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| Adrenal gland disorder | |
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| Depiction of location ofadrenal glands in human body. | |
| Specialty | Endocrinology  |
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 anadrenal gland dysfunction. The type of issue you have and the degree to which it affects your body's hormone levels determine the symptoms.[2]
Theadrenal gland produces hormones that affects growth, development and stress, and also helps to regulate kidney function. There are two parts of theadrenal glands, theadrenal cortex and theadrenal medulla. Theadrenal cortex producesmineralocorticoids, which regulate salt and water balance within the body,glucocorticoids (includingcortisol) which have a wide number of roles within the body, andandrogens, hormones with testosterone-like function.[3] Theadrenal medulla producesepinephrine (adrenaline) andnorepinephrine (noradrenaline).[3]
Adrenal adenomas are benign tumors that start in the cortex of theadrenal 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. Butadenomas with high levels of hormones frequently show up with primaryhyperaldosteronism, Cushing syndrome, orhyperandrogenism symptoms.[4]
Adrenocortical carcinoma, (ACC), is cancer that develops in theadrenal 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 orabdominal pain, fullness in the abdomen, or early satiety.[8]
Anadrenal 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 originates fromchromaffin cells and is a kind ofneuroendocrine tumor.[11]Pheochromocytomas are generally benign. 10% to 15% ofpheochromocytomas have the potential to be cancerous.[12]
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 tovon Hippel-Lindau syndrome.VHL gene mutations result invon Hippel-Lindau syndrome.[14]
Multiple endocrine neoplasia results in tumors or overgrowth on one or moreendocrine 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 theMEN1,RET, andCDKN1B genes.[16]
Addison's disease, or primaryadrenal insufficiency, is an uncommon chronic illness characterized by insufficient production ofcortisol andaldosterone by theadrenal glands.[17] Chronic primary adrenal insufficiency is typically characterized by an extended period ofmalaise,fatigue,anorexia,weight loss, joint and back pain, and skin darkening.Mineralocorticoid andglucocorticoid hormone deficiency must be physiologically replaced in order to treat primaryadrenal insufficiency.[18]
Adrenal crisis is a serious, life-threatening complication ofadrenal insufficiency.Hypotension, orhypovolemic shock, is the main symptom of adrenal crisis, other indications and symptoms includeweakness,anorexia,nausea, vomiting, fever,fatigue, abnormalelectrolytes,confusion, and coma.[19] Laboratory testing may detectlymphocytosis,eosinophilia,hyponatremia,hyperkalemia,hypoglycemia, and on occasion,hypercalcemia.[20]
Adrenal insufficiency is the clinical sign of insufficientglucocorticoid production or action, with or without concurrent insufficiency inmineralocorticoids and adrenalandrogens.[21]Adrenocorticotropic hormone deficiency or exogenousglucocorticoid oropioid medication suppression ofadrenocorticotropic hormone can causeadrenal insufficiency, as can primary adrenal disorders. Unintentionalweight loss,anorexia,postural hypotension, extreme exhaustion, muscle andabdominal pain, andhyponatraemia are characteristic clinical features.[22]
Congenital adrenal hyperplasia is a group ofautosomal recessive disorders characterized by impairedcortisol synthesis.[23][24] It results from the deficiency of one of the fiveenzymes required for thesynthesis of cortisol in theadrenal cortex.[25] Most of these disorders involve excessive or deficient production ofhormones such asglucocorticoids,mineralocorticoids, orsex steroids,[26][24] and can alter development ofprimary orsecondary sex characteristics in some affectedinfants, children, or adults.[27]
Cushing's disease is an illness where an excess ofadrenocorticotropic hormone (ACTH) is released by thepituitary gland.Cushing syndrome can be brought on byCushing disease.[28]
Hyperaldosteronism is caused by theadrenal gland's overproduction of the hormonealdosterone. The excess production of theadrenal gland, specifically thezona glomerulosa, is the cause of primaryhyperaldosteronism. Excessiverenin-angiotensin-aldosterone system activation results in secondaryhyperaldosteronism.[29]
Hypoaldosteronism is a clinical condition marked by either analdosterone deficiency or impaired tissue-level action of the hormone.Angiotensin I to Angiotensin II conversion, adrenal aldosterone synthesis and secretion, abnormal target tissue response toaldosterone, and renalrenin production and secretion are all potential causes of the disorder.[30]