Articles on Medical Diseases and Conditions

Onset of normal puberty in girls is somewhat variable, with disagreement in the literature concerning at what age to diagnose precocious puberty and at what age to suspect delayed puberty. The most generally agreed-on range of onset for female puberty is between 9 and 16 years. Signs of puberty include breast development, growth of pubic […]

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 […]

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 […]

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 […]

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 […]

This chapter will begin with adrenal cortex hormones and conclude with adrenal medulla hormones. The adrenal medulla produces epinephrine and norepinephrine. The relationships of the principal adrenal cortex hormones, their actions, and their metabolites are shown in Fig. 30-1. The adrenal cortex is divided into three areas. A narrow outer (subcapsular) region is known as […]