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Palliative Care and Endocrine Diseases

  • Pallavi D. RaoEmail author
  • K. M. Prasanna Kumar
Reference work entry

Abstract

Palliative care in endocrine diseases is similar to palliative care in any other disease. The aim will be to reduce the symptoms, avoid short-term complications and improve or maintain the quality of life by minimal interference and with least inconvenience to the patient. Palliative care in diabetes mellitus aims at avoiding hypoglycemia and symptomatic hyperglycemia, and not necessarily achieving euglycemia or postponing/preventing chronic complications of diabetes. Palliative care in thyroid disorders aims to help the patient remain asymptomatic in both hypothyroidism and hyperthyroidism and not normalizing the TSH. Palliative care in all other endocrine diseases like Cushing’s disease, pheochromocytoma, pituitary tumor, insulinoma, and hyperparathyroidism is also mostly minimal medical intervention to alleviate symptoms and improve quality of life. Replacing endocrine deficiency as in Addisons disease, hypothyroidism, hypocalcemia due to hypoparathyroidism is important and similarly managed to any other endocrine deficiency.

References

  1. Bollerslev J, Rejnmark L, Marcocci C, Shoback DM, Sitges-Serra A, van Biesen W, et al. European Society of Endocrinology Clinical Guideline: treatment of chronic hypoparathyroidism in adults. Eur J Endocrinol. 2015;173(2):G1–G20.CrossRefGoogle Scholar
  2. Boscaro M, Benato M, Mantero F. Effect of bromocriptine in pituitary-dependent Cushing’s syndrome. Clin. Endocrinol. (Oxf.). 1983;19(4):485–91.CrossRefGoogle Scholar
  3. Crane MG, Harris JJ. Effect of spironolactone in hypertensive patients. Am J Med Sci. 1970;260:311–30.CrossRefGoogle Scholar
  4. End of life Diabetes care. Clinical care recommendations 2nd ed. 2013.Google Scholar
  5. Griebeler ML, Kearns AE, Ryu E, Thapa P, Hathcock MA, Melton LJ 3rd, et al. Thiazide-associated hypercalcemia: incidence and association with primary hyperparathyroidism over two decades. J Clin Endocrinol Metab. 2016;101(3):1166–73.CrossRefGoogle Scholar
  6. Jeffcoate WJ, Rees LH, Tomlin S, Jones AE, Edwards CR, Besser GM. Metyrapone in long-term management of Cushing’s disease. Br Med J. 1977;2(6081):215–7.CrossRefGoogle Scholar
  7. Jonklaas J, Bianco AC, Bauer AJ, Burman KD, Cappola AR, Celi FS, Cooper S, Kim W, Peeters P, Rosenthal MS, Sawka AM. Guidelines for the Treatment of Hypothyroidism: Prepared by the American Thyroid Association Task Force on Thyroid Hormone Replacement. Thyroid. 2014;24(12):1670–751.CrossRefGoogle Scholar
  8. Krakoff J, Koch CA, Calis KA, Alexander RH, Nieman LK. Use of a parenteral propylene glycol-containing etomidate preparation for the long-term management of ectopic Cushing’s syndrome. J Clin Endocrinol Metab. 2001;86(9):4104–8.PubMedGoogle Scholar
  9. Lim PO, Young WF, MacDonald TM. A review of the medical treatment of primary aldosteronism. J Hypertens. 2001;19:353–61.CrossRefGoogle Scholar
  10. Liu JK, Fleseriu M, Delashaw JB Jr, Ciric IS, Couldwell WT. Treatment options for Cushing disease after unsuccessful transsphenoidal surgery. Neurosurg Focus. 2007;23(3):E8.CrossRefGoogle Scholar
  11. Rizk A, Honegger J, Milian M, Psaras T. Treatment options in Cushing’s disease. Clin Med Insights Oncol. 2012;6:75–84.CrossRefGoogle Scholar
  12. Rose BD. Diuretics. Kidney Int. 1991;39:336–52.CrossRefGoogle Scholar
  13. Sonino N, Boscaro M, Paoletta A, Mantero F, Ziliotto D. Ketoconazole treatment in Cushing’s syndrome: experience in 34 patients. Clin Endocrinol. 1991;35(4):347–52.CrossRefGoogle Scholar
  14. Sonino N, Boscaro M. Medical therapy for Cushing’s disease. Endocrinol Metab Clin N Am. 1999;28(1):211–22.CrossRefGoogle Scholar
  15. Ross DS, Burch B, Cooper David S, Greenlee MC, Laurberg P, Maia AL, Rivkees SA, Samuels M, Sosa JA, Stan MN, Walter MA. 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis. Thyroid. 2016;26(10):1343–421.CrossRefGoogle Scholar
  16. Takats KI, Szabolcs I, Foldes J, Foldes I, Ferencz A, Rimanoczy E, Goth M, Dohan O, Kovacs L, Szilagyi G. The efficacy of long term thyrostatic treatment in elderly patients with toxic nodular goitre compared to radioiodine therapy with different doses. Exp Clin Endocrinol Diabetes. 1999;107:70–4.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Centre for Diabetes and Endocrine CareBengaluruIndia

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