Articles on Medical Diseases and Conditions

Entries for the ‘Adrenal Function Tests’ Category

Adrenal and Nonadrenal Causes of Hypertension

Cushing’s syndrome, primary aldosteronism, unilateral renal disease (rarely, bilateral renal artery stenosis), and pheochromocytoma often produce hypertension. Hypertension due to these diseases is classified as secondary hypertension, in contrast to primary idiopathic (essential) hypertension. Although patients with these particular diseases that cause secondary hypertension are a relatively small minority of hypertension patients, the diseases are […]

Adrenal Medulla Dysfunction

The only syndrome in this category is produced by pheochromocytomas. Pheochromocytoma is a tumor of the adrenal medulla that frequently secretes epinephrine or norepinephrine. This causes hypertension, which may be continuous (about 30% of patients) or in short episodes (paroxysmal). Although rare, pheochromocytoma is one of the few curable causes of hypertension and so should […]

Hyporeninemic Hypoaldosteronism

Another adrenal cortex deficiency disease is hyporeninemic hypoaldosteronism. Since this condition is usually due to a deficiency of renin, the disorder is a secondary rather than a primary defect in aldosterone secretion. The characteristic laboratory feature is hyperkalemia, and the condition is usually discovered when a patient is found to have hyperkalemia not due to […]

Secondary Adrenal Insufficiency

Secondary adrenal insufficiency is due to deficient production of ACTH by the pituitary. This usually results from pituitary disease but is occasionally due to hypothalamic disorders. In general, primary adrenocortical insufficiency (Addison’s disease) is associated with inability of the adrenal to produce either cortisol or aldosterone. In addition, there may be cutaneous hyperpigmentation due to […]

Addison’s Disease

Addison’s disease is primary adrenocortical insufficiency from bilateral adrenal cortex destruction. Tuberculosis used to be the most frequent etiology but now is second to autoimmune disease atrophy. Long-term steroid therapy causes adrenal cortex atrophy from disuse, and if steroids are abruptly withdrawn, symptoms of adrenal failure may develop rapidly. This is now the most common […]

Primary Aldosteronism

Aldosterone is the major electrolyte-regulating steroid of the adrenal cortex. Production is stimulated by ACTH but is also influenced by serum sodium or potassium levels. In addition, aldosterone can be secreted under the influence of the renin-angiotensin system in quantities sufficient to maintain life even without ACTH. In plasma, some aldosterone is probably bound to […]

Cushing’s Syndrome. Part 2

48-hour dexamethasone suppression test. The 48-hour DST is the most widely used confirmatory procedure. Dexamethasone (Decadron) is a synthetic steroid with cortisone-like actions but is approximately 30 times more potent than cortisone, so that amounts too small for laboratory measurement may be given to suppress pituitary ACTH production. The test is preceded by two consecutive […]

Cushing’s Syndrome. Part 1

Cushing’s syndrome is caused by excessive body levels of adrenal glucocorticoids such as cortisol, either from (primary) adrenal cortex overproduction or from (secondary) therapeutic administration. This discussion will consider only the primary type due to excess adrenal production of cortisol. About 70% of cases (range 50%-80%) of Cushing’s syndrome due to adrenal overproduction of cortisol […]

Virilization Syndrome

This rare syndrome occurs in older children and in adults. It is manifested by virilism in females and by excessive masculinization in males. It may be due to idiopathic adrenal cortex hyperplasia, adrenal cortex adenoma, or cortex carcinoma. Tumor is more common than hyperplasia in these patients. Virilism in a female child or adult leads […]

Congenital Adrenal Hyperplasia

Congenital adrenal hyperplasia (CAH), also known as the “adrenogenital syndrome,” is an uncommon condition caused by a congenital defect in one of several enzymes that take part in the chain of reactions whereby cortisol is manufactured from its precursors. There are at least six fairly well-defined variants of CAH that result from the various enzyme […]