. . "Diagnostika a diferenci\u00E1ln\u00ED diagnostika hypokortikalizmu" . "Intern\u00ED medic\u00EDna pro praxi" . "3" . . "Diagnostika a diferenci\u00E1ln\u00ED diagnostika hypokortikalizmu"@cs . "Diagnostika a diferenci\u00E1ln\u00ED diagnostika hypokortikalizmu" . "Hypokortikalizmus je stav nedostate\u010Dn\u00E9 sekrece hormon\u016F k\u016Fry nadledvin, p\u0159edev\u0161\u00EDm glukokortikoid\u016F, a jeho p\u0159\u00EDznaky jsou d\u016Fsledkem nepom\u011Bru mezi jejich sekrec\u00ED a pot\u0159ebou. Jedn\u00E1 se o z\u00E1va\u017En\u00FD stav, maj\u00EDc\u00ED ve sv\u00E9 m\u00EDrn\u00E9 podob\u011B pouze nespecifick\u00E9 projevy, kter\u00FD ale m\u016F\u017Ee vy\u00FAstit a\u017E do obrazu hypokortik\u00E1ln\u00ED (addisonsk\u00E9) krize se \u0161okov\u00FDm stavem a rizikem \u00FAmrt\u00ED. Nezbytn\u00E1 je proto v\u010Dasn\u00E1 a spr\u00E1vn\u00E1 diagnostika a v\u010Dasn\u00E9 nasazen\u00ED substitu\u010Dn\u00ED l\u00E9\u010Dby. Bez ohledu na etiologii se z\u00E1kladn\u011B orientujeme podle s\u00E9rov\u00FDch koncentrac\u00ED kortizolu r\u00E1no nala\u010Dno, p\u0159i diagnostick\u00E9 nejistot\u011B a k odhalen\u00ED parci\u00E1ln\u00EDho deficitu pou\u017E\u00EDv\u00E1me dynamick\u00E9 stimula\u010Dn\u00ED testy, inzulinov\u00FD a cortrosynov\u00FD. Etiologickou diferenci\u00E1ln\u00ED diagnostiku prov\u00E1d\u00EDme podle plazmatick\u00FDch koncentrac\u00ED ACTH, zv\u00FD\u0161en\u00E9 koncentrace sv\u011Bd\u010D\u00ED pro prim\u00E1rn\u00ED (perifern\u00ED) etiologii, nezv\u00FD\u0161en\u00E9 (norm\u00E1ln\u00ED nebo sn\u00ED\u017Een\u00E9) koncentrace pro sekund\u00E1rn\u00ED (centr\u00E1ln\u00ED) etiologii. \u010Cl\u00E1nek shrnuje z\u00E1kladn\u00ED klinick\u00FD obraz a sou\u010Dasn\u00FD pohled na diagnostiku a diferenci\u00E1ln\u00ED diagnostiku hypokortikalizmu."@cs . "1212-7299" . "11173" . . . "Hypocorticism is a state of insufficient secretion of adrenal cortex hormones mainly that of glucocorticoids and its clinical signs reflect a disproportion between their secretion and demands. It is a serious state with nonspecific signs in mild forms; however, it can progress to severe addisonian crisis with circulatory failure and a risk of death. Early establishment of correct diagnosis and immediate introduction of replacement therapy are therefore essential. Assessment of morning serum cortisol levels is a basic examination to detect hypocorticism regardless of aetiology. In partial deficiency and in case of uncertainty dynamic testing using insulin tolerance or ACTH test is employed. For differential diagnosis between peripheral (primary) and central (secondary) causes measurement of morningACTH plasma levels is used and elevated levels indicate primary cause and decreased or normal levels indicate secondary cause. Present article cover current view of diagnosis and differential diagnosis of hypocorticism."@en . "Kr\u0161ek, Michal" . "Addison; pituitary; adrenals; cortisol; Hypocorticism"@en . . . "4"^^ . "1"^^ . . "1"^^ . "Diagnostika a diferenci\u00E1ln\u00ED diagnostika hypokortikalizmu"@cs . "Diagnosis and differential diagnosis of hypocorticism"@en . "RIV/00216208:11110/14:10282711" . "Hypokortikalizmus je stav nedostate\u010Dn\u00E9 sekrece hormon\u016F k\u016Fry nadledvin, p\u0159edev\u0161\u00EDm glukokortikoid\u016F, a jeho p\u0159\u00EDznaky jsou d\u016Fsledkem nepom\u011Bru mezi jejich sekrec\u00ED a pot\u0159ebou. Jedn\u00E1 se o z\u00E1va\u017En\u00FD stav, maj\u00EDc\u00ED ve sv\u00E9 m\u00EDrn\u00E9 podob\u011B pouze nespecifick\u00E9 projevy, kter\u00FD ale m\u016F\u017Ee vy\u00FAstit a\u017E do obrazu hypokortik\u00E1ln\u00ED (addisonsk\u00E9) krize se \u0161okov\u00FDm stavem a rizikem \u00FAmrt\u00ED. Nezbytn\u00E1 je proto v\u010Dasn\u00E1 a spr\u00E1vn\u00E1 diagnostika a v\u010Dasn\u00E9 nasazen\u00ED substitu\u010Dn\u00ED l\u00E9\u010Dby. Bez ohledu na etiologii se z\u00E1kladn\u011B orientujeme podle s\u00E9rov\u00FDch koncentrac\u00ED kortizolu r\u00E1no nala\u010Dno, p\u0159i diagnostick\u00E9 nejistot\u011B a k odhalen\u00ED parci\u00E1ln\u00EDho deficitu pou\u017E\u00EDv\u00E1me dynamick\u00E9 stimula\u010Dn\u00ED testy, inzulinov\u00FD a cortrosynov\u00FD. Etiologickou diferenci\u00E1ln\u00ED diagnostiku prov\u00E1d\u00EDme podle plazmatick\u00FDch koncentrac\u00ED ACTH, zv\u00FD\u0161en\u00E9 koncentrace sv\u011Bd\u010D\u00ED pro prim\u00E1rn\u00ED (perifern\u00ED) etiologii, nezv\u00FD\u0161en\u00E9 (norm\u00E1ln\u00ED nebo sn\u00ED\u017Een\u00E9) koncentrace pro sekund\u00E1rn\u00ED (centr\u00E1ln\u00ED) etiologii. \u010Cl\u00E1nek shrnuje z\u00E1kladn\u00ED klinick\u00FD obraz a sou\u010Dasn\u00FD pohled na diagnostiku a diferenci\u00E1ln\u00ED diagnostiku hypokortikalizmu." . . . "[BCC66B3A0016]" . . . "11110" . "RIV/00216208:11110/14:10282711!RIV15-MSM-11110___" . "CZ - \u010Cesk\u00E1 republika" . "http://www.internimedicina.cz/pdfs/int/2014/03/09.pdf" . . "Diagnosis and differential diagnosis of hypocorticism"@en . . . . "16" . "V" .