Cudurka xabaalaha

Cudurka Graves waa cillad isdifaac ah oo keenta qanjirka 'thyroid thyroid' (hyperthyroidism). Ciladda isdifaaca jirka waa xaalad dhacda marka nidaamka difaaca jirka uu si qalad ah u weeraro unugyada caafimaadka qaba.

Qanjirka 'thyroid' waa xubin muhiim u ah nidaamka endocrine. Qanjirka wuxuu ku yaalaa xagga hore ee qoorta kore halka qoorta ay iskula baxaan. Qanjirkani wuxuu sii daayaa hormoonnada thyroxine (T4) iyo triiodothyronine (T3), oo xukuma dheef-shiid kiimikaadka jirka. Xakamaynta dheef-shiid kiimikaadka ayaa muhiim u ah nidaaminta niyadda, miisaanka, iyo heerarka tamarta maskaxeed iyo jidheed.

Marka jirku sameeyo hormoon tayroodh badan, xaaladda waxaa loo yaqaan 'hyperthyroidism'. (Qanjirka 'thyroid' oo aan firfircooneyn ayaa keena hypothyroidism.)

Cudurka Graves waa sababta ugu badan ee keenta hyperthyroidism. Waxay sabab u tahay jawaab celin aan caadi ahayn oo habka difaaca jirka ah oo sababa qanjirka 'thyroid' inuu soo saaro hormoon tayroodh badan. Cudurka qabuuraha wuxuu ku badan yahay haweenka da'doodu ka weyn tahay 20 jir. Laakiin cilladdu waxay ku dhici kartaa da 'kasta waxayna ku dhici kartaa ragga sidoo kale.

Dadka da'da yar waxay yeelan karaan astaamahan:

• Welwelka ama gariirka, iyo sidoo kale dhibaatooyinka hurdada
• Ballaarinta naasaha ee ragga (waa suurtagal)
• Dhibaatooyinka uruurinta
• Daal
• Dhaqdhaqaaqa joogtada ah ee saxaro
• Timo lumis
• Dulqaad la’aanta kulaylka iyo dhididka oo badatay
• Rabitaanka cuntada oo kordhay, in kasta oo miisaankaagu yaraaday
• Xilliyada caadada ee aan caadiga ahayn ee dumarka
• Murqaha daciifka miskaha iyo garbaha
• Niyadjab, ay ka mid tahay xanaaq iyo xanaaq
• Kalsooni darrada (dareenka garaaca wadnaha oo xoog leh ama aan caadi ahayn)
  
• Wadna garaac dhakhso leh ama aan caadi ahayn
• Neefta oo ku qabata hawl qabad
• Gariir (gacmo yaraanta gacmaha)

Dad badan oo qaba cudurka Graves ayaa dhibaatooyin ka qaba indhahooda:

• Kubadaha indhaha waxay umuuqdaan inay soo baxayaan oo ay xanuun noqon karaan.
• Indhuhu waxay dareemi karaan cuncun, cuncun ama inay jeexjeexaan badanaa.
• Aragti laba-geesood ah ayaa jiri karta.
• Hoos u dhaca aragga iyo dhaawaca kiliyaha ayaa sidoo kale ku dhici kara xaaladaha daran.

Dadka waayeelka ah waxay yeelan karaan astaamahan:

• Wadna garaac dhakhso leh ama aan caadi ahayn
• Laab xanuun
• Xusuusta oo lunta ama feejignaanta oo yaraatay
• Tabar darri iyo daal

Bixiyaha xanaanada caafimaadka ayaa sameyn doona baaritaan jireed waxaana laga yaabaa inuu ogaado inaad kordhay heerka garaaca wadnaha. Baaritaanka qoortaada waxaa laga yaabaa inuu ogaado in qanjirkaaga qanjirada uu sii weynaaday (goiter).

Tijaabooyinka kale waxaa ka mid ah:

• Tijaabooyinka dhiigga si loo cabiro heerarka TSH, T3, iyo bilaash T4
• Qaadashada iodine shucaaca iyo iskaanka

Cudurkani wuxuu sidoo kale saameyn ku yeelan karaa natiijooyinka baaritaanka soo socda:

• Shaybaarka 'CT scan' ama 'ultrasound'
• Thyroid kiciya immunoglobulin (TSI)
• Thyroid peroxidase (TPO) antibody
• Anti-TSH Daawada antibiyootikada (TRAb)

Daaweyntu waxaa loogu talagalay in lagu xakameeyo qanjirka 'thyroid' aad u badan. Daawooyinka loo yaqaan 'beta-blockers' ayaa badanaa loo isticmaalaa in lagu daaweeyo astaamaha heerka garaaca wadnaha oo deg deg ah, dhidid, iyo walwal ilaa hyperthyroidism la xakameeyo.

Hyperthyroidism waxaa lagu daaweeyaa mid ama in ka badan waxyaabaha soo socda:

• Daawooyinka Antithyroid waxay xannibi karaan ama beddeli karaan sida qanjirka tayroodhku u isticmaalo iodine. Kuwani waxaa loo isticmaali karaa in lagu xakameeyo qanjirka 'thyroid' qanjirka 'qalliinka ka hor ama daaweynta radioiodine ama daaweyn muddo dheer ah.
• Daaweynta radioiodine ee iodine-ka shucaaca afka laga siiyo. Kadib waxay ku urursan tahay unugyada tayroodh xad dhaafka ah waxayna keentaa dhaawac.
• Qalliin ayaa laga yaabaa in lagu sameeyo si looga saaro qanjirka 'thyroid'.

Haddii aad qaadatay daaweyn iodine ama shucaac shucaac leh, waxaad u baahan doontaa inaad qaadatid hormoonnada tayroodhka beddelka ah inta ka dhiman noloshaada. Tani waa sababta oo ah daaweyntani waxay baabi'inayaan ama ka soo baxayaan qanjirka.

DAAWEYNTA INDHAHA

Qaar ka mid ah dhibaatooyinka indhaha ee la xiriira cudurka Graves ayaa inta badan wanaajiya daaweynta ka dib daawooyinka, shucaaca, ama qalliinka si loogu daaweeyo qanjirka 'thyroid'. Daaweynta radioiodine mararka qaarkood way ka sii dari kartaa dhibaatooyinka indhaha. Dhibaatooyinka indhaha ayaa uga sii daran dadka sigaarka caba, xitaa ka dib marka la daaweeyo hyperthyroidism-ka.

Mararka qaarkood, prednisone (daawo steroid ah oo xakameysa nidaamka difaaca jirka) ayaa loo baahan yahay si loo yareeyo cuncunka indhaha iyo bararka.

Waxaa laga yaabaa inaad u baahato inaad indhaha ka duubtid indhahaaga habeenkii si aad u qalajiso. Muraayadaha indhaha iyo dhibcaha isha ayaa yareyn kara cuncunka isha. Marar dhif ah, qalliin ama daaweyn shucaac ah (oo ka duwan shucaaca iodine-ka shucaaca leh) ayaa loo baahan karaa si looga hortago dhaawac hor leh oo soo gaara isha iyo aragga oo lumiya.

Cudurka qabrigu badanaa si fiican buu uga jawaab celiyaa daaweynta. Qalliinka qanjirka 'thyroid' ama shucaaca iodine inta badan wuxuu sababi doonaa qanjirka 'thyroid' oo aan firfircooneyn (hypothyroidism). Adigoon helin qiyaasta saxda ah ee beddelka hormoonka tayroodhka, hypothyroidism waxay u horseedi kartaa:

• Niyad jab
• Caajisnimo maskaxeed iyo mid jireed
• Miisaanka oo kordha
• Maqaarka qalalan
• Calool fadhiga
• Dulqaad la’aanta qabow
• Xilliga caadada ee aan caadiga ahayn ee dumarka

Wac bixiyahaaga haddii aad leedahay astaamo cudurka Graves. Sidoo kale wac haddii dhibaatooyinka ishaada ama astaamaha kale ay ka sii darayaan ama aysan ku fiicnayn daaweynta.

Aad qolka gargaarka deg-degga ah ama wac nambarka deg-degga ah ee deegaanka (sida 911) haddii aad leedahay astaamaha hyperthyroidism oo leh:

• Miyir beelid
• Qandho
• Wadna garaac dhakhso leh, aan caadi ahayn
• Neefsasho lama filaan ah

Faafi qanjirka 'thyrotoxic goiter'; Hyperthyroidism - Qabuuraha; Thyrotoxicosis - Qabriyada; Exophthalmos - Qabriyada; Ophthalmopathy - Qabuuraha; Exophthalmia - Qabriyada; Exorbitism - Qabuuro

• Qanjirada 'Endocrine'
• Ballaarinta qanjirka 'thyroid' - scintiscan
• Cudurka xabaalaha
• Qanjirka 'thyroid'

Hollenberg A, Wiersinga WM. Ciladaha Hyperthyroid. Gudaha: Melmed S, Auchus RJ, Golfine AB, Koenig RJ, Rosen CJ, eds. Williams Buugga Buugga Endocrinology. 14aad. Philadelphia, PA: Elsevier; 2020: cutubka 12.

Jonklaas J, Cooper DS. Qanjirka 'thyroid'. Gudaha: Goldman L, Schafer AI, eds. Daawada Goldman-Cecil. 26aad. Philadelphia, PA: Elsevier; 2020: cutubka 213.

Marcdante KJ, Kleigman RM. Cudurka qanjirka 'thyroid'. Gudaha: Marcdante KJ, Kliegman RM, eds. Nelson Muhiimadda Caafimaadka Caruurta. 8aad ed. Elsevier; 2019: cutubka 175.

Marino M, Vitti P, Chiovato L. Graves ’cudurka. Gudaha: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Dadka waaweyn iyo carruurta. 7aad ed. Philadelphia, PA: Elsevier Saunders; 2016: cutubka 82.

Ross DS, Burch HB, Cooper DS, iyo al. Tilmaamaha Ururka 'American Thyroid Association' ee loogu talagalay ogaanshaha iyo maaraynta cudurka 'hyperthyroidism' iyo sababaha kale ee loo yaqaan 'thyrotoxicosis'. Qanjirka 'thyroid'. 2016; 26 (10): 1343-1421. PMID: 27521067 pubmed.ncbi.nlm.nih.gov/27521067/.