PATIENTS WITH

ADRENAL DISORDERS

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 ADRENOCORTICAL INSUFFICIENCY
(ADDISON’S DISEASE)

Adrenal insufficiency is an endocrine—or

hormonal—disorder that occurs when the adrenal
glands do not produce enough of certain
hormones. The adrenal glands are located just
above the kidneys.

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• Results when adrenal cortex function is
inadequate to meet the patient’s need for
cortical hormones.
• Autoimmune or idiopathic atrophy of the
adrenal glands
• Other causes includes surgical removal of
both adrenal glands or infection of the
adrenal glands
• Inadequate secretion of ACTH from the
pituitary gland also results in adrenal
insufficiency because of decreased
stimulation of the adrenal cortex.
• Therapeutic use of corticosteroids is the
most common cause of adrenocortical
insufficiency.
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The symptoms of adrenal insufficiency usually
begin gradually. The most common symptoms are
• chronic, worsening fatigue
• muscle weakness
• loss of appetite
• weight loss
Other symptoms can include
• nausea
• vomiting
• diarrhea
• low blood pressure that falls further when
standing, causing dizziness or fainting
• irritability and depression
• a craving for salty foods due to salt loss
• hypoglycemia, or low blood glucose
• headache
• sweating
• in women, irregular or absent menstrual periods
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Symptoms of an Addisonian or
“adrenal” crisis include:

• sudden, penetrating pain in the lower

back, abdomen, or legs
• severe vomiting and diarrhea
• dehydration
• low blood pressure
• loss of consciousness
If not treated, an Addisonian crisis can
be fatal.
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•Adrenal insufficiency is most
often diagnosed through blood or
urine tests. Imaging studies such
as x rays, ultrasound,
computerized tomography (CT),
and magnetic resonance imaging
(MRI) may also be used.

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CUSHING’S SYNDROME
Cushing’s syndrome is a hormonal disorder caused by
prolonged exposure of the body’s tissues to high levels of the
hormone cortisol. Sometimes called hypercortisolism,
Cushing’s syndrome is relatively rare and most commonly
affects adults aged 20 to 50. People who are obese and have
type 2 diabetes, along with poorly controlled blood glucose—
also called blood sugar—and high blood pressure, have an
increased risk of developing the disorder.

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CLINICAL MANIFESTATIONS:

• Central type obesity, with a fatty buffalo hump in the neck

and supraclavicular areas
• Heavy trunk and thin extremities
• Moon- faced
• Virilization – appearance of masculine traits and the
recession of feminine traits.
• Hirsutism (excessive hair growth on the face)
• Breast atrophy
• Menses ceases
• Clitoris enlarges
• Voice deepens
• Libido is lost in male and female
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DIAGNOSTIC TEST:

• 24-hour urinary free cortisol level

• Midnight plasma cortisol and late-

night salivary cortisol
measurements

• Low-dose dexamethasone
suppression test (LDDST)

• Dexamethasone-corticotropin-
releasing hormone (CRH)
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