DOCSLIB.ORG

Test Selection and Interpretation the Quest Diagnostics

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text

Load more

The Quest Diagnostics Manual Endocrinology Test Selection and Interpretation Fourth Edition The Quest Diagnostics Manual Endocrinology Test Selection and Interpretation Fourth Edition Edited by: Delbert A. Fisher, MD Senior Science Officer Quest Diagnostics Nichols Institute Professor Emeritus, Pediatrics and Medicine UCLA School of Medicine Consulting Editors: Wael Salameh, MD, FACP Medical Director, Endocrinology/Metabolism Quest Diagnostics Nichols Institute San Juan Capistrano, CA Associate Clinical Professor of Medicine, David Geffen School of Medicine at UCLA Richard W. Furlanetto, MD, PhD Medical Director, Endocrinology/Metabolism Quest Diagnostics Nichols Institute Chantilly, VA ©2007 Quest Diagnostics Incorporated. All rights reserved. Fourth Edition Printed in the United States of America Quest, Quest Diagnostics, the associated logo, Nichols Institute, and all associated Quest Diagnostics marks are the trademarks of Quest Diagnostics. All third party marks − ®' and ™' − are the property of their respective owners. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopy, recording, and information storage and retrieval system, without permission in writing from the publisher. Address inquiries to the Medical Information Department, Quest Diagnostics Nichols Institute, 33608 Ortega Highway, San Juan Capistrano, CA 92690-6130. Previous editions copyrighted in 1996, 1998, and 2004. Re-order # IG1984 Forward Quest Diagnostics Nichols Institute has been committed to providing state of the art endocrine testing for nearly 4 decades. During this time, we have introduced assays for most of the endocrine systems hormones, important metabolites and carrier proteins, free hormones, many hormone receptors, endocrine system autoantibodies, relevant chromosomal abnormalities, and selected genetic mutations. Our commitment to state of the art diagnostics and our dedication to quality and service have always included both adult and pediatric patients, and we have an ongoing program providing adult and pediatric reference range and clinical correlations data. Additionally, we have special procedures for identification and handling of pediatric samples, including reduced sample volume, whenever possible. In this manual, we have consolidated detailed technical information for more than 150 of the endocrine and endocrine-related tests performed at Nichols Institute. The manual includes an overview of the physiology of each endocrine system, the diagnostic applications of each test, interpretation of test results, and a catalog of the endocrine-related dynamic or perturbation tests that facilitate diagnosis and patient management. For your convenience, we have included a guide for interconversion of conventional and SI units for our endocrine tests. In addition, we have indexed our endocrine tests in several formats to provide easier access to the information. National Quest Diagnostics test codes are listed for each of the tests described in the Alphabetical Test section. Methodologies may differ for the non-Nichols Institute regional laboratory tests; information and reference ranges for these tests are available from your sales representative or regional laboratory personnel. We trust that the manual will assist you in the diagnosis and management of your adult and pediatric patients and reiterate our commitment at Quest Diagnostics to provide you with the highest quality test results and ready availability of consultative services. Our laboratory staff and our Medical and Scientific Directors are available for consultation to help assure the most efficacious resolution of complex or confusing endocrine problems. We welcome your feedback and suggestions for improving our service to you. Delbert A. Fisher, MD Senior Science Officer Quest Diagnostics Nichols Institute v Acknowledgments Normative data were developed by the Clinical Correlations department under direction of Dr. Richard Reitz, Esther Carlton, and Collette Scheele. Text development, overall composition, and project direction were accomplished by Patricia Vendely. Mary Jane Michel assisted with typing; Lorraine Saunders was responsible for formatting; and Lynn Ricard helped with proofing. For their dedicated contributions, the editor is indeed grateful. Delbert A. Fisher, MD vi Contents Page Forward ....................................................................................................................v Acknowledgments ..............................................................................................vi Endocrine Test Categories and Associated Tests Adrenocortical Function ........................................................................................ 3 Cardiovascular/Lipids ............................................................................................ 4 Catecholamines....................................................................................................... 5 Congenital Adrenal Hyperplasia (CAH)............................................................... 5 Endocrine Autoimmunity....................................................................................... 5 Fluid, Electrolyte, and Renal.................................................................................. 6 Genetic (Biochemical and Cytogenetic) ............................................................... 7 Gonadal Function ................................................................................................... 8 Growth and Growth Hormone............................................................................... 9 Hypothalamic and Pituitary Function ................................................................... 9 Metabolic (Including Diabetes Mellitus) and Gastrointestinal Disorders......... 10 Multiple Endocrine Neoplasia ............................................................................. 11 Parathyroid and Mineral Metabolism.................................................................. 12 Thyroid Function .................................................................................................. 12 Additional Diagnostic Profiles.............................................................................. 13 Perturbation Tests................................................................................................. 14 Alphabetical Test Section See Test Index for list of tests included in this section....................................... 15 Test Application and Interpretation Preface................................................................................................................. 189 Disorders of Adrenal Function Background Physiology .................................................................................190 Adrenal Insufficiency ..................................................................................... 193 Adrenal Biosynthetic Enzyme Deficiencies .................................................. 193 Classical Congenital Adrenal Hyperplasia (CAH) ................................... 193 Nonclassical Disease (Partial Deficiency in Steroid Biosynthesis) .......... 205 Cushing's Syndrome ................................................................................... 206 Renin-Angiotensin – Aldosterone System (RAAS) ....................................... 207 Background Physiology............................................................................... 207 Assessment of Disorders of the RAAS ........................................................ 208 Primary Aldosteronism ........................................................................... 210 Renovascular Hypertension.................................................................... 210 Dexamethasone-suppressible Hyperaldosteronism .............................. 211 Pseudohypoaldosteronism...................................................................... 211 Adrenal Diagnosis via Urine GC/MS Metabolite Analysis .......................... 211 vii Contents Page References ....................................................................................................... 215 Disorders of Anterior Pituitary Function Background Physiology .................................................................................. 217 Hypopituitarism .............................................................................................. 218 Pituitary Adenomas......................................................................................... 220 General Features ......................................................................................... 220 Prolactinoma ............................................................................................... 221 Acromegaly.................................................................................................. 222 Cushing's Disease ........................................................................................ 223 Thyrotropinoma.......................................................................................... 223 Gonadotropinoma ...................................................................................... 223 References ....................................................................................................... 224 Disorders of Calcium and Bone Metabolism Background Physiology ................................................................................. 225 Laboratory Assessment of Disorders of
Recommended publications
  • Chapter 7: Monogenic Forms of Diabetes

    Chapter 7: Monogenic Forms of Diabetes

    CHAPTER 7 MONOGENIC FORMS OF DIABETES Mark A. Sperling, MD, and Abhimanyu Garg, MD Dr. Mark A. Sperling is Emeritus Professor and Chair, University of Pittsburgh, Department of Pediatrics, Children’s Hospital of Pittsburgh of UPMC, Pittsburgh, PA. Dr. Abhimanyu Garg is Professor of Internal Medicine and Chief of the Division of Nutrition and Metabolic Diseases at University of Texas Southwestern Medical Center, Dallas, TX. SUMMARY Types 1 and 2 diabetes have multiple and complex genetic influences that interact with environmental triggers, such as viral infections or nutritional excesses, to result in their respective phenotypes: young, lean, and insulin-dependence for type 1 diabetes patients or older, overweight, and often manageable by lifestyle interventions and oral medications for type 2 diabetes patients. A small subset of patients, comprising ~2%–3% of all those diagnosed with diabetes, may have characteristics of either type 1 or type 2 diabetes but have single gene defects that interfere with insulin production, secretion, or action, resulting in clinical diabetes. These types of diabetes are known as MODY, originally defined as maturity-onset diabetes of youth, and severe early-onset forms, such as neonatal diabetes mellitus (NDM). Defects in genes involved in adipocyte development, differentiation, and death pathways cause lipodystrophy syndromes, which are also associated with insulin resistance and diabetes. Although these syndromes are considered rare, more awareness of these disorders and increased availability of genetic testing in clinical and research laboratories, as well as growing use of next generation, whole genome, or exome sequencing for clinically challenging phenotypes, are resulting in increased recognition. A correct diagnosis of MODY, NDM, or lipodystrophy syndromes has profound implications for treatment, genetic counseling, and prognosis.
  • DIAGMOL Town, ZIPCODE :…………………………………………………… Director : Prof

    DIAGMOL Town, ZIPCODE :…………………………………………………… Director : Prof

    Mr. Mrs. (IN UPPER CASE, please) Name:……………………………………………………. Maiden Name:……………………………………. DMGL / Service de Médecine Génétique Centre d’accueil des prélèvements (CAP) First name :………………………………………………… Bâtiment des Laboratoires (BATLab), local 8D-0-850.1 Date of birth : ............ / ........... / …………… 4 rue Gabrielle-Perret-Gentil, 1211 Genève 14 Legal representative (for minors) : father mother Molecular and Genomic Diagnostics Laboratory Name/first name :…………………………………………… Street/N°:……………………………………………………… http://www.hug-ge.ch/feuilles-de-demande DIAGMOL Town, ZIPCODE :…………………………………………………… Director : Prof. Stylianos ANTONARAKIS Hospitalisation Unit: …………… Physician :…………………… Lab managers: N° EdS : …………………………………………………………… Dr J.-L. BLOUIN, Dr Th. NOUSPIKEL, Dr. M. GUIPPONI Invoice address: Patient Prescriptor Insurance [email protected], [email protected], [email protected] Type of case : Disease AI Accident Pregnancy Lab direct or results: Phone/FAX: +41 (0) 22 37 21 826 / 21 860 N° AVS (Mandatory for AI) : ………………………...................... Sample Entrance Center (CAP) : Phone +41 (0) 22 37 21 800 Insurance : ………………… Insured N° : ……………………… PHYSICIAN PHYSICIAN (NAME/First name - Street/N°- Town, ZIPCODE - Phone/FAX. IN UPPER CASES, PLEASE) COPY TO OTHER PHYSICIAN (NAME/First name - Street/N°- Town, ZIPCODE - Phone/FAX. IN UPPER CASES, PLEASE) « The laboratory is granted permission by the Physician/Patient to transmit copies of the report to other physicians» Opposition of the patient to the registration of this request results in the electronic patient record (DPI) of the HUG If the patient belongs to a family already known to the laboratory, please indicate index case NAME: CLINICAL INFORMATIONS given by the physician: Ethnic origins Father Mother Currently pregnant Date of last menses Number of weeks of amenorrhea SAMPLE(S) Most of our tests work from 4 ml of blood in EDTA (children <2 ans : 1 On every and single NAME First name ml : ok) or from purified DNA (some exceptions apply for some tests) tube.
  • Background Briefing Document from the Consortium of Sponsors for The

    Background Briefing Document from the Consortium of Sponsors for The

    BRIEFING BOOK FOR Pediatric Advisory Committee (PAC) Prepared by Alan Rogol, M.D., Ph.D. Prepared for Consortium of Sponsors Meeting Date: April 8th, 2019 TABLE OF CONTENTS LIST OF FIGURES ................................................... ERROR! BOOKMARK NOT DEFINED. LIST OF TABLES ...........................................................................................................................4 1. INTRODUCTION AND BACKGROUND FOR THE MEETING .............................6 1.1. INDICATION AND USAGE .......................................................................................6 2. SPONSOR CONSORTIUM PARTICIPANTS ............................................................6 2.1. TIMELINE FOR SPONSOR ENGAGEMENT FOR PEDIATRIC ADVISORY COMMITTEE (PAC): ............................................................................6 3. BACKGROUND AND RATIONALE .........................................................................7 3.1. INTRODUCTION ........................................................................................................7 3.2. PHYSICAL CHANGES OF PUBERTY ......................................................................7 3.2.1. Boys ..............................................................................................................................7 3.2.2. Growth and Pubertal Development ..............................................................................8 3.3. AGE AT ONSET OF PUBERTY.................................................................................9 3.4.
  • Report of the Expert Committee on the Diagnosis and Classification Of

    Report of the Expert Committee on the Diagnosis and Classification Of

    COMMITTEE REPORT Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus THE EXPERT COMMITTEE ON THE DIAGNOSIS AND CLASSIFICATION OF DIABETES MELLITUS* he current classification and diagno- nosis of diabetes were warranted. The in insulin secretion, insulin action, or sis of diabetes used in the U.S. was Committee met on multiple occasions both. The chronic hyperglycemia of dia- T developed by the National Diabetes and widely circulated a draft report of betes is associated with long-term dam- Data Group (NDDG) and published in their findings and preliminary recom- age, dysfunction, and failure of various 1979 (1). The impetus for the classifica- mendations to the international diabe- organs, especially the eyes, kidneys, tion and diagnosis scheme proposed then tes community. Based on the numerous nerves, heart, and blood vessels. holds true today. That is, comments and suggestions received, in- Several pathogenic processes are in- cluding the opportunity to review unpub- volved in the development of diabetes. the growth of knowledge regarding the eti- lished data in detail, the Committee These range from autoimmune destruc- ology and pathogenesis of diabetes has led discussed and revised numerous drafts of tion of the ␤-cells of the pancreas with many individuals and groups in the diabe- a manuscript that culminated in this pub- consequent insulin deficiency to abnor- tes community to express the need for a lished document. malities that result in resistance to insulin revision of the nomenclature, diagnostic This report is divided into four sec- action. The basis of the abnormalities in criteria, and classification of diabetes.
  • Abstracts from the 9Th Biennial Scientific Meeting of The

    Abstracts from the 9Th Biennial Scientific Meeting of The

    International Journal of Pediatric Endocrinology 2017, 2017(Suppl 1):15 DOI 10.1186/s13633-017-0054-x MEETING ABSTRACTS Open Access Abstracts from the 9th Biennial Scientific Meeting of the Asia Pacific Paediatric Endocrine Society (APPES) and the 50th Annual Meeting of the Japanese Society for Pediatric Endocrinology (JSPE) Tokyo, Japan. 17-20 November 2016 Published: 28 Dec 2017 PS1 Heritable forms of primary bone fragility in children typically lead to Fat fate and disease - from science to global policy a clinical diagnosis of either osteogenesis imperfecta (OI) or juvenile Peter Gluckman osteoporosis (JO). OI is usually caused by dominant mutations affect- Office of Chief Science Advsor to the Prime Minister ing one of the two genes that code for two collagen type I, but a re- International Journal of Pediatric Endocrinology 2017, 2017(Suppl 1):PS1 cessive form of OI is present in 5-10% of individuals with a clinical diagnosis of OI. Most of the involved genes code for proteins that Attempts to deal with the obesity epidemic based solely on adult be- play a role in the processing of collagen type I protein (BMP1, havioural change have been rather disappointing. Indeed the evidence CREB3L1, CRTAP, LEPRE1, P4HB, PPIB, FKBP10, PLOD2, SERPINF1, that biological, developmental and contextual factors are operating SERPINH1, SEC24D, SPARC, from the earliest stages in development and indeed across generations TMEM38B), or interfere with osteoblast function (SP7, WNT1). Specific is compelling. The marked individual differences in the sensitivity to the phenotypes are caused by mutations in SERPINF1 (recessive OI type obesogenic environment need to be understood at both the individual VI), P4HB (Cole-Carpenter syndrome) and SEC24D (‘Cole-Carpenter and population level.
  • EAU Pocket Guidelines on Male Hypogonadism 2013

    EAU Pocket Guidelines on Male Hypogonadism 2013

    GUIDELINES ON MALE HYPOGONADISM G.R. Dohle (chair), S. Arver, C. Bettocchi, S. Kliesch, M. Punab, W. de Ronde Introduction Male hypogonadism is a clinical syndrome caused by andro- gen deficiency. It may adversely affect multiple organ func- tions and quality of life. Androgens play a crucial role in the development and maintenance of male reproductive and sexual functions. Low levels of circulating androgens can cause disturbances in male sexual development, resulting in congenital abnormalities of the male reproductive tract. Later in life, this may cause reduced fertility, sexual dysfunc- tion, decreased muscle formation and bone mineralisation, disturbances of fat metabolism, and cognitive dysfunction. Testosterone levels decrease as a process of ageing: signs and symptoms caused by this decline can be considered a normal part of ageing. However, low testosterone levels are also associated with several chronic diseases, and sympto- matic patients may benefit from testosterone treatment. Androgen deficiency increases with age; an annual decline in circulating testosterone of 0.4-2.0% has been reported. In middle-aged men, the incidence was found to be 6%. It is more prevalent in older men, in men with obesity, those with co-morbidities, and in men with a poor health status. Aetiology and forms Male hypogonadism can be classified in 4 forms: 1. Primary forms caused by testicular insufficiency. 2. Secondary forms caused by hypothalamic-pituitary dysfunction. 164 Male Hypogonadism 3. Late onset hypogonadism. 4. Male hypogonadism due to androgen receptor insensitivity. The main causes of these different forms of hypogonadism are highlighted in Table 1. The type of hypogonadism has to be differentiated, as this has implications for patient evaluation and treatment and enables identification of patients with associated health problems.
  • A MRI Diagnosis of Congenital Urogenital Anomalies in 27 Years

    A MRI Diagnosis of Congenital Urogenital Anomalies in 27 Years

    Journal of Advances in Radiology and Medical Imaging Volume 4 | Issue 1 ISSN: 2456-5504 Case Report Open Access A MRI Diagnosis of Congenital Urogenital Anomalies in 27 Years Old Man D’Amato D*, Ranalli T, Tatulli D, Bocchinfuso F, Manenti G, Valente F and Bizzaglia M Diagnostic and Interventional Radiology, Policlinico Tor Vergata, University of Rome “Tor Vergata”, Rome, Italy *Corresponding author: D’Amato D, Diagnostic and Interventional Radiology, Policlinico Tor Vergata, University of Rome “Tor Vergata”, Viale Oxford 181, Rome, Italy, Tel: +393207034690, E-mail: [email protected] Citation: D’Amato D, Ranalli T, Tatulli D, Bocchinfuso F, Manenti G, et al. (2019) A MRI Diagnosis of Congenital Urogenital Anomalies in 27 Years Old Man. J Adv Radiol Med Image 4(1): 102 Received Date: April 04, 2019 Accepted Date: August 26, 2019 Published Date: August 28, 2019 Abstract Congenital anorchia is an uncommon clinical condition. Etiology and pathogenetic mechanisms are often unknown. Although some patients with anorchia present with ambiguous external genitalia or micropenis, most have a normal phenotype. XY Disorders of Sex Development classifications are numerous and success rate in establishing a precise diagnosis is far lower than in XX karyotype. We report the case of a young man, with 46 XY karyotype showing various uro-genital abnormalities. A definitive diagnosis was not established due to the complex clinical presentation. Ultrasonography and Magnetic Resonance Imaging techniques were useful tools in the definition of uro-genital anomalies and gonadal development in this complex scenario. Keywords: Anorchia; Cryptorchidism; Urogenital Anomalies; DSD; MRI List of abbreviations: MRI: Magnetic Resonance Imaging; US: Ultrasonography; DSD: Disorders of Sex Development, FSH: Follicle- Stimulating Hormone; HCG: Human Chorionic Gonadotropin; LH: Luteinizing Hormone; AMH Antimüllerian Hormone; LHRH LH- Releasing Hormone; SD: Standard Deviation Introduction The disorders of sexual differentiation constitute a challenging area for both diagnostic and therapeutic impact.
  • Genes in Eyecare Geneseyedoc 3 W.M

    Genes in Eyecare Geneseyedoc 3 W.M

    Genes in Eyecare geneseyedoc 3 W.M. Lyle and T.D. Williams 15 Mar 04 This information has been gathered from several sources; however, the principal source is V. A. McKusick’s Mendelian Inheritance in Man on CD-ROM. Baltimore, Johns Hopkins University Press, 1998. Other sources include McKusick’s, Mendelian Inheritance in Man. Catalogs of Human Genes and Genetic Disorders. Baltimore. Johns Hopkins University Press 1998 (12th edition). http://www.ncbi.nlm.nih.gov/Omim See also S.P.Daiger, L.S. Sullivan, and B.J.F. Rossiter Ret Net http://www.sph.uth.tmc.edu/Retnet disease.htm/. Also E.I. Traboulsi’s, Genetic Diseases of the Eye, New York, Oxford University Press, 1998. And Genetics in Primary Eyecare and Clinical Medicine by M.R. Seashore and R.S.Wappner, Appleton and Lange 1996. M. Ridley’s book Genome published in 2000 by Perennial provides additional information. Ridley estimates that we have 60,000 to 80,000 genes. See also R.M. Henig’s book The Monk in the Garden: The Lost and Found Genius of Gregor Mendel, published by Houghton Mifflin in 2001 which tells about the Father of Genetics. The 3rd edition of F. H. Roy’s book Ocular Syndromes and Systemic Diseases published by Lippincott Williams & Wilkins in 2002 facilitates differential diagnosis. Additional information is provided in D. Pavan-Langston’s Manual of Ocular Diagnosis and Therapy (5th edition) published by Lippincott Williams & Wilkins in 2002. M.A. Foote wrote Basic Human Genetics for Medical Writers in the AMWA Journal 2002;17:7-17. A compilation such as this might suggest that one gene = one disease.
  • Hypothyroidism

    Hypothyroidism

    Hypothyroidism Alejandro Diaz, MD,*† Elizabeth G. Lipman Diaz, PhD, CPNP‡ *Miami Children’s Hospital, Miami, FL †The Herbert Wertheim College of Medicine, Florida International University, Miami, FL ‡University of Miami School of Nursing and Health Studies, Miami, FL Educational Gap Congenital hypothyroidism is one the most common causes of preventable intellectual disability. Awareness that not all cases are detected by the newborn screening is important, particularly because early diagnosis and treatment are essential in preserving cognitive abilities. Objectives After completing this article, readers should be able to: 1. Identify the causes of congenital and acquired hypothyroidism in infants and children. 2. Interpret an abnormal newborn screening result and understand indications for further evaluation and treatment. 3. Recognize clinical signs and symptoms of hypothyroidism. 4. Understand the importance of early diagnosis and treatment of congenital hypothyroidism. 5. Understand the presentation, diagnostic process, treatment, and prognosis of Hashimoto thyroiditis. 6. Differentiate thyroid-binding globulin deficiency from central hypothyroidism. AUTHOR DISCLOSURE Drs Diaz and Lipman Diaz have disclosed no financial relationships 7. Identify sick euthyroid syndrome and other causes of abnormal thyroid relevant to this article. This commentary does function test results. not contain a discussion of an unapproved/ investigative use of a commercial product/ device. ABBREVIATIONS CH congenital hypothyroidism BACKGROUND FT3 free triiodothyronine FT4 free thyroxine The thyroid gland produces hormones that have important functions related to energy HT Hashimoto thyroiditis metabolism, control of body temperature, growth, bone development, and maturation LT4 levothyroxine of the central nervous system, among other metabolic processes throughout the body. rT3 reverse triiodothyronine The thyroid gland develops from the endodermal pharynx.
  • Homozygous Hypomorphic HNF1A Alleles Are a Novel Cause of Young-Onset Diabetes and Result in Sulphonylurea-Sensitive Diabetes

    Homozygous Hypomorphic HNF1A Alleles Are a Novel Cause of Young-Onset Diabetes and Result in Sulphonylurea-Sensitive Diabetes

    Diabetes Care 1 Shivani Misra,1 Neelam Hassanali,2 Homozygous Hypomorphic Amanda J. Bennett,2 Agata Juszczak,2 Richard Caswell,3 Kevin Colclough,3 HNF1A Alleles Are a Novel Cause Jonathan Valabhji,4 Sian Ellard,3 of Young-Onset Diabetes and Nicholas S. Oliver,1,4 and Anna L. Gloyn2,5,6 Result in Sulphonylurea-Sensitive Diabetes https://doi.org/10.2337/dc19-1843 OBJECTIVE Heterozygous loss-of-function mutations in HNF1A cause maturity-onset diabetes of the young (MODY). Affected individuals can be treated with low-dose sulpho- nylureas. Individuals with homozygous HNF1A mutations causing MODY have not been reported. RESEARCH DESIGN AND METHODS We phenotyped a kindred with young-onset diabetes and performed molecular genetic testing, a mixed meal tolerance test, a sulphonylurea challenge, and in vitro assays to assess variant protein function. RESULTS A homozygous HNF1A variant (p.A251T) was identified in three insulin-treated 1 family members diagnosed with diabetes before 20 years of age. Those with the Diabetes, Endocrinology and Metabolism, Im- NOVEL COMMUNICATIONS IN DIABETES homozygous variant had low hs-CRP levels (0.2–0.8 mg/L), and those tested dem- perial College London, London, U.K. 2Oxford Centre for Diabetes, Endocrinology and onstrated sensitivity to sulphonylurea given at a low dose, completely transitioning off Metabolism, University of Oxford, Oxford, U.K. insulin. In silico modeling predicted a variant of unknown significance; however, in vitro 3Institute of Biomedical and Clinical Science, Uni- studies supported a modest reduction in transactivation potential (79% of that for the versity of Exeter Medical School, Exeter, U.K.
  • Jeffrey Kleinberger Ph.D. Candidate Molecular Medicine Program, Genome Biology Track Graduate Program in Life Sciences, University of Maryland, Baltimore

    Jeffrey Kleinberger Ph.D. Candidate Molecular Medicine Program, Genome Biology Track Graduate Program in Life Sciences, University of Maryland, Baltimore

    Discovery and Analysis of Patients with Monogenic Diabetes in Multiple Cohorts to Guide Future Diagnosis Item Type dissertation Authors Kleinberger, Jeffrey Publication Date 2017 Abstract Monogenic diabetes is hyperglycemia caused by a variant in a single gene, and it accounts for approximately 1-2% of all diabetes cases. A genetic diagnosis of monogenic diabetes is important because the most common gene etiologies can be effectively ... Keywords MODY; monogenic diabetes; screening; Clinical Trial; Diabetes Mellitus, Type 2; Zebrafish Download date 05/10/2021 09:00:42 Link to Item http://hdl.handle.net/10713/7072 Jeffrey Kleinberger Ph.D. Candidate Molecular Medicine Program, Genome Biology Track Graduate Program in Life Sciences, University of Maryland, Baltimore Contact Information Medical School Teaching Facility 357 685 West Baltimore St. Baltimore, MD 21201 [email protected] Education Juniata College Huntingdon, PA August 2004 – May 2008 Cum Laude distinction (GPA: 3.701) Biochemistry major Coursework included: Organic Chemistry, Bioinorganic Chemistry, Analytical Chemistry, Physical Chemistry, Chemistry Research, Biology, Cell Biology, Genetics, Biostatistics, Molecular Techniques, Physiology, Microbiology, Biochemistry and Molecular Biology (I-III), Calculus (I&II), Physics (I&II), Scientific Glassblowing, College Writing Seminar, Art of Public Speaking, Intro to Psychology, Learning & Conditioning, Mod. Knowledge & The Self, United States to 1877, The American Revolution, Survey of Western Art, Modern Architecture,
  • Hyperthyroidism

    Hyperthyroidism

    135 Review Article Hyperthyroidism Amanda R. Doubleday, Rebecca S. Sippel Division of Endocrine Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA Contributions: (I) Conception and design: All authors; (II) Administrative support: None; (III) Provision of study materials or patients: None; (IV) Collection and assembly of data: All authors; (V) Data analysis and interpretation: All authors; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors. Correspondence to: Rebecca S. Sippel, MD. Division of Endocrine Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Clinical Science Center-H4/722, Box 7375, 600 Highland Ave, Madison, WI 53792-3284, USA. Email: [email protected]; Amanda R. Doubleday, DO, MBA. Division of Endocrine Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, K4/739 Clinical Science Center, 600 Highland Ave, Madison, WI 53792-3284, USA. Email: [email protected]. Abstract: Hyperthyroidism is a condition where the thyroid gland produces and secretes inappropriately high amounts of thyroid hormone which can lead to thyrotoxicosis. The prevalence of hyperthyroidism in the United States is approximately 1.2%. There are many different causes of hyperthyroidism, and the most common causes include Graves’ disease (GD), toxic multinodular goiter and toxic adenoma. The diagnosis can be made based on clinical findings and confirmed with biochemical tests and imaging techniques including ultrasound and radioactive iodine uptake scans. This condition impacts many different systems of the body including the integument, musculoskeletal, immune, ophthalmic, reproductive, gastrointestinal and cardiovascular systems. It is important to recognize common cardiovascular manifestations such as hypertension and tachycardia and to treat these patients with beta blockers.