Female hirsutism is a relatively common problem in which the overriding concern of the physician is to rule out an ovarian or adrenal tumor. The type and distribution of hair can be used to differentiate physiologic hair growth from nonphysiologic growth (hirsutism). In females there are two types of hair: fine, thin, nonpigmented vellus hair […]
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 Long-term steroid therapy causes adrenal cortex atrophy from disuse, and if steroids are abruptly withdrawn, symptoms of adrenal failure may develop rapidly.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 […]
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 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 […]
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 […]
