Polycystic

The use of V2 antagonists is promising in the treatment of the hyponatremia that usually accompanies congestive heart failure and cirrhosis, two edematous conditions in which the use of diuretics is indicated. In addition, V2 antagonists may be beneficial in the treatment of polycystic kidney disease. 

PKD2, also called polycystin 2, is a TRP-related protein defective in human autosomal polycystic kidney disease, the most common life-threatening genetic disease. PKD2 appears to be a cation channel in the plasma membrane, although there is evidence that it is an intracellular Ca2+release channel. Mammalian homologs include polycystin-like (PCL). 

Polycystic kidney disease (Polycyst in-1 activates canonical Wnt signaling pathway) Injury-induced renal fibrosis Heart failure Ulcerative colitis Osteoporosis-Pseudoglioma Syndrome (genetic syndrome of defective bone formation) Ulcerative colitis Familial Alzheimer s disease (through interaction with Presenilin-1) Familial Alzheimer s disease (through interaction with Presenilin-1)... 

As noted above, many of the AEDs induce hepatic microsomal enzyme systems and thus reduce the effectiveness of hormonal contraceptives. Women taking AEDs that may reduce the effectiveness of hormonal contraceptives should be encouraged to also use other forms of birth control. Due to induction or inhibition of sex hormone metabolism and changes in binding of hormones to sex hormone binding globulin, some AEDs may reduce fertility. For example, valproate has been associated with a drug-induced polycystic ovarian syndrome. Women who experience difficulties with fertility should seek the advice of health care professionals with expertise in fertility. 

Signs of insulin resistance or conditions associated with insulin resistance (acanthosis nigricans, hypertension, dyslipidemia, or polycystic ovary disease)... 

Differential diagnoses include diabetes mellitus and metabolic syndrome because patients with these conditions share several similar characteristics with Cushing s syndrome patients (e.g., obesity, hypertension, hyperlipidemia, hyperglycemia, and insulin resistance). In women, the presentations of hirsutism, menstrual abnormalities, and insulin resistance are similar to those of polycystic ovary syndrome. Cushing s syndrome can be differentiated from these conditions by identifying the classic signs and symptoms of truncal obesity, "moon faces" with facial plethora, a "buffalo hump" and supraclavicular fat pads, red-purple skin striae, and proximal muscle weakness. 

Ovarian polycystic ovarian syndrome Pituitary tumors ... 

The use of metformin and thiazolidinediones for anovulatory bleeding associated with polycystic ovary syndrome is beneficial for anovulatory bleeding and fertility and also improves glucose tolerance and decreases overall cardiovascular risk. 

Table 46-1 illustrates the pathophysiology of amenorrhea relative to the organ system(s) involved, as well as the specific condition that results in amenorrhea. Amenorrhea is also a normal side effect that may result from the use of low-dose oral contraceptives (OCs), extended-cycle OC pill use, or depot medroxyprogesterone acetate use.5 Many women may experience delayed return of menses after discontinuation of OCs. Postpill amenorrhea usually is a self-limited condition. Further evaluation for other unrecognized conditions, such as polycystic ovary syndrome (PCOS), should be considered if spontaneous resolution of the amenorrhea does not occur within 3 to 6 months following discontinuation of the OCs.6,7... 

BMD, bone mineral density NSAID, non-steroidal anti-inflammatory drug OCs, oral contraceptives PCOS, polycystic ovary syndrome PMDD, premenstrual dysphoric disorder. 

American College of Obstetricians and Gynecologists. Polycystic ovary syndrome. ACOG Practice Bulletin number 41. Obstet Gynecol 2002 100 1389-402. 

Guzick DS. Polycystic ovary syndrome. Obstet Gynecol 2004 103(1) 181-193. 

Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and longterm health risks related to polycystic ovary syndrome. Fertil Steril 2004 81(l) 19-25. 

PCKD Polycystic kidney disease QA Quality assurance... 

Polycystic kidney disease A disorder in which clusters of cysts develop within the kidneys. 

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