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Endocrinology

Endocrine emergencies

Endocrine emergencies require prompt recognition and management to prevent severe complications and mortality. Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic syndrome (HHS) are life-threatening conditions that necessitate urgent medical attention, focusing on fluid resuscitation, insulin therapy, and electrolyte management. Effective management involves careful monitoring and adjustment of treatment based on patient response.

Pituitary apoplexy is a medical emergency characterized by severe neurological and endocrine complications. Rapid diagnosis and intervention are crucial, including imaging studies, hormonal replacement therapy, and surgical considerations. A multidisciplinary approach ensures optimal patient outcomes.

Thyroid emergencies, such as thyroid storm and myxedema coma, require immediate medical attention. Early recognition and intervention are vital, with management strategies including supportive care and specific therapeutic interventions. A multidisciplinary approach is essential for optimal patient care.

Acute adrenal insufficiency, or adrenal crisis, is a life-threatening condition that demands immediate intervention. Rapid administration of hydrocortisone, fluid resuscitation, and supportive care are crucial. Diagnostic evaluation and long-term management strategies, including patient education, are essential for preventing recurrence and ensuring optimal outcomes.


Acute decompensated diabetes mellitus: diabetic ketoacidosis (DKA) & hyperosmolar hyperglycemic syndrome (HHS)

Guideline

Diabetic ketoacidosis (DKA) & hyperosmolar hyperglycemic syndrome (HHS)

Hyperglycemic Crises in Adults With Diabetes: A Consensus Report

Guillermo E. Umpierrez et al., Diabetes Care (2024)

What’s inside

This consensus report provides updated guidelines for the diagnosis and management of hyperglycemic crises, including diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS), in adults with diabetes.

Why it’s relevant

Hyperglycemic crises are life-threatening complications of diabetes, requiring prompt and effective management to prevent morbidity and mortality.

Key focus

  • Diagnostic criteria for DKA and HHS
  • Fluid and electrolyte management strategies
  • Insulin therapy protocols and monitoring
  • Prevention of recurrence and patient education

Takeaway

The report emphasizes early recognition, tailored insulin therapy, and fluid and electrolyte management to improve outcomes in patients with hyperglycemic crises.


Pituitary apoplexy

Guideline

Pituitary apoplexy

Society for Endocrinology Endocrine Emergency Guidance: Emergency management of pituitary apoplexy in adult patients

Stephanie E Baldeweg et al., Endocrine Connections (2016)

What’s inside

This article provides guidance from the Society for Endocrinology on the emergency management of pituitary apoplexy in adult patients, focusing on rapid diagnosis and treatment.

Why it’s relevant

Pituitary apoplexy is a medical emergency that can lead to severe neurological and endocrine complications. Prompt recognition and management are essential to prevent long-term morbidity and mortality.

Key focus

  • Recognition of the clinical signs and symptoms of pituitary apoplexy
  • Immediate diagnostic evaluation, including imaging studies
  • Management of acute symptoms, such as visual impairment and altered consciousness
  • Hormonal replacement therapy for associated endocrine dysfunction
  • Surgical intervention considerations and timing
  • Long-term follow-up and management strategies

Takeaway

The guidance emphasizes the importance of rapid diagnosis and intervention in managing pituitary apoplexy, highlighting the need for a multidisciplinary approach to ensure optimal patient outcomes.


Thyroidal emergencies

Review

Thyroid emergencies

Thyroid emergencies

Dorina Ylli et al., Polish Archives of Internal Medicine (2019)

What’s inside

This article reviews thyroid emergencies, focusing on the recognition and management of severe thyroid dysfunctions that require immediate medical attention.

Why it’s relevant

Thyroid emergencies, such as thyroid storm and myxedema coma, are life-threatening conditions that necessitate prompt diagnosis and treatment to prevent adverse outcomes.

Key focus

  • Clinical presentation and diagnostic criteria for thyroid storm and myxedema coma
  • Pathophysiology and risk factors associated with thyroid emergencies
  • Management strategies, including supportive care and specific therapeutic interventions
  • Importance of early recognition and intervention to improve patient outcomes
  • Considerations for long-term management and prevention of recurrence

Takeaway

The article emphasizes the importance of recognizing and managing thyroid emergencies promptly, highlighting the need for a multidisciplinary approach to ensure optimal patient care and outcomes.


Acute adrenal insufficiency

For critical illness-related corticosteroid insufficiency (CIRCI) look here.

Guideline

Acute adrenal insufficiency / adrenal crisis

Society for Endocrinology Endocrine Emergency Guidance: Emergency management of acute adrenal insufficiency (adrenal crisis) in adult patients

Wiebke Arlt et al., Endocrine Connections (2016)

What’s inside

This article provides guidance from the Society for Endocrinology on the emergency management of acute adrenal insufficiency, also known as adrenal crisis, in adult patients.

Why it’s relevant

Acute adrenal insufficiency is a life-threatening condition that requires immediate medical intervention. Prompt recognition and treatment are essential to prevent severe complications and mortality.

Key focus

  • Recognition of the signs and symptoms of adrenal crisis
  • Immediate administration of hydrocortisone as the primary treatment
  • Importance of fluid resuscitation and supportive care
  • Diagnostic evaluation to confirm adrenal insufficiency and identify the underlying cause
  • Long-term management and prevention strategies, including patient education and emergency preparedness

Takeaway

The guidance emphasizes the importance of rapid intervention and appropriate management strategies in adrenal crisis to ensure patient stabilization and improve outcomes.

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