Parathyroid hyperplasia

Parathyroid hyperplasia yog qhov loj ntawm tag nrho 4 lub qog parathyroid. Parathyroid caj pas nyob hauv lub caj dab, ze lossis txuas rau sab tom qab ntawm lub qog ua haujlwm lub qog.

Parathyroid qog pab tswj kev siv tshuaj calcium thiab tshem tawm los ntawm lub cev. Lawv ua qhov no los ntawm kev tsim cov kab mob parathyroid hormone (PTH). PTH pab tswj cov calcium, phosphorus, thiab cov vitamin D ntau ntau hauv cov ntshav thiab nws tseem ceeb rau cov pob txha noj qab haus huv.

Parathyroid hyperplasia yuav tshwm sim rau tib neeg yam tsis muaj keeb kwm kab mob ntawm tsev neeg, lossis ua ib feem ntawm 3 qhov muaj keeb:

• Ntau tus kab mob endocrine neoplasia I (MEN I)
• TXIV NEEJ IIA
• Raug rho tawm ntawm tsev neeg hyperparathyroidism

Hauv cov neeg uas muaj caj ces noob caj noob ces, kev hloov pauv (sib hloov) tau dhau los ntawm tsev neeg. Koj tsuas yog xav tau txais cov gene los ntawm ib tus niam txiv txhawm rau txhim kho tus mob.

• Hauv cov txiv neej I, teeb meem hauv cov qog ntshav parathyroid tshwm sim, nrog rau qog hauv cov qog pituitary thiab cov leeg nqaij hlav.
• Hauv MEN IIA, kev ua haujlwm dhau ntawm cov qog ntshav parathyroid tshwm sim, nrog rau qog hlav hauv qog adrenal lossis cov thyroid caj pas.

Parathyroid hyperplasia uas tsis yog ib feem ntawm kev mob tshwm sim yog ntau dua. Nws tshwm sim vim lwm yam mob. Cov xwm txheej feem ntau uas tuaj yeem ua rau parathyroid hyperplasia yog cov mob raum thiab cov kab mob vitamin D tsis txaus. Hauv ob qho xwm txheej no, cov qog parathyroid ua kom dav ntxiv vim tias cov vitamin D thiab calcium tsis ntau dhau.

Cov tsos mob tuaj yeem suav nrog:

• Cov pob txha lov lossis pob txha mob
• Cem quav
• Tsis muaj lub zog
• Mob leeg
• Xeev siab

Kev kuaj ntshav yuav ua kom ntsuas cov theem ntawm:

• Tshuaj calcium
• Phus Thas
• Hlau nplaum
• PTH
• Vitamin D
• Raum muaj nuj nqi (Creatinine, BUN)

Yuav kuaj 24-teev rau kev ntsuas seb muaj cov calcium ntau npaum li cas tawm hauv lub cev mus rau hauv cov zis.

Kev xoo hluav taws xob xoo thiab kev ntsuas pob txha ceev (DXA) tuaj yeem pab tshawb txog kev puas, pob txha, thiab pob txha muag. Kev ntsuas hluav taws xob (ultrasound) thiab CT scans tuaj yeem ua kom pom cov qog parathyroid hauv caj dab.

Yog tias parathyroid hyperplasia yog vim muaj kab mob hauv lub raum los sis muaj cov vitamin D tsawg thiab nws pom thaum ntxov, koj tus kws kho mob yuav xav kom koj noj cov tshuaj vitamin D, vitamin D-zoo li tshuaj, thiab lwm yam tshuaj.

Kev phais feem ntau yog ua thaum parathyroid caj pas ua ntau PTH thiab ua rau cov tsos mob. Feem ntau 3 1/2 cov qog tau muab tshem tawm. Cov ntaub so ntswg ntxiv tuaj yeem cog rau sab caj npab lossis caj dab. Qhov no tso cai yooj yim nkag mus rau cov ntaub so ntswg yog tias cov tsos mob rov qab. Cov ntaub so ntswg no cog rau tiv thaiv lub cev los ntawm kev muaj PTH tsawg heev, uas tuaj yeem ua rau cov calcium qis (los ntawm hypoparathyroidism).

Tom qab kev phais mob, cov ntshav calcium siab yuav ua mob ntev lossis rov qab los. Kev phais mob qee zaum tuaj yeem ua rau hypoparathyroidism, uas ua rau cov ntshav calcium tsis txaus siab.

Parathyroid hyperplasia tuaj yeem ua rau hyperparathyroidism, uas ua rau cov ntshav calcium nce siab ntxiv.

Cov kev mob tshwm sim suav nrog cov calcium ntxiv nyob rau hauv ob lub raum, uas tuaj yeem ua rau lub raum pob zeb, thiab osteitis fibrosa cystica (thaj chaw mos ua kom tsis muaj zog ntxiv hauv cov pob txha).

Kev phais mob qee zaum tuaj yeem ua rau puas txoj hlab ntshav uas tswj lub suab. Qhov no tuaj yeem cuam tshuam lub zog ntawm koj lub suab.

Lwm yam kev mob tshwm sim los ntawm lwm cov qog uas yog ib feem ntawm MEN syndromes.

Hu rau koj tus kws khomob yog:

• Koj muaj cov tsos mob ntawm hypercalcemia
• Koj muaj ib tsev neeg muaj keeb kwm muaj MEN syndrome

Yog tias koj muaj keeb kwm tsev neeg keeb kwm ntawm MEN syndromes, koj yuav xav kuaj cov noob caj noob ces saib seb puas muaj cov gene. Cov uas muaj lub cev tsis xws luag yuav muaj kev tshuaj ntsuam mob niaj hnub kom paub cov tsos mob thaum ntxov.

Ntug parathyroid qog; Txha caj qaum - parathyroid hyperplasia; Ua pob txha mos - parathyroid hyperplasia; Osteopenia - parathyroid hyperplasia; Muaj calcium ntau ntxiv - parathyroid hyperplasia; Mob raum - parathyroid hyperplasia; Raum tsis ua haujlwm - parathyroid hyperplasia; Sab hauv parathyroid - parathyroid hyperplasia

• Cov qog endocrine
• Parathyroid qog

Reid LM, Kamani D, Randolph GW. Kev tswj hwm ntawm parathyroid mob. Hauv: Flint PW, Francis HW, Haughey BH, li al, eds. Cummings Otolaryngology: Taub Hau Thiab Caj DabCov. 7 tus ed. Philadelphia, PA: Elsevier; 2021: chap 123.

Thakker RV. Parathyroid qog, hypercalcemia thiab hypocalcemia. Hauv: Goldman L, Schafer AI, eds. Goldman-Cecil TshuajCov. 26th ed. Philadelphia, PA: Elsevier; 2020: cha 232.