WHAT ARE ADRENAL GLAND DISORDERS?

WHAT ARE ADRENAL GLAND DISORDERS?

  1. 1
    WHAT IS THE MEANING OF ADRENAL GLAND DISORDERS?
    • Hyperfunction of the adrenal glands involves excess production of the adrenal hormones cortisol (resulting in Cushing syndrome) or aldosterone (resulting in hyperaldosteronism).
    • Adrenal gland hypofunction is associated with primary (Addison disease) or secondary adrenal insufficiency.
  2. 2
    WHAT ARE THE CAUSES OF ADRENAL GLAND DISORDERS?
    • Cushing syndrome results from effects of supraphysiologic glucocorticoid levels originating from either exogenous administration or endogenous overproduction by the adrenal gland (adrenocorticotropic hormone [ACTH] dependent) or by abnormal adrenocortical tissues (ACTH independent).
    • ACTH-dependent Cushing syndrome (80% of all Cushing syndrome cases) is usually caused by overproduction of ACTH by the pituitary gland, causing adrenal hyperplasia. Pituitary adenomas account for about 85% of these cases (Cushing disease). Ectopic ACTH-secreting tumours and nonneoplastic corticotropin hypersecretion cause the remaining 20% of ACTH-dependent cases.
    • Ectopic ACTH syndrome refers to excessive ACTH production resulting from an endocrine or nonendocrine tumour, usually of the pancreas, thyroid, or lung (e.g., small-cell lung cancer).
    • ACTH-independent Cushing syndrome is usually caused by adrenal adenomas and carcinomas.
  3. 3
    WHAT ARE THE SIGNS AND SYMPTOMS OF ADRENAL GLAND DISORDERS?
    • The most common findings in Cushing syndrome are central obesity and facial rounding (90% of patients). Peripheral obesity and fat accumulation occur in 50% of patients. Fat accumulation in the dorsocervical area (buffalo hump) is nonspecific, but increased supraclavicular fat pads are more specific for Cushing syndrome. Patients are often described as having moon facies and a buffalo hump.
    • Other findings may include myopathy or muscular weakness, abdominal striae, hypertension, glucose intolerance, psychiatric changes, gonadal dysfunction, facial plethora (a reddish complexion), and amenorrhea and hirsutism in women.
    • Up to 60% of patients develop Cushing-induced osteoporosis; about 40% present with back pain, and 20% progress to spinal compression fractures.
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