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PubMed2001

Drugs in pregnancy. Endocrine disease (including diabetes).

This chapter reviews the treatment of endocrine disease in pregnancy, including diabetes mellitus, hypo- and hyperthyroidism, adrenal and pituitary disorders, and hyper- and hypoparathyroidism. Pregnancy in some of these disorders is relatively rare, so that management is often based on limited information and clinical judgement rather than on strong evidence-based criteria.

Adrenal Gland Diseases↗
PubMed2002

Catch-up growth and endocrine changes in childhood celiac disease. Endocrine changes during catch-up growth.

Childhood celiac disease may lead to a failure of statural growth. After institution of a gluten-free diet most patients exhibit catch-up growth. Catch-up growth is a remarkable phenomenon characterized by a supranormal height velocity. One of the hypothetical mechanisms of catch-up growth is that an increased activity of the somatotrophic axis is involved. In order to provide further insight in the physiology of catch-up growth, auxological and endocrine changes were prospectively studied in 28 children with newly diagnosed celiac disease. The results demonstrate a malnutrition-like state of the somatotrophic axis at the time of diagnosis and a rapid recovery of this axis towards normal functioning after institution of the gluten-free diet. Although several correlations between these endocrine alterations and auxological parameters were detected, it is questionable whether the endocrine changes are the driving force behind catch-up growth.

Body Height↗
PubMed1990

[The renin-angiotensin-aldosterone (RAA) system in endocrine diseases].

Modern, views are presented on the pathogenesis of arterial hypertension in certain diseases of endocrine glands. In patients with phaeochromocytoma, virilizing tumours, acromegaly, in Cushing's disease, and in Conn's syndrome at the present state of knowledge it is not possible to formulate unequivocal conclusions concerning the effects of renin-angiotensin-aldosterone system on the mechanism of arterial hypertension development in these endocrinopathies.

Adrenal Gland Neoplasms↗
PubMed1992

[Recent progress in endocrine surgery: more refined and rational interventions for varied endocrine diseases].

Better understanding of pathogenesis and natural history of various endocrine diseases along with development of new and sensitive assays for accurate measurement of hormones and of modern image diagnostic procedures for clear demonstration of pathological tissues has enabled us to detect many kinds of endocrine diseases much more frequently than before and to perform a more refined and rational surgical intervention. Endocrine surgery is now a challenging and fascinating field of general surgery. This fact is best exemplified as follows: (1) different therapeutic approaches for intrathyroidal and extrathyroidal papillary carcinomas of the thyroid, (2) early detection and 131I treatment of clinically occult hematogenous metastasis of follicular carcinoma of the thyroid, (3) clinical usefulness of the serum calcitonin and CEA concentrations as sensitive tumor markers in the treatment of medullary thyroid carcinoma, (4) rational use of preoperative localization test and unilateral neck exploration for parathyroid adenoma, and specific surgical intervention for metastatic parathyroid carcinoma, (5) how to treat adrenal incidentalomas and a trial of subclassification of pheochromocytomas into epinephrine- and norepinephrine-secreting tumors, and (6) intraoperative localization of insulinoma by ultrasound and newly developed surgical approaches for gestrinoma.

Endocrine System Diseases↗
PubMed1987

Use of molecular probes in the study of endocrine diseases.

DNA hybridization techniques are now commonly used in studies of endocrine disease. Although solution and filter hybridization have been more widely used in endocrine studies, ISH offers many advantages to the pathologist. Individual cells can be visualized directly with the microscope to study the expression of specific gene products. ISH is somewhat similar to immunohistochemistry and can be set up rapidly in most histology laboratories, especially when nonradioactive biotinylated probes are used. The ability to combine ISH with immunochemical techniques offers to the pathologist the use of two powerful diagnostic tools simultaneously. Although DNA hybridization has only begun to have an impact in diagnostic pathology, many studies using this technique in the diagnosis of endocrine diseases are emerging. The availability of more probes, especially with nonradioactive detection systems, should accelerate the application of these techniques in diagnostic pathology. As the number of molecular probes available for hybridization studies increases, pathologists can have a major impact in this field by carefully evaluating probes that have potential diagnostic value for their specificity and sensitivity in a wide variety of normal and abnormal human tissues. Such careful and critical analyses will contribute greatly to the confidence with which these molecular probes can be used as another tool in the analysis of difficult diagnostic lesions. Molecular hybridization techniques will also contribute greatly to our knowledge of basic biology and pathophysiology in the study of abnormal gene expression in endocrine and other pathologic conditions.

Adrenal Glands↗
PubMedDate not supplied

[The clinical value of contrast-less mammography in endocrine diseases].

The authors analyze the X-ray picture of the changes occurring in the mammary glands in women with various endocrine diseases and in men with gynecomastia. Contrastless mammagraphy was carried out in 189 persons. In studying the mammagrams in patients with endocrine diseases assessment was made of the state of the subcutaneous-adipose cellular tissue, total dimensions of the organ. The majority of the endocrine diseases were accompanied at the initial stages of their development by changes in the endocrine gland, this serving as a direct indication for the use of contrastless roentgenography for the purpose of earlier and proper choice of the therapeutic method.

Acromegaly↗
PubMedDate not supplied

Affective disorders and endocrine disease. New insights from psychosomatic studies.

This is a review of psychosomatic interactions between affective disorders (depressive and anxiety disturbances, irritable mood) and endocrine disease. Particular reference is made to stressful life events in the pathogenesis of endocrine disease, psychopathology of hormonal disturbances, and pathophysiology of hypothalamic-pituitary-adrenal axis function in depression and Cushing's disease. These psychosomatic interactions may lead to appraisal of common etiological mechanisms in endocrine and psychiatric disorders, of the value of retaining the category of organic affective syndromes in psychiatric classification, and of the need for research on quality-of-life measures in endocrine disease. The establishment of "psychoendocrine units," where both endocrinologists and psychiatrists should work, is advocated. Such psychoendocrine units may serve and benefit clinical populations who currently defy traditional medical subdivisions.

Adrenocorticotropic Hormone↗
PubMed2005

Characterization of antipituitary antibodies targeting pituitary hormone-secreting cells in idiopathic growth hormone deficiency and autoimmune endocrine diseases.

OBJECTIVE: In order to investigate whether somatotrophs are the target of antipituitary antibodies (APA) in adult patients with growth hormone deficiency (GHD), we studied the sera of 37 APA positive patients. PATIENTS: Patients were grouped as follows: nine patients with APA at high titre (> 1 : 8) affected by apparently idiopathic GHD; four of them (group 1a) with isolated GHD diagnosed during childhood and five with GHD diagnosed during adulthood associated with autoimmune endocrine diseases (group 1b), and 28 patients with autoimmune endocrine diseases without pituitary impairment, previously found positive for APA at low titre (1 : 8, group 2). MEASUREMENTS: APA were evaluated by a four-layer double indirect immunofluorescence technique. RESULTS: In group 1a patients, APA immunostained exclusively GH-producing cells. In group 1b patients, APA were directed not only to GH- but also to other pituitary hormone-producing cells. In group 2 patients, APA were directed selectively to PRL-producing cells and rarely to some GH-producing cells. CONCLUSIONS: In the present study, we demonstrated that GH-secreting cells are the target of the autoimmune reaction in autoimmune GHD and that the immunostaining of only the somatotrophs is typical of isolated GHD. In contrast, the finding of diffuse staining of APA indicates the need to search for other autoimmune diseases. Finally, the presence of APA at low titre directed against PRL-secreting cells in patients with autoimmune endocrine diseases in the absence of pituitary impairment, seems to be only a nonspecific marker of pituitary autoimmunity. A longitudinal study would be useful to clarify the relationship between the different pituitary cell involvement and the natural history of pituitary dysfunction in autoimmune hypophysitis.

Adult↗
PubMed2003

The genetics of autoimmune endocrine disease.

The common autoimmune endocrinopathies result from an interaction between environmental factors and genetic predisposition. Several chromosomal gene regions have been shown to contribute to more than one disease, supporting the clinical observation that the autoimmune endocrine diseases cluster within individuals and families. Genetic studies have implicated the major histocompatability complex (MHC)-human leucocyte antigen (HLA) genes on chromosome 6p21, although this chromosomal region does not explain all of the genetic contribution to the various disorders. Non-MHC-HLA genes, including disease-specific loci, are beginning to be identified and the publication of the draft sequence of the human genome will undoubtedly expediate future discoveries. Combined with the establishment of large cohorts of subjects with disease and the development of technology capable of performing high-throughput genotyping, genetic studies are likely to impact on the future treatment and prevention of the common autoimmune endocrine diseases.

Antigens, CD↗
PubMed1995

Colorectal manifestations of endocrine disease.

PURPOSE: The aim of this review is to alert the colon and rectal surgeon to the colorectal manifestations of endocrine disease. METHODS: This report was obtained by a review of the medical literature. Endocrine disease may initially present as a symptom felt to be referable to colorectal disease. Furthermore symptoms of well-established endocrine disorders may have refractory colorectal symptoms. RESULTS: Constipation is the most common gastrointestinal symptom of diabetics; however, in patients with brittle diabetes, diarrhea may be chronic and intermittent. Unexplained diarrhea, despite an exhaustive work-up for an etiology, should alert the clinician to the possibility of a pancreatic endocrine tumor. Thyroid disorders, depending on activity of the gland, may have refractory constipation, diarrhea, or steatorrhea as the only presenting symptoms. Constipation is a common symptom of hypercalcemia, secondary to hyperparathyroidism. Primary hyperparathyroidism has been associated with increased incidence of malignancies, specifically of colonic origin. In patients with acromegaly a threefold to eightfold increased risk of colon carcinoma or adenomatous polyps is seen. Chronic adrenal insufficiency may present initially as diarrhea and malabsorption. The adrenal gland is a frequent site of metastases from colorectal cancer. Pheochromocytomas may be a cause of occult gastrointestinal bleeding or ischemic colitis. CONCLUSION: Unexplained symptoms referable to the colon and rectum should alert the clinician to the possibility of an underlying endocrine disorder.

Colonic Diseases↗