haʻahaʻa loa i ke koko (hiki ke hoʻohuli ʻia)
• ʻO ka mālama iodine radioactive no ka hyperthyroidism (kākaʻikahi loa)

ʻO DiGeorge Syndrome kahi maʻi kahi hypoparathyroidism e kū nei ma muli o ka nalowale ʻana o nā gland parathyroid i ka wā hānau. Hoʻopili kēia maʻi i nā pilikia olakino ʻē aʻe me ka hypoparathyroidism. Hoʻomaopopo pinepine ʻia i ka wā kamaliʻi.

Kū kekahi hypoparathyroidism ʻohana me nā maʻi endocrine e like me ka lawa ʻole o ka adrenal i kahi maʻi i kapa ʻia ʻo type I polyglandular autoimmune syndrome (PGA I).

ʻO ka hoʻomaka ʻana o ka maʻi he lohi loa ia a hiki i nā ʻōuli ke akahai. He nui ka poʻe i ʻike ʻia me ka hypoparathyroidism i loaʻa i nā ʻōuli no nā makahiki ma mua o ko lākou ʻike ʻia. Mālie paha nā ʻōuli e hana ʻia ke kuhi ma hope o ka hoʻokolohua ʻana i ke koko e hōʻike ana i ka calcium liʻiliʻi.

Pākuʻi ʻia paha nā ʻōuli i kekahi o kēia mau mea:

• ʻO nā lehelehe, nā manamana lima, a me nā manamana wāwae (maʻamau loa)
• Pākuʻi kaʻiʻo (ʻoi loa)
• ʻO nā spasms Muscle i kapa ʻia ʻo tetany (hiki ke hoʻopili i ka larynx, e pilikia ai ka hanu ʻana)
• Abdominal eha
• Rhythm puʻuwai maʻamau
• Nā kui kuʻi
• Kālepaʻa
• Waiho Calcium i kekahi mauʻaʻaʻa
• Hoemi i ka ʻike
• Lauoho maloʻo
• ʻIli maloʻo, scaly
• ʻEha ma ka maka, nā wāwae, a me nā wāwae
• Paumana ʻeha
• Ka hopu ʻana i nā maʻi
• ʻO nā niho e ulu ʻole i ka manawa, a i ʻole
• Nāwaliwali niho enamel (i nā keiki)

E hana ka mea mālama ola i kahi hoʻokolohua kino a nīnau e pili ana i nā ʻōuli.

ʻO nā hoʻāʻo e hana ʻia me:

• Hōʻaʻo koko PTH
• Hōʻike koko kalepona
• Makanekiuma
• 24-hola mimi hoʻāʻo

ʻO nā hoʻokolohua ʻē aʻe i kauoha ʻia e komo pū:

• E nānā ʻo ECG i kahi mele naʻau ʻokoʻa
• CT scan e nānā no nā waihona calcium i ka lolo

ʻO ka pahuhopu o ka mālama ʻana e hōʻemi i nā ʻōuli a hoʻihoʻi i ke kaulike calcium a me ka mineral i loko o ke kino.

Hoʻomaʻamaʻa ʻia ka calcium carbonate a me nā huaora D. Pono e lawe i kēia mau mea no ke ola. Ana ʻia nā pae o ke koko i nā manawa āpau e ʻike pono ua pololei ka mahele. Paipai ʻia kahi papa kalima nui, haʻahaʻa-phosphorous.

Hoʻokomo ʻia paha nā kuʻikuʻi o PTH no kekahi poʻe. Hiki i kāu kauka ke haʻi iā ʻoe inā kūpono kēia lāʻau iā ʻoe.

ʻO ka poʻe i loaʻa i nā hōʻeha hoʻoweliweli ola o nā pae calcium liʻiliʻi a i hoʻolōʻihi ʻia nā kuʻikuʻi lōʻihi e hāʻawi ʻia i ka calcium ma o kahi aa (IV). Lawe ʻia nā akahele e pale ai i ka hopu ʻana a i ʻole nā ​​spary larynx. Nānā ʻia ka puʻuwai no nā ʻōiwi maʻamau a paʻa ke kanaka. Ke kaohi ʻia ka hoʻouka hoʻoweliweli ola, hoʻomau ka hoʻomau ʻana me ka lāʻau i lawe ʻia e ka waha.

E maikaʻi paha ka hopena inā e ʻike koke ʻia ke kuhi. Akā ʻaʻole hiki ke hoʻohuli i nā loli i nā niho, cataract, a me ka helu ʻana o ka lolo i nā keiki i ʻike ʻole i ka hypoparathyroidism i ka wā o ka hoʻomohala.

Hiki i ka hypoparathyroidism i nā keiki ke alakaʻi i ka ulu maikaʻi ʻole, nā niho ʻole, a me ka ulu lohi o ka noʻonoʻo.

ʻO ka nui o ka mālama ʻana me ka wikamina D a me ka calcium hiki ke kumu i ke kiʻekiʻe o ke kōpaʻa o ke koko (hypercalcemia) a i ʻole ke kiʻekiʻe o ka mīmū (hypercalciuria). Hoʻopilikia ka lāʻau lapaʻau ʻoi aku paha i kekahi manawa i ka hana o ka hakuʻala, a i ʻole ke kumu e holo pono ʻole ai ka hakuʻala.

Hoʻonui ka Hypoparathyroidism i ka makaʻu o:

• Addison maʻi (wale nō ke kumu o ka autoimmune)
• Kālepaʻa
• Maʻi ʻo Parkinson
• Anemia anuanu (ʻo ke kumu ʻo autoimmune ke kumu)

Kāhea i kāu mea hāʻawi inā hoʻomohala ʻoe i nā hōʻailona o ka hypoparathyroidism.

ʻO ka hopu ʻana a i ʻole nā ​​pilikia hanu kahi pilikia. Kāhea iā 911 a i ʻole ka helu kūloko kūloko koke.

ʻO hypocalcemia pili i ka Parathyroid

• Nānā Endocrine
• Nūʻau parathyroid

Clarke BL, Brown EM, Collins MT, et al. Epidemiology a me ka hōʻailona o hypoparathyroidism. ʻO J Clin Endocrinol Metab. 2016; 101 (6): 2284-2299. PMID: 26943720 pubmed.ncbi.nlm.nih.gov/26943720/.

ʻO Reid LM, Kamani D, Randolph GW. Ka mālama ʻana i nā maʻi parathyroid. I: Flint PW, Francis HW, Haughey BH, et al, eds. ʻO Cummings Otolaryngolog: Ke poʻo poʻo a me ka ʻāʻī. ʻEpekema 7 Piladelapia, PA: Elsevier; 2021: chap 123.

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.