Diabetic and endocrine emergencies

Abstract

Endocrine emergencies constitute only a small percentage of the emergency workload of general doctors, comprising about 1.5% of all hospital admission in England in 2004–5. Most of these are diabetes related with the remaining conditions totalling a few hundred cases at most. Hence any individual doctor might not have sufficient exposure to be confident in their management. This review discusses the management of diabetic ketoacidosis, hyperosmolar hyperglycaemic state, hypoglycaemia, hypercalcaemia, thyroid storm, myxoedema coma, acute adrenal insufficiency, phaeochromocytoma hypertensive crisis and pituitary apoplexy in the adult population.

Myxedema Coma After Surgical Procedures: Case Report

“…These patients were successfully rescued with 300 µg of levothyroxine, followed by 60 µg/day. 2,5,[7][8][9][10][11][12] By the way, attention should be paid for the risk of cardiac complications and the body temperature. The core temperature must be checked using a low-reading thermometer, as the mortality of this condition is related to the severity of the hypothermia.…”

Underlying medical conditions

“…The management of hypoglycaemia includes the following 8 , depending on level of consciousness and ability to swallow. If awake and orientated, the patient should be treated with two to six dextrose tablets followed by long-acting carbohydrates.…”

“…In these cases, one of the following alternatives can be considered: guanethidine 30-40 mg orally every 6 h or reserpine 2.5-5 mg intramuscularly every 4 h. The safety of both of these drugs during pregnancy has not been established. 24 and 25 • High-dose corticosteroids: dexamethasone 4 mg intravenously every 6 h. 8 • Supportive care includes intravenous fluid to correct dehydration and lower body temperature. Intravenous fluid should contain 5-10% dextrose to prevent hypoglycaemia.…”

Coma mixedematoso em paciente com neurofibromatose tipo 1: associação rara

“…Tais fatores incluem exposição ao frio, sepse, drogas (diuréticos, sedativos, analgésicos, anestésicos, amiodarona, lítio, fenitoína), distúrbios hidroeletrolíticos, trauma, acidente vascular cerebral, infarto agudo do miocárdio, insuficiência cardíaca, hemorragias gastrointestinais, queimaduras, anestesia e ingestão de alguns alimentos como o repolho chinês que contém glucosinolatos cujos metabóli-tos inibem a captação de iodo (1,(3)(4)(5)(6)(7).…”