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Autoimmune endocrine disease.

Endocrine cells may become targets for autoimmune processes resulting in cellular dysfunction and diseases which cause considerable morbidity. The thyroid follicular cells, the parietal cells of the gastric mucosa, the insulin-producing islet cells and the adrenal cortical cells are most often affected. This rank order may indicate a relationship between antigen mass and prevalence of disease in a given organ (15).

Autoantibodies↗

[Feminine acne: dermatologic disease or endocrine disease?].

Acne is a problem of the pilo-sebaceous follicle caused by the conjunction of three factors: seborrhea, follicle obstruction, and follicle inflammation. The key element, seborrhea, is under androgenic control. Acne in women is also influenced by developments and modifications in genital life, as well as by hormonal contraceptive and replacement therapies. Acne is rare prior to puberty, when it may indicate endocrine disease. At puberty, acne is quasi-physiological, because of the relative hyperandrogenism induced by the andrenarche preceding pubarche, as well as by the relative shortage of estrogens and progesterone during the first menstrual cycles. Other signs of hyperandrogenism, such as menstrual cycle difficulties and excess weight, which favor a hormonal origin, must be sought in cases of persistent or late-onset acne in adults. There is a mirror image of puberty during the peri-menopausal period, but with decreased seborrhea, so acne is rare. Finally, a tumoral origin must be sought in the rare cases of acne occurring after menopause. Hormonal investigation of acne should not be systematic, but is justified during prepuberty when other symptoms are associated with acne that resists well-conducted dermatological treatment. The therapeutic approach should be primarily dermatological, but hormone-oriented treatment should be considered when such therapy fails, or in the presence of other signs of hyperandrogenism. Sometimes the association of isotretinoin and an anti-androgen treatment are necessary to effectively treat such acne. Finally, particular attention must be paid to contraceptive therapies and hormone treatments, which can induce or aggravate acne, especially during the peri-menopausal period.

Acne Vulgaris↗

Subtle psychiatric presentations of endocrine diseases.

Endocrine disorders frequently present initially to psychiatrists. This article reviews the differential diagnosis of psychiatric and endocrine disorders. The range of endocrinopathies is presented, with emphasis placed on the common psychiatric symptomatology associated with these conditions. Various signs and symptoms that might stimulate a psychiatrist to pursue a work-up for each endocrine disorder are also emphasized.

Calcium Metabolism Disorders↗

The nature of autoantigens targeted in autoimmune endocrine diseases.

Autoimmune endocrine diseases result from autoimmune processes involving autoreactive T cells and/or autoantibodies. Considerable progress has been made in elucidating the self- (auto-) antigens involved in these processes. These include tissue-specific membrane receptors, enzymes and secreted hormones. As discussed here by Yao-Hua Song and colleagues, diagnostic and therapeutic applications should now result from these discoveries.

Autoantibodies↗

Endocrine diseases in dogs and cats: similarities and differences with endocrine diseases in humans.

Over several millennia, humans have created hundreds of dog and cat breeds by selective breeding, including fixation of mutant genes. The domestic dog is unique in the extent of its variation in height, weight and shape as well as its behavior. It is primarily the relatively long persistence of high levels of growth hormone (GH) release at a young age that accounts for the large body size in giant breeds of dogs. Several of the endocrine diseases of humans are also known to occur as similar entities in dogs and cats. With some variations, this is true for conditions such as diabetes mellitus and the hypofunction syndromes of the thyroid and adrenal cortex. Also, the hyperfunction syndromes of hypercortisolism and hyperparathyroidism in dogs and cats have many similarities with their human counterparts. The exception seems to be Graves' disease. This condition, which is due to production of thyroid-stimulating hormone (TSH)-receptor antibodies, has not been observed in dogs and cats. The very common form of hyperthyroidism in cats is due to toxic adenomas. In the 1980s it was discovered that in dogs exogenous progestins and endogenous progesterone can induce GH excess. This GH excess originates form the mammary gland and may give rise to acromegaly and insulin resistance. GH production by the mammary gland is not unique to the dog. It has become clear that cats and humans also express the GH gene in the mammary gland. There is increasing evidence that this locally produced GH not only plays a role in the morphologic changes of the mammary gland associated with the ovarian cycle and gestation, but that it is also involved in the development of breast cancer. In dogs, induction of mammary GH production by progestin administration allows for treatment of GH deficiency.

Animals↗

[The importance of immunogenetic studies in Itsenko-Cushing disease combined with other endocrine diseases].

Ninety-seven patients suffering from Itsenko [correction of Icenko]-Cushing disease were examined. Analysis was made first of all of the clinical and laboratory signs pointing to the presence of other endocrine diseases to distinguish two groups of patients. The first group included subjects who did not manifest any concomitant diseases. The number of men and women was the same. The second group was made up of patients with associated Itsenko [correction of Icenko]-Cushing disease and other endocrine diseases. In this particular group, women were predominant. The first group patients demonstrated the predominance of the DR7 incidence, the second group that of the DR5. The method of estimating HLA associations identified is proposed. It allows distinguishing specific and nonspecific associations. In Itsenko [correction of Icenko]-Cushing disease, DR7 association is specific, whereas B8 and DR5 associations are unspecific. A specific polyendocrine autoimmune syndrome associated with Itsenko [correction of Icenko]-Cushing disease was revealed. A concept of the pathogenesis of Itsenko [correction of Icenko]-Cushing disease is advanced.

Adult↗

Autoimmune endocrine disease.

Autoimmune endocrine diseases are serious disorders that utilize immense health care resources and cause tremendous disability. They include type 1 diabetes mellitus, thyroiditis, Graves disease, Addison disease, and polyglandular syndromes. Analysis of the basis of autoimmune diseases has been aided by the application of new knowledge in immunologic physiology. Recent investigations using these techniques have revealed complicated disorders that have varied pathogenesis and complex genetic predispositions. While the mainstay of treatment for these diverse diseases remains the replacement of hormones produced by the damaged endocrine organ, investigations into the pathogenesis of these disorders provide hope for the development of specific therapeutic measures to block their pathologic basis.

Addison Disease↗

[Cardiac failure in endocrine diseases].

Several endocrine diseases show the symptoms of cardiac failure. Among them, patients with acromegaly show a specific cardiomyopathy which results in a severe left-sided cardiac failure. Hypoparathyroidism also induces cardiac failure, which is resulted from hypocalcemia and low levels of serum parathyroid hormone. In the cases of hypothyroidism, the patients with myxedemal coma show a severe cardiac failure, which is characterized by disturbance of central nervous system, renal function, and cardiac function. In the patients with thyroid crisis (storm), the cardiac failure comes from the great reduction of cardiac output with dehydration. The reduction of circulation volume, observed in the patients with pheochromocytoma easily induces cardiac failure (shock) just after the removal of adrenal tumor. In patients with malignant carcinoid syndrome, right-sided ventricular failure which may be occurred through the actions of biogenic amines is observed.

Acromegaly↗

Neurologic complications of endocrine diseases.

The endocrine system maintains a constant internal milieu for proper nervous system functioning. It is not surprising that abnormalities develop anywhere along the neuroaxis when disease of the endocrine organs occurs. Appreciating the neurologic signs and symptoms of endocrine disease is of utmost importance, given the relative ease in confirming the diagnosis, their excellent response to treatment, and the devastating consequences if not appreciated. This article reviews the findings seen in disorders of calcium metabolism, thyroid and adrenal disease, diabetes mellitus, and acromegaly.

Cushing Syndrome↗