Adrenal insufficiency after operative removal of apparently nonfunctioning adrenal adenomas

Article Abstract:

Patients who have tumors of the adrenal gland are usually identified by elevated levels of circulating (blood) adrenal hormones, and depending on the type of hormones secreted by the tumor, either a masculinization (e.g., development of a beard) in women or feminization in men (e.g., development of breasts, loss of hair). With the development of imaging equipment such as CAT scanners, tumors of the adrenal gland which are asymptomatic or which do not secrete high levels of hormones are now being found. The current case study reports on two cases where patients' adrenal tumors were found without the typical display of adrenal tumor symptoms. Following surgery, these patients suffered from the lack of adrenal hormones (adrenal insufficiency). It is suspected that the tumors were capable of producing sufficient levels of adrenal hormones to suppress (via pituitary control) the normal activity of the adrenal gland on the opposite side. All patients with adrenal tumors should be examined in a manner that will allow the detection of hormonal suppression before surgery is required to detect the problem. Similarly, patients with adrenal tumors that are not treated surgically should have similar function tests performed over time.

Measurement, Physiological aspects, College admissions, Hydrocortisone, Adenoma, Dexamethasone, ACTH, Corticotropin, Iatrogenic diseases, Adrenalectomy

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Glucocorticoid-Induced Adrenal Insufficiency

Article Abstract:

Doctors should carefully monitor patients on corticosteroids when the dose is reduced. A 36-year-old woman had been taking corticosteroids for asthma for many years. When her doctor reduced the dose, she became weak and unable to function. Blood tests showed a very low cortisol level. Corticosteroids suppress the production of cortisol by the adrenal glands but the gland usually recovers when the drug is reduced. Most doctors never see a case such as this women because they reduce the dose gradually. Hormone measurements can indicate whether these patients still have functioning adrenal glands.

Corticosteroids, Adrenocortical hormones, Hypothalamic-pituitary-adrenal axis

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Adrenal insufficiency

Article Abstract:

A case study of a 44-year old woman who had symptoms and biochemical evidence of adrenal insufficiency (AI), as shown by her abnormal cortisol response to andrenocorticotropin hormone (ACTH) is presented. The symptoms of AI are nonspecific and this disease often goes undiagnosed for extended periods of time, with the risk of potential serious consequences.

United States, Case studies, Adrenal glands

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