Myxedema Coma
Introduction Myxedema coma is an important endocrine emergency caused by untreated or prolonged hypothyroidism that culminates in a comatose state. It is seen more commonly in elderly women during the…
Acute Adrenal Insufficiency
Introduction Adrenal crisis is the most severe manifestation of adrenal insufficiency (AI); it can be the first manifestation of AI or can occur in patients already established on glucocorticoid therapy….
Diabetic Emergencies: Ketoacidosis, Hyperglycemic Hyperosmolar State, and Hypoglycemia
Diabetic Ketoacidosis INTRODUCTION Diabetic ketoacidosis (DKA) is an acute metabolic complication of diabetes characterized by an absolute or relative insulin deficiency resulting in hyperglycemia, hyperketonemia, and metabolic acidosis. DKA is…
Ocular Emergencies in Graves’ Ophthalmopathy
Introduction Thyroid eye disease (TED), also known as thyroid orbitopathy and Graves’ ophthalmopathy, is an autoimmune-driven process that results in pathologic changes of the extraocular muscles, orbital fat, and surrounding…
Amiodarone-Induced Thyrotoxicosis
Introduction Amiodarone is a benzofuranic acid with potent antiarrhythmic properties that contains iodine amounting to 37% of its weight. Thus a 200-mg tablet (typical maintenance daily dose) provides approximately 70…
Severe Thyrotoxicosis and Thyroid Storm
Introduction Thyroid hormone excess, also known as thyrotoxicosis, encompasses a wide range of signs and symptoms. Thyrotoxicosis and hyperthyroidism may have semantic distinctions but are often used interchangeably. Patients with…
Diabetic autonomic neuropathy, measurement and management; part II: management
Autonomic neuropathy Diabetes, like aging, precipitates a cascade of secondary symptoms: sleep and GI disturbance, dizziness or lightheadedness, secondary hypertension, urogenital dysfunction, higher risk of cardiovascular disease, and more. This…
Management of diabetic foot disease
Introduction The unrelenting increase in the global prevalence in diabetes mellitus has meant that the burden of its associated complications is expected to increase significantly over the next few decades….
Diabetic autonomic neuropathy, measurement and management; part 1: measurement
Autonomic neuropathy A brief history Autonomic Neuropathy is well established as a “crystal ball” for morbidity and mortality risks in patients diagnosed with Diabetes . Unfortunately, Autonomic Neuropathy is poorly…
Motor dysfunction in diabetes
Introduction In diabetic neuropathy (DN), symptoms and signs depend on the severity of impairment of sensory, autonomic, and motor nerves, clinically presenting in a symmetrical or asymmetrical pattern . In…
