Medical condition
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]
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
References
^ Grossman, Ashley B. (May 2, 2022).
"Hormonal and Metabolic Disorders" . Merck Manuals Consumer Version . Retrieved February 9, 2024 .
^
"Adrenal Gland Disorders" . National Library of Medicine. January 19, 2024. Retrieved February 9, 2024 .
^
a
b
Adrenal Glands , Johns Hopkins Medicine Health Library.
^ Mahmood, Ejaz; Loughner, Chelsea L.; Anastasopoulou, Catherine (August 17, 2023).
"Adrenal Adenoma" . StatPearls Publishing.
PMID
30969728 . Retrieved February 9, 2024 .
^ Cleveland Clinic medical professional (October 11, 2017).
"Adrenocortical Carcinoma: What Is It, Causes, Symptoms & Outlook" . Cleveland Clinic . Retrieved February 9, 2024 .
^
"Adrenocortical Carcinoma" . Johns Hopkins Medicine . December 7, 2021. Retrieved February 9, 2024 .
^ 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 .
^ 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 .
^ 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 .
^
"UpToDate" . UpToDate . Retrieved February 9, 2024 .
^
"Pheochromocytoma" . National Cancer Institute . February 12, 2020. Retrieved February 9, 2024 .
^ Cleveland Clinic medical professional (June 30, 2022).
"Pheochromocytoma: Causes, Symptoms & Treatment" . Cleveland Clinic . Retrieved February 9, 2024 .
^
"Von Hippel-Lindau Disease (VHL)" . National Institute of Neurological Disorders and Stroke . November 28, 2023. Retrieved February 9, 2024 .
^
"Von Hippel-Lindau syndrome: MedlinePlus Genetics" . MedlinePlus . October 1, 2018. Retrieved February 9, 2024 .
^
"Multiple Endocrine Neoplasia (MEN)" . pennmedicine.org . Retrieved February 9, 2024 .
^
"Multiple endocrine neoplasia: MedlinePlus Genetics" . MedlinePlus . March 1, 2017. Retrieved February 9, 2024 .
^ Cleveland Clinic medical professional (September 20, 2023).
"Addison's Disease: What It Is, Causes, Symptoms & Treatment" . Cleveland Clinic . Retrieved February 9, 2024 .
^ 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 .
^ 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 .
^ 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 .
^ 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 .
^ 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 .
^ 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 .
^
a
b 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 .
^ 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 .
^ 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 .
^ 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 .
^
"Cushing disease: MedlinePlus Medical Encyclopedia" . MedlinePlus . Retrieved February 9, 2024 .
^ Dominguez, Alejandro; Muppidi, Vijayadershan; Gupta, Sonu (February 12, 2023).
"Hyperaldosteronism" . StatPearls Publishing.
PMID
29763159 . Retrieved February 9, 2024 .
^ Rajkumar, Venkatraman; Waseem, Muhammad (August 7, 2023).
"Hypoaldosteronism" . StatPearls Publishing.
PMID
32310452 . Retrieved February 9, 2024 .
^ 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 .
^ 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 .
^ 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 .
Further reading
External links
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