Adrenal disorders

Adrenal insufficiency
Adrenal gland

Adrenal disorders Main Page
Overview
Classification Aldosterone Related Hypoaldosteronism Primary Hyperaldosteronism Cortisol Related Adrenal Insufficiency Addison's disease Secondary adrenal insufficiency Cushing's Syndrome CAH Pheochromocytoma Incidentaloma

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Usama Talib, BSc, MD [2] Mehrian Jafarizade, M.D [3]

Overview

Adrenal or suprarenal glands are important endocrine glands that produce variety of hormones, such as epinephrine, steroids, aldosterone, and cortisol. Each gland consists of an outer capsule, underneath cortex, and the central part called medulla. The cortex is further classified into thee layers, each layer produces specific hormone. Congenital adrenal hyperplasia is the disease of adrenal cortex, which is classified into seven types based on the genetic causes that lead to hyperplasia and hormonal imbalance. There are three zones of hormonal synthesis in the adrenal cortex; zona glumerulosa secrets aldosterone, zona fasciculate secrets cortisol, and zona reticularis secrets androgens. Impairment of each pathway and enzyme may lead to a specific subtype of congenital adrenal hyperplasia, such as 21-hydroxylase deficiency, 17 alpha-hydroxylase deficiency, 11β-hydroxylase deficiency, 3 beta-hydroxysteroid dehydrogenase deficiency, cytochrome P450-oxidoreductase (POR) deficiency (ORD), and congenital lipoid adrenal hyperplasia. Other adrenal cortex disease are hyperaldosteronism due to zona glumerulosa hyperplasia and Cushing's syndrome due to zona fasciculate disease. Pheochromocytoma is a neuroendocrine tumor of the medullary part of the adrenal glands, which fails to involute after birth. They secrete excessive amount of catecholamines, mostly epinephrine and norepinephrine. Incidentaloma is another adrenal tumor that often discovered as an incidental finding in ultrasonography. Most incidentalomas are nonfunctional but some of them are found to secrete low levels of cortisol, aldosterone, or catecholamines.

Classification

Adrenal disorders                                                                                                                   Cortical           Medullary       Incidentaloma                                                                             Cortisol related   Aldosterone related   Congenital adrenal hyperplasia (CAH)                                                                         •Adrenal insufficiency •Cushing syndrome   •Hypoaldosteronism •Primary hyperaldosteronism   • 21-hydroxylase deficiency •11β-hydroxylase deficiency •17 alpha-hydroxylase deficiency •3 beta-hydroxysteroid dehydrogenase deficiency •Cytochrome P450-oxidoreductase (POR) deficiency (ORD) •Lipoid congenital adrenal hyperplasia   •Pheochromocytoma       •Non-secretory •Secretory