Endocrine abnormalities

Environmentally Induced Endocrine Abnormalities in Eish Heavy metals... 

In leukemia, the intensified use of methotrexate and glucocorticoids is responsible for causing an increased frequency of neurotoxicity and, in older children and adults, avascular necrosis of bone. High cumulative doses of anthracyclines can cause cardiomyopathy. Cranial irradiation causes neuropsychologic deficits and endocrine abnormalities that lead to obesity, short stature, precocious puberty, and osteoporosis.3 As newer and more intensive treatments enter clinical trials, close observation for long-term side effects will assume even greater importance.24... 

Endocrine abnormalities Hypothyroidism Adrenal insufficiency Pituitary insufficiency Chronic renal disease Chronic inflammatory disease Granulomatous diseases Collagen vascular diseases Hepatic disease... 

Synthetic steroids may cause endocrine abnormalities by actions on other steroid receptors. Gynecomastia, impotence, and benign prostatic hyperplasia all have been reported with spironolactone. Such effects have not been reported with eplerenone because it is much more selective than spironolactone for the mineralocorticoid receptor, being virtually inactive on androgen or progesterone receptors. 

Drugs that mimic or block the effects of hypothalamic and pituitary hormones have pharmacologic applications in three primary areas (1) as replacement therapy for hormone deficiency states (2) as antagonists for diseases that result from excess production of pituitary hormones and (3) as diagnostic tools for identifying several endocrine abnormalities. 

Octreotide Somatostatin analog mechanism not certain May alter portal blood flow and variceal pressures Patients with bleeding varices or at high risk of repeat bleeding Reduced endocrine and exocrine pancreatic activity other endocrine abnormalities GI upset... 

I consider hormonal steroid profiles to be those analyses that encompass a panel of steroids that can diagnose different endocrine abnormalities. A panel of multiple steroids used to diagnose a single condition, for example 21-hydroxylase deficiency, would not be a steroid profile under this definition. 

Diagnosis of Endocrine Disorders. Hormones or their antagonists can be administered to determine the presence of excess endocrine function or endocrine hypofunction. For example, hormones or their synthetic analogs can be administered that either increase or decrease pituitary secretion to determine if pituitary function is normal. Likewise, antagonists to specific hormones can be administered to see if symptoms are caused by excessive hormone production. Specific examples of how hormones are used to diagnose endocrine abnormalities are presented in subsequent chapters. 

Malignant bone marrow disorders Endocrine abnormalities... 

In vitamin Be-deflcient experimental animals, there are skin lesions (e.g., acrodynia in the rat) and fissures or ulceration at the corners of the mouth and over the tongue, as well as a number of endocrine abnormalities defects in the metabolism of tryptophan (Section 9.5.4), methionine (Section 9.5.5), and other amino acids hypochromic microcytic anemia (the first step of heme biosynthesis is pyridoxal phosphate dependent) changes in leukocyte count and activity a tendency to epileptiform convulsions and peripheral nervous system damage resulting in ataxia and sensory neuropathy. There is also impairment of immune responses, as a result of reduced activity of serine hydroxymethyltransferase and hence reduced availability of one-carbon substituted folate for nucleic acid synthesis (Section 10.3.3). It has been suggested... 

The earliest endocrine abnormality in almost all types of cardiac disease is increased release of the heart s own hormones, the natriuretic peptides ANP and BNP (A for atrial, B for brain, where it was first discovered), and their concentration in plasma may become a guide to therapy. These peptides normally suppress renin and aldosterone production. 

Androgenic activity drives sebum production in the sebaceous glands however, most acne patients do not have an endocrine abnormality. Acne-affected pilosebaceous units apparently have a hyperresponsiveness to circulating androgens. Increased sebum production per se is not necessarily responsible for acne, but may rather be viewed as an underlying factor. 

Useful as part of combination therapy in women with or without endocrine abnormalities... 

E5. Emmanouel, D. S Lindheimer, M. D and Katz, A. I., Endocrine abnormalities in chronic renal failure Pathogenetic principles and clinical applications. Semin. Nephrol. 1, 151-175... 

Cathro and Coyle (C4) have described the second pregnancy of a woman who had already given birth to an infant with adrenal hypoplasia. The first infant died of respiratory failure 18 hours after birth and postmortem examination revealed very small adrenal glands but no other detectable endocrine abnormality. During the latter part of the second pregnancy, the maternal estriol excretion was low (1 mg/24 hours), an expected finding since 16a-OH-DHA produced by the fetus is an important precursor of estriol (D6, D9) (Section 4.1.1.). Evidence for adrenocortical insufficiency in the infant was obtained from the low level of cortisol in the umbilical cord blood. The infant was satisfactorily treated at birth with steroid therapy. 

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