disorders of adrenals

M.Prasad NaiduMSc Medical Biochemistry,

Ph.D.Research Scholar

Disorders of adrenal glandsHyperactivity:-1. Cushing’s syndrome2. Hyperaldosteronism3. Adrenogenital syndromeHypoactivity:-1. chronic adrenal insufficiency:Addison’s disease2. acute adrenal insufficiency: Addisonian crisis or Adrenal

crisis3. Congenital adrenal hyperplasia

Cushing’s syndromeA disorder characterized by obesity due to

hypersecretion of GCs.Causes:-Due to excessive secretion of GCs.Particularly due to oversecretion of cortisolIf it is due to pituitary origincushing’s DiIf it is due to adrenal origin cushing’s Sy

Pituitary origin(cushing’s disease) ↑ of ACTH causes secretion of GCs↑Elevation of ACTH secretion occurs due to1. Tumor in pituitary cells particularly in basophils

which secrete ACTH.2. cancer of lungs3. hypothalamic disorder causing CRF↑

Adrenal origin(cushing’s syndrome)Increased secretion of Cortisol occurs in the following

conditions.1. Tumor in zona fasciculata of A.cortex.2. carcinoma of adrenal cortex.3. Treatment with excessive dose of ACTH which

stimulates A.cortex excessively.4. Treatment with excessive GCs can also cause

Cushing’s syndrome.

symptomsthere is redistribution of fat in abnormal manner (pot

belly)Obesity affecting the faceThe muscles become weak bcos of protein depletion.Osteoporosis develops and bones become susceptable to

fracture.Hyperglycemia due to gluconeogenesisHyperglycemia leads to glucosuria and adrenal diabetes.Hypertension.

Addison’s diseaseCauses:- failure of a.cortex to secrete corticosteroids

occurs due to the following:1. atrophy of A.cortex due to autoimmune diseases2. destruction of the gland during TB3. destruction of hormone secreting cells in A.cortex by

malignant tissues.4. congenital failure to secrete cortisol5. failure of anterior pituitary6. lesion in area of hypathalamus where corticotropin

releasing hormone is produced.

Signs and symptomsPigmentation of skin & mucus membraneMuscular weaknessHypotensionHypoglycemiaNausea, vomitting & diarrhea (if prolonged leads to

dehydration & loss of body wt.)Susceptibility to any type of infection and Inability to withstand any stress↓cardiac output and decreased workload of the heart

leading to decrease in the size of heart.