Discover and read the best of Twitter Threads about #Endotips
Most recents (3)
❗️Chronic Adrenal insufficiency treatment has several options
Follow the 🧵 for more information about these options.
#Endotips #MedTwitter
(1/10)
Follow the 🧵 for more information about these options.
#Endotips #MedTwitter
(1/10)
First and foremost:
- Primary adrenal insufficiency (adrenal lesion): CORTICOSTEROID and MINERALOCORTICOID are needed;
- Secondary adrenal insufficiency (ACTH impairment): CORTICOSTEROID only is needed.
(2/10)
- Primary adrenal insufficiency (adrenal lesion): CORTICOSTEROID and MINERALOCORTICOID are needed;
- Secondary adrenal insufficiency (ACTH impairment): CORTICOSTEROID only is needed.
(2/10)
Let's start with the MINERALOCORTICOID:
- Natural mineralocorticoid: aldosterone
- Replacement: fludrocortisone (usually 100 mcg/day)
- Goal: avoid both hypotension and hyperkalemia. Plasma renin activity (PRA) at the upper level of normal.
(3/10)
- Natural mineralocorticoid: aldosterone
- Replacement: fludrocortisone (usually 100 mcg/day)
- Goal: avoid both hypotension and hyperkalemia. Plasma renin activity (PRA) at the upper level of normal.
(3/10)
Carney triad vs. Carney dyad 🧬 #endotips (thread👇)
A diagnosis of Carney triad requires co-existing paraganglioma (PGL), pulmonary chondroma, and gastrointestinal stromal tumor (GIST) with either a germline pathogenic variant in SDHx or SDHC locus-specific hypermethylation
A diagnosis of Carney triad requires co-existing paraganglioma (PGL), pulmonary chondroma, and gastrointestinal stromal tumor (GIST) with either a germline pathogenic variant in SDHx or SDHC locus-specific hypermethylation
In contrast, Carney dyad is the association of PGL and GIST with a germline pathogenic variant in SDHx. Don't confuse them with Carney complex, an autosomal dominant lentiginosis syndrome with myxomas, endocrine tumors or overactivity, and schwannomas👇
Carney-Stratakis syndrome is another name for Carney diad (discovered by two giants in the field, Dr Aidan Carney from @MayoClinic and Dr Constantine Stratakis from @NIH)
#endocation #endorules #endotips #endotwitter
🫀Molecular mechanisms involved in the different types of monogenic hypertension (thread)👇
🫀Molecular mechanisms involved in the different types of monogenic hypertension (thread)👇
🔹Gordon syndrome
▪️Autosomal dominant: WNK1 (GoF), WNK4 (LoF)
▪️AKA Pseudohypoaldosteronism Type II
▪️⬇️renin, normal/⬆️aldosterone (mimicking biochemically mild primary aldosteronism), BUT hyperkalemia
▪️Metabolic acidosis, hypercalciuria,⬇️UNa
▪️Rx: low dose thiazide
▪️Autosomal dominant: WNK1 (GoF), WNK4 (LoF)
▪️AKA Pseudohypoaldosteronism Type II
▪️⬇️renin, normal/⬆️aldosterone (mimicking biochemically mild primary aldosteronism), BUT hyperkalemia
▪️Metabolic acidosis, hypercalciuria,⬇️UNa
▪️Rx: low dose thiazide
🔹Liddle syndrome
▪️SCNN1A/B/G (GoF), dominant
▪️⬇️renin/aldosterone/K, alkalosis
▪️Spectrum: mild to severe
▪️Rx: low salt diet and ENaC inhib. (amiloride, triamterene)
▪️SCNN1A/B/G (GoF), dominant
▪️⬇️renin/aldosterone/K, alkalosis
▪️Spectrum: mild to severe
▪️Rx: low salt diet and ENaC inhib. (amiloride, triamterene)
