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IndexEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - August 31, 2009 Category: Endocrinology Source Type: journals

Recombinant Human Insulin-Like Growth Factor-1 Treatment: Ready for PrimetimeEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The combination of targeted gene knockout studies in animals and human mutational analysis has demonstrated the key role of the IGF system in mammalian growth, both in utero and postnatally. The concept of IGF deficiency as a diagnostic category for children with growth failure first was proposed in the mid 1990s, and has gained support through the demonstration of patients with mutations in key components of the growth hormone (GH)-IGF axis, as well as the widespread use of IGF-I assays for evaluating short stature. The US Food and Drug Administration has approved IGF-I therapy for treating children who have severe primar...
Source: Endocrinology and Metabolism Clinics of North America - August 31, 2009 Category: Endocrinology Authors: George M. Bright, Jessica R. Mendoza, Ron G. Rosenfeld Source Type: journals

Strategies for Maximizing Growth in Puberty in Children with Short StatureEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The approach to the child with growth retardation who is in puberty remains an important clinical challenge. The use of high-dose growth hormone (GH), suppression of puberty with GnRH analogs in combination with GH, and the use of selective inhibitors of the aromatase enzyme with aromatase inhibitors (also in combination with GH) are all therapeutic choices that have been studied. Aromatase blockade effectively blocks estrogen production in males with a reciprocal increase in testosterone, and a new generation of aromatase inhibitors, including anastrozole, letrozole and exemestane, is under investigation in adolescent sub...
Source: Endocrinology and Metabolism Clinics of North America - August 31, 2009 Category: Endocrinology Authors: Nelly Mauras Source Type: journals

Growth Hormone: The Expansion of Available Products and IndicationsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article describes its historical use, current indications and studies for possible future uses. (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - August 31, 2009 Category: Endocrinology Authors: Sherry L. Franklin, Mitchell E. Geffner Source Type: journals

Nutrition and Bone Growth in PediatricsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Children's growth is a hallmark of their normal development and the association between nutrition and linear growth in children is well accepted. Growth requires an adequate supply of many different nutritional factors, some form the “building materials,” whereas others play regulatory roles. In this article we describe the growth of the growth plate and discuss the role of nutritional affected hormones on this process. In addition we describe the effect of local regulators and nutritional factors on the growth process and suggest the involvement of new regulatory factors in the translation of nutrition to growth. (Sou...
Source: Endocrinology and Metabolism Clinics of North America - August 31, 2009 Category: Endocrinology Authors: Galia Gat-Yablonski, Michal Yackobovitch-Gavan, Moshe Phillip Source Type: journals

Metabolic Syndrome in Pediatrics: Old Concepts Revised, New Concepts DiscussedEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article addresses the causes of metabolic syndrome and the relevance of obesity in the pediatric population. (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - August 31, 2009 Category: Endocrinology Authors: Ebe D'Adamo, Nicola Santoro, Sonia Caprio Source Type: journals

Pediatric Obesity: Etiology and TreatmentEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article reviews factors that contribute to excessive weight gain in children and outlines current knowledge regarding approaches for treating pediatric obesity. Most of the known genetic causes of obesity primarily increase energy intake. Genes regulating the leptin signaling pathway are particularly important for human energy homeostasis. Obesity is a chronic disorder that requires long-term strategies for management. The foundation for all treatments for pediatric obesity remains restriction of energy intake with lifestyle modification. There are few long-term studies of pharmacotherapeutic interventions for pediatr...
Source: Endocrinology and Metabolism Clinics of North America - August 31, 2009 Category: Endocrinology Authors: Melissa K. Crocker, Jack A. Yanovski Source Type: journals

Perinatal Endocrinology: Common Endocrine Disorders in the Sick and Premature NewbornEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article describes the most common conditions and current knowledge regarding management. (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - August 31, 2009 Category: Endocrinology Authors: Sharon J. Hyman, Yeray Novoa, Ian Holzman Source Type: journals

Congenital Disorders of the Thyroid: Hypo/HyperEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article summarizes the ontogenesis and genetics of the thyroid with regards to its possible congenital dysfunction and briefly refers to the roles of the mother-placenta-fetal unit, iodine effect, and organic and functional changes of the negative feedback mechanism, as well as maturity and illness, in some forms of congenital hypo- and hyperthyroidism. This article also describes the published literature and the authors' data on the clinical aspects of congenital hypothyroidism, on the alternating hypo- and hyperthyroidism in the neonatal period, and on neonatal hyperthyroidism. (Source: Endocrinology and Metabolism ...
Source: Endocrinology and Metabolism Clinics of North America - August 31, 2009 Category: Endocrinology Authors: Ferenc Péter, Ágota Muzsnai Source Type: journals

Genomics in Pediatric Endocrinology—Genetic Disorders and New TechniquesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article introduces some of these concepts and some of the genetic techniques being used. (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - August 31, 2009 Category: Endocrinology Authors: Alfred Tenore, Daniela Driul Source Type: journals

PrefaceEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The last issue of Endocrinology and Metabolism Clinics of North America dedicated to pediatric endocrinology was published in 2005. The great volume of significant scientific advances since then in endocrinology in general and pediatric endocrinology in particular has made it impossible to cover even the most salient advances in just one volume. Therefore, I am grateful to the editor, Dr. LeRoith, as well as the publisher for agreeing to produce a two-volume series on pediatric endocrinology. (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - August 31, 2009 Category: Endocrinology Authors: Robert Rapaport Source Type: journals

ForewordEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
These issues contain a potpourri of endocrinological conditions important to the pediatric endocrinologist. (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - August 31, 2009 Category: Endocrinology Authors: Derek LeRoith Source Type: journals

Forthcoming IssuesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - August 31, 2009 Category: Endocrinology Source Type: journals

ContentsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - August 31, 2009 Category: Endocrinology Source Type: journals

IndexEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - April 21, 2009 Category: Endocrinology Source Type: journals

Anti-Parathyroid and Anti-Calcium Sensing Receptor Antibodies in Autoimmune HypoparathyroidismEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The parathyroid glands are an infrequent target for autoimmunity, the exception being autoimmune polyglandular syndrome type 1, in which autoimmune hypoparathyroidism is the rule. Antibodies that are directed against the parathyroid cell surface calcium-sensing receptor (CaSR) have recently been recognized to be present in the serum of patients with autoimmune hypoparathyroidism. In some individuals, these anti-CaSR antibodies have also been shown to produce functional activation of the receptor, suggesting a direct pathogenic role in hypocalcemia. Additionally, a few hypercalcemic patients with autoimmune hypocalciuric hy...
Source: Endocrinology and Metabolism Clinics of North America - April 21, 2009 Category: Endocrinology Authors: Edward M. Brown Source Type: journals

Diagnosis and Management of Polyendocrinopathy SyndromesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The autoimmune polyendocrinopathy syndromes are variable in presentation and can be challenging to diagnose and manage. Diagnosis of the type 1 autoimmune polyendocrinopathy syndrome can be difficult at an early age when often only one manifestation is present, and it may take years for others to appear. Increased awareness of polyendocrinopathy syndromes, combined with analysis of specific autoantibodies and molecular genetics, should help earlier diagnosis of these conditions and prevent serious complications. Further definition of susceptibility genes and autoantigens, as well as a better understanding of the pathogenes...
Source: Endocrinology and Metabolism Clinics of North America - April 21, 2009 Category: Endocrinology Authors: Catherine J. Owen, Tim D. Cheetham Source Type: journals

Fine Tuning for Quality of Life: 21st Century Approach to Treatment of Addison's DiseaseEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Despite treatment with glucocorticoids and mineralocorticoids, the ability to work and quality of life of patients who have adrenal insufficiency remains low. There are no helpful objective measures of optimal glucocorticoid replacement, so this is best achieved by careful clinical assessment. Adequacy of mineralocorticoid replacement may be judged by assessing postural change in blood pressure, serum electrolytes, and plasma renin activity. Novel delayed-release and sustained-release formulations of hydrocortisone seem to more closely mimic diurnal serum cortisol rhythms than conventional hydrocortisone tablets. Such prep...
Source: Endocrinology and Metabolism Clinics of North America - April 21, 2009 Category: Endocrinology Authors: Nicole Reisch, Wiebke Arlt Source Type: journals

Immunology of Addison's Disease and Premature Ovarian FailureEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Autoimmune Addison's disease and autoimmune ovarian insufficiency are caused by selective targeting by T and B lymphocytes to the steroidogenic apparatus in these organs. Autoantibodies toward 21-hydroxylase are a clinically useful marker for autoimmune Addison's disease. Autoantibodies to 21-hydroxylase are found in premature ovarian insufficiency, but others also can be present, notably antibodies against side-chain cleavage enzyme. The autoimmune response primarily targets the theca cells, yielding elevated concentrations of inhibin, which is emerging as a useful diagnostic marker for autoimmune etiology of ovarian insu...
Source: Endocrinology and Metabolism Clinics of North America - April 21, 2009 Category: Endocrinology Authors: Eystein S. Husebye, Kristian Løvås Source Type: journals

Thyroid-Associated Orbitopathy: Who and How to TreatEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Thyroid-associated orbitopathy is the most frequent and troublesome nonthyroidal complication of Graves' disease. It is mandatory to determine whether sight-threatening orbitopathy is present, as this requires prompt and aggressive treatment. Therapies for non–sight-threatening disease range from supportive measures only to medical therapies for active eye disease and surgical rehabilitation for burnt-out disease. Intravenous steroids and orbital radiotherapy are the mainstays of medical therapy. Rehabilitative surgery is frequently a staged process that may involve sequentially: orbital decompression, strabismus surgery...
Source: Endocrinology and Metabolism Clinics of North America - April 21, 2009 Category: Endocrinology Authors: Jane Dickinson, Petros Perros Source Type: journals

Treatment of Graves' Hyperthyroidism: Evidence-Based and Emerging ModalitiesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article reviews the current evidence so the reader can evaluate advantages and disadvantages of these treatment modalities. Surgery is rarely used, except for patients who have a large goiter or ophthalmopathy. Fewer than 50% of patients treated with ATD remain in long-term remission. Therefore, radioactive iodine is used increasingly. No data as yet support the routine use of biologic therapies (eg, rituximab). Prospective, randomized studies comparing available and any novel therapeutic options for GD are needed. The focus of these studies should include, but not be limited to, cost and quality of life. (Source: End...
Source: Endocrinology and Metabolism Clinics of North America - April 21, 2009 Category: Endocrinology Authors: Laszlo Hegedüs Source Type: journals

Toward Better Models of Hyperthyroid Graves' DiseaseEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article discusses the pursuit of a better experimental model for hyperthyroid Graves' disease and outlines how this research has clarified the immunology of the disease. (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - April 21, 2009 Category: Endocrinology Authors: Selc¸uk Dağdelen, Yi-chi M. Kong, J. Paul Banga Source Type: journals

The Thyroid-Stimulating Hormone Receptor: Impact of Thyroid-Stimulating Hormone and Thyroid-Stimulating Hormone Receptor Antibodies on Multimerization, Cleavage, and SignalingEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The thyroid-stimulating hormone receptor (TSHR) has a central role in thyrocyte function and is also one of the major autoantigens for the autoimmune thyroid diseases. We review the post-translational processing, multimerization, and intramolecular cleavage of TSHR, all of which may modulate its signal transduction. The recent characterization of monoclonal antibodies to the TSHR, including stimulating, blocking, and neutral antibodies, have also revealed unique biologic insights into receptor activation and the variety of these TSHR antibodies may help explain the multiple clinical phenotypes seen in autoimmune thyroid di...
Source: Endocrinology and Metabolism Clinics of North America - April 21, 2009 Category: Endocrinology Authors: Rauf Latif, Syed A. Morshed, Mone Zaidi, Terry F. Davies Source Type: journals

Advances in Type 1 Diabetes Therapeutics: Immunomodulation and β-Cell SalvageEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Refinements in our understanding of the pathogenic mechanisms of Type 1 diabetes from studies of animal models and clinical observation have led to new clinical trials to prevent disease progression and restore the loss of ß-cells that defines the disease. Antigen-specific agents have shown initial promise and non–antigen-specific agents now have improved safety compared with older agents. In addition, preclinical studies with other agents have shown efficacy. Ultimately, a combination of immunologic and cellular therapies may be needed to restore metabolic control. Agents that augment recovery of dysfunctional ß-cells...
Source: Endocrinology and Metabolism Clinics of North America - April 21, 2009 Category: Endocrinology Authors: Frank Waldron-Lynch, Kevan C. Herold Source Type: journals

Genetics of Type 1 Diabetes and Autoimmune Thyroid DiseaseEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The search for the susceptibility alleles for the complex genetic conditions of type 1 diabetes and autoimmune thyroid diseases has gained momentum in recent years. Studies have revealed several novel disease susceptibility alleles of relevance to both conditions, which brings the total number of genetic variants contributing to type 1 diabetes to ten. Additional genetic loci remain to be discovered, particularly in the autoimmune thyroid diseases. In the future, the density and coverage of single nucleotide polymorphisms available for high throughput genotyping will improve, and detailed analysis of the role of copy numbe...
Source: Endocrinology and Metabolism Clinics of North America - April 21, 2009 Category: Endocrinology Authors: Simon H.S. Pearce, Tony R. Merriman Source Type: journals

Clearing the AIRE: On the Pathophysiological Basis of the Autoimmune Polyendocrinopathy Syndrome Type-1Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Autoimmune polyendocrine syndrome type-1 clinically manifests as the triad of hypoparathyroidism, primary adrenocortical insufficiency, and chronic mucocutaneous candidiasis. Mutations in the gene that encodes the autoimmune regulator protein, AIRE, have been identified as the cause of the autoimmune polyendocrine syndrome type-1. The loss of immunologic tolerance to tissue-restricted antigens consequent to an absence of AIRE expression in the thymus results in the thymic export of autoreactive T cells that initiate autoimmunity. In this article, we discuss the role of AIRE in autoimmune polyendocrine syndrome type-1 and i...
Source: Endocrinology and Metabolism Clinics of North America - April 21, 2009 Category: Endocrinology Authors: Noriko Shikama, Gretel Nusspaumer, Georg A. Holländer Source Type: journals

Regulatory T Cells: Key Players in Tolerance and AutoimmunityEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
CD4 + CD25 + regulatory T (TR) lymphocytes are essential to the maintenance of immunologic tolerance in the host. The discovery of Foxp3 as a transcription factor essential to the differentiation of TR ushered in detailed studies of the molecular mechanisms of TR cell development, peripheral homeostasis, and effector functions. In humans, loss of function mutations in genes that regulate T-cell development and function have been associated with TR cell deficiency or dysfunction and syndromes of autoimmunity and immune dysregulation. Augmentation of TR cells by immunotherapy and pharmacologic agents is a promising strategy ...
Source: Endocrinology and Metabolism Clinics of North America - April 21, 2009 Category: Endocrinology Authors: Talal A. Chatila Source Type: journals

PrefaceEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Autoimmune disorders are among the most frequently encountered conditions in endocrine practice. Despite this, and disregarding minor developments in drug delivery, treatment has remained effectively unchanged for more than 50 years for thyroid disorders and even longer for autoimmune diabetes. This situation might be acceptable if the existing treatments were perfect and if patient quality of life and satisfaction were high; however, this is clearly not the case. In particular, people who have autoimmune diabetes, Addison's disease, and thyroid eye disease are left with chronic and morbid conditions, manageable only to a ...
Source: Endocrinology and Metabolism Clinics of North America - April 21, 2009 Category: Endocrinology Authors: Simon H.S. Pearce Source Type: journals

ForewordEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This issue of Endocrinology and Metabolism Clinics focuses on clinical and molecular advances in autoimmune endocrine conditions. (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - April 21, 2009 Category: Endocrinology Authors: Derek LeRoith Source Type: journals

Forthcoming IssuesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - April 21, 2009 Category: Endocrinology Source Type: journals

ContentsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - April 21, 2009 Category: Endocrinology Source Type: journals

This issue of Endocrinology and Metabolism Clinics focuses on clinical and molecular advances in autoimmune endocrine conditions. Foreword.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 19328408 [PubMed - in process] (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - April 7, 2009 Category: Endocrinology Authors: LeRoith D Tags: Endocrinol Metab Clin North Am Source Type: journals

Autoimmune disorders are among the most frequently encountered conditions in endocrine practice. Preface.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 19328409 [PubMed - in process] (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - April 7, 2009 Category: Endocrinology Authors: Pearce SH Tags: Endocrinol Metab Clin North Am Source Type: journals

Regulatory T cells: key players in tolerance and autoimmunity.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
CD4 + CD25 + regulatory T (TR) lymphocytes are essential to the maintenance of immunologic tolerance in the host. The discovery of Foxp3 as a transcription factor essential to the differentiation of TR ushered in detailed studies of the molecular mechanisms of TR cell development, peripheral homeostasis, and effector functions. In humans, loss of function mutations in genes that regulate T-cell development and function have been associated with TR cell deficiency or dysfunction and syndromes of autoimmunity and immune dysregulation. Augmentation of TR cells by immunotherapy and pharmacologic agents is a promising strat...
Source: Endocrinology and Metabolism Clinics of North America - April 7, 2009 Category: Endocrinology Authors: Chatila TA Tags: Endocrinol Metab Clin North Am Source Type: journals

Clearing the AIRE: on the pathophysiological basis of the autoimmune polyendocrinopathy syndrome type-1.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Autoimmune polyendocrine syndrome type-1 clinically manifests as the triad of hypoparathyroidism, primary adrenocortical insufficiency, and chronic mucocutaneous candidiasis. Mutations in the gene that encodes the autoimmune regulator protein, AIRE, have been identified as the cause of the autoimmune polyendocrine syndrome type-1. The loss of immunologic tolerance to tissue-restricted antigens consequent to an absence of AIRE expression in the thymus results in the thymic export of autoreactive T cells that initiate autoimmunity. In this article, we discuss the role of AIRE in autoimmune polyendocrine syndrome type-1 a...
Source: Endocrinology and Metabolism Clinics of North America - April 7, 2009 Category: Endocrinology Authors: Shikama N, Nusspaumer G, Holländer GA Tags: Endocrinol Metab Clin North Am Source Type: journals

Genetics of type 1 diabetes and autoimmune thyroid disease.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The search for the susceptibility alleles for the complex genetic conditions of type 1 diabetes and autoimmune thyroid diseases has gained momentum in recent years. Studies have revealed several novel disease susceptibility alleles of relevance to both conditions, which brings the total number of genetic variants contributing to type 1 diabetes to ten. Additional genetic loci remain to be discovered, particularly in the autoimmune thyroid diseases. In the future, the density and coverage of single nucleotide polymorphisms available for high throughput genotyping will improve, and detailed analysis of the role of copy n...
Source: Endocrinology and Metabolism Clinics of North America - April 7, 2009 Category: Endocrinology Authors: Pearce SH, Merriman TR Tags: Endocrinol Metab Clin North Am Source Type: journals

Advances in Type 1 diabetes therapeutics: immunomodulation and beta-cell salvage.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Refinements in our understanding of the pathogenic mechanisms of Type 1 diabetes from studies of animal models and clinical observation have led to new clinical trials to prevent disease progression and restore the loss of beta-cells that defines the disease. Antigen-specific agents have shown initial promise and non-antigen-specific agents now have improved safety compared with older agents. In addition, preclinical studies with other agents have shown efficacy. Ultimately, a combination of immunologic and cellular therapies may be needed to restore metabolic control. Agents that augment recovery of dysfunctional beta...
Source: Endocrinology and Metabolism Clinics of North America - April 7, 2009 Category: Endocrinology Authors: Waldron-Lynch F, Herold KC Tags: Endocrinol Metab Clin North Am Source Type: journals

The thyroid-stimulating hormone receptor: impact of thyroid-stimulating hormone and thyroid-stimulating hormone receptor antibodies on multimerization, cleavage, and signaling.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The thyroid-stimulating hormone receptor (TSHR) has a central role in thyrocyte function and is also one of the major autoantigens for the autoimmune thyroid diseases. We review the post-translational processing, multimerization, and intramolecular cleavage of TSHR, all of which may modulate its signal transduction. The recent characterization of monoclonal antibodies to the TSHR, including stimulating, blocking, and neutral antibodies, have also revealed unique biologic insights into receptor activation and the variety of these TSHR antibodies may help explain the multiple clinical phenotypes seen in autoimmune thyroi...
Source: Endocrinology and Metabolism Clinics of North America - April 7, 2009 Category: Endocrinology Authors: Latif R, Morshed SA, Zaidi M, Davies TF Tags: Endocrinol Metab Clin North Am Source Type: journals

Toward better models of hyperthyroid Graves' disease.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article discusses the pursuit of a better experimental model for hyperthyroid Graves' disease and outlines how this research has clarified the immunology of the disease. PMID: 19328415 [PubMed - in process] (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - April 7, 2009 Category: Endocrinology Authors: Dağdelen S, Kong YC, Banga JP Tags: Endocrinol Metab Clin North Am Source Type: journals

Treatment of Graves' hyperthyroidism: evidence-based and emerging modalities.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article reviews the current evidence so the reader can evaluate advantages and disadvantages of these treatment modalities. Surgery is rarely used, except for patients who have a large goiter or ophthalmopathy. Fewer than 50% of patients treated with ATD remain in long-term remission. Therefore, radioactive iodine is used increasingly. No data as yet support the routine use of biologic therapies (eg, rituximab). Prospective, randomized studies comparing available and any novel therapeutic options for GD are needed. The focus of these studies should include, but not be limited to, cost and quality of life. PMID: 19...
Source: Endocrinology and Metabolism Clinics of North America - April 7, 2009 Category: Endocrinology Authors: Hegedüs L Tags: Endocrinol Metab Clin North Am Source Type: journals

Thyroid-associated orbitopathy: who and how to treat.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Thyroid-associated orbitopathy is the most frequent and troublesome nonthyroidal complication of Graves' disease. It is mandatory to determine whether sight-threatening orbitopathy is present, as this requires prompt and aggressive treatment. Therapies for non-sight-threatening disease range from supportive measures only to medical therapies for active eye disease and surgical rehabilitation for burnt-out disease. Intravenous steroids and orbital radiotherapy are the mainstays of medical therapy. Rehabilitative surgery is frequently a staged process that may involve sequentially: orbital decompression, strabismus surge...
Source: Endocrinology and Metabolism Clinics of North America - April 7, 2009 Category: Endocrinology Authors: Dickinson J, Perros P Tags: Endocrinol Metab Clin North Am Source Type: journals

Immunology of Addison's disease and premature ovarian failure.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Autoimmune Addison's disease and autoimmune ovarian insufficiency are caused by selective targeting by T and B lymphocytes to the steroidogenic apparatus in these organs. Autoantibodies toward 21-hydroxylase are a clinically useful marker for autoimmune Addison's disease. Autoantibodies to 21-hydroxylase are found in premature ovarian insufficiency, but others also can be present, notably antibodies against side-chain cleavage enzyme. The autoimmune response primarily targets the theca cells, yielding elevated concentrations of inhibin, which is emerging as a useful diagnostic marker for autoimmune etiology of ovarian ...
Source: Endocrinology and Metabolism Clinics of North America - April 7, 2009 Category: Endocrinology Authors: Husebye ES, Løvås K Tags: Endocrinol Metab Clin North Am Source Type: journals

Fine tuning for quality of life: 21st century approach to treatment of Addison's disease.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Despite treatment with glucocorticoids and mineralocorticoids, the ability to work and quality of life of patients who have adrenal insufficiency remains low. There are no helpful objective measures of optimal glucocorticoid replacement, so this is best achieved by careful clinical assessment. Adequacy of mineralocorticoid replacement may be judged by assessing postural change in blood pressure, serum electrolytes, and plasma renin activity. Novel delayed-release and sustained-release formulations of hydrocortisone seem to more closely mimic diurnal serum cortisol rhythms than conventional hydrocortisone tablets. Such ...
Source: Endocrinology and Metabolism Clinics of North America - April 7, 2009 Category: Endocrinology Authors: Reisch N, Arlt W Tags: Endocrinol Metab Clin North Am Source Type: journals

Diagnosis and management of polyendocrinopathy syndromes.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The autoimmune polyendocrinopathy syndromes are variable in presentation and can be challenging to diagnose and manage. Diagnosis of the type 1 autoimmune polyendocrinopathy syndrome can be difficult at an early age when often only one manifestation is present, and it may take years for others to appear. Increased awareness of polyendocrinopathy syndromes, combined with analysis of specific autoantibodies and molecular genetics, should help earlier diagnosis of these conditions and prevent serious complications. Further definition of susceptibility genes and autoantigens, as well as a better understanding of the pathog...
Source: Endocrinology and Metabolism Clinics of North America - April 7, 2009 Category: Endocrinology Authors: Owen CJ, Cheetham TD Tags: Endocrinol Metab Clin North Am Source Type: journals

Anti-parathyroid and anti-calcium sensing receptor antibodies in autoimmune hypoparathyroidism.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The parathyroid glands are an infrequent target for autoimmunity, the exception being autoimmune polyglandular syndrome type 1, in which autoimmune hypoparathyroidism is the rule. Antibodies that are directed against the parathyroid cell surface calcium-sensing receptor (CaSR) have recently been recognized to be present in the serum of patients with autoimmune hypoparathyroidism. In some individuals, these anti-CaSR antibodies have also been shown to produce functional activation of the receptor, suggesting a direct pathogenic role in hypocalcemia. Additionally, a few hypercalcemic patients with autoimmune hypocalciuri...
Source: Endocrinology and Metabolism Clinics of North America - April 7, 2009 Category: Endocrinology Authors: Brown EM Tags: Endocrinol Metab Clin North Am Source Type: journals

Extensive papillary carcinoma of the thyroid gland treated by external beam radiotherapy, surgery and postoperative radioactive iodine therapy.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We report a case with an extensive papillary carcinoma of thyroid gland treated by external beam radiotherapy as a cytoreductive therapy followed by total thyroidectomy. Postoperatively the patient was given radioactive iodine. The patient is free from tumor a year after the treatment. PMID: 19294401 [PubMed - as supplied by publisher] (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - March 18, 2009 Category: Endocrinology Authors: Naveed A, Kanaan F, Tjernstrom NO Tags: Eur Arch Otorhinolaryngol Source Type: journals

Basic aspects and clinical applicability in the field of lipidology. Foreword.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 19217508 [PubMed - in process] (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - February 20, 2009 Category: Endocrinology Authors: LeRoith D Tags: Endocrinol Metab Clin North Am Source Type: journals

The field of clinical lipidology. Preface.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 19217509 [PubMed - in process] (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - February 20, 2009 Category: Endocrinology Authors: Smith DA Tags: Endocrinol Metab Clin North Am Source Type: journals

Foreword.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 19217508 [PubMed - as supplied by publisher] (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - February 18, 2009 Category: Endocrinology Authors: Leroith D Tags: Endocrinol Metab Clin North Am Source Type: journals

Preface.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 19217509 [PubMed - as supplied by publisher] (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - February 18, 2009 Category: Endocrinology Authors: Smith DA Tags: Endocrinol Metab Clin North Am Source Type: journals