Washington manual of endocrinology 3rd ed subspeciality consult

THE WASHINGTON MANUAL™ Endocrinology Subspecialty Consult Third Edition Editors Janet B McGill, MD, MA, FACE Professor of Medicine Division of Endocrinology, Metabolism, and Lipid Research Washington University School of Medicine St Louis, Missouri Thomas J Baranski, MD, PhD Associate Professor of Medicine Division of Endocrinology, Metabolism, and Lipid Research Washington University School of Medicine St Louis, Missouri William E Clutter, MD Associate Professor of Medicine Division of Endocrinology, Metabolism, and Lipid Research Washington University School of Medicine St Louis, Missouri Series Editors Katherine E Henderson, MD Assistant Professor of Clinical Medicine Division of Medical Education Washington University School of Medicine Barnes-Jewish Hospital St Louis, Missouri Thomas M De Fer, MD Professor of Medicine Division of Medical Education Washington University School of Medicine St Louis, Missouri Senior Acquisitions Editor: Sonya Seigafuse Senior Product Manager: Kerry Barrett Vendor Manager: Bridgett Dougherty Senior Marketing Manager: Kimberly Schonberger Manufacturing Manager: Ben Rivera Design Coordinator: Stephen Druding Editorial Coordinator: Katie Sharp Production Service: Aptara, Inc © 2013 by Department of Medicine, Washington University School of Medicine Printed in China All rights reserved This book is protected by copyright No part of this book may be reproduced in any form by any means, including photocopying, or utilized by any information storage and retrieval system without written permission from the copyright owner, except for brief quotations embodied in critical articles and reviews Materials appearing in this book prepared by individuals as part of their official duties as U.S government employees are not covered by the above-mentioned copyright Library of Congress Cataloging-in-Publication Data The Washington manual endocrinology subspecialty consult – 3rd ed / editors, Thomas J Baranski, William E Clutter, Janet B McGill p ; cm – (Washington manual subspecialty consult series) Includes bibliographical references and index ISBN 978-1-4511-1407-2 (alk paper) I Baranski, Thomas J.II Clutter, William E.III McGill, Janet B IV Washington University (Saint Louis, Mo.) School of Medicine V Title: Endocrinology subspecialty consult.VI Series: Washington manual subspecialty consult series [DNLM: Endocrine System Diseases–Handbooks Metabolic Diseases–Handbooks WK 39] 616.4’8 dc23 2012020563 The Washington Manual™ is an intent-to-use mark belonging to Washington University in St Louis to which international legal protection applies The mark is used in this publication by LWW under license from Washington University Care has been taken to confirm the accuracy of the information presented and to describe generally accepted practices However, the authors, editors, and publisher are not responsible for errors or omissions or for any consequences from application of the information in this book and make no warranty, expressed or implied, with respect to the currency, completeness, or accuracy of the contents of the publication Application of the information in a particular situation remains the professional responsibility of the practitioner The authors, editors, and publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accordance with current recommendations and practice at the time of publication However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions This is particularly important when the recommended agent is a new or infrequently employed drug Some drugs and medical devices presented in the publication have Food and Drug Administration (FDA) clearance for limited use in restricted research settings It is the responsibility of the health care provider to ascertain the FDA status of each drug or device planned for use in their clinical practice To purchase additional copies of this book, call our customer service department at (800) 638-3030 or fax orders to (301) 223-2320 International customers should call (301) 223-2300 Visit Lippincott Williams & Wilkins on the Internet: at LWW.com Lippincott Williams & Wilkins customer service representatives are available from 8:30 am to pm, EST 10 5 Contributing Authors Ana Maria Arbelaez, MD Assistant Professor of Pediatrics Division of Pediatric Endocrinology and Diabetes Washington University School of Medicine St Louis, Missouri Shunzhong Bao, MD Fellow Division of Endocrinology, Metabolism, and Lipid Research Washington University School of Medicine St Louis, Missouri Thomas J Baranski, MD, PhD Associate Professor of Medicine Division of Endocrinology, Metabolism, and Lipid Research Washington University School of Medicine St Louis, Missouri Carlos Bernal-Mizrachi, MD Assistant Professor of Medicine Division of Endocrinology, Metabolism, and Lipid Research Washington University School of Medicine St Louis, Missouri Kim Carmichael, MD Associate Professor of Medicine Division of Endocrinology, Metabolism, and Lipid Research Washington University School of Medicine St Louis, Missouri Sara Chowdhury, MD Clinical Fellow Division of Endocrinology, Metabolism, and Lipid Research Washington University School of Medicine St Louis, Missouri Roberto Civitelli, MD Sydney M and Stella H Schoenberg Professor of Medicine Professor of Orthopaedic Surgery and of Cell Biology and Physiology Director, Bone and Mineral Diseases Division of Endocrinology, Metabolism, and Lipid Research Washington University School of Medicine St Louis, Missouri William E Clutter, MD Associate Professor of Medicine Division of Endocrinology, Metabolism, and Lipid Research Washington University School of Medicine St Louis, Missouri Philip E Cryer, MD Irene E and Michael M Karl Professor of Endocrinology and Metabolism in Medicine Division of Endocrinology, Metabolism, and Lipid Research Washington University School of Medicine St Louis, Missouri Kathryn Diemer, MD Assistant Professor of Medicine Division of Bone and Mineral Diseases Washington University School of Medicine St Louis, Missouri Judit Dunai, MD Clinical Fellow Division of Endocrinology, Metabolism, and Lipid Research Washington University School of Medicine St Louis, Missouri Simon J Fisher, MD, PhD Associate Professor of Medicine, Cell Biology, and Physiology Division of Endocrinology, Metabolism, and Lipid Research Washington University School of Medicine St Louis, Missouri Stephen J Giddings, MD, PhD Associate Professor of Medicine St Louis VA Medical Center Washington University School of Medicine St Louis, Missouri Anne C Goldberg, MD, FACP, FAHA Associate Professor of Medicine Division of Endocrinology, Metabolism, and Lipid Research Washington University School of Medicine St Louis, Missouri Scott Goodwin, MD Clinical Fellow Division of Endocrinology, Metabolism, and Lipid Research Washington University School of Medicine St Louis, Missouri Paul Hruz, MD, PhD Associate Professor of Pediatrics Division of Pediatric Endocrinology and Diabetes Washington University School of Medicine St Louis, Missouri Mariko Johnson, MD Clinical Fellow Division of Endocrinology, Metabolism, and Lipid Research Washington University School of Medicine St Louis, Missouri Prajesh M Joshi, MD Clinical Fellow Division of Endocrinology, Metabolism, and Lipid Research Washington University School of Medicine St Louis, Missouri Kavita Juneja, MD Clinical Fellow Division of Endocrinology, Metabolism, and Lipid Research Washington University School of Medicine St Louis, Missouri Nadia Khoury, MD Clinical Fellow Division of Endocrinology, Metabolism, and Lipid Research Washington University School of Medicine St Louis, Missouri Janet B McGill, MD, MA, FACE Professor of Medicine Division of Endocrinology, Metabolism, and Lipid Research Washington University School of Medicine St Louis, Missouri Dominic N Reeds, MD Associate Professor of Medicine Division of Geriatrics and Nutritional Science Washington University School of Medicine St Louis, Missouri Amy E Riek, MD Instructor in Medicine Division of Endocrinology, Metabolism, and Lipid Research Washington University School of Medicine St Louis, Missouri David A Rometo, MD Clinical Fellow Division of Endocrinology, Metabolism, and Lipid Research Washington University School of Medicine St Louis, Missouri Julie Silverstein, MD Instructor in Medicine Division of Endocrinology, Metabolism, and Lipid Research Washington University School of Medicine St Louis, Missouri Richard I Stein, PhD Research Assistant Professor, Center for Human Nutrition Behavioral Director, Weight Management Program Washington University School of Medicine St Louis, Missouri Garry Tobin, MD Associate Professor of Medicine Division of Endocrinology, Metabolism, and Lipid Research Washington University School of Medicine St Louis, Missouri Dwight A Towler, MD, PhD Lang Professor of Medicine Division of Endocrinology, Metabolism, and Lipid Research Washington University School of Medicine St Louis, Missouri Zhiyu Wang, MD, PhD 10 causes of classification of clinical presentation definition of diagnosis of diagnostic testing for dietary modifications for epidemiology of and fractures fragility fractures hip fractures vertebral fractures glucocorticoid-induced imaging for bone mineral density testing plain films laboratory assessment in monitoring/follow-up in pathophysiology of prevention of risk factors for testing guidelines for treatment of indications for lifestyle modifications in medications for P Paget’s disease of bone (PDB) classification of clinical presentation of complication cardiovascular fractures 552 malignant sarcomatous degeneration neurologic definition of diagnosis of diagnostic testing for epidemiology of etiology of environmental influences genetic factors monitoring/follow-up in monostotic pathophysiology polyostotic skeletal sites involved in treatment of medications for surgical therapy Pamidronate for hypercalcemia for Paget’s disease of bone Pancreatic disease, and diabetes Pancreaticoduodenal tumors, nonfunctioning, in MEN1 Parathyroid hormone (PTH) PEARS (The Parathyroid Epidemiology and Audit Research Study) Pegvisomant (Somavert), for acromegaly Pelvic ultrasound, in primary amenorrhea Pentetreotide scintigraphy Pernicious anemia Phendimetrazine (Bontril), for weight loss Phenteremine (Adipex-P), for weight loss Pheochromocytoma adrenal biochemical assays for 553 classification of clinical presentation of history physical examination definition of diagnosis of diagnostic criteria for diagnostic testing for differential diagnosis of electrocardiography in epidemiology of etiology of extra-adrenal and hypercalcemia imaging in malignant in MEN2 monitoring/follow-up in outcome/prognosis for pathophysiology of and pregnancy rule of tens for treatment of α-adrenergic blocker in calcium channel blocker in metyrosine in preoperative management surgical resection Phosphorus-binding agents, for hyperparathyroidism Pioglitazone (Actos), for diabetes mellitus Pituitary adenomas classification of clinical presentation of 554 hormonal hypersecretion hormonal hyposecretion pituitary apoplexy diagnostic testing in imaging studies laboratories studies differential diagnosis hypophysitis pituitary granulomas pituitary hyperplasia sellar/parasellar cysts etiology of monitoring/follow-up in treatment for medical therapy radiotherapy surgical management Pituitary apoplexy Pituitary carcinomas Pituitary granulomas Pituitary hyperplasia Pituitary metastases Pituitary tumors, in MEN1 Plasma aldosterone concentration (PAC) Plasma renin activity (PRA) POEMS syndrome Polycystic ovary syndrome (PCOS) clinical presentation of history physical examination complications hypertension impaired glucose tolerance 555 infertility type diabetes diagnosis of diagnostic criteria for diagnostic testing for differential diagnosis of acromegaly androgen-secreting neoplasms Cushing’s syndrome drug-induced disorders hyperprolactinemia hypothyroidism late-onset CAH epidemiology of menstrual history in monitoring/follow-up in pathophysiology of treatment of antiandrogens atorvastatin insulin sensitizers oral contraceptives Orlistat simvastatin weight reduction Polyendocrinopathy See also Autoimmune polyendocrine syndromes (APS) Polyuria See also Diabetes insipidus (DI) hypotonic non-hypotonic Potomania Pramlintide (Symlin) for diabetes mellitus for type diabetes mellitus (T1DM) 556 for weight loss Prediabetes Prednisone, for primary aldosteronism Pregnancy adrenal insufficiency in Cushing’s syndrome in hypothyroidism in prolactinomas and thyroid function during Premature ovarian failure (POF) Pretibial myxedema Primary adrenal insufficiency Primary aldosteronism See Conn’s syndrome Primary hyperparathyroidism (PHP) and hypercalcemia in MEN1 in MEN2 Primary hypothyroidism, and male hypogonadism Primary polydypsia Progestin challenge test Prolactinomas classification of clinical presentation of history physical examination conditions associated with definition of diagnostic criteria elevated prolactin level diagnostic testing for imaging studies laboratory testing differential diagnosis of 557 adrenal insufficiency chest wall injuries hypothyroidism idiopathic hyperprolactinemia lactotroph adenomas lactotroph hyperplasia macroprolactinemia medications physiologic causes renal/hepatic failure epidemiology of and male hypogonadism monitoring/follow-up in pregnancy and treatment for medications radiotherapy surgical management Prolia See Denosumab Propylthiouracil (PTU), for hyperthyroidism in pregnancy Prostate cancer, vitamin D and Prostate-specific antigen (PSA) Pseudo-Cushing’s syndrome Pseudohypoparathyroidism Puberty Q Quinagolide, for prolactinomas R Radioactive iodine uptake (RAIU) in hyperthyroidism Radioisotope thyroid scans Radiotherapy 558 for acromegaly and male hypogonadism for pituitary adenomas for prolactinomas RAI therapy, for hyperthyroidism Raloxifene for hyperparathyroidism for osteoporosis Rathke’s cleft cysts Reidel’s thyroiditis See also Thyroiditis Repaglinide, for diabetes mellitus Reset osmostat syndrome Retinopathy, in diabetes Rheumatoid arthritis (RA), vitamin D and Rickets Risedronate (Actonel, Atelvia) for osteoporosis for Paget’s disease of bone Rosiglitazone (Avandia), for diabetes mellitus S Saline, intravenous, for SIADH-induced hyponatremia Salt tablets, for SIADH-induced hyponatremia Salt wasters Sarcoidosis and male hypogonadism Saxagliptin (Onglyza), for diabetes mellitus Secondary aldosteronism Sellar/parasellar cysts Semen analysis, in male hypogonadism Sevelamer, for hyperparathyroidism Sibutramine (Meridia), for weight loss Simple virilizers Single thyroid nodules 559 clinical presentation of diagnostic testing of Sitagliptin (Januvia), for diabetes mellitus Somatostatin analogues (SSA) for acromegaly for carcinoid syndrome for pituitary adenomas Somatotroph adenomas Spironolactone for hirsutism for polycystic ovary syndrome for primary aldosteronism Statins, as lipid lowering agent Strontium (Ranelate), for osteoporosis Subtotal thyroidectomy, in hyperthyroidism Sulfonylureas, for diabetes mellitus Sun exposure Supersaturated potassium iodide (SSKI) Swyer’s syndrome Syndrome of inappropriate secretion of antidiuretic hormone (SIADH) clinical presentation of definition of diagnostic criteria for differential diagnosis of epidemiology of etiology of pathophysiology of treatment of medications non-pharmacologic therapies T Temozolomide, for pituitary adenomas Teriparatide (Forteo), for osteoporosis 560 Testicular feminization See Androgen insensitivity syndrome (AIS) Testosterone therapy, in male hypogonadism Thelarche Thiazide diuretics and hypercalcemia in hyperparathyroidism and hypotonic hyponatremia Thiazolidinediones (TZDs) for diabetes mellitus for polycystic ovary syndrome Thionamides, for hyperthyroidism Thyroglobulin (Tg) Thyroid adenomas, and hyperthyroidism Thyroid carcinoma classification of anaplastic carcinoma follicular carcinoma medullary carcinoma of thyroid papillary carcinoma diagnosis of treatment of Thyroid disease, adrenal insufficiency in Thyroid function clinical presentation diagnostic procedures fine-needle aspiration cytology drugs on, effect of imaging tests radioisotope thyroid scans ultrasonography laboratory testing antithyroid antibodies plasma calcitonin 561 plasma free T4 plasma thyroglobulin plasma total T3 plasma total T4 radioactive iodine uptake thyroid-stimulating hormone thyroid-stimulating immunoglobulins nonthyroidal illness on, effect of in pregnancy Thyroiditis acute infectious Hashimoto’s painless Reidel’s subacute Thyroid-stimulating hormone (TSH) Thyroid-stimulating immunoglobulins (TSIs) Thyrotoxicosis, and hypercalcemia Thyrotroph adenomas Thyroxine Thyroxine-binding globulin (TBG) Tiludronate, in Paget’s disease of bone Topiramate, for weight loss Total thyroidectomy, for thyroid carcinoma Toxic multinodular goiter (MNG), and hyperthyroidism Transsphenoidal microadenectomy, for Cushing’s disease Trauma, and male hypogonadism Triamterene, for primary aldosteronism Triiodothyronine Trousseau’s sign T-score Turner syndrome Type B insulin resistance syndrome 562 Type diabetes mellitus (T1DM) clinical presentation of complications of and diabetic ketoacidosis diagnosis of diagnostic testing for epidemiology of etiology of pathogenesis of screening for treatment of adjunct therapy continuous subcutaneous insulin infusion diet glucose monitoring goal of insulin dose adjustments insulin therapy multiple daily injections Type diabetes mellitus (T2DM) bariatric surgery in classification of clinical presentation of definition of diagnosis of diagnostic criteria for diagnostic testing for epidemiology of etiology of lifestyle modification medications for non-insulin injectable hypoglycemic agents oral combination pills 563 oral hypoglycemic agents, 277–281, 278t–280t monogenic forms of and nonketotic Hyperosmolar Coma and obesity pathophysiology of insulin deficiency insulin resistance prevention of risk factors for screening for treatment of U U-500 insulin UK Prospective Diabetes Study (UKPDS) Urinary 5-HIAA testing 24 hour urine free cortisol, for Cushing’s syndrome V Vasopressin receptor antagonists, for SIADH-induced hyponatremia Velocardiofacial syndromes Vertebral fractures Virilization, signs of Visceral adiposity Vitamin D bone effects of deficiency clinical presentation of complications diagnostic testing for epidemiology of etiology of medical therapy for monitoring/follow-up in 564 non-pharmacologic therapies for prevention of risk factors for dietary intake of metabolism of molecular actions of non-calcemic actions of nutritional forms of resistance role of, in body status, classification for synthesis and effects of toxicity Vitamin D supplementation, for hypocalcemia Vitiligo W Water deficit, calculation of Water deprivation test Weight loss benefits of diet for low-carbohydrate diets low-fat diet in obese diabetic patients goals of physical activity for surgery for (See Bariatric surgery) Whipple’s triad Whole body RAI (WBI) scan Wolfram syndrome Z Zoledronic acid (Reclast) 565 for hypercalcemia for osteoporosis for Paget’s disease of bone Zollinger–Ellison syndrome, in MEN1 Zonisamide, for weight loss Z-score 566 [...]... of Medicine Co-Director of the Infectious Disease Division Washington University School of Medicine 12 Preface third edition of The Washington Manual ™ Endocrinology Subspecialty This Consult was written by Washington University endocrine fellows and faculty members The manual is designed to serve as a guide for students, house staff, and fellows involved in inpatient and outpatient endocrinology consults... Blanchard, Chief of the Division of Medical Education in the Department at of Medicine at Washington University School of Medicine, for his advice and guidance I believe this Subspecialty Manual will meet its desired goal of providing practical knowledge that can be directly applied at the bedside and in outpatient settings to improve patient care Victoria J Fraser, MD Dr J William Campbell Professor Interim... Missouri Kevin Yarasheski, PhD Professor of Medicine, Cell Biology, and Physiology, and Physical Therapy Division of Endocrinology, Metabolism, and Lipid Research Washington University School of Medicine St Louis, Missouri 11 Chairman’s Note is a pleasure to present the new edition of The Washington Manual ™ ItSubspecialty Consult Series: Endocrinology Subspecialty Consult This pocketsize book continues...Clinical Fellow Division of Endocrinology, Metabolism, and Lipid Research Washington University School of Medicine St Louis, Missouri Michael P Whyte, MD Professor of Medicine, Pediatrics, and Genetics Division of Bone and Mineral Diseases Washington University School of Medicine Medical-Scientific Director, Center for Metabolic Bone Disease and Molecular... chapter has been added that covers Inpatient Management of Diabetes Drug dosing information was reviewed and updated in each chapter Clinical pearls are highlighted in boldfaced text within the chapters We are indebted to the remarkable efforts of the fellows and attending physicians who contributed to the current edition of this manual and worked enthusiastically to provide high-quality, contemporary,... care and education is unsurpassed, and their efforts and skill in compiling this manual are evident in the quality of the final product In particular, I would like to acknowledge our editors, Drs Thomas J Baranski, William E Clutter, and Janet B McGill, and the series editors, Drs Katherine Henderson and Tom De Fer, who have worked tirelessly to produce another outstanding edition of this manual I... review of the field of endocrinology Rather, it focuses on practical approaches to endocrine disorders commonly seen in consultation, with emphasis on key components of evaluation and treatment Several changes in content were made with the third edition All chapters have been updated to provide the latest information on the pathophysiology and treatment of endocrine disorders A new chapter has been added... The diagnosis and treatment of growth hormone deficiency in adults Curr Opin Endocrinol Diabetes Obes 2010;17(4):377–383 22 Melmed S, Kleinberg D Anterior pituitary In: Kronenberg HM, Melmed S, Polonsky KS, eds Williams Textbook of Endocrinology, 11th ed Philadelphia, PA: Saunders/Elsevier, 2008: 155–261 23 Fleseriu M, Delashaw JB Jr, Cook DM Acromegaly: A review of current medical therapy and new drugs... infertility, loss of body hair, or gynecomastia More subtle manifestations include decreased cognitive function and energy, and loss of muscle and bone mass Men almost never have galactorrhea The clinical presentation of prolactinomas can vary based on the size of the tumor Symptoms of mass effect generally only occur in the presence of a macroadenoma History The history should focus on symptoms of hormonal... of prolactinoma is a persistently elevated prolactin level The likelihood of prolactinoma can be roughly estimated based on the degree of elevation in the prolactin.5 Levels above normal but 200 ng/mL: usually diagnostic of prolactinoma Alternate causes of mild to moderate prolactin elevations should be considered ...THE WASHINGTON MANUAL Endocrinology Subspecialty Consult Third Edition Editors Janet B McGill, MD, MA, FACE Professor of Medicine Division of Endocrinology, Metabolism, and Lipid Research Washington. .. Assistant Professor of Clinical Medicine Division of Medical Education Washington University School of Medicine Barnes-Jewish Hospital St Louis, Missouri Thomas M De Fer, MD Professor of Medicine... Assistant Professor of Pediatrics Division of Pediatric Endocrinology and Diabetes Washington University School of Medicine St Louis, Missouri Shunzhong Bao, MD Fellow Division of Endocrinology,