Diseases of the Endocrine Glands - The adrenal glands

The adrenals are paired glands located just above each kidney. Their outer part is called the cortex . The inner part is called the medulla and is not governed by the anterior pituitary. The cortex produces several hormones that affect the metabolism of salt, water, carbohydrate, fat, and protein, as well as secondary sex characteristics, skin pigmentation, and resistance to infection.

Adrenal Glands

An insufficiency of these hormones can be caused by bacterial infection of the cortex, especially by meningococcus; by a hemorrhage into it; by an obstruction of blood flow into it; by its destruction because of tuberculosis; or by one of several unusual diseases.

In one type of sudden or acute underfunctioning of the cortex, the patient has a high fever, mental confusion, and circulatory collapse. Unless treated promptly, the disorder is likely to be fatal. When it persists after treatment, or when it develops gradually, it is called Addison's disease and is usually chronic. The patient suffers from weakness, loss of body hair, and increased skin pigmentation. Hormone-replacement treatment is essential, along with added salt for as long as hypofunction persists.

The Adrenal Glands

The formation of an excess of certain cortical hormones (i.e., hormones produced in the adrenal cortex)—a disorder known as Cushing's syndrome —may be caused by a tumor of the anterior pituitary gland, which produces too much specific stimulating hormone, or by a tumor of one or both of the adrenal glands. It is a rare disease, more common in women, especially following pregnancy. Symptoms include weakness, loss of muscle tissue, the appearance of purple streaks in the skin, and an oval or “moon” face.

Treatment involves eliminating the overproducing tissue either by surgery or irradiation and then replacing any hormonal deficiencies with proper medication.

An excess of certain other cortical hormones because of an increase in cortical tissue or a tumor can result in the early onset of puberty in boys, or in an increase in the sexuality of females of any age. Surgical removal of the overproducing tissue is the only treatment.

The Adrenal Medulla

The medulla of the adrenal glands secretes two hormones: epinephrine (or adrenaline ) and norepinephrine . Although they contribute to the proper functioning of the heart and blood vessels, neither one is absolutely indispensable. Disease caused by hypo-function of the medulla is unknown. Hyperfunction is a rare cause of sustained high blood pressure. Even more rarely, it causes episodic or paroxysmal high blood pressure accompanied by such symptoms as throbbing headache, profuse perspiration, and severe anxiety. The disorder is caused by a tumor effectively treated by surgical removal. Cancer of the adrenal medulla is extremely rare and virtually incurable.

Changes in hormone production can be caused by many intangible factors and are often temporary disorders. However, persistent or recurrent symptoms should be brought to a physician's attention. The accurate diagnosis of an endocrine disease depends on careful professional evaluation of specific laboratory tests, individual medical history, and thorough examination. No one should take hormones or medicines that affect hormone production without this type of evaluation, since their misuse can cause major problems.

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