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__NOTOC__
{{Infobox_Disease |
  Name          = Cholesterolosis of gallbladder |
  Image          = Cholesterolosis of the Gallbladder.jpg |
  Caption        = Cholesterolosis of the gallbladder. |
}}
{{Cholesterolosis of gall bladder}}
{{CMG}}
==Overview==
In [[surgical pathology]], '''strawberry [[gall bladder]]''', more formally '''cholesterolosis of the gall bladder''' and '''gall bladder cholesterolosis''', is a change in the gallbladder wall due to excess [[cholesterol]]/cholesterol [[gallstones]]. 
The name ''strawberry gallbladder'' comes from the typically stippled appearance of the [[mucosa]]l surface on [[gross examination]], which resembles the appearance of a [[strawberry]].
==Related Chapters==
* [[Cholecystectomy]]
* [[Rokitansky-Aschoff sinuses]]
==External Links==
* {{GPnotebook|932839443}}
*[http://cancerweb.ncl.ac.uk/cgi-bin/omd?strawberry+gallbladder Strawberry gallbladder] - cancerweb.ncl.ac.uk.
* {{cite journal |author=Izzo L, Boschetto A, Brachini G, ''et al'' |title=["Strawberry" gallbladder: review of the literature and our experience] |language=Italian |journal=Il Giornale di chirurgia |volume=22 |issue=1-2 |pages=33–6 |year=2001 |pmid=11272434 |doi=}}
{{Gastroenterology}}
[[Category:Digestive diseases]]
[[Category:Pathology]]
[[Category:General surgery]]
[[Category:Gastroenterology]]
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}
===Sinusitis===
[[Sinusitis]] can occur from one of these conditions:
*Small hairs ([[cilia]]) in the [[sinuses]], which help move [[mucus]] out, do not work properly due to some [[medical conditions]].
*[[Colds]] and [[allergies]] may cause too much [[mucus]] to be made or block the opening of the [[sinuses]].
*A [[deviated nasal septum]], nasal [[bone spur]], or [[nasal polyps]] may block the opening of the [[sinuses]].
*[[Acute sinusitis]] is caused by damage to the lining of the [[sinuses]] from [[surgery]] or [[infections]].
*[[Chronic sinusitis]] may be caused by [[bacteria]] or a [[fungus]].
* Drug side effect- [[Alfuzosin]], [[Bicalutamide]], [[Botulinum toxin]], [[Ciclesonide]], [[Cidofovir]], [[Lamotrigine]], [[Omalizumab]], [[Metronidazole Topical]], [[Mifepristone]], [[Naproxen and esomeprazole magnesium]], [[Oxaprozin]], [[Pentamidine Isethionate]], [[Pirfenidone]], [[Secukinumab]], [[Sertraline]], [[Tamsulosin]], [[Topiramate]], [[Travoprost]], [[Zanamivir]], [[zileuton]]
==Mediastinitis==
===Acute===
*In modern practice, most cases of acute mediastinitis result from [[Complication (medicine)|complications]] of cardiovascular or endoscopic surgical procedures. 
*[[Dental caries|Odontogenic]] (infected tooth)
*Perforation of the esophagus ([[Boerhaave syndrome]])
*[[Retropharyngeal space|Retropharyngeal]] infections
===Chronic===
Chronic medistinitis is usually a radiologic diagnosis manifested by diffuse fibrosis of the soft tissues of the mediastinum.  This is sometimes the consequence of prior granulomatous disease, most commonly [[histoplasmosis]].  Other identifiable causes include [[tuberculosis]] and [[radiation]] therapy.  Fibrosing mediastinitis most frequently causes problems by constricting blood vessels or airways in the mediastinum.  This may result in such complications as [[superior vena cava syndrome]] or [[pulmonary edema]] from compression of pulmonary veins.
*[[ Asymmetric septal hypertrophy]]
*[[Acute rheumatic fever]]
*[[Adenoidectomy ]]
*[[Aortic valve regurgitation]]
*[[Aortic valve stenosis]]
*[[Bacteroides]]
*[[Bicuspid aortic valves ]]
*[[Biliary tract]] surgery
*[[Calcific aortic stenosis]]
*Calcific [[valvular disease]]
*[[Candida albicans]]
*[[Cardiac catheterization ]]
*[[Cardiac myxoma]]
*[[Cardiac surgery ]]
*Chronic [[hemodialysis ]]
*Coagulase-negative [[staphylococci]]
*[[Coarctation of the aorta ]]
*[[Congenital Heart Disease ]]
*[[Cystoscopy ]]
*[[Dental extractions ]]
*[[Dental implants ]]
*[[Dental sepsis]]
*[[Diphtheria ]]
*[[Endoscopic retrograde cholangiopancreatography ]]
*[[Enterococci ]]
*[[Fungi ]]
*[[Gram negative]] rods
*[[Group A streptococcus ]]
*[[HACEK organisms]
*History of [[endocarditis ]]
*[[HIV ]]
*[[Immune]] impairment
*Intravascular procedure in settings of [[bacteremia]]
*Intravenous [[catheter]]-related[[ infection ]]
*[[Intravenous drug use ]]
*[[Marantic endocarditis]]
*[[Mitral valve prolapse]] with regurgitation
*[[Mycobacterium avium-intracellulare]]
*Non-HACEK [[gram-negative bacteria ]]
*Other [[streptococci ]]
*[[Paraneoplastic syndrome]]
*[[Patent ductus arteriosus]]
*Peritoneovenous [[shunts]] for [[ascites ]]
*[[Pregnancy ]]
*Previous [[bacterial]] [[endocarditis ]]
*Prostatic surgery 
*[[Prosthetic heart valve ]]
*[[Prosthetic heart valves]]
*[[Q fever]]
*[[Respiratory tract]] procedures 
*[[Rheumatic Heart Disease ]]
*Root canals procedure
*[[S. aureus ]]
*[[Salmonellosis ]]
*[[Sclerotherapy ]]
*Septal defects
*[[Skin infection ]]
*[[Staphylococcus epidermidis  ]]
*[[Streptococcus bovis ]]
*[[Streptococcus]] milleri
*[[Streptococcus viridans]]
*[[structural heart disease]]
*Surgical systemic-pulmonary [[shunts]] and conduits
*[[Systemic lupus erythematosus ]]
*[[Tetralogy of Fallot]]
*[[Tuberculosis ]]
*Ulcerative lesions of the [[colon]] due to  [[inflammatory bowel disease ]]
*Ulcerative lesions of the [[colon]] due to [[carcinoma ]]
*[[Urethral]] dilation
*[[Ventricular septal defect]]
*Ventriculoatrial [[shunts]] for [[hydrocephalus ]]
*[[Whipple disease]]
==Ventricular Tachycardia==
Common causes of ventricular tachycardia include [[ischemic heart disease]], illicit drugs ([[cocaine]] and [[methamphetamine]]), [[structural heart disease]] (including [[congenital heart disease]]s such as [[tetralogy of Fallot]]), inherited [[channelopathies]], [[drug toxicity]] ([[digoxin]], drugs that [[prolong the QT interval]]) and [[electrolyte disturbances]] (such as [[hypokalemia]], [[hypomagnesemia]], and [[hypocalcemia]]).
{| style="float: right; width: 500px; margin: 5px 10px;"
! style="font-size: 85%; background: #545454; color: #F8F8FF; padding: 5px 10px;" | Table 1. Common Bacterial Pathogens in Neutropenic Patients
|-
! style="font-size: 85%; background: #DCDCDC;" | Gram-Positive Pathogens
|-
| style="font-size: 85%; background: #F5F5F5;" |
:* Coagulase-negative staphylococci
:* Staphylococcus aureus, including methicillin-resistant strains
:* Enterococcus species, including vancomycin-resistant strains
:* Viridans group streptococci
:* Streptococcus pneumoniae
:* Streptococcus pyogenes
|-
! style="font-size: 85%; background: #DCDCDC;" | Gram-Negative Pathogens
|-
| style="font-size: 85%; background: #F5F5F5;" |
:* Escherichia coli
:* Klebsiella species
:* Enterobacter species
:* Pseudomonas aeruginosa
:* Citrobacter species
:* Acinetobacter species
:* Stenotrophomonas maltophilia
|}
[[Septicemia|Bloodstream infections]] caused by endogenous flora and reactivation of latent infections account for a majority of initial febrile episode in neutropenic patients with cancer.  Common bacterial isolates that cause bacteremia in the setting of neutropenia are listed in Table 1.<ref>{{Cite journal | doi = 10.1007/s00277-011-1373-2 | issn = 1432-0584 | volume = 91 | issue = 5 | pages = 767–774 | last = Pagano | first = L. | coauthors = M. Caira, G. Rossi, M. Tumbarello, R. Fanci, M. G. Garzia, N. Vianelli, N. Filardi, P. De Fabritiis, A. Beltrame, M. Musso, A. Piccin, A. Cuneo, C. Cattaneo, T. Aloisi, M. Riva, G. Rossi, U. Salvadori, M. Brugiatelli, S. Sannicolò, M. Morselli, A. Bonini, P. Viale, A. Nosari, F. Aversa, Hema e-Chart Group, Italy | title = A prospective survey of febrile events in hematological malignancies | journal = Annals of Hematology | date = 2012-05 | pmid = 22124621 }}</ref>  Certain endogenous microorganisms may be reactivated and exit latency during immunosuppression. These include [[herpes simplex virus]], [[varicella-zoster virus]], [[Epstein-Barr virus]], [[cytomegalovirus]], [[HBV|hepatitis B]] and [[HCV|C]] viruses, and ''[[Mycobacterium tuberculosis]]''.  Exogenous pathogens carried by contaminated blood products, medical equipment and devices, water sources, and health care workers represent less common sources of infection. These include ''[[Clostridium difficile]]'', [[respiratory syncytial virus]], [[vancomycin]]-resistant [[enterococci]], and other multidrug resistant bacteria.<ref>{{Cite book | edition = 5 edition | publisher = Saunders | isbn = 9781455728657 | last = MD | first = John E. Niederhuber | coauthors = James O. Armitage MD, James H. Doroshow MD, Michael B. Kastan MD PhD, Joel E. Tepper MD | title = Abeloff's Clinical Oncology: Expert Consult Premium Edition - Enhanced Online Features and Print, 5e | location = Philadelphia, Pennsylvania | date = 2013-11-05 }}</ref>
Fungal infections often take place in the setting of prolonged or profound neutropenia after administration of empirical therapy.  [[Candidiasis]] may range in severity from mucosal or cutaneous infection to [[septicemia]], [[endocarditis]], or disseminated infection.  [[Aspergillus]], on the contrary, typically causes life-threatening infection of the sinuses and lungs, particularly after protracted neutropenia.<ref>{{Cite journal | doi = 10.1093/cid/ciq147 | issn = 1537-6591 | volume = 52 | issue = 4 | pages = 427–431 | last = Freifeld | first = Alison G. | coauthors = Eric J. Bow, Kent A. Sepkowitz, Michael J. Boeckh, James I. Ito, Craig A. Mullen, Issam I. Raad, Kenneth V. Rolston, Jo-Anne H. Young, John R. Wingard, null Infectious Diseases Society of Americaa | title = Clinical practice guideline for the use of antimicrobial agents in neutropenic patients with cancer: 2010 Update by the Infectious Diseases Society of America | journal = Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America | date = 2011-02-15 | pmid = 21205990 }}</ref>
===Causes by Organ System===
{|style="width:75%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Chemical/Poisoning'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Dental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Dermatologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
|bgcolor="Beige"| [[Acetaminophen and Oxycodone]], Aclarubicin, [[Albendazole]], [[Alemtuzumab]], [[Alkylating antineoplastic agent]], Alkylators, [[Arsenicals]], [[Auranofin]], [[Azathioprine]], [[Aztreonam]], [[Boceprevir]], Busulphan, [[carbamazepine]], [[Carboplatin]], [[Cefadroxil]], [[Ceftazidime]], [[Certolizumab pegol]], [[Chlorpromazine]], [[Chloramphenicol]], [[Chlorpropamide]], [[Cidofovir]], [[Clomipramine]], [[Colchicine toxicity]], [[Cytotoxic drugs]] and [[radiation]], [[Dactinomycin]], [[Doxorubicin]], [[Ethosuximide]], [[Febuxostat]], [[Flucytosine]], [[Gold]], [[Gemifloxacin mesylate]], [[Idarubicin]], [[indomethacin ]], [[Interferon beta- 1a]], [[Lincomycin Hydrochloride]] [[Minocycline hydrochloride]], [[Non steroidal anti-inflammatory drugs]], [[Ofatumumab]], [[Omacetaxine]], [[Oxaprozin]], [[Oxcarbazepine]], [[Penicillamine]], [[phenacemide ]], Phenylbutazone, [[Piperacillin]], [[Pralatrexate]], [[ propylthiouracil ]], [[Pyrimethamine]], [[Rabeprazole]], [[Radium chloride]], [[ sulfonamides]], [[Tamoxifen]], [[Tolbutamide]], [[Tolazamide]], [[Trifluoperazine]], [[Trimethadione]], [[Thiothixene]], [[Valganciclovir hydrochloride]]
|-
|-bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Endocrine'''
|bgcolor="Beige"|[[Thyroid carcinoma]]
|-
|-bgcolor="LightSteelBlue"
| '''Environmental'''
|bgcolor="Beige"|[[Tobacco]] use, Environmental/occupational (eg, benzene)
|-
|-bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
|bgcolor="Beige"|[[Portal hypertension]], Intestinal [[lymphangiectasia]], [[ Hepatitis ]]
|-
|-bgcolor="LightSteelBlue"
| '''Genetic'''
|bgcolor="Beige"|[[Ataxia telangiectasia]], [[Barth syndrome]], [[Chediak-Higashi disease]], defect in synthesis of adenosylcobalamin, DNA repair deficiencies, [[Down syndrome]], [[Dubowitz syndrome]], [[familial]] monosomy 7, [[Fanconi anaemia]], genotoxic therapy, glutathione synthase deficiency, [[glycogen storage diseases]], mutagen exposure, [[mutagen]]-detoxification (GSTq1-null), [[neurofibromatosis 1]], [[Niemann-Pick disease]], Nijmege breakage syndrome, [[Noonan syndrome]], organic acid metabolism defect, [[Pearson syndrome]], [[Seckel syndrome]], [[Severe combined immunodeficiency]], T- B+ due to JAK3 deficiency, [[trisomy 8]] mosaicism, [[Wiskott-Aldrich syndrome]]
|-
|-bgcolor="LightSteelBlue"
| '''Hematologic'''
|bgcolor="Beige"|[[Sickle cell disease]], Reticular dysgenesis, [[Paroxysmal nocturnal haemoglobinuria]], [[Non-Hodgkin lymphoma]], Myelpathic [[anemia]],
[[Myeloma]], [[Myelofibrosis]], [[Myelodysplastic syndrome]], [[Megaloblastic anaemia]], [[Malignant histiocytosis]], Leucoerythroblastic [[anaemia]],
Large granular [[lymphocytic leukemia]], [[Langerhans cell histiocytosis]], Ineffective erythropoiesis, Hypoplastic [[myelodysplastic syndromes ]],
[[Hypersplenism]], [[Hodgkin lymphoma]], [[Histiocytosis X]], [[Hepatosplenic T-cell lymphoma]], [[Hemoglobin H disease]], Hematopoietic cell transplantation, [[Hairy cell leukaemia]], [[Haemoglobin SC disease]], [[Haemoglobin E disease]], [[Graft versus host disease]], Familial [[myelofibrosis]], Familial histiocytic reticulosis, [[Eosinophilic fasciitis ]], [[Cyclical neutropenia]], Congenital [[neutropenia]] (Kostmann's or Shwachman-Diamond syndrome), [[Common variable hypogammaglobulinaemia]], [[Chronic myeloid leukaemia]], [[Chronic lymphocytic leukaemia]], Bleeding (Excessive), [[Autoimmune lymphoproliferative syndrome]] type 2, [[Autoimmune lymphoproliferative syndrome]] type 1, [[Aplastic anemia]], Amegakaryocytic [[thrombocytopenia]], [[Aggressive NK-cell leukemia]], [[Acute lymphoblastic leukemia]]
|-
|-bgcolor="LightSteelBlue"
| '''Iatrogenic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Infectious Disease'''
|bgcolor="Beige"|[[Q fever]], [[Parvovirus B19]] infection, Oklahoma tick fever, [[Mycobacterium tuberculosis]], [[Legionella pneumophila]], [[Lassa fever]], [[Human immunodeficiency virus ]], [[Epstein-Barr virus]] Seronegative,  [[Dengue]], [[Brucellosis]]
|-
|-bgcolor="LightSteelBlue"
| '''Musculoskeletal/Orthopedic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Neurologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Nutritional/Metabolic'''
|bgcolor="Beige"|[[Vitamin C deficiency]], [[Vitamin B12 deficiency]], [[Marasmus]], [[Malabsorption syndrome]], [[Kwashiorkor]], [[Iron deficiency]],
[[Intrinsic factor]] deficiency, [[Folate deficiency]], [[Copper deficiency]]
|-
|-bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
|bgcolor="Beige"|[[Pregnancy ]]
|-
|-bgcolor="LightSteelBlue"
| '''Oncologic'''
|bgcolor="Beige"|[[Thymoma ]], [[Prostate cancer]], Metastatic neoplasm, [[Melanoma]], [[Germ cell tumors]] (embryonal dysgenesis), [[Ewing sarcoma]], [[Chondrosarcoma]], Cancer treatment
|-
|-bgcolor="LightSteelBlue"
| '''Ophthalmologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Overdose/Toxicity'''
|bgcolor="Beige"| No underlying causes


{| style="cellpadding=0; cellspacing= 0; width: 600px;"
|-
|-
 
| style="padding: 0 5px; font-size: 100%; background: #F5F5F5;" align=center | '''Diagnosis'''||style="padding: 0 5px; font-size: 100%; background: #F5F5F5;" align=center |'''Incidence'''||style="padding: 0 5px; font-size: 100%; background: #F5F5F5;" align=center |'''Onset'''||style="padding: 0 9px; font-size: 100%; background: #F5F5F5;" align=center | '''Common symptom'''
|-bgcolor="LightSteelBlue"
 
| '''Psychiatric'''
 
|bgcolor="Beige"|[[Anorexia nervosa]]
 
|-
|-
| style="font-size: 90%; padding: 0 10px; background: #DCDCDC" align=left |❑ [[Polycystic ovary syndrome]] <br>


|-bgcolor="LightSteelBlue"
❑ [[hirsutism|Idiopathic hirsutism]]<br>


| '''Pulmonary'''
❑ [[Congenital adrenal hyperplasia]] <br>


|bgcolor="Beige"| No underlying causes
❑ Ovarian and androgen secreting tumors <br>


|-
❑ Drug induced <br>


|-bgcolor="LightSteelBlue"
❑ [[HAIR-AN Syndrome]] <br>
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left |❑ 70-85%<br><br> ❑ 5-15%<br><br> ❑ 1-8%<br><br>
❑ 0.3-0.1%<br>


| '''Renal/Electrolyte'''


|bgcolor="Beige"|[[Renal failure, chronic]]
❑ 0.5-1% <br>


|-


|-bgcolor="LightSteelBlue"
❑ 3-4%
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left |❑ PCOS insidious<br> 


| '''Rheumatology/Immunology/Allergy'''
❑ Idiopathic hirsutism Insidious<br>
❑ CAH rapid <br><br>
❑ Tumors rapid <br>


|bgcolor="Beige"|[[Systemic lupus erythematosus]], [[Rheumatoid disease]], [[Osteopetrosis]] autosomal recessive 2, [[Osteopetrosis]] lethal


Osteoclastoma, [[Ankylosing spondylitis]]


|-


|-bgcolor="LightSteelBlue"


| '''Sexual'''
❑ HAIRAN syndrome insidious
 
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left |
|bgcolor="Beige"| No underlying causes
❑ Irregular menses, hyperandrogenism, polycystic ovary <br>
 
No other known cause, normal ovaries, normal anbdrogens <br>
|-
 
|-bgcolor="LightSteelBlue"
 
| '''Trauma'''
 
|bgcolor="Beige"| No underlying causes
 
|-
 
|-bgcolor="LightSteelBlue"
 
| '''Urologic'''
 
|bgcolor="Beige"| No underlying causes
 
|-


|-bgcolor="LightSteelBlue"


| '''Miscellaneous'''


|bgcolor="Beige"|Topoisomerase II interactive agents, [[Plummer-Vinson syndrome]], [[Obesity]], [[Idiopathic ]], Glue vapors, Dyskeratosis congenita Shwachman-Diamond syndrome,  Diamond-Blackfan [[anemia]], [[Castleman disease]], [[Bloom's syndrome ]]
❑ Total testosterone > 200ng and does not respond to treatment <br>


|-
❑ Related to medications (steroids, danazol etc) <br>


❑ Subset of PCOS with insulin resistance and acanthosis nigricans
|}
|}


===Causes in Alphabetical Order===
{{col-begin|width=84%}}
{{col-break|width=33%}}
*[[Aclarubicin]]


*[[Acute lymphoblastic leukemia]]


*[[Aggressive NK-cell leukemia]]


*[[Albendazole]]


*[[Alemtuzumab]]


*[[Alkylating antineoplastic agent]]


*Alkylators


*Amegakaryocytic [[thrombocytopenia ]]


*[[Ankylosing spondylitis]]


*[[Anorexia nervosa]]


*[[Aplastic anemia]]


*[[Arsenicals]]


*[[Ataxia telangiectasia]]


*[[Auranofin]]


*[[Autoimmune lymphoproliferative syndrome type 1]]


*[[Autoimmune lymphoproliferative syndrome type 2]]


*[[Azathioprine]]


*[[Aztreonam]]
'''For patient information, click [[Hirsutism (patient information)|here]]'''


*Benzene Solvents
{{Infobox_Disease |
  Name          = {{PAGENAME}} |
  Image          = |Nuremberg chronicles - Strange People - Hairy Lady (XIIv).jpg
  Caption        = |A lady with hirsutism, as depicted in the ''Nuremberg Chronicle'' (1493)
        = |
}}
{{SI}}
{{CMG}}


*Beta-emitters (eg, radioactive P-32)  
==Overview==
'''Hirsutism''' (from Latin ''hirsutus'' = shaggy, hairy) is defined as excessive and increased [[hair]] growth in women in locations where the occurrence of [[terminal hair]] normally is minimal or absent. It refers to a male pattern of body hair ([[androgenic hair]]) and it is therefore primarily of cosmetic and [[psychological]] concern. Hirsutism is a [[symptom]] rather than a [[disease]] and may be a sign of a more serious medical indication, especially if it develops well after [[puberty]].


*[[Bleeding (Excessive)]]
== Appearance and evaluation ==
Hirsutism only affects women, since the rising of androgens causes a male pattern of body hair, particularly in locations where women normally do not develop terminal hair within their [[puberty]] ([[chest hair|chest]], [[abdominal hair|abdomen]], back and [[facial hair|face]]). The medical term for excessive hair growth that affect both men and women is [[hypertrichosis]].


*[[Bloom's syndrome ]]
One method of evaluating hirsutism is the [[Ferriman-Gallwey score]] which gives a score based on the amount and location of hair growth on a woman.
==Etiology==
The cause of hirsutism can be either an increased level of [[androgen]]s (male [[hormone]]s) or an oversensitivity of [[hair follicles]] to androgens. Male hormones such as [[testosterone]] stimulate hair growth, increase size and intensify the pigmentation of hair. Other symptoms associated with a high level of male hormones include [[Acne vulgaris|acne]] and deepening of the voice and increased muscle mass.


*[[Boceprevir]]
Growing evidence implicates high circulating levels of insulin in women to the development of hirsutism. This theory is consistent with the observation that obese (and thus presumably insulin resistant hyperinsulinemic) women are at high risk of becoming hirsute. Further, treatments that lower insulin levels will lead to a reduction in hirsutism.


*[[Brucellosis]]
It is speculated that insulin, at high enough concentration, stimulates the ovarian theca cells to produce androgens. There may also be an effect of high levels of insulin to activate the insulin-like growth factor-I (IGF-1) receptor in those same cells. Again, the result is increased androgen production.


*Busulphan
The following may be some of the conditions that may increase a woman's normally low level of male hormones:
* [[Polycystic ovary syndrome]]
* [[Cushing's disease]]
* [[Tumor]]s in the [[ovaries]] or [[adrenal gland]] ([[cancer]])
* [[Congenital adrenal hyperplasia]]
* [[Insulin resistance]]
* Drugs like [[Ciclosporin]], [[conjugated estrogens]], [[Desogestrel and Ethinyl Estradiol]], [[Dexamethasone]], [[ethynodiol diacetate and ethinyl estradiol]], [[Ethosuximide]], [[Fluoxymesterone]], [[Methyltestosterone]], [[Oxandrolone]], [[Oxymetholone]], [[prednisolone]], [[Tiagabine]]


*Cancer treatment
== Physical Examination ==
====Skin====
[[Image:hirsuitism (PCOS, Cushing's Syndrome, Phenytoin, Leydig Cell Tumor).jpg|thumb|left|hirsuitism (PCOS, Cushing's Syndrome, Phenytoin, Leydig Cell Tumor)
<ref>http://picasaweb.google.com/mcmumbi/USMLEIIImages/</ref>]]
{{clr}}


*[[carbamazepine]]
==Differential Diagnosis of Causes of {{PAGENAME}}==


*[[Carboplatin]]
#Idiopathic:
#*familial,
#*possibly increased sensitivity to androgens.
#variant of normal menopause.
#Polycystic ovarian syndrome.
#obesity
#Drugs:
#*androgens,
#*anabolic steroids,
#*methyltestosterone,
#*minoxidil,
#*diazoxide,
#*phenytoin,
#*glucocorticoids,
#*cyclosporine.
#*phenytoin,
#Congenital adrenal hyperplasia.
#Adrenal virilizing tumor.
#Ovarian virilizing tumor:
#*arrhenoblastoma,
#*hilus cell tumor.
#Pituitary adenoma.
#pregnancy
#Insulin resistance
#Cushing's syndrome.
#Hypothyroidism (congenital and juvenile).
#Acromegaly.
#Androgen-secreting tumors of the ovaries
#*Sertoli-Leydig cell tumors,
#*granulosa-theca cell tumors,
#*hilus-cell tumors
#hyperprolactinemia
#Testicular feminization.


*[[Castleman disease]]
== Treatment ==
Many women with unwanted hair seek methods of [[hair removal]] to control the appearance of hirsutism. But the actual causes should be evaluated by physicians, who can conduct blood tests, pinpoint the specific origin of the abnormal hair growth, and advise on the best course of treatment.


*[[Cefadroxil]]
== See also ==
 
* [[androgenic hair]]
*[[Ceftazidime]]
* [[hypertrichosis]]  
 
* [[hair removal]]  
*[[Chediak-Higashi disease]]
 
*[[Chloramphenicol]]
 
*[[Chlorpropamide]]
 
*[[Chondrosarcoma]]
 
*[[Chronic lymphocytic leukaemia]]
 
*[[Chronic myeloid leukaemia]]
 
*[[Cidofovir]]
 
*[[Clomipramine]]
 
*[[Colchicine toxicity]]
 
*[[Common variable hypogammaglobulinaemia]]
 
*Congenital [[neutropenia]] (Kostmann's or Shwachman-Diamond syndrome)
 
*[[Copper deficiency]]
 
*[[Cyclical neutropenia]]
 
*[[Cytotoxic]] drugs and [[radiation ]]
 
*Defect in synthesis of adenosylcobalamin
 
*[[Dengue]]
 
*[[Diamond-Blackfan anemia]]
 
*DNA repair deficiencies
 
*[[Down syndrome]] (trisomy 21)
 
*[[Doxorubicin]]
 
* [[Dyskeratosis congenita]]
 
* [[Shwachman-Diamond syndrome]]
 
{{col-break|width=33%}}
 
*Environmental/occupational (eg, benzene)
 
*[[Eosinophilic fasciitis ]]
 
*[[Epstein-Barr virus]] Seronegative
 
*[[Ewing sarcoma]]
 
*[[Familial]] histiocytic reticulosis
 
*[[Familial]] monosomy 7
 
*[[Familial]] [[myelofibrosis]]
 
*[[Fanconi anaemia]]
 
*[[Flucytosine]]
 
*[[Folate deficiency]]
 
*Genotoxic therapy
 
*[[Germ cell]] tumors (embryonal dysgenesis)
 
*Glue vapors
 
*Glutathione synthase deficiency
 
*[[Gold ]]
 
*[[Graft versus host disease]]
 
*[[Haemoglobin E disease]]
 
*[[Haemoglobin SC disease]]
 
*[[Hairy cell leukaemia]]
 
*Hematopoietic cell transplantation
 
*[[Hemoglobin H disease]]
 
*[[ Hepatitis ]]
 
*[[Hepatosplenic T-cell lymphoma]]
 
*[[Histiocytosis X]]
 
*[[Hodgkin lymphoma]]
 
*[[Human immunodeficiency virus ]]
 
*[[Hypersplenism]]
 
*Hypoplastic [[myelodysplastic syndromes ]]
 
*[[Idarubicin]]
 
*[[Idiopathic ]]
 
*[[indomethacin ]]
 
*Ineffective [[erythropoiesis]]
 
*Intestinal [[lymphangiectasia]]
 
*[[Infliximab]]
 
*Intrinsic factor deficiency
 
*[[Iron deficiency]]
 
*[[Kwashiorkor]]
 
*[[Langerhans cell histiocytosis]]
 
*Large granular lymphocytic [[leukemia]]
 
*[[Lassa fever]]
 
*[[Legionella pneumophila]]
 
*Leucoerythroblastic [[anaemia]]
 
*[[Malabsorption syndrome]]
 
*[[Malignant histiocytosis]]
 
*[[Marasmus]]
 
*[[Megaloblastic anaemia]]
 
*[[Melanoma]]
 
*Metastatic neoplasm
 
{{col-break|width=33%}}
 
*Mutagen exposure
 
*Mutagen-detoxification (GSTq1-null)
 
*[[Mycobacterium tuberculosis]]
 
*[[Myelodysplastic syndrome]]
 
*[[Myelofibrosis]]
 
*[[Myeloma]]
 
*Myelpathic [[anemia]]
 
*[[Neurofibromatosis 1]]
 
*[[Niemann-Pick disease]]
 
*[[Non steroidal anti-inflammatory drugs ]]
 
*[[Non-Hodgkin lymphoma]]
 
*[[Obesity]]
 
*Oklahoma [[tick fever]]
 
*Osteoclastoma
 
*[[Osteopetrosis]] lethal
 
*[[Osteopetrosis]], autosomal recessive 2
 
*[[Osteosarcoma]]
 
*[[Oxaprozin]]
 
*[[Paroxysmal nocturnal haemoglobinuria]]
 
*[[Parvovirus B19 infection]]
 
*[[phenacemide ]]
 
*[[phenylbutazone ]]
 
*[[Plummer-Vinson syndrome]]
 
*[[Portal hypertension]]
 
*[[Pregnancy ]]
 
*[[Prostate cancer]]
 
*[[Propylthiouracil]]
 
*[[Pyrimethamine]]
 
*[[Q fever]]
 
*[[Radium chloride]]
 
*[[Renal failure, chronic]]
 
*Reticular dysgenesis
 
*[[Rheumatoid disease]]
 
*[[Severe combined immunodeficiency]], T- B+ due to JAK3 deficiency
 
*[[Sickle cell disease]]
 
*[[Sulfonamides ]]
 
*[[Systemic lupus erythematosus]]
 
*[[Tamoxifen]]
 
*[[Thymoma ]]
 
*[[Thyroid carcinoma]]
 
*[[Tobacco use ]]
 
*Topoisomerase II interactive agents
 
*[[Trisomy]] 8 mosaicism
 
*[[Valganciclovir hydrochloride]]
 
*[[Vitamin B12 deficiency]]
 
*[[Vitamin C deficiency]]
 
*[[Wiskott-Aldrich syndrome]]
 
*[[Xeroderma pigmentosum]]
{{col-end}}


==References==
* Ferriman D, Gallwey JD: Clinical assessment of body hair growth in women. ''Journal of Clinical Endocrinology'' 1961; 21:1440-1447.




{{Diseases of the skin and subcutaneous tissue}}




[[Category:Integumentary system]]
[[Category:Gynecology]]
[[Category:Dermatology]]
[[Category:Hair-related diseases]]


<!-- The below are interlanguage links. -->


<br>
[[bg:Хирзутизъм]]
[[de:Hirsutismus]]
[[et:Hirsutism]]
[[es:Hirsutismo]]
[[fr:Hirsutisme]]
[[id:Hirsutisme]]
[[nl:Hirsutisme]]
[[pl:Hirsutyzm]]
[[pt:Hirsutismo]]


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{{WikiDoc Sources}}




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==Causes of Hypotension==
== Causes ==
===Life Threatening Causes===
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.
*[[Anaphylaxis]]
*[[aortic aneurysm|Aortic aneurysm rupture]]
*[[Bleeding]]
*[[Dehydration]]
*[[Hypothermia]]
*[[Shock]]
<font color="white">{{Smallcaps|{{PAGENAME}} developed by WikiDoc.org}}</font>
===Common Causes===
*[[ACE inhibitors]]
*[[Addison's disease]]
*[[Alpha blockers]]
*[[Beta blockers]]
*[[Bleeding]]
*[[Calcium channel blockers]]
*[[Diabetes mellitus]]
*[[Diuretics]]
*[[Hypoglycemia]]
*[[Hypothermia]]
*[[Hypovolemia]]
*[[Pregnancy]]
*[[Sepsis]]
*[[Shock]]
*[[Tricyclic antidepressants]]
<font color="white">{{Smallcaps|{{PAGENAME}} developed by WikiDoc.org}}</font>
===Causes by Organ System===
{|style="width:80%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | [[aortic aneurysm|Aortic aneurysm rupture]], [[aortic arch syndrome]], [[aortic isthmus stenosis]], [[aortic regurgitation]], [[aortic stenosis]], [[aortocaval compression syndrome]], [[atrial myxoma]], [[AV block|atrioventricular node conduction block]], [[brain natriuretic peptide|B type natriuretic peptide]], baroceptor dysfunction in the elderly, [[capillary leak syndrome]], [[cardiac tamponade]], [[cardiogenic shock]], [[carotid sinus hypersensitivity]], [[carotid sinus syndrome]], [[coarctation of aorta]], [[complete heart block]], [[constrictive pericarditis]], [[cor triatriatum]], [[dehydration]], [[dissecting aortic aneurysm]], [[distributive shock]], [[Eisenmenger's syndrome]], [[embolism]], [[endotoxic shock]], [[gray baby syndrome]], [[cardiac arrhythmia|heart arrhythmia]], [[heart block]], [[heart failure]], heart injury, [[hemorrhagic shock]], hemorrhagic shock and encephalopathy syndrome, [[hypertrophic obstructive cardiomyopathy]], [[hypovolemic shock]], [[idiopathic hypotension]], [[iliac artery aneurysm|iliac artery aneurysm rupture]], [[internal bleeding]], [[ischaemic heart disease]], [[myocardial infarction]], [[myocardial ischemia]], [[obstructive shock]], [[orthostatic hypotension]], [[pericardial effusion]], [[pericarditis]], [[perimyocarditis]], [[post-tussive syncope]], [[postural hypotension]], [[pulmonary embolism]], [[shock]], [[sick sinus syndrome]], [[supraventricular tachycardia ]], [[syncope]], [[tetralogy of Fallot]], [[shock|traumatic shock]], [[tricuspid stenosis]], [[vasovagal syncope]], [[ventricular fibrillation]], [[WPW syndrome]]
|-
|bgcolor="LightSteelBlue"| '''Chemical / poisoning'''
|bgcolor="Beige"| [[Acetaldehyde]], [[adiponitrile ]], [[copper]], [[cyanides]], [[demeton-S-methyl]], [[diazinon ]], [[dioxathion]], [[disulfoton ]], [[ethion ]], [[fensulfothion]], [[fenthion]], honey bee bite, indian tobacco, [[malathion]], [[methidathion]], [[methiocarb]], [[methomyl]], [[mushroom poisoning ]], [[parathion]], [[phosdrin]], [[conium|poison hemlock]], [[profenofos]], scorpion bite, [[sodium nitrite]], [[terbufos]], [[pyrophosphate|tetraethyl pyrophosphate ]], [[tetrodotoxin]], [[tobacco ]], wasp bite
|-
|bgcolor="LightSteelBlue"| '''Dermatologic'''
|bgcolor="Beige"| [[Gray baby syndrome]], [[mastocytosis ]]
|-
|bgcolor="LightSteelBlue"| '''Drug Side Effect'''
|bgcolor="Beige"| [[Acetophenazine]], [[alcuronium]], [[alfuzosin]], [[aliskiren]], alseroxylon, [[ambenonium]], [[ambrisentan]], [[amifostine]], [[aminoglutethimide]], [[amitriptyline]], [[amlodipine]], [[amoxapine]], [[amphotericin B]], [[amrinone]], [[amyl nitrate]], [[antipsychotic agents]], [[apomorphine]], azilsartan medoxomil, [[brain natriuretic peptide|B type natriuretic peptide]], [[baclofen]], [[beta blockers]], [[bethanechol]], bethanidine, [[bortezomib]], [[bosentan]], [[bretylium]], [[bromocriptine]], [[bupivacaine]], [[cabergoline]], [[calcium channel blockers]], [[candesartan]], [[captopril]], [[chloroquine]], [[chlorpheniramine]], [[chlorpromazine]], [[chlorthalidone]], [[cilazapril]], [[cinacalcet]], [[cinnarizine]], [[clevidipine]], [[clomipramine]], [[clonidine]], [[colchicine]], [[cyclobenzaprine]], [[deserpidine]], [[desferrioxamine]], [[desipramine]], [[dexmedetomidine]], [[diazoxide]], [[dichlorvos ]], dicobalt edetate, [[dicrotophos ]], [[diltiazem]], [[diphenhydramine]], [[dipyridamole]], [[disopyramide]], [[distigmine]], [[diuretics]], [[donepezil ]], [[dothiepin]], [[doxazosin]], [[doxepin]], [[enalapril]], [[epidural anaesthesia]], [[eplerenone]], [[epoprostenol]], [[etoposide]], [[felodipine ]], [[fenoldopam]], [[fentanyl]], [[fosinopril]], [[general anaesthesia]], [[glyceryl trinitrate]], [[granulocyte-macrophage colony stimulating factor]], [[gray baby syndrome]], [[guanadrel]], [[guanethidine]], [[guanfacine]], [[haloperidol]], [[hexamethonium]], [[hydralazine]], [[hydroxyzine]], [[imipramine]], [[indapamide]], [[indoramin]], [[interleukin 2]], iodine containing radiocontrast media, [[irbesartan]], [[isosorbide dinitrate]], [[isosorbide mononitrate]], [[isoxsuprine]], [[isradipine]], [[ketanserin]], [[labetalol]], [[l-dopa]], [[levomepromazine]], [[levosimendan]], [[lidocaine ]], [[lisinopril]], [[lithium]], [[lofexidine]], [[losartan]], [[mecamylamine]], [[methyldopa]], [[metirosine]], [[metolazone]], [[minoxidil]], [[morphine]], [[moxonidine]], [[nefazodone]], [[neostigmine]], [[niacin]], [[nicorandil]], [[nifedipine]], [[nimodipine]], [[nitroprusside]], [[nortriptyline]], [[olanzapine]], [[olmesartan]], [[omapatrilat]], [[opioid poisoning]], [[paliperidone]], [[pentamidine]], [[perazine]], [[pergolide]], [[phenothiazines]], [[phenoxybenzamine]], [[phentolamine]], pimobendan, [[pinacidil]], [[pipothiazine]], [[piribedil]], [[pramipexole]], [[prazosin]], [[protamine sulfate]], [[protriptyline]], [[quetiapine]], [[ramipril]], [[rasagiline]], [[reboxetine]], [[reserpine]], [[rilmenidine]], [[risperidone]], [[rituximab]], [[ropinirole]], [[rotigotine]], sassafras oil, [[serotonin syndrome]], [[sildenafil]], [[silodosin]], [[sodium nitroprusside]], [[spironolactone]], [[streptokinase]], [[sulphonamides]], [[tacrine]], [[tadalafil]], [[tamsulosin]], [[terazosin]], [[tetrabenazine]], [[tizanidine]], [[tolazoline]], [[tramadol]], [[treprostinil]], [[trifluperidol]], [[trimethaphan]], [[trimipramine]], [[tubocurarine]], [[urapidil]], [[valerian]], [[valsartan]], [[vardenafil]], [[verapamil]], [[ziconotide]], [[zotepine]]
|-
|bgcolor="LightSteelBlue"| '''Ear Nose Throat'''
|bgcolor="Beige"| No underlying causes
|-
|bgcolor="LightSteelBlue"| '''Endocrine'''
|bgcolor="Beige"| [[Achalasia-addisonianism-alacrima syndrome]], [[ACTH deficiency]], [[Addison's disease]], [[addisonian crisis]], [[adrenal hemorrhage]], [[adrenogenital syndrome]], [[adrenoleukodystrophy ]], [[Allgrove syndrome]], [[APECED syndrome ]], [[brain natriuretic peptide|B type natriuretic peptide]], [[carcinoid syndrome ]], [[congenital adrenal hyperplasia]], [[diabetes insipidus]], [[diabetic neuropathy|diabetic autonomic neuropathy]], [[diabetic ketoacidosis]], [[hyperosmolar hyperglycemic nonketotic coma]], [[hypoaldosteronism]], [[hyporeninemic hypoaldosteronism]], [[hypothyroidism]], [[Myxedema]], [[myxedema coma]], [[panhypopituitarism]], [[pituitary insufficiency]], [[pseudohypoaldosteronism]], Renon-Delille syndrome, [[serotonin syndrome]], [[triple-A syndrome]]
|-
|bgcolor="LightSteelBlue"| '''Environmental'''
|bgcolor="Beige"| [[Snake bite]], [[zero gravity ]]
|-
|bgcolor="LightSteelBlue"| '''Gastroenterologic'''
|bgcolor="Beige"| [[Achalasia-addisonianism-alacrima syndrome]], [[acute liver failure ]], [[acute pancreatitis]], [[viral gastroenteritis|acute viral gastroenteritis]], [[Allgrove syndrome]], bowel strangulation, deglutition syncope, [[diarrhea]], [[peptic ulcer|duodenal ulcer bleeding]], [[peptic ulcer|gastric ulcer bleeding]], [[gastric volvulus]], [[hepatic vein thrombosis]], [[hepatitis]], [[intususception]], [[mastocytosis ]], [[necrotizing enterocolitis]], [[paralytic ileus]], [[peritonitis ]], [[hypotension|postprandial hypotension]], [[retroperitoneal haemorrhage]], [[small bowel obstruction]], [[splenic rupture]], [[superior mesenteric artery|superior mesenteric artery occlusion]], [[triple A syndrome]], [[tropical sprue ]], [[variceal bleeding]], [[vomiting]]
|-
|bgcolor="LightSteelBlue"| '''Genetic'''
|bgcolor="Beige"|[[Achalasia-addisonianism-alacrima syndrome]], [[acute intermittent porphyria]], [[Allgrove syndrome]], [[ APECED syndrome]], [[Bartter syndrome]], corticosteroid-binding globulin deficiency , familial juvenile hyperuricemic nephropathy type 2, hereditary peripheral nervous disorder, hereditary sensory and autonomic neuropathy type 3, [[pseudohypoaldosteronism]], Renon-Delille syndrome, [[Riley-Day syndrome]], [[triple A syndrome]], [[Wohlwill-Andrade syndrome]]
|-
|bgcolor="LightSteelBlue"| '''Hematologic'''
|bgcolor="Beige"| [[Acute intermittent porphyria]], [[anemia]]
|-
|bgcolor="LightSteelBlue"| '''Iatrogenic'''
|bgcolor="Beige"| After a major surgery, [[blood transfusion ]], dialyzer hypersensitivity syndrome, [[epidural anesthesia]], gastric acid stimulation test using histamines, [[general anesthesia]], [[mechanical ventilation]], post-operative, [[renal dialysis]], [[transfusion reaction]]
|-
|bgcolor="LightSteelBlue"| '''Infectious Disease'''
|bgcolor="Beige"| [[viral gastroenteritis|Acute viral gastroenteritis]], [[botulism]], [[cholera]], [[dengue hemorrhagic fever]], [[hantavirus]], [[lassa fever]], [[rocky mountain spotted fever ]], [[septic shock]], [[septicemia ]], [[toxic shock syndrome]], [[vibrio vulnificus]], [[Waterhouse-Friederichsen syndrome]], [[Weil syndrome]]
|-
|bgcolor="LightSteelBlue"| '''Musculoskeletal / Ortho'''
|bgcolor="Beige"| [[Cervical spine injury]], [[fracture of bone]], [[vertebral fracture]]
|-
|bgcolor="LightSteelBlue"| '''Neurologic'''
|bgcolor="Beige"| [[pure autonomic failure|Autonomic failure]], [[autonomic neuropathy]], [[Binswanger's disease ]], [[Bradbury-Eggleston syndrome]], [[diabetic neuropathy|diabetic autonomic neuropathy]], [[DOPA decarboxylase|DOPA decarboxylase deficiency]], [[dopamine beta hydroxylase deficiency]], [[dysautonomia]], [[glossopharyngeal neuralgia]], [[Guillain-Barre syndrome]], hemorrhagic shock and encephalopathy syndrome, hereditary peripheral nervous disorder, hereditary sensory and autonomic neuropathy type 3, [[multiple system atrophy]], [[neurogenic shock]], [[Parkinson's disease]], [[polyradiculitis]], [[Riley-Day syndrome]], [[seizures]], [[Shy-Drager syndrome]], [[syringomyelia]], [[tabes dorsalis]], [[vasovagal syncope]], [[Wohlwill-Andrade syndrome]]
|-
|bgcolor="LightSteelBlue"| '''Nutritional / Metabolic'''
|bgcolor="Beige"| [[Dehydration]],[[dieting|excessive dieting]],[[kwashiorkor]]
|-
|bgcolor="LightSteelBlue"| '''Obstetric/Gynecologic'''
|bgcolor="Beige"| [[Aortocaval compression syndrome]], [[ectopic pregnancy|ectopic pregnancy rupture]], [[ovarian hyperstimulation syndrome]], [[postpartum haemorrhage]], [[pregnancy]], puerpural shock, [[septic abortion ]], [[uterine rupture]]
|-
|bgcolor="LightSteelBlue"| '''Oncologic'''
|bgcolor="Beige"| [[Atrial myxoma]], [[carcinoid syndrome ]], [[mastocytosis ]], [[pheochromocytoma]], [[serotonin-secreting tumor]]
|-
|bgcolor="LightSteelBlue"| '''Opthalmologic'''
|bgcolor="Beige"| No underlying causes
|-
|bgcolor="LightSteelBlue"| '''Overdose / Toxicity'''
|bgcolor="Beige"| [[Acetophenazine]], [[alcuronium]], [[alfuzosin]], [[aliskiren]], alseroxylon, [[ambenonium]], [[ambrisentan]], [[amifostine]], [[aminoglutethimide]], [[amitriptyline]], [[amlodipine]], [[amoxapine]], [[amphotericin B]], [[amrinone]], [[antipsychotic agents]], [[apomorphine]], azilsartan medoxomil, [[baclofen]], [[beta blockers]], [[bethanechol]], bethanidine, [[bortezomib]], [[bosentan]], [[bretylium]], [[bromocriptine]], [[bupivacaine]], [[cabergoline]], [[calcium channel blockers]], [[candesartan]], [[captopril]], [[chloroquine]], [[chlorpheniramine]], [[chlorpromazine]], [[chlorthalidone]], [[cilazapril]], [[cinnarizine]], [[clevidipine]], [[clomipramine]], [[clonidine]], [[colchicine]], [[cyclobenzaprine]], [[deserpidine]], [[desferrioxamine]], [[desipramine]], [[dexmedetomidine]], [[diazoxide]], [[dichlorvos ]], dicobalt edetate, [[dicrotophos ]], [[diltiazem]], [[diphenhydramine]], [[dipyridamole]], [[disopyramide]], [[distigmine]], [[diuretics]], [[donepezil ]], [[dothiepin]], [[doxazosin]], [[doxepin]], [[enalapril]], [[epidural anaesthesia]], [[eplerenone]], [[epoprostenol]], [[etoposide]], [[felodipine ]], [[fenoldopam]], [[fentanyl]], [[fosinopril]], [[general anaesthesia]], [[glyceryl trinitrate]], [[granulocyte-macrophage colony stimulating factor]], [[guanadrel]], [[guanethidine]], [[guanfacine]], [[haloperidol]], [[hexamethonium]], [[hydralazine]], [[hydroxyzine]], [[imipramine]], [[indapamide]], [[indoramin]], [[interleukin 2]], [[irbesartan]], [[isosorbide dinitrate]], [[isosorbide mononitrate]], [[isoxsuprine]], [[isradipine]], [[ketanserin]], [[labetalol]], [[l-dopa]], [[levomepromazine]], [[levosimendan]], [[lidocaine ]], [[lisinopril]], [[lithium]], [[lofexidine]], [[losartan]], [[magnesium|magnesium overdose]], [[mecamylamine]], [[methyldopa]], [[metirosine]], [[metolazone]], [[minoxidil]], [[morphine]], [[moxonidine]], [[nefazodone]], [[neostigmine]], [[niacin]], [[nicorandil]], [[nifedipine]], [[nimodipine]], [[nitroprusside]], [[nortriptyline]], [[olanzapine]], , [[olmesartan]], [[omapatrilat]], [[opioid poisoning]], [[paliperidone]], [[pentamidine]], [[perazine]], [[pergolide]], [[phenothiazines]], [[phenoxybenzamine]], [[phentolamine]], pimobendan, [[pinacidil]], [[pipothiazine]], [[piribedil]], [[pramipexole]], [[prazosin]], [[protamine sulfate]], [[protriptyline]], [[quetiapine]], [[ramipril]], [[rasagiline]], [[reboxetine]], [[reserpine]], [[rilmenidine]], [[risperidone]], [[rituximab]], [[ropinirole]], [[rotigotine]], sassafras oil, [[sildenafil]], [[silodosin]], [[sodium nitroprusside]], [[spironolactone]], [[streptokinase]], [[sulphonamides]], [[tacrine]], [[tadalafil]], [[tamsulosin]], [[terazosin]], [[tetrabenazine]], [[tizanidine]], [[tolazoline]], [[tramadol]], [[treprostinil]], [[trifluperidol]], [[trimethaphan]], [[trimipramine]], [[tubocurarine]], [[urapidil]], [[valerian]], [[valsartan]], [[vardenafil]], [[verapamil]], [[ziconotide]], [[zotepine]]
|-
|bgcolor="LightSteelBlue"| '''Psychiatric'''
|bgcolor="Beige"| [[Anorexia nervosa]], [[depression]]
|-
|bgcolor="LightSteelBlue"| '''Pulmonary'''
|bgcolor="Beige"| [[Post-tussive syncope]], [[pulmonary edema]], [[pulmonary embolism]], [[tension pneumothorax]]
|-
|bgcolor="LightSteelBlue"| '''Renal / Electrolyte'''
|bgcolor="Beige"| [[Bartter syndrome]], [[dehydration]], familial juvenile hyperuricemic nephropathy type 2, [[hypermagnesaemia]], [[hypokalemia]], [[hyponatremia]]
|-
|bgcolor="LightSteelBlue"| '''Rheum / Immune / Allergy'''
|bgcolor="Beige"| [[Amyloidosis]], [[anaphylactic shock]], [[anaphylactoid reaction]], [[blood transfusion ]], dialyzer hypersensitivity syndrome, food additive allergy, [[Guillain-Barre syndrome]], honey bee bite, [[mastocytosis]], scorpion bite, [[transfusion reaction]], [[urticaria]], wasp bite, [[Wohlwill-Andrade syndrome]], x-ray studies using contrast media
|-
|bgcolor="LightSteelBlue"| '''Sexual'''
|bgcolor="Beige"| Renon-Delille syndrome
|-
|bgcolor="LightSteelBlue"| '''Trauma'''
|bgcolor="Beige"| Blood vessel trauma, [[burns]], [[spinal cord injury|cervical spine injury]], [[chemical burn]], [[fracture of bone]], heart injury, [[pericardial effusion]], [[shaken baby syndrome]], [[tension pneumothorax]], [[shock|traumatic shock]]
|-
|bgcolor="LightSteelBlue"| '''Urologic'''
|bgcolor="Beige"| No underlying causes
|-
|bgcolor="LightSteelBlue"| '''Dental'''
|bgcolor="Beige"| No underlying causes
|-
|bgcolor="LightSteelBlue"| '''Miscellaneous'''
|bgcolor="Beige"| [[Alcohol]], [[alcohol withdrawal syndrome]], [[decompression sickness]], deglutition syncope, [[dehydration]], [[fatigue]], [[heat exhaustion]], [[hypothermia]], insufficient fluid intake, low salt diet, [[micturition syncope]], prolonged bed rest, [[snake bite]], [[syncope]], [[volume depletion ]], [[zero gravity ]]
|-
|}
<font color="white">{{Smallcaps|{{PAGENAME}} developed by WikiDoc.org}}</font>
===Causes in Alphabetical Order===
{{col-begin|width=80%}}
{{col-break|width=33%}}
*[[Abdominal aortic aneurysm]]
*[[Acetaldehyde]]
*[[Acetophenazine]]
*[[Achalasia-addisonianism-alacrima syndrome]]
*[[ACTH deficiency]]
*[[Acute intermittent porphyria]]
*[[Acute liver failure]]
*[[Acute pancreatitis]]
*[[viral gastroenteritis|Acute viral gastroenteritis]]
*[[Addisonian crisis]]
*[[Addison's disease]]
*[[Adiponitrile]]
*[[Adrenal cortex insufficiency]]
*[[Adrenal hemorrhage]]
*[[Adrenogenital syndrome]]
*[[Adrenoleukodystrophy]]
*After a major surgery
*[[Alcohol]]
*[[Alcohol withdrawal syndrome]]
*[[Alcuronium]]
*[[Alfuzosin]]
*[[Aliskiren]]
*[[Allgrove syndrome]]
*Alseroxylon
*[[Ambenonium]]
*[[Ambrisentan]]
*[[Amifostine]]
*[[Aminoglutethimide]]
*[[Amitriptyline]]
*[[Amlodipine]]
*[[Amoxapine]]
*[[Amphotericin B]]
*[[Amrinone]]
*[[Amyl nitrate]]
*[[Amyloidosis]]
*[[Anaphylactic shock]]
*[[Anaphylactoid reaction]]
*[[Anemia]]
*[[Anorexia nervosa]]
*[[Antipsychotic agents]]
*[[aortic aneurysm|Aortic aneurysm rupture]]
*[[Aortic arch syndrome]]
*[[Aortic isthmus stenosis]]
*[[Aortic regurgitation]]
*[[Aortic stenosis]]
*[[aortic insufficiency|Aortic valve incompetence]]
*[[Aortocaval compression syndrome]]
*[[APECED syndrome]]
*[[Apomorphine]]
*[[Atrial myxoma]]
*[[AV block|Atrioventricular node conduction block]]
*[[Autoimmune adrenalitis]]
*[[pure autonomic failure|Autonomic failure]]
*[[Autonomic neuropathy]]
*Azilsartan medoxomil
*[[brain natriuretic peptide|B type natriuretic peptide]]
*[[Baclofen]]
*Baroceptor dysfunction in the elderly
*[[Bartter syndrome]]
*[[Beta blockers]]
*[[Bethanechol]]
*Bethanidine
*[[Binswanger's disease]]
*[[Blood transfusion]]
*Blood vessel trauma
*[[Bortezomib]]
*[[Bosentan]]
*[[Botulism]]
*Bowel strangulation
*Box jellyfish poisoning
*[[Bradbury-Eggleston syndrome]]
*[[Bretylium]]
*[[Bromocriptine]]
*[[Bupivacaine]]
*[[Burns]]
*[[Cabergoline]]
*[[Calcium channel blockers]]
*[[Candesartan]]
*[[Capillary leak syndrome]]
*[[Captopril]]
*[[Carcinoid syndrome]]
*[[Cardiac arrhythmias]]
*[[congestive heart failure|Cardiac failure, left sided]]
*[[Cardiac tamponade]]
*[[Cardiogenic shock]]
*[[Carotid sinus hypersensitivity]]
*[[Carotid sinus syndrome]]
*[[Cervical spine injury]]
*[[Charcot-Marie-Tooth disease]]
*[[Chemical burn]]
*[[Chloroquine]]
*[[Chlorpheniramine]]
*[[Chlorpromazine]]
*[[Chlortalidone]]
*[[Cholera]]
*[[Chronic pyelonephritis]]
*[[Chronic renal failure]]
*[[Cilazapril]]
*[[Cinnarizine]]
*[[Clevidipine]]
*[[Clomipramine]]
*[[Clonidine]]
*[[Coarctation of aorta]]
*[[Colchicine]]
*[[Complete heart block]]
*[[Congenital adrenal hyperplasia]]
*[[Constrictive pericarditis]]
*[[Copper]]
*[[Cor triatriatum]]
*Corticosteroid-binding globulin deficiency
*[[Cyanides]]
*[[Cyclobenzaprine]]
*[[Decompression sickness]]
*Deglutition syncope
*[[Dehydration]]
*[[Demeton-S-methyl]]
*[[Dengue hemorrhagic fever]]
*[[Depression]]
*[[Deserpidine]]
*[[Desferrioxamine]]
*[[Desipramine]]
*[[Dexmedetomidine]]
*[[Diabetes insipidus]]
*[[diabetic neuropathy|Diabetic autonomic neuropathy]]
*[[Diabetic ketoacidosis]]
*Dialyzer hypersensitivity syndrome
*[[Diarrhea]]
*[[Diazinon]]
*[[Diazoxide]]
*[[Dichlorvos]]
*Dicobalt edetate
*[[Dicrotophos]]
*[[Diltiazem]]
*[[Dioxathion]]
*[[Diphenhydramine]]
*[[Dipyridamole]]
*[[Disopyramide]]
*[[Dissecting aortic aneurysm]]
*[[Distigmine]]
*[[Distributive shock]]
*[[Disulfoton]]
*[[Diuretics]]
*[[Donepezil]]
*[[DOPA decarboxylase|DOPA decarboxylase deficiency]]
*[[Dopamine]]
*[[Dopamine beta hydroxylase deficiency]]
*[[Dothiepin]]
*[[Doxazosin]]
*[[Doxepin]]
*[[peptic ulcer|Duodenal ulcer bleeding]]
*[[Dysautonomia]]
*[[Dysrhythmia]]
*[[ectopic pregnancy|Ectopic pregnancy rupture]]
{{col-break|width=33%}}
*[[Eisenmenger's syndrome]]
*[[Embolism]]
*[[Enalapril]]
*[[Endotoxic shock]]
*[[Epidural anaesthesia]]
*[[Eplerenone]]
*[[Epoprostenol]]
*[[Ethion]]
*[[Etoposide]]
*[[dieting|Excessive dieting]]
*Excessive fluid loss through dialysis
*Familial juvenile hyperuricemic nephropathy type 2
*[[Fatigue]]
*[[Felodipine]]
*[[Fenoldopam]]
*[[Fensulfothion]]
*[[Fentanyl]]
*[[Fenthion]]
*[[Focal cerebral ischemia]]
*Food additive allergy
*[[Fosinopril]]
*Gastric acid stimulation test using histamines
*[[peptic ulcer|Gastric ulcer bleeding]]
*[[Gastric volvulus]]
*[[General anaesthesia]]
*[[Gitelman syndrome]]
*[[Glossopharyngeal neuralgia]]
*[[Glyceryl trinitrate]]
*[[Granulocyte-macrophage colony stimulating factor]]
*[[Gray baby syndrome]]
*[[Guanadrel]]
*[[Guanethidine]]
*[[Guanfacine]]
*[[Guillain-Barre syndrome]]
*[[Haloperidol]]
*[[Hantavirus]]
*[[cardiac arrhythmia|Heart arrhythmia]]
*[[Heart block]]
*[[Heart failure]]
*Heart injury
*[[Heat exhaustion]]
*[[Hemorragic fever with renal syndrome]]
*[[Hemorrhage]]
*[[Hemorrhagic shock]]
*Hemorrhagic shock and encephalopathy syndrome
*[[Hepatic vein thrombosis]]
*[[Hepatitis]]
*Hereditary peripheral nervous disorder
*Hereditary sensory and autonomic neuropathy type 3
*[[Hexamethonium]]
*[[Histamine]]
*[[HIV]]
*Honey bee bite
*[[Hydralazine]]
*[[Hydroxyzine]]
*[[Hyperglycemia]]
*[[Hypermagnesemia]]
*[[Hyperosmolar hyperglycemic nonketotic coma]]
*[[Hypertrophic obstructive cardiomyopathy]]
*[[Hypoaldosteronism]]
*[[Hypokalemia]]
*[[Hyponatremia]]
*[[Hyporeninemic hypoaldosteronism]]
*[[Hypothermia]]
*[[Hypothyroidism]]
*[[Hypovolemia]]
*[[Hypovolemic shock]]
*[[Idiopathic hypotension]]
*[[iliac artery aneurysm|Iliac artery aneurysm rupture]]
*[[Imipramine]]
*[[Indapamide]]
*Indian tobacco
*[[Indoramin]]
*[[Infliximab]]
*Insufficient fluid intake
*[[Interleukin 2]]
*[[Internal bleeding]]
*[[Intususception]]
*Iodine containing radiocontrast media
*[[Irbesartan]]
*[[Ischaemic heart disease]]
*[[Isoprenaline]]
*[[Isosorbide dinitrate]]
*[[Isosorbide mononitrate]]
*[[Isoxsuprine]]
*[[Isradipine]]
*[[Ketanserin]]
*[[Kwashiorkor]]
*[[Labetalol]]
*[[Lactic acidosis]]
*[[Lassa fever]]
*[[L-dopa]]
*[[Levomepromazine]]
*[[Levosimendan]]
*[[Lidocaine]]
*[[Lisinopril]]
*[[Lithium]]
*[[Lofexidine]]
*[[Losartan]]
*Low salt diet
*[[Lyme disease]]
*[[Lysuride]]
*[[magnesium|Magnesium overdose]]
*[[Malathion]]
*[[MAOI]]
*[[Marijuana]]
*[[Mastocytosis]]
*Maternal hypotension syndrome
*[[Mecamylamine]]
*[[Mechanical ventilation]]
*[[Methidathion]]
*[[Methiocarb]]
*[[Methomyl]]
*[[Methyldopa]]
*Methyldopate
*[[Metirosine]]
*[[Metolazone]]
*[[Micturition syncope]]
*[[Minoxidil]]
*[[Mitral stenosis]]
*[[Mitral valve incompetence]]
*[[Morphine]]
*[[Moxonidine]]
*[[Multiple system atrophy]]
*[[Mushroom poisoning]]
*[[Myocardial infarction]]
*[[Myocardial ischemia]]
*[[Myocarditis]]
*[[Myxedema]]
*[[Myxedema coma]]
*[[Necrotizing enterocolitis]]
*[[Nefazodone]]
*[[Neostigmine]]
*[[Neurogenic shock]]
*[[Niacin]]
*[[Nicorandil]]
*[[Nifedipine]]
*[[Nimodipine]]
*[[Nitroprusside]]
*[[Nortriptyline]]
*[[Obstructive shock]]
*[[Olanzapine]]
*[[Olmesartan]]
*[[Omapatrilat]]
*[[Opioid poisoning]]
*[[Orthostatic hypotension]]
*[[Ovarian hyperstimulation syndrome]]
*[[Paliperidone]]
*[[Pancreatitis]]
*[[Panhypopituitarism]]
*[[Paralytic ileus]]
*[[Parathion]]
{{col-break|width=33%}}
*[[Parkinson's disease]]
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*[[Perazine]]
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*[[Pericardial effusion]]
*[[Pericarditis]]
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*Pimobendan
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*[[Piribedil]]
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*Post-operative
*[[Postpartum haemorrhage]]
*[[hypotension|Postprandial hypotension]]
*[[Post-tussive syncope]]
*[[Postural hypotension]]
*[[Pramipexole]]
*[[Prazosin]]
*[[Pregnancy]]
*[[Primary pulmonary hypertension]]
*[[Profenofos]]
*Prolonged bed-rest
*[[Protamine sulfate]]
*[[Protriptyline]]
*[[Pseudohypoaldosteronism]]
*Puerpural shock
*[[Pulmonary edema]]
*[[Pulmonary embolism]]
*[[Pulmonary stenosis]]
*[[pericarditis|Pyogenic pericarditis]]
*[[Quetiapine]]
*[[Ramipril]]
*[[Rasagiline]]
*[[Reboxetine]]
*[[Renal dialysis]]
*Renal tubular dysgenesis
*Renon-Delille syndrome
*[[Reserpine]]
*[[Respiratory acidosis]]
*[[Retroperitoneal haemorrhage]]
*[[Rickettsia prowazekii]]
*[[Riley-Day syndrome]]
*[[Rilmenidine]]
*[[Risperidone]]
*[[Rituximab]]
*[[Rocky mountain spotted fever]]
*[[Ropinirole]]
*[[Rotigotine]]
*[[Sarcoidosis]]
*Sassafras oil
*Scorpion bite
*[[Seizures]]
*[[Sepsis]]
*[[Septic abortion]]
*[[Septic shock]]
*[[Septicemia]]
*[[Serotonin syndrome]]
*[[Serotonin-secreting tumor]]
*[[bleeding|Severe bleeding]]
*[[Shaken baby syndrome]]
*[[Shock]]
*[[Shy-Drager syndrome]]
*[[Sick sinus syndrome]]
*[[Sildenafil]]
*[[Silodosin]]
*[[Sjogren syndrome]]
*[[Small bowel obstruction]]
*[[Snake bite]]
*[[Sodium nitrite]]
*[[Sodium nitroprusside]]
*[[Spironolactone]]
*[[Splenic rupture]]
*[[Streptokinase]]
*[[Sulphonamides]]
*[[superior mesenteric artery|Superior mesenteric artery occlusion]]
*[[Supraventricular tachycardia]]
*[[Syncope]]
*[[Syphilis]]
*[[Syringomyelia]]
*[[candidiasis|Systemic candidiasis]]
*[[Tabes dorsalis]]
*[[Tacrine]]
*[[Tadalafil]]
*[[Tamsulosin]]
*[[Tension pneumothorax]]
*[[Terazosin]]
*[[Terbufos]]
*[[Tetrabenazine]]
*[[pyrophosphate|Tetraethyl pyrophosphate]]
*[[Tetralogy of Fallot]]
*[[Tetrodotoxin]]
*[[Thoracic aortic aneurysm]]
*[[Tizanidine]]
*[[Tobacco]]
*[[Tolazoline]]
*[[Toxic shock syndrome]]
*[[Toxoplasmosis]]
*[[Tramadol]]
*[[Transfusion reaction]]
*[[Trauma]]
*[[shock|Traumatic shock]]
*[[Treprostinil]]
*[[Tricuspid stenosis]]
*[[Tricyclic antidepressants]]
*[[Trifluperidol]]
*[[Trimethaphan]]
*[[Trimipramine]]
*[[Triple A syndrome]]
*[[Tropical sprue]]
*[[Tuberculous pericarditis]]
*[[Tubocurarine]]
*[[Ulcerative colitis]]
*[[Urapidil]]
*[[Uremic pericarditis]]
*[[Urticaria]]
*[[Uterine rupture]]
*[[Valsartan]]
*[[Vancomycin resistant enterococcal bacteremia]]
*[[Vardenafil]]
*[[Variceal bleeding]]
*Vascular neuropathy
*[[Vasovagal syncope]]
*[[Ventricular familial preexcitation syndrome]]
*[[Ventricular fibrillation]]
*[[Verapamil]]
*[[Vertebral fracture]]
*[[Vibrio vulnificus]]
*[[pericarditis|Viral pericarditis]]
*[[VLCAD deficiency]]
*[[Volume depletion]]
*[[Vomiting]]
*Wasp bite
*[[Waterhouse-Friederichsen syndrome]]
*[[Weil syndrome]]
*[[Wohlwill-Andrade syndrome]]
*[[WPW syndrome]]
*[[Xamoterol]]
*X-ray studies using contrast media
*[[Zero gravity]]
*[[Ziconotide]]
*[[Zotepine]]
{{col-end}}
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*[[Adenine phosphoribosyltransferase deficiency]]
*[[Allopurinol]]
*[[Aniline]]
*[[Behcet's disease]]
*[[Benign prostatic hyperplasia]]
*[[Benzidine]]
*[[Bladder incontinence]]
*[[Bladder stones]]
*[[Bleomycin]]
*[[Candida]]
*[[Carbenicillin]]
*[[Cetirizine]]
*[[Chemical cystitis]]
*[[Chlamydia]]
*[[Chlordimeform]]
*[[Congenital abnormalities of the urinary tract]]
*[[Crohn's disease]]
*[[Cyclophosphamide]]
*[[Cystoscopy]]
*[[Danazol]]
*[[Dehydration]]
*[[Diabetes]]
*[[Diabetic neuropathy]]
*[[Diaphragm]]
*[[Diarrhea]]
*[[Diverticulitis]]
*[[Doxorubicin]]
*[[Drug induced cystitis]]
*[[Endometriosis]]
*[[Enterobacter]]
*[[Episiotomy scar infection]]
*[[Escherichia coli]]
*[[Ether]]
*[[Foreign body cystitis]]
*[[Gonorrhea]]
*[[carcinoma|Gynecological cancers]]
*[[Hemorrhagic cystitis]]
*[[Honeymoon cystitis]]
*[[Hunner's ulcer]]
*[[Ifosfamide]]
*[[Immobility]]
*[[Interstitial cystitis]]
*[[acetic acid|Intravesical acetic acid]]
*[[Kidney stones]]
*[[Klebsiella]]
*[[Lupus]]
*[[Methaqualone]]
*[[Methenamine mandelate]]
*[[Methicillin]]
*[[Methotrexate]]
*[[Mucoepithelial dysplasia, Witkop type]]
*[[nonoxynol-9|Nonoxynol-9 suppositories]]
*[[NSAIDS]]
*[[Penicillin VK]]
*[[Penicillins]]
*[[PID]]
*[[Piperacillin]]
*[[Posterior urethral valves]]
*[[Prostatitis]]
*[[Pseudomonas aeruginosa]]
*[[Radiotherapy]]
*[[Schistosomiasis]]
*[[Serratia]]
*[[Sexually transmitted diseases]]
*[[spermicide|Spermicidal jellies]]
*[[Spinal cord injury]]
*[[Staphylococcus saprophyticus]]
*[[Tampon]]
*[[Temozolomide]]
*[[Tiaprofenic acid]]
*[[Ticarcillin]]
*[[Toluidine]]
*[[Trichomoniasis]]
*[[Tuberculosis]]
*[[Urachal cancer]]
*[[Urachal cyst]]
*[[Urethral syndrome]]
*[[Urethritis]]
*[[Urinary catheter]]
*[[Urinary obstruction]]
*[[Urinary stones]]
*[[Urofacial syndrome]]
*[[Vesicoenteric fistula]]
*[[Xanthinuria]]
==References==
{{Reflist|2}}


==Overview==
==Overview==

Latest revision as of 02:18, 14 September 2017

Diagnosis Incidence Onset Common symptom
Polycystic ovary syndrome

Idiopathic hirsutism

Congenital adrenal hyperplasia

❑ Ovarian and androgen secreting tumors

❑ Drug induced

HAIR-AN Syndrome

❑ 70-85%

❑ 5-15%

❑ 1-8%

❑ 0.3-0.1%


❑ 0.5-1%


❑ 3-4%

❑ PCOS insidious

❑ Idiopathic hirsutism Insidious
❑ CAH rapid

❑ Tumors rapid



❑ HAIRAN syndrome insidious

❑ Irregular menses, hyperandrogenism, polycystic ovary
❑ No other known cause, normal ovaries, normal anbdrogens


❑ Total testosterone > 200ng and does not respond to treatment

❑ Related to medications (steroids, danazol etc)

❑ Subset of PCOS with insulin resistance and acanthosis nigricans










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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Hirsutism (from Latin hirsutus = shaggy, hairy) is defined as excessive and increased hair growth in women in locations where the occurrence of terminal hair normally is minimal or absent. It refers to a male pattern of body hair (androgenic hair) and it is therefore primarily of cosmetic and psychological concern. Hirsutism is a symptom rather than a disease and may be a sign of a more serious medical indication, especially if it develops well after puberty.

Appearance and evaluation

Hirsutism only affects women, since the rising of androgens causes a male pattern of body hair, particularly in locations where women normally do not develop terminal hair within their puberty (chest, abdomen, back and face). The medical term for excessive hair growth that affect both men and women is hypertrichosis.

One method of evaluating hirsutism is the Ferriman-Gallwey score which gives a score based on the amount and location of hair growth on a woman.

Etiology

The cause of hirsutism can be either an increased level of androgens (male hormones) or an oversensitivity of hair follicles to androgens. Male hormones such as testosterone stimulate hair growth, increase size and intensify the pigmentation of hair. Other symptoms associated with a high level of male hormones include acne and deepening of the voice and increased muscle mass.

Growing evidence implicates high circulating levels of insulin in women to the development of hirsutism. This theory is consistent with the observation that obese (and thus presumably insulin resistant hyperinsulinemic) women are at high risk of becoming hirsute. Further, treatments that lower insulin levels will lead to a reduction in hirsutism.

It is speculated that insulin, at high enough concentration, stimulates the ovarian theca cells to produce androgens. There may also be an effect of high levels of insulin to activate the insulin-like growth factor-I (IGF-1) receptor in those same cells. Again, the result is increased androgen production.

The following may be some of the conditions that may increase a woman's normally low level of male hormones:

Physical Examination

Skin

hirsuitism (PCOS, Cushing's Syndrome, Phenytoin, Leydig Cell Tumor) [1]

Differential Diagnosis of Causes of Sandbox Ochuko

  1. Idiopathic:
    • familial,
    • possibly increased sensitivity to androgens.
  2. variant of normal menopause.
  3. Polycystic ovarian syndrome.
  4. obesity
  5. Drugs:
    • androgens,
    • anabolic steroids,
    • methyltestosterone,
    • minoxidil,
    • diazoxide,
    • phenytoin,
    • glucocorticoids,
    • cyclosporine.
    • phenytoin,
  6. Congenital adrenal hyperplasia.
  7. Adrenal virilizing tumor.
  8. Ovarian virilizing tumor:
    • arrhenoblastoma,
    • hilus cell tumor.
  9. Pituitary adenoma.
  10. pregnancy
  11. Insulin resistance
  12. Cushing's syndrome.
  13. Hypothyroidism (congenital and juvenile).
  14. Acromegaly.
  15. Androgen-secreting tumors of the ovaries
    • Sertoli-Leydig cell tumors,
    • granulosa-theca cell tumors,
    • hilus-cell tumors
  16. hyperprolactinemia
  17. Testicular feminization.

Treatment

Many women with unwanted hair seek methods of hair removal to control the appearance of hirsutism. But the actual causes should be evaluated by physicians, who can conduct blood tests, pinpoint the specific origin of the abnormal hair growth, and advise on the best course of treatment.

See also

References

  • Ferriman D, Gallwey JD: Clinical assessment of body hair growth in women. Journal of Clinical Endocrinology 1961; 21:1440-1447.




bg:Хирзутизъм de:Hirsutismus et:Hirsutism id:Hirsutisme nl:Hirsutisme


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Primary treatment option
Atropine
❑ Administer a first dose 0.5 mg IV bolus
❑ Repeat every 3-5 minutes
❑ Administer a maximum dose of 3 mg
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Secondary treatment options
If atropine ineffective:
❑ Administer dopamine infusion (2-10 mcg/kg/min)
OR
❑ Administer epinephrine infusion (2-10 mcg/min)
OR
❑ Proceed with transcutaneous pacing
 
 
 
 
 
 
 
 
 
 
 
 
 
 
❑ Consult a cardiologist
❑ Consider transvenous pacing
 
 
 
 
 
 




Overview

Causes

Life Threatening Causes

Common Causes

Diagnosis

Focused Initial Rapid Evaluation

Complete Evaluation

 
 
 
 
 
 
 
 
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Treatment

Do's

Don'ts

References

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