Endocrine and Metabolic Medical Emergencies E-Book

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Serie: Wiley-Endocrine Society
• Sprache: Englisch

Seitenzahl: 1852

Veröffentlichungsjahr: 2018

Beschreibung

The Essential Guide to Recognizing and Treating Acute Endocrine and Metabolic Illness Endocrinology covers some of the most common conditions and serious public health challenges facing medicine today, and endocrine and metabolic emergencies constitute a large proportion of the clinical workload. Endocrine and Metabolic Medical Emergencies: A Clinician's Guide provides a singular reference to help endocrinologists, acute and general medicine clinicians, hospitalists and critical care physicians, and general practitioners recognize the symptoms of endocrine emergencies and provide the highest standards of care. Already the definitive and most comprehensive guide to endocrine emergency care, this new second edition: provides acute care guidance for a range of both common and unusual endocrine emergencies; details the effects of acute medical and critical illness on metabolic and endocrine systems, and their impacts on endocrine investigations; discusses special patient populations, including the impacts of aging, pregnancy, transplantation, late-effects, perioperative, inherited metabolic disorders and HIV/AIDS on presentation and management; and features detailed coverage of disorders by system, as well as, metabolic bone diseases, neuroendocrine tumors, and more. Packed with case studies, images, and chapters written by distinguished authors, this guide is designed for both quick reference and study. Coverage includes the presentation, diagnosis, management, and treatment of endocrine and metabolic disorders in an acute care setting, as well as the most up-to-date guidance on issues including clinical lipidology, glucose, sodium, calcium and phosphate, and more. Blending the latest science with clinical and practical advice, this invaluable resource helps clinicians stay up to date with the field's relevant body of knowledge while providing the practical, clinical insight they need in order to provide their patients with the utmost level of care.

Leseprobe

I dedicate this book to all people living with endocrine and metabolic problems and the healthcare professionals who look after them. I also dedicate this book to my family, especially wife Marcia and parents Enid and Sid, without whose continued support and encouragement the book would never have been started never mind finished!

Endocrine and Metabolic Medical Emergencies

A Clinician’s Guide

Edited by

Glenn Matfin, BSc (Hons), MSc (Oxon), MB ChB, DGM, FACE, FACP, FRCP

Consultant in Acute and General Medicine, Diabetes and Endocrinology Honorary Professor of Medicine National Health Service, UK Professor of Medicine MBRU College of Medicine Dubai Healthcare City Dubai, UAE

Second Edition

This Work is a co-publication between the Endocrine Society and John Wiley & Sons, Ltd.

This first published 2018© 2018 John Wiley & Sons Ltd

This Work is a co-publication between the Endocrine Society and John Wiley & Sons, Ltd.

Edition HistoryEndocrine Society/Endocrine Press (1e, 2014)

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by law. Advice on how to obtain permission to reuse material from this title is available at http://www.wiley.com/go/permissions.

The right of Glenn Matfin to be identified as the author of this work has been asserted in accordance with law.

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Library of Congress Cataloging-in-Publication Data

Names: Matfin, Glenn, editor.Title: Endocrine and metabolic medical emergencies : a clinician's guide /  [edited] by Glenn Matfin.Description: Second edition. | Hoboken, NJ : Wiley, 2018. | Includes bibliographical references and index. | Identifiers: LCCN 2017049999 (print) | LCCN 2017050741 (ebook) | ISBN  9781119374763 (pdf) | ISBN 9781119374756 (epub) | ISBN 9781119374732  (cloth)Subjects: | MESH: Endocrine System Diseases | Metabolic Diseases | Emergency  TreatmentClassification: LCC RC649 (ebook) | LCC RC649 (print) | NLM WK 140 | DDC  616.4–dc23LC record available at https://lccn.loc.gov/2017049999

Cover images: ©donskarpo / Getty Images-Thyroid level conceptual meter©shansekala / Getty Images-Stethoscope on cardiogram concept for heart care©juststock / Getty Images-Hypoglycemia Printed Diagnosis Medical ConceptCover design by Wiley

1  2018

Contents

Notes on Contributors

Foreword

Preface

List of Abbreviations

Part I General Aspects of Acute Medical Emergencies

Introduction Acute Medical Care: A Crisis with Solutions

Introduction

What Is the Impact of the Acute Medical Crisis on Diabetes and Endocrinology Speciality Delivery?

Solutions/Opportunities

Acknowledgments

References

1 Early Management of Acute Medical Emergencies

Introduction

Recognition of Medical Emergencies

The ABCDE Approach

Definitive Diagnosis and Treatment

Conclusions

References

Part II General Endocrine and Metabolic Aspects of Acute and Critical Illness

Introduction Endocrine Testing and Responses in Acute and Critical Illness

Acknowledgments

References

2 Endocrine Testing in Acute and Critical Illness

Introduction

Factors Influencing Laboratory Hormone Results or Their Interpretation in Acute Illness

Examples of Endocrine System Testing in Acute and Critical Illness

Hypothalamic-Pituitary-Thyroid (HPT) Axis

The Hypothalamic-Pituitary-Adrenal (HPA) Axis

Catecholamines

Hypothalamic-Pituitary Gonadal (HPG) Axis

Growth Hormone and Insulin-Like Growth Factor-1

Vitamin D

Conclusions

References

3 Endocrine Responses to Critical Illness

Introduction

Hypothalamic-Pituitary-Thyroid Axis

Hypothalamic-Pituitary-Adrenal Axis

The Hyperglycemic Response to Critical Illness: To Treat or Not to Treat?

Conclusions

Acknowledgments

References

Part III Special Populations

4 Endocrine and Metabolic Emergencies in Pregnancy

Introduction

Diabetes Mellitus

Pituitary Disease

Adrenal Disease

Thyroid Disease in Pregnancy

Parathyroid Disease in Pregnancy

Conclusions

References

5 Endocrine and Metabolic Emergencies in Inherited Metabolic Diseases

Introduction

Rhabdomyolysis

Encephalopathy

Acute Adrenal Crisis

Stroke

Cardiac Disease

Psychiatric Presentations

Pregnancy

Conclusions

References

6 Endocrine and Metabolic Emergencies in Transitional Care

Introduction

Type 1 Diabetes Mellitus

Hyperglycemic Hyperosmolar State (HHS)

Autoimmune Polyglandular Syndromes (APS)

Adrenal Insufficiency

Endocrine Hypertension

Traumatic Brain Injury (TBI)

Growth Hormone Deficiency (GHD)

Diabetes Insipidus (DI)

Hypothyroidism

Conclusions

References

7 Emergency Perioperative Diabetes and Endocrine Management

Introduction

Emergency Perioperative Diabetes and/or Hyperglycemia Management

Approaches to Management of Perioperative Diabetes and/or Hyperglycemia

Emergency Perioperative Endocrine and Metabolic Management

Pituitary

Thyroid

Adrenal Crisis

Sodium Level

Calcium

Neuroendocrine Tumors (NETs)

Conclusions

References

8 Endocrine and Metabolic Emergencies in HIV/AIDS

Introduction

Hypoadrenalism

Lactic Acidosis and Mitochondrial Toxicity

Hyperglycemia

Hypertriglyceridemia

Thyrotoxicosis

Hypercalcemia

Conclusions

References

9 Endocrine and Metabolic Emergencies in Late-Effects Patients

Introduction

Organization of Care for Cancer Survivors

Adrenal Insufficiency

Radiation Affecting the Hypothalamic Pituitary Axis

Adrenal Suppression Following Glucocorticoids

Immune Checkpoint Inhibitors and Endocrine Dysfunction

Thyroid Dysfunction

Diabetes Insipidus

Metabolic Disorders

Other Non-Endocrine Consequences

Conclusions

References

10 Endocrine and Metabolic Emergencies in Transplantation

Introduction

Hyperglycemia

Hypoglycemia

Dyslipidemia

Pituitary Disease

Adrenal Disease

Thyroid Disease

Calcium and Phosphate Disorders

Hypercalcemia

Hypocalcemia

Hypophosphatemia

Conclusions

References

11 Endocrine and Metabolic Changes with Aging: Endocrin-Aging: Recognizing and Managing Care in Older Frail Persons

Introduction

Pituitary Dysfunction in the Elderly

Hypothyroidism

Hyperthyroidism

Primary Adrenal Insufficiency (Addison's Disease)

Type 2 Diabetes Mellitus

Hyperglycemic Crisis

Hypoglycemia

Hypercalcemia

Sarcopenia and Hormones

Conclusions

References

Part IV Pituitary Disorders

Introduction Emergency Management of Pituitary Disorders

Conclusions

References

12 Hypopituitarism

Introduction

Etiology

Pathophysiology

Clinical Features and Findings

Conclusions

References

13 Pituitary Apoplexy

Introduction

Predisposing and Precipitating Factors

Pathophysiology

Clinical Presentation

Endocrine Dysfunction

Diagnostic Evaluation

Management of Pituitary Apoplexy

Conclusions

References

14 Macroprolactinomas

Introduction

Visual Field Defect at Presentation

Cerebrospinal Fluid (CSF) Rhinorrhea

Pituitary Apoplexy

Tumor Enlargement during Pregnancy

Conclusions

References

Part V Thyroid Disorders

Introduction Emergency Management of Thyroid Disorders

Introduction

Thyroid Emergencies

Conclusions

References

15 Myxedema Coma

Introduction

Pathophysiology

Clinical Manifestations

Prognosis

Conclusions

References

16 Life-Threatening Thyrotoxicosis: Thyroid Storm and Adverse Effects of Antithyroid Drugs

Introduction

Clinical Presentation

Treatment

After the Storm: Definitive Treatment

Prevention of Thyroid Storm

Adverse Effects of Antithyroid Drugs

Conclusions

Acknowledgments

References

17 Amiodarone-Induced Thyrotoxicosis

Introduction

Pathophysiology

Amiodarone-Induced Thyroid Disease

Conclusions

References

18 Thyrotoxic Periodic Paralysis

Introduction

Pathophysiology

Clinical Features

Conclusions

Acknowledgments

References

19 Sight-Threatening Graves’ Orbitopathy

Introduction

Pathophysiology

Dysthyroid Optic Neuropathy (DON)

Corneal Breakdown

Subluxation of the Globe

Conclusions

References

Part VI Adrenal Disorders

Introduction Emergency Management of Adrenal Disorders

Introduction

Pheochromocytoma and Paraganglioma

Primary Aldosteronism

Incidentally Discovered Adrenal Tumors

Conclusions

References

20 Acute Adrenal Insufficiency

Introduction

Pathophysiology

Etiology of Adrenal Insufficiency

Clinical Assessment

Diagnostic Testing of Adrenal Insufficiency

Treatment

Treatment of Precipitating Illness

Special Populations

Prevention of Adrenal Crisis

Conclusions

References

21 Acute Medical Aspects Related to Florid Cushing's Syndrome

Introduction

Etiology

Florid Cushing's Syndrome Investigation

Clinical Signs and Features

Management

Diagnostic Considerations

Conclusions

References

22 Endocrine Hypertensive Emergencies

Introduction

Hypertensive Emergencies

Pathogenesis

Hypertensive Emergencies Associated with Pheochromocytoma

Other Endocrine Causes of Hypertensive Emergencies

Diagnostic Considerations

Clues to Endocrine Causes of Hypertensive Emergencies

Treatment of Hypertensive Emergencies

Treatment of Pheochromocytoma-Related Hypertensive Emergencies

Treatment of Other Endocrine Hypertensive Emergencies

Conclusions

References

Part VII Calcium, Phosphate, and Metabolic Bone Diseases

Introduction Emergency Management of Calcium, Phosphate, and Metabolic Bone Diseases

23 Hypocalcemia

Introduction

Pathophysiology

Etiology

Diagnostic Considerations

Clinical Assessment

Acute Intervention

Permanent Hypoparathyroidism

Emerging Therapies

Conclusions

Acknowledgments

References

24 Hypercalcemia

Introduction

Pathophysiology

Etiology

Diagnostic Considerations

Clinical Signs and Features

Management of Severe Hypercalcemia

Treatment of Precipitating Illness

Emerging Treatments

Hypercalcemia in Pregnancy

Conclusions

References

25 Acute Medical Aspects Related to Phosphate Disorders

Introduction

Pathophysiology of Phosphate Homeostasis

Hypophosphatemia as a Metabolic Emergency

Hyperphosphatemia as a Metabolic Emergency

Conclusions

Acknowledgments

References

26 Acute Medical Aspects Related to Osteoporosis and Its Therapy

Introduction

Safety Concerns with Osteoporosis Therapy

Work-Up and Management of the Acute Fragility Fracture

Conclusions

References

27 Acute Medical Aspects Related to Paget's Disease of Bone

Introduction

Severe Bone Pain in Persons with Paget's Disease

Neurological Complications of Paget's Disease

Hypercalcemia

High Output Cardiac Failure

Conclusions

References

28 Acute Medical Aspects Related to Kidney Stones

Introduction

Epidemiology

Pathophysiology

Pathology

Differential Diagnosis

Risk Factors

Emergency Care Evaluation

Management

Prevention of Recurrence

Conclusions

References

Part VIII Neuroendocrine Tumors

Introduction Emergency Management of Neuroendocrine Tumors

Introduction

Small Intestinal NETs

Pancreatic NETs

Syndromes Related to Ectopic Hormonal Secretion

Conclusions

References

29 Acute Endocrine and Metabolic Emergencies Related to Neuroendocrine Tumors

Introduction

Specific Tumors and Situations

Syndromes Related to Ectopic Hormonal Secretion

Conclusions

References

Part IX Glucose Disorders

Introduction Emergency Management of Glucose Disorders

Introduction

References

30 Management of Diabetes and/or Hyperglycemia in Non-Critical Care Hospital Settings

Introduction

Inpatient Hyperglycemia and Hypoglycemia: A Brief Definition

Prevalence of Hyperglycemia and Hypoglycemia in Non-Critical Care Settings

Hyperglycemia and Outcomes in Non-Critical Care Settings

Hypoglycemia and Outcomes in Non-Critical Care Hospital Settings

Glycemic Variability

Management of Inpatient Hyperglycemia in Non-Critically Ill Hospitalized Patients

Personalized Hyperglycemia Management in Non-Critical Care Settings: A New Paradigm

Hospital Use of Incretin Therapy in Non-Critical Care Settings

Recommendations After Hospital Discharge

Conclusions

References

31 Hypoglycemia

Introduction

Definition of Hypoglycemia

Epidemiology

Glucose Measurements

Physiology of Glucose Metabolism

Management of Hypoglycemia

Etiology

Conclusions

Acknowledgments

References

32 Severe Hyperglycemia, Diabetic Ketoacidosis, and Hyperglycemic Hyperosmolar State

Introduction

Pathophysiology

Etiology

Diagnostic Considerations

Clinical Signs and Features

Management of Severe Hyperglycemia, DKA, and HHS

Treatment of Precipitating Illness

DKA in Pregnancy

Conclusions

References

33 Short-Term Intensive Insulin Therapy in Patients with Newly Presenting Type 2 Diabetes

Introduction

Clinical Evidence of STII Therapy in Newly Presenting T2DM

Clinical Practice of STII Therapy in Newly Presenting T2DM

Conclusions

References

34 Management of Concentrated Insulins in Acute Care Settings

Introduction

Background to Concentrated Insulins

Admission

During Hospitalization

Discharge

Conclusions

References

35 Management of Insulin Pumps in Hospitalized Patients

Introduction

Contexts of Inpatient CSII Therapy

General Considerations

Contraindications to Inpatient CSII Self-Management

Patient Agreement

Admission/Post-admission Procedures

Practical Experience with Inpatient CSII Self-Management

Continuous Glucose Monitoring Systems

Specific Scenarios

Use of CSII in the Perioperative Period

Limitations of Guidelines

Conclusions

References

36 Management of Diabetes and/or Hyperglycemia during Enteral and Parenteral Nutrition

Introduction

Glycemic Goals in Patients Receiving Enteral and Parenteral Nutrition

Managing Hyperglycemia in Patients During Specialized Nutrition Support

Lipid Management Issues Unique to PN

Hospital Discharge Diabetes Management Options for Patients Receiving Specialized Nutrition Support

Hypoglycemia in Patients Receiving Specialized Nutrition Support

Conclusions

Acknowledgments

References

37 Management of Diabetes and/or Hyperglycemia in Hospitalized Patients with Renal Insufficiency

Introduction

Diabetes, Hypoglycemia, and Chronic Kidney Disease

Insulin Therapy in Patients with Diabetes and/or Hyperglycemia in CKD/ESRD

Non-Insulin Therapies in Patients with Diabetes and/or Hyperglycemia in CKD/ESRD

Diagnosis and Management of Diabetic Ketoacidosis in Advanced CKD/ESRD

Practical Management of Diabetes and/or Hyperglycemia in CKD/ESRD

Conclusions

Acknowledgments

References

38 Management of Glucocorticoid-Induced Diabetes and/or Hyperglycemia

Introduction

Definition

Prevalence

Risk Factors for the Development of GID

Common Glucocorticoid Regimens

Pathophysiology and Pattern of GIH

Diagnosis

Associated Adverse Outcomes

Treatment Options

General Management Approach

Conclusions

References

39 Management of Diabetes and/or Hyperglycemia in Acute Coronary Syndrome, Acute Stroke, and Acute Heart Failure

Introduction

Acute Coronary Syndromes

Strokes and TIAs

Heart Failure

Conclusions

References

40 Acute Diabetic Foot

Introduction

Prevention of Diabetes Foot Complications

Classification and Diagnosis

Management of Diabetic Foot Infections

Osteomyelitis

Necrotizing Fasciitis

Charcot Neuroarthropathy

Peripheral Arterial Disease (PAD)

Discharge Planning

Conclusions

Acknowledgments

References

Part X Sodium Disorders

Introduction Emergency Management of Sodium Disorders

References

41 Emergency Management of Acute and Chronic Hyponatremia

Introduction

Classification of Hyponatremia by Plasma Tonicity, Extracellular Fluid Volume Status, and Severity

Hyponatremia Symptoms, Morbidity, and Mortality

Treatment of Symptomatic Hyponatremia: General Principles

Currently Available Therapies for Treatment of Symptomatic Hyponatremia

Hyponatremia Treatment Guidelines Based on Symptom Severity

Monitoring the Serum [Na

+

] in Hyponatremic Patients

Common Clinical Questions about the Therapy of Symptomatic Hyponatremia

References

42 Emergency Management of Acute and Chronic Hypernatremia

Introduction

The Physiological Control of Water Balance

Causes of Hypernatremia

Consequences of Hypernatremia

Management of Acute Hypernatremia

Management of Chronic Hypernatremia

Conclusions

References

Part XI Obesity and Clinical Lipidology

Introduction Emergency Management Related to Obesity and Clinical Lipidology

Obesity

Clinical Lipidology

References

43 Acute Emergencies Related to Bariatric Surgery

Introduction

Bariatric Procedures

Bariatric Surgery-Related Issues

Conclusions

References

44 Chylomicronemia Syndrome: Very Severe Hypertriglyceridemia and Acute Pancreatitis

Introduction

History

Epidemiology

Pathophysiology

Etiology

Clinical Features

Investigations

Treatment

Conclusions

Acknowledgments

References

45 Statin-Related Myopathy and Rhabdomyolysis

Introduction

Definition of Terms

Historical Background

Risk Factors and Prevention of Myopathy/Rhabdomyolysis

Statin-Associated Muscle Symptoms (SAMS)

Muscle Symptoms with CK ≥ 5 to 10 × ULN

Myopathy

Rhabdomyolysis

Conclusions

References

Index

Wiley End User License Agreement

List of Table

Chapter 1

Table 1.1

Table 1.2

Table 1.3

Chapter 2

Table 2.1

Chapter 3

Table 3.1

Chapter 4

Table 4.1

Chapter 5

Table 5.1

Table 5.2

Table 5.3

Chapter 6

Table 6.1

Table 6.2

Chapter 8

Table 8.1

Chapter 9

Table 9.1

Chapter 10

Table 10.1

Table 10.2

Chapter 11

Table 11.1

Table 11.2

Table 11.3

Table 11.4

Chapter 12

Table 12.1

Table 12.2

Table 12.3

Chapter 13

Table 13.1

Chapter 14

Table 14.1

Chapter 15

Table 15.1

Table 15.2

Table 15.3

Table 15.4

Chapter 16

Table 16.1

Table 16.2

Table 16.3

Table 16.4

Table 16.5

Table 16.6

Chapter 17

Table 17.1

Table 17.2

Chapter 18

Table 18.1

Table 18.2

Chapter 3

Table 19.1

Chapter 20

Table 20.1

Table 20.2

Table 20.3

Table 20.4

Chapter 22

Table 22.1

Table 22.2

Table 22.3

Table 22.4

Chapter 23

Table 23.1

Table 23.2

Table 23.3

Table 23.4

Chapter 24

Table 24.1

Table 24.2

Table 24.3

Table 24.4

Chapter 25

Table 25.1

Table 25.2

Table 25.3

Chapter 26

Table 26.1

Table 26.2

Chapter 27

Table 27.1

Table 27.2

Chapter 28

Table 28.1

Chapter 29

Table 29.1

Chapter 30

Table 30.1

Chapter 31

Table 31.1

Table 31.2

Table 31.3

Table 31.4

Chapter 32

Table 32.1

Table 32.2

Table 32.3

Chapter 33

Table 33.1

Chapter 34

Table 34.1

Table 34.2

Table 34.3

Table 34.4

Table 34.5

Table 34.6

Table 34.7

Chapter 35

Table 35.1

Table 35.2

Chapter 36

Table 36.1

Table 36.2

Table 36.3

Table 36.4

Chapter 37

Table 37.1

Table 37.2

Table 37.3

Table 37.4

Chapter 38

Table 38.1

Table 38.2

Chapter 39

Table 39.1

Table 39.2

Table 39.3

Table 39.4

Table 39.5

Chapter 40

Table 40.1

Table 40.2

Table 40.3

Table 40.4

Table 40.5

Table 40.6

Table 40.7

Chapter 41

Table 41.1

Table 41.2

Table 41.3

Table 41.4

Table 41.5

Chapter 42

Table 42.1

Table 42.2

Table 42.3

Chapter 43

Table 43.1

Table 43.2

Table 43.3

Chapter 44

Table 44.1

Table 44.2

Table 44.3

Table 44.4

Chapter 45

Table 45.1

Table 45.2

Table 45.3

Table 45.4

Guide

Cover

Table of Contents

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723

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e1

iii

xvi

xvii

xviii

xix

xx

xxi

1

2

3

4

5

6

7

8

9

21

22

23

24

25

26

27

83

195

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201

243

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251

313

315

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320

375

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379

465

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485

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490

673

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675

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677

678

717

719

720

721

722

C1

ii

iv

x

xi

xii

xiii

xiv

xv