Diabetes insipidus is a disease in which large volumes of dilute urine (polyuria) are excreted due to vasopressin (AVP) deficiency [central diabetes insipidus (CDI)], AVP resistance [nephrogenic diabetes insipidus (NDI)], or excessive water intake (primary polydipsia). Polyuria is characterized by a urine volume in excess of 2 l/m2/24 h or approximately 150 ml/kg/24 h at birth, 100–110 ml/kg/24 h until the age of 2 years and 40–50 ml/kg/24 h in the older child and adult. Continue reading
The Catastrophic Antiphospholipid Syndrome (CAPS) is a rare life-threatening form of Antiphospholipid Syndrome (APS) in which widespread intravascular thrombosis results in multiorgan ischemia and failure. CAPS is the initial presentation of APS in nearly half of patients, while the remaining half has a history of APS. Continue reading
Screening is recommended for type 2 diabetes because reliable tests are available, and lifestyle changes and medications reduce progression and adverse sequelae of the disease, even in persons who are initially asymptomatic. Continue reading
SLICC classification criteria improved the clinical relevance of the ACR criteria, incorporated recent findings on the immunology of SLE, and resolved several problems attributed to the ACR criteria.
In overt hyperthyroidism, serum levels of free T4 and triiodothyronine (T3) or levels of T3 alone are elevated, and serum thyrotropin (TSH) levels are suppressed. In subclinical hyperthyroidism, levels of free T4 and T3 are normal, thyrotropin levels are suppressed, and thyroid hormone levels are usually in the middle to upper range of normal. Continue reading
Gout, which is characterized by deposition of monosodium urate monohydrate (MSU) in synovial fluid and other tissues, is the most common form of inflammatory arthritis. Continue reading
POEMS syndrome is a rare paraneoplastic syndrome due to an underlying plasma cell disorder (PCD). The acronym, which was coined by Bardwick in 1980, refers to several, but not all, of the features of the syndrome: polyradiculoneuropathy, organomegaly, endocrinopathy, monoclonal PCD, and skin changes. Continue reading
A diagnosis of primary Sjögren’s syndrome is often made on the basis of a classic triad of symptoms: dryness of the mouth and eyes, fatigue, and pain. Systemic complications, which are present in 30 to 40% of patients, may provide the first clues to the disease.
Quantitative testing of a patient’s basal pain perception before surgery has the potential to be of clinical value if it can accurately predict the magnitude of pain and requirement of analgesics after surgery. Continue reading
WHO treatment guides for cancer pain provide explanations of the pathophysiology of such pain, how to make adequate assessments, how to choose analgesics, and how to use the ladder. Early studies on its effectiveness demonstrated that the method proposed by the WHO offered inexpensive treatment and adequate relief for 70% to 90% of cancer patients with pain. Continue reading