Hashimoto thyroiditis (HT) is a chronic inflammation of the thyroid gland initially described over a century ago but of still incompletely defined etiopathogenesis. It is now considered the most common autoimmune disease, the most common endocrine disorder, as well as the most common cause of hypothyroidism.
Endocrinology and Metabolism
New Diagnostic Criteria of Adrenal Subclinical Cushing’s Syndrome
New diagnostic criteria and the treatment policy for adrenal subclinical Cushing’s syndrome (SCS) are proposed on behalf of the Japan Endocrine Society. The current diagnostic criteria for SCS have elicited two main problems: (i) the relatively low reliability of a low range of serum cortisol essential for the diagnosis by an overnight 1-mg dexamethasone suppression test (DST); (ii) different cutoff values for serum cortisol after a 1-mg DST compared with those of other countries.
Diagnostic Criteria of Acute Adrenal Insufficiency
The Endocrine Society guidelines on the diagnosis and treatment of Acute Adrenal Insufficiency (AAI) defines an adrenal crisis as a medical emergency with hypotension, abdominal symptoms and laboratory abnormalities requiring emergency treatment.
Point Scale for Metabolic Obesity in People with Normal Body Weight (MONW)
Disorders of metabolic obesity with normal body weight (MONW) are widely recognized risk factors for the development of cardiovascular diseases and type 2 diabetes. Despite this, MONW is not diagnosed in clinical practice.
Diagnosis of Congenital Adrenal Hyperplasia
Congenital Adrenal Hyperplasia (CAH) is a disease of multiple hormonal imbalances. Mutations in CYP21A2 (the gene encoding 21-hydroxylase, a cytochrome P-450 enzyme) result in lack of 21-hydroxylase, which is required for the production of cortisol and aldosterone in the adrenal cortex. A deficiency of this enzyme has cascading effects. Reduced cortisol leads to overproduction of pituitary corticotropin, which stimulates the accumulation of cortisol precursors and their subsequent diversion through the steroid pathways that produce adrenal androgens. Today, the classic form is the most common cause of atypical genitalia in 46,XX newborns and of primary adrenal insufficiency during childhood.
Diagnostic Criteria for Familial Hypercholesterolemia (FH)
The clinical diagnosis of FH is founded on personal and family history, physical examination, and lipid concentrations. Three groups have developed clinical diagnostic tools for FH: the US MedPed Program, the Simon Broome Register Group in the United Kingdom, and the Dutch Lipid Clinic Network.
Testing to Diagnose Hormone-Secreting Pituitary Tumors
Pituitary adenomas account for approximately 15% of intracranial tumors. Management of these benign tumors requires diagnosis of the specific intrasellar disease and comprehensive, multidisciplinary treatment of local mass effects and peripheral endocrinopathies. Since tumors can produce different hormones, their consequences and management vary widely.
Criteria to Initiate Evaluation for Growth Hormone Deficiency (GHD)
Tools for the diagnosis of GHD include auxology, radiographic assessment of bone age, measurement of insulin-like growth factor 1 (IGF-I) and IGF binding protein 3 (IGFBP-3), provocative growth hormone (GH) testing, cranial magnetic resonance imaging (MRI), and, in certain cases, genetic testing. Growth velocity and the degree of short stature are primary considerations in the decision to pursue evaluation for GHD.
Diagnosis of Primary Hypoparathyroidism
Primary hypoparathyroidism is a condition characterized by hypocalcemia and hyperphosphatemia resulting from the primary absence or deficiency of parathyroid hormone (PTH) or from the secretion of biologically inactive PTH.
Diagnosis of Subclinical Hyperthyroidism
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.