Hypercalcemia

Hypercalcemia o lona uiga ua tele naua lau calcium i lou toto.

Parathyroid hormone (PTH) ma Vitamini D fesoasoani e faʻatautaia le paleni o le kalusi i le tino.

• PTH e faia e le parathyroid glands. Nei o laiti laiti glands tu i le ua i tua o le thyroid gland.
• E maua le Vitamini D pe a faʻapea e paʻu le paʻu i le susulu o le la, ma mea e maua mai i meaʻai poʻo mea faʻaopopo.

Ole mafuaʻaga masani ole maualuga ole suka ile toto ole maualuga ole PTH na faʻatuʻu e le parathyroid glands. O lenei sili tupu e mafua mai i:

• Se faʻalauteleina o se tasi pe sili atu o le parathyroid glands.
• Se tupu i luga o se tasi o glands. Tele o taimi, o nei tuputupu aʻe e lelei (ae leʻo le kanesa).

E mafai foi ona maualuga le toto ole kalisiu pe a fai e maualalo lou tino i vai poʻo le vai.

O isi tulaga e mafai foi ona mafua ai hypercalcemia:

• Nisi ituaiga o kanesa, pei o mama ma kanesa o le susu, poʻo kanesa ua sosolo atu i ou totoga.
• Tele vitamini D i lou toto (hypervitaminosis D).
• Le le minoi i le moega mo le tele o aso po o vaiaso (tele lava i tamaiti).
• Tele kalisiu i au taumafataga. E taʻua lea ole susu-alkali syndrome. E masani ona tupu pe a inu e se tagata le sili atu ile 2000 milligrams of calcium bicarbonate faʻaopoopoga i le aso faʻatasi ai ma le tele o vailaʻau o Vitamini D.
• Ova tele lou kelu toto.
• Faʻamaʻi fatugao faaumiumi poʻo fatugaʻi toilalo.
• Vailaau e pei o lithium ma thiazide diuretics (vai fualaʻau).
• Nisi faʻamaʻi poʻo faʻafitauli tau soifua maloloina pei o, Paget faʻamaʻi, mamapala ma le sarcoidosis.
• O se measina tuutuuga e aafia ai le mafai gafatia e le tino ona pulea le calcium.

O aliʻi ma fafine o soʻo se tausaga e mafai ona iai le maualuga ole suka i le toto. Peitai, e taatele i fafine i luga atu o le 50 tausaga (pe a maeʻa le menopause). I le tele o tulaga, o lenei mafuaʻaga ona o le soona galue parathyroid gland.

O le tulaga e masani ona maua faʻamaonia i le amataga o le taimi e faʻaaoga ai le masani ai o suʻega toto. Tele o tagata e leai ni faʻailoga.

Faʻailoga ona o le maualuga o le calcium level e ono eseese, faʻamoemoe i le mafuaʻaga ma le umi na i ai le faʻafitauli. Latou te ono aofia ai:

• Faʻailoga o manava, pei o le niniva poʻo le puaʻi, leaga le manaʻo, poʻo le papala
• Faʻateleina le fiainu poʻo sili atu urination masani, ona o le suia i le fatugaʻo
• Musika vaivai poʻo mimigi
• Suiga i le auala e galue ai lou faiʻai, pei o le lagona lelava pe lelava pe le mautonu
• Tiga o ponaivi ma ponaivi ponaivi e faigofie ona gagau

E manaʻomia se saʻiliga saʻo ile hypercalcemia. Tagata e i ai fatugaʻo maʻa tatau tatau ona i ai suʻega e iloilo ai mo hypercalcemia.

• Suka kalama
• Serum PTH
• Serum PTHrP (PTH-fesoʻotaʻi polotini)
• Serum vitamini D tulaga
• Mimi kalisiu

Togafitiga e faʻatatau i le mafuaʻaga o le hypercalcemia i soo se taimi e mafai ai. Tagata e maua muamua hyperparathyroidism (PHPT) ono manaʻomia se taotoga e aveʻese le le masani ai parathyroid gland. Lenei o le a faʻamalolo ai le hypercalcemia.

Tagata e maua i le hypercalcemia vaivai atonu e mafai ona mataitu lelei le tulaga i le taimi e aunoa ma togafitiga.

I fafine o loʻo i le menopause, togafitiga ma le estrogen mafai i nisi taimi fesuiaʻi agamalu hypercalcemia.

Ogaoga hypercalcemia e mafua ai faʻailoga ma manaʻomia le nofo i le falemaʻi ono togafitia i mea nei:

• Fluids ala i se alatoto - Lenei o le sili ona taua togafitiga.
• Calcitonin
• Dialysis, pe a fai e afaina le fatugaʻo.
• Diuretic vailaʻau, pei o furosemide.
• Fualaʻau e taofi ai le gagauina o ponaivi ma mitiia e le tino (bisphosphonates).
• Glucocorticoids (vailaʻau).

O le lelei o lau faʻamoemoe e faʻamoemoeina i le mafuaʻaga o lou maualuga calcium tulaga. O le vaʻaiga e lelei mo tagata e maua i le hyperparathyroidism laʻititi poʻo le hypercalcemia e i ai se mafuaʻaga togafitia. Tele o taimi, e leai ni faʻalavelave.

Tagata e maua i le hypercalcemia ona o tulaga pei o kanesa poʻo le sarcoidosis atonu e le lelei. O lenei e masani ona mafua mai i le faʻamaʻi lava, nai lo le maualuga tulaga calcium.

GASTROINTESTINAL

• Pancreatitis
• Faʻamaʻi papala pepeptic

KIDNEY

• Kalisiu teu i le fatugaʻo (nephrocalcinosis) e mafua ai le lelei fatugaʻo gaioiga
• Faʻamaligiina
• Toto maualuga
• Le manuia fatugaʻo
• Maʻa fatugaʻo

Faʻapitoa

• Faʻanoanoa
• Faigata e taulaʻi pe mafaufau

FAʻAALIGA

• Ovi o le ponaivi
• Fractures
• Osteoporosis

O nei faʻafitauli o le hypercalcemia mo se taimi umi e le masani ai i aso nei i le tele o atunuʻu.

Faʻafesoʻotaʻi lau auaunaga faʻasoifua maloloina pe a fai oe:

• Talafaʻasolopito o le aiga o le hypercalcemia
• Aiga talaʻaga o hyperparathyroidism
• Faʻailoga o le hypercalcemia

Tele mafuaʻaga o le hypercalcemia le mafai ona puipuia. Tamaʻitaʻi e sili atu ma le 50 tausaga e tatau ona vaʻaia e le aunoa i latou latou tautua ma siaki le maualuga ole latou suka ile toto pe a iai ni faʻailoga ole hypercalcemia.

Talanoa i lau tautua e uiga i le saʻo fualaʻu pe a fai o loʻo e inuina le calcium ma le vailaʻau D.

Kalisiu - maualuga; Maualuga kalisiu tulaga; Hyperparathyroidism - hypercalcemia

• Hypercalcemia - faʻateʻa

• Laʻau Endocrine

Aronson JK. Vitamini D faʻatusa. I le: Aronson JK, ed. Meyler's Side Effects o Fualaʻau. 16th lomiga. Waltham, MA: Elsevier B.V.; 2016: 487-487.

Coleman RE, Brown J, Holen I. Bone metastases. I: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, eds. Abeloff's Clinical Oncology. 6th ed. Filatelefia, PA: Elsevier; 2020: chap 56.

Darr EA, Sritharan N, Pellitteri PK, Sofferman RA, Randolph GW. Faʻatautaia o faʻafitauli parathyroid. I le: Flint PW, Haughey BH, Lund V, et al, eds. Cummings Otolaryngology: Taʻavale ma le ua. 6th ed. Filatelefaia, PA: Elsevier Saunders; 2015: mata 124.

Thakker RV. O le parathyroid glands, hypercalcemia, ma le hypocalcemia. I totonu: Goldman L, Schafer AI, eds. Faʻafomaʻi Goldman-Cecil. 26th lomiga. Filatelefia, PA: Elsevier; 2020: mata 232