Adrenal gland disorder

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Adrenal gland disorder
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Adrenal gland disorders (or diseases) are conditions that interfere with the normal functioning of the adrenal glands. [1] Your body produces too much or too little of one or more hormones when you have an adrenal gland dysfunction. The type of issue you have and the degree to which it affects your body's hormone levels determine the symptoms. [2]

Contents

The adrenal gland produces hormones that affects growth, development and stress, and also helps to regulate kidney function. There are two parts of the adrenal glands, the adrenal cortex and the adrenal medulla. The adrenal cortex produces mineralocorticoids, which regulate salt and water balance within the body, glucocorticoids (including cortisol) which have a wide number of roles within the body, and androgens, hormones with testosterone-like function. [3] The adrenal medulla produces epinephrine (adrenaline) and norepinephrine (noradrenaline). [3]

Tumors of the adrenal gland

Adrenal adenoma

Adrenal adenomas are benign tumors that start in the cortex of the adrenal gland. They fall into one of two categories: functional or non-secreting. Adenomas that are nonfunctional or have modest levels of hormone secretion may not show any symptoms at all and may remain asymptomatic. But adenomas with high levels of hormones frequently show up with primary hyperaldosteronism, Cushing syndrome, or hyperandrogenism symptoms. [4]

Adrenocortical carcinoma

Adrenocortical carcinoma, (ACC), is cancer that develops in the adrenal glands' cortex, or outer layer. [5] Adrenocortical carcinoma usually occurs randomly, independent of a genetic predisposition. [6] The majority of patients' primary complaints at first are indications and manifestations of excess hormones. [7] Due to local tumor growth, some patients have vague symptoms such as flank or abdominal pain, fullness in the abdomen, or early satiety. [8]

Adrenal incidentaloma

An adrenal incidentaloma is a mass lesion larger than 1 cm in diameter that was unintentionally found through radiologic examination. [9] In patients who do not yet have a confirmed cancer diagnosis, adrenal incidentaloma is infrequently caused by malignancy. [10]

Pheochromocytoma

Pheochromocytoma originates from chromaffin cells and is a kind of neuroendocrine tumor. [11] Pheochromocytomas are generally benign. 10% to 15% of pheochromocytomas have the potential to be cancerous. [12]

Hereditary disorders associated with adrenal tumors

Von Hippel–Lindau disease

Von Hippel–Lindau disease is a rare genetic multi-system disorder where certain body parts develop non-cancerous tumors. [13] Pheochromocytomas are a particular kind of tumor that are linked to von Hippel-Lindau syndrome. VHL gene mutations result in von Hippel-Lindau syndrome. [14]

Multiple endocrine neoplasia

Multiple endocrine neoplasia results in tumors or overgrowth on one or more endocrine glands. [15] Multiple endocrine neoplasia is classified into three main forms: type 1, type 2, and type 4. Multiple endocrine neoplasia can be brought on by mutations in the MEN1, RET, and CDKN1B genes. [16]

Disorders of hormone over/under-production

Addison's disease

Addison's disease, or primary adrenal insufficiency, is an uncommon chronic illness characterized by insufficient production of cortisol and aldosterone by the adrenal glands. [17] Chronic primary adrenal insufficiency is typically characterized by an extended period of malaise, fatigue, anorexia, weight loss, joint and back pain, and skin darkening. Mineralocorticoid and glucocorticoid hormone deficiency must be physiologically replaced in order to treat primary adrenal insufficiency. [18]

Adrenal crisis

Adrenal crisis is a serious, life-threatening complication of adrenal insufficiency. Hypotension, or hypovolemic shock, is the main symptom of adrenal crisis, other indications and symptoms include weakness, anorexia, nausea, vomiting, fever, fatigue, abnormal electrolytes, confusion, and coma. [19] Laboratory testing may detect lymphocytosis, eosinophilia, hyponatremia, hyperkalemia, hypoglycemia, and on occasion, hypercalcemia. [20]

Adrenal insufficiency

Adrenal insufficiency is the clinical sign of insufficient glucocorticoid production or action, with or without concurrent insufficiency in mineralocorticoids and adrenal androgens. [21] Adrenocorticotropic hormone deficiency or exogenous glucocorticoid or opioid medication suppression of adrenocorticotropic hormone can cause adrenal insufficiency, as can primary adrenal disorders. Unintentional weight loss, anorexia, postural hypotension, extreme exhaustion, muscle and abdominal pain, and hyponatraemia are characteristic clinical features. [22]

Congenital adrenal hyperplasia

Congenital adrenal hyperplasia is a group of autosomal recessive disorders characterized by impaired cortisol synthesis. [23] [24] It results from the deficiency of one of the five enzymes required for the synthesis of cortisol in the adrenal cortex. [25] Most of these disorders involve excessive or deficient production of hormones such as glucocorticoids, mineralocorticoids, or sex steroids, [26] [24] and can alter development of primary or secondary sex characteristics in some affected infants, children, or adults. [27]

Cushing's disease

Cushing's disease is an illness where an excess of adrenocorticotropic hormone (ACTH) is released by the pituitary gland. Cushing syndrome can be brought on by Cushing disease. [28]

Hyperaldosteronism

Hyperaldosteronism is caused by the adrenal gland's overproduction of the hormone aldosterone. The excess production of the adrenal gland, specifically the zona glomerulosa, is the cause of primary hyperaldosteronism. Excessive renin-angiotensin-aldosterone system activation results in secondary hyperaldosteronism. [29]

Hypoaldosteronism

Hypoaldosteronism is a clinical condition marked by either an aldosterone deficiency or impaired tissue-level action of the hormone. Angiotensin I to Angiotensin II conversion, adrenal aldosterone synthesis and secretion, abnormal target tissue response to aldosterone, and renal renin production and secretion are all potential causes of the disorder. [30]

Notable people with adrenal gland disorders

See also

Related Research Articles

<span class="mw-page-title-main">Adrenal gland</span> Endocrine gland

The adrenal glands are endocrine glands that produce a variety of hormones including adrenaline and the steroids aldosterone and cortisol. They are found above the kidneys. Each gland has an outer cortex which produces steroid hormones and an inner medulla. The adrenal cortex itself is divided into three main zones: the zona glomerulosa, the zona fasciculata and the zona reticularis.

<span class="mw-page-title-main">Multiple endocrine neoplasia</span> Group of genetic conditions

Multiple endocrine neoplasia is a condition which encompasses several distinct syndromes featuring tumors of endocrine glands, each with its own characteristic pattern. In some cases, the tumors are malignant, in others, benign. Benign or malignant tumors of nonendocrine tissues occur as components of some of these tumor syndromes.

<span class="mw-page-title-main">Addison's disease</span> Endocrine disorder

Addison's disease, also known as primary adrenal insufficiency, is a rare long-term endocrine disorder characterized by inadequate production of the steroid hormones cortisol and aldosterone by the two outer layers of the cells of the adrenal glands, causing adrenal insufficiency. Symptoms generally come on slowly and insidiously and may include abdominal pain and gastrointestinal abnormalities, weakness, and weight loss. Darkening of the skin in certain areas may also occur. Under certain circumstances, an adrenal crisis may occur with low blood pressure, vomiting, lower back pain, and loss of consciousness. Mood changes may also occur. Rapid onset of symptoms indicates acute adrenal failure, which is a clinical emergency. An adrenal crisis can be triggered by stress, such as from an injury, surgery, or infection.

<span class="mw-page-title-main">Primary aldosteronism</span> Medical condition

Primary aldosteronism (PA), also known as primary hyperaldosteronism, refers to the excess production of the hormone aldosterone from the adrenal glands, resulting in low renin levels and high blood pressure. This abnormality is caused by hyperplasia or tumors. About 35% of the cases are caused by a single aldosterone-secreting adenoma, a condition known as Conn's syndrome.

<span class="mw-page-title-main">Adrenal insufficiency</span> Medical condition

Adrenal insufficiency is a condition in which the adrenal glands do not produce adequate amounts of steroid hormones. The adrenal glands—also referred to as the adrenal cortex—normally secrete glucocorticoids, mineralocorticoids, and androgens. These hormones are important in regulating blood pressure, electrolytes, and metabolism as a whole. Deficiency of these hormones leads to symptoms ranging from abdominal pain, vomiting, muscle weakness and fatigue, low blood pressure, depression, mood and personality changes to organ failure and shock. Adrenal crisis may occur if a person having adrenal insufficiency experiences stresses, such as an accident, injury, surgery, or severe infection; this is a life-threatening medical condition resulting from severe deficiency of cortisol in the body. Death may quickly follow.

<span class="mw-page-title-main">Adrenocortical carcinoma</span> Medical condition

Adrenocortical carcinoma (ACC) is an aggressive cancer originating in the cortex of the adrenal gland.

<span class="mw-page-title-main">Hyperandrogenism</span> Medical condition

Hyperandrogenism is a medical condition characterized by high levels of androgens. It is more common in women than men. Symptoms of hyperandrogenism may include acne, seborrhea, hair loss on the scalp, increased body or facial hair, and infrequent or absent menstruation. Complications may include high blood cholesterol and diabetes. It occurs in approximately 5% of women of reproductive age.

<span class="mw-page-title-main">Multiple endocrine neoplasia type 1</span> Medical condition

Multiple endocrine neoplasia type 1 (MEN-1) is one of a group of disorders, the multiple endocrine neoplasias, that affect the endocrine system through development of neoplastic lesions in pituitary, parathyroid gland and pancreas. Individuals suffering from this disorder are prone to developing multiple endocrine and nonendocrine tumors. It was first described by Paul Wermer in 1954.

<span class="mw-page-title-main">Multiple endocrine neoplasia type 2</span> Medical condition

Multiple endocrine neoplasia type 2 is a group of medical disorders associated with tumors of the endocrine system. The tumors may be benign or malignant (cancer). They generally occur in endocrine organs, but may also occur in endocrine tissues of organs not classically thought of as endocrine. MEN2 is a sub-type of MEN and itself has sub-types, as discussed below. Variants in MEN2A have been associated with Hirschsprung disease. Screening for this condition can begin as young as eight years old for Pheochromocytoma.

<span class="mw-page-title-main">Hypoaldosteronism</span> Medical condition

Hypoaldosteronism is an endocrinological disorder characterized by decreased levels of the hormone aldosterone. Similarly, isolated hypoaldosteronism is the condition of having lowered aldosterone without corresponding changes in cortisol.

Secondary hypertension is a type of hypertension which has a specific and identifiable underlying primary cause. It is much less common than essential hypertension, affecting only 5-10% of hypertensive patients. It has many different causes including obstructive sleep apnea, kidney disease, endocrine diseases, and tumors. The cause of secondary hypertension varies significantly with age. It also can be a side effect of many medications.

<span class="mw-page-title-main">Adrenalectomy</span> Surgical removal of adrenal glands

Adrenalectomy is the surgical removal of one or both adrenal glands. It is usually done to remove tumors of the adrenal glands that are producing excess hormones or is large in size. Adrenalectomy can also be done to remove a cancerous tumor of the adrenal glands, or cancer that has spread from another location, such as the kidney or lung. Adrenalectomy is not performed on those who have severe coagulopathy or whose heart and lungs are too weak to undergo surgery. The procedure can be performed using an open incision (laparotomy) or minimally invasive laparoscopic or robot-assisted techniques. Minimally invasive techniques are increasingly the gold standard of care due to shorter length of stay in the hospital, lower blood loss, and similar complication rates.

<span class="mw-page-title-main">Endocrine disease</span> Medical condition

Endocrine diseases are disorders of the endocrine system. The branch of medicine associated with endocrine disorders is known as endocrinology.

<span class="mw-page-title-main">Adrenal tumor</span> Medical condition

An adrenal tumor or adrenal mass is any benign or malignant neoplasms of the adrenal gland, several of which are notable for their tendency to overproduce endocrine hormones. Adrenal cancer is the presence of malignant adrenal tumors, and includes neuroblastoma, adrenocortical carcinoma and some adrenal pheochromocytomas. Most adrenal pheochromocytomas and all adrenocortical adenomas are benign tumors, which do not metastasize or invade nearby tissues, but may cause significant health problems by unbalancing hormones.

<span class="mw-page-title-main">Adrenocortical adenoma</span> Medical condition

An adrenocortical adenoma or adrenal adenoma is commonly described as a benign neoplasm emerging from the cells that comprise the adrenal cortex. Like most adenomas, the adrenocortical adenoma is considered a benign tumor since the majority of them are non-functioning and asymptomatic. Adrenocortical adenomas are classified as ACTH-independent disorders, and are commonly associated with conditions linked to hyperadrenalism such as Cushing's syndrome (hypercortisolism) or Conn's syndrome (hyperaldosteronism), which is also known as primary aldosteronism. In addition, recent case reports further support the affiliation of adrenocortical adenomas with hyperandrogenism or florid hyperandrogenism which can cause hyperandrogenic hirsutism in females. "Cushing's syndrome" differs from the "Cushing's disease" even though both conditions are induced by hypercortisolism. The term "Cushing's disease" refers specifically to "secondary hypercortisolism" classified as "ACTH-dependent Cushing's syndrome" caused by pituitary adenomas. In contrast, "Cushing's syndrome" refers specifically to "primary hypercortisolism" classified as "ACTH-independent Cushing's syndrome" caused by adrenocortical adenomas.

The ACTH test is a medical test usually requested and interpreted by endocrinologists to assess the functioning of the adrenal glands' stress response by measuring the adrenal response to adrenocorticotropic hormone or another corticotropic agent such as tetracosactide or alsactide (Synchrodyn). ACTH is a hormone produced in the anterior pituitary gland that stimulates the adrenal glands to release cortisol, dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulfate (DHEA-S), and aldosterone.

Hypoadrenocorticism in dogs, or, as it is known in people, Addison's disease, is an endocrine system disorder that occurs when the adrenal glands fail to produce enough hormones for normal function. The adrenal glands secrete glucocorticoids such as cortisol and mineralocorticoids such as aldosterone; when proper amounts of these are not produced, the metabolic and electrolyte balance is upset. Mineralocorticoids control the amount of potassium, sodium, and water in the body. Hypoadrenocorticism is fatal if left untreated.

Endocrine oncology refers to a medical speciality dealing with hormone producing tumors, i.e. a combination of endocrinology and oncology.

Feline hyperaldosteronism is a disease in cats. The symptoms are caused by abnormally high concentrations of the hormone aldosterone, which is secreted by the adrenal gland. The high concentrations of aldosterone may be due directly to a disorder of the adrenal gland, or due to something outside of the adrenal gland causing it to secrete excessive aldosterone.

<span class="mw-page-title-main">Adrenalism</span>

Adrenalism describes the condition of an excessive or substandard secretion of hormones related to the adrenal glands, which are found directly superior to the kidneys. Adrenalism can be further distinguished as hyperadrenalism, referring to the excessive secretion of hormones, and hypoadrenalism, referring to the insufficient secretion of hormones.

References

  1. ↑ Grossman, Ashley B. (May 2, 2022). "Hormonal and Metabolic Disorders". Merck Manuals Consumer Version. Retrieved February 9, 2024.
  2. ↑ "Adrenal Gland Disorders". National Library of Medicine. January 19, 2024. Retrieved February 9, 2024.
  3. 1 2 Adrenal Glands, Johns Hopkins Medicine Health Library.
  4. ↑ Mahmood, Ejaz; Loughner, Chelsea L.; Anastasopoulou, Catherine (August 17, 2023). "Adrenal Adenoma". StatPearls Publishing. PMID   30969728 . Retrieved February 9, 2024.
  5. ↑ Cleveland Clinic medical professional (October 11, 2017). "Adrenocortical Carcinoma: What Is It, Causes, Symptoms & Outlook". Cleveland Clinic. Retrieved February 9, 2024.
  6. ↑ "Adrenocortical Carcinoma". Johns Hopkins Medicine. December 7, 2021. Retrieved February 9, 2024.
  7. ↑ Allolio, Bruno; Fassnacht, Martin (June 1, 2006). "Adrenocortical Carcinoma: Clinical Update". The Journal of Clinical Endocrinology & Metabolism. 91 (6). The Endocrine Society: 2027–2037. doi:10.1210/jc.2005-2639. ISSN   0021-972X. PMID   16551738.
  8. ↑ Fassnacht, Martin; Allolio, Bruno (2009). "Clinical management of adrenocortical carcinoma". Best Practice & Research Clinical Endocrinology & Metabolism. 23 (2). Elsevier BV: 273–289. doi:10.1016/j.beem.2008.10.008. ISSN   1521-690X. PMID   19500769.
  9. ↑ Young, William F. (February 8, 2007). "The Incidentally Discovered Adrenal Mass". New England Journal of Medicine. 356 (6). Massachusetts Medical Society: 601–610. doi:10.1056/nejmcp065470. ISSN   0028-4793. PMID   17287480.
  10. ↑ "UpToDate". UpToDate. Retrieved February 9, 2024.
  11. ↑ "Pheochromocytoma". National Cancer Institute. February 12, 2020. Retrieved February 9, 2024.
  12. ↑ Cleveland Clinic medical professional (June 30, 2022). "Pheochromocytoma: Causes, Symptoms & Treatment". Cleveland Clinic. Retrieved February 9, 2024.
  13. ↑ "Von Hippel-Lindau Disease (VHL)". National Institute of Neurological Disorders and Stroke. November 28, 2023. Retrieved February 9, 2024.
  14. ↑ "Von Hippel-Lindau syndrome: MedlinePlus Genetics". MedlinePlus. October 1, 2018. Retrieved February 9, 2024.
  15. ↑ "Multiple Endocrine Neoplasia (MEN)". pennmedicine.org. Retrieved February 9, 2024.
  16. ↑ "Multiple endocrine neoplasia: MedlinePlus Genetics". MedlinePlus. March 1, 2017. Retrieved February 9, 2024.
  17. ↑ Cleveland Clinic medical professional (September 20, 2023). "Addison's Disease: What It Is, Causes, Symptoms & Treatment". Cleveland Clinic. Retrieved February 9, 2024.
  18. ↑ Nieman, Lynnette K.; Chanco Turner, Maria L. (2006). "Addison's disease". Clinics in Dermatology. 24 (4). Elsevier BV: 276–280. doi:10.1016/j.clindermatol.2006.04.006. ISSN   0738-081X. PMID   16828409.
  19. ↑ Bouillon R (December 2006). "Acute adrenal insufficiency". Endocrinology and Metabolism Clinics of North America. 35 (4). Elsevier BV: 767–75, ix. doi:10.1016/j.ecl.2006.09.004. PMID   17127145.
  20. ↑ Rushworth RL, Torpy DJ, Falhammar H (August 2019). "Adrenal Crisis". The New England Journal of Medicine. 381 (9): 852–861. doi:10.1056/NEJMra1807486. PMID   31461595. S2CID   263427558.
  21. ↑ Charmandari, Evangelia; Nicolaides, Nicolas C; Chrousos, George P (2014). "Adrenal insufficiency". The Lancet. 383 (9935). Elsevier BV: 2152–2167. doi:10.1016/s0140-6736(13)61684-0. ISSN   0140-6736. PMID   24503135. S2CID   205970313.
  22. ↑ Husebye, Eystein S; Pearce, Simon H; Krone, Nils P; Kämpe, Olle (2021). "Adrenal insufficiency". The Lancet. 397 (10274). Elsevier BV: 613–629. doi:10.1016/s0140-6736(21)00136-7. ISSN   0140-6736. PMID   33484633. S2CID   265816016.
  23. ↑ El-Maouche D, Arlt W, Merke DP (November 2017). "Congenital adrenal hyperplasia" (PDF). Lancet. 390 (10108): 2194–2210. doi:10.1016/S0140-6736(17)31431-9. PMID   28576284. S2CID   13737960.
  24. 1 2 Speiser PW, Arlt W, Auchus RJ, Baskin LS, Conway GS, Merke DP, Meyer-Bahlburg HFL, Miller WL, Murad MH, Oberfield SE, White PC (2018). "Congenital Adrenal Hyperplasia Due to Steroid 21-Hydroxylase Deficiency: An Endocrine Society Clinical Practice Guideline". The Journal of Clinical Endocrinology and Metabolism. 103 (11): 4043–4088. doi:10.1210/jc.2018-01865. PMC   6456929 . PMID   30272171.
  25. ↑ Speiser PW, White PC (August 2003). "Congenital adrenal hyperplasia". The New England Journal of Medicine . 349 (8): 776–88. doi:10.1056/NEJMra021561. PMID   12930931.
  26. ↑ La, Betty; Tung, Celestine; Choi, Eugene A.; Nguyen, Ha (1 November 2021). "A Gigantic Uterine Leiomyoma and Big Bilateral Adrenal Myelolipomas as a Result of Untreated Congenital Adrenal Hyperplasia". AACE Clinical Case Reports. 7 (6): 342–345. doi:10.1016/j.aace.2021.05.002. PMC   8573279 . PMID   34765728.
  27. ↑ Aubrey Milunsky; Jeff Milunsky (29 January 2010). Genetic Disorders and the Fetus: Diagnosis, Prevention and Treatment. John Wiley and Sons. pp. 600–. ISBN   978-1-4051-9087-9 . Retrieved 14 June 2010.
  28. ↑ "Cushing disease: MedlinePlus Medical Encyclopedia". MedlinePlus. Retrieved February 9, 2024.
  29. ↑ Dominguez, Alejandro; Muppidi, Vijayadershan; Gupta, Sonu (February 12, 2023). "Hyperaldosteronism". StatPearls Publishing. PMID   29763159 . Retrieved February 9, 2024.
  30. ↑ Rajkumar, Venkatraman; Waseem, Muhammad (August 7, 2023). "Hypoaldosteronism". StatPearls Publishing. PMID   32310452 . Retrieved February 9, 2024.
  31. ↑ Mandel, Lee R. (September 2009). "Endocrine and Autoimmune Aspects of the Health History of John F. Kennedy". Annals of Internal Medicine. 151 (5): 350–354. doi:10.7326/0003-4819-151-5-200909010-00011. PMID   19721023. S2CID   10969109.
  32. ↑ Upfal, Annette (2005). "Jane Austen's lifelong health problems and final illness: New evidence points to a fatal Hodgkin's disease and excludes the widely accepted Addison's". Medical Humanities . 31 (1). BMJ Publishing Group: 3–11. doi: 10.1136/jmh.2004.000193 . PMID   23674643.
  33. ↑ Marsden, Brian (1997-07-18). "Eugene Shoemaker (1928-1997)". Comet Shoemaker-Levy Collision with Jupiter. Jet Propulsion Laboratory. Archived from the original on 11 July 2007. Retrieved 2007-07-25.

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