Endocrine System Disease Diagnosis

Endocrine System Disease Diagnosis

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    A diagnosis of a glucagonoma is established with a significant elevation of glucagon levels in the blood. Other common laboratory abnormalities include elevated blood sugar and chromogranin A values, and anemia (decreased red blood cells). Symptoms of glucagonomas are often vague and may be evident for years before a diagnosis is secured. Consequently, the tumors may be relatively large (an average diameter of 4-6cm) when they are discovered. 
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    In most patients with primary hyperparathyroidism (80%), only one of the four parathyroid glands is diseased. Localizing tests are radiology tests designed to help identify which parathyroid gland(s) are hyperactive. One such localizing test is a sestamibi scan which involves injecting a small amount of special radioactive material into a vein and taking an X-ray image of the chest, neck, and head. The advantages of a sestamibi scans are their widespread availability and their ability to evaluate for diseased glands outside of the neck.

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    Parathyroid Gland
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    A Endocrinology Diabetes & Metabolism, answered on behalf of

    Diagnosis for insulinomas requires observation of insulin level as it relates to blood sugar level. A low blood sugar level combined with a high insulin level confirms the diagnosis that an insulinoma exists. After diagnosis, the next step is localization of the tumor, accomplished using imaging studies including CT, MRI, octreotide scanning (injection of radioisotope into the vein and subsequent scanning to record the radiation given off by the radioisotope), and ultrasound. However, in some patients, these imaging techniques are unable to localize the tumor. In these cases, attempts to locate the lesion are performed by experienced endocrine surgeons during an operation and are successful in the majority of patients.

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    The gastrinoma diagnosis should be suspected on the basis of the clinical presentation and established in almost all patients by demonstrating elevated basal gastric acid secretion (BAO) and fasting elevations of the protein gastrin, which is produced by the gastrinoma. It is this protein gastrin, which leads to the increased acid secretion causing the ulcer formation.
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    To diagnose a thyroid nodule, a complete medical history and physical examination should be done by your physician. Pertinent signs and symptoms of the thyroid nodule should be discussed. The patient's neck should be inspected and then examined while sitting up at rest and again while swallowing. The firmness of the nodule and whether it moves easily should be noted. 
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    An inferior petrosal venous sinus sampling test involves threading a long, tiny plastic tube or catheter up through the veins of the body to measure the blood levels of ACTH directly from the veins that come from the pituitary. This is done through a small needle-stick in the groin area and is generally not painful.
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    The CRH stimulation test will see if the body can increase the amount of cortisol and ACTH made by the body in response to corticotropin releasing hormone (CRH). Patients with Cushing's disease (pituitary adenoma) should be able to increase the levels of cortisol and ACTH while patients with an ectopic tumor usually cannot.
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    In the saline suppression test, the patient is given a salt solution through an IV, after which the levels of aldosterone and renin in the blood are measured. In patients with primary hyperaldosteronism, the level of aldosterone in the blood is still high and the level of renin is low even after this salt loading.
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    In the 24-hour urinary excretion of aldosterone test, a patient eats a high-salt diet for 5 days before measuring the amount of aldosterone in the urine over a 24-hour period. In patients with primary hyperaldosteronism, aldosterone will not be suppressed by the salt load, and the level of aldosterone in the urine will be high.
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    It is important to note that certain high blood pressure medications may interfere with the diagnostic tests for primary hyperaldosteronism and thus, after consultation with a physician, should be discontinued 4 to 6 weeks prior to testing. The best screening tests to determine if a patient has primary hyperaldosteronism are simple blood tests that measure the levels of potassium, aldosterone, and renin in the blood.