By Lee Kennedy, Ansu Basu
One in all a chain of books within the sequence of "Problem Solving", this publication provides a complete case load of sufferer problems visible through the final practitioner and endocrinologist. first and foremost of every case are a number of useful inquiries to stimulate the reader. this can be then via medical presentation and the reader is led during the logical work-up to arrive a prognosis. An set of rules accompanies such a lot instances to supply a pictorial fast evaluation of the medical steps. References are key yet saved to a minimal. all of the significant parts of endocrinology are lined: thyroid, adrenal gland, pituitary, copy, development and improvement, calcium and bone, endocrine high blood pressure, water, electroytes and glucose. The authors additionally finish with a bit on healing elements. the executive writer, Professor Lee Kennedy, is a British expatriate, now in a number one scientific function in Australia. Lee has event in several medical components and is concerned with educating clinical scholars.
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Additional info for Problem Solving in Endocrinology and Metabolism
In 80–90% of cases the cause is autoimmune destruction of the cortex. Tuberculosis is the second commonest aetiology and accounts for a greater proportion of cases in developing countries. In autoimmune adrenal failure, the endocrine cells of the adrenal cortex are destroyed predominantly by autoreactive T cells. There is also a humoral immune component, and circulating anti-adrenal antibodies are a useful marker for immune-mediated Addison’s disease. Anti-adrenal antibodies, detected by immunofluorescence, are present in about 80% of patients at diagnosis, declining gradually to around 10% at 15 years after diagnosis.
There is a risk of extraocular nerve palsy. 3 studied expression of TSH receptor antibody in extraocular muscle biopsies of patients with TED compared with non-thyroid patients undergoing surgery for strabismus. All of the biopsies from TED patients expressed TSH receptor and none of the control biopsies did so. 2 The critical role of increased adipose tissue in TED has been confirmed in a recently published study: orbital tissue from TED patients being treated by orbital decompression was studied using microarrays to investigate gene expression.
5 Kahaly GJ, Pitz S, Hommel G, Dittmar M. Randomized, single blind trial of intravenous versus oral steroid monotherapy in Graves’ orbitopathy. J Clin Endocrinol Metab 2005; 90: 5234–40. 6 Wémeau JL, Caron P, Beckers A, et al. Octreotide (long-acting release formulation) treatment in patients with Graves’ orbitopathy: clinical results of a four-month, randomized, placebocontrolled, double-blind study. J Clin Endocrinol Metab 2005; 90: 841–8. qxd 10/4/06 8:47 AM S E C T I O N Page 49 T W O 02 Adrenal 11 Addison’s disease 12 Autoimmune polyglandular syndromes 13 The incidental adrenal nodule 14 Cushing’s syndrome 15 Congenital adrenal hyperplasia P R O B L E M 11 Addison’s Disease Case History A 38-year-old Caucasian man complains of fatigue and light-headedness over the past 6 months.