May
03
23:00
Endocrine diseases

Hypoparathyroidism

Hypoparathyroidism

Hypoparathyroidism Hypoparathyroidism (tetany) - a disease characterized by increased neuro - muscular excitability, decreased function of the parathyroid glands and convulsive syndrome.The disease can occur at any age, absolutely, there are cases where the presence of functional hypoparathyroidism in newborns

Etiology

damage or removal of parathyroid glands during surgery;their defeat in the intoxications, infections, autoimmune disorders;due to decreased tissue sensitivity to parathyroid hormone

Pathogenesis

insufficient allocation of parathyroid hormone, which leads to hyperphosphatemia and hypocalcemia (disorders of calcium - phosphorus homeostasis).There is a risk of seizures, there is a neuro - muscular excitability

flow and symptoms

seizures in most cases preceded by formication and numbness in the area of ​​the upper lip, fingers, feet and hands;there is the feeling of cold extremities, and stiffness.After that developing quite painful clonic and tonic convulsions sp

ecific muscle groups: legs, torso and face.

Hypoparathyroidism

Hands obstetrician

Spasmodic symptoms mostly occur in the flexor muscles, in this regard, the hand takes quite a characteristic position, which is called "hand obstetrician."When hypoparathyroidism flexor muscles of the lower extremities fingers podgibayutsya to the sole and the foot itself is bent inward ("horse foot").Due to the convulsive events of facial muscles, which are accompanied by lockjaw, to form the so-called "fish mouth".

In the case of the spread of seizures in the muscles of the neck, may cause laryngospasm, which will be accompanied by cyanosis, shortness of breath and sometimes asphyxia.Perhaps the development of pilorospazme with nausea, vomiting and acidosis;spasms of the bladder and the bowel muscles.As a result of spasm of the coronary vessels of the heart, there are sharp pains in the region of the heart.Also tetany attacks can be triggered by various stimuli: mechanical, thermal, pain, hyperventilation.

In the long periods of the disease in patients between attacks can be confusing: hearing loss, ringing in the ears, blurred vision, sweating.It appears caries and brittle teeth, brittle nails, develops hypocalcemic cataract.Often, there are changes in the psyche: neuroses, impaired memory, reduced intelligence.

there is a decrease in blood calcium (especially its ionized fraction) and parathyroid hormone, and opposite the phosphorus content significantly higher than the norm.The excretion of phosphorus and calcium in the urine is reduced

Treatment

cupping hypoparathyroidism administered intravenously 10 to 20 ml of 10% solution of calcium gluconate or chloride, and 2 ml intramuscular parathyroidin.After the introduction of these drugs usually attack quickly enough stops.

When administered PTH effect occurs much more slowly (through two - three hours).It is administered in a dosage of 2 - 4 ml intramuscularly or subcutaneously, every three - four o'clock until complete cessation of attack.

for prevention of attacks inside prescribed calcium supplements (glycerophosphate, lactate, gluconate) at a dose of 4 - 6 grams per day;paratireodin in 2 ml dose three times per week courses and a half to two months;drugs for improving calcium absorption in the intestine (digidrotahisterol) at a dosage of 10 to 25 drops three times a day;Anabolic steroids (Nerobolum, silabolin, retabolil, methandrostenolone).In addition, patients must adhere to a certain diet, which focuses on the ingestion of foods rich in calcium (lemons, strawberries, apricots, cheese, milk, cabbage, etc.).

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