Differential diagnoses Hirsutism and/or hyperandrogenaemia Oligomenorrhea or amenorrhea Distinctive characteristics Clinical features Laboratory tests Hyperprolactinaemia; prolactinoma Mild or absent Present Galactorrhoea; macroprolactinomas may cause visual disturbances headache, cranial nerve palsies…
Features due to glucocorticoid insufficiency Weakness Malaise Weight loss Nausea and vomiting Hypoglycaemia Myalgia Anaemia Features due to mineralocorticoid insufficiency Hypotension Dehydration Hyponatraemia Features due to reduced adrenal androgens Decreased…
Fig. 14.1 Pathways of steroid metabolism. A block due to deficiency of 21-hydroxylase causes accumulation of precursors (17-hydroxyprogesterone, androstenedione, testosterone) and deficiency of glucocorticoids (cortisol) and mineralocorticoids (aldosterone) Classical 21-Hydroxylase…
Fig. 3.1 Diagnostic workup for patients with Cushing’s syndrome. Modified from Melcescu, Koch. Testing for endocrine hypertension, Chapter 7, In: Leslie De Groot, editor, online http:// www.endotext.org; 2012 Ectopic ACTH…
Fig. 7.1 A 23-year-old female who presented with severe left flank pain with normal blood pressure. Biochemical testing revealed elevated plasma and urine normetanephrine levels. Anatomic imaging showed the following…
Fig. 4.1 (a) Schematic representation of the structure of the human glucocorticoid receptor (hGR) gene. Alternative splicing of the primary transcript gives rise to the two mRNA and protein isoforms,…
Unilateral forms of PA (surgically treatable) Aldosterone-producing adenoma 30–40% Unilateral adrenal hyperplasia <5% Aldosterone-producing carcinoma Rare Bilateral forms of PA (medically treated) Bilateral adrenal hyperplasia 60–70% Familial hyperaldosteronism type I…
Fig. 11.1 The frailty cycle. Modified from ref. [21] Such chronic diseases are mainly atherosclerosis, diabetes mellitus, and obesity. Thus, in view of the multifactorial origin of aging symptoms, effects…
References No. cases Prevalence (%) Measurement Criteria for hypertension (mmHg) Nabarro [123] 256 30.5 Clinical Not known Rodrigues et al. [24] 34 26 Clinical 160/95 Kraatz et al. [23] 158…
Fig. 13.1 Putative mechanisms for development of obesity-hypertension (OH) Table 13.1 Mechanical and humoral factors implicated in OH Hyperinsulinemia and insulin resistance Chronic noninfective inflammation Chronic adipocytokinemia (elevated local adipose…
