Hyponatremia in Oncology Patients.
Authors: Grohé C Abstract Hyponatremia is frequent in cancer patients and potentially deleterious. Cancer patients have specific requirements due to the nature and treatment of their disease, which can directly impact the occurrence and severity of hyponatremia, and limit treatment choices. Although essential for successful hyponatremia management, appropriate diagnostic testing is not routinely performed in the current practice. Despite clear evidence that hyponatremia is associated with poor outcome in oncology patients, most patients are still hyponatremic while under observation. Guidance on specific tre...
Source: Frontiers of Hormone Research - February 26, 2020 Category: Endocrinology Tags: Front Horm Res Source Type: research

Euvolemic Hyponatremia Secondary to the Syndrome of Inappropriate Antidiuresis.
Authors: Verbalis JG Abstract Euvolemic hyponatremia is the most common cause of hyponatremia in both hospitalized patients and outpatients. The most common etiology of euvolemic hyponatremia is the syndrome of inappropriate antidiuresis (SIAD). Diagnosis of SIAD involves evaluation of a set of long-standing clinical and laboratory criteria for this diagnosis. Many treatment options for SIAD exist, and choosing among them should be based on the chronicity of the hyponatremia and neurological symptomatology. Importantly, clinical judgment and risk/benefit analysis that is individualized for specific patients should ...
Source: Frontiers of Hormone Research - February 26, 2020 Category: Endocrinology Tags: Front Horm Res Source Type: research

Etiology and Epidemiology of Hyponatremia.
Authors: Burst V Abstract Hyponatremia is a frequently encountered clinical finding, and by far the most common disorder of electrolyte and water homeostasis throughout the world. Given the complex pathophysiology of hyponatremia as well as its clinical implications, which range from apparently asymptomatic presentations to life-threatening conditions, a comprehensive understanding of its possible causes and of the frequencies of occurrence of the various types of hyponatremia in distinct clinical settings is essential for successful disease management. In this chapter, the diverse etiologies of hyponatremia are su...
Source: Frontiers of Hormone Research - February 26, 2020 Category: Endocrinology Tags: Front Horm Res Source Type: research

Hyponatremia Is Linked to Bone Loss, Osteoporosis, Fragility and Bone Fractures.
This study pointed out that age-dependent decline in bone density may mask hyponatremia-induced bone loss. Multiple independent retrospective studies, epidemiological studies, and prospective clinical studies have since confirmed and extended our findings, reporting evidence for increased bone fractures and increased mortality in patients with hyponatremia. Cell culture studies have elucidated some of the adaptive mechanisms by which low extracellular fluid [Na+] increases osteoclast formation and bone resorbing activity, thereby liberating stored sodium from the bone matrix. Studies on older SIAD rats indicated that the d...
Source: Frontiers of Hormone Research - February 26, 2020 Category: Endocrinology Tags: Front Horm Res Source Type: research

Hypervolemic Hyponatremia (Liver).
Authors: Solà E, Ginès P Abstract Hyponatremia is a frequent complication in patients with advanced cirrhosis. Patients with cirrhosis can develop two types of hyponatremia, hypovolemic or hypervolemic (dilutional) hyponatremia. Hypervolemic hyponatremia is the most common type and it develops as a consequence of an impairment in the renal capacity to eliminate solute-free water. The key mechanism leading to solute-free water retention is a non-osmotic hypersecretion of vasopressin (AVP), secondary to a reduction in effective arterial blood pressure existing in patients with advanced cirrhosis. Hyperv...
Source: Frontiers of Hormone Research - February 26, 2020 Category: Endocrinology Tags: Front Horm Res Source Type: research

The Diagnostic Approach to the Patient with Hyponatremia: Are the Correct Investigations Being Done?
Authors: Tzoulis P, Runkle-De la Vega I Abstract Numerous observational studies have confirmed that inadequate investigation of hyponatremia leads to diagnostic errors and incorrect treatment. In fact, only one out of five patients diagnosed as having syndrome of inappropriate antidiuresis (SIAD) have had all the tests necessary to meet the diagnostic criteria. Diagnostic errors could help explain why a majority of patients presenting hyponatremia during hospitalization are discharged while still hyponatremic. The correct differentiation of hypovolemic from euvolemic patients is a clinical diagnostic challenge. Yet...
Source: Frontiers of Hormone Research - February 26, 2020 Category: Endocrinology Tags: Front Horm Res Source Type: research

Hypervolemic Hyponatremia in Heart Failure.
Authors: Davila CD, Udelson JE Abstract Heart failure (HF) represents the most common cause of hypervolemic hyponatremia in current clinical practice. The presence of hyponatremia has been independently associated with worse outcomes in this patient population. The pathogenesis of hyponatremia in HF involves complex neurohormonal and cardio-renal interactions, including an increase in non osmotic secretion of arginine vasopressin (AVP) and insufficient tubular flow in the diluting segments of the nephron. The treatment of hyponatremia in HF involves decongestant therapy with diuretics, neurohormonal blockade and in...
Source: Frontiers of Hormone Research - February 26, 2020 Category: Endocrinology Tags: Front Horm Res Source Type: research

Hyponatremia in Neurosurgical Patients.
Authors: Hannon MJ, Thompson CJ Abstract Hyponatremia is a frequent occurrence in patients with neurosurgical disorders. Acute onset hyponatremia is particularly common in patients who have any type of cerebral insult, including traumatic brain injury, subarachnoid hemorrhage, and brain tumors. Furthermore, it is a common complication of intracranial procedures. Acute hyponatremia creates an osmotic gradient between the brain and the plasma, which promotes the movement of water from the plasma into brain cells, causing cerebral edema and neurological compromise. It is therefore far more likely to be symptomatic, an...
Source: Frontiers of Hormone Research - February 26, 2020 Category: Endocrinology Tags: Front Horm Res Source Type: research

Exercise-Associated Hyponatremia.
Authors: Hew-Butler T Abstract Exercise-associated hyponatremia (EAH) refers to below-normal serum sodium concentrations [Na+] that develop during exercise. The pathogenesis of EAH is best described as a spectrum ranging between profound polydipsia to modest sweat sodium losses with hypovolemia and relative dilution. Non-osmotic arginine vasopressin (AVP) remains the unifying pathogenic stimulus to abnormal renal water retention in acute symptomatic EAH. Cases of hyponatremia are mostly reported after endurance sports, but are also observed after shorter duration events and in team sport athletes. The signs and sym...
Source: Frontiers of Hormone Research - February 26, 2020 Category: Endocrinology Tags: Front Horm Res Source Type: research

Morbidity and Mortality of Hyponatremia.
Authors: Peri A Abstract In hypotonic hyponatremia, which is the most common form of hyponatremia, clinical manifestations are largely due to brain swelling caused by entry of water into the cells. In acute and severe hyponatremia, dramatic symptoms, such as seizures, acute psychosis, permanent brain damage, brain-stem herniation, leading to coma and death may occur. In chronic hyponatremia, symptoms are generally less dramatic and may include headache, nausea, vomiting, gait alterations, muscle cramps, restlessness, and disorientation. It has become evident in recent years that mild forms of chronic hyponatremia m...
Source: Frontiers of Hormone Research - February 26, 2020 Category: Endocrinology Tags: Front Horm Res Source Type: research

Future of Hyponatremia Research.
Authors: Verbalis JG, Peri A, Thompson CJ PMID: 32097939 [PubMed - as supplied by publisher] (Source: Frontiers of Hormone Research)
Source: Frontiers of Hormone Research - February 26, 2020 Category: Endocrinology Tags: Front Horm Res Source Type: research

Historical Aspects of Hyponatremia.
Authors: Thompson CJ, Peri A, Verbalis JG PMID: 32097942 [PubMed - as supplied by publisher] (Source: Frontiers of Hormone Research)
Source: Frontiers of Hormone Research - February 26, 2020 Category: Endocrinology Tags: Front Horm Res Source Type: research

Hyponatremia-Inducing Drugs.
Authors: Liamis G, Megapanou E, Elisaf M, Milionis H Abstract In clinical practice, several medications such as diuretics, psychotropic drugs, and anticonvulsants have been reported to be a frequent cause of hyponatremia. Drugs may cause hyponatremia either by affecting the homeostasis of sodium and water (e.g., diuretics) or by altering the water homeostasis as a consequence of the syndrome of inappropriate secretion of antidiuretic hormone. On the contrary, drugs commonly prescribed in everyday clinical practice, including proton pump inhibitors, antibiotics, angiotensin-converting enzyme inhibitors, hypoglycemic...
Source: Frontiers of Hormone Research - February 26, 2020 Category: Endocrinology Tags: Front Horm Res Source Type: research

Physiology and Pathophysiology of Water Homeostasis.
Authors: Rondon-Berrios H, Berl T Abstract In the evolutionary process, the successful adaptation of living organisms initially to an aqueous and thereafter to an arid terrestrial environment posed radically different challenges to the maintenance of water balance. Whereas the former required defense against water excess, the latter called for water conservation. To meet such challenges, the mammalian nephron evolved mechanisms for increasing both water excretion by diluting and water conservation by concentrating the urine. This chapter reviews the process whereby the osmosensors control thirst and the secretion o...
Source: Frontiers of Hormone Research - February 26, 2020 Category: Endocrinology Tags: Front Horm Res Source Type: research

Hyponatremia and Glucocorticoid Deficiency.
Authors: Garrahy A, Thompson CJ Abstract Hyponatremia is the commonest electrolyte deficiency in clinical practice. Of the many causes of hyponatremia, syndrome of inappropriate antidiuresis (SIAD) is the commonest. Glucocorticoid deficiency, due to central/secondary adrenal insufficiency, is the key differential diagnosis for SIAD, as it presents with a similar biochemical picture of euvolemic hyponatremia and inappropriate urinary concentration. The underlying mechanisms for the development of hyponatremia in glucocorticoid deficiency are: (1) impaired renal water handling in the absence of circulating cortisol a...
Source: Frontiers of Hormone Research - February 26, 2020 Category: Endocrinology Tags: Front Horm Res Source Type: research

Hypovolemic Hyponatremia.
Authors: Mohottige D, Lehrich RW, Greenberg A Abstract The etiology of hyponatremia is often multifactorial. The most common causes include hypovolemia from gastrointestinal (GI) or other fluid losses, thiazide diuretics, and SIAD [1]. In this chapter, we will discuss hypovolemic hyponatremia, as well as the clinical parameters that help distinguish between hypovolemic and euvolemic states. These include not only the urine [Na+] concentration but also the fractional uric acid excretion, a parameter that can be employed even when diuretics have been prescribed [2,3,4,5,6,7]. Among the common causes of hypovolemic hy...
Source: Frontiers of Hormone Research - February 26, 2020 Category: Endocrinology Tags: Front Horm Res Source Type: research

Adverse Consequences of Overly-Rapid Correction of Hyponatremia.
Authors: Sterns RH Abstract A time-dependent loss of cell solute protects against lethal cerebral edema in hyponatremia. This adaptation, which makes survival possible when the serum sodium concentration is extremely low, also makes the brain vulnerable to injury if chronic (>48 hours) hyponatremia is corrected more rapidly than lost brain solutes can be recovered. Rapid correction of chronic hyponatremia results in programmed cell death of astrocytes and oligodendrocytes and presents clinically with a delayed onset of neurological findings, known as the osmotic demyelination syndrome. This iatrogenic complicati...
Source: Frontiers of Hormone Research - February 26, 2020 Category: Endocrinology Tags: Front Horm Res Source Type: research

Androgens and Severe Insulin Resistance States: Basic and Clinical Aspects.
Authors: Gambineri A, Zanotti L, Ibarra-Gasparini D Abstract Hyperandrogenism with or without polycystic ovary syndrome can be sustained by an extreme form of insulin resistance (IR), and is thus a secondary form of hyperandrogenism, which may be due to a defect in insulin signal transduction or in the adipose tissue. Severe IR due to adipose tissue dysfunction is the most frequent form, which may be the result of a deficiency in the adipose tissue, that is, the lipodystrophies, or to the unrestrained accumulation of adipose tissue. These forms are in some cases produced by a single-gene defect. The diagnosis remai...
Source: Frontiers of Hormone Research - September 11, 2019 Category: Endocrinology Tags: Front Horm Res Source Type: research

Androgen-Secreting Ovarian Tumors.
Authors: Macut D, Ilić D, Mitrović Jovanović A, Bjekić-Macut J Abstract About 1% of ovarian tumors that comprise testicular cell types can cause hyperandrogenism followed by characteristic virilization. Androgenic group of tumors originated mainly from sex-cord stromal ovarian tumors are including steroid cell tumors, Leydig tumors, granulosa cell tumors, Sertoli cell tumors, Sertoli-Leydig cell tumors, gonadoblastomas, and some other rare forms as ovarian metastases from neuroendocrine tumors. Germline or somatic mutations in some genes like DICER1, STK11, and FOXL2 are associated with the development of some ...
Source: Frontiers of Hormone Research - September 11, 2019 Category: Endocrinology Tags: Front Horm Res Source Type: research

In utero Androgen Excess: A Developmental Commonality Preceding Polycystic Ovary Syndrome?
Authors: Abbott DH, Kraynak M, Dumesic DA, Levine JE Abstract In utero androgen excess reliably induces polycystic ovary syndrome (PCOS)-like reproductive and metabolic traits in female monkeys, sheep, rats, and mice. In humans, however, substantial technical and ethical constraints on fetal sampling have curtailed safe, pathogenic exploration during gestation. Evidence consistent with in utero origins for PCOS in humans has thus been slow to amass, but the balance now leans toward developmental fetal origins. Given that PCOS is familial and highly heritable, difficulties encountered in discerning genetic contribut...
Source: Frontiers of Hormone Research - September 11, 2019 Category: Endocrinology Tags: Front Horm Res Source Type: research

Understanding the Role of Androgen Action in Female Adipose Tissue.
Authors: Schiffer L, Arlt W, O'Reilly MW Abstract Adipose tissue is an important target of androgen action in humans. Androgens exert important effects on adipose tissue biology, including fat mass expansion and distribution, insulin signalling and lipid metabolism. In conditions of female androgen excess such as polycystic ovary syndrome (PCOS), androgens exert metabolically deleterious effects on adipose tissue function in a depot-specific manner. Androgen excess in women is metabolically deleterious, and adverse metabolic effects may be mediated by effects on preadipocyte differentiation and adipocyte hypertroph...
Source: Frontiers of Hormone Research - September 11, 2019 Category: Endocrinology Tags: Front Horm Res Source Type: research

Obesity and Androgens in Women.
Authors: Pasquali R, Oriolo C Abstract Androgen excess is often associated with obesity states, at any age of life, because of changes in the pattern of secretion or metabolism of androgens and in their actions at the level of target tissues, particularly the adipose tissue. Androgen excess plays an important role in favouring the expansion of visceral fat, which characterize so-called visceral obesity. Moreover, there is evidence that the combination of androgen excess and obesity may favour the development of metabolic disorders, such as the metabolic syndrome and type 2 diabetes. In obese adolescent girls, andro...
Source: Frontiers of Hormone Research - September 11, 2019 Category: Endocrinology Tags: Front Horm Res Source Type: research

Androgens, Body Composition, and Their Metabolism Based on Sex.
Authors: Giagulli VA, Castellana M, Pelusi C, Triggiani V Abstract Differences between males and females are commonly attributed to sexual hormones. Androgens are responsible for the development of primary and secondary sexual characteristics in males, whereas they influence sexual behaviour, glycaemic control, lipid profile, bone metabolism and erythropoiesis in both sexes. In this chapter, we discuss preclinical and clinical data on sex-specific androgen metabolism and androgen effect on body composition. PMID: 31499499 [PubMed - in process] (Source: Frontiers of Hormone Research)
Source: Frontiers of Hormone Research - September 11, 2019 Category: Endocrinology Tags: Front Horm Res Source Type: research

Endocrinology of Hirsutism: From Androgens to Androgen Excess Disorders.
Authors: Yilmaz B, Yildiz BO Abstract Unwanted sexual hair growth has a considerable negative impact on a woman's self-esteem and quality of life. Excessive growth of terminal hair in women in a man-like pattern is defined as hirsutism and affects up to 1 in 7 women. Androgens secreted by the ovary and adrenal are the main regulator of physiological and pathological alterations of skin hair. Hirsutism is the result of the interaction between circulating serum androgens and hair follicles. Hirsutism is the most commonly used clinical diagnostic criterion of hyperandrogenism and majority of hirsutism cases are due to...
Source: Frontiers of Hormone Research - September 11, 2019 Category: Endocrinology Tags: Front Horm Res Source Type: research

Androgens in Cushing's Syndrome.
Authors: Arnaldi G, Martino M Abstract Although polycystic ovary syndrome (PCOS) is the most common androgen excess disorder, screening for Cushing's Syndrome (CS) should be considered in women with PCOS phenotype, particularly if they are also affected by other disturbances that increase their pretest probability (e.g., osteoporosis/bone fractures). Approximately 70-80% of women with CS present menstrual abnormalities, and PCOS findings are found in 46% of these patients. Diagnostic efforts should strengthen if the clinical picture is severe or of rapid onset in order to ensure the earliest and most appropriate tr...
Source: Frontiers of Hormone Research - September 11, 2019 Category: Endocrinology Tags: Front Horm Res Source Type: research

The Role of Androgen Excess on Insulin Sensitivity in Women.
Authors: Diamanti-Kandarakis E, Pappalou O, Kandaraki EA Abstract Sex steroids, except for their primary reproductive role, exert key effects on metabolic target tissues. Androgen receptors have been detected in various tissues, participating in both central and peripheral regulation of metabolism and insulin action. The physiological role of androgens in regulating multiple aspects of female insulin signaling and energy metabolism becomes evident early in utero, thus programming how insulin-targeted tissues will behave in later life. Across lifespan, distinct effects of androgens in all insulin-targeted tissues ar...
Source: Frontiers of Hormone Research - September 11, 2019 Category: Endocrinology Tags: Front Horm Res Source Type: research

Hyperandrogenism and Adrenocortical Tumors.
Authors: Di Dalmazi G Abstract Androgen-secreting tumors are a rare cause of hyperandrogenism of adrenal origin. Although these tumors are identified in less than 2% of patients, the prevalence of adrenocortical carcinomas is relevant (2/3 of the cases). Those tumors are associated with simultaneous elevation of several androgens, mainly androstenedione, DHEAS, and testosterone, in more than half of the patients, as measured either by immunoassay or mass spectrometry. Despite the recent advances on the pathogenesis of adrenocortical tumors, to date no driver molecular event have been identified in those tumors. Thi...
Source: Frontiers of Hormone Research - September 11, 2019 Category: Endocrinology Tags: Front Horm Res Source Type: research

Androgen Excess in Women: Proteomic and Metabolomic Approaches.
Authors: Insenser M, Escobar-Morreale HF Abstract Most research efforts addressing the pathophysiology of polycystic ovary syndrome (PCOS) applied targeted approaches focusing on specific genes and/or proteins that were selected on the basis of previous knowledge about their putative roles in metabolic and signalling pathways. On the contrary, the use of nontargeted approaches is not constricted by previous knowledge on the issue and offers the potential advantage of revealing novel associations with unexpected molecules that might lead to new mechanistic explanations for the etiology and the pathophysiology of PCO...
Source: Frontiers of Hormone Research - September 11, 2019 Category: Endocrinology Tags: Front Horm Res Source Type: research

Androgens in Congenital Adrenal Hyperplasia.
Authors: Pignatelli D, Pereira SS, Pasquali R Abstract Congenital Adrenal Hyperplasias (CAH) are genetic diseases transmitted in an autosomal recessive way and these diseases affect many aspects of human health. The majority of CAH cases is due to a deficiency in 21-hydroxylase as a result of the existence of mutations in both alleles of the CYP21A2 gene. Since the identification of mild, non-classic forms of this disease, CAH has been recognized to be one of the most common genetic diseases in human beings. This disease is generally associated with elevated secretion of androgens, sometimes resulting in virilizing...
Source: Frontiers of Hormone Research - September 11, 2019 Category: Endocrinology Tags: Front Horm Res Source Type: research

Androgens in Menopausal Women: Not Only Polycystic Ovary Syndrome.
Authors: Kostakis EK, Gkioni LN, Macut D, Mastorakos G Abstract Menopause is the period of a woman's life that is characterized by the permanent cessation of menses associated to hormonal changes, of which the most important is the decrease of estrogen levels. Following menopause, the concentrations of circulating androgens decrease. However, increased concentrations of luteinizing hormone induce androgens secretion from the ovaries and presumably from the adrenal glands. Peripheral conversion of androgens results to the circulating hormonal androgen profile. Some pathological conditions are associated with greater...
Source: Frontiers of Hormone Research - September 11, 2019 Category: Endocrinology Tags: Front Horm Res Source Type: research

Primary Hyperparathyroidism.
Authors: Masi L Abstract The 4 parathyroid glands derive from the third and fourth pharyngeal pouches and descend caudally to the anterior neck. Through the secretion of parathyroid hormone (PTH), the parathyroid glands are primarily responsible for maintaining extracellular calcium and phosphorus concentrations. Hypercalcemia may be distinguished in parathyroid-hypercalcemia and nonparathyroid hypercalcemia. The most common disorders include primary hyperparathyroidism (PHPT), malignancy, granulomatous diseases, and medications. PHPT is a disease characterized by excessive secretion of PTH. PHPT is most commonly d...
Source: Frontiers of Hormone Research - January 16, 2019 Category: Endocrinology Tags: Front Horm Res Source Type: research

Secondary and Tertiary Hyperparathyroidism.
Authors: Messa P, Alfieri CM Abstract Secondary hyperparathyroidism (SHP) is a frequent complication of kidney diseases. At variance with all the other forms of SHP, which are compensatory conditions, renal SHP has many pathogenetic peculiarities, which have been only in part defined. Furthermore, in the long course of chronic kidney diseases (CKD), SHP sometimes transforms into a hypercalcemic condition resembling the autonomous form of hyperparathyroidism (tertiary hyperparathyroidism; THP). The clinical consequences of SHP in CKD patients are manifold, encompassing not only bone and mineral disorders, but also o...
Source: Frontiers of Hormone Research - January 16, 2019 Category: Endocrinology Tags: Front Horm Res Source Type: research

Classification of Hypoparathyroid Disorders.
Authors: Cianferotti L Abstract The term hypoparathyroidism encompasses a huge group of disorders all characterized by an abnormal mineral homeostasis determined by inadequate secretion of parathyroid hormone. Postsurgical hypoparathyroidism is a complication of neck surgery (thyroidectomy, parathyroidectomy, lymph node, and cancer neck dissection), closely related to the extent of the surgical procedure and the experience of the surgeon. If lasting more than 6 months it is defined as chronic hypoparathyroidism, requiring life-long replacement therapy with active vitamin D metabolites. All the other forms of nonsur...
Source: Frontiers of Hormone Research - January 16, 2019 Category: Endocrinology Tags: Front Horm Res Source Type: research

Familial and Hereditary Forms of Primary Hyperparathyroidism.
Authors: Cetani F, Saponaro F, Borsari S, Marcocci C Abstract Individuals with a familial predisposition to the development of parathyroid tumors constitute a small minority of all patients with primary hyperparathyroidism (PHPT). These familial syndromes exhibit Mendelian inheritance patterns and the main causative genes in most families have been identified. They include multiple endocrine neoplasia (MEN; types 1, 2A, and 4), hyperparathyroidism-jaw tumor (HPT-JT) syndrome, familial isolated hyperparathyroidism, familial hypocalciuric hypercalcemia (FHH), and neonatal severe PHPT. Each MEN type is associated with...
Source: Frontiers of Hormone Research - January 16, 2019 Category: Endocrinology Tags: Front Horm Res Source Type: research

Clinical Presentation of Hypoparathyroidism.
Authors: Giusti F, Brandi ML Abstract Parathyroid hormone (PTH) is one of the major hormones that regulates serum calcium. Hypoparathyroidism occurs when PTH secretion is insufficient. The main symptoms of hypoparathyroidism are the result of low blood calcium levels, hypocalcemia, which interferes with normal muscle contraction and nerve conduction. As a result, people with hypoparathyroidism can experience paresthesia, an unpleasant tingling sensation around the mouth and in the hands and feet, as well as muscle cramps and severe spasms known as "tetany" that affect the hands and feet. Many also report ...
Source: Frontiers of Hormone Research - January 16, 2019 Category: Endocrinology Tags: Front Horm Res Source Type: research

Familial Hypocalciuric Hypercalcemia and Neonatal Severe Hyperparathyroidism.
Authors: Vannucci L, Brandi ML Abstract Familial hypocalciuric hypercalcemia (FHH) and neonatal severe hyperparathyroidism (NSHPT) are genetically determined variants of primary hyperparathyroidism. FHH usually has a benign course, and patients do not require treatment, whereas NSHPT is a severe disorder often requiring early parathyroidectomy for young patients to survive. Recent discoveries in the genetic basis and new findings in therapeutic approaches have led to a great interest in these rare diseases. PMID: 30641521 [PubMed - in process] (Source: Frontiers of Hormone Research)
Source: Frontiers of Hormone Research - January 16, 2019 Category: Endocrinology Tags: Front Horm Res Source Type: research

Asymptomatic Primary Hyperparathyroidism.
Authors: Clarke BL Abstract Asymptomatic primary hyperparathyroidism has become the most common presentation of primary hyperparathyroidism in Europe and North America, and an increasingly common presentation in other parts of the world. As many as 25% of asymptomatic patients may develop indications for parathyroidectomy when followed long-term for up to 15 years. Patients who remain asymptomatic should be monitored for the development of complications that justify surgery. Patients who become symptomatic should be referred for surgery. Surgery may improve quality of life even in patients who remain asymptomatic. ...
Source: Frontiers of Hormone Research - January 16, 2019 Category: Endocrinology Tags: Front Horm Res Source Type: research

Parathyroid Carcinoma.
Authors: Cetani F, Pardi E, Marcocci C Abstract Parathyroid carcinoma (PC) is a rare endocrine malignancy, accounting for
Source: Frontiers of Hormone Research - January 16, 2019 Category: Endocrinology Tags: Front Horm Res Source Type: research

Nonparathyroid Hypercalcemia.
Authors: Goltzman D Abstract Primary hyperparathyroidism is among the most common causes of hypercalcemia. However, ingestion of medication, including hydrochlorathiazide, lithium, and foscarnet, excessive vitamin A ingestion, endocrinopathies such as hyperthyroidism, adrenal insufficiency, and acromegaly, abnormal nutrient intake such as parenteral nutrition in preterm infants and milk-alkali syndrome, and prolonged immobilization have all been associated with hypercalcemia. The most common cause of nonparathyroid hypercalcemia is neoplasia. Hypercalcemia is generally due to the secretion of parathyroid hormone (P...
Source: Frontiers of Hormone Research - January 16, 2019 Category: Endocrinology Tags: Front Horm Res Source Type: research

Normocalcemic Hyperparathyroidism.
Authors: Corbetta S Abstract Parathyroid hormone (PTH) disorders are characterized by a wide spectrum of clinical and biochemical presentations. The increasing use of serum PTH assay in the set of the diagnostic workout in patients with osteoporosis has identified patients with features of surgically confirmed primary hyperparathyroidism (PHPT) associated with persistent normal serum calcium levels, which has been recognized as a distinct entity from hypercalcemic PHPT (HPHPT) by the last international consensus. Normocalcemic PHPT (NPHPT) affects about 6-8% of PHPT patients. Although hypercalcemia is absent, patie...
Source: Frontiers of Hormone Research - January 16, 2019 Category: Endocrinology Tags: Front Horm Res Source Type: research

Hypoparathyroidism.
The objective of this chapter is to provide a comprehensive review of the physiology of calcium homeostasis, the causes of hypocalcemia, and the epidemiology of hypoparathyroidism. It is very important to determine the underlying cause of the hypoparathyroidism in order to effectively treat our patients and improve quality of life. PMID: 30641528 [PubMed - in process] (Source: Frontiers of Hormone Research)
Source: Frontiers of Hormone Research - January 16, 2019 Category: Endocrinology Tags: Front Horm Res Source Type: research

A New Era for Chronic Management of Hypoparathyroidism: Parathyroid Hormone Peptides.
Authors: Marcucci G, Brandi ML Abstract Several studies have investigated replacement therapy with recombinant human parathyroid hormone [rhPTH(1-84)] for patients affected by chronic hypoparathyroidism who are not adequately controlled with standard treatment. In 2015, the Food and Drug Administration (FDA) in the USA approved rhPTH(1-84), named Natpara®, for the pharmacological management of hypoparathyroidism. In Europe, in February 2017, the European Medicines Agency (EMA) recommended granting a conditional marketing authorization in the European Union for rhPTH(1-84). Here we review the studies conducted w...
Source: Frontiers of Hormone Research - January 16, 2019 Category: Endocrinology Tags: Front Horm Res Source Type: research

Conventional Treatment of Hypoparathyroidism.
Authors: Marcucci G, Brandi ML Abstract The treatment of hypoparathyroidism depends on the severity of hypocalcemia, how rapidly the hypocalcemia developed, and the symptomatology. Chronic hypoparathyroidism is usually treated with oral supplementations, including calcium, calcitriol, or other active vitamin D analogs, and at times, thiazide diuretics. Although the standard therapy can adequately control patients with this disease, sometimes very high doses are required to maintain serum calcium levels in the normal range, with poor compliance and risk of long-term complications. PMID: 30641530 [PubMed - in pro...
Source: Frontiers of Hormone Research - January 16, 2019 Category: Endocrinology Tags: Front Horm Res Source Type: research

Inactivating PTH/PTHrP Signaling Disorders.
Authors: Mantovani G, Elli FM Abstract Pseudohypoparathyroidism (PHP), pseudo-PHP, acrodysostosis, and progressive osseous heteroplasia are heterogeneous disorders characterized by physical findings, differently associated in each subtype, including short bones, short stature, a stocky build, ectopic ossifications (features associated with Albright's hereditary osteodystrophy), as well as laboratory abnormalities consistent with hormone resistance, such as hypocalcemia, hyperphosphatemia, and elevated parathyroid hormone (PTH) and thyroid-stimulating hormone levels. All these disorders are caused by impairments in ...
Source: Frontiers of Hormone Research - January 16, 2019 Category: Endocrinology Tags: Front Horm Res Source Type: research

Preliminaries.
Authors: PMID: 30453291 [PubMed - in process] (Source: Frontiers of Hormone Research)
Source: Frontiers of Hormone Research - November 21, 2018 Category: Endocrinology Tags: Front Horm Res Source Type: research

Metabolic Syndrome in Cushing's Syndrome Patients.
Authors: Ferraù F, Korbonits M Abstract Cushing's syndrome (CS), including visceral obesity, dyslipidemia, hypertension and diabetes among its many manifestations, is "a model" of metabolic syndrome. Glucocorticoid (GC) excess, through a combination of effects on liver, muscle, adipose tissue and pancreas, increases gluconeogenesis and impairs insulin sensitivity, leading to carbohydrate abnormalities. Dyslipidemia is a common finding in CS as a consequence of GC-related increased lipolysis, lipogenesis and adipogenesis. CS patients experience typical changes in body composition, with fat redistrib...
Source: Frontiers of Hormone Research - June 13, 2018 Category: Endocrinology Tags: Front Horm Res Source Type: research

Metabolic Syndrome in Polycystic Ovary Syndrome.
Authors: Pasquali R Abstract Both prevalence and incidence of the metabolic syndrome is very high in women with polycystic ovary syndrome (PCOS). Obesity and visceral fat enlargement play a dominant role in determining the final phenotype of PCOS. Androgen excess and insulin resistance may be responsible for the development of all features of the metabolic syndrome. The major factors responsible for this association seem to be related to a triumvirate including androgen excess, insulin resistance and associated hyperinsulinemia, and obesity, particularly the abdominal-visceral phenotype. With respect to obesity, it...
Source: Frontiers of Hormone Research - June 13, 2018 Category: Endocrinology Tags: Front Horm Res Source Type: research

Metabolic Complications in Adrenal Insufficiency.
Authors: Ueland GA, Husebye ES Abstract Pharmacological glucocorticoid treatment is associated with adverse metabolic consequences such as hypertension, overweight, reduced glucose tolerance, diabetes mellitus and ultimately increased mortality in cardiovascular disease. Here we review the evidence of detrimental effects of hormone replacement therapy in adrenal insufficiency (AI). Registry studies indicate increased cardiovascular mortality, hypertension, diabetes, and dyslipidemia in both primary and secondary AI, but when cohorts with carefully characterized patients are studied the picture is less clear, and re...
Source: Frontiers of Hormone Research - June 13, 2018 Category: Endocrinology Tags: Front Horm Res Source Type: research

Metabolic Syndrome in Hyperprolactinemia.
Authors: Andersen M, Glintborg D Abstract The metabolic syndrome (MetS) is a conglomerate of clinical findings that convey into increased morbidity and mortality from type 2 diabetes mellitus (T2D) and cardiovascular disease. Hyperprolactinemia (hyperPRL) is associated with components of MetS, especially during pregnancy. Endogenous levels of sex steroids are high during pregnancy in contrast to untreated or replaced hypogonadism in most patients with a prolactinoma and hypogonadism may confer increased risk of MetS in hyperPRL. Dopamine-D2-agonist therapy can improve MetS in patients with a prolactinoma and lower ...
Source: Frontiers of Hormone Research - June 13, 2018 Category: Endocrinology Tags: Front Horm Res Source Type: research

The Metabolic Syndrome in Central Hypogonadotrophic Hypogonadism.
Authors: Dwyer AA, Quinton R Abstract The metabolic syndrome (MetS) is a term used to describe the constellation of cardiometabolic risk factors including central adiposity, dyslipidemia, insulin resistance, non-alcoholic fatty liver disease and arterial hypertension. Notably, a number of studies have shown high rates of testosterone (T) deficiency in men with MetS and type 2 diabetes mellitus (T2DM). Both hypogonadism and MetS confer increased health risk for morbidity and mortality as men with the MetS are at twice the risk for developing cardiovascular disease and at 5-fold higher risk for developing T2DM. Moreo...
Source: Frontiers of Hormone Research - June 13, 2018 Category: Endocrinology Tags: Front Horm Res Source Type: research