Hypothyroidism - Causes, Symptoms and Treatment .MF .
Hypoparathyroidism - a disease in which the reduced content of parathyroid hormone or its complete disappearance, which leads to disruption of calcium absorption in the intestine, reducing its excretion from the bones, reduce its reuptake in the kidney.Lack
PTH reduces calcium and phosphate in the blood increase, which leads to an increase neuromuscular excitability, which results in cramps.
Basic information about the function of the parathyroid (okoloschitvidnyh) glands.
parathyroid gland - the most "young" body is open endocrinologists.It was first described by the Swedish anatomist I.K.Sundstriem in 1880.In humans, there are four parathyroid glands, which are located two on each side at the rear surface of the thyroid gland.However, there may be deviations in the amount of iron (may be 3,5 or 6), and their position (may be arranged in the thickness of the thyroid gland).
parathyroid glands produce parathyroid hormone, which along with vitamin D and calcitonin (thyroid hormone) regulate the ex
The human body contains about 1kg.calcium kotorogonahoditsya 99% in the bone, and 1% in the soft tissues.Every day, people with food consumes about 1g.calcium.
phosphorus content of about 600g.(85% in the skeleton, 15% - in the soft tissues), and 25 g. magnesium.With food daily receives about 2g.phosphates, which are suppliers of phosphorus, which is urgently needed by the body.
Understanding hypoparathyroidism Hypoparathyroidism
- a disease in which the reduced content of parathyroid hormone or its complete disappearance, which leads to disruption of calcium absorption in the intestine, reducing its excretion from the bones, reduce its reuptake in the kidney.
Lack of parathyroid hormone caused by reduction in the amount of calcium and phosphate in the blood increase, which leads to increased neuromuscular excitability, which results in cramps.
calcium metabolism Disorders of phosphorus, magnesium contributes to the development of chronic forms of the disease tissue malnutrition, manifested growth retardation in children, skin changes and lens.
There are 3 forms of hypoparathyroidism:
- Acute - occurs with frequent and severe bouts of neuromuscular excitability (convulsions), and it is difficult compensated.
- Chronic - attacks are not frequent, and are due to physical exertion, infection, trauma, menstruation, nervous strain.Exacerbations are more often in spring and autumn.When properly selected treatment can be achieved bespristupnyh long periods.
- Latent - without visible symptoms, revealed only when a special examination.
symptoms of hypoparathyroidism
When symptoms of hypoparathyroidism are combined into 4 groups of syndromes (symptoms, having the same mechanism of the origin and characterized by a certain state of the body):
- tetanic, convulsive syndrome (increased neuromuscular excitability).
- Syndrome sensitivity changes and autonomic functions (functions of the internal organs).
- Syndrome lesions of the central nervous system and brain disorders.
- skin changes and trophic disturbances (power tissue disorders).
tetanic, convulsions when
hypoparathyroidism This syndrome is the leading with hypoparathyroidism .It is characterized by an increase neuromuscular excitability, which manifests itself in the form of cramps (muscle contraction for a period of time, accompanied by pain).
Cramps do not appear suddenly, they necessarily precede precursors: paresthesia (numbness, crawling on hands and feet), burning, tingling, tension, stiffness in the muscles of the arms and legs.After the precursors develop individual muscle cramps.They apply to certain groups of muscles, symmetrically on both sides.More often than not involved the muscles of the upper extremities, and then cramps in the lower limbs move muscles.Sometimes the facial muscles are involved, much less of the trunk muscles and internal organs.
If convulsions occur characteristic changes on the part of authorities, depending on which muscles are affected.
cramping muscles are subjected to the following:
- limbs - often affects flexors (muscles that provide flexion of limbs).In the throes of the upper extremities hand is shown to the body, bent at the elbow and wrist joints.
- with the defeat of the facial muscles, it takes on a characteristic appearance: the corners of the mouth are lowered, the mouth takes the form of "fish", eyebrows shifted forever Semi-underslung.
- body, while reducing them going backwards extension of the trunk;
- esophagus, which leads to a violation of swallowing;
- spasm of muscles of the intestine causes constipation and intestinal colic (stabbing pain in the central abdomen);
- possible occurrence of anuria (absence of urine) due to spasm of the muscles of the bladder.
Convulsions in hypoparathyroidism are very painful and can last from minutes to several hours, can occur spontaneously and be caused by any stimuli (pain, temperature, electrical, mechanical) can be due to muscle strain during intensive physical activity,nervous breakdown, while taking a hot bath, while straightening the legs.
cramps can be accompanied by pallor, increase or decrease pressure, increased or decrease in heart rate, vomiting, diarrhea.In very severe attacks, patients may lose consciousness.
syndrome changes of autonomic function and sensitivity changes
Autonomic disorders in patients appear as:
- sensations of heat or cooling;
- hyperhidrosis (excessive sweating);
- vertigo (sensation of movement of surrounding objects or own body and balance disorders).
- fainting (transient loss of consciousness);
- ringing in the ears;
- violation concentration of visual attention and visual impairment in the dark (night vision);
- sense of "mortgaging" the ears;
- sometimes pain and violation of contraction of the heart (irregular heart).
sensitivity changes characterized by increased sensitivity to noise, sounds sharp, loud music.There is a change of perception of the ambient temperature (when all the heat, the patient is cold and vice versa).Violation of sensitivity is observed by the taste buds: a decrease in sensitivity to sour and rise to bitter and sweet.
defeat syndrome of the central nervous system, brain disorders
Prolonged reduced calcium content in the blood of patients begin to mark the change of mentality, emotional disturbances (depression, melancholy), insomnia.
Skin changes trophic disorders
These changes occur in chronic diseases.This is characterized by dryness, peeling, eczema (skin flaking, accompanied by itching), possible pigmentation or depigmentation, ie,the skin becomes non-uniform color.Perhaps the appearance of bubbles on the skin with liquid contents.
lesions observed on the part of the skin appendages in the form of dysplasia, early graying and thinning of hair (sometimes there is loss to complete baldness), brittle, pale, dull nails, the nails are often affected by fungal diseases.
Trophic violations in this case is meant by a violation of the power organ tissues, primarily bone, calcium, phosphorus and magnesium.At the same time there is a change from the dental system: children - a violation of formation of teeth, enamel defects;in patients of all age groups - caries, defects in tooth enamel.In children, there is also growth retardation.
In the long hypoparathyroidism may develop cataracts - clouding of the lens with a decrease in visual acuity up to complete its loss.
Causes of hypoparathyroidism
Causes of hypoparathyroidism are mainly related to disorders of the thyroid gland, which is explained by a very close interaction between the two glands (located in the human body tightly adhering to each other).
By hypoparathyroidism result:
- Damage to the parathyroid glands or the violation of their circulation in thyroid operations.
- removal of iron at their location in the interior of the thyroid gland.
- Inflammation of the parathyroid glands in thyroiditis (inflammation of the thyroid gland).
- defeat of their radiation in the treatment of hyperthyroidism with radioactive iodine.
- Infectious Diseases.
- Inferiority development and tumor lesion paraschitvidnyh glands.
Diagnosis of acute and chronic hypoparathyroidism
Acute and chronic forms of hypoparathyroidism are called explicit, as in both cases the patients will have symptoms of the disease, only expressed in different degrees.
Diagnostics explicit form is simple, because it is based on the presence of characteristic symptoms (primarily seizures).
Diagnosis is based on the following data:
- indication of a history (collection of patient data from the patient's disease, words and entries in the medical card) for an operation on the thyroid gland, parathyroid glands, treatment with radioactive iodine;
- bouts of seizures (with the words of the patient);
- decrease in calcium content in the blood and urine, which is detected by laboratory tests;
- increase in phosphate in the blood and decrease in urine;
- reduction in parathyroid hormone in the blood;
- change of heart an electrocardiogram;
- cataracts (clouding of the lens, leading to vision loss).
diagnosis of latent hypoparathyroidism
latent forms of hypoparathyroidism is very difficult to identify, as there are no specific symptoms, so diagnosis using special tests or symptoms.
Symptom Hvosteksa - reduction of facial muscles when tapped in front of the external auditory canal (the place exit of the facial nerve).
Trousseau Symptom - cramps in hands 2-3 minutes after pulling the shoulder harness or collar tonometer (apparatus for measuring blood pressure).
Symptom Weiss - muscle contraction eyelids and frontal muscles with effleurage the outer edge of the eye socket.
Symptom Hoffmann - the appearance of paresthesias with pressure at the inner edge of the eyebrow (branching nerve section).
Schlesinger Symptom - cramps in the extensor muscles of the thigh and foot during rapid flexion of the hip becoming the straightened knee.
Symptom Erb - increased electroexcitability limb nerve stimulation at low current, resulting in convulsions.
Treatment of hypoparathyroidism
used to treat hypoparathyroidism diet rich in calcium and magnesium salts (milk, dairy products, vegetables, fruits) with phosphorus restriction (meat).Refusal of meat products especially needed during seizures.It is advisable the introduction of a food ergocalciferol, which is found in fish oils, herring, liver, egg yolk.
sedatives and anticonvulsants (Luminal, etc.) is used to treat symptoms of the disease.