DOI: https://doi.org/10.30978/UJPE2020-3-37

Рекомендації щодо діагностики та лікування псевдогіпопаратиреозу та пов’язаних з ним розладів: оновлені практичні настанови для лікарів і пацієнтів

Prepared by Yu. S. Kavetska

Анотація


Пацієнти, які постраждали від псевдогіпопаратиреозу або пов’язаних з ним розладів, характеризуються такими фізичними ознаками, як брахідактилія, невисокий зріст, кремезна будова тіла, ожиріння з раннім початком, ектопічна осифікація, затримка неврологічного розвитку, а також резистентністю до гормонів, найбільш виражену до паратиреоїдного гормону. Крім того, у пацієнтів може виникати резистентність до інших гормонів, що призводить до маніфестного або субклінічного гіпотиреозу, гіпогонадизму та дефіциту гормону росту, порушення росту без доказів гормональних відхилень за результатами вимірювань, діабету 2 типу та проблем зі скелетом з потенційно серйозним обмеженням рухливості. Псевдогіпопаратиреоз та супутні розлади — це насамперед клінічний діагноз. З огляду на мінливість клінічного, рентгенологічного та біохімічного стану, встановлення молекулярного діагнозу має вирішальне значення для пацієнтів. Це полегшує лікування, зокрема профілактику ускладнень, скринінг і лікування ендокринних дефіцитів, підтримувальні заходи та відповідні генетичні консультації. На основі першої міжнародної консенсусної заяви щодо зазначених розладів ця стаття пропонує оновлений та готовий до використання інструмент, який допоможе лікарям і пацієнтам визначити відповідні втручання та їх терміни.
Рекомендується застосовувати скоординований протягом усього життя мультидисциплінарний підхід, починаючи, наскільки це можливо, у ранньому дитинстві та продовжуючи протягом усього дорослого життя з відповідним і своєчасним переходом від педіатричної до дорослої медичної допомоги.


Ключові слова


акродизостоз; розлади кісток; брахідактилія; обмін кальцію та фосфатів; консенсус; діагностика; управління; осифікація; паратиреоїдний гормон; псевдогіпопаратиреоз; лікування

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