Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
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Case Reports
A case of unilateral adrenal hyperplasia: the diagnostic dilemma of hyperaldosteronism.
To report the successful laparoscopic surgical management of a case of right unilateral adrenal hyperplasia. ⋯ This rare type of hyperaldosteronism, known as unilateral adrenal hyperplasia, is difficult to categorize not only because it fails to typify a conventional subtype but also because it is difficult to confirm the pathologic diagnosis. Recognition of the variety of provocative, biochemical, and imaging results that may be seen in this disorder is important in making the correct diagnosis. Determining unilaterality of disease by selective adrenal vein sampling can result in a cure of hypertension and hypokalemia by surgical resection.
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To present two new cases of gynecomastia as the initial manifestation of hyperthyroidism. ⋯ Because of the rarity of gynecomastia as the initial symptom of hyperthyroidism, we believe that thyroid function tests are not indicated in the workup of patients whose major complaint is gynecomastia.
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To present an approach to the complete but cost-effective office evaluation and treatment of erectile dysfunction. ⋯ A multidisciplinary approach to the evaluation and treatment of erectile dysfunction is logical, and the endocrinologist--because of an extensive background in internal medicine and expertise in hormonal diagnosis and treatment--should be the focal point of this diagnostic and therapeutic team.
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To present an overview of autoimmune thyroid disease (AITD) that can occur in pregnancy. ⋯ Treatment of maternal hyperthyroidism must consider both maternal and fetal thyroid status. In general, the lowest dose of antithyroid medication sufficient to produce maternal euthyroidism or slight hyperthyroidism is used. In pregnant women with hypothyroidism, doses of L-thyroxine should be sufficient to normalize maternal thyroid function without regard to the fetus. Identification and treatment of affected infants soon after birth will ensure a normal outcome. Whether inadequately treated maternal hypothyroidism is associated with a permanent intellectual deficit in the offspring is currently unknown.