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Endocrine Diseases
Published in Miriam Orcutt, Clare Shortall, Sarah Walpole, Aula Abbara, Sylvia Garry, Rita Issa, Alimuddin Zumla, Ibrahim Abubakar, Handbook of Refugee Health, 2021
While the diagnosis and management of many endocrine disorders may be beyond the scope of programmes in resource-limited settings, prevalent diseases that should be addressed include diabetes and thyroid dysfunction. Diabetes is increasing in prevalence globally (8.5% in 2014), particularly in low- and middle-income countries where migrants live and where resources to manage its complications are less available – attention to early prevention, diagnosis and management is required. This chapter covers presentation, examination and management of diabetes, hypothyroidism and hyperthyroidism.
The Endocrine System: Solid and Diffuse
Published in Jeremy R. Jass, Understanding Pathology, 2020
Endocrine disorders are a large topic that will be considered here genetically and mainly in relation to the structural changes within endocrine glands. The concept of chemical messengers has expanded considerably since the early view of the endocrine gland as an organ that manufactures and secretes hormones into the bloodstream in order to regulate metabolic activities in distant sites. Chemical messengers may operate over much shorter distances, as occurs in the case of the diffuse endocrine system composed of single scattered cells found in such organs as the gut, lung, testis, ovary and prostate. The local effect of secreted hormones is sometimes described as paracrine. A secretion may even act on the cell of origin (autocrine effect). When the cells of the diffuse endocrine system are imagined as a mass, their total volume will be greater than that of the solid endocrine organs.
McCune−Albright Syndrome
Published in Dongyou Liu, Handbook of Tumor Syndromes, 2020
Endocrine disorders also affect the thyroid, pituitary, and adrenal glands. Enlargement of the thyroid gland (goiter), development of thyroid nodules, and increased secretion of thyroid hormone (hyperthyroidism) may occur. The symptoms of hyperthyroidism are fast heart rate, high blood pressure, weight loss, tremors, sweating, anxiety, and heat intolerance. Growth hormone levels are increased in some individuals, affecting growth and muscle mass. Increased growth hormone may cause large head (macrocephaly, due to excess expansion of fibrous dysplasia in the skull), vision problems, and acromegaly (a condition of growth excess after closure of epiphyseal plates, leading to large hands and feet, arthritis, and coarse facial features) [25].
Free thyroxine measurement in clinical practice: how to optimize indications, analytical procedures, and interpretation criteria while waiting for global standardization
Published in Critical Reviews in Clinical Laboratory Sciences, 2023
Federica D’Aurizio, Jürgen Kratzsch, Damien Gruson, Petra Petranović Ovčariček, Luca Giovanella
Thyroid dysfunction is among the most common endocrine disorders and accurate biochemical testing is needed to confirm or rule out a diagnosis. Notably, true hyper- and hypothyroidism in the setting of a normal TSH are highly unlikely, making the assessment of FT4 levels inappropriate in most cases. However, FT4 measurement is integral in both the diagnosis and management of relevant central dysfunctions (central hypothyroidism and central hyperthyroidism) as well as in monitoring therapy in hyperthyroid patients treated with anti-thyroid drugs or radioiodine. In such settings, accurate FT4 quantification is required. Significant progress has been made in the standardization of procedures for FT4 testing, but technical and implementational challenges, including the establishment of clinical decision limits in different patient populations and education of all stakeholders, remain. Accordingly, different assays and reference values cannot be interchanged. Two-way communication between laboratories and clinical specialists is pivotal to properly select a reliable FT4 assay, establish RIs, approaching discordant results, and monitor the analytical and clinical performance of this method over time.
Updated perspectives on how and when lithium should be used in the treatment of mood disorders
Published in Expert Review of Neurotherapeutics, 2023
Janusz K. Rybakowski, Ewa Ferensztajn-Rochowiak
For lithium, acute renal failure and acute myocardial infarction are absolute contraindications. In the case of impairment of kidney function expressed as an increase in creatinine concentration and a decrease in glomerular filtration rate (GFR), the possibility of using lithium should be carefully considered. A relative contraindication may be the presence of arrhythmia, especially Brugada syndrome in the patient or family. This would also be the case for psoriasis because lithium can exacerbate or cause such a condition. Endocrine disorders include thyroid disease, mainly hypothyroidism, as well as Addison’s disease. Myelogenous leukemia may be a contraindication because lithium tends to cause an increase in the number of neutrophils. Lithium should not be introduced during dehydration or low sodium concentration. Caution should be exercised when cerebellar dysfunction is suspected, as cerebellar damage is described as a complication of high doses of lithium. Also, myasthenia may be a relative contraindication, as muscle weakness is often reported after high doses of lithium. Lithium should be introduced with caution in the case of cerebral circulatory disorders, Parkinson’s disease, and uncompensated epilepsy [60].
Pathophysiology and mechanism of long COVID: a comprehensive review
Published in Annals of Medicine, 2022
D. Castanares-Zapatero, P. Chalon, L. Kohn, M. Dauvrin, J. Detollenaere, C. Maertens de Noordhout, C. Primus-de Jong, I. Cleemput, K. Van den Heede
We retrieved 54 articles that exclusively addressed hypotheses concerning potential underlying mechanisms of long COVID symptoms (see Table 1). Of these, 34 speculated on mechanisms that could specifically explain long COVID symptoms [10–43], whereas 18 focussed on organ injury developed during acute illness possibly resulting in persisting symptoms [44–61]. Concerning the latter, the suggested mechanism consisted of organ injury that complicated acute disease, possibly provoking persistent symptoms. The reported organ injuries were: stroke [46,52,55], myocardial infarction and fibrosis [41,43,49,51,55,57,59], acute encephalitis [43,50], neuromuscular disorders [40,41,43,46,48,56], renal failure [41,43,60,61], and hepatobiliary damages [43,44]. The other articles reported on endocrine disorders that were unrelated to organ damage, while including hypotheses on new-onset diabetes [62] and thyroid disorders [63].