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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Kearns-Sayre syndrome (KSS) is a form of mitochondrial myopathy in which specific clinical features, namely progressive external ophthalmoplegia, pigmentary retinal degeneration and cardiac conduction defects, occur. KSS has also been associated with a variety of endocrine and metabolic disorders, in particular short stature, gonadal failure, diabetes mellitus, thyroid disease, hyperaldosteronism, hypomagnesaemia, and bone, tooth and calcification abnormalities. A case is described exhibiting all of these features. A survey of the literature was conducted to determine the prevalence of these conditions among reported cases. Cases with hypoparathyroidism were considered separately to see if they constituted a distinct subgroup with multiple endocrine dysfunction. Short stature was common, being documented in 38% of cases. Gonadal dysfunction before or after puberty was also common (20% of cases) and affected both sexes equally. Diabetes mellitus was recorded in 13% of cases, half of which required insulin. Thyroid disease, hyperaldosteronism and hypomagnesaemia were uncommon but were probably not looked for in many cases. Bone or tooth abnormalities and calcification of the basal ganglia were found both in those with and without hypoparathyroidism. While endocrine and metabolic dysfunction was found more commonly in those with hypoparathyroidism this is likely to be due to increased recognition rather than increased prevalence. No evidence of an autoimmune polyendocrine syndrome including hypoparathyroidism was found.
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PMID:Endocrine dysfunction in Kearns-Sayre syndrome. 142 98

Our study was done to determine whether patients with schizophrenia and a coexisting physical disorder could adequately discuss the physical illness with a physician. We defined the minimal standard of adequate communication as the ability to acknowledge and name a physical problem during an index hospitalization. Of the 110 patients studied, 38 had a total of 54 medical illnesses (diabetes mellitus, hyponatremia, thyroid disorder, urinary tract infection, bladder dysfunction, hypertension, anemia, liver disorder, and seizure disorder). After two years of follow-up, 28 of these 38 patients agreed to participate in the second part of the study. Upon interview, 24 patients were unable to name at least one of their physical problems. This study reproduces the previous findings of psychiatric patients' difficulty in communicating about physical illness. It suggests that the communication difficulty is constant and not lessened in the nonacute situation.
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PMID:Communication difficulty of patients with schizophrenia and physical illness. 335 75

A previous investigation of IST in Rochester, Minnesota, from 1960 through 1979 yielded an incidence of 1.1/100,000 person-years. The rate in women was almost three times higher than that in men. Thyroid disorders, other endocrine disorders, right-hand preference, symptomatic ovarian cysts, other disorders of the female genito-reproductive system, emotional depression, cerebral aneurysm, and family history of diabetes mellitus were common. In 347 cases of IST personally evaluated (151 seen between 1969-1971, a sample of 49 seen in 1978, and 147 other cases evaluated in 1985) the female-to-male ratio was 1.6:1. The mean age at onset was 43.5 years for women and 42 years for men, and the distributions of age at onset were virtually identical for the two sexes. Thyroid disorder was prevalent in all three referral patients samples. The increased frequency of thyroid disorder was due to a high overall frequency in female patients, 28.4% (95% confidence interval, 22.3-34.4%). Thyroid disorders were 4.5 times more frequent in women with IST than in men with IST. In the control population of 61 patients with peripheral sensory neuropathy, in which sex distribution and mean age at onset of symptoms were comparable to those in IST patients, the incidence of thyroid disorder overall was only 8.2% (in women, 6.6%). Only 12 of the 347 referral IST patients were non-right-handers. Five of these 12 were female patients (2.3% of the 215 women; 95% confidence interval, 0.3-4.3%), significantly below the anticipated frequency (10%) or the observed frequency (10% and 15.16%) in two attempted control populations. Light eyes seem to be unusually common in IST patients, as are personal and family histories of essential tremor. These results may reflect shared biologic risk factors which relate age, gender or estradiol/testosterone function, cerebral anatomic and chemical lateralization, endocrinopathy including elevated thyrotropin levels, immune status, emotional depression, common cells of origin in the neural crest, race, and familial occurrence to IST and other focal dystonias and essential tremor.
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PMID:Spasmodic torticollis: clinical and biologic features and their implications for focal dystonia. 340 May 4

We describe a personal series of 60 cases of parkinsonism with onset under the age of 40 years. Known causes for early onset of secondary parkinsonism, such as Wilson's disease or encephalitis, were excluded in every case. Two groups were identified: those with onset after the age of 21 in whom no hereditary factors could be ascertained (56 cases), and those with onset before 21 years all of whom had familial parkinsonism. In neither group have we found any association with prematurely grey hair, hypertension, diabetes, pernicious anaemia, or thyroid disorder. Among their families, we have not found any association with diabetes, pernicious anaemia, or thyroid disorder. We propose that cases of apparent idiopathic Parkinson's disease beginning between age 21-40 years should be called "young onset Parkinson's disease." Twenty percent of such patients in our series had at least one first- or second-degree relative in the same or antecedent generations with parkinsonism, but only 1.5% of their relatives at risk had parkinsonism, which is similar to the prevalence in the general population. Ten percent of these patients had at least one relative with essential tremor, but only 1.6% of their relatives at risk had tremor, which again was similar to the prevalence in the population in general. These patients with young onset Parkinson's disease responded well to levodopa therapy. However, dyskinesias and response fluctuations occurred early and frequently. The prevalence of dyskinesias and response fluctuations was strongly correlated with the duration of levodopa treatment, but not with the duration (or probably the severity) of the disease before levodopa therapy was commenced. The involuntary movements often were severe and frequently were diphasic. Despite long disease duration, the incidence of dementia in young onset patients aged less than 65 years was negligible. We believe that most, if not all, patients in this group have degenerative Lewy body idiopathic Parkinson's disease, representing the lower end of a skewed deviation for age of onset of this disease. We have so far failed to identify any additional environmental factor which may have accelerated disease onset in these patients. In contrast, cases of parkinsonism beginning before age 21 years were invariably familial. We proposed that they should be called "juvenile parkinsonism." All affected relatives with parkinsonism also had young disease onset, and all but one were siblings. None of four such patients seen by us has demented, and computed tomography (CT) scan has been normal in all four. We believe that most such patients have some form of genetically determined secondary parkinsonism.
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PMID:Young onset Parkinson's disease. 350 66

Twenty one patients with idiopathic Parkinsonism beginning before the age of 40 years were investigated. The mean duration of the disease was 19 years. There was a good and sustained response to levodopa. Only four patients reached stages IV and V (Hoehn and Yahr). Intolerance to levodopa was observed in the more advanced stages of the disease. In the series the familial incidence of Parkinsonism (2 cases) and essential tremor (3 cases) was very low. Thyroid disorder, diabetes mellitus or macrocytic anaemia was not found in any of the cases.
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PMID:Juvenile Parkinsonism: clinical and metabolic characteristics. 355 15

Acanthosis nigricans is a marker for disorders of insulin action, endocrine abnormalities, and cancer of internal organs. To evaluate the clinical significance of this marker the systemic alterations and clinical features of 26 patients with acanthosis nigricans seen at two institutions were reviewed. Most subjects affected by acanthosis nigricans were female (20 patients), Caucasian (22 patients), in the third decade of life (13 patients), and overweight (24 patients greater than 120 percent ideal body weight). Gonadal disease, present in 17 patients, was expressed as polycystic ovary syndrome (11 cases), disorders of prolactin secretion (two cases, one with polycystic ovary syndrome), streak gonads (one case), and hypogonadism of the male (four cases). Thyroid disease and tinea versicolor were present in four patients each. Three patients were receiving insulin therapy for diabetes mellitus, and in two additional patients diabetes mellitus was detected during the diagnostic workup. All patients had elevated fasting insulin levels; most of them also had an exaggerated insulin response to a glucose load. Two of 18 patients tested had antibodies against the insulin receptor in the circulation. Skin biopsy of acanthosis nigricans lesions from all 26 patients showed a typical pattern of hyperkeratosis, acanthosis, and epidermal papillomatosis. Colloidal iron staining showed glycosaminoglycan infiltration of the papillary dermis (21 of 21 cases), consisting mainly of hyaluronic acid. It is concluded that: (1) hyperinsulinenemia and local dermal glycosaminoglycan deposition are regular features in acanthosis nigricans and (2) patients with acanthosis nigricans should be screened for diabetes mellitus, gonadal disease, and hypothyroidism.
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PMID:Spectrum of endocrine abnormalities associated with acanthosis nigricans. 367 58

The prevalences of thyroid disease, insulin-dependent and non-insulin-dependent diabetes were compared in first degree relatives of diabetics with and without coexisting autoimmune thyroid disease. Thyroid disease was more common in siblings of diabetics with thyroid disease than in those of diabetics without thyroid disease. Insulin-dependent diabetes was more common in siblings of diabetics with a personal or family history of thyroid disease than in those of diabetics without such a history. The prevalence of non-insulin-dependent diabetes was unrelated to that of thyroid disease but was greater in siblings of non-insulin-dependent diabetics than in those of insulin-dependent diabetics. These findings add further support to the aetiological distinction between insulin-dependent and non-insulin-dependent diabetes and suggest that further heterogeneity exists within the population of insulin-dependent diabetics based on the presence of a personal or family history of thyroid disease.
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PMID:Familial distribution of thyroid disease and diabetes: further evidence for aetiological heterogeneity of diabetes mellitus. 635 Nov 52

The effect of endocrine disorders on bone mass is being increasingly studied. It is suggested that the preceding thyroid disorder, rather than thyroxine replacement itself, may reduce bone mass. Fracture rate does not appear to be increased in primary hyperparathyroidism once the condition is diagnosed. Although osteopenia is widely accepted to be associated with diabetes mellitus, two studies report increased bone mass in this condition. However, diabetes appears to adversely affect bone formation and urinary calcium excretion. Osteopenia is not a problem in acromegaly despite that patients are often hypogonadal. The possible associations of thyroid disease with connective tissue disorders are discussed, and the role of androgens in the pathogenesis of connective tissue disease is debated.
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PMID:Endocrine disorders. 803 83

The prevalence of various chronic diseases was compared in 517 individuals with alopecia areata, and 2,969 of their first degree relatives. As previous reports have suggested an increased incidence of diabetes in relatives of patients with alopecia areata, special attention was given to the prevalence of Type 1 and Type 2 diabetes in the patients and in their relatives. Several immunologic diseases were increased in alopecia probands and relatives. Thyroid disease, vitiligo, Addison disease, and pernicious anemia were more prevalent in probands and in their relatives than in the general population. Specifically, a high rate of thyroid disease was found in probands (14.7%) and in their first degree relatives (4.2%). Only one proband had Type 1 diabetes, yet there were 14 sibs with Type 1 diabetes. Thus, Type 1 diabetes was significantly more prevalent in the sibs (1.2%) than in either the probands with alopecia (0.2%), or the general population (0.12-0.25%) (P < 0.05)). In contrast, Type 2 diabetes was not more common in probands or in sibs than in the general population. These data suggest that alopecia areata protects against Type 1 diabetes in predisposed individuals. The high rate of thyroid disease suggests that screening probands and first degree relatives for thyroid disease should be considered.
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PMID:Increased risk for type I (insulin-dependent) diabetes in relatives of patients with alopecia areata (AA). 807 51

Research exploring the relationship between psychological factors and the onset, exacerbation, and perpetuation of endocrine diseases has focused primarily on three diseases: diabetes mellitus (DM), Graves' disease, and Cushing's disease. There is insufficient evidence to support the position that psychological factors directly affect the onset of DM. Recent laboratory studies suggest that stress is associated with changes in glucose regulation in a subset of diabetic patients and that temperament and coping strategies influence glycemic control in diabetic children and adolescents. Relaxation training may improve blood glucose control in non-insulin-dependent DM patients. There is no good evidence that psychological characteristics affect the development and course of thyroid disorder or Cushing's disease. Recommendations are made for future research.
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PMID:Psychological factors affecting physical condition. Endocrine disease literature review. 842 87


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