Adrenal gland and paraganglia
Adrenal hyperfunction / hyperplasia
Adrenal hyperfunction, general

Author: Nat Pernick, M.D. (see Authors page)

Revised: 1 March 2016, last major update February 2013

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PubMed Search: Adrenal hyperfunction
Table of Contents
General
General
  • Causes are Cushing syndrome, hyperaldosteronism, adrenogenital syndrome or other congenital adrenal hyperplasia
  • May be ACTH-dependent (Cushing disease, ectopic ACTH syndrome, ectopic CRH syndrome) or independent (hyperplasia, adenoma, carcinoma, iatrogenic)
  • Symptoms: initially weight gain, hypertension; later truncal obesity, moon facies, buffalo hump (fat in posterior neck and back), atrophy of fast twitch (type 2) fibers causing muscle weakness, hyperglycemia, glucosuria, polydipsia (due to increased gluconeogenesis, reduced glucose uptake by cells), loss of collagen in proteins (fragile skin), bone resorption (osteoporosis), abdominal striae, infections, mental disturbances, hirsutism and menstrual abnormalities
  • Diagnosis: elevated 24 hour urine free cortisol, loss of diurnal pattern of cortisol secretion
  • Myelolipomatous change: may be a marker of cortisol hyperactivity