Cushing’s syndrome

Cushing’s syndrome Can be caused by exogenous admin, over production of ACTH by the pituitary gland causes adrenal hyperplasia Can be caused by excessive ACHT production resulting from a tumor (usually in the pancreas, thyroid or lung) May be either ACTH-dependent or ACTH-independent S/S:  buffalo hump & supraclavicular fat pads, stretch lines on the stomach … Continue reading

Hyperaldosteronism

Primary hyperaldosteronism is caused by a physiologic abnormality of the adrenal cortex More common in women ages 30-50 S/S:  Arterial HTN, muscle weakness, fatigue, tetany, parasthesia, paralysis, headache, reduced glucose tolerance, metabolic alkalosis, nocturnal polyuria, polydipsia, most ppl are asymptomatic Diagnostic test:  Serum K < 3.5 mEq/L   +  Urinary K > 30 mEq/24 hours Saline loading … Continue reading

Addison’s Disease

Addison’s Disease is a primary adrenal insufficiency. Results from the destruction of the adrenal cortex from idiopathic etiology (unknown cause) Half of addison’s patients have multiple endocrine related disorders (ex. Ovary, thyroid, pancreas, parathyroid gland) Addison’s patients are deficient in cortisol, aldosterone, & various other androgens that may be produced by these endocrine organs Can … Continue reading

Primary Vs. Secondary Adrenal Insufficiency

Relative Potencies of Glucocorticoids

Addisonian Crisis

Acute adrenal insufficiency (endocrine emergency requiring hospitalization) Seen in patients with adrenal or pituitary insufficiency Can be triggered by an event such as stress, surgery, infection or trauma Most commonly caused by the chronic use of exogenous glucocorticoids followed by an abrupt withdrawal which causes hypotalamic-pituitary-adrenal axis (HPA_ suppression Symptoms:  weakness, weight loss, GI symptoms, … Continue reading

Hypoaldosteronism

Low levels of aldosterone usually associated w/ low renin status, diabetes, complete heart block, orthostatic hypotension, status post tumor removal Labs:  hyponatremia, hyperkalemia, hyper-Cl metabolic acidosis Correct mineralocorticoid deficiency:  fludrocortisone 0.1-0.3 mg PO QD Need to monitor BP & electrolytes