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Diamanti-Kandarakis E, Duntas L, Kanakis GA, Kandaraki E, Karavitaki N, Kassi E, Livadas S, Mastorakos G, Migdalis I, Miras AD, Nader S, Papalou O, Poladian R, Popovic V, Rachoń D, Tigas S, Tsigos C, Tsilchorozidou T, Tzotzas T, Bargiota A, Pfeifer M. DIAGNOSIS OF ENDOCRINE DISEASE: Drug-induced endocrinopathies and diabetes: a combo-endocrinology overview. Eur J Endocrinol 2019; 181:R73-R105. [PMID: 31242462 DOI: 10.1530/eje-19-0154] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Accepted: 06/03/2019] [Indexed: 11/08/2022]
Abstract
In the currently overwhelming era of polypharmacy, the balance of the dynamic and delicate endocrine system can easily be disturbed by interfering pharmaceutical agents like medications. Drugs can cause endocrine abnormalities via different mechanisms, including direct alteration of hormone production, changes in the regulation of the feedback axis, on hormonal transport, binding and signaling, as well as similar changes to counter-regulatory hormone systems. Furthermore, drugs can interfere with the hormonal assays, leading to erroneous laboratory results that disorientate clinicians from the right diagnosis. The purpose of this review is to cover a contemporary topic, the drug-induced endocrinopathies, which was presented in the monothematic annual Combo Endo Course 2018. This challenging part of endocrinology is constantly expanding particularly during the last decade, with the new oncological therapeutic agents, targeting novel molecular pathways in the process of malignancies. In this new context of drug-induced endocrine disease, clinicians should be aware that drugs can cause endocrine abnormalities via different mechanisms and mimic a variety of clinical scenarios. Therefore, it is extremely important for clinicians not only to promptly recognize drug-induced hormonal and metabolic abnormalities, but also to address the therapeutic issues for timely intervention.
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Affiliation(s)
| | - L Duntas
- Endocrine Clinic Evgenidion Hospital, University of Athens
| | - G A Kanakis
- Department of Endocrinology, Athens Naval & VA Hospital, Athens, Unit of Reproductive Endocrinology, Athens, Greece
| | - E Kandaraki
- Department of Endocrinology, Diabetes and Metabolism, Hygeia Hospital
| | - N Karavitaki
- Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners
- Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - E Kassi
- Department of Biological Chemistry, First Department of Internal Medicine, Laikon Hospital Medical School, NKUA
| | - S Livadas
- Endocrine Unit, Metropolitan Hospital
| | - G Mastorakos
- Endocrine Unit, 2nd Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, 'Aretaieion' University Hospital
| | - I Migdalis
- Second Medical Department and Diabetes Centre, NIMTS Hospital, Athens, Greece
| | - A D Miras
- Division of Endocrinology Diabetes and Metabolic Medicine, Imperial College London, London, UK
| | - S Nader
- Department of Internal Medicine-Endocrine Division, McGovern Medical School, Houston, Texas, USA
| | - O Papalou
- Department of Endocrinology, Diabetes and Metabolism, Hygeia Hospital
| | - R Poladian
- Department of Endocrinology, MLH University Hospital, Beirut, Lebanon
| | - V Popovic
- School of Medicine, University of Belgrade, Belgrade, Serbia
| | - D Rachoń
- Department of Clinical and Experimental Endocrinology, Medical University of Gdańsk, Gdańsk, Poland
| | - S Tigas
- Department of Endocrinology, Ioannina University Hospital, Ioannina, Greece
| | - C Tsigos
- Harokopio University of Athens and HYGEIA Hospital, Athens, Greece
| | | | - T Tzotzas
- St. Luke's Hospital, Panorama, Thessaloniki, Greece
| | - A Bargiota
- Department of Internal Medicine - Endocrinology, University of Thessaly, Larissa, Greece
| | - M Pfeifer
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
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