Disturbance of Suprarenal Cortex

Hyperaldosteronism (aldosteronism)

Hyperaldrenalism (Cushing Syndrome)

Hypoadrenalism (Addison's Disease)

Adrenogenital Syndrome

Hyperaldosteronism (Aldosteronism)

TYPES

    A) Primary Aldosteronism (Conn's syndrome)

          - due to Tumor of Zona Glomerulosa Cells leads to secretion  

            of large amounts of aldosterone

    B) Secondary Aldosteronism

          - Stimulation of renin-angiotensin system (eg heart failure & 

             renal failure)

          - Decreased degradation of aldosterone by liver ( eg Hepatic 

            Failure) 

CLINICAL FEATURES

1. Cardiovascular - Hypertension due to Na retention
2. Blood 

• Increase plasma [Na] - leads to increase blood volume
• Decrease plasma [K] - hypokalamia
• Excess Hydrogen secretion - Alkalosis

Hyperaldrenalism (Cushing's Syndrome) - due to increase circulating levels of glucocorticoids / increased androgen or estrogen levels

               

TYPES

     A) Primary (ACTH-independent)

            - due to adrenal adenoma / carcinoma

     B) Secondary  (ACTH dependent)

           - due to ecxcess secretion at CRH / pituitary tumor

CLINICAL FEATURES

1. Metabolic changes 
• Increased BMR
• Fat Metabolism
• Carbohydrate Metabolism
• Protein Metabolism
2. Skin changes
• development of prple Stria
• In Secondary Cushing's Syndrome, there will be Skin pigmentation & Hirsutism
3. Cardiovascular Changes
• hypertension
• Edema & Increased Capillary Fragility
4. Blood Changes
• Mild polycythemia
• Mild Lymphopenia
5. Disturbance of Reproductive Functions
• Amenorrhea (Irregular Menstruation in Females)
• Impotence (in Males)

Hypoadrenalism ( Addison's Disease)

 

CAUSES

  - failure/destruction of adrenal cortex due to :

           a) Autoimmune disease

           b) T.B

CLINICAL FEATURES

1. Metaboilic Changes ( due to cortisol deficiency)
• Decreased BMR
• Hypoglycemia
• Failure of kidney diuresis
• weakness of skeletal muscle
2. Manifestation due to aldosterone deficiency
• Excessive loss of Na in urine cause hypovolemia & hypotension
• H retention lead to acidosis
• hyperkalemia
3. Pigmentation of the skin & mucous membranes
• caused by direct action of ACTH on melanocytes 
• More prominent in 
• light expose areas (eg face , front of neck, back of hands)
• Pressure points ( eg Back of trunk, elbow, front of knee)
4. Gastrointestinal Symptoms
• anorexia, nausea,vomiting,diarrhea
5. Addisonian crisis
• Patient are exposed to stress ( eg trauma, illness, surgery), thus patient can't tolerate with it, and falls severely ill, weakened & shocked
• Treatment 
• Saline infusion
• High doses of cortisol & aldosterone
• Eliminate the stress

Adrenogenital Syndrome

CAUSES

  - Tumour of adrenal cortex that secretes excessive amounts of androgens

CLINICAL FEATURES

1. In females
• Virilism (Adult)
• appearance of male secondary sex characters
• Characterized by :
• hirsutism
• deepness of voice
• amenorrhea
• hypertrrophy of clitoris with atrophy of external genitalia
• Pseudo-Hermaphroditism (before Puberty)
• born with genetic constitution and gonads of females butt with external genitalia of males
• signs of virilism develop later in life
2. In Males
• Precocious pseudo-puberty( males before Puberty)
• early development of male secondary sex characteristic without testicular growth
• No affect (Adult)