In this sweeping exploration of the relatively recent obesity epidemic, Michael L. Power and Jay Schulkin probe evolutionary biology, history, physiology, and medical science to uncover the causes of our growing girth. The unexpected answer? Our own evolutionary success. For most of the past few million years, our evolutionary ancestors' survival depended on being able to consume as much as possible when food was available and to store the excess energy for periods when it was scarce. In the developed world today, high-calorie foods are readily obtainable, yet the propensity to store fat is part of our species' heritage, leaving an increasing number of the world's people vulnerable to obesity. In an environment of abundant food, we are anatomically, physiologically, metabolically, and behaviorally programmed in a way that makes it difficult for us to avoid gaining weight. Power and Schulkin's engagingly argued book draws on popular examples and sound science to explain our expanding waistlines and to discuss the consequences of being overweight for different demographic groups. They review the various studies of human and animal fat use and storage, including those that examine fat deposition and metabolism in men and women; chronicle cultural differences in food procurement, preparation, and consumption; and consider the influence of sedentary occupations and lifestyles. A compelling and comprehensive examination of the causes and consequences of the obesity epidemic, "The Evolution of Obesity" offers fascinating insights into the question, Why are we getting fatter?

The book is in question and answer format, very easy and comfortable to read. It incorporates objective structures practical examination (OSPE) and other format on Endocrinology questions. Contents of the book have been updated as per the latest guidelines by various endocrine organizations all over the world, especially American Association of Clinical Endocrinology (AACE) guidelines, American Diabetes Association (ADA), European Association for the Study of Diabetes (EASD), American Thyroid Association (ATA) guidelines, and other organizations of the world.

Despite advances in the diagnosis and treatment of osteoporosis in the last ten years, the condition still poses major clinical challenges. Non-adherence to drug therapy is a widespread problem in patients with rheumatic diseases and osteoporosis in particular.
Part of the Oxford Rheumatology Library, this second edition summarizes the latest developments in the management of osteoporosis and includes new chapters covering the clinical role of denosumab and orthopaedic issues in the management of fractures in patients with osteoporosis. This practical pocketbook is an essential resource for trainees and clinicians in rheumatology, endocrinology, and geriatric medicine, as well as general practitioners and paramedical staff involved in osteoporosis care.

 

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Osteoporosis is a common, underdiagnosed, and undertreated condition, complicated by fractures which lead to significant mortality and morbidity. The prevalence of osteoporotic fractures in postmenopausal women exceeds the combined prevalence of breast cancer, stroke, heart failure, and myocardial infarction. Often called "the silent disease," it does not reveal itself with obvious symptoms until a fracture occurs. In the first year after sustaining a hip fracture, mortality is increased by almost 24% in women and is even higher in men. About half of those who sustain an osteoporotic hip fracture become so disabled that they are no longer able to resume their daily activities, and as many as 20% require long-term institutional care. Effective treatments for osteoporosis are now available if it is diagnosed and addressed in a timely manner. Unfortunately, this disease remains shockingly underdiagnosed and undertreated, even in patients who sustain low-trauma hip fractures.
The past two decades have witnessed radical changes in the diagnosis and management of osteoporosis. The densitometric diagnosis of osteoporosis is noninvasive, quick, and relatively simple. Tools are now available to predict the patient's probability of sustaining fractures, to identify patients who are particularly vulnerable, and to determine which patients will benefit from further investigation and treatment. Various associations have developed guidelines to help clinicians reach a diagnosis and initiate treatment. Due to better understanding of the basic pathophysiology of bone turnover, potent and relatively safe medications that significantly reduce the risk of fractures are now widely available. It is of paramount importance that this disease be diagnosed and treated as early as possible in order to take advantage of these developments and reduce the enormous socioeconomic and psychological impact of osteoporosis.
Given the burden of osteoporotic fractures, all clinicians should have a working knowledge of e diagnosis, treatment, and prevention of the disease. Clinicians should feel comfortable diagnosing and initiating treatment for the majority of patients with osteoporosis. Only complicated cases or patients who are unresponsive to treatment should be referred to specialists. The aim of this book is to distill the available information on osteoporosis into an easily comprehensible format that will serve as a practical guide for busy clinicians. Numerous boxes, tables, diagrams, and figures present the information in an accessible manner. This book will be of particular use to general practitioners, endocrinologists, rheumatologists, gynecologists, internists, geriatricians, and orthopedic surgeons.

Greenspan’s Basic & Clinical Endocrinology delivers a succinct, leading-edge overview of the underlying molecular biology of the endocrine system and the latest perspectives on the diagnosis and treatment of specific diseases and disorders. Featuring an enhanced design that includes hundreds of full-color illustrations and clinical photographs, Greenspan’s is a true must-have during traditional or integrated courses in endocrinology, endocrinology rotation, or exam prep in internal medicine and endocrinology and as reference for disease management.

Greenspan’s provides clinically relevant coverage of metabolic bone disease, pancreatic hormones and diabetes mellitus, hypoglycemia, obesity, geriatric endocrinology, and many other diseases and disorders. Supporting this essential material is a handy appendix of normal hormone reference ranges across the lifespan.

Here’s why Greenspan’s is an essential tool for learning how to manage endocrine patients:

• The Tenth Edition is enhanced by updated content throughout each chapter
• NEW CHAPTERS on Transgender Endocrinology and Disorders of Sexual Determination and Differentiation
• Important chapter on Evidence-Based Endocrinology and Clinical Epidemiology
• Concise, balanced coverage of both scientific and clinical principles that guide patient management
• The best source for current concepts in endocrine pathophysiology to aid clinical decision making
• The most practical, current insights into diagnostic testing
• More than 270 full-color illustrations and clinical photographs

If you are in need of a well-illustrated, completely up-to-date guide to the entire field of clinical endocrinology, this trusted classic belongs on your desk or computer.

 

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Description:

Offering current guidelines on the relatively new practice of puberty suppression for gender-dysphoric adolescents, Pubertal Suppression in Transgender Youth provides a succinct, easy-to-digest overview of this timely topic. This concise, clinically-focused resource by Dr. Courtney Finlayson covers all relevant topics, from a brief history of medical care of transgender youth to emerging developments in the field.

 

 Table of Contents

 

·  Copyright

·  List of Contributors

·  Chapter 1. History of Care of Transgender Youth

·  Dedication

·  Chapter 2. Models of Care and Current Guidelines for Care of Transgender Individuals

·  Gender-Affirming Care

·  Multidisciplinary Care

·  Practice Guidelines

·  Mental Healthcare

·  Medical Care

·  Adjunctive Services

·  Barriers to Care

·  Summary

·  Chapter 3. Puberty

·  Physical Changes Associated With Puberty

·  Physiology of Puberty

·  Delayed Puberty or Absent Puberty (Sexual Infantilism)

·  Precocious Puberty (Sexual Precocity)

·  Chapter 4. GnRH Analogs (Mechanism, Past Studies, Drug Options, Use in Precocious Puberty, Use in Gender-Nonconforming Youth)

·  Historical Perspective

·  Physiology and Mechanism of Action

·  Use in Central Precocious Puberty

·  Outcomes in Central Precocious Puberty

·  Use in Gender-Nonconforming Youth

·  Options for Treatment

·  Outcomes in Gender-Nonconforming Youth

·  Challenges in Care

·  Conclusion

·  Chapter 5. Rationale for the Initiation, Use, and Monitoring of GnRHa in Gender Non-conforming Youth

·  Introduction

·  Rationale

·  Initiation

·  Monitoring

·  Conclusion

·  Chapter 6. Psychosocial Considerations in Pubertal Suppression Treatment

·  Introduction

·  Possible Effects of Gonadotropin-Releasing Hormone Analogues on Gender Identity and/or Sexuality Development

·  Unknown Neurocognitive Sequelae of Pubertal Suppression Treatment

·  Psychosocial Implications of Known Medical Side Effects of Gonadotropin-Releasing Hormone Analogue Treatment

·  Family Factors

·  Conclusion

·  Chapter 7. Medical Side Effects of GnRH Agonists

·  Bone Health

·  Brain

·  Fertility

·  Body Mass Index and Body Composition

·  Summary

·  Chapter 8. Surgical Side Effects of GnRHa

·  Introduction

·  Goals of Surgery

·  Timing of Surgery

·  Surgical Considerations for Individuals on GnRHa

·  Areas of Uncertainty

·  Conclusion

·  Chapter 9. Fertility Preservation: Considerations for Gender-Diverse Youth

·  Risk of Infertility due to Hormonal Therapies

·  Fertility Preservation Options in Birth-Assigned Males

·  Fertility Preservation Options in Birth-Assigned Females

·  Attitudes Toward FP and Other Psychological Considerations

·  Ethical Considerations

·  Financial Considerations

·  Future Directions

·  Conclusions

·  Chapter 10. Duration of Pubertal Suppression and Initiation of Gender-Affirming Hormone Treatment in Youth

·  Pubertal Suppression and Gender-Affirming Hormone Therapies

·  Relevant Time Points in Clinical Guidelines and Protocols

·  Unresolved Questions

·  Case Examples

·  Initiation of Gender-Affirming Hormones

·  Testosterone

·  Estrogen

·  Conclusions

·  Chapter 11. Ethical Considerations of GnRHa Treatment and Consent Process

·  Introduction

·  Pubertal Suppression

·  Benefits of Pubertal Suppression

·  Ethical Issues

·  Conclusion

·  Chapter 12. Emerging Developments in Pubertal Suppression for Gender Incongruent/Gender Dysphoric Youth

·  Triptorelin, a New Gonadotropin-Releasing Hormone Agonist

·  Prolonged Use of Histrelin acetate implant in Transgender Youth

·  Gonadotropin-Releasing Hormone Agonist Use in Nonbinary Youth

·  Gonadotropin-Releasing Hormone and Gonadotropin Antagonists

·  Kisspeptin and Neurokinin B Antagonists

·  Oxandrolone as an Alternative Gender-Affirming Masculinizing Hormone

·  Low-Dose Estrogen and Testosterone

·  Antiandrogens and Androgen Receptor Inhibitors

·  Antiandrogens

·  Conclusion

 

 

Imaging in Endocrinology will provide endocrinologists and radiologists of all levels with an outstanding diagnostic imaging atlas to aid them in the diagnosis and management of all the major endocrine diseases they are likely to encounter. In full colour throughout, the 300 high–quality images consist of CT scans, MRI, NMR and histopathology slides, and are arranged by each specific endocrine condition, resulting in a visually outstanding and easily accessible tool that guides the user through exactly what to look out for and provides a practical and extremely useful aid in helping them formulate a diagnosis.

Every major endocrine condition is covered in a specific section, including diseases of the thyroid, pituitary, reproductive and adrenal glands, the pancreas, bone metabolism problems, and the various forms of endocrine cancers. Each disease covered will offer a comparison of the normal findings so as to further assist in diagnosis.
An accompanying website contains an online slide–atlas of all the figures in the book, to allow users to download all figures for use in presentations. Led by Paolo Pozzilli, an internationally–recognised expert in this field, the authors have assembled a wonderful collection of images that will be greatly valued by endocrinologists and radiologists alike, ensuring this is the perfect tool to consult when assessing patients with endocrine disease.

 Pret: 764 lei 570 lei (valabil in perioada 17 – 30 martie 2020)

About this Textbook

 Diabetes has become a worldwide health problem, the global estimated prevalence approaches ten percent and the burden of this disease in terms of morbidity and mortality is unprecedented. The advances acquired through the knowledge of the mechanisms of the disease and the variety of therapeutic approaches contrast with the inability of private and public health systems in underdeveloped and even developed countries to achieve the goals of treatment. This paradox has been described in many sources: the surge of scientific advances contrast with an unprecedented amount of human suffering. Thus, a patient centered and an evidence-based approach with the capacity to produce measurable clinical and economic outcomes is required.

The purpose of this textbook is multiple: to offer a comprehensive resource covering all aspects of outpatient management; to address diabetes as a health problem from an epidemiological, economic and clinical perspective; to discuss the role of social determinants of health on the worldwide increase in diabetes; to highlight the challenges and obstacles in providing adequate care; and to outline a multidisciplinary approach to management in which medical visits retain their importance as part of a team comprising the patient, his or her family and a multidisciplinary group of health professionals who are able to move beyond the traditional approach of diabetes as a disease and greatly improve outcomes.

 

Table of contents (64 chapters)

 

Preface: A New Disease?

Pages 1-8

Rodriguez-Saldana, Joel

The Dynamics of Diabetes Prevalence, Morbidity, and Mortality

Pages 11-21

Gregg, Edward W. (et al.)

Economic Costs, from Individuals to Health Systems: Evidence from a Middle-Income Country

Pages 23-32

Arredondo, Armando (et al.)

The Ecological Approach to Self-Management in Diabetes

Pages 33-59

Fisher, Edwin B. (et al.)

Social Determinants of Health and Diabetes Outcomes

Pages 61-69

Hashimoto, Hideki

Definition, Diagnostic Criteria, Screening, Diagnosis, and Classification of Diabetes and Categories of Glucose Intolerance

Pages 71-85

Nandhini, Lakshmana Perumal (et al.)

Pathophysiology of Type 1 Diabetes

Pages 89-99

Gómez-Díaz, Rita A.

Pathophysiology of Type 2 Diabetes

Pages 101-116

Kesavadev, Jothydev (et al.)

Genetic Determinants of Type 2 Diabetes

Pages 117-125

Cruz, Miguel (et al.)

Gene Expression Modifications in Type 2 Diabetes

Pages 127-144

Suarez-Sanchez, Fernando (et al.)

The Immune System and Inflammation in Type 2 Diabetes

Pages 145-167

Macedo, Rebeca García

Dysfunction and Death of Pancreatic Beta Cells in Type 2 Diabetes

Pages 169-184

Ortega-Camarillo, Clara

Obesity in the Pathophysiology of Diabetes

Pages 185-213

Paniagua González, Juan Antonio (et al.)

Pathogenesis of Gestational Diabetes Mellitus

Pages 215-225

Kintiraki, Evangelia (et al.)

Non-alcoholic Fatty Liver in the Pathogenesis of Diabetes

Pages 227-235

Villela Nogueira, Cristiane A. (et al.)

Diabetes Management in Asia

Pages 239-253

Shivashankar, Roopa (et al.)

Diabetes Management in the United States

Pages 255-271

Ali, Mohammed K. (et al.)

Diabetes Management in Africa

Pages 273-288

Choukem, Simeon Pierre (et al.)

The Patient-Centered Medical Home, Primary Care, and Diabetes

Pages 291-304

Rodriguez-Saldana, Joel

Outpatient Diabetes Management and the Chronic Care Model

Pages 305-332

Rodriguez-Saldana, Joel

Clinical Practice Guidelines, Evidence-Based Medicine, and Diabetes

Pages 333-355

Rodriguez-Saldana, Joel

Measuring Diabetes Quality of Care: Clinical Outcomes, Cost-Effectiveness, and Patient Experience of Care

Pages 357-365

O’Connor, Patrick J. (et al.)

Clinical Inertia: The Role of Physicians in Diabetes Outcomes

Pages 367-380

Rodriguez-Saldana, Joel

Patient Adherence: Challenges, Myths, and Realities

Pages 381-400

Rodriguez-Saldana, Joel

Challenges and Opportunities in Diabetes Education

Pages 403-416

Dickinson, Jane K. (et al.)

Diabetes and Mental Health: From Distress to Depression

Pages 417-428

Heinze, Gerhard (et al.)

Tools of Self-Care: Self-Monitoring of Blood Glucose and Tele-Health Resources

Pages 429-450

Ginsberg, Barry H.

Continuous Glucose Monitoring in Clinical Practice: Ambulatory Glucose Profile and the Application of Advanced Glucose Sensing Technologies to Clinical Decision-Making

Pages 451-462

Mazze, Roger S.

Type 2 Diabetes and Lifestyle Medicine

Pages 463-476

Galaviz, Karla I. (et al.)

Evidence and Implementation of Medical Nutrition Therapy in Persons with Diabetes

Pages 477-483

Maryniuk, Melinda Downie (et al.)

Evidence and Implementation of Physical Activity and Exercise

Pages 485-498

Jáuregui-Ulloa, Edtna (et al.)

The “Old” Oral Antidiabetics

Pages 501-513

Buhse, Susanne (et al.)

Incretin Therapies: Current Use and Emerging Possibilities

Pages 515-529

Schlögl, Haiko (et al.)

Sodium-Glucose Cotransporter 2 Inhibitors

Pages 531-539

Dailey, George, III (et al.)

Use of Insulin in Outpatient Diabetes Management

Pages 541-554

Faradji, Raquel N. (et al.)

Insulin Pump Therapy

Pages 555-570

Faradji, Raquel N. (et al.)

Diabetes and Hypertension

Pages 573-585

Khangura, D. (et al.)

Diabetes and Atherogenic Dyslipidemia

Pages 587-596

Mooradian, Arshag D.

Obesity and Diabetes

Pages 597-610

Wharton, Sean (et al.)

Diabetes and Smoking: The Burden of Evidence

Pages 611-616

Aggarwal, Sameer (et al.)

Diabetic Ketoacidosis

Pages 619-627

Umpierrez, Guillermo E.

Hypoglycemia: Diagnosis, Management, and Prevention

Pages 629-653

Faradji, Raquel N. (et al.)

Inpatient Management of Diabetes and Hyperglycemia

Pages 655-668

Horton, William B.

Diabetes and Infection

Pages 669-691

Atreja, Atulya (et al.)

Biochemical Mechanisms of Vascular Complications in Diabetes

Pages 695-707

Margarita Díaz-Flores, (et al.)

Diabetes and Cardiovascular Disease

Pages 709-730

Coutiño-Castelán, Daniel (et al.)

Diabetes and Stroke: The Role of Glucose Regulation

Pages 731-746

Lowe, Forrest (et al.)

Peripheral Arterial Disease and Diabetes Mellitus

Pages 747-763

Cheun, Tracy J. (et al.)

Ophthalmic Disease in Diabetes

Pages 765-775

Henriques, José (et al.)

Diabetes and Oral Health

Pages 777-790

Díaz-Romero, Rosa Maria (et al.)

Renal Disease in Diabetes

Pages 791-807

Garza-García, Carlos A. (et al.)

Peripheral Diabetic Neuropathies

Pages 809-823

Feher, Gergely

Diabetic Cardiac Autonomic Neuropathy

Pages 825-850

Serhiyenko, Viktoria (et al.)

Autonomic Visceral Neuropathy and Gastrointestinal Disorders

Pages 851-861

Drewes, Anne Mohr (et al.)

Urologic Complications in Patients with Diabetes

Pages 863-871

Casco, Stephania (et al.)

Musculoskeletal Complications of Diabetes Mellitus

Pages 873-881

Singla, Rajiv (et al.)

Diabetes and the Skin

Pages 883-898

Mestdagh, Justine (et al.)

Foot Complications

Pages 899-918

Harkless, Lawrence B. (et al.)

Diabetes and Cancer

Pages 919-937

Krajewska (Wojciechowska), Joanna (et al.)

Diabetes in Children and Adolescents

Pages 941-966

Miranda Lora, América Liliana (et al.)

Pregnancy: Pregestational and Gestational Management

Pages 967-976

García-Argueta, María Isabel (et al.)

The Elderly with Diabetes

Pages 977-989

Valencia-Rodrigo, Willy Marcos

The Artificial Pancreas

Pages 993-998

Ginsberg, Barry H. (et al.)

Unproven Therapies for Diabetes

Pages 999-1013

Kesavadev, Jothydev (et al.)

 At the dawn of precision medicine, there is a new opportunity for novel approaches to understand, diagnose and treat endometrial disorders that affect fertility, reproductive outcomes, and women’s health more broadly. Herein, the editors have assembled critically evaluated state-of-the-art chapters presenting basic and clinical knowledge about the human endometrium that impacts or will impact clinical practice. All clinicians and researchers in Reproductive Medicine will find this book useful as a reference and a valuable tool for continued advancement in the understanding and management of the "endometrial factor".

 

This timely and clinically oriented book uniquely addresses the entire spectrum of treatment for severe obesity and diabetes. It thoroughly examines all aspects from robotic surgery to cell therapy, from the latest antidiabetic drugs to endoscopic procedures and devices, from appetite-inhibiting signals and nutrients to gastric arterial embolization. It offers objective and authoritative information for practicing professionals; not only are successful interventions discussed and updated, but cutting-edge and experimental pathways are also anticipated.

Obesity is the foremost nutritional challenge worldwide. Its companion is type-2 diabetes, the most prevalent metabolic disease. Together they represent the diabesity epidemic, which is draining resources, overwhelming healthcare facilities, and impacting life expectancy and quality of life everywhere. No country has been spared, and most medical specialties have been affected. Many books focus on the surgical options for obesity and diabetes, namely bariatric and metabolic operations. Information on the clinical and pharmacological treatment is also available, conveyed by standard texts on internal medicine and endocrinology. Yet endoscopic maneuvers and prostheses, cell therapy for diabetes, and other innovative approaches are hard to come by, as conventional texts overlook such therapies. This timely publication bridges the gaps between all different therapeutic options, also covering advances in the conservative, surgical and parasurgical domains.

This book will appeal to seasoned specialists, students and healthcare professionals in training alike.

 

DESCRIPTION

The revised and updated third edition of the essential guide to the diagnosis and treatment of the diabetic foot

The revised third edition of the Atlas of the Diabetic Foot is an updated guide to the information needed for the prevention and treatment of diabetic foot problems with the aim of reducing amputations. In addition to offering the theoretical knowledge, the book is filled with more than 500 color photos from real-life cases. The cases explore a wide-variety of foot issues and the text includes information about differential diagnosis and treatment. The authors—noted experts in the field—describe the epidemiology, pathophysiology and classification of diabetic foot ulcers. In addition, the book highlights the diagnosis of the main risk factors for the diabetic foot, namely diabetic neuropathy, peripheral arterial disease and the anatomic deformities of the lower extremities.

The updated third edition, include 5 videos that clearly demonstrate the methods of examination for diabetic neuropathy and peripheral arterial disease. The text includes methods of callus removal and debridement as well as offloading. In addition, it contains information on how a total contact cast is constructed. This essential resource:

·         Contains a full color presentation of diabetic foot cases

·         Explains the prevention and treatment of diabetic foot problems in a revised and updated edition

·         Includes a larger format that allows for a better quality images

·         Offers a companion website with high-resolution digital files of photographs of the case studies presented

·         Presents a multidisciplinary approach appropriate for a wide audience foot and diabetic professionals

Written for diabetes specialists, endocrinologists and diabetic nurse specialists, podiatrists and podiatry nurse specialists, Atlas of the Diabetic Foot offers the information needed to help with the prevention, diagnosis and management of the diabetic foot.

TABLE OF CONTENTS

Preface to the Third Edition vii

Preface to the Second Edition ix

Preface to the First Edition xi

Acknowledgements xiii

About the Companion Website xv

1 Introduction 1

2 Diabetic Neuropathy 11

3 Anatomic Risk Factors for Diabetic Foot Ulceration 23

4 Other Foot-Related Risk Factors 49

5 Skin and Systemic Diseases with Manifestations in the Feet 63

6 Neuropathic Ulcers 75

7 Peripheral Vascular Disease 91

8 Ischemic and Neuro-Ischemic Ulcers and Gangrene 107

9 Heel Ulcers 135

10 Charcot Foot 147

11 Infections 169

12 Methods of Prevention 197

13 Methods of Ulcer Healing 205

14 Amputations 229

Appendix 237

Index 239

 

 Childhood obesity has reached epidemic proportions in the United States and continues to increase in prevalence in almost all countries in which it has been studied, including developed and developing countries around the globe. The causes of obesity are complex and multi-factorial. Childhood obesity becomes a life-long problem in most cases and is associated with long term chronic disease risk for a variety of diseases including type 2 diabetes, cardiovascular disease, non-alcoholic fatty liver disease, as well as psychosocial as issues and obesity seems to affect almost every organ system in the body. 

In recent years there has been tremendous progress in the understanding of this problem and in strategies for prevention and treatment in the pediatric years. Childhood Obesity: Causes, Consequences, and Intervention Approaches presents current reviews on the complex problem of obesity from the multi-level causes throughout early life before adulthood and the implications for this for long-term disease risk. It reviews numerous types of strategies that have been used to address this issue from conventional clinical management to global policy strategies attempting to modify the global landscape of food, nutrition, and physical activity. Each chapter is written by a global authority in his or her respective field with a focus on reviewing the current status and recent developments.

The book features information on contributing factors to obesity, including developmental origins, social/family, birth cohort studies, influence of ethnicity, and global perspectives. It takes a life-course approach to the subject matter and includes exhaustive treatment of contributing factors to childhood obesity, such as assessment, environmental factors, nutrition and dietary factors, host factors, interventions and treatment, consequences, and further action for future prevention. This broad range of topics relevant to the rapidly changing field of childhood obesity is suitable for students, health care professionals, physicians, 

 The Third Edition of Medical Management of Thyroid Disease provides the most up-to-date practical guidance for the diagnosis and management of common and uncommon thyroid diseases. It reflects the advancement in guidelines and research for thyroid cancer, nodules and hypothyroidism; all presented in an accessible format with more illustrations and algorithms for management. The contributions of internationally renowned endocrinologists present the clinical aspects from the world’s perspective.

Key Features

• Completely revised and updated

• Reorganized with more algorithms for quick reference and enhanced usability

• Edited by internationally renowned physicians in the field

• Authoritative, comprehensive and yet easily digestible

Features:
• Provides a cutting-edge, problem-orientated approach to the management of clinical problems in endocrinology
• Presents complete updates of existing chapters and new research data, diagnostic techniques, treatment options, and safety concerns
• Discusses neuroendocrine disease and examines strides made by the identification of aryl hydrocarbon receptor–interacting protein mutations
• Reviews changes in diagnostic imaging
• Explores the rapidly increasing incidence of neuroendocrine tumors and their management
• Reviews the endocrinology of aging
• Includes protocols for pituitary function testing

Summary:
Endocrinology is a complex specialty that spans a wide range of diseases, disorders, and conditions. The field is now moving toward an increasingly personalized approach to patient management, with a greater focus on mechanisms of disease and biomarkers. Written by internationally renowned specialists, the second edition of Endocrinology in Clinical Practice provides a cutting-edge, problem-orientated approach to the management of clinical problems in endocrinology.
Highlights of the new edition include:
• An overview of neuroendocrine disease
• Strides made by the identification of aryl hydrocarbon receptor–interacting protein mutations in patients with familial isolated pituitary adenomas
• The diverse roles of IGF-I
• Changes in diagnostic imaging and the increasing use of positron emission tomography
• The rapidly increasing incidence of neuroendocrine tumors and their management
• Hereditary primary hyperparathyroidism and multiple endocrine neoplasia
• Mechanistic and genomic advances related to disorders of calcium regulation and infertility
• The endocrinology of aging
• Protocols for pituitary function testing With complete updates to existing chapters, the second edition also presents new research data, diagnostic techniques, treatment options, and safety concerns related to existing therapies. This edition offers current guidance and scientifically focused information relevant to a range of clinical problems, making it an essential reference for practicing endocrinologists and specialist clinicians.

The acclaimed clinical guide to managing both pediatric endocrine disorders and inborn errors of metabolism

No other text so skillfully blends the disciplines of endocrinology and inborn metabolic disorders into one clinically focused, highly visual resource as Pediatric Endocrinology and Inborn Errors of Metabolism.

In this practical, user-friendly tutorial, a team of international contributors delivers the latest information and clinical insights clinicians need to confidently diagnose and manage pediatric patients. This full-color resource guides readers through the etiology, pathophysiology, presenting signs and symptoms, diagnostic laboratory examinations, and treatments regimens of each disorder. Pediatric Endocrinology and Inborn Errors of Metabolism successfully balances authority and comprehensiveness with a strong clinical, practical approach that delivers an unmatched integrated discussion of the fields.

• Full-color presentation with numerous photos, illustrations, diagnostic algorithms, tables, and text boxes that summarize key concepts and assist in the decision-making process

• At-a-Glance feature beginning each disease-based chapter summarizes all the clinical information you need to differentiate between disorder sub-types in one easy-to-find place 

• Complete and detailed information on all laboratory and radiographic testing used to diagnose disorders in both disciplines

An up-to-date reference for managing thyroid and parathyroid diseases

 A highly illustrated, detailed and didactic text on medical and surgical aspects of thyroid and parathyroid diseases. -- Pediatric Endocrinology Reviews

The book is well illustrated...and serves as an up-to-date and comprehensive guide to the evaluation and treatment of those with thyroid and parathyroid disorders. It is well resourced and written with insight, and includes the newer surgical techniques, such as minimally invasive surgery and robotics. -- Journal of Laryngology & Otology

...an excellent foundation for understanding all aspects of thyroid and parathyroid disease. -- Head & Neck

Thyroid and Parathyroid Diseases, Second Edition, has been revised and updated to reflect recent advances in the medical and surgical management of thyroid and parathyroid diseases. This new edition serves as both a comprehensive guide to patient evaluation as well as an atlas of advanced surgical techniques for managing patients needing operative intervention. Separate chapters are devoted to minimally invasive techniques and remote access/robotic thyroidectomy techniques, both of which have enjoyed increased application throughout the world.

New in the second edition:

·         A section on state-of-the-art, evidence-based management of challenging parathyroid conditions such as multiple endocrine neoplasia and renal hyperparathyroidism

·         A more detailed discussion of thyroid cancer evaluation and staging

·         A new chapter dedicated to parathyroid cancer

·         Nearly 200 additional full-color illustrations

This new edition is a valuable resource for all surgeons, endocrinologists, and residents seeking to expand their knowledge of thyroid and parathyroid diseases, as well as seasoned clinicians who want to improve patient care and incorporate the latest surgical advancements into their practice.

 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.

 

• First textbook to be devoted entirely to hypoparathyroidism
• Provides essential, up-to-date information on the pathology, diagnosis, and treatment of hypoparathyroidism 
• Covers a wide range of hypoparathyroid disorders Discusses novel replacement therapy with PTH 1-34 and 1-84 
• Includes a chapter on surgical hypoparathyroidism

About this book

Hypoparathyroidism, a condition in which insufficient parathyroid hormone (PTH) is produced to maintain normocalcemia is associated with a variety of acute and chronic symptoms and complications due to hypocalcemia. Replacement therapy utilizing PTH has long been awaited, and this book is new and very timely as it coincides with the  publication of results on the role of the PTH molecule in the pharmacological management of this disorder. This advance is sparking renewed interest in hypoparathyroidism, which is attributable to neck surgery in most cases and to inherited disorders in a minority.

Hypoparathyroidism has been written by acknowledged experts in the field and provides essential, up-to-date information on the pathology, diagnosis, and treatment of the condition. It opens by addressing in detail the anatomy and physiology of the parathyroids and describing the epidemiology and clinical presentation of hypoparathyroidism. The full range of hypoparathyroid disorders are then discussed, including the various genetic forms, postoperative hypoparathyroidism, and other forms of acquired hypoparathyroidism. Individual chapters focus on refractory disease, the impact of the condition on bone, and the management of acute hypocalcemia. Both conventional treatment for hypoparathyroidism and the novel replacement therapy with PTH  peptides are then thoroughly examined. Pseudohypoparathyroidism is also extensively discussed, with information on the various forms, differential diagnosis, and genetic testing. This book will be of interest to all endocrinologists, and also to surgeons and internal medicine physicians.

Table of contents (38 chapters)

 

·         The History: From Ivar Sandström to the Sequence of Parathyroid Hormone

Mannstadt, Michael (et al.)

Pages 3-10

·         Embryology of the Parathyroid Glands

Manley, Nancy R.

Pages 11-18

·         PTH and PTH-Related Peptides

Isaia, Giancarlo (et al.)

Pages 19-24

·         PTH Assays and Their Clinical Significance

D’Amour, Pierre

Pages 25-32

·         Control of Parathyroid Hormone Secretion by Extracellular Ca

Brown, Edward M.

Pages 33-48

·         Phosphate Control of PTH Secretion

Messa, Piergiorgio

Pages 49-59

·         Role of Magnesium in Parathyroid Physiology

Steen, Oren (et al.)

Pages 61-67

·         The PTH/Vitamin D/FGF23 Axis

Goltzman, David (et al.)

Pages 69-79

·         The PTH Receptorsome and Transduction Pathways

Gardella, Thomas J.

Pages 81-87

·         G Protein Gsα and

Bastepe, Murat

Pages 89-98

·         Parathyroid Hormone Actions on Bone and Kidney

Pajevic, Paola Divieti (et al.)

Pages 99-109

·         PTH and PTHrP: Nonclassical Targets

Cianferotti, Luisella

Pages 111-126

·         In Vitro Cellular Models of Parathyroid Cells

Gomez, Ana Rita (et al.)

Pages 127-135

·         Epidemiology of Hypoparathyroidism

Clarke, Bart L.

Pages 139-154

·         Clinical Presentation of Hypoparathyroidism

Wheeler, Amber L. (et al.)

Pages 155-165

·         Familial Isolated Hypoparathyroidism

Hendy, Geoffrey N. (et al.)

Pages 167-175

·         Autoimmune Hypoparathyroidism

Kemp, E. Helen (et al.)

Pages 177-188

·         DiGeorge Syndrome

Tarsitano, Marina (et al.)

Pages 189-197

·         Hypoparathyroidism, Deafness, and Renal Anomaly Syndrome

Nesbit, M. Andrew

Pages 199-213

·         Hypoparathyroidism, Dwarfism, Medullary Stenosis of Long Bones, and Eye Abnormalities (Kenny-Caffey Syndrome) and Hypoparathyroidism, Retardation, and Dysmorphism (Sanjad-Sakati) Syndrome

Hershkovitz, Eli (et al.)

Pages 215-224

·         Hypoparathyroidism in Mitochondrial Disorders

Orsucci, Daniele (et al.)

Pages 225-230

·         Postoperative Hypoparathyroidism

Tonelli, Francesco (et al.)

Pages 231-247

·         Hypoparathyroidism During Pregnancy, Lactation, and Fetal/Neonatal Development

Kovacs, Christopher S.

Pages 249-269

·         Rare Causes of Acquired Hypoparathyroidism

Wémeau, Jean-Louis

Pages 271-278

·         Refractory Hypoparathyroidism

Masi, Laura

Pages 279-286

·         Bone Histomorphometry in Hypoparathyroidism

Dempster, David W.

Pages 287-296

·         Management of Acute Hypocalcemia

Cooper, Mark Stuart (et al.)

Pages 297-301

·         Conventional Treatment of Chronic Hypoparathyroidism

Rejnmark, Lars

Pages 303-312

·         Follow-up in Chronic Hypoparathyroidism

Mannstadt, Michael (et al.)

Pages 313-318

·         Treatment of Hypoparathyroidism with Parathyroid Hormone 1–34

Winer, Karen K. (et al.)

Pages 319-331

·         Replacement Therapy with PTH(1–84)

Rubin, Mishaela R. (et al.)

Pages 333-342

·         Classification of Pseudohypoparathyroidism and Differential Diagnosis

Mantovani, Giovanna (et al.)

Pages 345-354

·         Pseudohypoparathyroidism Type 1a, Pseudopseudohypoparathyroidism, and Albright Hereditary Osteodystrophy

Weinstein, Lee S.

Pages 355-362

·         Pseudohypoparathyroidism Type Ib (PHP-Ib): PTH-Resistant Hypocalcemia and Hyperphosphatemia Due to Abnormal

Jüppner, Harald

Pages 363-372

·         Genetic Testing in Pseudohypoparathyroidism

Linglart, Agnès (et al.)

Pages 373-388

·         Blomstrand’s Chondrodysplasia

Giusti, Francesca (et al.)

Pages 389-395

·         Hypoparathyroidism During Magnesium Deficiency or Excess

Rizzoli, René

Pages 397-403

·         Advocacy and Hypoparathyroidism in the Twenty-First Century

Sanders, James E. (et al.)

Pages 407-414

The WHO Classification of Tumours of Endocrine Organs is the 10th volume in the 4th Edition of the WHO series on histological and genetic typing of human tumours. This authoritative, concise reference provides an international standard for oncologists and pathologists and will serve as an indispensable guide for use in the design of studies evaluating response to therapy and clinical outcome. Diagnostic criteria, pathological features, and associated genetic alterations are described in a disease-oriented manner. Sections on all recognized neoplasms and their variants include new ICD-O codes, epidemiology, clinical features, pathology, genetics, prognosis, and predictive factors. The book, prepared by 166 authors from 25 countries, contains more than 700 color images and tables and more than 3100 references.

The field of microbial endocrinology is expressly devoted to understanding the mechanisms by which the microbiota (bacteria within the microbiome) interact with the host (“us”). This interaction is a two-way street and the driving force that governs these interactions are the neuroendocrine products of both the host and the microbiota. Chapters include neuroendocrine hormone-induced changes in gene expression and microbial endocrinology and probiotics. This is the first in a series of books dedicated to understanding how bi-directional communication between host and bacteria represents the cutting edge of translational medical research, and hopefully identifies new ways to understand the mechanisms that determine health and disease.​

Management of Prader-Willi Syndrome brings together the contributions of professionals with considerable expertise in diagnosis and management of PWS. Clinical, social, family, and community issues are explored and management strategies identified. The text presents historical, medical, and genetic information to orient the reader. The major portion deals with pragmatic guidelines, rather than research and diagnosis, and is directed to health and educational specialists in academic, clinical, and community settings. This manual is endorsed by The Prader-Willi Syndrome Association, which is recognized world-wide.

Description:

Kidney Transplantation, Bioengineering, and Regeneration: Kidney Transplantation in the Regenerative Medicine Era investigates how the field of regenerative medicine is changing the traditional premises of solid organ transplantation, specifically within the field of kidney transplantation. In Section 1, chapters illustrate the state of the art in kidney transplantation as well as the research behind the bioengineering and regeneration of kidney organoids for therapeutic renal replacement.

In Section II, chapters catalog the technologies that are being developed and the methods that are being implemented to bioengineer or regenerate kidneys in order to restore function, while critically highlighting those technological advances which hold the most promise. The book thus encompasses clinical renal transplantation, tissue engineering, biomaterial sciences, stem cell biology, and developmental biology, as they are all applied to the kidney.

• Focuses on the synergy between renal organ transplantation and regenerative medicine, highlighting the advances within transplantation, bioengineering, regeneration, and repair
• Educates the transplant community on important regenerative medicine research pertinent to kidney transplantation
• Develops a shared language for clinicians, surgeons, and basic researchers to reach across the fields of transplantation and regenerative medicine, and facilitate more productive investigation and research
• Catalogs the technologies being developed and methods being implemented to bioengineer or regenerate kidneys to restore function

 

·  Introduction

·  Part I: Kidney Transplantation

·  Section I: Epidemiology of Kidney Disease and Transplantation

·  Chapter 1. Epidemiology of End-Stage Renal Failure: The Burden of Kidney Diseases to Global Health

·  Chapter 2. Transplant Programs Worldwide and the Spanish Miracle

·  Section II: Donor Selection and Allocation

·  Chapter 3. The Deceased Kidney Donor

·  Chapter 4. The Living Donor

·  Chapter 5. Criteria for Kidney Allocation in the United States

·  Chapter 6. Strategies to Increase the Donor Pool

·  Section III: Kidney Preservation and Transplant Procedures

·  Chapter 7. Kidney Preservation

·  Chapter 8. Ex-vivo Normothermic Perfusion in Renal Transplantation

·  Chapter 9. Kidney Transplant Recipient Surgery

·  Chapter 10. Robotic-Assisted Kidney Transplantation

·  Chapter 11. Orthotopic Kidney Transplantation

·  Chapter 12. Kidney Transplantation Combined With Other Organs

·  Chapter 13. Pediatric Renal Transplantation

·  Section IV: Kidney Recipient: Before and Peritransplant

·  Chapter 14. Indications for Renal Transplantation: Evaluation of Transplant Candidates

·  Abstract

·  Chapter 15. Early Postoperative ICU Care of the Kidney Transplant Recipient

·  Chapter 16. Approaches to Minimize Delayed Graft Function in Renal Transplantation

·  Section V: Transplantation Immunology and Immunomodulation

·  Chapter 17. Histocompatibility Testing in the Transplant Setting

·  Chapter 18. The Immune Response to the Allograft

·  Chapter 19. Induction Immunosuppression in Kidney Transplantation

·  Chapter 20. Maintenance Immunosuppression in Kidney Transplantation

·  Chapter 21. Novel Drugs in Kidney Transplantation

·  Chapter 22. Hematopoietic Stem Cell Transplantation for Induction of Allograft Tolerance

·  Chapter 23. Regulatory T Cell Therapy in Transplantation

·  Chapter 24. Mesenchymal Stromal Cells to Improve Solid Organ Transplant Outcome:

·  Chapter 25. Renal Transplantation Across HLA and ABO Barriers

·  Section VI: Graft Monitoring Tools

·  Chapter 26. Pathology of the Renal Allograft

·  Chapter 27. Imaging-Based Monitoring of the Renal Graft

·  Chapter 28. Immune Monitoring in Kidney Transplantation

·  Chapter 29. Renal Function Measurements

·  Chapter 30. Pharmacokinetics and Genomics of Immunosuppressive Drugs

·  Chapter 31. Gene Expression Technology Applied to Kidney Transplantation

·  Section VII: Early Posttransplant Immune Events

·  Chapter 32. Acute Cellular Rejection

·  Chapter 33. Acute Antibody-Mediated Rejection

·  Section VIII: Early and Late Complications

·  Chapter 34. Vascular Complications in Renal Transplantation

·  Chapter 35. Infections in Kidney Transplant Recipients

·  Chapter 36. Metabolic Disorders Following Kidney Transplantation

·  Chapter 37. Cancer After Kidney Transplantation

·  Chapter 38. Cardiovascular Disease and Renal Transplantation

·  Chapter 39. Graft and Patient Survival

·  Chapter 40. Urological Complications of the Renal Graft

·  Chapter 41. Impact of De Novo Donor-specific Alloantibody in Primary Renal Allografts

·  Chapter 42. De Novo and Recurrence of Renal Disease

·  Section X: Transplant Issues in Specific Patient Groups

·  Chapter 43. Kidney Transplantation in the Elderly

·  Chapter 44. Dual Kidney Transplantation

·  Chapter 45. Kidney Transplantation in the Diabetic Patient

·  Chapter 46. Kidney Transplantation in the Hepatitis C Infected Recipient

·  Chapter 47. Pregnancy After Kidney Transplantation

·  Chapter 48. Nutrition of the Kidney Transplant Recipients

·  Section XI: Ethics and Costs

·  Chapter 49. Kidney Transplantation in Developing Countries

·  Chapter 50. Health-Related Quality of Life Outcomes After Kidney Transplantation

·  Chapter 51. Costs of Kidney Transplantation

·  Section XII: Unmet Needs

·  Chapter 52. Kidney Transplantation: Have the Promises Been Kept and Needs Met

·  Chapter 53. Innovations in Kidney Transplant Research

·  Part II: Kidney Bioengineering and Regeneration

·  Section I: Introduction

·  Chapter 54. Converging Organ Transplantation Towards Regenerative Medicine

·  Chapter 55. A Systems Engineering Approach to Restoring Kidney Structure and Function

·  Abstract

·  Section II: Kidney Development

·  Chapter 56. Kidney Development in the Mammal

·  Chapter 57. Renal Branching Morphogenesis

·  Section III: Bioengineering

·  Chapter 58. Principles of Stem Cell Biology Applied to the Kidney

·  Chapter 59. Extracellular Matrix Biology Applied to the Kidney

·  Chapter 60. Interplay Between Growth Factor Receptors, Small GTPases, and Mechanical Stress in the Maintenance of Kidney Glomerular Homeostasis

·  Chapter 61. Bioengineering Approach to Immunomodulation

·  Chapter 62. Principles of Organ Bioengineering

·  Chapter 63. Recellularization of Kidney Scaffold With Stem Cells

·  Section IV: Bioreactors and Biomaterials

·  Chapter 64. Bioreactors for Cell Culture Systems and Organ Bioengineering

·  Chapter 65. Synthetic Biomaterial for Regenerative Medicine Applications

·  Chapter 66. Immune Responses to Biomaterials Used in Renal Engineering

·  Section V: Regeneration

·  Chapter 67. Regeneration of Kidney From Human Reprogrammed Stem Cells

·  Chapter 68. Bioprinting Complex 3D Tissue and Organs

·  Chapter 69. Principles of Kidney Regeneration

·  Chapter 70. Markers of Repair and Regeneration in the Marginal Kidney

·  Chapter 71. Nephron Repair in Mammals and Fish

·  Chapter 72. Imaging of Glomerular Regeneration

·  Chapter 73. Reversibility of Renal Fibrosis

·  Chapter 74. Pharmacological Induction of Kidney Regeneration

·  Chapter 75. Developmental Approaches to Kidney Regeneration

·  Section VI: Adult Cells for Regeneration

·  Chapter 76. Nephron Progenitors

·  Chapter 77. Urine Progenitor Cells for Potential Application in Renal Tissue Repair

·  Chapter 78. Endothelial Progenitor Cells in Kidney Disease

·  Section VII: Cell Therapy For Renal Tissue Repair

·  Chapter 79. Mesenchymal Stromal Cells for Acute Renal Injury

·  Chapter 80. Amniotic Fluid Cells: Kidney Injury and Regeneration

·  Chapter 81. Renal Cells From Spermatogonial Germline Stem Cells for Protection Against Kidney Injury

·  Chapter 82. Kidney-on-a-Chip: Technologies for Studying Pharmacological and Therapeutic Approaches to Kidney Repair

·  Chapter 83. Renal Replacement Devices

·  Chapter 84. Xenotransplantation and Kidney Regenerative Technology

·  Chapter 85. Embryonic Organoid Transplantation

·  Chapter 86. Lineage Reprogramming Toward Kidney Regeneration

·  Chapter 87. Regenerating Kidney Structure and Function: An Industry Perspective

 

 

 

 The second edition of Endocrine Surgery is a comprehensive update of the previous edition published in 2003. Edited by three leading authorities in the field of surgical endocrinology, the book encompasses the clinical, imaging, nuclear, molecular, technological and evidence-based principles that are applied in the diagnosis and treatment of all categories of endocrine tumors. Authored by experts from across the globe, this textbook reflects the best international clinical practice and also provides an outstanding educational resource.

With full color illustrations throughout, the new edition emphasizes contemporary approaches in successive stages including: pituitary endocrine tumors; pathology and pathophysiology of pulmonary neuroendocrine cells; surgery of endocrine tumors of the lungs and thymus; robotic endocrine surgery; molecular testing of thyroid nodules; pediatric surgery for neuroblastoma and ganglioneuroma; multiple endocrine neoplasia; retroperitoneoscopic adrenalectomy; radionuclide imaging of carcinoid tumors, pancreas and adrenals; serotonin-induced cardiac valvular disease and surgical treatment; multimodal management of primary and metastatic neuroendocrine tumors; pathophysiology and surgery of Type II diabetes; post-bariatric surgery hyperinsulinemic hypoglycemia; and surgical management of metabolic syndrome.

Endocrine Surgery 2e provides the clinician with a definitive resource to reach curative outcomes in the treatment of patients with endocrine pituitary, thyroid, and parathyroid entities. Further coverage of broncho-pulmonary, adrenal, pancreatic, and intestinal neoplasia is also included, making this the definitive textbook on the subject.

 

Demetrius Pertsemlidis, MD FACS The Bradley H. Jack Professor of Surgery, Icahn School of Medicine at Mount Sinai, New York, USA

William B. Inabnet III, MD FACS Professor of Surgery and Chief, Division of Metabolic, Endocrine and Minimally Invasive Surgery, Icahn School of Medicine at Mount Sinai, New York, USA

Michel Gagner, M.D. FRCSC, FACS, FASMBS

Clinical Professor of surgery, Herbert Wertheim School of Medicine, Florida International 

 The seventh edition of Brook's Clinical Pediatric Endocrinology has been compiled by an experienced editorial team and internationally renowned contributors; it presents basic science and clinical management of endocrine disorders for all involved in the care of children and adolescents. It provides treatments for a variety of hormonal diseases, including diabetes and hypoglycaemia, growth problems, thyroid disease and disorders of puberty, sexual differentiation, calcium metabolism, steroid metabolism and hypopituitarism.

ABOUT THE AUTHOR

MEHUL T. DATTANI, MD, FRCP, FRCPCH, is Professor of Pediatric Endocrinology at the UCL GOS Institute of Child Health and Head of Pediatric Endocrinology at Great Ormond Street Hospital for Children, University College London Hospitals, and Institute of Child Health. He is currently the Chair of the Programme Organising Committee of the European Society for Paediatric Endocrinology.

 

CHARLES G.D. BROOK, MA, MD, FRCP, was the first Professor of Pediatric Endocrinology in the UK and the founder of the London Centre for Pediatric Endocrinology at Great Ormond Street Hospital and University College London Hospitals. He was the recipient of the Andrea Prader Prize in 2000, the most prestigious award for outstanding leadership and research in the gift of the European Society for Paediatric Endocrinology.

 

TABLE OF CONTENTS

List of Contributors xix

Preface xxiii

About the Companion Website xxv

1 Genetics and Genomics 1
Anu Bashamboo and Ken McElreavey

Introduction 1

Basic Concepts in Human Genetics and Genomics 1

Classes of RNA Molecules and their Functions 4

Gene Mutations and Inheritance 7

Human Populations and Genetic Variation 12

Epigenetics 14

Advances in Genomic Analysis 15

Establishing Variant Causality 19

The Age of Precision Medicine 24

Clinical Guidelines 24

Acknowledgments 25

Glossary of Terms 25

Further Reading 29

2 Measuring Hormones 31
Gerhard Binder

Introduction 31

Hormone Assays 31

Assay Validity 33

Technical Pitfalls When Measuring Hormones 36

Clinical Assay Validity 38

Stimulation Tests, Suppression Tests and Profiles 42

Optimal Clinical Use of Hormone Tests 44

Acknowledgements 44

References 44

3 Fetal Endocrinology 47
Harshini Katugampola, Evelien F. Gevers, and Mehul T. Dattani

Introduction 48

Transplacental Passage of Hormones 48

Development of Fetal Endocrine Systems 50

Neutralization of Hormone Activity in the Fetus 82

Plasticity of Fetal Endocrine Systems 84

Fetal Adaptations for Transition to Extrauterine Life 85

Frontiers in Fetal and Neonatal Endocrinology 89

References 90

4 Disorders of Sex Development 105
Martine Cools and Birgit Köhler

Normal Sex Development 105

Terminology 106

Causes of DSD 107

Impaired Gonadal Development 108

Disturbances of Testicular Hormone Production or Action 113

Virilization of an XX Individual 116

Management of DSD 118

Clinical Management 122

Other Examples of XY DSD 126

Future Perspectives 127

References 127

Weblinks 131

5 Disorders of Hypothalamo‐Pituitary Axis 133
Hoong‐Wei Gan, Kyriaki‐Sandy Alatzoglou, and Mehul T. Dattani

Introduction 133

The Hypothalamo‐Pituitary Neuroendocrine Axis 134

Hypothalamo‐Pituitary Development 134

Congenital Disorders of Hypothalamo‐Pituitary Development 144

Acquired Disorders of Hypothalamo‐Pituitary Dysfunction 155

Investigation of Hypopituitarism 172

Management of Hypopituitarism 173

Conclusion 174

References 174

6 Disorders of Growth 199
P.G. Murray and P.E. Clayton

Normal Growth 200

Short Stature 205

Acquired GH Deficiency 211

Disorders of GH Action and GH Sensitivity (Primary IGF‐I Deficiency) 213

Growth Disorders not Related to the GH‐IGF Axis 216

Syndromes Associated with Short Stature 219

Idiopathic Short Stature 225

Skeletal Dysplasias 227

Tall Stature 229

References 233

7 Puberty and Its Disorders 235
Sasha R. Howard, Nicolas de Roux, Juliane Leger, Jean‐Claude Carel, and Leo Dunkel

Normal Puberty 235

Precocious Puberty 256

Delayed Puberty 265

Conclusions 283

References 284

8 The Thyroid Gland 289
Catherine Peters and Nadia Schoenmakers

Section 1: Development of the Thyroid Axis 289

Section 2: Clinical Thyroid Disorders 301

Section 3: Diagnostic Pitfalls 315

References 320

Weblinks 334

9 The Adrenal Cortex and Its Disorders 335
Claire R. Hughes, Elim Man, and John C. Achermann

Introduction 335

Development, Function and Regulation of the Adrenal Gland 336

Adrenal Insufficiency (AI) 353

Adrenal Excess 393

Education, Support and Long‐Term Care 401

10 The Parathyroid and Disorders of Calcium and Bone Metabolism 409
Jeremy Allgrove and Moira Cheung

Introduction 409

Physiology of Calcium and Bone Metabolism 409

Physiology of Bone Metabolism 421

Interactions between Calciotropic Agents 425

Fetal and Neonatal Calcium Metabolism 425

Post‐Neonatal Calcium, Phosphate and Magnesium Metabolism and the Calcium Cascade 426

Clinical Conditions 426

Drugs Used in the Treatment of Disorders of Calcium and Bone Metabolism 467

Summary 470

References 472

Weblinks 479

11 Polyglandular Autoimmune Syndromes 481
Catherine J. Owen, Mario Abinun, Simon H.S. Pearce, and Tim D. Cheetham

Introduction 481

Autoimmune Polyendocrinopathy Syndrome Type 1 (APS1) 483

Autoimmune Polyendocrinopathy Syndrome Type 2 and Associated Disorders 494

Other Single Gene Disorders Associated with Immune Dysregulation and Autoimmune Endocrinopathies 499

Conclusion 502

References 502

12 Endocrine Neoplasia 507
Constantine A. Stratakis and Emmanouil Saloustros

Thyroid Neoplasia: Nodules and Cancer 507

Paragangliomas and Phaeochromocytomas 511

Adrenocortical Cancers 521

Tumours of the Ovary 524

Tumours of the Testes 528

References 530

13 Endocrine Late Effects of Cancer Treatments 533
Wassim Chemaitilly and Melissa M. Hudson

Prevalence and Risk Factors for Endocrine Late Effects 538

Diagnosis and Management of Common Endocrine Late Effects 546

Summary 550

References 550

Weblinks 552

14 Disorders of Water Balance 553
Natascia Di Iorgi, Flavia Napoli, Giovanni Morana, and Mohamad Maghnie

Regulation of Water Balance 554

Diabetes Insipidus (DI) 558

Central Diabetes Insipidus and Adipsia 572

Primary Polydipsia 572

Nephrogenic Diabetes Insipidus 573

The Syndrome of Inappropriate Antidiuretic Hormone Secretion 573

Management of Central Diabetes Insipidus 573

Treatment of Nephrogenic Diabetes Insipidus 574

Treatment of Inappropriate Antidiuretic Hormone Secretion 574

Challenges 575

Conclusions 575

Clinical Guidelines 575

References 576

15 Diabetes Mellitus 583
G.R. Ambler, F.J. Cameron, K. Joshi, and D.K. Wherrett

Type 1 Diabetes 583

Type 2 Diabetes 626

Cystic Fibrosis‐Related Diabetes 637

Monogenic Forms of Diabetes 639

Rare Forms of Diabetes 647

Living with Diabetes 648

References 649

16 Disorders Associated with Hypoglycaemia in Children 671
Pratik Shah, Emma Footit, and Ritika Kapoor

Introduction 671

Physiology of Blood Glucose Control 672

Role of Gut Hormones in Glucose Homeostasis 673

Metabolic Adaptation to Birth 673

Metabolic Adaptation to Feeding and Fasting 674

The Regulation of Insulin Secretion and Role of K_ATP Channels 675

Definition of Hypoglycaemia 676

Aetiology and Clinical Approach to Hypoglycaemia 678

Investigations for Hypoglycaemia 680

Emergency Management of Hypoglycaemia 682

Causes of Hypoglycaemia 682

17 Obesity 701
Wieland Kiess

Introduction 701

Definitions, Differential Diagnosis, Assessments and Measurements 701

Aetiology of Obesity 703

Common or Multifactorial Obesity and Fetal Programming 705

Neurobiology of Satiety and Hunger 705

Hedonistic Signals and Addiction 706

Behaviour, Hypothalamus and Obesogenic Environment 707

Biology of Adipose Tissue and Adipocytes 707

Microbiota 708

Endocrinology of Obesity 709

Epigenetics 709

Social Inheritance 709

Sociodemographics 710

Nutrition and Malnutrition 710

Physical Activity 711

Sedentary Behaviour 711

Endocrine‐Disrupting Chemicals and Toxicology 711

Media Use 712

Cultural Aspects 712

Evolution 712

Epidemiology 713

Developed Countries 713

Developing Countries 713

Co‐Morbidities and Consequences 713

Social Participation 718

Mortality 719

Health Economics 720

Treatments 720

Microbiota 723

Urban Living 724

Advertising Industries 724

Conclusions 725

Further Reading 726

Weblinks 728

18 Genetic Obesity Syndromes 729
Tinh‐Hai Collet and I. Sadaf Farooqi

Introduction 729

Genetic Contributors to Obesity: The Evidence 729

Genetic Obesity Syndromes: An Overview 730

Obesity with Developmental Delay 730

Obesity without Development Delay 732

Conclusions 734

References 734

Weblinks 736

19 Endocrine Care During Adolescence into Young Adulthood 737
Helena Gleeson

Introduction 737

Adolescence and Young Adulthood 737

Exploratory and Health‐Related Behaviours 740

Addressing Adherence 743

Young People with Endocrine Conditions 744

Conclusion 750

References 751

Index 757

This book brings together recognized experts in the field to describe their current techniques for the surgical treatment of diseased thyroid, parathyroid, and adrenal glands, as well as neuroendocrine tumors of small bowel, pancreas, liver, and skin. For each procedure, indications, operative steps, potential pitfalls and complications, and postoperative management are presented. The clear descriptions coupled with informative and beautiful illustrations will give the reader new perspectives and insights into the anatomy and conduct of these procedures. Endocrine surgery has been an area of special interest to surgeons for well over a century, while the increasing incidence of neuroendocrine tumors has more recently led to greater attention to these neoplasms. Significant advances have been made in a variety of areas, the most recent being the introduction of minimally invasive methods of removing diseased glands, and the improved understanding of the natural history of neuroendocrine tumors.

The International Textbook of Diabetes Mellitus has been a successful, well-respected medical textbook for almost 20 years, over 3 editions. Encyclopaedic and international in scope, the textbook covers all aspects of diabetes ensuring a truly multidisciplinary and global approach. Sections covered include epidemiology, diagnosis, pathogenesis, management and complications of diabetes and public health issues worldwide. It incorporates a vast amount of new data regarding the scientific understanding and clinical management of this disease, with each new edition always reflecting the substantial advances in the field. Whereas other diabetes textbooks are primarily clinical with less focus on the basic science behind diabetes, ITDM's primary philosophy has always been to comprehensively cover the basic science of metabolism, linking this closely to the pathophysiology and clinical aspects of the disease. Edited by four world-famous diabetes specialists, the book is divided into 13 sections, each section edited by a section editor of major international prominence. As well as covering all aspects of diabetes, from epidemiology and pathophysiology to the management of the condition and the complications that arise, this fourth edition also includes two new sections on NAFLD, NASH and non-traditional associations with diabetes, and clinical trial evidence in diabetes. This fourth edition of an internationally recognised textbook will once again provide all those involved in diabetes research and development, as well as diabetes specialists with the most comprehensive scientific reference book on diabetes available.

 A much-needed comprehensive resource, Endocrine Pathology covers clinical, radiologic, biochemical, molecular, cytogenetic, immunologic and histopathologic aspects of endocrine disorders, including the full spectrum of both neoplastic and non-neoplastic lesions. The first section of the book provides an overview of the clinical presentations of endocrine diseases, while the second section reviews the wide variety of investigative techniques used in their diagnosis. The third and largest section provides a comprehensive tissue- and organ-based approach to the diagnosis of endocrine disorders, including morphologic, genetic and proteomic features with clinicopathologic correlations. All chapters are richly illustrated with numerous color images, tables and algorithms, and the book is packaged with a password, giving the user online access to all text and images. Written and edited by the world's leading experts, this comprehensive and up-to-date book is the definitive resource on endocrine pathology for all pathologists, endocrinologists and researchers.

 

o    Highlights advances in laboratory technology and new concepts in the molecular basis of endocrine diseases, allowing readers to understand and adopt modern approaches to the diagnosis and management of endocrine disorders

o    Integrates numerous illustrations, tables, algorithms, charts and high-quality color images, all of which are available to the reader in both print and electronic formats

o    Provides a definite review of the evolving landscape of endocrine pathology practice, illustrating the role of the pathologist in the multidisciplinary medical team

 

Table of Contents

 

List of contributors
Preface
Part I. Clinical Approaches:
1. Clinical presentations of endocrine diseases Karen Gomez Hernandez and Shereen Ezzat
2. Familial endocrine tumor syndromes Charalampos Lyssikatos, Fabio R. Faucz and Constantine A. Stratakis
3. Immunologic basis of endocrine diseases Shawn Winer, Hubert Tsui, and Daniel Winer
Part II. Investigative Techniques:
4. Biochemical testing Paul M. Yip, Karen Gomez-Hernandez, and Shereen Ezzat
5. Radiologic imaging Artur Salmaslioglu, Baris Bakir, M. Gulbiz Dagoglu Kartal, Michael Chan, Juan Pablo Cruz, Walter Kucharczyk, Eugene Yu, and Karen Gulenchyn
6. Cytologic assessment Scott L. Boerner
7. Intraoperative consultations Ozgur Mete and Sylvia L. Asa
8. Morphology and immunohistochemistry Robert Osamura
9. Cytogenetic testing methods Hong Wang and Cuihong Wei
10. Experimental models of endocrine diseases Toru Tateno and Tae Nakano-Tateno
Part III. Anatomical Endocrine Pathology:
11. The brain as an endocrine organ (including the pineal gland) M. Beatriz S. Lopes, Sugoto Mukherjee, Michael A. Reardon, and Carrie A. Mohila
12. The pituitary gland Sylvia L. Asa and Ozgur Mete
13. Thyroid Vania Nosé, Ana Carolina de Jesus, Ozgur Mete, Sylvia L. Asa, Marco Volante, Mauro Papotti and Darcy Kerr
14. Parathyroid gland Lori A. Erickson
15. Adrenal cortex Kai Duan, Thomas J. Giordano and Ozgur Mete
16. Adrenal medulla and extra-adrenal paraganglia Lindsey Oudijk, Ronald R. de Krijger, Karel Pacak, and Arthur S. Tischler
17. Endocrine lesions of the gastrointestinal tract Stefano Serra
18. The endocrine pancreas Stefano Serra, Frediano Inzani and Guido Rindi
19. Liver in endocrine disease Oyedele A. Adeyi and Sandra E. Fischer
20. Pulmonary, thymic and mediastinal neuroendocrine lesions Mauro Papotti, Sylvie Lantuejoul, Giulio Rossi, and Marco Volante
21. The kidney in endocrine disease Clariss Cassol and Carmen Avila-Casado
22. Endocrine aspects of the male genitourinary system Michelle Downes
23. Endocrine lesions in the mammary gland Tadao Nakazawa and Tetsuo Kondo
24. The placenta N. J. Sebire and A. R. Bamber
25. The gynecologic tract – neuroendocrine tumors and ovarian tumors with endocrine association Marjan Rouzbahman and Blaise Clarke
26. Skin manifestations in endocrine diseases Karen A. Naert, Nadya Al-Faraidy, Ayman Al-Habeeb, Danny Ghazarian, Cuyan Demirkesen and Can Baykal
27. Cardiovascular system in endocrine disease Pooja Singhal and Jagdish Butany
28. Soft tissue in endocrine disease Brendan Dickson
29. Bone in endocrine disease Brendan Dickson, David Goltzman and Richard Kremer
30. The approach to metastatic endocrine tumors of unknown primary site Sara Hafezi-Bakthiari and Ozgur Mete
Index.

 

Through ten outstanding editions, Werner & Ingbar's The Thyroid: A Fundamental and Clinical Text has been the go-to reference for the most comprehensive coverage of the thyroid, including anatomy, development, biochemistry, physiology, pathophysiology, and treatment of all thyroid disorders. Now in full color throughout, the 11th Edition of this award-winning text remains the clinician’s preferred source of authoritative information on the thyroid—an essential resource for all endocrinologists and thyroid surgeons.

• Includes thorough updates and new content throughout the text, especially on thyroid cytopathology, thyroid imaging, and targeted therapy of thyroid cancer as well as a new full-color format.
• Covers all aspects of the thyroid, including thyroid hormone synthesis and secretion, thyroid function, and disorders such as thyrotoxicosis, hypothyroidism, and cancer.
• Discusses surgical management of thyroid cancer, thyroid disruptors, thyroid hormone analogs, thyroid dysfunction’s effects on other organ systems, the aging thyroid, subclinical hypothyroidism and hyperthyroidism, and thyroid disease in pregnancy.
• Features insights from international experts, including new editor Dr. Peter Kopp of Northwestern University’s Feinberg School of Medicine.

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Table of Contents:

 

Cover

Title Page

Copyright

Dedication

Contributors

Preface to the Eleventh Edition

Preface to the First Edition

Contents

Section I: The Normal Thyroid

A. History, Development, Anatomy

Chapter 1: The heritage of the thyroid: A brief history

GOITER, CRETINISM, AND THE THYROID GLAND

GOITER AND IODINE

THYROTOXICOSIS

HYPOTHYROIDISM AND THE RECOGNITION OF THYROID FUNCTION

THERAPY OF HYPOTHYROIDISM

DISCOVERY OF THE ACTIVE PRINCIPLE AND THERAPY OF HYPOTHYROIDISM

SCREENING AND THERAPY OF CONGENITAL HYPOTHYROIDISM

DISCOVERY OF CURRENT CONCEPTS OF THYROID HORMONE SYNTHESIS, TRANSPORT, AND ACTION

AUTOIMMUNE ETIOLOGY OF GRAVES DISEASE AND HASHIMOTO THYROIDITIS

THYROID CANCER

OUTLOOK

REFERENCES

Chapter 2: Development and anatomy of the hypothalamic–pituitary–thyroid axis

THE HYPOTHALAMIC–PITUITARY AXIS

SIGNALING AND TRANSCRIPTIONAL MECHANISMS INVOLVED IN HYPOTHALAMUS ORGANOGENESIS

SIGNALING AND TRANSCRIPTIONAL MECHANISMS INVOLVED IN PITUITARY ORGANOGENESIS

THE THYROID GLAND

THYROID BUD FORMATION

THYROID MIGRATION

THYROID FOLLICULOGENESIS

DIFFERENTIATED THYROID FOLLICULAR CELLS

HISTOLOGY AND STRUCTURE

THYROID TRANSCRIPTION FACTORS

OTHER TRANSCRIPTION FACTORS INVOLVED IN THYROID DEVELOPMENT

IN VITRO GENERATION OF THYROID CELLS FROM PLURIPOTENT STEM CELLS

MODELING THYROID BY TRANSCRIPTION FACTORS OVEREXPRESSION

MODELING THYROID BY CHEMICAL PATHWAYS MANIPULATIONS

CONCLUSIONS

ACKNOWLEDGMENTS

REFERENCES

B. Thyroid Hormone Synthesis and Secretion

Chapter 3: Thyroid hormone synthesis: Thyroid iodide transport

IDENTIFICATION BY FUNCTIONAL EXPRESSION OF THE CDNA ENCODING RAT NIS

THE NIS MOLECULE

ISOLATION OF THE CDNA ENCODING HUMAN NIS (hNIS) AND ELUCIDATION OF THE GENOMIC ORGANIZATION OF hNIS

NIS IN EXTRATHYROIDAL TISSUES

NIS MECHANISM AND STOICHIOMETRY

SUBSTRATE SPECIFICITY OF NIS

NIS TRANSPORTS THE ENVIRONMENTAL POLLUTANT ClO4− WITH A 1 Na+:1 ClO4− STOICHIOMETRY

IODIDE TRANSPORT DEFECT, A CONGENITAL CONDITION CAUSED BY MUTATIONS IN THE NIS (SLC5A5) GENE

NIS KO MICE, A USEFUL MODEL FOR STUDYING MULTIPLE RAMIFICATIONS OF HYPOTHYROIDISM

REGULATION OF NIS TRANSCRIPTION

REGULATION OF NIS IN THE THYROID BY TSH

REGULATION OF NIS BY I−

REGULATION OF NIS BY A K+ CHANNEL

NIS IN THYROID CANCER

I− EFFLUX

NIS IN BREAST CANCER

IMPACT OF NIS ON PUBLIC HEALTH

NIS GENE TRANSFER

CONCLUDING REMARKS AND AVENUES FOR FUTURE INVESTIGATION

REFERENCES

Chapter 4: Thyroid hormone synthesis

IODIDE UPTAKE INTO THE THYROID

THE GENE AND PROTEIN STRUCTURE OF THE SODIUM/IODIDE SYMPORTER

FUNCTIONAL CHARACTERIZATION OF THE SODIUM/IODIDE SYMPORTER

REGULATION OF IODIDE UPTAKE AND SODIUM/IODIDE SYMPORTER FUNCTION AND EXPRESSION

MUTATIONS IN THE SODIUM/IODIDE SYMPORTER GENE

IODIDE EFFLUX FROM THE THYROID

PENDRED SYNDROME AND PENDRIN (PDS/SLC26A4)

PROTEIN STRUCTURE OF PENDRIN

EXPRESSION AND REGULATION OF PENDRIN

FUNCTIONAL CHARACTERIZATION OF PENDRIN

GOITER AND THYROID DYSFUNCTION IN PENDRED SYNDROME

ANOCTAMIN

SLC26A7

THYROGLOBULIN

STRUCTURE OF THE THYROGLOBULIN GENE AND PROTEIN

MUTATIONS IN THE THYROGLOBULIN GENE

THYROID PEROXIDASE

THE GENE AND PROTEIN STRUCTURE OF THYROID PEROXIDASE

FUNCTIONAL CHARACTERIZATION OF THYROID PEROXIDASE

EXPRESSION AND REGULATION OF THYROID PEROXIDASE

MUTATIONS IN THYROID PEROXIDASE

THE HYDROGEN PEROXIDE–GENERATING SYSTEM

CLONING OF THE DUAL OXIDASE AND THE DUAL OXIDASE MATURATION FACTOR GENES

THE PROTEIN STRUCTURE OF DUAL OXIDASES AND THE DUAL OXIDASE MATURATION FACTORS

EXPRESSION AND REGULATION OF DUAL OXIDASES AND THE DUAL OXIDASE MATURATION FACTORS

MECHANISM OF HYDROGEN PEROXIDE GENERATION

REGULATION OF HYDROGEN PEROXIDE ACTIVITY

GENETIC DEFECTS IN HYDROGEN PEROXIDE GENERATION

IODINATION AND THYROID HORMONE SYNTHESIS

OXIDATION OF THYROID PEROXIDASE TO COMPOUND I AND COMPOUND II

OXIDATION OF IODIDE

IODINATION AND COUPLING OF TYROSYL RESIDUES

INHIBITION OF THYROID PEROXIDASE BY THIONAMIDE DRUGS

CELLULAR UPTAKE AND PROTEOLYSIS OF THYROGLOBULIN

SECRETION OF THYROID HORMONES

DEHALOGENATION OF MONOIODOTYROSINE AND DIIODOTYROSINE

IODOTYROSINE (IYD/DEHAL1) DEIODINASE GENE AND PROTEIN

DEHALOGENASE DEFICIENCY

REFERENCES

C. Peripheral Thyroid Hormone Binding and Metabolism

Chapter 5: Thyroid hormone transport proteins

EVOLUTIONARY CONSIDERATIONS

FUNCTIONS OF THBPs

CLINICAL CONSIDERATIONS

THYROID-BINDING GLOBULIN

STRUCTURE AND FUNCTION

PHYSIOLOGIC REGULATION OF TBG IN HUMANS

PATHOLOGY

HUMAN SERPINA7 GENE SEQUENCE VARIANTS AFFECTING TBG CONCENTRATION OR FUNCTION

TRANSTHYRETIN

STRUCTURE AND FUNCTION

PHYSIOLOGIC REGULATION OF TTR IN HUMANS

PATHOLOGY

HUMAN TTR GENE SEQUENCE VARIANTS AFFECTING TTR CONCENTRATION OR FUNCTION

DYSTRANSTHYRETINEMIC HYPERTHYROXINEMIA

ALBUMIN

STRUCTURE AND FUNCTION

PATHOPHYSIOLOGY

HUMAN ALB GENE VARIANTS AFFECTING ALB CONCENTRATION OR FUNCTION

p.Arg242His

OTHER SEQUENCE VARIANTS AT Arg242

p.Arg246Ile

T3 VARIANTS OF FDH

MINOR CARRIERS

CLINICAL IMPLICATIONS OF THBPs

REFERENCES

Chapter 6: Intracellular pathways of iodothyronine metabolism/implications of deiodination for thyroid hormone action

STRUCTURE OF THE DEIODINASES

TOPOLOGY AND SUBCELLULAR LOCALIZATION

STRUCTURE–FUNCTION RELATIONSHIPS OF DEIODINASES AND MECHANISM OF DEIODINATION

SPECIFIC PROPERTIES OF THE DEIODINASES

TYPE 1 DEIODINASE

TYPE 2 DEIODINASE

TYPE 3 DEIODINASE

NONDEIODINATIVE METABOLISM OF IODOTHYRONINES

PHYSIOLOGIC ROLES OF THE SELENODEIODINASES

DEIODINASES AND THE REGULATION OF T3 PRODUCTION

ADAPTATION TO HYPOTHYROIDISM

INTRACELLULAR TRIIODOTHYRONINE HOMEOSTASIS

DEIODINASES AND REGULATION OF THYROTROPIN SECRETION

DEIODINASES AND THE BIOLOGIC EFFECTS OF THYROID HORMONE

DEIODINASES AND THE CENTRAL NERVOUS SYSTEM

DEIODINASES AND THE SKELETON

DEIODINASES AND METABOLISM

DEVELOPMENTAL ROLES OF THE DEIODINASES

MATERNAL–FETAL PHYSIOLOGY

TRIIODOTHYRONINE MODULATION OF PLACENTAL THYROID HORMONE TRANSFER

D3 EXPRESSION AND THE REQUIREMENT FOR THYROXINE IN NORMAL PREGNANCY

THE DEIODINASES IN HUMAN PATHOPHYSIOLOGY

NONTHYROIDAL ILLNESS

CONSUMPTIVE HYPOTHYROIDISM

DEIODINASES IN CANCER

HYPERTHYROIDISM AND OVEREXPRESSION OF DEIODINASES

DEIODINASES IN THE ISCHEMIC HEART

DEIODINASES IN LUNG INJURY

CONCLUSION

ACKNOWLEDGMENT

REFERENCES

D. Thyroid Hormone Action

Chapter 7: Intracellular actions by thyroid hormones

THYROID HORMONE TRANSPORT AND METABOLISM

TR-DEPENDENT SIGNALING OF TH WITH DIRECT BINDING TO DNA (TYPE 1)

THYROID HORMONE RESPONSE ELEMENTS

TRANSCRIPTIONAL REGULATION BY TRs

THYROID HORMONE RECEPTOR–INTERACTING COREPRESSORS/BASAL REPRESSION

THYROID HORMONE RECEPTOR–INTERACTING COACTIVATORS/TRANSCRIPTIONAL ACTIVATION

NEGATIVE REGULATION BY TRs

POSTTRANSLATIONAL MODIFICATION OF TR

RESISTANCE TO TH

THYROID HORMONE RECEPTOR ISOFORM KNOCKOUT AND KNOCKIN MICE

TRANSCRIPTIONAL CASCADES

TR-DEPENDENT SIGNALING OF TH WITH INDIRECT BINDING TO DNA (TYPE 2)

TR-DEPENDENT SIGNALING OF TH WITHOUT DNA BINDING (TYPE 3)

TR-INDEPENDENT TH SIGNALING (TYPE IV)

TH ANALOGS, DISRUPTORS, AND METABOLITES

SUMMARY

REFERENCES

Chapter 8: Thyroid hormone structure–function relationships

THYROID HORMONE STRUCTURE, METABOLISM, AND ACTIVITY

TR ACTIVATION BY NATURAL AND SYNTHETIC AGONISTS

DEVELOPMENT OF SELECTIVE TR SUBTYPE AGONISTS

STRUCTURE–FUNCTION RELATIONSHIPS AT TR MUTANTS—THE ISSUE OF TH RESISTANCE

TR ANTAGONISM

THYROID HORMONE INTERACTIONS WITH ALTERNATE RECEPTORS AND BINDING PROTEINS

THYRONAMINES AND ANALOGS

CONCLUSION

REFERENCES

E. Factors That Control Thyroid Function

Chapter 9: Chemistry and biosynthesis of thyrotropin

CHEMISTRY

GENES ENCODING THE SUBUNITS OF THYROTROPIN

CHROMOSOME LOCALIZATION

STRUCTURE OF THE COMMON α-SUBUNIT GENE

STRUCTURE OF THE THYROTROPIN-β–SUBUNIT GENE

CENTRAL HYPOTHYROIDISM DUE TO THYROTROPIN-β–SUBUNIT GENE ABNORMALITIES

PRETRANSLATIONAL REGULATION OF THYROTROPIN BIOSYNTHESIS

NEGATIVE REGULATORS

POSITIVE REGULATORS

SUMMARY OF PRETRANSLATION REGULATION OF THE HUMAN COMMON α- AND TSH-β–SUBUNIT GENE EXPRESSION

POSTTRANSLATIONAL PROCESSING OF THYROTROPIN

IN VITRO TRANSLATION OF THYROTROPIN-β–SUBUNIT AND α-SUBUNIT MESSENGER RNA

BIOSYNTHESIS OF THYROTROPIN IN INTACT CELLS

PROCESSING OF HIGH-MANNOSE PRECURSOR OLIGOSACCHARIDES

TERMINAL SULFATION AND SIALYLATION OF COMPLEX OLIGOSACCHARIDES

DEVELOPMENTAL AND ENDOCRINE REGULATION OF THYROTROPIN GLYCOSYLATION

BIOACTIVITY AND METABOLIC CLEARANCE OF THYROTROPIN

THREE-DIMENSIONAL CONFORMATION OF THYROTROPIN

RECOMBINANT HUMAN THYROTROPIN

REFERENCES

Chapter 10: The thyrotropin receptor

THE STRUCTURE OF THE THYROTROPIN RECEPTOR

THE THYROTROPIN RECEPTOR GENE

RECOGNITION OF THE RECEPTOR BY THYROTROPIN

PROPOSED MECHANISM OF ACTIVATION OF THE RECEPTOR BY TSH

ACTIVATION BY THYROSTIMULIN

ACTIVATION BY CHORIONIC GONADOTROPIN

ACTIVATION BY THYROTROPIN-RECEPTOR ANTIBODIES

ACTIVATION BY LOW–MOLECULAR-WEIGHT DRUG-LIKE CHEMICALS

DOWNREGULATION OF THE THYROTROPIN RECEPTOR

REFERENCES

Chapter 11: Aging and the thyroid

CHANGES IN THYROID ANATOMY WITH AGE

PHYSIOLOGIC CHANGES IN THYROID FUNCTION WITH AGE

CHALLENGES IN THE DIAGNOSIS AND MANAGEMENT OF THYROID DYSFUNCTION WITH AGE

CHALLENGES IN THE DIAGNOSIS AND MANAGEMENT OF NODULAR DISEASE AND THYROID CANCER

SUMMARY

REFERENCES

Chapter 12: Effects of drugs on TSH secretion, thyroid hormones’ absorption, synthesis, metabolism, and action

INTRODUCTION

DRUGS THAT ALTER SERUM TSH LEVELS (FIG. 12-1, PANEL 1)

DOPAMINE/DOPAMINE AGONISTS AND ANTAGONISTS

SOMATOSTATIN AND SOMATOSTATIN ANALOGS

REXINOIDS

OTHER DRUGS THAT SUPPRESS TSH SECRETION

DRUGS THAT REDUCE THYROID HORMONE ABSORPTION

BILE ACID SEQUESTRANTS

FERROUS SULFATE

SUCRALFATE AND ALUMINUM-CONTAINING ANTACIDS

CALCIUM CARBONATE AND PHOSPHATE BINDERS

OTHER MEDICATIONS THAT MAY REDUCE T4 INTESTINAL ABSORPTION

DRUGS THAT REDUCE SYNTHESIS AND SECRETION OF THYROID HORMONES (FIG. 12-1, PANEL 2)

THIONAMIDES (ANTITHYROID DRUGS)

IONIC INHIBITORS (PERCHLORATE, THIOCYANATE; SEE Chapter 13 ON THYROID DISRUPTORS)

LITHIUM

DRUGS THAT ALTER THE METABOLISM OF THYROID HORMONES (FIGS. 12-1, PANEL 3 AND 12-2)

DRUGS THAT INDUCE CYP3a (PHENYTOIN, CARBAMAZEPINE, PHENOBARBITAL, RIFAMPIN, RITONAVIR, SERTRALINE)

DRUGS THAT INHIBIT THE DEIODINATION OF T4 AND T3

PROPYLTHIOURACIL

PROPRANOLOL AND NADOLOL

DRUGS THAT ALTER THE TRANSPORT OR ACTION OF THYROID HORMONES (FIG. 12-1, PANEL 3)

NONSTEROIDAL ANTI-INFLAMMATORY DRUGS (SALICYLATES, SALSALATE, FENCLOFENAC)

FUROSEMIDE

HEPARIN AND FATTY ACIDS

ESTROGEN AND SELECTIVE ESTROGEN MODULATORS (SERM) (TAMOXIFEN, RALOXIFENE)

ANDROGENS

OTHER DRUGS ALTERING TBG LEVELS

DRUGS ACTING AT MULTIPLE SITES TO ALTER THYROID HORMONE HOMEOSTASIS

IODINATED RADIOGRAPHIC CONTRAST AGENTS

PHENYTOIN

AMIODARONE

GLUCOCORTICOIDS

CYTOKINES (INTERFERON, INTERLEUKIN, AND TUMOR NECROSIS FACTOR)

TYROSINE KINASE INHIBITORS

DRUGS ALTERING THYROID FUNCTION THROUGH ALTERATIONS IN IMMUNITY

IMMUNE RECONSTITUTION SYNDROME

ANTI-CD52 ANTIBODY ALEMTUZUMAB

CHECKPOINT INHIBITORS

REFERENCES

Chapter 13: Thyroid disruptors

INTRODUCTION

SUBSTANCES THAT INHIBIT THYROIDAL IODINE UPTAKE

PERCHLORATE

THIOCYANATE

NITRATE

COMPOUNDS WITH DIRECT ACTIONS ON THE THYROID HORMONE RECEPTOR

POLYCHLORINATED BIPHENYLS

POLYBROMINATED DIPHENYL ETHERS

BISPHENOL-A AND PHTHALATES

TRICLOSAN

COMPOUNDS THAT DISPLACE T4 FROM SERUM THYROID BINDING PROTEINS

PCBs AND PBDEs

COMPOUNDS THAT INHIBIT THYROPEROXIDASE ACTIVITY

ISOFLAVONES

COMPOUNDS THAT DECREASE T4 HALF-LIFE BY ACTIVATING HEPATIC ENZYMES

ORGANOCHLORINE PESTICIDES

DIOXINS AND FURANS

COMPOUNDS THAT INHIBIT DEIODINASE ACTIVITY

OTHER EXPOSURES

STYRENES

PERFLUORINATED AND GEN X COMPOUNDS

ORGANOPHOSPHATE PESTICIDES

SUNSCREENS

LEAD

SUMMARY

REFERENCES

Chapter 14: Nonthyroidal illness syndrome

INTRODUCTION

DESCRIPTION OF NTIS

CHANGES IN SERUM THYROID HORMONE AND THYROTROPIN CONCENTRATIONS

CHANGES IN THYROID HORMONE KINETICS

CHANGES IN THE HYPOTHALAMIC–PITUITARY–THYROID AXIS

CHANGES IN PERIPHERAL THYROID HORMONE METABOLISM

PATHOGENESIS OF NTIS

PATHOGENESIS OF CHANGES IN THE HYPOTHALAMIC–PITUITARY–THYROID AXIS

CHANGES IN HPT AXIS DURING FASTING

CHANGES IN HPT AXIS DURING ILLNESS

PATHOGENESIS OF CHANGES IN PERIPHERAL THYROID HORMONE METABOLISM

CHANGES IN SERUM IODOTHYRONINE–BINDING PROTEINS

CHANGES IN IODOTHYRONINE TRANSPORT INTO TISSUES

CHANGES IN IODOTHYRONINE DEIODINASES

CHANGES IN IODOTHYRONINE NUCLEAR RECEPTORS

CLINICAL RELEVANCE OF NTIS

PROGNOSTIC IMPORTANCE OF NTIS

DIAGNOSIS OF THYROID DISEASE IN NTIS

TREATMENT OF PATIENTS WITH NTIS

SPECIFIC TYPES OF NTIS

CHRONIC RENAL FAILURE

LIVER DISEASE

HUMAN IMMUNODEFICIENCY VIRUS INFECTION

PSYCHIATRIC DISEASE

CONCLUSION

REFERENCES

Chapter 15: Iodine deficiency and excess, endemic cretinism

INTRODUCTION

THE ECOLOGY OF IODINE

DIETARY SOURCES, ABSORPTION, AND METABOLISM OF IODINE

GOITROGENS

IODINE REQUIREMENTS

ADULTHOOD

PREGNANCY AND LACTATION

INFANCY AND CHILDHOOD

ASSESSMENT OF IODINE DEFICIENCY

URINARY IODINE CONCENTRATION

BREAST MILK IODINE CONCENTRATION

THYROID SIZE

THYROID-STIMULATING HORMONE AND THYROID HORMONES

THYROGLOBULIN

EFFECTS OF IODINE DEFICIENCY

THYROIDAL ADAPTATION TO IODINE DEFICIENCY

EFFECTS OF HYPOTHYROIDISM DUE TO IODINE DEFICIENCY ON THE DEVELOPING BRAIN

CRETINISM

THE BENEFITS OF CORRECTION OF IODINE DEFICIENCY

IODINE INTERVENTIONS IN SEVERELY DEFICIENT PREGNANT WOMEN

IODINE INTERVENTIONS IN MILD TO MODERATELY DEFICIENT PREGNANT WOMEN

INFANCY

CHILDHOOD

ADULTHOOD

THYROID CANCER

EPIDEMIOLOGY

TREATMENT AND PREVENTION

SALT FORTIFICATION WITH IODINE

IODINE SUPPLEMENTATION

EFFECTS OF EXCESS IODIDE

PHYSIOLOGIC RESPONSE TO EXCESS IODIDE

TOLERABLE UPPER LIMITS FOR IODINE INTAKE

MONITORING OF IODINE EXCESS IN POPULATIONS

SOURCES OF EXCESS IODIDE

IODINE-INDUCED HYPOTHYROIDISM OR GOITER IN THE ABSENCE OF APPARENT UNDERLYING THYROID DISEASE

IODINE AND THYROIDITIS

IODINE-INDUCED THYROTOXICOSIS

AMIODARONE-INDUCED THYROID DISEASE (SEE Chapter 11)

REFERENCES

Section II: Assessment of Thyroid Structure and Function

Chapter 16: Physical examination of the thyroid gland

HISTORY

PHYSICAL EXAMINATION

INSPECTION

PALPATION

FACING THE PATIENT

STANDING BEHIND THE PATIENT

AUSCULTATION

PALPATING LOBES AND EVALUATING THYROID SIZE

THYROID NODULES

HEMIAGENESIS

CONSISTENCY

PAIN/TENDERNESS

LYMPHADENOPATHY

DISTINGUISHING BENIGN FROM MALIGNANT DISEASE

REFERENCES

Chapter 17: Laboratory measurement of thyroid-related hormones, proteins, and autoantibodies in serum

INTRODUCTION

NOMENCLATURE FOR SENSITIVITY AND ASSESSMENT OF ASSAYS

FUNCTIONAL VERSUS ANALYTICAL SENSITIVITY OF ASSAYS

THYROID-STIMULATING HORMONE

METHODS FOR SERUM TSH MEASUREMENTS

REQUIREMENTS FOR SERUM TSH MEASUREMENTS

TSH ISOFORMS

INDICATIONS FOR TRH TESTING

TSH REFERENCE INTERVALS

THE CLINICAL UTILITY OF TSH MEASUREMENT

TSH AND THYROID FUNCTION ASSESSMENT IN PREGNANCY (SEE Chapter 66)

HOSPITALIZED PATIENTS

THYROID HORMONE MEASUREMENTS

SERUM TOTAL THYROID HORMONE (TT4 AND TT3) ASSAY METHODOLOGY

CLINICAL UTILITY OF TT4 AND TT3 MEASUREMENTS

TT4 AND TT3 REFERENCE INTERVALS

SERUM FREE THYROID HORMONE TESTS (FT4 AND FT3)

DIRECT FT4 AND FT3 METHODS

INDIRECT FT4 AND FT3 ESTIMATE TESTS

SERUM-FREE THYROXINE AND FREE TRIIODOTHYRONINE INDEXES

THYROID HORMONE–BINDING PROTEINS

FAMILIAL DYSALBUMINEMIC AND TRANSTHYRETIN-ASSOCIATED HYPERTHYROXINEMIAS

SERUM THYROGLOBULIN (Tg)

REQUIREMENTS FOR SERUM Tg METHODS

FACTORS THAT INFLUENCE CIRCULATING Tg CONCENTRATIONS

ANALYTICAL AND TECHNICAL CONSIDERATION

THYROID-SPECIFIC AUTOANTIBODIES

ANTI–TSH RECEPTOR AUTOANTIBODIES

ANTITHYROID PEROXIDASE AUTOANTIBODIES

ANTITHYROGLOBULIN AUTOANTIBODIES

INTERFERENCES WITH THYROID TEST OUTCOMES

INTERFERENCES WITH THYROID MEASUREMENT METHODOLOGIES

ASSAY INTERFERENCES

AUTOMATION OF THYROID TESTS

REFERENCES

Chapter 18: Nonisotopic thyroid imaging

INTRODUCTION

PLAIN RADIOGRAPHY

ULTRASONOGRAPHY

BASIC PHYSICS AND TECHNICAL PRINCIPLES (1)

CONDUCTING THE EXAMINATION

CLINICAL APPLICATIONS

DEVELOPMENTAL ABNORMALITIES

THE NORMAL THYROID GLAND

GOITER

DIFFUSE NONNEOPLASTIC THYROID DISEASES

NODULES AND MULTINODULAR GOITER

INTERVENTIONAL PROCEDURES

COMPUTED TOMOGRAPHY

BASIC PHYSICS PRINCIPLES (22)

THE NORMAL THYROID GLAND

DIFFUSE THYROID DISEASE

INCIDENTALOMAS

CT IN LARGE BENIGN GOITERS

ECTOPIC THYROID TISSUE

CT AND PREOPERATIVE PLANNING OF THYROID CARCINOMAS, LYMPHOMAS, AND METASTASIS

CT AND FOLLOW-UP OF THYROID CARCINOMAS

MAGNETIC RESONANCE IMAGING

BASIC PHYSICS PRINCIPLES (41)

NORMAL THYROID TISSUE

DIFFUSE THYROID DISEASE

THYROID INCIDENTALOMAS AND NODULE CHARACTERIZATION

PREOPERATIVE PLANNING OF THYROID CARCINOMAS: ASSESSING INVASION (48)

FOLLOW-UP OF THYROID CARCINOMAS

CONCLUSION

REFERENCES

Chapter 19: Thyroid radionuclide uptake and imaging studies

INTRODUCTION

RADIOPHARMACEUTICALS

MODALITIES

RADIOIODINE

UPTAKE STUDIES

PLANAR IMAGING: HYPERTHYROIDISM

PLANAR IMAGING: THYROID CANCER

TOMOGRAPHY

DOSIMETRY

FDG PET/CT IN THYROID CANCER

FDG PET/CT IN INCIDENTAL THYROID DISEASE

IMAGING OF MEDULLARY THYROID CANCER

CONCLUSIONS

REFERENCES

Chapter 20: Cytopathology of the thyroid gland

INTRODUCTION

SPECIMEN PREPARATIONS

THYROID FNA CLASSIFICATION

NONDIAGNOSTIC OR UNSATISFACTORY (CATEGORY I)

BENIGN (CATEGORY II)

ATYPIA OF UNDETERMINED SIGNIFICANCE/FOLLICULAR LESION OF UNDETERMINED SIGNIFICANCE (AUS/FLUS) (CATEGORY III)

FOLLICULAR OR ONCOCYTIC (HüRTHLE-CELL) NEOPLASM OR SUSPICIOUS FOR FOLLICULAR OR ONCOCYTIC (HüRTHLE-CELL) NEOPLASM (CATEGORY IV)

SUSPICIOUS FOR MALIGNANCY (CATEGORY V)

MALIGNANT (CATEGORY VI)

CORE NEEDLE BIOPSY

KEY CYTOMORPHOLOGIC FEATURES OF THYROID FINE-NEEDLE ASPIRATION DIAGNOSES

DIFFUSE TOXIC GOITER

CHRONIC LYMPHOCYTIC THYROIDITIS (11,15)

ATYPIA OF UNDETERMINED SIGNIFICANCE/FOLLICULAR LESION OF UNDETERMINED SIGNIFICANCE (AUS/FLUS)

SUSPICIOUS FOR FOLLICULAR NEOPLASM/FOLLICULAR NEOPLASM (INCLUDING TUMORS WITH ONCOCYTIC FEATURES)

MALIGNANT LESIONS

PAPILLARY THYROID CARCINOMA AND ITS VARIANTS

MEDULLARY THYROID CARCINOMA

POORLY DIFFERENTIATED CARCINOMA

ANAPLASTIC CARCINOMA

ROLE OF ANCILLARY STUDIES IN THE DIAGNOSIS OF THYROID TUMORS IN CYTOLOGIC SPECIMENS’ IMMUNOHISTOCHEMISTRY

REFERENCES

Chapter 21: Histopathology of the thyroid gland

NORMAL THYROID

PATHOLOGIC DIAGNOSIS OF THYROID LESIONS

DEVELOPMENTAL VARIATIONS

GOITER

GRAVES DISEASE/DIFFUSE TOXIC GOITER

DYSHORMONOGENETIC GOITER

IATROGENIC AND RELATED HYPERPLASIAS

AUTOIMMUNE THYROIDITIS

SILENT THYROIDITIS

SPECIFIC INFECTIOUS THYROIDITIS

GRANULOMATOUS THYROIDITIS

PALPATION THYROIDITIS

AMIODARONE INJURY WITH THYROTOXICOSIS

RIEDEL THYROIDITIS (AKA RIEDEL STRUMA)

COMBINED RIEDEL STRUMA AND FIBROSING HASHIMOTO THYROIDITIS

MISCELLANEOUS DISORDERS

RADIATION EFFECTS

AMYLOIDOSIS

BLACK THYROID

NEOPLASMS

BENIGN NEOPLASMS

ADENOMAS AND ADENOMATOUS NODULES

MALIGNANT NEOPLASMS

PAPILLARY CARCINOMA

FOLLICULAR CARCINOMA

HÜRTHLE-CELL NEOPLASM/ONCOCYTIC FOLLICULAR NEOPLASM

PATHOLOGIC DIAGNOSIS OF PAPILLARY AND FOLLICULAR CARCINOMA OF THYROID: CONTROVERSIES

CLEAR CELL TUMORS

HIGH-GRADE THYROID CARCINOMA

POORLY DIFFERENTIATED THYROID CARCINOMA

ANAPLASTIC CARCINOMA

SQUAMOUS CELL CARCINOMA, MUCOEPIDERMOID CARCINOMA, AND INTRATHYROIDAL THYMOMA-LIKE NEOPLASMS

MEDULLARY THYROID CARCINOMA

CALCITONIN NEGATIVE NEUROENDOCRINE CARCINOMA OF THYROID

LYMPHOMA

SARCOMA

CARCINOMA IN ECTOPIC THYROID TISSUE

METASTATIC NEOPLASMS

REFERENCES

Section III: Thyroid Diseases: Thyrotoxicosis

A. Causes of Thyrotoxicosis

Chapter 22: Pathogenesis of Graves disease

INTRODUCTION

AUTOIMMUNITY

DEFINITION OF AN AUTOANTIGEN

THE NATURE OF T CELLS

ANTIBODY AND T-CELL INTERACTIONS WITH ANTIGEN

SECOND SIGNALS

CRITERIA FOR AN AUTOIMMUNE DISEASE

RESTRICTION VERSUS POLYCLONALITY

THYROID IMMUNOLOGY

INTRATHYROIDAL B CELLS

AUTOANTIBODIES TO THE HUMAN TSHR

BIOACTIVITY OF TSHR ANTIBODIES

PREVALENCE OF TSHR ANTIBODIES IN GRAVES DISEASE

IMMUNOLOGIC CHARACTERISTICS OF TSHR ANTIBODIES

TSHR FUNCTION IN GRAVES DISEASE

LESSONS FROM MONOCLONAL TSHR ANTIBODIES WITH STIMULATING ACTIVITY

OTHER THYROID ANTIBODIES IN GRAVES DISEASE

THE INTRATHYROIDAL LYMPHOCYTIC INFILTRATE

FUNCTIONAL ANALYSIS OF INTRATHYROIDAL T CELLS

T-CELL SELECTION

APOPTOSIS IN GRAVES DISEASE

THE INTRATHYROIDAL T-CELL RECEPTOR V GENE REPERTOIRE

REGULATORY EFFECTS OF T CELLS IN AUTOIMMUNE THYROID DISEASE

THE Th17 CELLS

IMMUNE MECHANISMS IN THE PATHOGENESIS OF GRAVES DISEASE

FAILURE OF IMMUNE CELL DELETION AND/OR SUPPRESSION

SPECIFICITY CROSSOVER (MOLECULAR MIMICRY)

BYSTANDER EFFECTS

EPIGENETIC CHANGES

THYROID CELL EXPRESSION OF HLA MOLECULES

ANIMAL MODELS OF GRAVES DISEASE

KNOWN RISK FACTORS FOR PRECIPITATING GRAVES DISEASE (TABLE 22-5)

SUSCEPTIBILITY GENES

INFECTION

THYROID AUTOANTIBODIES

THYROID TISSUE DAMAGE

STRESS

SEX STEROIDS

THE X CHROMOSOME

THE POSTPARTUM PERIOD

MATERNAL MICROCHIMERISM

IODINE

IRRADIATION

OVERVIEW OF THE ETIOLOGY OF GRAVES DISEASE

REFERENCES

Chapter 23: Thyrotropin-induced thyrotoxicosis

INTRODUCTION

EPIDEMIOLOGY

PATHOLOGIC AND PATHOGENIC ASPECTS

SIGNS AND SYMPTOMS

LABORATORY AND BIOCHEMICAL FEATURES

SERUM THYROTROPIN AND THYROID HORMONE LEVELS

PITUITARY GLYCOPROTEIN HORMONE α-SUBUNIT

PARAMETERS OF PERIPHERAL THYROID HORMONE ACTION

DIAGNOSTIC TESTING

IMAGING STUDIES AND LOCALIZATION

DIFFERENTIAL DIAGNOSIS

TREATMENT AND OUTCOME

CRITERIA OF CURE AND FOLLOW-UP

REFERENCES

Chapter 24: Toxic adenoma and toxic multinodular goiter

EPIDEMIOLOGY

CLINICAL ASPECTS OF THYROID AUTONOMY

DIAGNOSIS OF THYROID AUTONOMY

NATURAL HISTORY

MORPHOLOGY

ETIOLOGY

LESSONS FROM EPIDEMIOLOGIC STUDIES

FROM HYPERPLASTIC GROWTH TO NODULAR TRANSFORMATION

TRANSFORMATION TO HOT THYROID NODULES

TREATMENT OF AUTONOMOUS THYROID NODULES (SEE CHAPTER 32)

SURGERY

RADIOIODINE THERAPY

COST-EFFECTIVE MANAGEMENT OF THYROID AUTONOMY

FOLLOW-UP

ACKNOWLEDGMENT

REFERENCES

Chapter 25: Trophoblastic tumors

INTRODUCTION

HUMAN CHORIONIC GONADOTROPIN

GRADATIONS OF SEVERITY

CLINICAL FEATURES

DIAGNOSIS

HYPEREMESIS GRAVIDARUM

MUTANT THYROID-STIMULATING HORMONE RECEPTOR

THERAPY

REFERENCES

Chapter 26: Sporadic painless, painful subacute and acute infectious thyroiditis

INTRODUCTION

DESTRUCTION-INDUCED THYROIDITIS

PAINFUL THYROID

SPORADIC PAINLESS THYROIDITIS

ETIOLOGY

CLINICAL MANIFESTATIONS

LABORATORY FINDINGS

CYTOLOGY

IMAGING

PATHOLOGY

DIFFERENTIAL DIAGNOSIS

CLINICAL MANAGEMENT

SUBACUTE THYROIDITIS

ETIOLOGY

INFECTIOUS ASSOCIATION

AUTOIMMUNE ASSOCIATION

GENETIC ASSOCIATION

CLINICAL MANIFESTATIONS

LABORATORY FINDINGS

CYTOLOGY

IMAGING

PATHOLOGY

DIFFERENTIAL DIAGNOSIS

CLINICAL MANAGEMENT

ACUTE INFECTIOUS THYROIDITIS

ETIOLOGY

BACTERIAL INFECTIONS

FUNGAL INFECTIONS

MYCOBACTERIAL INFECTIONS

PARASITIC INFECTIONS

SYPHILITIC INFECTIONS

THYROIDAL INFECTIONS IN IMMUNOCOMPROMISED PATIENTS

CLINICAL MANIFESTATIONS

LABORATORY FINDINGS

CYTOLOGY

IMAGING STUDIES

CLINICAL MANAGEMENT

REFERENCES

Chapter 27: Thyrotoxicosis of extrathyroidal origin

INTRODUCTION

EXOGENOUS THYROID HORMONE

CAUSES

CLINICAL PRESENTATION AND DIAGNOSIS

TREATMENT

THYROTOXICOSIS DUE TO METASTATIC THYROID CARCINOMA

DEFINITION AND EPIDEMIOLOGY

CLINICAL PRESENTATION AND DIAGNOSIS

TREATMENT

STRUMA OVARII

DEFINITION AND EPIDEMIOLOGY

CLINICAL PRESENTATION AND DIAGNOSIS

TREATMENT

ACKNOWLEDGMENT

REFERENCES

B. Organ System Manifestations

Chapter 28: Overview of the clinical manifestations of thyrotoxicosis

INTRODUCTION

PREVALENCE OF CLINICAL FINDINGS

ORGAN SYSTEM–SPECIFIC MANIFESTATIONS

CENTRAL NERVOUS SYSTEM

BEHAVIORAL HEALTH MANIFESTATIONS

CARDIOVASCULAR MANIFESTATIONS

PULMONARY MANIFESTATIONS

GASTROINTESTINAL MANIFESTATIONS

RENAL MANIFESTATIONS

INTEGUMENTARY FINDINGS

MUSCULOSKELETAL MANIFESTATIONS

REPRODUCTIVE CHANGES

HEMATOLOGIC MANIFESTATIONS

MODULATING FACTORS

AGE

PREGNANCY

COMORBIDITY

ETIOLOGY OF THYROTOXICOSIS

CLINICAL ASSESSMENT

REFERENCES

Chapter 29: Ophthalmopathy

INTRODUCTION

EPIDEMIOLOGY AND NATURAL HISTORY

PATHOGENESIS

RISK FACTORS AND PREVENTION

CLINICAL PRESENTATION

DIAGNOSIS

TREATMENT OF HYPERTHYROIDISM IN PATIENTS WITH GO

MANAGEMENT OF GO

CONCLUSIONS

REFERENCES

Chapter 30: The cardiovascular system in thyrotoxicosis

THYROID HORMONE ACTION ON THE HEART AND VASCULAR SYSTEM

CLINICAL CONSEQUENCES OF THYROTOXICOSIS

CARDIOVASCULAR SYMPTOMS AND SIGNS IN THYROTOXICOSIS

ATRIAL FIBRILLATION

ELECTROCARDIOGRAPHIC CHANGES

HEART FAILURE

HYPERTENSION AND VASCULAR DYSFUNCTION

MAJOR ADVERSE CARDIOVASCULAR EVENTS

ROLE OF OTHER HORMONES IN THYROTOXICOSIS

SUBCLINICAL THYROTOXICOSIS

AMIODARONE AND IODINE CONTAINING CONTRAST AGENTS

REFERENCES

Chapter 31: Thyroid hormones in intermediary metabolism, thermogenesis, and obesity

THYROID HORMONE SIGNALING, TISSUE- AND TARGET GENE–SPECIFICITY IN RELATION TO INTERMEDIARY AND ENERGY METABOLISM

THYROID HORMONE ACTION ON INTERMEDIARY METABOLISM

CARBOHYDRATE METABOLISM

CLINICAL CORRELATES

PROTEIN METABOLISM

CLINICAL CORRELATES

LIPID METABOLISM

CLINICAL CORRELATES

THYROID HORMONE ACTION ON ENERGY METABOLISM

THYROID HORMONE ACTION ON RESTING ENERGY EXPENDITURE

THYROID HORMONE ACTION ON ADAPTIVE THERMOGENESIS

THYROID HORMONE ACTION ON ACTIVITY-RELATED ENERGY EXPENDITURE

THYROID HORMONE ACTION ON THERMIC EFFECT OF FOOD

ENERGY STATUS AND THYROID HORMONE HOMEOSTASIS

CLINICAL CORRELATES

POTENTIAL USE OF THYROID HORMONE AS TREATMENT FOR WEIGHT LOSS AND DYSLIPIDEMIA

CONCLUSIONS

ACKNOWLEDGMENTS

REFERENCES

Chapter 32: The skeletal system in thyrotoxicosis

REGULATION OF THYROID STATUS

CONTROL OF INTRACELLULAR T3 AVAILABILITY

MECHANISM OF THYROID HORMONE ACTION

ROLE OF TSH IN BONE

BONE REMODELING CYCLE

SKELETAL CONSEQUENCES OF CHILDHOOD THYROTOXICOSIS

SKELETAL EFFECTS OF THYROID HORMONES IN ADULTS

POPULATION STUDIES IN NORMAL EUTHYROID INDIVIDUALS

STUDIES OF ADULT THYROTOXICOSIS

EFFECTS OF TREATMENT FOR THYROTOXICOSIS

SUBCLINICAL HYPERTHYROIDISM

PATIENTS TREATED WITH SUPPRESSIVE DOSES OF THYROXINE

REFERENCES

Chapter 33: Thyroid dermopathy and thyroid acropachy

THYROID DERMOPATHY

HISTOLOGIC FINDINGS IN THYROID DERMOPATHY

CLINICAL MANIFESTATIONS

PATHOGENESIS

DIFFERENTIAL DIAGNOSIS

TREATMENT

OUTCOMES OF THERAPY OF THYROID DERMOPATHY

FUTURE DIRECTIONS FOR THERAPY

THYROID ACROPACHY

REFERENCES

Chapter 34: Psychiatric and cognitive effects of thyrotoxicosis

INTRODUCTION

NEUROPSYCHIATRIC MANIFESTATIONS OF OVERT THYROTOXICOSIS

COGNITIVE MANIFESTATIONS OF OVERT THYROTOXICOSIS

SUBCLINICAL THYROTOXICOSIS: NEUROPSYCHIATRIC AND COGNITIVE ASPECTS

DIFFERENTIAL DIAGNOSIS: BEHAVIORAL SYNDROMES THAT MAY MIMIC THYROTOXICOSIS

PSYCHOLOGICAL FACTORS IN THE PATHOPHYSIOLOGY OF THYROTOXICOSIS

TREATMENT OF THYROTOXICOSIS: NEUROPSYCHIATRIC ASPECTS

POSSIBLE LINK BETWEEN THYROID HORMONE AND ATTENTION DEFICIT/HYPERACTIVITY DISORDER

USE OF THYROID HORMONE IN AFFECTIVE DISORDERS

LITHIUM AND THYROID FUNCTION

REFERENCES

Chapter 35: Thyrotoxic storm

CLINICAL FEATURES

LABORATORY FINDINGS

PATHOGENESIS

TREATMENT

THERAPY TO REDUCE THYROID HORMONE SYNTHESIS AND SECRETION

THERAPY DIRECTED AGAINST SYSTEMIC DISTURBANCES

THERAPY DIRECTED AGAINST THE PERIPHERAL ACTIONS OF THYROID HORMONE

THERAPY DIRECTED AGAINST PRECIPITATING ILLNESS

REFERENCES

C. Diagnosis and Management of Thyrotoxicosis

Chapter 36: Diagnosis of thyrotoxicosis

INTRODUCTION

CLINICAL DIAGNOSIS

CLUES FROM ROUTINE LABORATORY TESTS

LABORATORY TESTING FOR THYROTOXICOSIS

SERUM THYROXINE DETERMINATIONS

SERUM TRIIODOTHYRONINE DETERMINATIONS

SERUM THYROTROPIN DETERMINATIONS

SCREENING, CASE FINDING, AND DIAGNOSIS

DIAGNOSING THE CAUSE OF THYROTOXICOSIS

REFERENCES

Chapter 37: Treatment of thyrotoxicosis

INTRODUCTION

THYROTOXICOSIS CAUSED BY GRAVES DISEASE

DRUG THERAPY OF THYROTOXICOSIS CAUSED BY GRAVES DISEASE

ANTITHYROID DRUGS (Fig. 37-1)

MECHANISMS OF ACTION

INTRATHYROIDAL ACTIONS

EXTRATHYROIDAL ACTIONS

EFFECTS ON THE IMMUNE SYSTEM

CLINICAL PHARMACOLOGY OF THE ANTITHYROID DRUGS

METHIMAZOLE

PROPYLTHIOURACIL

CLINICAL CONSIDERATIONS IN THE USE OF ANTITHYROID DRUGS

SIDE EFFECTS OF ANTITHYROID DRUGS

FOLLOW-UP OF PATIENTS TAKING AN ANTITHYROID DRUG FOR GRAVES DISEASE

REMISSIONS AND ANTITHYROID DRUG THERAPY

THERAPY FACTORS RELATING TO REMISSION OF GRAVES DISEASE

DISCONTINUATION OF ANTITHYROID DRUG THERAPY

OTHER DRUGS USED IN THE TREATMENT OF THYROTOXICOSIS CAUSED BY GRAVES DISEASE

INORGANIC IODIDE

ORAL CHOLECYSTOGRAPHIC AGENTS

β-ADRENERGIC ANTAGONIST DRUGS

RADIOACTIVE IODINE THERAPY FOR THYROTOXICOSIS (Fig. 37-1)

PRACTICAL THERAPEUTIC CONSIDERATIONS

COMPLICATIONS AND POTENTIAL RISKS OF RADIOIODINE THERAPY

POSTRADIOIODINE WORSENING OF THYROID FUNCTION

RADIOIODINE THERAPY AND GRAVES OPHTHALMOPATHY

INDICATIONS FOR RADIOIODINE THERAPY

SURGICAL THERAPY FOR THYROTOXICOSIS (Fig. 37-1)

SPECIAL CONSIDERATIONS IN THE TREATMENT OF THYROTOXICOSIS

TREATMENT OF CHILDREN AND ADOLESCENTS

TREATMENT OF ELDERLY PATIENTS

THYROTOXICOSIS IN PREGNANT WOMEN AND DURING LACTATION

THYROTOXIC STORM

THYROTOXICOSIS DUE TO TOXIC ADENOMA AND MULTINODULAR GOITER

TOXIC ADENOMA

TOXIC MULTINODULAR GOITER

REFERENCES

Chapter 38: Subclinical thyrotoxicosis

ETIOLOGY

ENDOGENOUS SUBCLINICAL THYROTOXICOSIS

EXOGENOUS SUBCLINICAL THYROTOXICOSIS

EVALUATION

DIFFERENTIAL DIAGNOSIS

EPIDEMIOLOGY AND NATURAL HISTORY

CLINICAL AND BIOLOGIC IMPORTANCE

PHYSIOLOGY OF SUPPRESSION OF TSH SECRETION

CARDIOVASCULAR CONSEQUENCES

BONE AND MINERAL METABOLISM

COGNITIVE DYSFUNCTION AND DEMENTIA

TREATMENT

CHOICE OF TREATMENT MODALITY

SIDE EFFECTS OF TREATMENT FOR SUBCLINICAL THYROTOXICOSIS

FUTURE DIRECTIONS

REFERENCES

Section IV: Thyroid Diseases: Hypothyroidism

A. Causes of Hypothyroidism

Chapter 39: Chronic autoimmune thyroiditis

INTRODUCTION

PREDISPOSITION TO CHRONIC AUTOIMMUNE THYROIDITIS

PATHOGENESIS OF CHRONIC AUTOIMMUNE THYROIDITIS

ANTIGEN PRESENTATION

T-CELL RESPONSES

B-CELL RESPONSES

EFFECTOR MECHANISMS

EXPERIMENTAL AUTOIMMUNE THYROIDITIS

CLINICAL ASPECTS

ASSOCIATED DISORDERS

REFERENCES

Chapter 40: Genetic defects causing hypothyroidism

MONOGENIC CAUSES OF THYROID DYSGENESIS

KEY TRANSCRIPTION FACTOR MUTATIONS IN TD

NKX2-1

PAX8

FOXE1

GLIS3

TSHR

ADDITIONAL GENES ASSOCIATED WITH TD

NKX2-5

JAG1

CDCA8 (BOREALIN)

TUBB1

NETRIN 1 (NTN1)

SYNDROMES WHICH MAY BE ASSOCIATED WITH CH

GENETIC CAUSES OF DYSHORMONOGENESIS

THYROGLOBULIN

TPO

DUOX2 AND DUOXA2

IYD (PREVIOUSLY KNOWN AS DEHAL1)

SLC5A5 (NIS)

SLC26A4 (PENDRIN)

SLC26A7

EVIDENCE FOR AN UNDIAGNOSED GENETIC COMPONENT IN TD

REFERENCES

Chapter 41: Primary hypothyroidism due to other causes

INTRODUCTION

RADIOACTIVE IODINE (131I THERAPY)

THYROIDECTOMY

TREATMENT OF TOXIC NODULAR GOITER

TREATMENT OF NONTOXIC NODULAR GOITER

EXTERNAL RADIATION

HYPOTHYROIDISM DUE TO THERAPEUTIC PHARMACOLOGIC AGENTS

LITHIUM CARBONATE

CYTOKINES

AMIODARONE

TYROSINE KINASE INHIBITORS

IMMUNE CHECKPOINT INHIBITORS

OTHER DRUGS

HYPOTHYROIDISM DUE TO INFILTRATIVE DISORDERS

RIEDEL THYROIDITIS (INVASIVE FIBROUS THYROIDITIS)

AMYLOIDOSIS

SARCOIDOSIS

SCLERODERMA

HEMOCHROMATOSIS

CYSTINOSIS

OTHER INFILTRATIVE OR INFECTIOUS DISORDERS (SEE CHAPTER 22)

PRIMARY THYROID LYMPHOMA

CONSUMPTIVE HYPOTHYROIDISM

INDUSTRIAL AND ENVIRONMENTAL AGENTS (SEE CHAPTER 12)

EMBRYOLOGIC VARIANTS

LINGUAL THYROID (SEE CHAPTER 63)

REFERENCES

Chapter 42: Central hypothyroidism

INTRODUCTION

EPIDEMIOLOGY

PATHOGENESIS

CLINICAL FEATURES AND DIAGNOSIS

TREATMENT OF CeH

REFERENCES

B. Organ System Manifestations of Hypothyroidism

Chapter 43: Overview of the clinical manifestations of hypothyroidism

INTRODUCTION

CLINICAL MANIFESTATIONS

OVERT HYPOTHYROIDISM

SUBCLINICAL HYPOTHYROIDISM

CARDIOVASCULAR DISEASE AND MORTALITY

PULMONARY SYSTEM

NEUROPSYCHIATRIC FEATURES

MUSCULOSKELETAL SYSTEM

INFECTIOUS COMPLICATIONS

SKIN AND CONNECTIVE TISSUE

KIDNEYS AND ELECTROLYTE METABOLISM

GASTROINTESTINAL TRACT AND LIVER

HEMATOLOGY AND HEMOSTASIS

PITUITARY DISORDERS IN HYPOTHYROIDISM

ADRENAL DISORDERS IN HYPOTHYROIDISM

SUMMARY

REFERENCES

Chapter 44: Hypothyroidism and the heart

CLINICAL CONSEQUENCES OF HYPOTHYROIDISM

CV SYMPTOMS AND SIGNS

ELECTROCARDIOGRAPHIC CHANGES IN HYPOTHYROIDISM

CORONARY ARTERY DISEASE IN HYPOTHYROIDISM

CV RISK FACTORS IN HYPOTHYROIDISM

LIPIDS

BLOOD PRESSURE AND VASCULAR DYSFUNCTION

THROMBOGENESIS

SUBCLINICAL HYPOTHYROIDISM

SPECIAL SITUATIONS IN HYPOTHYROIDISM RELATED TO THE HEART

POSTACUTE MYOCARDIAL INFARCTION

HEART FAILURE

TREATMENT OF HYPOTHYROIDISM IN PATIENTS WITH CORONARY ARTERY DISEASE

CARDIAC SURGERY AND CARDIAC TRANSPLANTATION PROCEDURES

REFERENCES

Chapter 45: The skeletal system in hypothyroidism

PHYSIOLOGIC CONTROL OF THYROID HORMONE ACTION

THYROID HORMONE TRANSPORT AND METABOLISM IN BONE

THYROID HORMONE RECEPTOR FUNCTION IN BONE

ROLE OF TSH ON SKELETAL GROWTH AND MATURATION

SKELETAL DEVELOPMENT

SKELETAL CONSEQUENCES OF CHILDHOOD HYPOTHYROIDISM

SKELETAL CONSEQUENCES OF IMPAIRED SENSITIVITY TO THYROID HORMONE

SKELETAL CONSEQUENCES OF ADULT HYPOTHYROIDISM

A POSSIBLE ROLE FOR THYROID HORMONE SIGNALING IN OSTEOARTHRITIS

REFERENCES

Chapter 46: Psychiatric and cognitive effects of hypothyroidism

INTRODUCTION

PSYCHIATRIC AND COGNITIVE EFFECTS OF OVERT HYPOTHYROIDISM

PSYCHIATRIC AND COGNITIVE EFFECTS OF SUBCLINICAL HYPOTHYROIDISM

EFFECT OF THYROID FUNCTION VARIATIONS WITHIN THE NORMAL RANGE ON MOOD AND COGNITION

HASHIMOTO ENCEPHALOPATHY

REFERENCES

Chapter 47: Myxedema Coma

INTRODUCTION

CLINICAL FEATURES: PRECIPITATING EVENTS

GENERAL DESCRIPTION

HYPOTHERMIA

RESPIRATORY SYSTEM

CARDIOVASCULAR MANIFESTATIONS

GASTROINTESTINAL MANIFESTATIONS

RENAL AND ELECTROLYTE MANIFESTATIONS

NEUROPSYCHIATRIC MANIFESTATIONS

INFECTIONS

DIAGNOSIS

TREATMENT

VENTILATORY SUPPORT

HYPONATREMIA

HYPOTHERMIA

HYPOTENSION

GLUCOCORTICOID THERAPY

THYROID HORMONE THERAPY

COMMENTS

REFERENCES

C. Management of Hypothyroidism

Chapter 48: Diagnosis of hypothyroidism

INTRODUCTION

CLINICAL DIAGNOSIS

CLINICAL MANIFESTATIONS

PREDISPOSITION TO HYPOTHYROIDISM

CHRONIC AUTOIMMUNE THYROIDITIS AND HYPOTHYROIDISM

LABORATORY TESTING

SERUM THYROXINE DETERMINATIONS

SERUM TSH DETERMINATIONS

OTHER MEASURES OF THYROID HORMONE ACTION

SCREENING, CASE FINDING, AND DIAGNOSIS

DIAGNOSING THE CAUSE OF HYPOTHYROIDISM

FUTURE ADVANCES IN LABORATORY ASSESSMENT

REFERENCES

Chapter 49: Treatment of hypothyroidism

HISTORICAL PERSPECTIVE ON THE TREATMENT OF HYPOTHYROIDISM

LEVOTHYROXINE THERAPY

ENDPOINTS DURING LEVOTHYROXINE THERAPY

FACTORS AFFECTING LEVOTHYROXINE DOSE

INITIATION AND ADJUSTMENT OF LEVOTHYROXINE THERAPY

CHOICE OF LEVOTHYROXINE PRODUCT

LEVOTHYROXINE ABSORPTION, METABOLISM, AND TRANSPORT

LEVOTHYROXINE THERAPY IN SPECIFIC SUBPOPULATIONS

PATIENT SATISFACTION WITH LEVOTHYROXINE THERAPY

LEVOTHYROXINE THERAPY AND T3 LEVELS

THERAPIES OTHER THAN LEVOTHYROXINE

THYROID EXTRACTS

SYNTHETIC COMBINATION THERAPY

LIOTHYRONINE THERAPY

SUMMARY

REFERENCES

Chapter 50: Subclinical hypothyroidism

INTRODUCTION

ETIOLOGY AND NATURAL HISTORY

CLINICAL AND BIOLOGIC IMPORTANCE

CURRENT EVIDENCE

TREATMENT CONSIDERATIONS

TREATMENT RECOMMENDATIONS

CONCLUSIONS

REFERENCES

Section V: Thyroid Diseases: Nontoxic Diffuse and Multinodular Goiter

Chapter 51: Multinodular goiter: pathogenesis and management

INTRODUCTION

ETIOLOGY

EPIDEMIOLOGY

NATURAL HISTORY

CLINICAL MANIFESTATIONS

DIAGNOSIS EVALUATION

MANAGEMENT

IODINE SUPPLEMENTATION

TSH SUPPRESSIVE THERAPY WITH LEVOTHYROXINE

ANTITHYROID DRUGS

SURGERY

131I THERAPY

OTHER TREATMENT OPTIONS

SUMMARY

REFERENCES

Chapter 52: Clinical evaluation and management of thyroid nodules

CLINICAL EVALUATION

LABORATORY EVALUATION

SERUM HORMONE AND OTHER MEASUREMENTS

IMAGING STUDIES

ULTRASONOGRAPHY

ELASTOGRAPHY

RADIONUCLIDE THYROID SCINTIGRAPHY

OTHER IMAGING STUDIES

FINE-NEEDLE ASPIRATION BIOPSY

RISK STRATIFICATION FOR THYROID NODULES

TECHNIQUE OF FINE-NEEDLE BIOPSY

RESULTS OF FINE-NEEDLE BIOPSY

LIMITATIONS OF FINE-NEEDLE ASPIRATION BIOPSY OF THYROID NODULES

CLINICAL RECOMMENDATIONS BASED UPON FNA CYTOLOGY RESULTS

NONDIAGNOSTIC CYTOLOGY: BETHESDA I

BENIGN CYTOLOGY: BETHESDA II

ATYPIA OF UNDETERMINED SIGNIFICANCE/FOLLICULAR LESION OF UNDERMINED SIGNIFICANCE (AUS/FLUS) CYTOLOGY: BETHESDA III

FOLLICULAR NEOPLASM CYTOLOGY (INCLUDES HüRTHLE CELL NEOPLASM): BETHESDA IV

ROLE OF MOLECULAR TESTING FOR BETHESDA III AND IV NODULES

SUSPICIOUS FOR MALIGNANCY CYTOLOGY: BETHESDA V

MALIGNANT CYTOLOGY: BETHESDA VI

TREATMENT AFTER THYROID SURGERY

REFERENCES

Section VI: Thyroid Cancers

Chapter 53: Carcinomas of follicular epithelium: epidemiology and pathogenesis

RADIATION

EXTERNAL RADIATION AND THYROID CARCINOMA

INTERNAL RADIATION AND THYROID CARCINOMA

COMPARISON OF EXTERNAL AND INTERNAL RADIATION

PREVENTING IODINE 131–RELATED THYROID CARCINOMA

EVALUATION OF IRRADIATED PATIENTS

RADIATION AND OTHER HEAD AND NECK TUMORS

CLINICAL FEATURES OF RADIATION-RELATED THYROID NEOPLASMS

GENETIC PREDISPOSITION

SYNDROMIC NONMEDULLARY THYROID CARCINOMA

NONSYNDROMIC FAMILIAL NONMEDULLARY THYROID CARCINOMA (FNMTC)

GENETIC SUSCEPTIBILITY

PRE-EXISTING THYROID DISEASE

HORMONAL AND REPRODUCTIVE FACTORS

DIETARY FACTORS

IODINE AND GOITROGENS

OTHER DIETARY FACTORS

ANTHROPOMORPHIC AND METABOLIC FACTORS

SMOKING AND OTHER ENVIRONMENTAL AGENTS

SUMMARY

REFERENCES

Chapter 54: Genomic landscapes of thyroid cancers of follicular cell derivation

GENOMIC HALLMARKS OF NEOPLASMS ARISING FROM THYROID FOLLICULAR CELLS

FOLLICULAR NEOPLASMS

AUTONOMOUSLY FUNCTIONING ADENOMA

FOLLICULAR ADENOMA AND CARCINOMA

PAPILLARY CARCINOMA

NIFTP

RARE PTC VARIANTS

OTHER SOMATIC MUTATIONS

TERT PROMOTER MUTATIONS

SOMATIC COPY NUMBER ALTERATIONS

HÜRTHLE CELL NEOPLASMS

POORLY DIFFERENTIATED THYROID CANCER

ANAPLASTIC THYROID CANCER

GENETIC SUSCEPTIBILITY AND ENVIRONMENTAL FACTORS

DIAGNOSTIC IMPLICATIONS OF THYROID CANCER GENOMICS

REFERENCES

Chapter 55: Carcinoma of the follicular epithelium: surgical therapy

INTRODUCTION

THYROIDECTOMY NOMENCLATURE

EXTENT OF THYROIDECTOMY AND RISK OF COMPLICATIONS

SURGERY FOR INDETERMINATE THYROID NODULES

THYROIDECTOMY FOR THYROID CARCINOMA DERIVED FROM FOLLICULAR EPITHELIUM

CERVICAL LYMPH NODE DISSECTION NOMENCLATURE

EXTENT OF LYMPH NODE DISSECTION AND RISK OF COMPLICATIONS

LYMPHATIC DRAINAGE AND LOCATION OF NODAL METASTASIS IN THYROID CARCINOMA DERIVED FROM FOLLICULAR EPITHELIUM

CLINICAL ASPECTS OF NODAL METASTASIS IN THYROID CARCINOMA DERIVED FROM FOLLICULAR EPITHELIUM

PROGNOSIS OF NODAL METASTASIS IN THYROID CARCINOMA DERIVED FROM FOLLICULAR EPITHELIUM

CENTRAL LYMPH NODE DISSECTION

LATERAL LYMPH NODE DISSECTION

SUMMARY

REFERENCES

Chapter 56: Staging and prognosis of differentiated thyroid cancer

INTRODUCTION

STAGING TO PREDICT RISK OF THYROID CANCER DEATH

ELEMENTS AND COMPARISON OF PUBLISHED STAGING SYSTEMS

EVOLUTION OF THE TNM SYSTEM TO THE CURRENT 8TH EDITION

VALIDATION AND CONTROVERSIES IN 8TH EDITION TNM STAGING

PREDICTING THE RISK OF THYROID CANCER RECURRENCE

ELEMENTS OF INITIAL RISK STRATIFICATION SYSTEMS

VALIDATION AND CONTROVERSIES FOR INITIAL RISK SYSTEMS

DYNAMIC RISK STRATIFICATION/RESPONSE-TO-THERAPY

ELEMENTS OF DYNAMIC RISK STRATIFICATION

VALIDATION AND CONTROVERSIES FOR DYNAMIC RISK STRATIFICATION

HOW TO USE CURRENT RISK STRATIFICATION SYSTEMS IN PRACTICE

CONCLUSIONS

REFERENCES

Chapter 57: Medical management of differentiated epithelial cell thyroid cancer

RADIOACTIVE IODINE THERAPY

THE GOALS OF THE FIRST ADMINISTERED ACTIVITY OF RADIOACTIVE IODINE AFTER THYROIDECTOMY

ABLATION OF RESIDUAL NORMAL THYROID TISSUE

RAI TREATMENT AS AN ADJUVANT THERAPY

PREPARATION FOR RAI THERAPY

SELECTION OF RADIOACTIVE IODINE ACTIVITY FOR REMNANT ABLATION

WHOLE-BODY 131I SCANS AND SPECT/CT

RAI THERAPY FOR LOCAL OR DISTANT METASTATIC DISEASE

INDICATIONS FOR RAI THERAPY

TREATMENT OF PATIENTS WITH HIGH SERUM THYROGLOBULIN LEVELS AND NEGATIVE IMAGING STUDIES

COMPLICATIONS OF RAI THERAPY

FOLLOW-UP PARADIGMS

EARLY FOLLOW-UP RECOMMENDATIONS (FIRST YEAR AFTER INITIAL THERAPY)

FOLLOW-UP PARADIGMS BASED ON RESPONSE TO THERAPY RESTRATIFICATION

ONGOING, DYNAMIC RISK ASSESSMENT DURING LONG-TERM FOLLOW-UP

TSH-SUPPRESSIVE THYROID HORMONE THERAPY

EXTERNAL BEAM RADIOTHERAPY

SYSTEMIC THERAPY FOR ADVANCED DISEASE

BIOLOGICALLY TARGETED THERAPIES

CYTOTOXIC CHEMOTHERAPY

OTHER PALLIATIVE INTERVENTIONS FOR SYMPTOMATIC METASTATIC DTC

REFERENCES

Chapter 58: Papillary microcarcinomas

INCREASING INCIDENCE OF THYROID CANCER WITH STABLE MORTALITY

SURGERY OF PAPILLARY MICROCARCINOMA AND OUTCOMES

FREQUENT MULTIPLICITY AND REGIONAL LYMPH NODE METASTASIS

PROGNOSIS OF HIGH-RISK AND LOW-RISK PAPILLARY MICROCARCINOMA

SURGICAL APPROACH TO PMCs

ACTIVE SURVEILLANCE OF LOW-RISK PAPILLARY MICROCARCINOMA

HISTORY AND HYPOTHESIS

PROTOCOL OF THE ACTIVE SURVEILLANCE AT KUMA HOSPITAL

OUTCOMES OF ACTIVE SURVEILLANCE

EVALUATION OF THE RISK OF TRACHEA AND RECURRENT LARYNGEAL NERVE INVASION

INCIDENCES OF UNFAVORABLE EVENTS IN IMMEDIATE SURGERY VERSUS ACTIVE SURVEILLANCE

MEDICAL ECONOMY OF MANAGEMENT OF PAPILLARY MICROCARCINOMA

FACTORS THAT MIGHT BE ASSOCIATED WITH DISEASE PROGRESSION

NATURAL HISTORY OF PAPILLARY CARCINOMA

LIFETIME PROBABILITY OF DISEASE PROGRESSION

TUMOR VOLUME KINETICS DURING ACTIVE SURVEILLANCE

ESTIMATING TUMOR GROWTH BEFORE PRESENTATION

IMPLEMENTING ACTIVE SURVEILLANCE

REFERENCES

Chapter 59: Medullary thyroid cancer

NATURAL HISTORY

TUMOR PROGRESSION

PREOPERATIVE SCREENING

SURGICAL TREATMENT

DYNAMIC RISK STRATIFICATION AND FOLLOW-UP

RECURRENT AND PERSISTENT DISEASE

REOPERATION

DISTANT DISEASE

CONCLUSION

REFERENCES

Chapter 60: Poorly differentiated thyroid cancer, anaplastic thyroid cancer, and miscellaneous tumors of the thyroid

POORLY DIFFERENTIATED THYROID CANCER

DEFINITION/EPIDEMIOLOGY

TREATMENT/PROGNOSIS

ANAPLASTIC THYROID CANCER

INTRODUCTION

EPIDEMIOLOGY

PATHOGENESIS

CLINICAL PRESENTATION AND DIFFERENTIAL DIAGNOSIS

PATHOLOGY

GENOMICS/MOLECULAR PATHOLOGY/IMMUNOLOGY

STAGING

MANAGEMENT—GENERAL CONSIDERATIONS

MANAGEMENT—STAGE IVA

MANAGEMENT—STAGE IVB

MANAGEMENT—STAGE IVC

MANAGEMENT—OLIGOMETASTATIC STAGE IVC

PALLIATIVE AND HOSPICE CARE

ATC SUMMARY

MISCELLANEOUS TUMORS OF THE THYROID GLAND

HYALINIZING TRABECULAR TUMOR

SQUAMOUS CELL CARCINOMA

THYROID MUCOEPIDERMOID CARCINOMA

SCLEROSING MUCOEPIDERMOID CARCINOMA WITH EOSINOPHILIA

MUCINOUS CARCINOMA OF THE THYROID

ECTOPIC THYMOMA

SPINDLE EPITHELIAL TUMOR WITH THYMUS-LIKE DIFFERENTIATION

INTRATHYROID THYMIC CARCINOMA

PARAGANGLIOMA AND MESENCHYMAL/STROMAL TUMORS

HEMATOLYMPHOID TUMORS

GERM CELL TUMORS (BENIGN TERATOMA, IMMATURE TERATOMA, MALIGNANT TERATOMA)

SECONDARY MALIGNANCIES OF THE THYROID

ACKNOWLEDGMENTS

REFERENCES

Chapter 61: Thyroid cancer in children

RISK OF THYROID CANCER IN THE PEDIATRIC PATIENT WITH A THYROID NODULE

DIFFERENTIATED THYROID CANCERS

PAPILLARY THYROID CARCINOMA (PTC)

PAPILLARY THYROID MICROCARCINOMA (PTMC)

FOLLICULAR VARIANT PTC

FOLLICULAR THYROID CARCINOMA (FTC)

MEDULLARY THYROID CARCINOMA

MULTIPLE ENDOCRINE NEOPLASIA 2A

MULTIPLE ENDOCRINE NEOPLASIA 2B

EARLY THYROIDECTOMY IN MEN2

MANAGEMENT OF MTC IN MEN2

REFERENCES

Section VII: The Thyroid in Infancy and Childhood

Chapter 62: The maturation of thyroid function in the fetus, in the perinatal period and during childhood

MATURATION OF THYROID FUNCTION IN UTERO

ORGANOGENESIS AND STRUCTURAL DIFFERENTIATION OF THE THYROID GLAND

FUNCTIONAL DIFFERENTIATION OF THE THYROID GLAND AND ONSET OF THYROID HORMONE SYNTHESIS

THE ROLE OF THE PLACENTA FOR MATERNOFETAL INTERACTION

MATURATION OF THE HYPOTHALAMIC–PITUITARY–THYROID AXIS

SYNTHESIS OF THE THYROID HORMONE TRANSPORT PROTEINS

REGULATION OF THYROID HORMONE LEVELS IN UTERO BY SULFATION

REGULATION OF THYROID HORMONE LEVELS IN UTERO BY DEIODINATION

ONTOGENY OF TRANSMEMBRANE THYROID HORMONE TRANSPORTERS

ONTOGENY OF THYROID HORMONE RECEPTORS

THE ROLE OF THYROID HORMONES FOR THE FETUS AND THE CHILD

BRAIN DEVELOPMENT

COCHLEA DEVELOPMENT

RETINA DEVELOPMENT

MUSCLE AND MYOCARDIAL DEVELOPMENT

BONE DEVELOPMENT AND LINEAR GROWTH

METABOLIC EFFECTS

PERINATAL AND POSTNATAL CHANGES IN THYROID HORMONE SYNTHESIS AND METABOLISM

PHYSIOLOGIC CHANGES IN THE TERM NEONATE

THYROID FUNCTION IN THE PRETERM NEONATE

THYROID FUNCTION IN SMALL FOR GESTATIONAL AGE NEONATES

INFANTS, CHILDREN, AND ADOLESCENTS

REFERENCES

Chapter 63: Hypothyroidism in infants and children

CONGENITAL HYPOTHYROIDISM

NEWBORN SCREENING

RATIONALE FOR BIOCHEMICAL SCREENING FOR CH

PREMATURE AND VERY LOW–BIRTH-WEIGHT NEWBORNS

NEWBORNS WITH TRISOMY 21

EVALUATION OF NEWBORNS WITH A POSITIVE SCREENING RESULT

QUALITY ASSESSMENT OF SCREENING PROGRAMS

CLASSIFICATION OF CH (Table 63-2)

ETIOLOGY AND PATHOGENESIS

PERMANENT CH

TRANSIENT CH

CLINICAL PRESENTATION

DIAGNOSTIC EVALUATION (Table 63-3)

TREATMENT AND OUTCOME

ACQUIRED HYPOTHYROIDISM (CH)

ETIOLOGIES (Table 63-4)

CLINICAL PRESENTATION (Fig. 63-4)

EVALUATION

TREATMENT

PROGNOSIS

REFERENCES

Chapter 64: Impaired sensitivity to thyroid hormone: defects of transport, metabolism, and action

TH SECRETION, CELL-MEMBRANE TRANSPORT, METABOLISM, AND ACTION

THE PARADOX OF COEXISTING MANIFESTATIONS OF THYROID HORMONE DEFICIENCY AND EXCESS

THYROID HORMONE ACTION DEFECTS KNOWN AS RESISTANCE TO THYROID HORMONE

RESISTANCE TO THYROID HORMONE BETA (RTHβ)

CLINICAL CLASSIFICATION

INCIDENCE AND INHERITANCE

ETIOLOGY AND GENETICS

MOLECULAR MECHANISMS OF TR ACTION

PROPERTIES OF MUTANT TRβ RECEPTORS AND ASSOCIATED DOMINANT-NEGATIVE EFFECT

MOLECULAR BASIS OF THE VARIABLE RTHβ PHENOTYPE

RTHβ WITHOUT THRB GENE MUTATIONS (NON–TRβ-RTH)

ANIMAL MODELS OF RTHβ

PATHOGENESIS

PATHOLOGY

CLINICAL FEATURES

COURSE OF THE DISEASE

LABORATORY FINDINGS

TH AND ITS METABOLITES

THYROTROPIN AND OTHER THYROID STIMULATORS

THYROID GLAND ACTIVITY AND INTEGRITY OF HORMONE SYNTHESIS

IN VIVO EFFECTS OF TH

IN VITRO TESTS OF THYROID HORMONE ACTION

RESPONSES TO THE ADMINISTRATION OF THYROID HORMONE

EFFECTS OF OTHER DRUGS

DIFFERENTIAL DIAGNOSIS

TREATMENT

RESISTANCE TO THYROID HORMONE ALPHA (RTHα)

BACKGROUND

INCIDENCE AND INHERITANCE

ETIOLOGY AND GENETICS

MOLECULAR BASIS OF THE DEFECT AND PROPERTIES OF THE MUTANT TRα

ANIMAL MODELS OF RTHα (SEE ALSO ANIMAL MODELS UNDER RTHβ, ABOVE)

CLINICAL FEATURES

LABORATORY FINDINGS

DIFFERENTIAL DIAGNOSIS

TREATMENT

THYROID HORMONE CELL MEMBRANE TRANSPORTER DEFECT (THCMTD)

CELL MEMBRANE TRANSPORTERS OF TH

INHERITANCE AND INCIDENCE

ETIOLOGY

THE MCT8 GENE AND MUTATIONS

CLINICAL FEATURES AND COURSE OF THE DISEASE

LABORATORY FINDINGS

SERUM TESTS OF THYROID FUNCTION

OTHER SERUM TESTS

X-RAYS AND IMAGING

TESTS IN TISSUES

GENETIC TESTING

ANIMAL MODELS OF MCT8 DEFICIENCY

MOLECULAR BASIS OF THE DISORDER

DIFFERENTIAL DIAGNOSIS

TREATMENT

THYROID HORMONE METABOLISM DEFECT

INTRACELLULAR METABOLISM OF TH

ETIOLOGY AND GENETICS

INCIDENCE AND INHERITANCE

THE SBP2 GENE AND MUTATIONS

CLINICAL FEATURES AND COURSE OF THE DISEASE

LABORATORY FINDINGS

MOLECULAR BASIS OF THE DISORDER

THMD CAUSED BY MUTATION IN THE TRU-TCA1-1 GENE

ANIMAL MODELS OF THMD

DIFFERENTIAL DIAGNOSIS

TREATMENT

ACKNOWLEDGMENTS

REFERENCES

Chapter 65: Hyperthyroidism in the neonate, child, and adolescent

CLINICAL EVALUATION OF THE HYPERTHYROID STATE

BIOCHEMICAL EVALUATION OF THYROID FUNCTION

GRAVES DISEASE

ANTITHYROID DRUG THERAPY

RADIOACTIVE IODINE THERAPY

THYROIDECTOMY AND RISKS

SOMATIC COMPLICATIONS OF GD

NEONATAL THYROTOXICOSIS

FETAL CONSIDERATIONS

OTHER CAUSES OF HYPERTHYROIDISM

HASHITOXICOSIS

SUMMARY

REFERENCES

Section VIII: Thyroid Disorders in Pregnancy and Postpartum

Chapter 66: Thyroid disorders during preconception, pregnancy, and the postpartum period

PRECONCEPTION

EPIDEMIOLOGY

PHYSIOLOGY

CLINICAL OUTCOMES AND MANAGEMENT

PREGNANCY

EPIDEMIOLOGY

PHYSIOLOGY

DIAGNOSIS OF THYROID DISEASE

OVERT HYPOTHYROIDISM

SUBCLINICAL HYPOTHYROIDISM

ISOLATED HYPOTHYROXINEMIA

AUTOIMMUNE THYROID DISEASE IN PREGNANCY

HYPERTHYROIDISM

POSTPARTUM

POSTPARTUM THYROIDITIS

REFERENCES

Index