Cover
Half title
Copyright
Full title
Dedication
ACKNOWLEDGMENTS
PREFACE
CONTRIBUTORS
CONTENTS
Part 1 - Thyroid
Chapter 1 - Severe Thyrotoxicosis and Thyroid Storm
Introduction
Pathophysiology of Thyrotoxicosis and Thyroid Storm
Evaluation of Patients for Thyrotoxicosis
SIGNS AND SYMPTOMS OF THYROID STORM
CAUSES OF THYROTOXICOSIS AND THYROID STORM
LABORATORY FINDINGS
DIAGNOSIS OF THYROID STORM
TREATMENT OF THYROID STORM
Supportive Care
Beta-Blockers
Antithyroid Drugs
Iodine
Lithium
Steroids
Adjunct Treatments
TREATMENT OF COMPENSATED THYROTOXICOSIS
Socioeconomic Factors
Follow-up After Discharge
Conclusions
References
Chapter 2 - Amiodarone-Induced Thyrotoxicosis
Introduction
Pathogenesis and Subtypes
Diagnostic Evaluation and Classification
LABORATORY EVALUATION
RADIOLOGIC INVESTIGATIONS
SUMMARIZING CLASSIFICATION OF AMIODARONE-INDUCED THYROTOXICOSIS
Approach to Management
Adjunct Therapies
Role of Amiodarone Discontinuation and Resumption
Role of Thyroidectomy in Management
Conclusions
References
Chapter 3 - Ocular Emergencies in Graves’ Ophthalmopathy
Introduction
Demographics
Clinical Evaluation
External Pathology
PERIORBITAL EDEMA
UPPER AND LOWER EYELID RETRACTION
PROPTOSIS
SPONTANEOUS SUBLUXATION OF THE GLOBE
DIPLOPIA
Anterior Segment Pathology
CORNEAL KERATOPATHY
CONJUNCTIVAL INJECTION AND CHEMOSIS
Posterior Segment Pathology
RETINAL PATHOLOGY—CHOROIDAL FOLDS
COMPRESSIVE OPTIC NEUROPATHY
Conclusion
References
Chapter 4 - Myxedema Coma
Introduction
Pathophysiology
Clinical Presentation
MANIFESTATIONS IN THE RESPIRATORY SYSTEM
CARDIOVASCULAR MANIFESTATIONS
GASTROINTESTINAL MANIFESTATIONS
RENAL AND ELECTROLYTE MANIFESTATIONS
HYPOTHERMIA
NEUROPSYCHIATRIC MANIFESTATIONS
HEMATOLOGIC MANIFESTATIONS
Diagnosis
Management
THYROID HORMONE REPLACEMENT
Routes of Administration
Doses
“Thyroid Sick Syndrome”
Preferred Regimen
ANTIBIOTIC THERAPY
VENTILATOR SUPPORT
HYPONATREMIA
HYPOTHERMIA
HYPOTENSION
CORTICOSTEROIDS
Myxedema Coma and Surgery
General Supportive Measures
Prognosis
References
Chapter 5 - Acute Suppurative Thyroiditis
Background
Bacterial Infection
Fungal Infection
Granulomatous Infections
Laboratory Testing and Diagnostic Imaging for Acute Suppurative Thyroiditis
Treatment of AST and Recommended Follow-up
References
Chapter 6 - Thyrotoxic Periodic Paralysis: A Review and Suggestions for Treatment
Introduction
Clinical Presentation
Diagnosis
Differential Diagnosis
Pathophysiology
Genetic Aspects
Acute Treatment
Definitive Treatment
Anesthesia Considerations
Summary
References
Part2 - Postoperative Thyroid Surgical Emergencies
Chapter 7 - Recurrent Laryngeal Nerve Paralysis – Management of Recurrent Laryngeal Nerve Injuries
Introduction
Intraoperative Management of the RLN With Thyroid Carcinoma Invasion
SHAVING OFF AND PARTIAL LAYER RESECTION
RECONSTRUCTION AFTER RESECTION OF A PORTION OF THE RLN
Background and Mechanism
Several Surgical Procedures for RLN Reconstruction
Evaluation of the Outcomes of the RLN Reconstruction
References
Chapter 8 - Post-Thyroidectomy Emergencies: Management of Tracheal and Esophageal Injuries
Introduction
Trachea
ANATOMY
INCIDENCE AND RISKS FACTORS
CLINICAL PRESENTATION
DIAGNOSIS AND INITIAL TREATMENT
NONOPERATIVE MANAGEMENT
OPERATIVE MANAGEMENT
CONCLUSION
Esophagus
ANATOMY
INCIDENCE AND RISK FACTORS
CLINICAL PRESENTATION
DIAGNOSIS AND INITIAL TREATMENT
NONOPERATIVE MANAGEMENT
ENDOSCOPIC MANAGEMENT
OPERATIVE MANAGEMENT
CONCLUSION
References
Chapter 9 - Radioactive Iodine (131I) Thyroid Ablation and the Salivary Glands
Introduction
Reassessment of 131I Therapy
Adverse Effects of 131I
SIALADENITIS
Case Reports
HYPOSALIVATION
TASTE
SECONDARY PRIMARY SALIVARY GLAND MALIGNANCY
FACIAL NERVE
Treatment
References
Part 3 - Parathyroid
Chapter10 - Hypercalcemic Crisis
Introduction
Etiology/Pathophysiology
PTH-DEPENDENT HYPERCALCEMIA
PTH-INDEPENDENT HYPERCALCEMIA
Presentation, Evaluation, and Diagnosis
PATHOPHYSIOLOGY OF SYMPTOMATIC HYPERCALCEMIA
MANAGEMENT
Summary
References
Chapter11 - Hypocalcemic Crisis: Acute Postoperative and Long-Term Management of Hypocalcemia
Introduction
Clinical Presentation
Physical Examination
Diagnostic Tests
Prevention of Postoperative Hypocalcemia
Prophylactic Postoperative Calcium and Vitamin D Replacement
Medical Management of Acute and Chronic Postoperative Hypocalcemia
SUMMARY
Chronic Management of Hypocalcemia
GOALS IN THE MANAGEMENT OF Acute and Chronic HYPOPARATHYROIDISM
CONVENTIONAL MANAGEMENT
Calcium Supplements
Vitamin D Supplements
Cholecalciferol (Vitamin D3) or Ergocalciferol (Vitamin D2)
Thiazide Diuretics
NEWER APPROACHES TO THE MANAGEMENT OF CHRONIC HYPOPARATHYROIDISM
Parathyroid Hormone
Safety of rhPTH(1-84)
Indications for the use for rhPTH(1-84)
References
Part4 - Adrenal Glands
Chapter 12 - Acute Adrenal Hypertensive Emergencies: Pheochromocytoma, Cushing’s, Hyperaldosteronism
Introduction
Pheochromocytoma/Paraganglioma (PPGL)
CLINICAL FEATURES
Indications for Testing for Pheochromocytoma/Paragangliomas4,5
DIAGNOSIS
IMAGING
GENETIC TESTING
PREOPERATIVE MEDICAL MANAGEMENT
ACUTE MEDICAL MANAGEMENT OF PPGL CAUSING HYPERTENSIVE EMERGENCY
SURGERY
PATHOLOGY
FOLLOW-UP
Primary Aldosteronism
CLINICAL FEATURES
DIAGNOSIS
IMAGING
ADRENAL VENOUS SAMPLING
TREATMENT
ACUTE MEDICAL MANAGEMENT OF HYPERTENSIVE EMERGENCY CAUSED BY PRIMARY HYPERALDOSTERONISM
Cushing’s Syndrome
CLINICAL PRESENTATION
DIAGNOSIS
TREATMENT
Surgery
Radiation Therapy
Medical Therapy
ACUTE MEDICAL MANAGEMENT OF HYPERTENSIVE EMERGENCY CAUSED BY HYPERCORTISOLISM
References
Chapter 13 - Pheochromocytoma: Perioperative and Intraoperative Management
Incidence, Clinical Significance, and Diagnosis
Preoperative Management
CATECHOLAMINES AND ADRENORECEPTORS
ALPHA ADRENERGIC BLOCKERS
Anesthetic Preoperative Assessment and Optimization
ARTERIAL PRESSURE CONTROL
VOLUME DEPLETION
HEART RATE AND ARRHYTHMIA CONTROL
ASSESSMENT OF MYOCARDIAL FUNCTION
REVERSAL OF ELECTROLYTE AND GLUCOSE DISTURBANCES
Anesthetic Preparation and Goals for the Operating Room
Anesthetic Induction and Monitoring
Anesthetic Maintenance
Anesthetic Management of Intraoperative Hypertension and Hypotension
Postoperative Management
Postoperative Follow-Up
Conclusion
References
Chapter 14 - Acute Adrenal Insufficiency
Introduction
DEFINITION AND PATHOPHYSIOLOGY
EPIDEMIOLOGY
Clinical Presentation
RECOGNIZING ACUTE ADRENAL INSUFFICIENCY
PRIMARY ADRENAL INSUFFICIENCY
SECONDARY ADRENAL INSUFFICIENCY
Diagnosis
Management of Acute Adrenal Insufficiency
Chronic Management of Adrenal Insufficiency and Prevention of Adrenal Crisis
References
Part5 - Endocrine Pancreas and Pancreatic Neuroendocrine Tumors
Chapter 15 - Diabetic Emergencies: Ketoacidosis, Hyperglycemic Hyperosmolar State, and Hypoglycemia
Diabetic Ketoacidosis
INTRODUCTION
DEFINITION
Euglycemic Diabetic Ketoacidosis
EPIDEMIOLOGY
PATHOPHYSIOLOGY
Insulin Deficiency and Counterregulatory Hormones
Free Fatty Acids in Diabetic Ketoacidosis
Dehydration
Pathophysiology of Euglycemic Diabetic Ketoacidosis
CLINICAL PRESENTATION
Clinical Findings
Laboratory Findings
DIFFERENTIAL DIAGNOSIS
DIABETIC KETOACIDOSIS PRECIPITANTS
TREATMENT
Fluid Replacement
Electrolyte Replacement
Potassium
Phosphate
Bicarbonate
Insulin
RESOLUTION OF DIABETIC KETOACIDOSIS
COMPLICATIONS OF DIABETIC KETOACIDOSIS
Hypokalemia and Hypoglycemia
Cerebral Edema
Other Complications
PREVENTION OF DIABETIC KETOACIDOSIS
Hyperglycemic Hyperosmolar State
INTRODUCTION
DEFINITION
PATHOPHYSIOLOGY
CLINICAL PRESENTATION
Clinical Findings
Laboratory Findings
TREATMENT
Fluid Replacement
Electrolyte Replacement
Insulin
Hypoglycemia
DEFINITION
CLINICAL PRESENTATION
DIFFERENTIAL DIAGNOSIS
EVALUATION
History
Laboratory Evaluation
TREATMENT
Special Considerations
PREVENTION
Conclusion
References
Chapter 16 - Pancreatic Neuroendocrine Emergencies in the Adult (Gastrinoma, Insulinoma, Glucagonoma, VIPoma, Somatostatin ...
Overview
Gastrinoma
ACUTE/EMERGENT DISEASE: PRESENTATION, MANAGEMENT, AND OUTCOMES
Hemorrhage
Perforation
Gastric Outlet Obstruction
Outcomes
Insulinoma
ACUTE/EMERGENT DISEASE: PRESENTATION, MANAGEMENT, AND OUTCOMES
Undifferentiated Hypoglycemia
Refractory Hypoglycemia With Known Insulinoma
Outcomes
Glucagonoma
ACUTE/EMERGENT DISEASE: PRESENTATION, MANAGEMENT, AND OUTCOMES
Pulmonary Embolism
Outcomes
VIPoma
ACUTE/EMERGENT DISEASE: PRESENTATION, MANAGEMENT, AND OUTCOMES
Outcomes
Somatostatinoma
ACUTE/EMERGENT DISEASE: PRESENTATION, MANAGEMENT, AND OUTCOMES
Outcomes
PPoma/Nonfunctional Neuroendocrine Tumors
ACUTE/EMERGENT DISEASE: PRESENTATION, MANAGEMENT, AND OUTCOMES
Outcomes
References
Part6 - Neuroendocrine Tumors: Gastrointestinal Neuroendocrine Tumors
Chapter 17 - Carcinoid Syndrome and Carcinoid Crisis
Introduction
Definition
Incidence
Risk Factors
Current Understanding of Pathophysiology
Treatment With Somatostatin Analogues (Octreotide)
Treatment With Vasopressors, Including β-Adrenergic Agonists
Conclusion
References
Part7 - Pituitary
Chapter 18 - Postsurgical and Posttraumatic Hyponatremia
Introduction
Definition and Classification of Hyponatremia
Arginine Vasopressin
General Treatment Considerations for Hyponatremia
Hyponatremia in the Surgical and TBI Setting: Preoperative Hyponatremia
Hyponatremia in the Surgical and TBI Setting: Postoperative Hyponatremia
Neurosurgical Patients
Traumatic Brain Injury Patients
Evaluation of Postoperative and Post-TBI Hyponatremia
Treatment of Postoperative and Post-TBI Hyponatremia
Summary
References
Chapter 19 - Diabetes Insipidus and Acute Hypernatremia
Introduction
Physiology of Water and Sodium Homeostasis
Etiologies of Hypernatremia
Clinical Presentation of Hypernatremia
Diagnostic Evaluation
Management
Prognosis
References
Chapter 20 - Hypopituitarism
Introduction
EPIDEMIOLOGY
ETIOLOGIES
DIAGNOSIS
Central Adrenal Insufficiency
INTRODUCTION
CLINICAL PRESENTATION
DIAGNOSTIC EVALUATION
MANAGEMENT
Central Hypothyroidism
INTRODUCTION
CLINICAL PRESENTATION
DIAGNOSTIC EVALUATION
MANAGEMENT
Central Hypogonadism
INTRODUCTION
CLINICAL PRESENTATION
DIAGNOSTIC EVALUATION
MANAGEMENT
Growth Hormone Deficiency
INTRODUCTION
CLINICAL PRESENTATION
DIAGNOSTIC EVALUATION
MANAGEMENT
Prolactin Deficiency
Interactions Between Hormones
GLUCOCORTICOIDS AND THYROID HORMONE
GLUCOCORTICOIDS AND ESTROGEN
GLUCOCORTICOIDS AND GROWTH HORMONE
GLUCOCORTICOIDS AND VASOPRESSIN
THYROID HORMONE AND GROWTH HORMONE
THYROID HORMONE AND ESTROGEN
GROWTH HORMONE AND ESTROGEN
Special Situations
PITUITARY SURGERY
TRAUMATIC BRAIN INJURY
RADIATION
APOPLEXY
IMMUNE CHECKPOINT INHIBITOR TOXICITY
PREGNANCY
Diagnosis of Hypopituitarism During Pregnancy
Treatment of Hypopituitarism During Pregnancy
References
Chapter 21 - Pituitary Apoplexy
Introduction
Epidemiology
PRESENCE OF PITUITARY ADENOMA
Pathophysiology
Precipitating Factors
VASCULAR FACTORS: BLOOD PRESSURE FLUCTUATIONS AND BLEEDING RISK
INCREASED DEMAND: PREGNANCY, PITUITARY GLAND TESTING, AND HORMONAL THERAPY
Clinical Presentation
HEADACHE AND IMPAIRED CONSCIOUSNESS
VISUAL DISTURBANCES AND OTHER FOCAL NEUROLOGIC DEFICITS
ENDOCRINE DYSFUNCTION
Diagnosis
CLINICAL ASSESSMENT
RADIOLOGIC IDENTIFICATION
Computed Tomography
Magnetic Resonance Imaging
Management
GRADING SYSTEM
ACUTE MANAGEMENT
SURGICAL MANAGEMENT
CONSERVATIVE MEDICAL MANAGEMENT
Outcomes
NEURO-OPHTHALMOLOGIC AND NEUROLOGIC SYMPTOMS
PITUITARY FUNCTION
ASSESSING OUTCOMES BETWEEN SURGICAL AND MEDICAL MANAGEMENT
RECURRENCE AND FOLLOW-UP
Conclusion
References
Part8 - Endocrine Emergencies During Pregnancy
Chapter 22 - Endocrine Emergencies in Obstetrics
Thyroid Storm
Diabetic Ketoacidosis
Hyperparathyroidism
References
Chapter 23 - Graves’ Hyperthyroidism in Pregnancy
Background
Pathophysiology and Natural History of Graves’ Hyperthyroidism During Pregnancy
Clinical Presentation of Graves’ Hyperthyroidism in Pregnancy
Etiology of Hyperthyroidism in Pregnancy
Laboratory Measurements and Considerations in Pregnancy
THYROID-STIMULATING HORMONE
THYROXINE
TRIODOTHYRONINE (T3)
THYROID-STIMULATING IMMUNOGLOBLULINS (TSI) AND THYROID-STIMULATING HORMONE RECEPTOR ANTIBODIES (TRAb)
Management and Treatment Options
Complications of Graves’ Hyperthyroidism in Pregnancy
THYROID STORM
FETAL THYROTOXICOSIS
FETAL HYPOTHYROIDISM
NEONATAL HYPERTHYROIDISM
NEONATAL HYPOTHYROIDISM
Postpartum Considerations
Prevention—Preconception Counseling
Summary
References
Part9 - Immunotherapy–Associated Endocrinopathies
Chapter 24 - Endocrinopathies Associated With Immune Checkpoint Inhibitors
Mechanism of Action of Anti-cytotoxic T-Lymphocyte Antigen 4 and Anti-programmed Death 1/or Its Ligand for Cancer Therapy
Specific Endocrinopathies Associated With Immune Checkpoint Inhibitor Therapy
HYPOPHYSITIS
PRIMARY THYROID DYSFUNCTION
PRIMARY ADRENAL INSUFFICIENCY
INSULIN-DEPENDENT DIABETES
Combination Therapy
Endocrinopathies and Treatment Response
Diagnosis and Management
HYPOPHYSITIS
PRIMARY THYROID DYSFUNCTION
PRIMARY ADRENAL INSUFFICIENCY
INSULIN-DEPENDENT DIABETES
COMBINATION THERAPY
Conclusions
References
Part10 - Endocrine Responses in Critically Ill Trauma Patients: Nuclear Emergency
Chapter 25 - Endocrine Responses in Critically Ill and Trauma Patients
Introduction
Normal Response to Stress
SYMPATHETIC NERVOUS SYSTEM
RENIN–ANGIOTENSIN–ALDOSTERONE SYSTEM
ARGININE VASOPRESSIN
GROWTH HORMONE
HYPOTHALAMIC–PITUITARY–ADRENAL AXIS
Regulation of the HPA Axis
Glucocorticoids in Acute Critical Illness
Glucocorticoids in Chronic Critical Illness
Inappropriate or Inadequate Response to Stress
ADRENAL INSUFFICIENCY
THYROIDAL DISEASE
GLYCEMIC DYSREGULATION
Summary
References
Chapter 26 - Use of Potassium Iodide in a Nuclear Emergency
Preamble
How Does Potassium Iodide Protect the Thyroid?
What Are the Sources of Exposure to Radioactive Iodine?
What Are the Risks of Exposure to Radioactive Iodine?
Availability of Potassium Iodide in the United States
Guidelines for Use
Safety and Possible Side Effects of Potassium Iodide
Additional Measures to Protect the Thyroid
The Aftermath
References
Index