Endocrine and Metabolic Medical Emergencies: A Clinician’s Guide

Book Preface

The field of endocrinology is in constant evolution, reflecting the rapid pace of changemin medicine and science more generally. In its earliest stages, endocrinology defined the clinical features of acromegaly, Graves’ disease, myxedema, Cushing’s syndrome, and diabetes mellitus. This era was followed by the discovery of hormones and a renaissance catalyzed by radioimmunoassays (RIAs). These measurements allowed rigorous determinations of circulating hormones and an understanding of complex hormonal
feedback mechanisms. The last few decades have witnessed a more sophisticated understanding of perturbations of homeostasis in which we better diagnose disorders such as primary hyperparathyroidism, subclinical hyperthyroidism, and subclinical hypercortisolism.

Endocrine and Metabolic Medical Emergencies was conceived by Glenn Matfin, an endocrinologist with extensive clinical experience in several countries and in areas relevant to the topics covered in the text. He and his co-authors recognized a paradigmshift in the field of endocrinology and metabolism. Namely, our patients rarely present with endocrine disease in isolation. Rather, hormonal disorders occur in combination with other conditions such as critical illness, or HIV/AIDS, which directly or through their treatments precipitate endocrine disease or illicit physiologic responses that alter hormonal pathways. Hospitalized patients are also increasingly complex and critically ill. This setting is rife with stress-related hormonal responses and is rarely appropriate for the methodical evaluation of endocrine conditions. Consequently, in the hospital setting, the emphasis has shifted to acute management of endocrine emergencies such as hypoglycemia, hyponatremia, hypercalcemia, adrenal insufficiency, thyroid storm, and pituitary apoplexy.

The essence of medical textbooks is to transfer knowledge and improve clinical care. The second edition of this book expands the repertoire of traditional endocrine emergencies to myriad other conditions that require urgent attention to optimize clinical outcomes. It contains more than a dozen new chapters by internationally renowned experts. Endocrine and Metabolic Medical Emergencies is a timely resource for managing today’s complex inpatients with endocrine abnormalities. Each chapter addresses a common situation encountered by the practicing endocrinologist. Thanks to this book, we are now armed with innovative chapters such as “Endocrine and Metabolic Emergencies in Transplantation” and “Management of Concentrated Insulins in Acute Care Settings.” We are indebted to these authors for an innovative contribution to the medical literature.

J. Larry Jameson
Philadelphia, PA