Hyperthermia is a condition that happens due to a steep rise in the body temperature above 104° Fahrenheit or 40° Celsius. It is a kind of heat illness that is common among patients admitted to the emergency department. In this situation, the heat regulation system of the body fails to handle the heat in the surrounding environment.

Difference between Hypothermia & Hyperthermia

Hypothermia is the condition when the body temperature falls extremely low leading to dangerous outcomes. It usually occurs when the body temperature touches or goes below 95°F (35°C).

On the contrary, as mentioned above hyperthermia is a condition when the body temperature rises very high to uncontrollable levels. Both of these are considered as a case of medical emergency.

Hyperthermia often confused with fever

Although, at times it is confused with fever, it is a completely different case. While sick, the body temperature rises to fight out the infectious materials entered into the body and as a result, the temperature is high on the thermometer.

But in case of hyperthermia, the body temperature rises but not on purpose. In this case, the heating and cooling mechanisms of the body become uncontrollable and the body cannot get rid of the heat.

Hypothermia Hyperthermia on Celsius and Fahrenheit thermometers

Stages of Hyperthermia

Hyperthermia occurs on many levels. They are:

1. Heat Stress: It is a condition when the temperature starts climbing and the affected person is unable to cool himself/herself through sweating. It may lead to serious complications like heat exhaustion or stroke. Dizziness, nausea, weakness, headache and constant thirst are some of the common symptoms. It is advised that in such an event, the patient move to a cooler place and drinks lots of water or fluids that are high on electrolytes. Doing so will keep the body hydrated and help in regulating the heart rate, muscle health and nerve function.
2. Heat Fatigue: Working in high heat may cause discomfort or psychological stress and result in heat fatigue. People who are not comfortable to work in hot weather are highly vulnerable to such a situation. Symptoms such as feeling hot, tired and thirsty are coupled with physical strain. It’s advised to get out of the troubled area and drink loads of fluids.
3. Heat Syncope: It is a situation when the blood pressure drops considerably followed by reduced blood flow in the brain and accompanied by fainting. Essentially a result of working in a very hot environment, patient is advised to consume beta-blockers for lowering the blood pressure. Lightheadedness and dizziness are the common symptoms before a person faints. It’s best to relax, drink lots of fluids and move to a cooler area.
4. Heat cramps: It is a condition that usually occurs after an intense exertion or exercise. It is fallout of electrolyte imbalance that is typically felt around the leg, arm or abdomen region. Moving to a cooler place and drinking lots of fluids rich in electrolytes are essential to get relieved.
5. Heat edema: This may happen when a person stands or sits in a heated area for a considerable period of time. The lower legs, ankles and hands tend to swell due to fluid buildup in the extremities. In medical terms, it is defined as a response that involves aldosterone-stimulated re-absorption of sodium in the blood through the kidneys. It spontaneously subsidizes over time once a person gets used to the environment. The best remedy would be to cool down and put the feet up besides keeping the body dehydrated.
6. Heat Rash: Actively working in heated conditions for a long period can result in red pimple like bumps on the skin. It mostly develops beneath the clothing that has soaked with sweat. They usually disappear on their own after cooling down and changing clothes.
7. Heat exhaustion: Being the most critical stages, it happens when the body is unable to cool on its own. Besides sweating, the common symptoms include dizziness, thirst, weakness, rapid pulse, concentration and coordination issues. It is referred to as the last stage before the heat stroke, hence it’s really important to rest and stay hydrated as soon these symptoms start emerging.

Causes of hyperthermia

Hyperthermia may occur if the standard body temperature control system is not able to regulate the internal temperature levels. Usually, when the outside temperature is remarkably high, the body temperature tends to cool itself through sweating and evaporation of the heat. But at times, the cooling mechanism becomes ineffective resulting in hyperthermic conditions. Consequently in high humid areas, evaporation through sweating will not be possible and the body heat cannot be released easily.

There may be several underlying causes for Hyperthermia which include:

• Overexertion
• Extended exposure to heat
• Underlying medical condition
• Side effects of medicines
• Inadequate fluid intakes
• Excessive loss of fluids
• Electrolyte imbalances
• Dehydration

Symptoms of hyperthermia

• Heat-related illness
• Muscle cramps
• Fatigue
• Dizziness
• Headache
• Nausea
• Vomiting
• Weakness
• Elevated heart rate
• Reddened skin
• Reduced sweating
• Confusion
• Brain damage
• Normal to elevated temperature usually greater than 40.5 degrees
• Dehydration
• Hot, dry skin
• Irritability
• Coordination issues
• Flushed skin
• Weak or rapid pulse beat

Who are at risk?

• Athletes exercising hard in hot climatic conditions
• Older people of 65 years or above
• Infants and small children within four years
• Cardiac patients
• Patients suffering from dehydration
• Patients prone to infection
• Intake of medicines to increase sweat or heat production
• People working in hot environments
• Exposure to heat for a prolonged time
• People working around large ovens
• High-pressure patients
• Diuretics
• Overweight people
• People with mental illness
• Chronically ill people

Diagnosis of hyperthermia

Proper examination should be done to diagnose this disease as most people tend to confuse it with fever. Common tests that doctors often prescribe include:

• CT scan of the head
• Blood tests
• Lumbar puncture
• Urine tests
• Kidney examination

Treatment for hyperthermia

There are two techniques that are commonly used to treat hyperthermia, they are:

• Internal cooling: It involves ice water gastric or rectal lavage, thoracic or peritoneal lavage and extracorporeal blood cooling.
• External cooling: It is a lot easy to implement this method besides being easy to tolerate and is highly effective.
  • Direct application of ice baths, ice packs or hypothermic blanket to axillae, groin and neck is the conductive cooling techniques.
  • Removal of clothing and moving to a cooler area preferably air-conditioned is referred to as convective technique.
  • Alternatively, the evaporative cooling method may also be used by removal of clothing and switching on fan. This needs to be done in conjunction with misting the skin using tepid water or by application of single layer of wet sheet on the body.

Other possible treatments include:

• Flushing the stomach and rectum with cold water
• Cardiopulmonary bypass
• Muscle relaxing medications
• Reducing tissue damage

Home remedies for hyperthermia

• Remove tight and unnecessary clothing
• Wrap the patient in wet sheets
• Spray cool water
• Blow cool air
• Place Ice packs on neck and armpits
• Drink two to three quarts of water daily
• Avoid excessive exercising particularly during very hot times
• Avoid traveling during hot weathers
• Wear hats and loose clothes when outside
• Take cool baths and showers
• Avoid hot meals or drinks
• Avoid alcohol intake
• Stay indoors
• Reduce consumption of caffeine
• Increase intake of salts & minerals
• Apply sunscreen lotions

Homeopathic medications for Hyperthermia

• Nux Vomica
• Petroleum as
• Arsenicum Album
• Sulphur
• Pulsatilla
• Rhus Toxicodendron
• Abrotanum
• Tamus
• Plantago

Expected Duration of Hyperthermia

Typically the patient suffering needs to stay in the hospital for one or more days to detect and avoid the complications. But the effects of it on the body organs stay longer and may recover within two months but can extend up to a year.

When to call a doctor?

Medical attention and seeking emergency help is necessary when the person has been exposed to the heat for quite a long time and has had symptoms like

• Confusion
• Fainting
• Staggering
• Hallucinations
• Unusual agitation
• Coma

Prognosis

Untreated hyperthermia can lead to major consequences such as:

• Kidney damage
• Damage to the liver
• Heart arrhythmias
• congestive heart failures
• Coma
• Death

The post Hyperthermia appeared first on Prime Health Channel.

Non-alcoholic fatty liver disease or NAFLD constitutes a group of conditions in which excess fat accumulates in the liver of people who drink little or no alcohol.

Nonalcoholic Steatohepatitis

Nonalcoholic steatohepatitis (NASH), a more serious form of the disease, occurs when, along with the fat build up, there is inflammation and subsequent irreversible damage to the liver.

Signs and Symptoms

Both NAFLD and NASH may have no symptoms at the early stage. However, if they do occur, one may encounter:

• Abnormal or sudden weight loss
• Weakness and fatigue all the time
• Persistent upper abdominal pain

Causes

It is not clear why NAFLD occurs in some people.  However, some studies holding environmental factors to be the cause, point out that overconsumption of certain nutrients like cholesterol, iron or refined sugar, may result in an excess amount of fat that neither breaks down nor gets eliminated, thereby leading to the condition.

According to some other studies, genetic changes may also be responsible for the condition. Instructions given by the PNPLA3 gene results in formation of a protein believed to regulate the development and breaking down of fats. The activity of this gene decreases when one fasts, increasing immediately again with food intake – the production of the protein varying as per the requirements of the body. When someone has irregular eating habits, the normal working of the gene disrupts; it can no longer break down fat smoothly and thus surplus fat is formed. Also, a variation of the gene may lead to a decrease in the breakdown of fat by the protein, thus resulting in excess fat.

Though it is also not known why NAFLD degenerates into NASH, certain studies have put forward some mechanisms as responsible for the inflammation of NASH. These are:

• Release of toxic inflammatory chemicals by fat cells
• Self-destruction or apoptosis of liver cells
• Effects of free radicals (oxidative stress)
• Effects of intestinal microorganisms on nutrient breakdown and absorption
• Abnormal reaction of the immune system to surplus fatty tissues in the liver

Risk Factors

The common risk factors of both NAFLD and NASH include:

• Obesity, particularly the concentration of fat in the belly
• Resistance to insulin
• Elevated blood sugar levels suggesting type 2 Diabetes
• High levels of fat, chiefly triglycerides, in the blood
• Metabolic syndrome

Other than these, possible associated conditions behind the development of only NAFLD include:

• Polycystic ovary syndrome
• Sleep apnea
• Underactive thyroid (hypothyroidism)
• Underactive pituitary gland (hypopituitarism)
• In rare cases, medicines such as methotrexate and tamoxifen
• Fast loss in weight induced due to surgery
• High blood pressure (hypertension)

Complications

• Type 2 Diabetes
• Cardiovascular diseases
• Cirrhosis or late-stage scarring (fibrosis) of the liver
• Gallstone disease (GD)

Fatty liver

Diagnosis and Tests

NAFLD, being asymptomatic, mostly remains undetected. It is only when certain tests done for other reasons refer to a liver problem, when the condition is suspected. Tests undertaken to confirm the condition and rule out other diseases include:

• CBC (Complete blood count)
• Chronic viral hepatitis (hepatitis A, hepatitis C, and others) tests
• Liver enzyme and liver function tests to look for an unusual liver or abnormal levels of the liver enzymes, alanine aminotransferase (ALT) and aspartate aminotransferase (AST)
• Screening test for celiac disease
• Blood sugar fasting
• Hemoglobin A1C, to determine the stability of blood sugar
• Lipid profile, to measure blood fats, such as cholesterol and triglycerides

Imaging Tests

Plain ultrasound, computerized tomography (CT) scanning, and magnetic resonance imaging (MRI) are often the initial tests done for detecting any liver abnormality. While transient elastography, and magnetic resonance elastography are done to measure liver stiffness, which may suggest fibrosis or scarring

Liver Biopsy

If the above tests do not confirm the condition, a small tissue from the liver is taken to check for signs of inflammation or scarring (biopsy).

Treatment and Management

Self-Regulation

At present, no medical treatments are available for NAFLD and NASH. However, certain lifestyle changes that can help manage the conditions are:

• Weight loss through regular exercise
• Abstaining from drinking alcohol and smoking
• Controlling diabetes and cholesterol
• Protecting the liver

Diet Tips and Restrictions

Since excess fat can generate the condition, care should be taken to maintain a healthy diet.

Foods to Eat

• Choline-rich (a B complex vitamin) foods such as cauliflower, mushroom, and eggs
• Monosaturated fatty acids, present in vegetable oils like sesame, olive, canola, and peanut
• Fiber-rich foods like lentils, black beans, broccoli, and Brussels sprouts

Recent studies suggest drinking coffee may be associated with a lower risk of the NAFLD symptoms deteriorating and advancing to NASH.

Foods to Avoid

• Eatables made from palm or coconut oil
• Baked goods
• Meat and dairy products

Current Concepts and Management Strategies

• According to recent studies, weight reduction through bariatric surgery may help severely obese people with NAFLD. Administration of the drug metformin may also help with improving the insulin resistance of NAFLD affected people.
• In case of NASH, the two experimental approaches that are gaining prominence include the administration of supplements such as vitamin E and vitamin D, selenium, and betaine, and a liver transplantation. However, more research needs to be done in these areas.

In Pregnancy

There is scarce data available regarding the association of NAFLD with pregnancy.  As per certain individual case studies, the condition does not pose any threat to either the mother or her baby as long as it does not develops into NASH.

Prognosis and Life Expectancy

NAFLD is usually curable and most people recover after following a restricted lifestyle, and treatment regime, going on to have normal life expectancy. However, the condition may return in some cases or lead to NASH, liver cirrhosis and even cause death. It is estimated that among 100 people suffering from NAFLD, about 2 develop cirrhosis over 15-20 years; whereas, nearly 12 among 100 people with NASH have cirrhosis over about 8 years.

Incidence and Prevalence

About 20‑30% of US population is affected by NAFLD, whereas about 2‑3% has NASH.

NAFLD and NASH ICD-9-CM Codes and ICD-10-CM Codes

The ICD-9-CM code of NAFLD is 571.8, and ICD-10-CM code is K76.0

The ICD-9-CM code of NASH is 571.8, and ICD-10-CM code is K75.81

The post Non-Alcoholic Fatty Liver Disease (Nonalcoholic Steatohepatitis) appeared first on Prime Health Channel.

The term ‘Cretinism’ refers to severe hypothyroidism during birth [¹] (deficiency of thyroid hormone) leading to stunted physical and mental growth.

It is also known as:

• Congenital hypothyroidism
• Congenital Iodine-deficiency Syndrome [²]
• Salt Deficiency Syndrome

In children aged 2 years or above, the disease is referred to as primary hypothyroidism.

Cretinism Epidemiology

The exact prevalence and incidence statistics are unknown. However, many people are supposed to be affected by this disease the world over. Severe thyroid deficiency is noted in 3,000-4,000 infants in countries like North America, Europe, Australia and Japan.

Cretinism affects all populations and affects females twice more than males.

Cretinism Types

Cretinism is classified into the following two types:

Endemic cretinism

It has the highest prevalence and arises due to insufficient dietary iodine intake. It is common in areas with iodine-deficient soils. This form is regarded as a major public health problem in many countries [³].

Neurological Cretinism

It is caused by thyroid deficiency in moths during the first and second trimesters of pregnancy. This leads to fetal iodine deficiency and consequent thyroid insufficiency, leading to neurological problems like inability to hear and perform motor functions and brain damage.

Myxedamatous Cretinism

Mental detainment is less severe in this form than in Neurological cretinism. It is marked by a number of abnormal effects, such as myxedematous (dry) skin, infrequent hair and a protruding abdomen.

Cretinism Symptoms

In people with Cretinism, the following abnormal physical characteristics may be noted:

• Foreshortened base of the skull
• Low hair line
• Short and wide face
• Pallor [⁴]
• Underdeveloped mandible
• Overdeveloped maxilla
• Large, thick and protruding tongue (Macroglossia)
• Delayed eruption of primary and permanent teeth
• Short and thickened long bones
• Late appearing of epiphyses
• Irregular and deformed epiphyses (in some cases)

Some signs become apparent during early infancy itself, and include:

• Gradual development of a coarse, dry skin
• Mild inflammation of face and tongue
• Umbilical hernia
• Drooling from an open mouth
• Listlessness
• Slow movement
• Constipation
• Myxedema
• Feeding difficulties and choking

Mental retardation becomes apparent in the later stages and is manifested by problems like retarded learning ability and reduced intelligence. The effects in such phases involve:

• Breathing difficulties (Dyspnea)
• Inactivity
• Heart valve abnormality
• Jaundice
• Slow pulse (Bradycardia)
• Excessive sleeping
• Blandness
• Little crying

Newborns with Cretinism can be of normal weight and height. But if left untreated, patients may have stunted growth to the point of dwarfism. Bones and muscles may also degenerate.

Cretinism Etiology

Lack of thyroid hormones is the cause. Thyroid deficiency may result from:

• Iodine deficiency (in developing nations)
• Impaired thyroid gland (in developed countries)
• Hereditary condition interrupting thyroid synthesis (inheriting analogous genes causing thyroid gland to manufacture less thyroid hormones)
• Intake of antithyroid drugs during pregnancy (uncommon)

Dietary iodine deficiency during pregnancy [⁵] is a chief cause in many parts of the world.

Cretinism Risk Factors

The risk factors include:

• Being female
• Being of Hispanic origin
• Being white-complexioned (ratio is lower among blacks)

Cretinism Diagnosis

It is typically detected within a week after birth [⁶]. Hormone levels in infants are tested. If deficiency is observed, a thyroid scan is performed to evaluate the thyroid gland.

In some cases, diagnostic tests such as x-rays and ultrasound tests may be used. The findings of these imaging exams may be useful for differential diagnosis and to avoid misdiagnosis.

Cretinism Treatment

If Cretinism is confirmed by tests, hormone replacement therapy is used in the form of oral thyroxine. The treatment should ideally be initiated within the first few weeks of life and continued throughout life. The doses should be increased or reduced whenever deemed as appropriate.

Cretinism Complications

The complications include:

• Permanently stunted physical development
• Impaired mental abilities
• Abnormal enlargement of the thyroid gland (goiter)

Irreversible changes may occur unless treatment is initiated with the first 6 weeks of life.

Cretinism Prognosis

When treated early, the outcome is good. Newborns diagnosed and treated within the first few weeks after birth generally have normal intelligence. Late-treatment or non-treatment causes delayed growth and intellectual disability [⁷].

Death is uncommon in patients who receive medical treatment. Life expectancy is average in most Cretinism sufferers.

Cretinism Prevention

As endemic cretinism arises from a dietary iodine deficiency, iodine administration has been established as a health policy in many countries. Screening of newborns can help detect the disorder in the first trimester of pregnancy [⁸]. Adequate dietary iodine intake by pregnant mothers can also prevent Cretinism in infants.

Cretinism Pictures

The images below show the appearance of Cretinism sufferers.

Picture 1 – Cretinism

Picture 2 – Cretinism Image

Cretinism ICD9 Code

The ICD9 Code for Cretinism is 243.

The post Cretinism appeared first on Prime Health Channel.

Galactorrhea is a condition characterized by milky discharge from the nipple that is unrelated to normal milk production associated with childbirth and breastfeeding. Although Galactorrhea itself is not a disease and is frequently benign, it can be an indication of some serious underlying problem. It generally occurs in women, including those who never had children and even in menopausal women. However, it can also affect men as well as adolescents and infants of both sexes. The milky white liquid may get discharged from either or both breasts with or without any stimulation.

The condition is also spelled as Galactorrhoea.

Galactorrhea Epidemiology

The disease is believed to occur in almost 5% to 32% of women. In women, the condition might occur due to physiological factors. In men, it is always pathological. Many women with this disease also suffer from Amenorrhoea.

Galactorrhea Causes

The disorder can be caused by a number of factors, some of which are known whereas others are idiopathic. Tumors of pituitary gland known as prolactinomas or pituitary adenomas can give rise to this condition. Pituitary tumors are generally non-cancerous. A hormone known as Prolactin triggers milk production. Excessive secretion of prolactin or hyperprolactinaemia caused by pituitary tumors can lead to galactorrhea. Overproduction of prolactin may even cause cessation of menstrual periods of a woman and lead to infertility.

Other factors that may give rise to this disorder include:

Hormonal imbalances

The hormonal problems that can give rise to this condition include:

• Hypothyroidism
• Elevated levels of TRH and TSH hormones

Drugs and medications

The various drugs and medications which can cause the disorder include:

• Reserpine
• Verapamil
• Tranquilizers
• Phenothiazines
• Metoclopramide
• Antinausea drugs
• Certain pain killers
• Blood pressure drugs
• Proton-pump inhibitors
• Tricyclic antidepressants
• Serotonin reuptake inhibitors
• Some antigastroesophageal reflux medicines
• Second generation H2 receptor antagonist drug Cimetidine
• Starting or stopping to consume birth control pills and/or other hormones

Herbs

This condition can also be caused by the consumption of certain herbs, such as:

• Anise
• Nettle
• Fennel
• Licorice
• Blessed thistle
• Fenugreek seed

Illicit drugs

Various illicit drugs can cause this disorder. These include:

• Opiates
• Cocaine
• Marijuana
• Risperidone
• Methyldopa
• Antipsychotics

Excessive sexual stimulation of breasts

Excessive sexual arousal of the breasts can also result in the disease.

Diseases

The condition can be caused by certain diseases, such as:

• Lymphoma
• Sarcoidosis
• Esophagitis
• Acromegaly
• Tuberculosis
• Schistosomiasis
• Hypernephroma
• Cushing’s disease
• Multiple sclerosis
• Null-cell adenoma
• Hydatidiform mole
• Craniopharyngioma
• Chronic kidney failure
• Empty-sella syndrome
• Renal adenocarcinoma
• Pituitary-stalk resection
• Bronchogenic carcinoma
• Chronic liver disease or cirrhosis
• Spinal cord injuries, tumors or surgery
• Hypothalamic tumors or diseases like tuberculosis

Chronic emotional stress

Long-term emotional stress may also be responsible for this disorder.

Chest wall conditions

Galactorrhoea can occur due to certain chest wall conditions, like:

• Burns
• Trauma
• Shingles
• Surgical scars
• Herpes zoster
• Atopic dermatitis
• Tumors of the chest wall

Breast conditions

Some specific breast conditions can also lead to the development of this disorder. These include:

• Breast trauma
• Breast surgery
• Mammary duct ectasia
• Intraductal papilloma, a type of benign tumor of breast duct
• Mastitis or a type of breast infection occurring mainly in breastfeeding women

Galactorrhea in men

In men, the occurrence of Galactorrhea might be linked with deficiency of testosterone (male hypogonadism) and is usually accompanied by breast enlargement and/or tenderness (Gynecomastia). Other problems associated with deficiency of testosterone include erectile dysfunction and lack of adequate sexual desire.

Galactorrhea in newborns

Galactorrhea may also occasionally be seen in newborns. High levels of maternal estrogen cross the placenta and enter into the blood of infants. This can lead to the enlargement of the breast tissue of the infant which might be associated with milky nipple discharge. Milk secreted from the breasts of newborn infants is referred to as “Witch’s milk” or “Neonatal milk”.

Galactorrhea Symptoms

The primary symptom of this disorder is discharge of a milky white liquid from the nipple that is not associated with breastfeeding. This discharge can emanate from one or both the breasts. Other signs and symptoms that might occur alongside this discharge include:

• Headaches
• Visual difficulties
• Impotence (men only)
• Loss of sex drive
• Intolerance of heat or cold
• Increased thirst and/or urination
• Acne or abnormal growth of hair
• Bloody or bad-smelling discharge
• Nipple discharge that involve multiple milk ducts
• Abnormal menstruation or absence of menstruation
• Non-milky nipple discharge, which may be bloody, yellow or clear
• Disordered or irregular appetite and a decrease or increase in weight

Galactorrhea Diagnosis

Finding out the underlying causes of this disorder might be a difficult task as a number of factors can lead to it. A doctor is likely to first inquire about the symptoms of patients and their overall medical history. He or she will then recommend certain physical examinations, which may include the following:

• Inspection of the nipples and the area surrounding them; checking for breast lumps as well as other suspicious areas having thickened breast tissues
• Analysis of the fluid discharged from the nipples, to check the presence of fat droplets in the fluid
• Blood tests, for checking the levels of hormones such as prolactin and thyroid-stimulating hormone
• A pregnancy test, to confirm or exclude pregnancy as possible factor causing nipple discharge
• Mammography, to produce images of the breast tissues and check whether there are any lumps or suspicious breast tissues
• Ultrasounds, for the same purpose as mentioned above
• MRI (magnetic resonance imaging) scans, to check for tumors or other abnormalities of the pituitary gland, if blood tests reveal elevated levels of prolactin
• CT scans

If a doctor suspects the symptoms of Galactorrhea to be caused by some form of medication, he or she might instruct sufferers to stop taking that particular drug for a short span of time for assessing the possible cause.

Galactorrhea Differential Diagnosis

The differential diagnoses of the condition include ensuring the absence of diseases that can produce similar symptoms. These include:

• Neurological disorders
• Pituitary adenomas
• Hypothyroidism
• Breast stimulation
• Chest wall irritation
• Numerous medications
• Other physiological causes

The following conditions are often considered during the DDx of Galactorrhea:

• Drug reactions
• Duct papilloma
• Pituitary tumors
• Testicular tumors
• Ovarian neoplasm
• Craniopharyngioma
• Cushing’s Syndrome
• Renal cell carcinoma
• Mammary duct ectasia
• Chiari-Frommel syndrome
• Complications from surgeries
• Prolactin producing tumor (ectopic)
• Pituitary microadenoma and prolactinoma

Galactorrhea Treatment

The treatment for this condition depends on the underlying causes. Medical treatment is not required in some mild instances; the symptoms dissolve automatically on their own. In such cases, breast binders may be used to protect the nipples from overstimulation. If the milky discharge is caused by some medications, they should be replaced by safer alternatives.

If an underactive thyroid gland is responsible for this condition, it should be treated with medications such as Levothyroxine. This can help to counter insufficient production of hormones by the thyroid gland.

If Galactorrhea is caused by a benign pituitary tumor, it can be removed by medications or surgery. Small tumors can be treated by medications such as bromocriptine. The larger tumors can be treated by the following methods:

Surgery

The tumor and the nearby tissues can be removed surgically. This option is especially considered when medicines fail to generate expected results.

Radiotherapy or Radiation therapy

Radiation can be used to shrink the tumors when drugs and surgery do not produce effective results.

Galactorrhea Complications

Certain medications used for curing this disease may produce side effects, such as:

• Headaches
• Dizziness
• Nausea

Untreated hyperprolactinaemia may also increase the risk of development of Osteoporosis.

Galactorrhea Prognosis

The outcome of treatment for patients having prolactinomas is generally good. Most prolactinomas either regress or remain stable. In pregnant women, these tumors should be observed closely as they may increase significantly in size. The tumors may also recur after treatment.

Galactorrhea Prevention

The following precautionary measures should be followed to minimize the risks of development of Galactorrhea:

• Avoid wearing clothing or apparel that irritates the breasts.
• Avoid frequent self-examination of the breasts; usually once per month is sufficient.
• Avoid too much sexual stimulation of breasts.
• Avoid the usage of illicit drugs.

Galactorrhea Pictures

The following images give a clearer idea regarding the nature of this disease.

Picture 1 – Galactorrhea

Picture 2 – Galactorrhea Image

References:

http://www.mayoclinic.com/health/galactorrhea/DS00761

http://www.thirdage.com/hc/c/galactorrhea

http://medicine.med.nyu.edu/endocrinology/conditions-we-treat/conditions/galactorrhea

http://en.wikipedia.org/wiki/Galactorrhea

http://pms.about.com/od/pelvichealthdiseases/f/8057_glactorrhe.htm

The post Galactorrhea appeared first on Prime Health Channel.

What is Acromegaly?

It is an abnormal condition of the pituitary gland resulting in excessive production of growth hormone, abbreviated as GH. This is a serious disorder as the tissues in the body continue to grow at an uncontrollable rate even after puberty.

Acromegaly Incidence

Nearly 4,676 cases of the disorder are reported every year per million people. It is typically observed in adults between the ages of 40 and 45.

Acromegaly Symptoms

Increased secretion of growth hormone manifests in the form of abnormal physical changes in the body. Few cases of the hormonal disorder are associated with abrupt increase in body growth. Here, the clinical features are more distinct and develop rapidly. In remaining cases, there is a delay in the presentation of symptoms and may take several years to appear.

Picture 1 – Acromegaly

Some of the fairly common symptoms of the condition are:

• Enlargement of the hands and feet
• Sausage-like fingers
• Distinct facial characteristics, including broad lips and nose
• Thickened ears
• Coarsening and thickening of the skin, especially on the palms and soles
• Hyperpigmentation of the skin
• Excessive lubrication of the skin, causing acne
• Formation of benign skin tags
• Swollen tongue and neck
• Profuse sweating
• Increased prominence of the lower jaw with gaps between the teeth
• Bulging eyes
• Visual impairment
• Headaches
• Enlarged head
• Protruding forehead
• Extensive hair growth all over the body
• Numbness and tingling sensations in the thumb and fingers due to Carpal Tunnel Syndrome
• Pain, inflammation and stiffness in the joints
• Swollen vocal cords, resulting in
• Sleep interruption
• Irregular menstruation in females
• Impotency in males

In aggressive cases, the muscles of the heart, kidneys, spleen and liver get severely affected with few patients having insulin deficiency as an additional endocrinological illness. Anomalies in these vital organs give rise to problems like:

• Shortness of breath
• Fatigue
• Irritability
• Excessive thirst
• Frequent urination
• Chest pain
• Weakness
• Increased heart beat
• Exercise intolerance
• Fainting

Acromegaly Causes

The pituitary gland is a tiny structure in the head. It is the master gland of the endocrine system known for producing hormones, including GH, that regulate other glands and control various body functions. The presence of GH in blood stimulates the liver to release insulin-like growth factor 1 (IGF-1), which in turn triggers cellular growth and division. The pituitary is divided into anterior and posterior sections. The anterior pituitary forms the front portion of the gland and secretes hormones that affect the following:

• Growth
• Development of the sex organs
• Pigmentation of the skin
• Functioning of the cortex of adrenal glands

The back portion of the gland constitutes the posterior pituitary, which produces hormones for increased uterine contractions and reabsorption of water by the kidneys. Interestingly, the pituitary gland is stimulated to release GH by growth hormone-releasing hormone (GHRH) produced by the hypothalamus of the brain. In order to inhibit the secretion of excess GH, the hypothalamus produces another important hormone called Somastatin. Under normal circumstances the levels of GHRH, GH, Somastatin and IGF-1 are properly maintained by a well-regulated feedback loop in the body. However, the defect in this condition lies in the anterior pituitary, which causes disruption of the feedback loop and leads to overproduction of growth hormone in adults. The overfunction of the anterior pituitary, resulting in excessive release of GH, can be attributed to the following causes:

Pituitary adenoma

The condition is marked by noncancerous tumors in the pituitary gland. Carcinoma of the pituitary has a minimum possibility. More than 90% of patients have a dysfunctional pituitary due to an adenoma. The benign lesions influence the secretion of GH, which in turn raises the level of IGF-1 in the blood. This results in uninterrupted growth of bones and cartilages, causing physical changes. The inability of the feedback loop to neutralize the level of IGF-1 also contributes to the rapid buildup of the hormone. The tumors turn more lethal when they increase in size and begin to invade the nearby brain tissues. The benign growths preferably compress the optic nerve, a cranial nerve transmitting visual information from the retina to the brain. This explains the cause of headaches and ocular impairment. The damaging effects of the tumors create a hormonal imbalance, causing menstrual irregularities and reduced libido in males.

The late appearance of symptoms in some patients can be related to a slow growth of the adenomas. The invasive type of the tumor is the one, which deteriorates the surrounding tissues of the brain. The variance in size of the lesions determines the rate of GH production. Medical experts believe that a genetic mutation in one of the pituitary cells causes adenomas. The gene mainly transmits chemical signals within pituitary cells to trigger cellular division required for secretion of GH. The genetic condition is not a congenital defect but normally occurs during life. In other cases, the noncancerous tumors form without a known cause.

Gigantism

Chronic overactivity of the anterior pituitary gland can cause increased secretion of growth hormone before the end of adolescence. Affected children become abnormally tall and could be 7 or 8 feet in height. In the absence of treatment, such patients face the other problems of the hormonal disorder when they reach adulthood. Excessive production of GH after puberty does not induce gigantism but only causes enlargement of the bones.

Non-pituitary tumors

Malfunctioning of the anterior pituitary cannot always be ascribed to adenomas. Such localized tumors can develop in lungs, pancreas and adrenal glands that stimulate the hypothalamus to produce adequate amount of GHRH, which in turn leads to elevated GH levels. In contradictory cases, the affected organs may themselves produce GH. In such a situation, the underlying problem is not present in the pituitary gland.

Acromegaly in cats

This hormonal disorder can also occur in cats and is known as Feline acromegaly. It is more common in cats aged between 8-14 years. Affected animals exhibit enlarged extremities, uncontrolled diabetes mellitus, increased urine output and difficulty in swallowing.

Acromegaly Diagnosis

Many physicians may misinterpret the condition as an ordinary inflammation of the upper and lower extremities due to some infection. The symptoms may not be intense enough to get easily recognized. However, the condition is more evident in severely affected patients. The anomalous physical features and functional problems in the internal organs may warrant standard diagnostic tests like:

Blood test

This laboratory exam assists in measuring the level of growth hormone in the blood. However, the presence of GH does not confirm the disorder as the hormone has a tendency to fluctuate. Identification of the disorder can be done by checking the IGF-1 level. If a patient shows elevated quantity of IGF-1 and GH in the blood then this suffice the preliminary diagnosis of an impaired pituitary. Measurement of the amount of IGF-binding protein-3, which normally binds to IGF-1, implies functional abnormality of the master gland. In addition to these entities, high levels of cholesterol and triglyceride also indicate an underlying endocrine disorder. The test can even find out whether the adenomas are eliciting the release of hormones other than GH. These include:

• Gonadotropic hormones
• Prolactin
• Adrenocorticotropic hormone
• Thyroid stimulating hormone

X-ray

Unusual elongation of the bones with respect to the age of the patient signify hormonal imbalance.

Imaging procedures

An MRI or CT scan of the brain after the infusion of a luminescent material called gadolinium shows the presence, type and location of the pituitary tumor. When the examiner does not find an adenoma then the chest, abdomen and pelvis are scanned for tumors.

Echocardiogram

The movement of the heart can be properly monitored with the help of an ultrasound. Affected patients normally show an abnormal heart rhythm. The condition of the valves and blood vessels should also be evaluated for any other cardiac disorder.

Acromegaly Treatment

A patient’s suitability for a particular kind of treatment is judged by the following factors:

Picture 2 – Acromegaly Image

• Age
• Cause
• Severity of the symptoms

After assessing the condition of patients, the appropriate treatment method is accomplished, which aims at alleviating the symptoms, correcting the GH levels and restoring the normal function of the pituitary. Some of these are:

Surgery

Abnormal levels of GH in the body and its consequences are detrimental to the health of the patients. Therefore, irrespective of the cause, surgery should be the first therapeutic approach for this condition. Endonasal Transphenoidal surgery is the first procedure used to remove adenomas. Here, an incision is made in the nasal cavity wall through which the small surgical instruments are inserted to remove the tumor. Transsphenoidal surgery is the second opted method for remission of the symptoms caused by the tumors. In this procedure, an incision is made in the gum beneath the upper lip. The next step involves the incision of the septum in order to reach the nasal cavity and excise the tumor. Elimination of the pituitary lesions reduces the pressure exerted on the surrounding brain tissues and decreases the GH levels.

Drug therapy

Octreotide or lanreotide, which are the artificial preparations of the hormone called somatostatin, can inhibit the production of GH. These somatostatin analogues usually show promising results and need to be injected every 2 to 4 weeks. Symptomatic relief is quickly achieved following the administration of the drugs. Somatostatin analogues directly act on both pituitary and non-pituitary tumor by diminishing its size. Regular intake of the drug can lead to many gastrointestinal side effects like bloating, nausea and loose motions. Patients who do not respond well to somatostatin shots can be administered with dopamine antagonists like Bromocriptine or Cabergoline. These medicines are affordable, owing to its availability in the form of tablets. Like every drug, dopamine antagonists also produce side effects like dizziness, stomach upset, sinus congestion and nausea. Therefore, to prevent this, low dose of the drug is advisable.

Growth hormone receptor blockers have been recently discovered as the most effective drugs for treating the anomalous condition of the pituitary. These drugs block the site on the cells where GH normally attaches and triggers their growth and division. Pegvisomant (Somavert) is the only GH receptor that has been approved by the US Food and Drug Administration. Fatigue, sweating and headache are some of its side effects.

Radiation therapy

The use of radiation treatment is apt for older patients who cannot undergo surgery due to other underlying illnesses. External beam therapy is one type of the method. Here, a single or several beams of high energy X-rays from a linear accelerator is focused on the causative tumor. The second type is stereotactic radiotherapy, which requires a number of ionizing beams from various directions to be targeted at the site of tumor. The procedure can be, however, risky for some patients and may result in growth of secondary tumors.

Acromegaly Prognosis

The outlook following a surgical procedure is generally good but may cause some complications. The size of the tumor determines how well the patients respond to the treatment. Nearly 80-85% of patients with small size tumors recover fast as opposed to large lesions in which the success rate is 50-65%. The life expectancy of such patients post treatment is high. However, untreated patients can only survive up to 50 years.

Acromegaly Complications

Some of the severe complications of the disorder are:

• Hypertension
• Renal failure
• Cardiac failure
• Enlarged heart
• Complete vision loss

Acromegaly Support groups

Many online support groups help affected patients and their family members to deal with the disease. These kinds of communities encourage interaction with other patients who are facing similar difficulties. Some of the well-renowned organizations are:

The Pituitary Network Association (PNA)

Email: www.pituitary.org

The Endocrine Society

Email: www.endo-society.org

AcromegalySupport.com

Email: www.acromegalysupport.com

Early detection and appropriate treatment can reduce the morbidity and fatality associated with Acromegaly. Immediate visit to a healthcare expert is necessary in cases where the symptoms last for more than a few weeks.

References:

http://en.wikipedia.org/wiki/Acromegaly

http://www.patient.co.uk/doctor/Acromegaly.htm

http://emedicine.medscape.com/article/116366-overview

http://www.mayoclinic.com/health/acromegaly/DS00478

The post Acromegaly appeared first on Prime Health Channel.

What is Pheochromocytoma?

Doctors and medical researchers define Pheochromocytoma as a rare type of tumor that develops in one of the adrenal glands present in the body. It secretes excessive amounts of two hormones norepinephrine and epinephrine which control blood pressure, metabolism and heart rate. This leads to the development of numerous health issues in patients.

Pheochromocytoma Synonyms

The condition is also known by other names like:

Picture 1 – Pheochromocytoma

• Paraganglionoma
• Chromaffin tumors

Pheochromocytoma ICD 9 Code

The ICD 9 Code for this abnormal growth is 227.0.

Pheochromocytoma Incidence

As aforesaid, this is a rare type of tumor. It arises in only 0.05-0.2% of all hypertensive patients. This is usually a noncancerous (benign) growth that develops inside the core of an adrenal gland.

The condition can occur at any age. However, it arises most commonly in middle aged people.

Pheochromocytoma Symptoms

The usual signs and symptoms of this condition are:

• Chest pain
• Abdominal pain
• Palpitations
• Nervousness
• Pallor
• Sweating
• Irritability
• Faster heart rate
• Acute headache
• Loss of weight

Some individuals also suffer from other associated symptoms such as sleeping difficulties, high blood pressure and hand tremors. Such symptoms result from excessive production of chemical compounds (known as Catecholamines). The intensity of the problems depends on whether the compounds are being released constantly or in short spurts. The sporadic secretion of the epinephrine and norepinephrine hormones may also lead to the occurrence of a few other symptoms from time to time.

Pheochromocytoma Causes

Researchers are still in the dark regarding the exact cause why some adrenal gland cells turn into a tumor. However, they are certain that the tumors develop in special cells known as Chromaffin cells.

Each human body comprises of two adrenal glands, either located above each kidney. The adrenal glands, situated over the kidneys, produce the hormones noradrenaline (norepinephrine) and adrenaline (epinephrine) as well as the chemical compounds known as Catecholamines. The release of these hormones is generally triggered by physical and emotional stress. These hormones are needed by the body to maintain blood pressure and help individuals cope with situations that cause stress to them. The hormones provide almost every body organ and tissue with vital instructions.

In people with Pheochromocytoma, these glands tend to manufacture these hormones in high amounts. This elevates the heart rate and blood pressure in sufferers.

Pheochromocytoma Diagnosis

Although 90% cases of this condition are benign, Pheochromocytoma can become life-threatening for its patients if left undiagnosed and untreated. Its diagnosis usually begins with an examination of the physical condition of sufferers. This may be followed by one or more medical tests like:

• Abdominal CT scan
• MIBG scintiscan
• Catecholamines blood test
• Glucose test
• MRI of abdomen
• Metanephrine blood test
• Adrenal biopsy
• Urine catecholamines

Blood and urine tests help detect any increase in the levels of the hormones adrenaline (Epinephrine) and noradrenaline (Norepinephrine) and the products formed due to their decomposition (Metanephrines). You may require collecting samples of urine over a period of 24-hours for testing. If the tests suggest presence of a Pheochromocytoma, determining the location of the neoplasm is the next step for physicians.

Imaging scans are also effective in determining the presence if these growths. In most cases, an abdominal CT (computerized tomography) scan can help diagnose the tumor. However, doctors may also consider it essential to scan other regions of the body, such as the chest, pelvis and neck. Other scanning techniques, such as Metaiodobenzylguanidine (MIBG), Positron Emission Tomography (PET) and Magnetic Resonance Imaging (MRI) may also be effectual in detecting a Pheochromocytoma neoplasm.

Most small tumors in the adrenal gland are not Pheochromocytoma growths. These only require observation and not any treatment. However, a small percentage of adrenal tumors are actually found to be Pheochromocytoma tumors even in the absence of any signs and symptoms.

Pheochromocytoma and Genetic Testing

In some cases, the condition may arise due to genetic mutations. Doctors may suggest use of genetic testing in such individuals. The need of genetic testing, and the type of it that has to be conducted, depends on the location of the neoplasm and associated medical problems. You should seek genetic counseling if you have a family history of this tumor or any ailment that is associated with it. Counseling will help you understand whether you require Genetic testing.

Pheochromocytoma Differential Diagnosis

The differential diagnosis of Pheochromocytoma includes telling its symptoms apart from those of other disorders, such as:

• Anxiety disorders
• Essential hypertension
• Carcinoid
• Paragangliomas
• Paroxysmal supraventricular tachycardia
• Insulinoma
• Mercury poisoning
• Hyperthyroidism
• Renovascular hypertension

Pheochromocytoma Treatment

The treatment of this neoplasm involves its surgical removal. This is generally carried out after stabilizing the pulse and blood pressure of patients with the aid of medications. Patients may need to stay in hospital to let physicians monitor their vital signs closely. It is essential to monitor all the vital signs of patients continuously in an ICU setting. In cases where surgery fails to remove the tumor, it is necessary to use medications to manage it. A combination of drugs generally needs to be administered to sufferers to keep the effects of excess hormone production in check.

Chemotherapy and Radiation therapy have not been found to be effective in treating this type of neoplasm.

Doctors are likely to use medications if blood pressure cannot be lowered in patients, or if they cannot be surgically treated.

Pheochromocytoma and Medications

The drugs that are commonly used for the treatment of these tumors include:

Alpha blockers

Also known as Alpha-adrenergic antagonists or Alpha-adrenergic blocking agents, these medicines soothe some muscles that help tiny blood capillaries to remain open. These prevent the Noradrenaline (Norepinephrine) hormone from stimulating the muscles located in the walls of veins and smaller arteries. This stimulation leads to the constriction of the vessel walls. Blocking that effect help the vessels remain relaxed and open. This reduces blood pressure and also improves flow of blood in sufferers.

Doxazosin (Cardura), Terazosin (Hytrin), Prazosin (Minipress) and Phenoxybenzamine (Dibenzyline) are some alpha blockers that are often used for treatment of this tumor. Weight gain, headache, nausea and pounding heartbeat are some side effects arising due to an intake of these drugs.

Beta blockers

These drugs prevent the negative effects of the norepinephrine hormone and make the heart beat more slowly and with less intensity. It reduces the nerve impulses travelling through the heart. The heart requires less blood and oxygen, due to which it does not pump with much force. These medicines keep the blood vessels distended by reducing the release of the renin enzyme from the kidneys of sufferers.

These medicines are also known as beta-adrenergic blocking agents.Atenolol (Tenormin), Propranolol (Inderal LA, Innopran XL) and Metoprolol (Lopressor, Toprol XL) are some of the beta blockers that are commonly used for curing this tumor. These may give rise to various side effects, which may include headache, dizziness, fatigue and stomach upset.

Calcium channel blockers

These prevent entry of calcium into the heart and the walls of the blood vessels. In this way, these medicines reduce blood pressure and help widen and relax the blood vessels present in the arteries. Nicardipine (Cardene SR), Amlodipine (Norvasc) and diltiazem (Cardizem LA, Tiazac) are some of these medicines. Headache, drowsiness, constipation and rapid heartbeat (tachycardia) are some common side effects arising due to an intake of these drugs, also referred to as Calcium antagonists.

Metyrosine (Demser)

This drug reduces blood pressure by limiting the manufacture of catecholamines in the body. The medicine may be administered when other drugs have failed to improve the condition. Anxiety, depression, diarrhea and drowsiness are some of the side effects arising due to use of these drugs.

In patients of Pheochromocytoma, alpha blockers are first used to restore normalcy to blood pressure. Once blood pressure goes down, irregular or rapid heart rhythm can be controlled with beta blockers. One of these medicines may be used to make patients physically ready for this disease.

Pheochromocytoma and Surgery

The tumor is commonly treated by removing an entire adrenal gland that has been affected due to the condition. In most cases, operative cure is effective in relieving the discomforting symptoms of the neoplasm. Blood pressure generally returns to normalcy after operative removal of glands. Prior to surgery, medicines are administered for obstructing the harmful effects of adrenal hormones and for regulating blood pressure. In case tumors develop in both adrenal glands and both glands are surgically removed, patients may need taking medicines for substituting the other adrenal hormones.

Physicians may consider Laparoscopic surgery as a curative option on the basis of the location and size of the neoplasm. This surgery involves inserting instruments, such as a Laparoscope (a thin endoscope that helps examine the organs of the abdomen or even conduct a minor surgery), through various small incisions. The process requires a smaller incision than a conventional surgery and also results in a faster recovery. Laparoscopic surgery is being used more widely for treating Pheochromocytoma. However, it is not suitable for everyone. In case you are suffering from this tumor, you should discuss with your doctor whether this operative technique is appropriate for you.

In some cases, operative treatment may not be possible due to the manner of growth of the neoplasm or its dispersion (metastasis) to other areas of the body. In people with malignant (cancerous) cases of this tumor, treatment may not be only restricted to drugs and surgery. It may also involve chemotherapy, radiation or ablation of the arteries that supply blood to the neoplasm.

Pheochromocytoma Prognosis

Around 95% of patients with benign tumors have been found to live even 5 years after their surgical removal. The 5-years survival rate is less than 50% after surgery in malignant cases. With standard curative approach, high blood pressure can be controlled in sufferers. Following a successful operation, the level of the hormones epinephrine and norepinephrine returns to normalcy.

Pheochromocytoma Complications

Unless treated in time, these tumors (although non-cancerous) may give rise to severe complications. In some cases, the problems can be life-threatening. Very high blood pressure may result in abnormal heart rhythm (heart arrhythmia) or stroke, which can prove fatal for sufferers. Any reading that is higher than 180/110 millimeters of mercury (mm Hg) is regarded as very high blood pressure.

High blood pressure, occurring due to the condition, may also cause severe damage to many of the vital organs of patients by exerting excessive force on the walls of the artery. The more the blood pressure, and the greater duration for which it goes unchecked, the greater the risk of damage is.

Prolonged exposure to excess adrenal hormones may also lead to other problems, such as:

• Congestive heart failure
• Increased susceptibility to diabetes
• Damage to the cardiac muscles

In 25% patients, it may not be possible to cure high blood pressure after operation. The tumor is found to recur in around 10% cases of the condition. Heart problems, severe high blood pressure (Hypertension) and Cardiac arrest are other complications that are associated to this disease.

Pheochromocytoma Risk Factors

This tumor is more frequent in people aged between 30 and 50. Around 10% of these growths are observed in children. Often, these neoplasms arise equally in men and women. These are comparatively less frequently observed in blacks than people of other racial backgrounds. The tumor can be related to other disorders, such as:

Picture 2 – Pheochromocytoma Image

• Multiple endocrine neoplasia 2A and 2B
• Neurofibromatosis
• Medullary carcinoma of the thyroid
• Von Hippel-Lindau disease

If you are experiencing a sudden increase in blood pressure that refuses to be controlled by medications, and have a family history of MEN II, NF 1, Familial paraganglioma or Von Hippel-Lindau disease, get in touch with a healthcare provider immediately. Timely detection and treatment will help you recover from this condition faster and avoid its complications.

References:

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001380/

http://www.mdguidelines.com/pheochromocytoma

http://www.mayoclinic.com/health/pheochromocytoma/DS00569/

http://emedicine.medscape.com/article/124059-overview

The post Pheochromocytoma appeared first on Prime Health Channel.

Zollinger-ellison Syndrome Definition

It is a disease characterized by elevated production of a hormone, known as Gastrin, in the body. The condition is abbreviated as ZES.

Zollinger-ellison Syndrome Synonyms

It is also known by other names like:

Picture 1 – Zollinger-ellison Syndrome

• Z-E Syndrome
• Gastrinoma
• Strom-Zollinger-ellison Syndrome

Zollinger-ellison Syndrome Incidence

This is an extremely rare syndrome and arises in only 1 to 3 individuals out of every one million people every year. The disease can affect anyone. However, it is particularly common in males aged between 30 and 50 years. People with this condition have a 20-61% risk of developing ZES. Those having a parent with the disorder are at a 50% risk of inheriting the gene that is causative of MEN 1.

Zollinger-ellison Syndrome Causes

The disorder results from the development of tumors (Gastrinoma) in the upper small intestine of the pancreas. These abnormal growths produce Gastrin in excess amounts, leading to the production of stomach acid in high quantities. There can be a single Gastrinoma tumor or more than one small growths of this type.

Approximately 50-75% of single growths of this type are malignant (cancerous) in nature. These often spread to the liver and the lymph nodes located nearby. Many people having Gastrinomas suffer from multiple tumors due to a disorder known as MEN I (Multiple Endocrine Neoplasia Type 1). Patients with MEN I often develop tumors of the pancreas, parathyroid gland (neck) and pituitary gland (brain).

What happens in Zollinger-ellison Syndrome?

In this condition, the tumors (Gastrinoma) secrete a hormone known as Gastrin. This hormone affects the stomach lining and stimulates it to produce excessive amounts of acid. It also elevates the amount of cells that line the stomach and secrete acids. This heightened acid secretion leads to swelling and the development of ulcers in the lower food pipe and the stomach. It also gives rise to other symptoms, such as diarrhea.

Zollinger-ellison Syndrome Symptoms

ZES gives rise to a number of signs and symptoms that resemble those arising due to Peptic ulcer. These may involve health problems like:

• Heartburn
• Fatigue
• Nausea
• Vomiting
• Reduced appetite
• Unintentional weight loss
• Anemia
• Abdominal pain
• Bleeding in the digestive tract
• Aching, gnawing, burning or discomforting sensations in the upper abdomen

In some case, it may also lead to Duodenitis.

Zollinger-ellison Syndrome Diagnosis

Patients usually visit a family physician or a GP (general practitioner) who is likely to refer them to a Gastroenterologist. In some cases, affected individuals are also referred to an oncologist (a physician who is a specialist in curing cancerous conditions). It is important to prepare from beforehand as such medical apoinments can only be of short duration. Patients should make a list of their symptoms, all the medications (including vitamin supplements) that they have been using and any recent changes (such as stressful occasions) in their life. Doing this would help them make the most of the limited time of their appointment.

The diagnosis of ZES usually begins with physicians asking you about your medical history. You may be asked whether you have a blood relative with the condition; in which case you are at increased risk of having the disorder.

Blood tests

Physicians would also analyze a sample of your blood in the laboratory to check for increased level of Gastrin hormone. Patients need to be on an empty stomach before undergoing this test. If you have been taking acid-reducing drugs for some time, you must stop using them for sometime top get proper results for your Gastrin measurement test. The test may be repeated for a few times as the levels of this hormone tend to fluctuate.

Upper Gastrointestinal Endoscopy

The test involves sedating patients and inserting an endoscope into the stomach and duodenum of patients to check whether Gastrin-producing tumors are present. You are not supposed to have anything after midnight the day before the test.

Secretin Stimulation Test

Various other conditions, other than ZES, may cause increase in the level of Gastrin. Due to this reason, it is important for doctors to test the acidity in the stomach of sufferers and check which condition is responsible for Gastrin increase in a sufferer. In cases where the stomach is found to manufacture acids, a medical exam known as Secretin Stimulation Test may be performed. The exam involves measurement of the Gastrin levels by injecting a hormone known as secretin and re-measuring the Gastrin levels. The level of the hormone will elevate more in cases where patients have ZES.

Endoscopic Ultrasound exams

In this test, an endoscope fitted with an ultrasound probe is used to examine the stomach and the duodenum. It lets physicians have a closer imaging of the digestive tract thus making it easier for them to identify the tumors. The removal of tissue sample is also possible through the use of an endoscope. To undergo this exam, patients need to go without food or drinks after midnight the day before having the test. They also require to be sedated before the test is conducted.

Imaging tests

Physicians may use imaging techniques like Ultrasound scans, Magnetic Resonance Imaging (MRI), Computerized Tomography (CT) Scans or Nuclear scans to locate tumors in patients.

Zollinger-ellison Syndrome Differential Diagnosis

The differential diagnosis of Zollinger-ellison Syndrome involves distinguishing it from other conditions that give rise to more or less similar symptoms. These include disorders like:

• Gastric Outlet Obstruction
• Atrophic gastritis
• Gastric cancer
• Pernicious anemia
• Chronic renal failure
• Gastric outlet obstruction
• Antral G-cell hyperfunction
• Ulcers and kidney stones
• Recurrent or refractory ulcer disease

Zollinger-ellison Syndrome Treatment

The treatment of ZES requires physicians to treat the ulcers as well as the tumors. However, successful removal of tumors would no longer make it necessary to remove the ulcers.

The treatment of tumors is usually performed with the aid of a surgery. This is usually carried out by a skilled surgeon who has the necessary skills and expertise to detect and remove the small tumors causative of the condition. However, surgery is useful only in case of a single tumor. Operation is not considered to be a curative option in case there are more than one tumors or tumors that have spread to the liver.

In some cases, other treatment options are also used for controlling the growth of tumors. These include:

• Liver transplant
• Injecting drugs into Gastrinomas (for alleviating symptoms of cancer)
• Chemotherapy, for reducing the pace of tumor growth
• Embolization (Destroying tumor by blocking the supply of blood to it)
• Radiofrequency ablation (Use of heat to destroy cancerous cells)
• Debulking (Removal of as much liver tumor as possible)

These days more radical operative techniques, such as completely removing the stomach or severing the nerves that encourage stomach acid production, are not used. Medicines are usually successful in lowering the production of acids and the development of ulcers.

Zollinger-ellison Syndrome and Medications

The condition is treated with medicines to provide relief from the symptoms of ulcer. In some cases, a class of drugs is administered to effectively reduce the secretion of gastric acid in the stomach. These are known as “Proton Pump Inhibitors” and involve medications like Lansoprazole (Prevacid), Esomeprazole (Nexium), Omeprazole (Prilosec) and Pantoprazole (Protonix). Tumors which are not possible to remove through surgery can sometimes be successfully with chemotherapy drugs like Doxorubicin (Doxil), 5-fluorouracil (Adrucil) and Streptozotocin (Zanosar).

Is Zollinger-ellison Syndrome Serious?

ZES is obviously a serious disorder and has potentially life-threatening consequences for its sufferers. This is because Gastrinoma growths, or the tumors that produce the Gastrin hormone, may spread from one area of the body to another. It may give rise to severe complications. The ulcers resulting from this disease are usually more painful and show lower response to treatment than normal peptic ulcers.

Zollinger-ellison Syndrome Complications

Some of the main complications that can develop from ZES include:

• Acute diarrhea
• Weight loss
• Intestinal bleeding
• Inability to identify tumor(s) during operation
• Spreading of tumors to other organs, most commonly the lymph nodes and the liver

Does Zollinger-ellison Syndrome Go Away?

Once the condition occurs, it does not go away without proper treatment. This is because the pancreatic tumor, that manufactures Gastrin in excess, is generally malignant (cancerous) and can spread to other regions of the body.

Zollinger-ellison Syndrome Risk Factors

The risk factors for this disorder include:

Picture 2 – Zollinger-ellison Syndrome Image

• MEN 1 Syndrome
• Having a family history of ulcer disorder

Zollinger-ellison Syndrome Prognosis

The prognosis is comparatively poor even when diagnosis and operation is conducted in the early stages to remove the Gastrinoma. However, the growth of these tumors tends to be slow. Patients are likely to survive for many years before the Gastrinoma tumors are diagnosed. In some cases, acid-suppressing drugs are found to be extremely effective in reducing the symptoms arising due to production of excessive amounts of acids. The outcome actually depends on the extent and nature of the Gastrinoma tumors in patients. Around 25% cases are regarded as malignant and the 10 year survival rate is estimated to be approximately 30%.

Zollinger-ellison Syndrome Prevention

It is not possible to prevent the development of this disorder in a specific way. However, family members of a patient require genetic counseling and screening if he or she is diagnosed with MEN 1. If you have been treated for ZES, regular visits to the doctor are necessary for you to ensure that there is no recurrence of Gastrinoma tumors.

You should get in touch with a physician in case of discomforting abdominal sensations. Visiting a healthcare provider is particularly important if you are also suffering from other problems like vomiting, nausea and diarrhea.

References:

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001366/

http://www.mayoclinic.com/health/zollinger-ellison-syndrome/DS00461

http://digestive.niddk.nih.gov/ddiseases/pubs/zollinger/

http://www.patient.co.uk/doctor/Zollinger-Ellison-Syndrome.htm

The post Zollinger-ellison Syndrome appeared first on Prime Health Channel.

What is Thyroiditis?

It is an endocrine disease characterized by a swelling of the thyroid gland. It is not a thyroid gland infection, as many like to believe, but only an inflammation.

Thyroiditis ICD9 Code

The ICD9 Code for this disease is 245.

Thyroiditis Types

The condition is differentiated into a number of types, such as:

Picture 1 – Thyroiditis

Hashimoto’s Thyroiditis

It is the most prevalent type of hypothyroidism in the United States. This autoimmune disorder is characterized by a thyroid gland inflammation that frequently leads to decreased thyroid functioning.

The disorder is also known by the name Chronic Thyroiditis.

Postpartum Thyroiditis

It commonly arises after pregnancy and may involve either Hypothyroidism or Hyperthyroidism or both – sequentially. It occurs in 5% of all women a year after giving birth.

Acute Thyroiditis

It is a very rare type of Thyroiditis and is marked by pain, inflammation and various other problems in the anterior part of the throat.

Subacute Thyroiditis

This form can result in both Hypothyroidism and Thyrotoxicosis. This rare disease can affect people of any age and sex.

Silent Thyroiditis

Also referred to as Painless Thyroiditis, it is more common in women and may arise at any age. Postpartum Thyroiditis is a variation of this disease that develops Postpartum.

Drug-induced Thyroiditis

As the name indicates, it occurs due to intake of drugs that are hazardous for health.

Radiation-induced Thyroiditis

It is a type of painful, acute thyroiditis that occurs due to radioactive therapy used for curing Hyperthyroidism. It may also result from use of radiation to cure cancerous conditions of the head and neck.

Riedel’s Thyroiditis

Also known as Riedel’s Trauma, this is a chronic an autoimmune variation of Thyroiditis. It is supposed to be a rare type of the disease that mostly affects women.

Thyroiditis Symptoms

The signs and symptoms of Thyroiditis tend to differ, based on the type of the condition that one is suffering from. The symptoms also depend on the rate of enlargement of the thyroid gland.

If the condition leads to a slow and chronic fast destruction or damage of thyroid cells, patients may suffer from symptoms similar to those of Hypothyroidism. In such cases, sufferers may experience problems like:

• Weight gain
• Constipation
• Fatigue
• Depression
• Dry Skin
• Poor tolerance to exercise

Such symptoms are usually common in sufferers of Hashimoto’s Thyroiditis.

If the condition results in rapid damage and destruction of thyroid cells, there can be a leakage of thyroid hormone stored within the gland. This can elevate the level of thyroid hormone in the bloodstream and give rise to problems similar to those of Hyperthyroidism. These involve:

• Anxiety
• Insomnia
• Palpitations
• Fatigue
• Weight loss
• Irritability

Such problems are seen to arise in patients affected with the toxic stage of painless, Subacute and Post-partum thyroiditis. Patients of Subacute thyroiditis can suffer from pain in the thyroid gland.

Generally, some problems are found to be common in most patients of this disease. These include:

• Rapid heartbeat
• Anxiety
• Slight nervousness
• Loss of around 5-10 pounds of weight
• Enhanced sweating
• Constipation
• Absence of hunger sensation
• Lethargy
• Lack of energy
• Moderate fever
• Cool, dry skin
• Reduced pulse rate, with less than 60 beats every minute
• Hoarseness
• Slow reflexes
• Inflammation around the eyes
• Firmness and enlargement of thyroid gland

Patients with subacute cases of the disorder usually suffer from pain in their thyroid gland.

Thyroiditis Causes

The disorder usually arises due to an attack on the thyroid gland by antibodies, due to a possible malfunction of the natural immune system of the body. It may also arise due to an infection of the gland caused by a microbe, such as a bacteria or virus, which can produce same effects as antibody attacks on the gland. Fever disorder may also cause this disease.

It can also occur as a side effect of usage of certain drugs, such as:

• Amiodarone
• Interferon-alpha
• Inter leukin-2
• Lithium

There can be possible damage of the thyroid cells due to usage of these medications.

Women who test positive for thyroid antibody during the first three months of their pregnancy have a 30 – 50% chance of developing this disorder during the postpartum period. Excessive intake of iodine may also contribute to thyroid conditions. In some cases, however, no identifiable cause can be found for this disease.

Thyroiditis Diagnosis

A physical examination can help detect enlargement of the thyroid gland and a possible Thyroiditis. The amount of thyroid hormones present in the bloodstream can be evaluated with the aid of Thyroid blood tests, such as:

• T3
• T4
• TSH (Thyroid Stimulating Hormone)

In some cases, thyroid scans may also be performed to probe the functioning of the thyroid gland in patients. A biopsy of the gland can help doctors understand the factors that might have resulted in the condition, such as an attack by antibodies. Diagnosis also helps detect the type of the disorder that the affected individual is having.

Thyroiditis Treatment

The disease is usually classified into three stages – overactive, underactive and return to normalcy. The type of treatment needed for this disease actually depends on the type and stage of it that one is diagnosed with.

Picture 2 – Thyroiditis Image

A patient exhibiting symptoms of hyperthyroidism may be prescribed with beta blockers which can help lower his or her heart rate. Such individuals may also be put through thyroid hormone replacement therapy, which helps restore hormone levels in the body and make metabolic activities more normal. This can help avoid further swelling of the thyroid gland.

Patients who suffer from throat ache due to a swollen gland are typically prescribed medicines to lower the painful symptoms. Acute cases of throat pain can be treated with the help of steroid therapy. The condition of Thyroiditis patients needs to be regularly examined to check the functioning of the thyroid gland.

Thyroiditis and Medications

The type of medicines used for treatment of this disorder actually depends on the form of Thyroiditis that a person is having. Some of the common medicines prescribed for this disorder include:

• Antibiotics
• Aspirin, to provide relief from pain and swelling
• Corticosteroid medications (such as Prednisone or Dexamethasone), to decrease swelling in acute cases
• Levothyroxine, in case of hypothyroidism or a large-sized goiter
• Propanolol, for curing Hyperthyroidism
• Short-term beta blockers, for relieving hyperthyroid symptoms
• Thyroxine, used in patients of hypothyroidism, to replace thyroid hormone

Thyroiditis and Surgery

Surgical treatment is rarely used for this disorder. In uncommon cases, however, partial thyroid removal may be done to ease pressure.

Thyroiditis Diet

A diet for patients of this disorder should be devoid of:

• Alcohol
• Caffeine
• Dairy products
• Refined foods
• Sugar
• Wheat

Patients taking thyroid medications should also consult their doctors before consuming foods or supplements containing iron or soy.

A diet recommended for such patients should include foods like:

• Beans
• Broccoli
• Brussels sprouts
• Cabbage
• Cauliflower
• Kale
• Mustard greens
• Soy
• Spinach
• Turnips

Such foods depress over activity of the thyroid glands. Hence, they are recommended for patients with hyperthyroid conditions. Those with hypothyroid conditions should avoid them. It is necessary to have such foods with caution as Thyroiditis sufferers tend to switch very quickly from hyper- to hypothyroidism.

Given below is a list of foods and supplements along with the quantity that a person should consume on a daily basis to have a normal metabolic function and proper thyroid hormone production.

• Essential fatty acids (1,000 – 1,500 mg, three times every day)
• Bromelain (250 – 500 mg 3 times per day between meals)
• Calcium (1,000 mg per day)
• Vitamin C (1,000 mg)
• Vitamin A (10,000 – 25,000 IU)
• Vitamin B complex [(50 -100 mg)
• Vitamin B2 (Riboflavin, 10 mg)
• Vitamin B3 (Niacin, 10 – 25 mg)
• Vitamin B6 (Pyridoxine, 5 – 15 mg)]
• Vitamin E (400 IU per day)
• Magnesium (200 – 600 mg per day)
• Selenium (200 mcg per day)
• Zinc (30 mg per day)

A physician may also recommend having particular nutritional supplements for a hypo- or hyperthyroid condition.

Thyroiditis Home Treatment

The home treatment for this disorder can be done with the aid of certain herbs. Herbal remedy is a safe and natural way to tone up and strengthen the body. As is the case with any therapy, it is advisable that you consult your physician before starting herbal treatment for this disease. This is particularly because some herbs tend to interact or interfere with certain drugs. The types of herbs that you should put to use should depend on the form of the condition that you are having.

In case of Hyperthyroid conditions, you may use:

• Bugleweed (Lycopus virginica)
• Lemon balm (Melissa officinalis)
• Motherwort (Leonurus cardiaca)
• Turmeric (Curcuma longa)

Hypothyroid patients may consider using:

• Coleus forskohlii (50 – 100 mg; 2 – 3 times per day)
• Guggul (Commiphora mikul) [25 mg for 3 times a day]
• Hawthorne (Crataegus monogyna) [500 mg for two times per day]

Alternative Treatment for Thyroiditis

The alternative cure for this disorder may involve:

Homeopathy

Although the potency of this type of treatment has not been medically reported, homeopathy may be effective as a supportive therapy for both hyperthyroidism and hypothyroidism.

Exercise

Regular workouts help improve functioning of the thyroid gland and can cure both hyperthyroidism and hypothyroidism.

Acupuncture

It may help address underlying excesses and deficiencies in thyroid hormone production and correct imbalances in the level of these hormones.

Massage

Therapeutic massage may provide patients with relief from stress and enhance the feeling of well being in sufferers.

However, such methods should only be used to support medical treatment and never be used alone as a remedial measure.

Thyroiditis Risk Factors

You are susceptible to this disorder if:

• You are a woman (women are more prone to this disorder than men)
• You have a personal or family history of the disease or any immune system disorder that heightens the risk of this condition
• You are taking certain medicines, such as Lithium or Amiodarone
• You are suffering or have recently suffered from any bacterial or viral ailment
• You have recently undergone Radiation therapy
• You are pregnant and within the first trimester period

Thyroiditis Prognosis

The outcome of this condition varies from one patient to another and depends on the type that one is having. In Acute cases of this disease, recovery is generally complete and the functioning of thyroid glands goes back to normal after treatment. In subacute cases, the condition may persist for 2-7 months. Patients may need inpatient care to complete approximately a fortnight of antibiotic course and also to recover from any surgical processes.

Thyroiditis Complications

In chronic autoimmune cases of the ailment, the main complication arises in the form of permanent hyperthyroidism. Around 20% children suffering from subclinical Hyperthyroidism enter remission and the condition becomes Euthyroidism.

Thyroiditis is a serious condition that can give rise to acute health problems, unless treated in time. Around 20-27 million individuals in the U.S are said to be suffering from problems of the thyroid gland, which might damage it permanently. If any of your family members or friends exhibit symptoms of this disease, immediately seek medical treatment from a professional healthcare provider. A physician, with necessary experience, can cure the condition very fast and prevent it from worsening.

References:

http://emedicine.medscape.com/article/925249-overview

http://www.medicinenet.com/thyroiditis/article.htm

http://www.umm.edu/altmed/articles/thyroiditis-000164.htm

http://www.endocrineweb.com/conditions/thyroid/thyroiditis

The post Thyroiditis appeared first on Prime Health Channel.

Adrenal Adenoma Definition

These are glandular type benign (non-cancerous) tumors that affect the adrenal glands located on top of the kidneys. Some of these growths secrete various hormones such as Cortisol, Aldosterone and Androgens which can result in health disorders like Cushing’s Syndrome, Conn’s Syndrome and Hyperandrogenism.

This type of tumor is commonly identified during the diagnosis of some other condition. Some adenomas can lead to stomach and back pain as well as serious health disorders.

Adrenal Adenoma Types

These abnormal growths can be categorized into two different types:

Picture 1 – Adrenal Adenoma

Functioning

These are lumps that produce various types of hormones and are termed as “functioning”. This type of adenomas can be very harmful for health as they produce excessive steroid hormones.

Non-functioning

These do not produce any hormone and are known as “non-functioning”.

Adrenal Adenoma Incidence

Such lumps can occur in both children and older people. However, aged individuals are more prone to the condition. Around 6% of the patients having adenomas of the adrenalin gland are aged over 60 years.

Adrenal Adenoma Causes

The exact causes of the condition are still unknown. However, according to the accepted theory, mutations in certain genes are responsible for this condition. However, the genes and the factors behind their mutations have not been identified yet.

These growths commonly occur in some genetic disorders like Beckwith-Wiedemann Syndrome, Multiple Endocrine Neoplasia Type I and Carney Complex.

Adrenal Adenoma Risk Factors

Individuals suffering from certain hereditary conditions like Congenital Adrenal Hyperplasia involving production of steroid hormones, have an increased risk of developing these growths. Patients who do not receive proper treatment are at higher risk.

The chances of having an adenoma of the adrenal gland increase with age.

Adrenal Adenoma Signs and Symptoms

In most cases, these masses do not give rise to any special symptoms. In many such cases, however, proper investigation reveals an abnormally high steroid hormone production by these adenomas. Excessive production of a steroid hormone, known as Cortisol, is the most common abnormality witnessed in patients. This hormone controls the balance of energy and response to stress.

Excessive steroid hormone production leads to various obvious symptoms. Massive cortisol production causes Cushing’s syndrome. Excessive amount of aldosterone is the reason behind Conn’s syndrome. Hair growth and acne is caused by excessive production of male sex hormones.

In cases where bleeding occurs into adenomas, patients experience symptoms like:

• Back pain
• Pain and discomfort in the flanks
• Loss of weight
• Abdominal pain

A functioning adenoma can give rise to various symptoms that are similar to those of Adrenal carcinoma or cancer.

Adrenal Adenoma Prevention

Presently, there is no known way of preventing this condition. Experts, however, are trying to find out some ways to prevent the development of these lumps in the adrenal gland.

Adrenal Adenoma Diagnosis

In many cases, an abdominal CT scan (computed-tomography) or MRI (magnetic-resonance imaging) originally conducted for diagnosis of some unrelated disease helps identify these unusual masses.

According to studies, 0.3% to 11% of the incidental identification of adrenal lumps is done by CT scan. In around 80% of these cases, the adenomas are benign and non-functioning.

In some rare instances, the adrenal mass is cancerous in nature which spreads from some other part of the body such as the bowel and lungs. Clinical examinations and tests, such as chest X-ray, are generally very useful for discovering the origin of these cancers. Metastatic cancer in adrenal glands, discovered by MRI or CT scan, is differentiated from benign adrenal adenomas by using specialized radiology.

Some adrenal cortex cancer, such as adrenocortical carcinoma, may also cause an adrenal mass. A combination of various hormones is produced by these large cancers.

In some cases adrenal masses arise from the adrenal medulla (the inner part of the adrenal gland), a part of the human nervous system. These masses produce the ‘fight-or-flight’ hormones called adrenaline and noradrenaline. Tumors growing in the adrenal medulla area are known as Phaeochromocytomas. Specialized scanning techniques, such as urine and blood tests, are used for distinguishing phaeochromocytomas from adenomas arising in the adrenal gland.

Recent findings show that a washout greater than 50 per cent indicates the presence of benign Adrenal Adenoma.

Adrenal Adenoma Differential Diagnosis

The following conditions are considered during the diagnosis of this adenoma:

• Adrenocortical carcinoma
• Phaeochromocytoma
• Adrenal metastasis
• Focal adrenal granulomatous disease
• Adrenal myelolipoma

Physicians have to differentiate adenomas from these conditions, which give rise to similar symptoms, for an accurate diagnosis.

Adrenal Adenoma Treatment

Functioning adenomas are treated by removing the affected adrenal gland, using a special surgical method known as adrenalectomy. Sometimes, a laparoscopic adrenalectomy is also used for treating the disorder. However, it is yet unknown if this new operative process is more useful than the standard surgery.

Picture 2 – Adrenal Adenoma Image

Adrenal lumps that are larger than 3 cm or have evidences of bleeding and degeneration should be removed immediately through surgery to reduce the risks of adrenal cancer. Non-functioning benign Adrenal Adenomas can be kept in check by medications and scanning that ensure that their condition is not declining. Only the lumps that are less than 3 cm in size and that do not produce hormones can be managed in this way. Follow-up measures for this type of lumps include regular scanning and imaging to prevent any further growth of the adenomas.

The possibilities of development of any complications due to Adrenalectomy are similar to that of other similar surgeries.

In some cases, the spleen situated below the left lung is removed during the surgery. The spleen is the organ that combats various bacterial infections. Due to this reason, doctors always vaccinate the patients against Pneumococci (a bacterium responsible for lobar pneumonia) after their left adrenal gland is removed.

Adrenal Adenoma Prognosis

The prognosis or outcome of this condition is generally very good when the adenomas are diagnosed and treated properly at an early stage.

Adrenal Adenoma Recurrence

Risk of recurrence of these growths, once they have been removed, is fortunately very low.

In certain cases, Adrenal Adenomas can cause serious health conditions. The functioning adenomas are more harmful as compared to the non-functioning ones. These tumors do not generally give rise to any life threatening condition. However, the functioning adenomas require early treatment. Otherwise, they can cause severe stomach pain. Proper treatment, carried out in time, can cure the condition and prevent complications.

References:

http://www.netdoctor.co.uk/diseases/facts/adrenaladenomas.htm

http://radiopaedia.org/articles/adrenal_adenoma

http://emedicine.medscape.com/article/376240-overview

http://www.rightdiagnosis.com/a/adrenal_adenoma_familial/treatments.htm

The post Adrenal Adenoma appeared first on Prime Health Channel.

Postpartum thyroiditis Definition

It is a temporary inflammation of the thyroid gland that develops in many women post pregnancy. The term “postpartum” refers to the period after delivery. The condition is usually painless and belongs to a group of thyroiditis known as Resolving Thyroiditis. It may involve either Hyperthyroidism or Hypothyroidism or both, consecutively. Hypothyroid symptoms extending beyond one year after delivery is generally not regarded as Postpartum thyroiditis.

This is a common disorder that affects many new mothers.

Postpartum thyroiditis Phases

It usually occurs in two phases that are generally transient.

Picture 1 – Postpartum thyroiditis

Hyperthyroid Phase

The initial phase of this disorder is characterized by hyperthyroidism, a condition marked by excessive production of thyroid hormones due to overactive thyroid glands. During this phase, symptoms generally appear two to six months post-delivery. Hormonal disturbances are normally very subtle and may often remain undetected. The thyroid gland loses control over the release of thyroid hormone that it normally stores, causing elevated levels of the hormone in the blood.

Hypothyroid Phase

Hypothyroidism may occur in the second phase where the thyroid gland does not produce sufficient amount of thyroid hormone. This phase is also temporary and can occur within three to twelve months after delivery. During hyperthyroid phase, sufficient damage to the thyroid gland may cause decreased production of thyroid hormone, resulting in this condition. In most cases, however, patients do not go through the initial phase and directly develop Hypothyroidism.

Postpartum thyroiditis Incidence

It affects about 5% of all women within a year after delivery. One in five women with this disorder develops permanent hypothyroidism that may require life-long treatment.

Postpartum thyroiditis Symptoms

This condition usually occurs within the first year after delivery. Symptoms are generally very mild and may vary from one patient to another. The two phases of this disorder are manifested by different sets of symptoms.

Hyperthyroid Phase

Some of the main signs and symptoms in this phase involve:

Nervousness

Patients may undergo extreme anxiety and easiness. They often experience an unpleasant feeling of fear and concern.

Goiter

In this condition, the thyroid suffers enlargement, which leads to an acute swelling of the neck or larynx.

Palpitation

In some patients, irregular or rapid beating of the heart may occur without any specific cause.

Heat intolerance

Sufferers show hypersensitivity to heat. Even a slight rise in temperature becomes unbearable for them. It is often accompanied by profuse sweating.

Fatigue

Some patients get physically exhausted very easily. They may even feel lethargic to perform routine activities.

Irritability

Mood swings and fussiness are other common symptoms of postpartum women.

Weight loss

New mothers may have a decreased appetite that causes extreme reduction in body weight.

Trembling hands

During this phase, the hands shake uncontrollably. This may even affect other parts of the body.

Muscular weakness

One or more muscles of the body may lose strength. Spasms may also develop in these regions.

Hypothyroid Phase

The main difficulties experienced in this phase are:

Inability to concentrate

Patients may lose focus and have difficulty in concentrating.

Carelessness

Affected individuals may develop lack of concern and casual approach. They can become quite negligent and behave in an improper manner.

Dry skin

Scaly and dry skin on the lower legs, arms, abdominal regions and thighs is a typical symptom of the hyperthyroid phase.

Cold intolerance

In the later phase, patients undergo abnormal sensitivity towards cold conditions or temperatures.

Muscle aches

This condition is quite common and may involve a single muscle or a group of muscles in the body.

Poor memory

Frequent episodes of momentary memory lapse may occur.

Postpartum thyroiditis Causes

Medical experts are yet in the dark regarding the cause of sudden inflammation of the thyroid gland occurring in some women after delivery. Nonetheless, there are some factors that are suspected to cause this condition.

Autoimmunity

It case of an autoimmune disorder, the immune system of the body turns against its own cells and tissues mistaking them as pathogen. It starts producing autoantibodies as a response. During pregnancy, the immune system gets suppressed to prevent the formation of antibodies against the fetus. This protects the fetus from getting rejected by the body, thus preventing a miscarriage. Post delivery, the immune system gets activated once again and produces antibodies like thyroglobulin (TgAb) that may attack the thyroid gland. This can cause Postpartum thyroiditis. Increased production of autoantibodies against thyroid peroxidase denoted as “TPOAb” causes cellular damage and alters the function of the thyroid gland.

Changes in T-cells

T-cells belong to a group of white blood cells (WBCs), known as lymphocytes, which play a major role in the immune system and guard the body against infection. There are a number of different types of T-cells like helper cells, cytotoxic cells that identify and destroy infectious agents. In this condition, however, the number of T- helper cells (such as CD4) increases in comparison to CD8 and directly attacks the thyroid gland.

Hashimoto’s thyroiditis

In this autoimmune condition, the thyroid gland is attacked by a variety of cell and antibody-mediated immune processes. Lymphocyte (T-cells) infiltration and follicle formation within the thyroid gland occurs, causing both Hypothyroidism and Hyperthyroidism.

Graves’ disease

In this disorder, an abnormal response of the immune system causes the thyroid gland to produce excessive amount of thyroid hormones. Thyroid autoantibodies are believed to stimulate thyroid hormone secretion while thyroid growth causes Hyperthyroidism and Goiter.

Type 1 diabetes

In this form of diabetes, autoimmune destruction of insulin-producing beta cells of the pancreas leads to elevation of glucose in the blood and urine of the patients. This may cause a greater risk for thyroid dysfunction in post partum women.

Postpartum thyroiditis Diagnosis

This condition usually remains undetected by physicians, owing to the subtleness of the symptoms of this disorder. In most cases, the level of thyroid hormone is checked to determine this condition. Some other diagnostic tests for the disorder include:

Picture 2 – Postpartum thyroiditis Image

Blood test

Thyroid stimulating hormone (TSH) and thyroid hormone thyroxine (T4) levels in the blood are normally measured by a routine blood test. Thyroxine (T4) is the key hormone produced in the thyroid gland. Higher levels of T4 level suppress the levels of TSH in blood, causing Hyperthyroidism. On the other hand, lower levels of T4 and higher levels of TSH in the blood normally indicate Hypothyroidism.

Thyroid scan

This diagnostic technique is used for the evaluation of Hyperthyroidism. Radioactive dye is orally administered to patients in the form of capsule or fluid. Thyroid gland absorbs the dye, which is later scanned by placing a scintillator counter over the neck. Images obtained after the completion of scan show those regions of the thyroid gland that have absorbed the dye. The absorption is generally very less and uneven.

Postpartum thyroiditis Treatment

Treatment depends on the phase of the condition that one is suffering from and the degree of symptoms that the patients exhibit.

Beta blockers

These are usually administered to the patients during Hyperthyroid phase to block the effects of thyroid hormones on the body, such as palpitations and tremors.

Thyroid hormone replacement

These are synthetic medicines that are given to the patients during Hypothyroid phase. Levothyroxine is a commonly used synthetic thyroid hormone that can restore the normal thyroid hormone levels in the body. It is generally prescribed to the patients for approximately six months, following which it should be discontinued for almost four to six weeks. In case patients develop permanent hypothyroidism after Postpartum thyroiditis, Levothyroxine must be taken on a daily basis.

Natural thyroid hormones, such as desiccated (dried and powdered) animal thyroid (Armour) that is obtained from pigs, can also be used for thyroid therapy. These are generally administered to the patients in form of supplements.

Radioactive iodine therapy

Iodine is an essential mineral for the human body. It is used by the thyroid gland to function properly. In this method, a radioactive form of iodine is used to destroy some of the gland cells. This is usually performed to reduce the production of thyroid hormone by the thyroid gland. However, this technique is generally not recommended for breast feeding mothers.

Postpartum thyroiditis is a common disorder with mild, temporary symptoms. 80% of the patients regain normal thyroid function without any therapy. It is not a life-threatening disorder and effective treatments are now available to relieve discomfort. Early detection must be done in order to shorten the extent of suffering in patients.

References:

http://en.wikipedia.org/wiki/Postpartum_thyroiditis#Diagnosis

http://www.mayoclinic.com/health/postpartum-thyroiditis/AN00153

http://www.thyroid.org.au/ThySoc/ThySocPPTD.html

http://www.drugs.com/cg/postpartum-thyroiditis.html

The post Postpartum thyroiditis appeared first on Prime Health Channel.