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Q: What is likely to be the most important global impact of byc atch?
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What condition is caused by malfunction of the adrenal gland?

One condition caused by malfunction of the adrenal gland is Addison's disease. Addison's disease occurs when the adrenal glands do not produce enough cortisol and sometimes aldosterone, leading to symptoms such as fatigue, weight loss, low blood pressure, and darkening of the skin. It is a chronic condition that requires lifelong treatment with hormone replacement therapy.


Cushing's disease?

DefinitionCushing's disease is a condition in which the pituitary gland releases too much adrenocorticotropic hormone (ATCH). The pituitary gland is an organ of the endocrine system.Cushing's disease is a form of Cushing syndrome.Alternative NamesPituitary Cushing's diseaseCauses, incidence, and risk factorsCushing's disease is caused by a tumor or excess growth (hyperplasia) of the pituitary gland. This gland is located at the base of the brain.People with Cushing's disease have too much ACTH. ACTH stimulates the production and release of cortisol, a stress hormone. Too much ACTH means too much cortisol.Cortisol is normally released during stressful situations. It controls the body's use of carbohydrates, fats, and proteins and also helps reduce the immune system's response to swelling (inflammation).SymptomsSymptoms usually include:Upper body obesity (above the waist) and thin arms and legsRound, red, full face (moon face)Slow growth rate in childrenSkin changes that are often seen:Acne or skin infectionsPurple marks (1/2 inch or more wide), called striae, on the skin of the abdomen, thighs, and breastsThin skin with easy bruisingMuscle and bone changes include:Backache, which occurs with routine activitiesBone pain or tendernessCollection of fat between the shoulders (buffalo hump)Thinning of the bones, which leads to rib and spine fracturesWeak musclesWomen often have:Excess hair growth on the face, neck, chest, abdomen, and thighsMenstrual cycle becomes irregular or stopsMen may have:Decreased fertilityDecreased or no desire for sexImpotenceOther symptoms that may occur include:Mental changes, such as depression, anxiety, or changes in behaviorFatigueHeadacheHigh blood pressureIncreased thirst and urinationSigns and testsTests are done to confirm there is too much cortisol in the body, then to determine the cause.These tests confirm too much cortisol:24-hour urine cortisolDexamethasone suppression test (low dose)These tests determine cause:Blood ACTH levelBrain MRICorticotropin-releasing hormone test, which acts on the pituitary gland to cause the release of ACTHDexamethasone suppression test (high dose)Petrosal sinus sampling - measures ACTH levels in the veins that drain the pituitary glandTreatmentTreatment involves surgery to remove the pituitary tumor, if possible. After surgery, the pituitary may slowly start to work again and return to normal.During the recovery process, you may need cortisol replacement treatments. Radiation treatment of the pituitary gland may also be used.If the tumor does not respond to surgery or radiation, you may get medications to stop your body from making cortisol.If these treatments are not successful, the adrenal glands may need to be removed to stop the high levels of cortisol from being produced.Expectations (prognosis)Untreated, Cushing's disease can cause severe illness, even death. Removal of the tumor may lead to full recovery, but the tumor can grow back.ComplicationsCompression fracturesDiabetesHigh blood pressureInfectionsKidney stonesPsychosisCalling your health care providerCall your health care provider if you develop symptoms of Cushing's disease.If you have had a pituitary tumor removed, call if you have signs of complications, including signs that the tumor has returned.ReferencesStewart PM. The adrenal cortex. In: Kronenberg H, Melmed S, Polonsky K, Larsen PR, eds. Williams Textbook of Endocrinology. Philadelphia, Pa: Saunders Elsevier; 2008:chap 14.


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