So worehyia ɔhaw wɔ calcium dodow a ɛba fam wɔ oprehyɛn akyi no ho? Ebetumi ayɛ ‘Hungry Bone Syndrome’!

Sɛnea ebia wunim no, wɔ oprehyɛn ahorow bi akyi, titiriw nea woyi thyroid ntini a ɛwɔ kɔn mu anaa parathyroid ntini a ɛbɛn hɔ no, nipadua no betumi anya ɔhaw ahorow kakraa bi. Ebia nnipa binom bɛte nka sɛ wɔabrɛ a wontumi nsusuw ho, wɔn nipadua mu yɛ wɔn yaw, anaasɛ wɔn adwene atu afra kakra. Enti sɛ wo anaa obi a wunim no rehyia biribi a ɛte sɛɛ a, ebetumi afi tebea bi a yɛrebɛka ho asɛm nnɛ a wɔfrɛ no ‘Hungry Bone Syndrome’. Edin no te sɛ nea ɛyɛ nwonwa kakra, ɛnte saa? Ebia wobɛdwene sɛ, "Dɛn na ɛkyerɛ sɛ wowɔ nnompe a ɔkɔm de no?" Momma yɛnhwɛ nea ɛyɛ, wɔ nsɛm a ɛnyɛ den mu.

Dɛn ne ‘Hungry Bone Syndrome’?

Sɛ yɛbɛka no tiawa a, Hungry Bone Syndrome yɛ tebea a ɛma wo mogya mu calcium dodow kɔ fam mpofirim dodo. Nnuruyɛfo frɛ eyi ``Hypocalcemia''. Wɔtaa hu tebea yi bere a wɔayɛ parathyroid ntini no oprehyɛn akyi. So wunim sɛ parathyroid ntini ahorow no ho hia yiye wɔ calcium a ɛwɔ yɛn nipadua mu no sohwɛ mu?

Ebia ɛnyɛ sɛ nnipa a wɔwɔ saa ‘nnompe a ɔkɔm de wɔn’ yi nni calcium dodow a ɛba fam nko, na mmom ɛtɔ mmere bi a magnesium (`(Hypomagnesemia)`) ne phosphorus (`(Hypophosphatemia)`) nso sua wɔ wɔn mogya mu. Eyinom nso yɛ nneɛma a ɛho hia a yɛn nipadua hia.

Nanso biribiara nni hɔ a ɛsɛ sɛ wohaw wo ho wɔ ho. ‘Hungry Bone Syndrome’ yɛ tebea a wobetumi asa na wɔasa . Ade a ɛho hia sen biara ne sɛ wubehu bere a ɛsɛ mu na woafi ayaresa ase.

Saa tebea yi abu so dɛn?

Nhwehwɛmufo nni adwene pɔtee biara wɔ sɛnea ‘nnompe a ɔkɔm de wɔn’ yi abu so no ho, efisɛ ebetumi ayɛ soronko wɔ onipa biara ho.

Nanso nhwehwɛmu ahorow bi ada no adi sɛ nnipa 100 biara mu 4 kosi 13 a wɔayɛ wɔn parathyroidectomy ama tebea bi a wɔfrɛ no primary hyperparathyroidism no nya saa tebea yi. Afei nso, amanneɛbɔ ahorow bi ka sɛ bere a wɔayɛ oprehyɛn ama hyperparathyroidism a ɛto so abien ne abiɛsa akyi no, hokwan a ɛwɔ hɔ sɛ tebea yi benya no betumi ayɛ kɛse akodu 100 biara mu 20 kosi 70. Enti, ɛte sɛ nea eyi betumi abu so kakra wɔ tebea horow bi mu.

Dɛn ne ‘Hungry Bone Syndrome’ ho sɛnkyerɛnne?

‘Hungry Bone Syndrome’ ho sɛnkyerɛnne no te sɛ nea mogya mu calcium a ɛba fam (Hypocalcemia) de ba no ara pɛ. Eyinom betumi ayɛ nketenkete te sɛ akuru ketewaa bi wɔ nnipa binom mu, kosi nea emu yɛ den te sɛ adwene mu naayɛ anaasɛ akisikuru wɔ afoforo mu. Nsɛnkyerɛnne no bi ni:

• Honam no a ɛrehuruhuruw anaasɛ ɛretwe: Nkate a ɛte sɛ nea nam a ɛwɔ nan anaa abasa no mu no rehuruhuruw ara kwa.
• Ntini mu mmerɛwyɛ: Te nka sɛ nkwa nnim na wabrɛ dodo sɛ wobɛyɛ biribiara.
• Nnompe mu yaw: Ɛte sɛ nea nnompe a ɛwɔ nipadua no mu no reyɛ yaw.
• Ɔbrɛ a emu yɛ den: Ɔbrɛ a ɛnkɔ so bere a wada mpo.
• Adwene a ɛyɛ basaa: Ɛyɛ den sɛ wode w’adwene besi biribi so, a wunnim nea ɔnyɛ.
• Ɔhaw ahorow a ɛwɔ nkae mu: Nneɛma a wo werɛ fi.
• Abufuw anaa abufuw: Nneɛma nketenkete ho abufuw, te nka sɛ ne ho nyɛ no dɛ.
• Adwenemhaw: Awerɛhow ne anidaso a enni mu a wɔte nka.
• Anofafa, tɛkrɛma, nsateaa ano, ne/anaa nan a ɛyɛ mmerɛw: Saa mmeae yi te nka sɛ ɛyɛ mmerɛw, anaasɛ ɛte sɛ nea nwansena retu mmirika akɔ akyirikyiri.
• Ɔhome a ɛyɛ den esiane menewa mu ntini a ɛyɛ mmerɛw nti (`(Laryngospasm)`): Eyi yɛ asiane kakra, ɛma ɛyɛ den sɛ wobɛhome.
• Ntini a ɛyɛ den na ɛtwetwe (`(Tetany)`): Tebea a nipadua no ntini yɛ den na ɛtwetwe.
• Akisikuru: Eyi nso yɛ sɛnkyerɛnne a anibere wom.

Nea ɛka saa sɛnkyerɛnne ahorow yi ho no, sɛnea yɛadi kan aka no, magnesium ne phosphorus a ɛba fam wɔ mogya no mu (`(Hypomagnesemia)` ne `(Hypophosphatemia)`) nso betumi aba. Saa tebea horow yi ho sɛnkyerɛnne te sɛ nea calcium sua no ara pɛ. Wobetumi nso de ntini mu haw, akisikuru, ne koma a ɛbɔ a ɛnteɛ (`(Arrhythmia)`) aba.

Mpɛn pii no , nnompe a ɔkɔm de no ba wɔ nnɔnhwerew 18 akyi wɔ parathyroid anaa thyroid oprehyɛn akyi .

Dɛn nti na ‘Hungry Bone Syndrome’ yi ba?

Nneɛma atitiriw pii na ɛde ‘Hungry Bone Syndrome’ ba:

• Bere a wɔayɛ parathyroid oprehyɛn (Parathyroidectomy) akyi esiane hyperparathyroidism a edi kan anaa nea ɛto so abien nti.
• Thyrotoxicosis yɛ tebea a ɛba bere a wɔatwa thyroid no nyinaa akyi.
• Bere a prostate kokoram trɛw kɔ nnompe no mu (ɛtrɛw kɔ mmeae afoforo).

Sɛ yɛbɛte nea enti a eyi ba no ase ankasa a, ɛho hia sɛ yɛte sɛnea wɔhwɛ calcium dodow so wɔ yɛn nipadua mu no ase kakra.

Fa no sɛ, wo thyroid ntini a ɛwɔ wo kɔn mu no akyi no, ntini nketewa anan a wɔfrɛ no parathyroid glands na ɛwɔ hɔ. Saa ntini ahorow yi yɛ hormone bi a wɔfrɛ no parathyroid hormone (PTH) . PTH hormone yi adwuma titiriw ne sɛ ɛbɛhwɛ calcium dodow a ɛwɔ mogya no mu (ɛnyɛ nnompe mu, na mmom mogya no mu). PTH nso boa ma wɔhwɛ phosphorus (a ɛno nso yɛ mineral) ne vitamin D (a ɛno nso yɛ hormone) dodow a ɛwɔ mogya ne nnompe mu no so.

Enti, sɛ wo nipadua te nka sɛ calcium dodow a ɛwɔ wo mogya mu no sua a, parathyroid ntini no ma hormone PTH no fi adi. Saa PTH yi kɔ na ɛma calcium kakraa bi fi nnompe no mu na ɛde ka mogya no ho. Afei calcium dodow a ɛwɔ mogya mu no san ba sɛnea na ɛte kan no.

Afei, fa no sɛ obi wɔ parathyroid ntini a ɛyɛ adwuma dodo, na wɔyɛ no oprehyɛn yi fi hɔ. Nea ɛba ne sɛ PTH hormone dodow a kan no na ɛkɔ soro yiye no so tew mpofirim. Ɛtɔ mmere bi a, sɛ wɔyɛ thyroid oprehyɛn a, sɛ parathyroid ntini a ɛbɛn hɔ no sɛe wɔ akwanhyia mu a, PTH dodow nso betumi akɔ fam.

Sɛ PTH dodow so tew mpofirim a, calcium dodow a ɛwɔ nnompe dedaw mu a ɛsan kɔ mogya no mu (`(Resorption)`) no so tew, na nnompe foforo a ɛba (`(Bone Formation)`) no kɔ soro. Eyi ma nnompe no "kɔm de" calcium. Ɛno nti na wɔfrɛ eyi ‘hungry bone syndrome’ no.

Eyi ne nea ɛba bere a prostate kokoram trɛw kɔ nnompe no mu no. Ɛhɔ no, nkwammoaa a ɛkyekye nnompe (`(Osteoblastic activity)`) dwumadi kɔ soro, enti nnompe no hia calcium pii.

Hena na ɔwɔ asiane kɛse mu sɛ obenya ‘Hungry Bone Syndrome’?

Ɛda adi sɛ nnipa binom benya saa tebea yi. Momma yɛnhwɛ nnipa ko a wɔyɛ:

• Parathyroid hormone (PTH) a ɛdɔɔso yiye wɔ mogya no mu.
• Alkaline phosphatase dodow a ɛkɔ soro wɔ mogya no mu.
• Mpɛn pii no, calcium dodow a ɛwɔ mogya no mu no sua.
• Vitamin D a wonnya nni.
• Thyroid ne parathyroid oprehyɛn a wɔyɛ bere koro mu.
• Urea nitrogen (BUN) dodow a ɛkɔ soro wɔ mogya mu.
• Kɛse mmoroso, kyerɛ sɛ, srade a ɛboro so.
• Oprehyɛn a wɔde yi parathyroid ntini a ɛsõ sen sɛnea ɛte daa no fi hɔ.
• Kokoram nkwammoaa a ɛtrɛw kɔ nnompe no mu (Metastatic tumors of the bones).
• Nyarewa a efi nnompe mu te sɛ akisikuru a ɛyɛ bruu ne osteitis fibrosa cystica a ɛwɔ hɔ.

Nnipa a wɔwɔ saa asiane ahorow yi taa nya ‘nnompe a ɔkɔm de wɔn yare’.

Ɔkwan bɛn so na nnuruyɛfo hu eyi?

Mpɛn pii no, oduruyɛfo bedi kan ahu sɛ ebia wowɔ ‘nnompe a ɔkɔm de wo’ denam mogya mu nhwehwɛmu a ɔbɛyɛ so. Mpɛn pii no, sɛ wo mogya mu calcium dodow nnu 8.4 mg/dL bɛboro nnanan a, wobu no sɛ asiane a ɛde ‘ɔkɔm nnompe yare’ ba.

Ɛnyɛ ɛno nko, na mmom ebia wo duruyɛfo no bɛyɛ nhwehwɛmu afoforo kakraa bi nso de ahu sɛ ebia tebea yi aka w’akwahosan afã afoforo anaa:

• Mogya mu nhwehwɛmu afoforo: Wobetumi asɔ wo mogya mu ahwɛ sɛ magnesium, phosphorus, parathyroid hormone (PTH), ne/anaasɛ vitamin D dodow wɔ mu anaa.
• EKG (Electrocardiogram): Saa sɔhwɛ yi susuw sɛnea wo koma no yɛ adwuma denam electrode ahorow a wɔde bata wo moma so no so. Eyi ho hia efisɛ mogya mu calcium a ɛba fam (hypocalcemia) ne ‘ɔkɔm nnompe mu yare’ betumi ama koma abɔ a ɛnteɛ.
• Nnompe ho mfoniniyɛ mu nhwehwɛmu: Saa nhwehwɛmu ahorow yi betumi ahwɛ sɛ ɔhaw ahorow bi wɔ wo nnompe mu, te sɛ nea abubu, dɛmdi, anaa akisikuru.

Dɛn ne ayaresa ahorow a wɔde sa ‘Hungry Bone Syndrome’?

Mma ɛnhaw wo, ayaresa pa wɔ hɔ a wɔde sa eyi. Botae titiriw a ɛwɔ ayaresa mu ne sɛ ɛbɛma calcium dodow a ɛwɔ wo mogya mu no asan ayɛ nea ɛfata. Mpɛn pii no, wo nsa bɛka saa ayaresa yi bere a wowɔ ayaresabea no. Ayaresa no betumi ayɛ:

• Calcium a wɔde fa ntini bi mu ma (`(IV Calcium - Calcium Gluconate)`): Eyi boa ma calcium dodow san ba ntɛmntɛm.
• Calcium a Wɔnom (Calcium Citrate anaa Calcium Carbonate): Wɔde eyinom ma na ama calcium dodow akɔ so atra hɔ.
• Vitamin D a Wɔnom: Vitamin D ho hia na ama nipadua no atumi atwe calcium.
• Magnesium a wɔde si ananmu: Sɛ magnesium dodow sua a, ɛsɛ sɛ wosiesie ɛno nso.

Nnuruyɛfo no bɛhwehwɛ wo tebea no mu na wɔahu ayaresa a ɛfata wo sen biara.

Bere tenten ahe na ebegye na obi ho atɔ no afi tebea yi mu? Dɛn ne daakye?

Asɛmpa no ne sɛ ɛkame ayɛ sɛ wotumi sa tebea yi, ‘Hungry Bone Syndrome’ koraa . Ɛno kyerɛ sɛ nkɔmhyɛ no ye yiye.

Nanso, sɛ wɔsa yare mpo a, bere a egye ansa na tebea yi asiesie koraa no betumi ayɛ soronko. Nnipa binom ho bɛtɔ wɔn wɔ nna kakraa bi mu, bere a afoforo nso betumi agye asram pii. Wɔ tebea horow a ɛntaa nsi koraa mu no, ebetumi atra hɔ afe biako.

Nea ɛho hia sen biara no, sɛ wɔansa a, hypocalcemia a emu yɛ den betumi de nsɛnnennen a ɛde nkwa to asiane mu te sɛ akisikuru aba. Enti, sɛ yare no ho sɛnkyerɛnne bi ba a, ɛho hia sɛ wɔhwehwɛ ayaresa ntɛm ara.

So wobetumi asiw ‘Hungry Bone Syndrome’ ano?

Esiane sɛ ‘ɔkɔm nnompe mu yare’ betumi aba wɔ parathyroid oprehyɛn (`(Parathyroidectomy)`) anaa thyroid oprehyɛn (`(Thyroidectomy)`) akyi nti, nnuruyɛfo bɔ mmɔden sɛ wɔbɛyɛ nneɛma bi de asiw ano ansa na wɔayɛ oprehyɛn no mpo. Ma yɛnhwɛ nea wɔyɛ:

• Nhwehwɛmu a wɔyɛ ansa na wɔayɛ oprehyɛn: Ansa na wobɛyɛ oprehyɛn , wo duruyɛfo no bɛhwɛ sɛnea wo nnompe mu nneɛma te, calcium dodow a ɛwɔ wo mogya mu, phosphate dodow, PTH dodow, ne vitamin D dodow. Saa nhwehwɛmu yi betumi aboa wo duruyɛfo ma wahu sɛ ebia wowɔ asiane mu sɛ wubenya ‘ɔkɔm nnompe mu yare’ anaa.
• Nneɛma a wɔde siw ano:Sɛ asiane kɛse wom sɛ wubenya ‘nnompe a ɔkɔm de wo’ a, ebia wo duruyɛfo bɛkamfo akyerɛ sɛ fa nnuru a wɔde ka ho anaa nnuru a ɛbɛma wo vitamin D ne calcium dodow akɔ so atra hɔ ansa na wɔayɛ wo oprehyɛn. Eyi betumi aboa ma wɔatew ‘nnompe a ɔkɔm de wɔn yare’ a ebetumi aba ne/anaasɛ sɛnea emu yɛ den no so.
• Oprehyɛn akyi a wɔbɛhwɛ: Sɛ wɔyɛ oprehyɛn wie a, ayaresabea kuw no bɛhwɛ sɛnea calcium, phosphate, magnesium, ne PTH wɔ wo mogya mu no daa. Eyi te saa sɛnea ɛbɛyɛ a sɛ wunya ‘hungry bone syndrome’ a, wobetumi ahu no ntɛm na wɔafi ase ayaresa no ntɛm ara.

Nanso, wɔ saa nneɛma yi nyinaa akyi no, ɛtɔ mmere bi a ‘ɔkɔm nnompe mu yare’ betumi aba. Nhwehwɛmufo da so ara ntumi nhu nea enti a eyi ba.

Bere bɛn na ɛsɛ sɛ mekɔ oduruyɛfo nkyɛn?

Sɛ woayɛ parathyroid anaa thyroid oprehyɛn na akyiri yi wunya mogya mu calcium a ɛba fam (`(Hypocalcemia)`) a yɛadi kan aka ho asɛm no ho sɛnkyerɛnne, te sɛ ntini mu akisikuru, mmerɛwyɛ ho nkate, nsakrae a ɛba w’adwene mu (te sɛ adwene mu naayɛ), ne anofafa ne nsateaa a ɛyɛ mmerɛw a, akyinnye biara nni ho sɛ ɛsɛ sɛ wuhu oduruyɛfo ntɛm ara sɛnea wubetumi.**Hungry bone syndrome' ne `(Hypocalcemia)` betumi aba wɔ parathyroid ne/anaasɛ thyroid oprehyɛn akyi, ebetumi abrɛ ase nna kakraa bi akyi, na afei asan ada adi bio. Enti, ɛho hia paa sɛ yɛhwɛ yare no ho sɛnkyerɛnne ketewaa bi mpo.

‘Hungry bone syndrome’ yɛ tebea a ebetumi aba bere a wɔayɛ oprehyɛn de ayi parathyroid anaa thyroid ntini no akyi. Asɛmpa no ne sɛ wobetumi asa na wɔasa. Nanso, ebia ebegye bere kakra ansa na ne ho atɔ no koraa. Esiane sɛ mogya mu calcium dodow a ɛso tew kɛse no betumi ayɛ asiane ama w’akwahosan nti, ɛbɛyɛ papa sɛ wobɛkɔ oduruyɛfo nkyɛn bere a woahu sɛnkyerɛnne ahorow no ara pɛ.

Fa nkrasɛm kɔ fie

Enti, sɛ yɛbɛka no tiawa a, ‘Hungry Bone Syndrome’ yɛ tebea a ebetumi aba bere a wɔayɛ parathyroid anaa thyroid ntini no oprehyɛn akyi. Nea ɛyɛ titiriw ne sɛ calcium dodow a ɛwɔ nipadua no mogya mu no so tew mpofirim. Eyi te saa efisɛ parathyroid hormone (`(PTH)`) dodow so tew wɔ oprehyɛn no akyi, na ɛma nnompe no "hwehwɛ" calcium.

Nsuro sɛ wobɛte eyi, efisɛ ‘Hungry Bone Syndrome’ yɛ tebea a wobetumi asa na wɔasa no yiye paa.

Nea ɛho hia sen biara ne sɛ, sɛ wowɔ saa sɛnkyerɛnne ahorow yi bi (te sɛ ntini a ɛtwetwe, ɔbrɛ, akisikuru) a, nsɛe bere na kɔ oduruyɛfo nkyɛn ntɛm ara sɛnea wubetumi. Saa kwan yi so no, wubetumi ahu tebea no ntɛm, afi ayaresa a ɛho hia no ase ntɛm, na woasa ansa na abɛyɛ ɔhaw kɛse. Kae sɛ w’akwahosan a wobɛhwɛ so no wɔ w’ankasa wo nsam.

`Nnompe a Ɔkɔm De Wɔn, Nnompe a Ɔkɔm De Wɔn, Calcium, Hypocalcemia, Parathyroid, Thyroid Oprehyɛn, PTH