Types of adrenal steroids
·
Glucocorticoids:
act on carbohydrate metabolism
·
Mineralocorticoids:
Na, K, and fluid balance in distal kidney tubules
·
Androgens:
converted to testosterone
Addison disease (primary hypoadrenalism) 1
·
Causes: autoimmune, infiltration, TB, surgical removal,
hemorrhage/infarction, infiltration
·
Effects: Impaired glucocorticoid, mineralocorticoid, and androgen
production
Addison disease (primary hypoadrenalism) 2
· Symptoms: weight loss, anorexia, malaise, fever, weakness,
depression, impotence/amenorrhoea, nausea/vomiting, diarrhea, constipation,
confusion, syncope, abdominal pain, myalgia, joint pain
·
Signs:
pigmentation, postural hypotension,
weight loss, muscle wasting, dehydration, loss of body hair
Cushing’s syndrome (increased circulating glucocorticoids) 1
· Causes: (a) increased ACTH
from pituitary, ectopic tumors, or drug administration (b) adrenal adenoma /
carcinoma (c) iatrogenic glucocorticoid administration
·
Symptoms:
weight gain, changed appearance,
depression, insomnia, amenorrhea/oligomenorhea, poor libido, thin skin easy to
bruise, acne, muscle weakness, back pain, polyuria/polydipsia, psychosis
Cushing’s syndrome (increased circulating glucocorticoids) 2
· Signs:
short stature, moon plethoric face,
depression/psychosis, acne, hirsuitism, thin bruising skin, poor wound healing,
pigmentation, skin infections, systemic hypertension, osteoporosis,
pathological fractures, Kyphosis due to osteoporosis, truncal / central obesity (buffalo hump),
abdominal striae, rib fractures, proximal muscle weakness
