Ðe wò ƒuwo kple wò aɖuwo gbɔdzɔa? Mina míasrɔ̃ nu tso nɔnɔme sia si mebɔ o (Hypophosphatasia) ŋu .

Èse dɔléle aɖe si me ƒuwo kple aɖuwo gbɔdzɔna eye wogbãna kpɔa? Ðewohĩ èkpɔ ame aɖe le wò ƒomea me alo xɔ̃wò aɖe ƒe vi si ŋu kuxi sia le. Egbea míele nu ƒom tso nɔnɔme aɖe si mebɔ o gake wòle vevie ŋutɔ si ŋu wòle be míanya nu tsoe ŋu. Woyɔa esia be hypophosphatasia, alo HPP.

Nukae nye Hypophosphatasia?

Kpuie ko la, hypophosphatasia (HPP) nye domenyiŋusẽfianu ƒe dɔléle si mebɔ o. Alesi wò ƒuwo kple aɖuwo tsinae koŋue wògblẽa nu le. Ne míagblɔe tututu la, dɔléle sia nana wò ƒuwo kple aɖuwo megasẽna alo nɔa ƒoƒom abe alesi wòle be woanɔ ene o. Le atikewɔwɔ gome la, womewɔa mineral alo calcify nyuie o. Edze le ƒu ƒe dɔléle si nye metabolic bone disease ƒe hatsotso me.

Bu eŋu kpɔ, míaƒe ƒuwo le abe kɔkrit sɔti siwo le xɔ aɖe me ene, ehiã be woasẽ. Wohiã mineral agbɔsɔsɔme si sɔ abe calcium kple phosphorus ene. Dɔwɔwɔ sia medzɔna nyuie le amesi ŋu HPP le ƒe ŋutilã me o. Esia wɔe be ƒuawo fa eye wogbɔdzɔna.

HPP ƒe sesẽme ate ŋu ato vovo ŋutɔ tso ame ɖeka gbɔ yi bubu gbɔ. Ame aɖewo ate ŋu anɔ bɔbɔe abe nuteɖeamedzi ƒe gbagbã le afɔku siwo dzɔna enuenu le ƒe titina me ene. Gake le go aɖewo me la, ate ŋu asẽ ale gbegbe be vidzĩa ate ŋu aku le vidzidɔ me (vidzidzi kuku) alo le ŋkeke ʋɛ aɖewo megbe tso edziɣi.

Nukawoe nye hypophosphatasia (HPP) ƒomevi veviwo?

Woma HPP ɖe hatsotso vevi adre me. Woma esiawo ɖe hatsotso si me dɔlélea ƒe dzesiwo dze egɔme tsoe kple alesi dɔlélea nu sẽe nu. Mina míalé ŋku ɖe nusiwo wonye ŋu, tso esiwo nu sẽ wu dzi va ɖo esiwo nu sẽ wu dzi:

• HPP si nu sẽ le vidzidzi me: Esiae nye ƒomevi si nu sẽ wu.
• HPP fafɛ si dzɔna do ŋgɔ na vidzidzi (perinatal): Le go sia me la, woate ŋu akpɔ ƒu ƒe tsitsi aɖewo.
• Vidzĩ ƒe HPP: Ƒomevi aɖe si dzena le vidzidzi megbe.
• Ðevimenɔɣi ƒe HPP: Esia hã ate ŋu anɔ bɔbɔe alo nu sesẽ.
• Ame tsitsiwo ƒe HPP: Dzesiawo dzena le ame tsitsi megbe.
• Odontohypophosphatasia: Aɖuwo koe esia gblẽa nu le. Vidzĩ ƒe aɖuwo gena kabakaba.
• Pseudohypophosphatasia: Esia mebɔ kura o. Togbɔ be alkaline phosphatase ƒe agbɔsɔsɔ le ʋu me sɔ hã la, dzesiawo sɔ kple vidzĩwo ƒe HPP tɔ.

Aleke gbegbee woyɔa dɔléle sia be HPP?

Le nyateƒe me la, HPP nye dɔléle si mebɔ kura le amehawo katã dome o. HPP ƒe dɔléle sesẽwo dzea vidzĩ siwo ade ɖeka le 100,000 ɖesiaɖe me va ɖo ɖeka le 300,000 ɖesiaɖe me siwo wodzina ƒe sia ƒe. Gake dɔlélea ƒe ƒomevi siwo fa wu, abe ame tsitsiwo ƒe HPP ene, mebɔ kura o. Ema fia be ame siwo ade ɖeka le ame 6,000 va ɖo 7,000 ɖesiaɖe me ate ŋu adze dɔa dzi.

Dɔlélea bɔ ɖe Mennotɔwo ƒe nuto si le Manitoba, Canada, me wu, afisi woka nya ta le be vidzĩ siwo ade ɖeka le 2,500 ɖesiaɖe me xɔa HPP sesẽ.

Nukae nye hypophosphatasia (HPP) ƒe dzesiwo?

HPP ƒe dzesiwo to vovo ŋutɔ. Dzesiawo ate ŋu ato vovo le ƒome ɖeka me gɔ̃ hã. Zi geɖe la, dzesi siwo nèkpɔna la nɔ te ɖe HPP ƒomevi si le ŋuwò dzi.

Dzesi siwo dzena le Vidzidzi me HPP

Zi geɖe la, ɖɔktawo ate ŋu akpɔ fugboea ƒe nɔnɔme siawo le ultrasound scan siwo wowɔ le fufɔɣi me:

• Abɔ kple afɔ kpuiwo, siwo bɔbɔ, siwo metsi o (siwo me mineral mele o).
• Akɔta ƒe akɔtaƒu siwo metsi o.
• Akɔta ƒe nɔnɔme madeamedziwo (flail chest).

Fufɔfɔ aɖewo ate ŋu awu enu kple vi kuku. Vidzĩ aɖewo ate ŋu aku le wo dzidzi ŋkeke ʋɛ aɖewo megbe le gbɔgbɔtsixetsixe si akɔta ƒe gbɔdzɔgbɔdzɔ hena vɛ ta.

HPP si me dɔlékui aɖeke mele o ƒe dzesi siwo dzena le vidzidzi me

Woate ŋu adzi vidzĩ siwo ŋu dɔléle sia le kple abɔ kple afɔ siwo wobɔbɔ. Ðɔktawo ate ŋu akpɔ esia le ultrasound wɔwɔ me le fufɔɣi.

Gake le vidzidzi megbe la, ƒumeŋuɖui siawo nyona ɖe edzi vivivi. Dzesi siwo ava emegbe ate ŋu atso vidzĩ ƒe HPP dzi va ɖo odontohypophosphatasia dzi.

Vidzĩwo ƒe HPP ƒe Nɔnɔmewo

Zi geɖe la, vidzĩwo ƒe HPP ƒe dzesiwo dzea egɔme dzena ne woxɔ ɣleti ade lɔƒo. Wo dometɔ aɖewoe nye:

• Kpekpeme ƒe dzidziɖedzi kple tsitsi ƒe kuxiwo.
• Vidzĩ ƒe aɖuwo ƒe bu kaba.
• Taɖu ƒe ƒuwo ƒe ƒoƒo ɖekae si mesɔ o (craniosynostosis), si ate ŋu ana ta ƒe nɔnɔme natrɔ (brachycephaly).
• Nyaƒoɖeamenu si dzina ɖe edzi le taɖua me (intracranial hypertension). Esia ate ŋu ana ta naɖu ame eye ŋkuwo nado (proptosis).
• Ƒu falɛfalɛ siwo gblẽ siwo ɖi rickets.
• Ƒu siwo le asibidɛ kple afɔkpodzi ƒe akpa si keke.
• Akɔta kple akɔta ƒe nɔnɔme madeamedziwo kple woƒe gbagbã.
• Yagbɔgbɔ sesẽ.
• Asrã si kpe ɖe ƒu ƒe vevesese ŋu.
• Lãmetsiwo ƒe ʋuʋu ƒe anyimanɔmanɔ (hypotonia). Ame aɖewo hã yɔa esia be "floppy infant syndrome".
• Calcium ƒe agbɔsɔsɔ si dzina ɖe edzi le ʋu me (hypercalcemia). Esia ate ŋu ana ame naɖe aɖuɖɔ, dɔmeɖui, ɖeɖi nate ame ŋu, eye nuɖuɖu magadzro ame o.
• Ƒã hafi alɔ̃madɔmadɔ ate ŋu adzɔ.

Le go aɖewo me la, ƒu ƒe mineralization ƒe kuxi siawo le vidzĩwo ƒe HPP me ate ŋu anyo ɖe edzi le wo ɖokui si le ɖevime. Gake ele vevie be woadi atike be woaxe mɔ ɖe kuxi siwo anɔ anyi ɖaa nu (e.g., ame ƒe kɔkɔme kpui, ƒu ƒe dɔmawɔmawɔ nyuie).

Ðevimenɔɣi ƒe HPP ƒe Dzesiwo

Ðevimenɔɣi ƒe HPP ate ŋu atso esi nu mesẽ o dzi va ɖo esi nu sẽ dzi. Dzesiawo ate ŋu anye:

• Ƒu ƒe mineral ƒe kpekpeme si sɔ ɖe ƒexɔxɔ nu kple ƒu ƒe gbagbã le eɖokui si (esiae nye HPP fafɛ ƒe nɔnɔme vevitɔ).
• Taɖu ƒe ƒuwo ƒe ƒoƒo kabakaba (craniosynostosis) eye wòhea nyaƒoɖeamenu si dzina ɖe edzi le taɖua me (intracranial hypertension).
• Ƒu ƒe dɔmawɔmawɔ nyuie si va dzena le ƒe 2-3 xɔxɔ lɔƒo.
• Ƒu kple ƒunukpeƒewo ƒe vevesese.
• Aɖu siwo ƒe aŋgbawo ƒuna ƒe bu kaba. Zi geɖe la, aɖu ɖeka alo esi wu nenema gena hafi xɔa ƒe 5.
• Gbɔdzɔgbɔdzɔ kple azɔlizɔzɔ ƒe megbetsitsi (afɔɖeɖe gbãtɔ mawɔmawɔ ɣleti 18).
• Azɔlizɔzɔ si le tsatsam.

Ɣeaɖewoɣi la, ɖevimenɔɣi ƒe HPP ate ŋu anyo ɖe edzi zi ɖeka le sɔhɛmenɔɣi. Gake kuxiawo ate ŋu agadzɔ ake le ƒe titina alo tsitsi me.

Ame Tsitsiwo ƒe HPP ƒe Dzesiwo

Ame tsitsiwo ƒe HPP ƒe dzesiwo hã to vovo ŋutɔ. Wo dometɔ aɖewoe nye:

• Ƒuwo ƒe fafa (osteomalacia).
• Ƒu ƒe vevesese.
• Aɖu siwo nɔa anyi ɖaa ƒe bu (ame tsitsi aɖewo siwo ŋu HPP le ate ŋu axɔ aɖuɖɔtoedɔ le woƒe ɖevime, alo ɖewohĩ woƒe vidzĩ ƒe aɖuwo bu kaba).
• Gbagbã, vevietɔ nuteɖeamedzi ƒe gbagbã le metatarsal ƒuwo alo pseudofractures (loose zones) ƒe afɔkpodzi.
• Vevesese atraɖii kple gbɔdzɔgbɔdzɔ si ƒu ƒe gbagbã enuenu hena vɛ.
• Calcium ƒoa xlã ƒunukpeƒewo, si wɔnɛ be ƒunukpeƒewo xɔa abi (calcific periarthritis) kple/alo vevesese.
• Ƒunukpeƒeveame sesẽ kpata (chondrocalcinosis alo pseudogout, si tsoa calcium si le ƒunukpeƒea me gbɔ).

Odontohypophosphatasia ƒe dzesiwo

Wò aɖuwo koe ƒomevi sia gblẽa nu le - wò ƒunukpeƒewo ƒe ƒuwo mekpɔa ŋusẽ ɖe wo dzi o. Dzesi vevitɔe nye be vidzĩ ƒe aɖuwo gena kaba, si fia le vidzĩme alo ɖevimenɔɣi. Ame aɖewo hã ate ŋu abu woƒe aɖu siwo nɔa anyi ɖaa le vome ne wole tsitsim.

Nukae hea hypophosphatasia (HPP) vɛ?

Nusi koŋ gbɔ HPP tsonae nye domenyiŋusẽfianu ƒe vovototowo. Etɔxɛe la, ALPL domenyiŋusẽfianu ƒe tɔtrɔ gbɔe wòtsona . Zi geɖe la, ALPL domenyiŋusẽfianu fiaa mɔ míaƒe ŋutilã be wòawɔ dɔlékui aɖe si woyɔna be Tissue-Nonspecific Alkaline Phosphatase (TNSALP) . Enzyme sia le vevie be míaƒe ƒuwo kple aɖuwo nate ŋu awɔ mineral nyuie, si fia be wosẽna.

Bu TNSALP enzyme sia ŋu kpɔ be eyae nye mɔ̃ɖaŋudɔwɔla gãtɔ le ƒuwɔƒe aɖe. Ne mewɔ dɔ nyuie o la, adzɔnuwo (i.e., ƒuwo) siwo dona tso dɔwɔƒea ƒe nyonyome dzi aɖe akpɔtɔ.

Ne tɔtrɔ siwo va le ALPL domenyiŋusẽfianu me xe mɔ na TNSALP enzyme la be woagawɔ nyuie o la, mate ŋu awɔ eƒe dɔ nyuie o.

Ƒu ƒe mineralization nye alesi wotsɔa nu sesẽ aɖe abe calcium phosphate ene yɔa ƒu ƒe ƒuƒoƒoa me. Proteinwo abe collagen kple mineralwo abe calcium kple phosphate ene ye le ƒu ƒe ƒuƒoƒo sia me.

Domenyiŋusẽfianu ƒe tɔtrɔ siwo xea mɔ na TNSALP enzyme ƒe dɔwɔwɔ keŋkeŋ gbɔe HPP ƒomevi siwo nu sẽ wu la tsona. Domenyiŋusẽfianu bubu siwo ɖea TNSALP enzyme ƒe dɔwɔwɔ dzi kpɔtɔna, gake womexea mɔ nɛ keŋkeŋ o la, hea dɔlélea ƒe ƒomevi siwo fa wu vɛ.

Aleke wonyia hypophosphatasia (HPP) ƒe domee?

Wonyia HPP ƒomevi sesẽwo, abe HPP le vidzidzi me ene, ƒe dome le autosomal recessive pattern me. Esia fia be ele be dzila evea siaa natsɔ ALPL domenyiŋusẽfianu si wogbugbɔ trɔ la ayi na wo vi. Zi geɖe la, HPP ƒe dzesi aɖeke menɔa dzilawo ŋu o eye womenya be domenyiŋusẽfianu ƒe tɔtrɔ le yewo si o, eyata ate ŋu awɔ nuku na ɖevia ne dɔlélea dze edzi.

Woate ŋu anyi HPP ƒomevi fafɛwo ƒe dome le autosomal recessive alo autosomal dominant ƒe nɔnɔme me. Autosomal dominant pattern fia be dɔlélea ate ŋu axɔ ɖevi ne dzila ɖeka koe nyi ALPL domenyiŋusẽfianu si trɔ la dome gɔ̃ hã .

Aleke wokpɔa dɔléle si nye hypophosphatasia (HPP) dzea sii?

Ðɔktawo zãa ŋutilãmedɔdada, nɔnɔmetatawo dodokpɔ, kple dodokpɔ siwo wowɔna le nudokpɔƒe koŋ tsɔ dea dzesi HPP. Ðɔkta si nya dɔlélea nyuie ate ŋu ade dzesii kaba. Gake ɖɔkta si menya nu tso HPP ŋu nyuie o ate ŋu axɔ ɣeyiɣi aɖe hafi anya dɔlélea.

Dodokpɔ siwo kpena ɖe ame ŋu wòkpɔa HPP lae nye:

• Alkaline Phosphatase (ALP) ʋudodokpɔ: ALP nye enzyme si do ƒome kple ƒumeŋusẽ ƒe agbɔsɔsɔ. Zi geɖe la, amesiwo ŋu HPP le ƒe ALP ƒe agbɔsɔsɔ dzi ɖena kpɔtɔna ne wole tsitsim. Gake dodokpɔ sia ɖeɖe mate ŋu aɖo kpe dɔlélea dzi o, elabena nɔnɔme bubuwo hã ate ŋu ana ALP ƒe agbɔsɔsɔ naɖiɖi.
• Pyridoxal 5ʹ-phosphate (PLP) ʋudodokpɔ: PLP nye vitamin B6 ƒomevi aɖe. Zi geɖe la, PLP sɔ gbɔ ɖe amesiwo ŋu HPP le la si.
• X-ray: Le HPP ƒe dɔléle sesẽwo me la, X-ray ate ŋu aɖe ƒu ƒe gbagbã siwo le dɔlélea koŋ ŋu afia. Gake esi wònye be nu bubu aɖewo hã li siwo hea ƒu ƒe kuxiwo vɛ ta la, ɖewohĩ viwòa ƒe ɖɔkta makpɔe adze sii enumake be enye HPP o.
• Domenyiŋusẽfianu dodokpɔ: Esia ate ŋu ade dzesi vovototo siwo le ALPL domenyiŋusẽfianu si hea HPP vɛ me. Gake womewɔa dodokpɔ sia le nudokpɔƒewo katã o.

Aleke wodaa hypophosphatasia (HPP) ƒe dɔléleae?

Fifia la, atike aɖeke meli na HPP o. Gake Asfotase alfa (Strensiq®) .Atike vevitɔ si wozãna na esiae nye atike si woyɔna be TNSALP. Wodonɛ abe atike si wodona ɖe ŋutigbalẽ te ene eye wòwɔa dɔ abe enzyme ɖɔliɖɔli ƒe atike ene. Woate ŋu azãe na ɖeviwo kple ame tsitsi siwo ƒe dzesiwo dzea egɔme tso ɖevime.

Numekukuwo ɖee fia be atike si nye Asfotase alfa ate ŋu ana ɖevi siwo ŋu vidzĩwo kple ɖeviwo ƒe HPP le ƒe gbɔgbɔ, calcium ƒe agbɔsɔsɔ, ƒu ƒe lãmesẽ, kple agbetsitsi nanyo ɖe edzi.

Dɔdamɔnu bubuwo ku ɖe dzesi kple kuxi tɔxɛwo dzi kpɔkpɔ ŋu. Ðewohĩ viwòa ahiã eŋutinunyala bibiwo ƒe ƒuƒoƒo aɖe be woada dɔ na wo. Esiawo ate ŋu anye:

• Ðeviwo ƒe dɔdalawo
• Ƒumeŋutinunyalawo
• Ðeviwo ƒe lãmenugbagbeviwo ƒe dɔwɔwɔ ŋuti nunyalawo
• Ðeviwo ƒe ahɔhɔ̃ŋutinunyalawo
• Aɖuŋutinunyalawo
• Aɖuɖɔtoedɔdalawo (aɖuɖɔtoe siwo ƒo xlã aɖuwo ŋuti nunyala bibiwo) .
• Vevesesenutsitike ŋuti nunyala bibiwo
• Lãmesẽdɔwɔlawo
• Dɔwɔɖui ŋuti dɔdamɔnufialawo

Atikewɔwɔ siwo kpena ɖe ame ŋu ƒe kpɔɖeŋu aɖewo:

• Yagbɔgbɔ ƒe kpekpeɖeŋu na gbɔgbɔtsixetsixe.
• Gakuku ƒe atikewɔwɔ alo amekoko na tagbɔdɔléle.
• Shunt alo taɖu ƒe dɔwɔwɔ na ame be woatsɔ ada nyaƒoɖeamenu si dzi ɖe edzi le taɖua me (intracranial hypertension).
• Vitamin B6 na alɔ̃madɔmadɔ si HPP hena vɛ.
• Aɖudɔdada edziedzi tso ɖevime ke be woada aɖukuxiwo kpɔ.
• Nuɖuɖu me calcium, aɖuɖɔtoemetike aɖewo, kple calcitonin dodo dzi ɖeɖe kpɔtɔ ate ŋu ana calcium nasɔ gbɔ ɖe ʋu me (hypercalcemia).
• Atike siwo me steroid mele o siwo tsia dɔdzẽ nu (NSAIDs) na ƒu kple ƒunukpeƒeveame.
• Ðewohĩ abia be woatsɔ ƒu aƒu gbe, abla ƒuwo, alo awɔ dɔ na ame be wòaɖɔ ƒu gbagbãwo ɖo (ememetɔtɔ).

Nukae wòle be makpɔ mɔ na ne hypophosphatasia (HPP) le vinye ŋu?

Ele vevie be nàɖo ŋku esia dzi: Ame eve siwo ŋu HPP le la mekpɔa ŋusẽ ɖeka o. Ame aɖeke mate ŋu agblɔ alesi tututu viwòa axɔ nɔnɔmea ne ele tsitsim o. Nu nyuitɔ si nàte ŋu awɔe nye be, ne anya wɔ la, nàƒo nu kple ɖɔkta si bi ɖe numekuku kple edada me le HPP me. Woate ŋu agblɔ dzesi alo tɔtrɔ siwo ŋu wòle be nàlé ŋku ɖo kple nusiwo ava dzɔ le etsɔme na wò.

Ðe woate ŋu axe mɔ ɖe hypophosphatasia (HPP) nua?

Esi wònye be HPP nye domenyiŋusẽfianu ƒe dɔléle ta la, womate ŋu axe mɔ ɖe enu o.

Ne ètsi dzi be yeatsɔ hypophosphatasia alo domenyiŋusẽfianu ƒe dɔléle bubuwo ayi viwòwo dzi la, ƒo nu kple wò ɖɔkta tso domenyiŋusẽfianu ŋuti aɖaŋuɖoɖo ŋu .

Aleke malé be na vinye si ŋu HPP le?

Ne HPP le viwòa ŋu la, ele vevie be nàƒo ɖokuiwò ɖe eme be nàkpɔ egbɔ be wokpɔ atikewɔwɔ nyuitɔ kekeake. Ðewohĩ ɖɔkta siwo nèkpɔna dometɔ aɖewo menya nu boo aɖeke tso dɔléle sia si mebɔ o ŋu o. Eyata ne èʋli viwòa ta la, àte ŋu akpe ɖe eŋu be wòanɔ agbe nyuitɔ kekeake.

Mia kple wò ƒomea miate ŋu abu hã be yewoage ɖe kpekpeɖeŋunaha aɖe me. Esia ana mɔnukpɔkpɔ wò be nàdo go ame bubu siwo to nuteƒekpɔkpɔ mawo tɔgbe me abe tɔwò ene, aƒo nu, ahagblɔ susuwo.

Ɣekaɣie wòle be vinyea nayi ɖɔkta gbɔ?

Ne hypophosphatasia le viwòa ŋu la, ele be wòakpe kple woƒe atikewɔlawo ƒe ƒuƒoƒoa edziedzi be woawɔ atike nɛ ahalé ŋku ɖe dɔlélea ƒe dzesiwo ŋu.

Viwò ƒe HPP dɔlélea gɔmesese ate ŋu agbɔ eme. Gake ɖo ŋku edzi be viwòa ƒe lãmesẽnyawo gbɔ kpɔha ana woawɔ ɖoɖo sesẽ aɖe si ku ɖe wo dzi kpɔkpɔ kple ŋkuléle ɖe wo ŋu si ku ɖe wo ŋu koŋ. Ele vevie be nàkpɔ egbɔ be wò, viwò, kple wò ƒomea xɔ kpekpeɖeŋu si wohiã, eye wò susu nanɔ viwòa ƒe lãmesẽ ŋu. Viwò ƒe lãmesẽnyawo gbɔ kpɔha le afisia be yewoado alɔ wò le mɔa ƒe afɔɖeɖe ɖesiaɖe me.

Nukae nye gbedasi si míedi be míatsɔ ayi aƒemee tso ŋutinya sia me?

Hypophosphatasia nye domenyiŋusẽfianu ƒe dɔléle si mebɔ o si gblẽa nu le ƒuwo kple aɖuwo ƒe ŋusẽ ŋu. Alesi nɔnɔme sia nu sẽe la toa vovo tso ame ɖeka gbɔ yi bubu gbɔ. Dɔlélea didi kaba kple edzikpɔkpɔ nyuie nye nu vevitɔ.

• Esi wònye be HPP nye domenyiŋusẽfianu ƒe dɔléle ta la, womate ŋu axe mɔ ɖe enu o.
• Dzesiawo ate ŋu adze egɔme ɣesiaɣi, tso edziɣi vaseɖe tsitsime.
• Nu vevitɔe nye be woade dzesi dɔlélea kaba eye woadi atike tso ɖɔkta bibiwo gbɔ.
• Atikewɔwɔ siwo li fifia (vevietɔ asfotase alfa) ate ŋu aɖu dzesiawo dzi eye woana agbenɔnɔ nanyo ɖe edzi.
• Ne nya bubu aɖewo gale asiwò ku ɖe esia ŋu la, mègavɔ̃ be yeaƒo nu kple wò ɖɔkta o. Woakpe ɖe ŋuwò.

Ðo ŋku edzi be menye wò ɖeka koe o. Dɔwɔnu kple kpekpeɖeŋunahawo li siwo ate ŋu akpe ɖe amesiwo le nɔnɔme siawo me kple woƒe ƒomewo ŋu.

` Hypophosphatasia, HPP, domenyiŋusẽfianu ƒe dɔlélewo, ƒu ƒe gbɔdzɔgbɔdzɔ, aɖudɔléle, ɖeviwo ƒe dɔlélewo, alkaline phosphatase