Ðe calcium ƒe agbɔsɔsɔ si mede ame dzi o le amekoko vɔ megbe le kuxi me tom? Ate ŋu anye ‘Dɔwuame ƒe Ƒu ƒe Dɔléle’!

Abe alesi nànyae ene la, le amekoko aɖewo megbe, vevietɔ esiwo ɖea lãkusi si le kɔ me alo lãkusi siwo te ɖe eŋu ɖa la, ŋutilãa ate ŋu ase veve vovovo ʋɛ aɖewo. Ame aɖewo ate ŋu ase le wo ɖokui me be ɖeɖi te wo ŋu ale gbegbe, woƒe ŋutilã le veve sem, alo wotɔtɔ vie. Eyata ne wò alo ame aɖe si nènya le nane si le abe esia ene me tom la, ate ŋu atso nɔnɔme aɖe si ŋu míele nu ƒom tsoe egbea si woyɔna be ‘Hungry Bone Syndrome’ gbɔ. Ŋkɔa ɖi nusi wɔ nuku vie, alo? Ðewohĩ ànɔ eŋu bum be, "Nukae wòfia be ƒu siwo dɔ le wuwum?" Mina míalé ŋku ɖe nusi wònye ŋu, le nya bɔbɔewo me.

Nukae nye ‘Dɔwuame ƒe Ƒu ƒe Dɔléle’?

Kpuie ko la, Hungry Bone Syndrome nye nɔnɔme si me wò ʋu me calcium ƒe agbɔsɔsɔ dzi ɖena kpɔtɔna zi ɖeka akpa. Ðɔktawo yɔa esia be ``Hypocalcemia''. Zi geɖe la, wokpɔa nɔnɔme sia le amekoko na parathyroid glands megbe. Ènya be parathyroid lãkusiwo le vevie ŋutɔ le calcium si le míaƒe ŋutilã me dzi ɖuɖu mea?

Menye ɖeko ame siwo ŋu ‘ƒu ƒe dɔwuame ƒe dɔléle’ sia le la ate ŋu anye be calcium ƒe agbɔsɔsɔ si mede o, ke ɣeaɖewoɣi la, magnesium (`(Hypomagnesemia)`) kple phosphorus (`(Hypophosphatemia)`) hã mesɔ gbɔ ɖe woƒe ʋu me o. Esiawo hã nye tomenu vevi siwo míaƒe ŋutilã hiã.

Gake naneke meli si ŋu woatsi dzi ɖo o. ‘Hungry Bone Syndrome’ nye dɔléle si woate ŋu ada ahadae . Nu vevitɔe nye be nàde dzesii le ɣeyiɣi nyuitɔ dzi eye nàdze atikewɔwɔ gɔme.

Aleke gbegbee nɔnɔme sia bɔe?

Le nyateƒe me la, numekulawo menya alesi gbegbe ‘ƒu ƒe dɔwuame ƒe dɔléle’ sia bɔe o, elabena ate ŋu ato vovo tso ame ɖeka gbɔ yi bubu gbɔ.

Gake numekuku aɖewo ɖee fia be ame 4 va ɖo 13 le ame 100 siwo woɖe parathyroidectomy na dɔléle aɖe si woyɔna be primary hyperparathyroidism ta la, ame 4 va ɖo 13 ye xɔa nɔnɔme sia. Azɔ hã, nyatakaka aɖewo gblɔ be le amekoko na dɔléle si nye hyperparathyroidism evelia kple etɔ̃lia megbe la, mɔnukpɔkpɔ si li be dɔléle sia nadze ame dzi ate ŋu ade 20 va ɖo 70 le 100. Eyata, edze abe esia ate ŋu abɔ vie wu le go aɖewo me ene.

Nukae nye ‘Hungry Bone Syndrome’ ƒe dzesiwo?

‘Hungry Bone Syndrome’ ƒe dzesiwo sɔ kple esiwo ʋumesukli ƒe agbɔsɔsɔ si mede o (Hypocalcemia) hena vɛ ŋutɔ. Esiawo ate ŋu anye nu suesuesuewo abe ƒunukpeƒetetedɔ sue aɖe ene le ame aɖewo gome, va ɖo esiwo nu sẽ abe tɔtɔ alo alɔ̃madɔmadɔ ene le ame bubuwo gome. Dzesiawo dometɔ aɖewoe nye esi:

• Lã la ʋuʋu alo hehe: Seselelãme abe ɖe lã si le afɔ alo abɔwo me le ʋuʋum ko ene.
• Lãmetsiwo ƒe gbɔdzɔgbɔdzɔ: Ese le eɖokui me be agbe mele ye si o eye ɖeɖi te ye ŋu akpa be yeate ŋu awɔ naneke o.
• Ƒu ƒe vevesese: Ese le eɖokui me abe ɖe ƒu siwo le ŋutilãa me le veve sem ene.
• Ðeɖiteameŋu sesẽ: Ðeɖiteameŋu si nu metsina le alɔ̃dɔdɔ megbe gɔ̃ hã o.
• Tɔtɔ: Esesẽna be wò susu nanɔ nu ŋu, manya nusi wòle be wòawɔ o.
• Ŋkuɖodzikuxiwo: Nuwo ŋɔŋlɔ be.
• Dzikudodo alo dzikudodo: Dzikudodo ɖe nu suesuesuewo ta, dzikudodo.
• Blanuiléle: Blanuiléle kple mɔkpɔkpɔbuɖeame ƒe seselelãme.
• Nuyiwo, aɖe, asibidɛwo, kple/alo afɔwo ƒe ʋuʋu: Teƒe siawo sena le wo ɖokui me be yewole ʋuʋum, alo abe anyidiwo le du dzi le tsatsam ene.
• Yagbɔgbɔ sesẽ le ŋɔti ƒe lãmekawo ƒe ʋuʋu ta (`(Laryngospasm)`): Esia nye afɔku vie, ena gbɔgbɔ sesẽna.
• Lãmetsiwo ƒe sesẽ kple ʋuʋu (`(Tetany)`): Nɔnɔme si me ŋutilã ƒe lãmekawo sesẽna eye woʋuʋuna.
• Alɔ̃madɔmadɔ: Esia hã nye dzesi sesẽ aɖe.

Tsɔ kpe ɖe dzesi siawo ŋu la, abe alesi míegblɔe va yi ene la, magnesium kple phosphorus ƒe agbɔsɔsɔ si mede ʋua me o (`(Hypomagnesemia)` kple `(Hypophosphatemia)`) hã ate ŋu adzɔ. Nɔnɔme siawo ƒe dzesiwo ɖi calcium si mebɔ o ƒe dzesiwo ŋutɔ. Woateŋu ahe lãmekawo ƒe kuxiwo, alɔ̃madɔmadɔ, kple dzi ƒe tsotso si mesɔ o (`(Arrhythmia)`) hã vɛ.

Zi geɖe la , ƒu si dɔ le wuwum la dzɔna le gaƒoƒo 18 me le parathyroid alo thyroid dɔwɔwɔ na ame megbe .

Nukatae ‘Dɔwuame ƒe Ƒumeŋuɖui’ sia dzɔna?

Nu vevi geɖewo li siwo gbɔ ‘Hungry Bone Syndrome’ tsona:

• Le parathyroid dɔwɔwɔ vɔ megbe (`(Parathyroidectomy)`) na hyperparathyroidism gbãtɔ alo evelia.
• Thyrotoxicosis nye dɔléle si dzɔna le ʋumenugbagbeviɣidɔ ɖeɖeɖa keŋkeŋ megbe.
• Ne prostate cancer kaka ɖe ƒuwo me (ekaka ɖe ƒuwo me).

Be míase nusita tututu esia dzɔna gɔme la, ele vevie be míase alesi wowɔa ɖoɖo ɖe calcium ƒe agbɔsɔsɔ ŋu le míaƒe ŋutilã me gɔme vie.

Bu eŋu kpɔ be, le wò lãkusi si le wò kɔ me megbe la, lãkusi sue ene siwo woyɔna be parathyroid glands le eme. Lãmenugbagbevi siawo wɔa lãmetsi aɖe si woyɔna be parathyroid hormone (PTH) . Dɔ vevitɔ si PTH lãmetsi sia wɔnae nye be wòakpɔ calcium ƒe agbɔsɔsɔ si le ʋua me dzi (menye le ƒuwo me o, ke boŋ le ʋua me). PTH kpena ɖe ame ŋu hã be woakpɔ phosphorus (si hã nye mineral) kple vitamin D (si hã nye lãmetsiŋusẽ) ƒe agbɔsɔsɔ le ʋu kple ƒuwo me.

Eyata ne wò ŋutilã kpɔe be calcium ƒe agbɔsɔsɔ le wò ʋu me le ʋɛ la, parathyroid lãkusiwo ɖea lãmetsi si nye PTH ɖe go. PTH sia yia ɖaɖea calcium sue aɖe ɖa le ƒuawo me eye wòtsɔnɛ kpena ɖe ʋua ŋu. Emegbe calcium ƒe agbɔsɔsɔ si le ʋu me la gatrɔna yia eƒe nɔnɔme nyuitɔ me.

Azɔ tsɔe be parathyroid gland siwo wɔa dɔ akpa le ame aɖe ŋu, eye wowɔ dɔ nɛ be woaɖe wo ɖa. Nusi dzɔnae nye be PTH lãmetsi si sɔ gbɔ ŋutɔ tsã la dzi ɖena kpɔtɔna zi ɖeka. Ɣeaɖewoɣi la, ne wowɔ dɔ na thyroid la, ne parathyroid gland siwo te ɖe wo ŋu gblẽ le vo me la, PTH ƒe agbɔsɔsɔ hã ate ŋu aɖiɖi.

Ne PTH ƒe agbɔsɔsɔ ɖiɖi kpata la, calcium ƒe agbɔsɔsɔ si le ƒu xoxowo me si wogbugbɔ gena ɖe ʋua me (`(Resorption)`) dzi ɖena kpɔtɔna, eye ƒu yeyewo ƒe wɔwɔme (`(Bone Formation)`) dzina ɖe edzi. Esia nana be ƒuawo "dɔa wu" calcium. Esia tae woyɔa esia be ‘dɔwuame ƒe ƒu ƒe dɔléle’ ɖo.

Esiae dzɔna ne ʋumenugbagbeviɣidɔ kaka ɖe ƒuwo me. Afimae lãmenugbagbevi siwo tua ƒuwo ƒe dɔwɔwɔ (`(Osteoblastic activity)`) dzina ɖe edzi, eyata ƒuawo hiã calcium geɖe wu.

Amekawoe le afɔku gã me be woaxɔ ‘Hungry Bone Syndrome’?

Anɔ bɔbɔe be dɔléle sia nadze ame aɖewo dzi. Mina míalé ŋku ɖe amesiwo wonye ŋu:

• Parathyroid hormone (PTH) ƒe agbɔsɔsɔ si sɔ gbɔ ŋutɔ le ʋua me.
• Alkaline phosphatase ƒe agbɔsɔsɔ si dzina ɖe edzi le ʋua me.
• Zi geɖe la, calcium ƒe agbɔsɔsɔ si le ʋua me medea ame dzi o.
• Vitamin D ƒe agbɔsɔsɔ si mede ame dzi o.
• Dɔwɔwɔ na thyroid kple parathyroid le ɣeyiɣi ɖeka me.
• Urea nitrogen (BUN) ƒe agbɔsɔsɔ si le ʋu me dzi ɖe edzi.
• Lolo akpa, si fia ami si gbɔ eme.
• Amekoko ƒe parathyroid gland si lolo wu esi sɔ la ɖeɖe ɖa.
• Kansa lãmenugbagbeviwo ƒe kaka ɖe ƒuwo me (Metastatic tumors of the bones).
• Dɔléle siwo do ƒome kple ƒuwo abe ƒumeŋuɖui siwo ƒe amadede nye aŋutiɖiɖi kple ƒumeŋuɖui si woyɔna be osteitis fibrosa cystica ene ƒe anyinɔnɔ.

Amesiwo ŋu afɔku siawo le la ate ŋu axɔ ‘dɔwuame ƒe ƒu ƒe dɔléle’.

Aleke ɖɔktawo wɔna kpɔa esia?

Zi geɖe la, ɖɔkta akpɔe gbã nenye be ‘ƒu si dɔ le wuwum’ le ŋuwò to ʋudodokpɔ si me calcium le wɔwɔ me. Zi geɖe la, ne wò ʋu me calcium ƒe agbɔsɔsɔ mede 8.4 mg/dL o wu ŋkeke ene la, wobua esia be enye afɔku na ‘ƒu ƒe dɔwuame ƒe dɔléle’.

Menye ema ɖeɖeko o, ke wò ɖɔkta ate ŋu awɔ dodokpɔ ʋɛ bubuwo hã atsɔ akpɔe ɖa be nɔnɔme sia kpɔ ŋusẽ ɖe wò lãmesẽ ƒe akpa bubuwo hã dzi:

• Ʋudodokpɔ bubuwo: Woate ŋu ado wò ʋu kpɔ be magnesium, phosphorus, parathyroid hormone (PTH), kple/alo vitamin D ƒe agbɔsɔsɔ le eme hã.
• EKG (Electrocardiogram): Dodokpɔ sia dzidzea wò dzi ƒe tsotso to elektrikŋusẽnamɔ̃wo dede wò akɔta me. Esia le vevie elabena ʋumenugbagbeviɣidɔ (hypocalcemia) kple ‘ƒu ƒe dɔwuame ƒe dɔléle’ ate ŋu ana dzi naƒo si mesɔ o.
• Ƒuwo ƒe nɔnɔmetatawo dodokpɔ: Dodokpɔ siawo ate ŋu akpɔe ɖa be kuxi aɖewo le wò ƒuwo ŋu, abe ƒu ƒe gbagbã, nuwɔametɔ, alo dɔdzẽ ene.

Nukae nye atike siwo wozãna na ‘Hungry Bone Syndrome’?

Mègatsi dzi o, atike nyuiwo li na esia. Taɖodzinu vevitɔ si le atikewɔwɔ ŋue nye be wòana calcium ƒe agbɔsɔsɔ si le wò ʋu me la nagaɖo afisi wòle be wòanɔ nyuie. Zi geɖe la, àxɔ atike sia esime nèle kɔdzi. Atikewɔwɔ ate ŋu anye:

• Calcium nana to ʋuka me (`(IV Calcium - Calcium Gluconate)`): Esia kpena ɖe ame ŋu be calcium ƒe agbɔsɔsɔme gaɖoa ame ŋu kabakaba.
• Calcium kpeɖeŋutɔ siwo woano (Calcium Citrate alo Calcium Carbonate): Wonaa esiawo be calcium ƒe agbɔsɔsɔ nanɔ eme.
• Vitamin D ƒe kpeɖeŋutɔ siwo woano: Vitamin D le vevie ŋutɔ be ŋutilãa nate ŋu axɔ calcium.
• Magnesium ɖɔliɖɔli: Ne magnesium ƒe agbɔsɔsɔ le sue la, ke ele be woaɖɔ ema hã ɖo.

Ðɔktawo alé ŋku ɖe wò nɔnɔmea ŋu ahakpɔ atike si sɔ na wò wu.

Ɣeyiɣi didi kae wòaxɔ hafi wòahaya tso nɔnɔme sia me? Nukae nye etsɔme?

Nya nyuiae nye be woate ŋu ada nɔnɔme sia, si nye ‘Hungry Bone Syndrome’, keŋkeŋ kloe . Ema fia be nyagblɔɖia nyo ŋutɔ.

Gake ne wowɔ atike nɛ gɔ̃ hã la, ɣeyiɣi si wòxɔna hafi nɔnɔme sia nu natso keŋkeŋ ate ŋu ato vovo. Ame aɖewo ƒe lãme sẽna le ŋkeke ʋɛ aɖewo megbe, gake bubuwo ya ate ŋu axɔ ɣleti geɖe. Le go siwo mebɔ kura o me la, ate ŋu anɔ anyi ƒe ɖeka.

Vevietɔ wu la, ne womewɔ atike nɛ o la, ʋumenugbagbeviɣidɔ sesẽ ate ŋu ahe kuxi siwo ate ŋu ade ame ƒe agbe afɔku me abe alɔ̃madɔmadɔ ene vɛ. Eyata ele vevie be nàdi atike kaba ne dzesiawo dze.

Ðe woate ŋu axe mɔ ɖe ‘Hungry Bone Syndrome’ nua?

Esi wònye be ‘ƒu ƒe dɔwuame ƒe dɔléle’ ate ŋu adzɔ le parathyroid dɔwɔwɔ (`(Parathyroidectomy)`) alo thyroid dɔwɔwɔ (`(Thyroidectomy)`) megbe ta la, ɖɔktawo dzea agbagba be yewoaɖe afɔ aɖewo atsɔ axe mɔ ɖe enu hafi woawɔ dɔ nɛ gɔ̃ hã. Na míakpɔ nusiwo wonye ɖa:

• Do ŋgɔ na amekoko ƒe dodokpɔ: Hafi woawɔ dɔ na wò , wò ɖɔkta alé ŋku ɖe wò ƒu me mineral ƒe agbɔsɔsɔme, calcium ƒe agbɔsɔsɔ le ʋu me, phosphate ƒe agbɔsɔsɔ, PTH ƒe agbɔsɔsɔ, kple vitamin D ƒe agbɔsɔsɔ ŋu. Dodokpɔ siawo ateŋu akpeɖe wò ɖɔkta ŋu wòanya nenye be èle afɔku me be ‘dɔwuame ƒe ƒu ƒe dɔléle’ xɔxɔ.
• Mɔ siwo woawɔ atsɔ axe mɔ ɖe enu:Ne èle afɔku me be ‘dɔwuame ƒe ƒu ƒe dɔléle’ nadze dziwò la, wò ɖɔkta ate ŋu aɖo aɖaŋu na wò be nàno kpeɖeŋutɔ alo atike siwo ana vitamin D kple calcium ƒe agbɔsɔsɔ nanɔ asiwò hafi woawɔ dɔ na wò. Esia ateŋu akpeɖeŋu be woaɖe ‘dɔwuame ƒe ƒu ƒe dɔléle’ ƒe alesi wòate ŋu adzɔe kple/alo eƒe sesẽ dzi akpɔtɔ.
• Amekoko megbe ŋkuléle ɖe eŋu: Le amekoko vɔ megbe la, kɔdzi ƒe ƒuƒoƒoa alé ŋku ɖe calcium, phosphate, magnesium, kple PTH ƒe agbɔsɔsɔ le wò ʋu me ŋu edziedzi. Esia le ale be ne ‘ƒu si dɔ le wuwum’ dze dziwò la, woate ŋu ade dzesii kaba eye woadze atikewɔwɔ gɔme enumake.

Gake togbɔ be wowɔ afɔɖeɖe siawo katã hã la, ɣeaɖewoɣi la, ‘ƒu ƒe dɔwuame ƒe dɔléle’ ate ŋu adze ame dzi. Numekulawo meka ɖe nusitae wòdzɔna alea dzi haɖe o.

Ɣekaɣie wòle be makpɔ ɖɔkta?

Ne wowɔ dɔ na wò hena parathyroid alo thyroid eye emegbe ʋu me calcium si mebɔ o (`(Hypocalcemia)`) ƒe dzesi siwo ŋu míeƒo nu tsoe va yi, abe lãmekawo ƒe ʋuʋu, gbɔdzɔgbɔdzɔ ƒe seselelãme, tɔtrɔ le wò susu me (abe tɔtɔ ene), kple nuyiwo kple asibidɛwo ƒe ʋuʋu la, ele be nàyi ɖɔkta gbɔ kaba ale si nàte ŋui godoo.**Hungry bone syndrome' kple `(Hypocalcemia)` ateŋu adzɔ le parathyroid kple/alo thyroid dɔwɔwɔ vɔ megbe, ateŋu aɖiɖi le ŋkeke ʋee aɖewo megbe, eye emegbe wòagadze ake. Eyata ele vevie ŋutɔ be nàlé ŋku ɖe dzesi suetɔ kekeake gɔ̃ hã ŋu.

‘Hungry bone syndrome’ nye nɔnɔme si ate ŋu adzɔ le amekoko be woaɖe parathyroid alo thyroid glands ɖa vɔ megbe. Nya nyuiae nye be woate ŋu adae ahadae. Ke hã, ate ŋu axɔ ɣeyiɣi aɖe hafi wòahaya keŋkeŋ. Esi wònye be calcium ƒe agbɔsɔsɔ si le ʋu me ƒe ɖiɖi vevie ate ŋu anye afɔku na wò lãmesẽ ta la, anyo wu be nàyi ɖɔkta gbɔ ne ènya kpɔ dzesiawo ko.

Tsɔ gbedasi yi aƒeme

Eyata ne míagblɔe bɔbɔe la, ‘Hungry Bone Syndrome’ nye nɔnɔme si ate ŋu adzɔ le amekoko na parathyroid alo thyroid gland megbe. Nusi wòwɔna koŋ enye be calcium ƒe agbɔsɔsɔ si le ŋutilãa ƒe ʋu me dzi ɖena kpɔtɔna zi ɖeka. Esia le alea elabena parathyroid hormone (`(PTH)`) ƒe agbɔsɔsɔ dzi ɖena kpɔtɔna le amekokoa megbe, si wɔnɛ be ƒuawo "biaa" calcium.

Mègavɔ̃ be yease nya sia o, elabena ‘Hungry Bone Syndrome’ nye dɔléle si woate ŋu ada ahadae nyuie ŋutɔ.

Nu vevitɔe nye be ne dzesi siawo dometɔ aɖe le ŋuwò (abe lãmekawo ƒe ʋuʋu, ɖeɖiteameŋu, lãmetutudɔ ene) la, mègagblẽ ɣeyiɣi eye nàkpɔ ɖɔkta kaba ale si nàte ŋui o. To mɔ sia dzi la, àte ŋu ade dzesi dɔlélea kaba, adze atikewɔwɔ si hiã la gɔme kaba, eye nàdae hafi wòava zu kuxi gãtɔ. Ðo ŋku edzi be wò lãmesẽ dzi kpɔkpɔ le wò ŋutɔ wò asi me.

`Dɔwuame Ƒu ƒe Dɔléle, Dɔwuame Ƒu ƒe Dɔléle, Calcium, Hypocalcemia, Parathyroid, Thyroid Amekoko, PTH