Endocrine Diseases
The endocrine system is a highly intricate network of glands and hormones that regulate vital body functions including metabolism, growth and development, sexual function, sleep, and mood.
Diabetic Ketoacidosis (DKA)
Diabetic Ketoacidosis (DKA) is a serious and potentially life-threatening acute complication of diabetes mellitus, most commonly seen in individuals with type 1 diabetes, though it may also occur in type 2 diabetes under stress conditions. It results from a profound deficiency of insulin, leading to unchecked hepatic glucose production, accelerated lipolysis, and consequent production of ketone bodies, which cause metabolic acidosis.
DKA typically develops rapidly, often within hours to a day, and may be precipitated by infections, missed insulin doses, myocardial infarction, trauma, or other acute medical conditions. The clinical picture includes polyuria, polydipsia, nausea, vomiting, abdominal pain, and signs of dehydration. As acidosis progresses, patients may develop Kussmaul breathing (deep, labored respiration), fruity-smelling breath due to acetone, and eventually altered mental status or coma in severe cases.
Continuous monitoring in an intensive care or high-dependency setting is often necessary, especially in moderate to severe cases. If left untreated, DKA can lead to cerebral edema, cardiac arrhythmias, shock, and death. However, with early intervention and proper medical management, most patients recover fully.
Thyrotoxicosis and Thyroid Storm
Thyrotoxicosis refers to the clinical state resulting from excessive circulating thyroid hormones—thyroxine (T4) and triiodothyronine (T3)—leading to a hypermetabolic condition affecting nearly every organ system. The most common cause is Graves’ disease, an autoimmune disorder that stimulates thyroid hormone overproduction. Other causes include toxic multinodular goiter, thyroiditis, and excessive intake of exogenous thyroid hormone.
Symptoms of thyrotoxicosis include weight loss despite increased appetite, heat intolerance, tremors, palpitations, anxiety, insomnia, sweating, muscle weakness, and menstrual irregularities. On examination, patients may show tachycardia, goiter, fine tremor, and exophthalmos (in Graves’ disease).
Thyroid storm, also called thyrotoxic crisis, is a rare but life-threatening exacerbation of thyrotoxicosis. It is usually precipitated by a stressful event such as infection, surgery, trauma, myocardial infarction, or the sudden withdrawal of anti-thyroid medications. It is a medical emergency requiring ICU-level care.