Handbook of Diagnostic Endocrinology

344 Pages·2003·2.552 MB·English

by  Sabrina Gill MD, Frances J. Hayes MD (auth.), Janet E. Hall MD, Lynnette K. Nieman MD (eds.)

H D E
ANDBOOK OF IAGNOSTIC NDOCRINOLOGY
C E
ONTEMPORARY NDOCRINOLOGY
P. Michael Conn, S E
ERIES DITOR
Androgens in Health and Disease, edited by Endocrinology of the Lung: Development
CARRIE BAGATELLAND WILLIAM J. and Surfactant Synthesis, edited by
BREMNER, 2003 CAROLE R. MENDELSON, 2000
Endocrine Replacement Therapy in Clinical Sports Endocrinology, edited by MICHELLE
Practice,edited by A. WAYNE MEIKLE, P. WARRENAND NAAMA W. CONSTANTINI,
2003 2000
Early Diagnosis and Treatment Gene Engineering in Endocrinology, edited
of Endocrine Disorders, edited by byMARGARET A. SHUPNIK,2000
ROBERT S. BAR,2003 Endocrinology of Aging, edited by JOHN E.
Type I Diabetes: Etiology and Treatment, MORLEYAND LUCRETIAVANDEN BERG,
edited by MARK A. SPERLING,2003 2000
Handbook of Diagnostic Endocrinology, Human Growth Hormone: Research and
edited by JANET E. HALLAND LYNNETTE Clinical Practice, edited by ROY G.
K. NIEMAN,2003 SMITHAND MICHAEL O. THORNER,2000
Pediatric Endocrinology: A Practical Hormones and the Heart in Health and
Clinical Guide, edited by SALLY Disease,edited by LEONARD SHARE,
RADOVICKAND MARGARET H. 1999
MACGILLIVRAY,2003 Menopause:Endocrinology and Manage-
Diseases of the Thyroid, 2nd ed., edited by ment,edited by DAVID B. SEIFERAND
LEWIS E. BRAVERMAN,2003 ELIZABETH A. KENNARD,1999
Developmental Endocrinology: The IGF System: Molecular Biology,
From Research to Clinical Practice, Physiology, and Clinical Applica-
edited by ERICA A. EUGSTERAND ORA tions,edited by RON G. ROSENFELD
HIRSCH PESCOVITZ,2002 AND CHARLES T. ROBERTS,JR.,1999
Osteoporosis:Pathophysiology and Clinical Neurosteroids:A New Regulatory Function
Management,edited by ERIC S. in the Nervous System, edited by
ORWOLLAND MICHAEL BLIZIOTES,2002 ETIENNE-EMILE BAULIEU, PAUL ROBEL,
Challenging Cases in Endocrinology, AND MICHAEL SCHUMACHER,1999
edited by MARK E. MOLITCH, 2002 Autoimmune Endocrinopathies, edited by
Selective Estrogen Receptor Modulators: ROBERT VOLPÉ,1999
Research and Clinical Applications, Hormone Resistance Syndromes, edited by
edited by ANDREA MANNIAND MICHAEL J. LARRY JAMESON,1999
F. VERDERAME,2002 Hormone Replacement Therapy, edited by
Transgenics in Endocrinology, edited by A. WAYNE MEIKLE,1999
MARTIN MATZUK, CHESTER W. BROWN, Insulin Resistance: The Metabolic Syndrome
AND T. RAJENDRA KUMAR,2001 X,edited by GERALD M. REAVENAND
Assisted Fertilization and Nuclear Transfer AMI LAWS,1999
in Mammals, edited by DON P. WOLF Endocrinology of Breast Cancer,edited by
AND MARY ZELINSKI-WOOTEN,2001 ANDREA MANNI,1999
Adrenal Disorders, edited by ANDREW N. Molecular and Cellular Pediatric
MARGIORISAND GEORGE P. CHROUSOS, Endocrinology,edited bySTUART
2001 HANDWERGER,1999
Endocrine Oncology, edited by STEPHEN P. Gastrointestinal Endocrinology,edited by
ETHIER, 2000 GEORGE H. GREELEY, JR.,1999
H
ANDBOOK
D
OF IAGNOSTIC
E
NDOCRINOLOGY
Edited by
J E. H ,
ANET ALL MD
Massachusetts General Hospital, Boston, MA
and
L K. N ,
YNNETTE IEMAN MD
National Institute of Child Health
and Human Development, National Institutes
of Health, Bethesda, MD
SPRINGER SCIENCE+BUSINESS
MEDIA, LLC
© 2003 Springer Science+Business Media New York
Originally published by Humana Press Inc. in 2003
Softcover reprint of the hardcover 1st edition 2003

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10 9 8 7 6 5 4 3 2 1
Handbook of diagnostic endocrinology /edited by Janet E. Hall and Lynnette K. Nieman.
p. ; cm.—(Contemporary endocrinology)
Includes bibliographical references and index.
ISBN 978-1-61737-172-1 ISBN 978-1-59259-293-7 (eBook)
DOI 10.1007/978-1-59259-293-7
1. Endocrine glands—Diseases—Diagnosis—Handbooks, manuals, etc. I. Hall, Janet E.
II. Nieman, Lynnette, K. III. Contemporary endocrinology (Totowa, NJ).
[DNLM: 1. Endocrine Diseases—diagnosis. 2. Diagnostic Techniques, Endocrine. WK
140 H236 2003 ]
RC649 .H298 2003
616.4’075—dc21 2002032870
P
REFACE
The aim of the Handbook of Diagnostic Endocrinologyis to provide a com-
prehensive overview of current approaches to the diagnosis of endocrine disor-
ders. Our ability to diagnose patients with diseases of the endocrine systems is
expanding exponentially with the development of new and more reliable assay
methods and the incorporation of both molecular and genetic approaches into
our understanding of the pathophysiology of these diseases. Although the pri-
mary focus of this volume is on the diagnosis of endocrine disease, the vast
majority of endocrine diseases require long-term management; therefore, many
of the chapters also discuss approaches to follow-up in these patients.
TheHandbook of Diagnostic Endocrinologycomprises 16 chapters. Immu-
noassays have long been the cornerstones of endocrine diagnoses. As an impor-
tant background, Sabrina Gill, Frances Hayes, and Patrick Sluss discuss the
many methodological advances that have expanded our repertoire of diagnostic
tests. With the increased number of tests available for endocrine evaluation, it
is incumbent that we understand the factors that affect assay performance and
their impact on our ability to use these tools to aid in clinical diagnosis. Joseph
Verbalis reviews the regulatory mechanisms underlying water and sodium
metabolism and presents a comprehensive approach to disorders of body fluids,
which are among the most commonly encountered problems in clinical medi-
cine. Mary Lee Vance outlines the diagnosis and long-term followup of patients
presenting with pituitary tumors, and Lynnette Nieman provides an approach to
the diagnosis and differential diagnosis of Cushing’s syndrome that includes a
critical appraisal of available tests. Although endocrine causes of hypertension
occur in only 10% of hypertensive subjects, this small fraction represents a large
number of patients. Jennifer Lawrence and Robert Dluhy present a thoughtful
and efficient approach to the diagnosis of these disorders. Anastassios Pittas and
Stephanie Lee then update the approach to the diagnosis of thyroid disease,
including an important discussion of currently available assays. Regina Castro
and Hossein Gharib present a cost-effective approach to evaluation of the com-
mon problem of thyroid nodules and discuss the preoperative evaluation and
postoperative followup of patients with thyroid cancer. Allison Goldfine pro-
vides an overview of the diagnosis of the various forms of diabetes and a com-
prehensive discussion of long-term monitoring of the primary disease and its
complications. Robert Ratner reviews the important area of gestational diabetes,
both its diagnosis and consequences, and John Service presents a clear approach
to the diagnosis of hypoglycemia. William Donahoo, Elizabeth Stephens, and
v
vi Preface
Robert Eckel provide a thorough discussion of the modalities that are currently
available for the assessment of dyslipidemia and obesity. Benjamin Leder and
Joel Finkelstein then review calcium metabolism and present a logical approach
to the diagnosis of hyper- and hypocalcemia. Patrick Doran and Sundeep Khosla
discuss the spectrum of osteoporosis and an approach to diagnosis and long-term
followup based on the currently available tools. Margaret Wierman reviews the
normal physiology of the hypothalamic–pituitary–testicular axis and the physi-
ology of erection, both of which are critical to the approach to evaluation of
hypogonadism and erectile dysfunction. Drew Tortoriello and Janet Hall then
discuss the physiology of normal menstrual function as a backdrop to their
approach to the evaluation and long-term followup of women with disorders of
menstrual function. Ricardo Azziz completes this volume with a practical and
focused discussion of the evaluation of androgen excess in women.
In Handbook of Diagnostic Endocrinology we provide the reader with a
concise approach to the diagnosis of endocrine disorders that is based on an
understanding of their pathophysiology and includes both clinical manifesta-
tions and the most current laboratory tests available. This work will serve as a
reference for students and fellows in training as well as an update for practicing
endocrinologists and internists.
We thank the contributors to this volume, without whose expertise and efforts
this work would not be possible.
Janet E. Hall, MD
Lynnette K. Nieman, MD
C
ONTENTS
Preface..........................................................................................v
Contributors.................................................................................ix
1 Issues in Endocrine Immunoassay .........................................1
Sabrina Gill, Frances J. Hayes, and Patrick M. Sluss
2 Disorders of Water Metabolism ...........................................23
Joseph G. Verbalis
3 Pituitary Tumors: Prolactinomas, Acromegaly,
Gonadotropin-Producing, Nonfunctioning......................55
Mary Lee Vance
4 Cushing’s Syndrome.............................................................67
Lynnette K. Nieman
5 Endocrine Hypertension .......................................................85
Jennifer E. Lawrence and Robert G. Dluhy
6 Evaluation of Thyroid Function .........................................107
Anastassios G. Pittas and Stephanie L. Lee
7 Thyroid Nodules and Thyroid Cancer................................131
M. Regina Castro and Hossein Gharib
8 Diagnosis and Management of Diabetes............................157
Allison B. Goldfine
9 Gestational Diabetes: Where Do We Look for It
and How Do We Find It? ...............................................179
Robert E. Ratner
10 Hypoglycemic Disorders....................................................193
F. John Service
11 The Evaluation of Dyslipidemia and Obesity....................213
William T. Donahoo, Elizabeth Stephens,
and Robert H. Eckel
12 Hyper- and Hypocalcemia..................................................239
Benjamin Z. Leder and Joel S. Finkelstein
vii
viii Contents
13 Osteoporosis........................................................................257
Patrick M. Doran and Sundeep Khosla
14 Hypogonadism and Erectile Dysfunction ..........................277
Margaret E. Wierman
15 Menstrual Dysfunction .......................................................295
Drew V. Tortoriello and Janet E. Hall
16 Differential Diagnosis and Evaluation
of Hyperandrogenism.....................................................323
Ricardo Azziz
Index.........................................................................................331
C
ONTRIBUTORS
RICARDO AZZIZ,MD,MPH,MBA, Department of Obstetrics and Gynecology,
Cedars-Sinai Medical Center, Los Angeles, CA
M. REGINA CASTRO,MD,Department of Medicine and Endocrinology,Albany
Medical College, Stratton VA Medical Center, Albany, NY
ROBERT G. DLUHY,MD,Division of Endocrinology-Hypertension, Brigham
and Women’s Hospital, Boston, MA
WILLIAM T. DONAHOO,MD,Division of Endocrinology, Metabolism and
Diabetes, University of Colorado Health Sciences Center, Denver, CO
PATRICK M. DORAN,MD,Division of Endocrinology, McGill University Health
Center, Montreal, Canada
ROBERT H. ECKEL,MD,Division of Endocrinology, Metabolism and Diabetes,
University of Colorado Health Sciences Center, Denver, CO
JOEL S. FINKELSTEIN,MD, Division of Endocrinology, Massachusetts General
Hospital, Boston, MA
HOSSEIN GHARIB,MD,FACE,Division of Endocrinology and Metabolism, Mayo
Clinic and Mayo Foundation, Rochester, MN
SABRINA GILL,MD, Division of Endocrinology and Metabolism, St. Paul’s
Hospital, Vancouver BC, Canada
ALLISON B. GOLDFINE,MD, Research Division, Joslin Diabetes Center, Boston,
MA
JANET E. HALL,MD,Reproductive Endocrine Unit, Division of Endocrinology,
Massachusetts General Hospital, Boston, MA
FRANCES J. HAYES,MD, Reproductive Endocrine Unit, Division of
Endocrinology, Massachusetts General Hospital, Boston, MA
SUNDEEP KHOSLA,MD, Division of Endocrinology and Metabolism, Mayo
Clinic, Rochester, MN
JENNIFER E. LAWRENCE,MD,Valdosta Specialty Clinic, Valdosta, GA
BENJAMIN Z. LEDER,MD, Division of Endocrinology, Massachusetts General
Hospital, Boston, MA
STEPHANIE L. LEE,MD,Division of Endocrinology, Diabetes and Metabolism,
Boston Medical Center, Boston, MA
LYNNETTE K. NIEMAN,MD, Pediatric and Reproductive Endocrinology Branch,
National Institute of Child Health and Human Development, National
Institutes of Health, Bethesda, MD
ANASTASSIOS G. PITTAS,MD, Division of Endocrinology, Diabetes, Metabolism
and Molecular Medicine, New England Medical Center, Boston, MA
ix
x Contributors
ROBERT E. RATNER,MD,MedStar Research Institute, Washington, DC
F. JOHN SERVICE,MD,PhD,Division of Endocrinology and Internal Medicine,
Mayo Clinic, Rochester, MN
PATRICK M. SLUSS,PhD, Reproductive Endocrine Unit, Division of
Endocrinology, Massachusetts General Hospital, Boston, MA
ELIZABETH STEPHENS,MD,Division of Endocrinology, Diabetes, and Clinical
Nutrition, Oregon Health and Science University, Portland, OR
DREW V. TORTORIELLO,MD,Department of Obstetrics and Gynecology,
Columbia Presbyterian Medical Center, New York, NY
MARY LEE VANCE,MD, Division of Endocrinology, University of Virginia
Health Services Center, Charlottesville, VA
JOSEPH G. VERBALIS,MD, Division of Endocrinology and Metabolism,
Georgetown University School of Medicine, Washington, DC
MARGARET E. WIERMAN,MD, Division of Endocrinology, Veterans Affairs
Medical Center, University of Colorado School of Medicine, Denver, CO