Adrenal Disease

Abstract

The adrenal gland comprises the adrenal medulla, which secretes noradrenaline (norepinephrine) and adrenaline (epinephrine), and the adrenal cortex, which is responsible for glucocorticoid, mineralocorticoid and androgen production. Disorders of the adrenal gland result in either excessive or deficient production of these hormones.

Keywords: Addison disease; Cushing syndrome; hyperaldosteronism; phaeochromocytoma

Figure 1.

Regulation of cortisol synthesis. ACTH, adrenocorticotrophic hormone; CRH, corticotrophin‐releasing hormone.

Figure 2.

Regulation of aldosterone synthesis. ACE, angiotensin‐converting enzyme; ACTH, adrenocorticotrophic hormone.

Figure 3.

Pathophysiology of primary adrenal insufficiency. ACTH, adrenocorticotrophic hormone.

Figure 4.

Diagnosis of adrenal Cushing syndrome. ACTH, adrenocorticotrophic hormone; LDDST, low‐dose dexamethasone suppression test; MRI, magnetic resonance imaging; UFC, urinary free cortisol.

Figure 5.

Investigation of primary hyperaldosteronism. CT, computed tomography; GRA, glucocorticoid‐remediable aldosteronism; MRI, magnetic resonance imaging.

Figure 6.

Adrenal steroid biosynthesis pathway. 3β‐HSD, 3β‐hydroxysteroid dehydrogenase; 21‐OH, 21‐hydroxylase; 11β‐OH, 11β‐hydroxylase; 17β‐OH, 17β‐hydroxylase.

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References

Bouloux PMG and Fakeeh M (1995) Investigation of phaeochromocytoma. Clinical Endocrinology 43: 657–664.

Daly PA and Landsberg L (1992) Phaeochromocytoma: diagnosis and management. Baillière's Clinical Endocrinology and Metabolism 6(1): 143–166.

Ganguly A (1998) Primary aldosteronism. New England Journal of Medicine 339(25): 1828–1834.

Harper R and Atkinson AB (1997) Adrenal causes of Cushing's syndrome. In: Sheaves R, Jenkins PJ and Wass JAH (eds) Clinical Endocrine Oncology, pp. 319–322. Oxford, UK: Blackwell Science.

Meier CA and Biller BM (1997) Clinical and biochemical evaluation of Cushing's syndrome. Endocrinology and Metabolism Clinics of North America 26(4): 741–760.

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Tyrrell JB (1992) Adrenocortical hypofunction. In: Wyngaarden JB, Smith LH and Bennett JC (eds) Cecil's Textbook of Medicine, 19th edn, pp. 1281–1288. Philadelphia: WB Saunders.

Vallotton MB (1996) Part I: Diagnosis of primary hyperaldosteronism. Clinical Endocrinology 45: 47–52.

Further Reading

Hunt PJ and Inder WJ (1995) Diagnosis, monitoring and management of congenital adrenal hyperplasia. Current Opinion in Endocrinology and Diabetes 2: 231–238.

Stewart PM and Dunne F (1997) Primary hyperaldosteronism. In: Sheaves R, Jenkins PJ and Wass JA (eds) Clinical Endocrine Oncology, pp. 312–318. Oxford, UK: Blackwell Science.

Young WF (1997) Phaeochromocytoma and primary aldosteronism: diagnostic approaches. Endocrinology and Metabolism Clinics of North America 26(4): 801–827.

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How to Cite close
Elsheikh, Mohgah, and Wass, John AH(Apr 2001) Adrenal Disease. In: eLS. John Wiley & Sons Ltd, Chichester. http://www.els.net [doi: 10.1038/npg.els.0002260]