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Metabolismo fosfocálcico na gravidez e aleitamento
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Durante a gravidez e aleitamento ocorrem alterações significativas no metabolismo fosfocálcico, e, consequentemente, na fisiologia esquelética materna, a fim de se satisfazer as exigências do feto e recém-nascido. O conhecimento da homeostase do metabolismo fosfocálcico é essencial para se proceder ao adequado diagnóstico e gestão do hiperparatiroidismo primário (HPTp), distúrbio que apresenta um quadro clínico caracterizado por níveis de hormona paratiroide (PTH) significativamente elevados, hipercalcemia e hipofosfatemia. Sendo uma condição patológica agravada progressivamente com o tempo caso não haja intervenção cirúrgica. O hiperparatiroidismo desencadeia, frequentemente, osteoporose, nefrolitíase associada a cólicas renais, nefrocalcinose, hipertensão e arritmias cardíacas.
A presente dissertação serve de revisão científica sobre o metabolismo fosfocálcico na gravidez e aleitamento, delineando detalhadamente, para tal, os mecanismos de absorção e excreção do fósforo e do cálcio, identificando e interrelacionando os principais componentes que regulam estes macrominerais, e explorando a importância da manutenção da homeostase do metabolismo fosfocálcico, a fim de melhor compreender a componente fisiológica e fisiopatológica e prevenir distúrbios passíveis de ocorrerem durante a gestação e lactação.
Detalhadamente, a tese em questão aborda o HPTp, uma patologia paratiroideia, refletindo acerca das várias opções viáveis de modo a concretizar um melhor diagnóstico, uma gestão contínua, e um tratamento adequado do distúrbio, especialmente durante a gravidez.
During pregnancy and lactation significant changes occur in phosphocalcium metabolism, and consequently in maternal skeletal physiology, to meet the demands of the fetus and newborn. Knowledge of the homeostasis of phosphocalcium metabolism is essential for the proper diagnosis and management of primary hyperparathyroidism (HPTp), a disorder that presents a clinical picture characterized by significantly elevated parathyroid hormone (PTH) levels, hypercalcemia, and hypophosphatemia. As a pathological condition that progressively worsens over time if there is no surgical intervention, hyperparathyroidism often triggers osteoporosis, nephrolithiasis associated with renal colic, nephrocalcinosis, hypertension, and cardiac arrhythmias. The present dissertation serves as a scientific review on phosphocalcium metabolism in pregnancy and lactation, outlining, in detail, the mechanisms of absorption and excretion of phosphorus and calcium, identifies and interrelates the main components that regulate these macrominerals, and explores the importance of maintaining the homeostasis of phosphocalcium metabolism in order to better understand the physiological and pathophysiological component and prevent disorders likely to run during pregnancy and lactation. In detail, the thesis in question addresses HPTp, a parathyroid pathology, reflecting on the various viable options to achieve better diagnosis, ongoing management, and appropriate treatment of the disorder, especially during pregnancy.
During pregnancy and lactation significant changes occur in phosphocalcium metabolism, and consequently in maternal skeletal physiology, to meet the demands of the fetus and newborn. Knowledge of the homeostasis of phosphocalcium metabolism is essential for the proper diagnosis and management of primary hyperparathyroidism (HPTp), a disorder that presents a clinical picture characterized by significantly elevated parathyroid hormone (PTH) levels, hypercalcemia, and hypophosphatemia. As a pathological condition that progressively worsens over time if there is no surgical intervention, hyperparathyroidism often triggers osteoporosis, nephrolithiasis associated with renal colic, nephrocalcinosis, hypertension, and cardiac arrhythmias. The present dissertation serves as a scientific review on phosphocalcium metabolism in pregnancy and lactation, outlining, in detail, the mechanisms of absorption and excretion of phosphorus and calcium, identifies and interrelates the main components that regulate these macrominerals, and explores the importance of maintaining the homeostasis of phosphocalcium metabolism in order to better understand the physiological and pathophysiological component and prevent disorders likely to run during pregnancy and lactation. In detail, the thesis in question addresses HPTp, a parathyroid pathology, reflecting on the various viable options to achieve better diagnosis, ongoing management, and appropriate treatment of the disorder, especially during pregnancy.
Descrição
Trabalho Final de Mestrado Integrado, Ciências Farmacêuticas, 2022, Universidade de Lisboa, Faculdade de Farmácia.
Palavras-chave
Phosphorus and calcium metabolism Pregnancy Lactation Hyperparathyroidism Mestrado integrado - 2022