ADRENAL CORTEX CUSHING CONN AND ADDISON DISEASE Snjeana

ADRENAL CORTEX CUSHING, CONN AND ADDISON DISEASE Snježana Vukelić Mentor: A. Žmegač Horvat

Adrenal cortex

Hormones secreted by cortex CORTICOSTEROIDS Glucocorticoids Mineralocorticoids CORTISOL ALDOSTERON • immune system • glucose • stress • blood pressure • water and salt balance

Cushing's syndrome

Cushing's syndrome • Pituitary adenomas • Ectopic ACTH sy • Adrenal tumors • Familial Cushing’s • Drug related Cushing’s disease 24 -hour urinary free cortisol level

Cushing's syndrome TREATMENT • SURGERY • RADIATION • CHEMOTHERAPY • CORTISOL-INHIBITING DRUGS

Conn's syndrome HYPERTENSION ↓ BLOOD POTASSIUM • TIREDNESS • MUSCLE WEAKNESS • POLYURIA ADRENAL ADENOMA

Conn's syndrome TREATMENT • SURGICAL REMOVAL (UNILATERAL ADRENALECTOMY) • SPIRINOLACTONE

Addison’s disease • WEIGHT LOSS • MUSCLE WEAKNESS • FATIGUE • LOW BLOOD PRESSURE • DARKENING OF SKIN

Addison’s disease • PRIMARY • destruction of adrenal cortex • SECONDARY • Lack of ACTH - drugs - autoimmune disorders - tumors and - tuberculosis infections of - chronic infection pituitary gland CORTISOL ALDOSTERONE CORTISOL

Addison’s disease DIAGNOSIS ACTH STIMULATION TEST TREATMENT REPLACEMENT THERAPY CORTISOL ALDOSTERONE HYDROCORTISONE FLUDROCORTISONE

Addison’s disease ADDISONIAN CRISIS ACUTE ADRENAL INSUFFICIENCY - SUDDEN PENETRATING PAIN IN LOWER BACK, ABDOMEN OR LEGS - SEVERE VOMITING AND DIARRHEA, FOLLOWED BY DEHYDRATION - LOW BLOOD PRESSURE - LOSS OF CONSCIOUSNESS - HYDROCORTISONE i. v. - 0, 9 % Na. Cl i. v. - DEXTROSE

Literature • http: //en. wikipedia. org/wiki/Adrenal_gland#A drenal_cortex • http: //users. rcn. com/jkimball. ma. ultranet/Biol ogy. Pages/A/Adrenals. html • http: //www. endocrineweb. com/adrenal. html