Articles in Endocrinology & Metabolism (5)

La tempesta tiroidea è un'emergenza endocrina ipermetabolica e potenzialmente letale caratterizzata da disfunzione multiorgano dovuta a tireotossicosi grave. La diagnosi si basa sulla scala clinica di Burch-Wartofsky associata a TSH soppresso e ormoni tiroidei elevati, e richiede un trattamento tempestivo con beta-bloccanti, tionamidi, iodio e corticosteroidi.

La chetoacidosi diabetica è un'emergenza metabolica grave causata da una carenza insulinica assoluta o relativa, caratterizzata dalla triade biochimica di iperglicemia, chetonemia e acidosi metabolica ad alto anion gap. Richiede un trattamento tempestivo con fluidoterapia aggressiva, infusione di insulina e monitoraggio rigoroso del potassio.

Hyperosmolar hyperglycaemic state is a life-threatening endocrine emergency characterized by severe dehydration, profound hyperglycaemia, and hyperosmolality without significant ketoacidosis, diagnosed via serum osmolality and metabolic panels, and managed primarily with aggressive intravenous fluid resuscitation and controlled insulin therapy.

Phaeochromocytoma is a rare, catecholamine-secreting neuroendocrine tumour arising from chromaffin cells of the adrenal medulla, classically presenting with paroxysmal hypertension, headaches, sweating, and palpitations. The gold-standard diagnostic approach relies on plasma free or 24-hour urinary fractionated metanephrines coupled with cross-sectional imaging (CT/MRI), followed by mandatory preoperative alpha-blockade and laparoscopic adrenalectomy.

Addisonian crisis is a life-threatening endocrine emergency characterized by acute, severe glucocorticoid and mineralocorticoid deficiency, presenting with refractory shock, profound weakness, and acute abdominal symptoms. The gold-standard diagnostic approach relies on drawing random serum cortisol and ACTH levels prior to immediate administration of stress-dose IV hydrocortisone and aggressive crystalloid resuscitation.