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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