By Terry F. Davies
During this thought-provoking booklet, exceptional clinicians offer stimulating guideline and insights right into a big range of endocrine matters, instructing readers glossy administration of the stipulations defined and delivering distinct access into the literature. The textual content displays a lot of the curriculum for scientific endocrine education urged by means of the organization of software administrators in medical Endocrinology. Concise instances are via a number of selection inquiries to improve studying.
Read Online or Download A Case-Based Guide to Clinical Endocrinology (Contemporary Endocrinology) PDF
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Extra resources for A Case-Based Guide to Clinical Endocrinology (Contemporary Endocrinology)
Mean serum PRL levels was normal and a partial empty sella in the left paramedian portion of the gland was documented on MRI. Menses reappeared in February 2003. 3, mean PRL levels remained normal to date. No change on MRI was found. The patient had a second healthy pregnancy in April 2004. No recurrence of hyperprolactinemia or change on MRI were found at the follow-up performed in July 2006. Lessons Learned Cabergoline is considered the most effective drug for treating prolactinomas. Bromocriptine and pergolide are also very effective, but cabergoline fosters better patient compliance than bromocriptine and normalizes PRL levels even in patients resistant to bromocriptine (3–7).
In my opinion, it is more likely that pregnancy occurred because of the restoration of physiologic pituitary function than vice versa. A positive role of pregnancy in the persistence of normalization of PRL levels cannot be ruled out, however. It is, instead, uncommon that the simple observation of a microprolactinoma causing amenorrhea and galactorrhea is followed by remission of the disease, as 24 A. Colao mentioned above. In such cases treatment (medical or surgical, according to the individual patient’s preference) is indicated.
Amiodarone is perhaps the most notorious cause of drug-induced hyperthyroidism, occurring in 3% to 10% of individuals exposed to the drug, depending on background iodine intake. Hyperthyroidism due to interferon-alfa and other immune mediators is being recognized with greater frequency. Interestingly, all of these drugs (iodine, amiodarone, interferon-alfa) can also produce hypothyroidism depending on the patient and the presence of underlying thyroid disease. The diagnosis of hyperthyroidism rests with finding elevated levels of thyroxine (T4 ) or triiodothyronine (T3 ) in conjunction with a suppressed serum TSH level.