Adrenal cortex - diseases

Which diseases are related to the adrenal glands?

In adrenal disorders, too much or too little hormone is produced - it creates an over- or under-function of various organs with a variety of clinical pictures.

Hyperfunction of the adrenal cortex

If the adrenal cortex produces too much aldosterone, it leads to Conn's disease (also called hyperaldosteronism). Symptoms of Conn's disease are:

  • high blood pressure
  • potassium deficiency
  • constipation
  • muscle weakness
  • great thirst
  • frequent urination

The cause may be a benign tumor in the adrenal cortex (conn adenoma). The tumor is usually removed, possibly additional drugs are given.

Cushing's syndrome

The overproduction of cortisol causes the clinical picture of hyperadrenocorticism. If the cause lies directly in the adrenal cortex, for example a tumor, this is called Cushing's disease.

A tumor in the pituitary or other malignant tumors such as lung cancer, however, cause the Cushing syndrome. Typical external symptoms are:

  • a round, big face
  • thin arms and legs
  • strong accumulations of fat in the abdominal and neck area (= Stammfettsucht)
  • red stripes on the skin (Striae rubrae)

There are also disorders of the sugar metabolism, in some cases diabetes, as well as the breakdown of bone and muscle tissue.

If the tumor can not be removed, the overproduction of cortisol is inhibited by medication. Incidentally, in a high-dose long-term treatment with anti-inflammatory drugs containing glucocorticosteroids such as prednisolone or dexamethasone as side effects similar symptoms as in Cushing's disease - so many people are afraid of cortisone intake, which is unfounded at the usual dosages.

Masculinization and feminization

Sometimes there are also androgen- or estrogen-producing, mostly malignant tumors in the adrenal cortex. The wrong hormone formation in women leads to a "masculinization" of the sexual characteristics (for example, absence of menstruation, beard growth) and in men accordingly to a "feminization" (among other things, shrinking of the testicles, growth of the mammary glands). These tumors are surgically removed.

Subfunction of the adrenal cortex

If the adrenal cortex produces too little cortisol, it is called adrenal insufficiency.

In primary adrenal insufficiency (Addison's disease), the cause is directly in the adrenal cortex: it is often an autoimmune disease, but even a tumor or an infectious disease such as tuberculosis can destroy the hormone-producing cells of the adrenal cortex.

In the secondary form, the cause is a hypofunction of the hypothalamus or pituitary gland. Tumors, inflammations, radiation treatments or circulatory disorders affect their hormone production. As a result, the hormonal control circuit is disturbed and the adrenal cortex produces no or too little cortisol. In addition to low blood pressure and fatigue, listlessness, loss of appetite and weight loss occur.

In Addison's disease, the skin (especially on the nipples), the nail bed and also fresh scars have a darker color than normal. People with a pituitary gland disorder are more likely to notice particularly pale skin.

In many people, the disease initially inconspicuous, only in a stress situation, it comes to a so-called Addison crisis: The lack of cortisol leads to blood pressure drop, shock, vomiting and diarrhea. Adrenocortical insufficiency is medically treated with cortisol and mineral corticosteroids.

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