2. INTRODUCTION
Adrenal sex hormones are secreted mainly by zona
reticularis. Zona fasciculata secretes small quantities of
sex hormones.
Adrenal cortex secretes mainly the male sex hormones,
which are called androgens. But small quantity of
estrogen and progesterone are also secreted.
Androgens secreted by adrenal cortex:
1. Dehydroepiandrosterone
2. Androstenedione
3. Testosterone.
Dehydroepiandrosterone is the most active adrenal
androgen. Androgens, in general, are responsible for
masculine features of the body
3. INTRODUCTION CONT’D
In congenital hyperplasia of adrenal cortex or
tumor of zona reticularis, an excess quantity of
androgens is secreted. In males, it does not
produce any special effect because, large quantity
of androgens are produced by testes also. But in
females, the androgens produce masculine
features. Some of the androgens are converted
into testosterone
5. PATHOPHYSIOLOGY OF ADRENAL CORTEX
Hypersecretion of adrenocortical hormones leads to
the following conditions:
1. Cushing syndrome
2. Hyperaldosteronism
3. Adrenogenital syndrome.
6. CUSHING SYNDROME
Cushing syndrome is a disorder characterized by
obesity caused by hypersecretion of
glucocorticoids, particularly cortisol. It may be either
due to pituitary origin or adrenal origin.
If it is due to pituitary origin, it is known as Cushing
disease. (Increased secretion of ACTH)
If it is due to adrenal origin it is called Cushing
syndrome.(Tumor in zona fasciculata of adrenal cortex)
Generally, these two terms are used
interchangeably..
7. SIGNS AND SYMPTOMS
Moon face: retention of water and
salt
Torso: Fat accumulation in the chest
and abdomen. Arms and legs are
very slim in proportion to torso
(torso means trunk of the body)
Buffalo hump: Due to fat deposit on
the back of neck and shoulder
Pot belly: Due to fat accumulation in
upper abdomen.
Purple striae: Reddish purple stripes
on abdomen due to three reasons.
8. CONT’D
Thinning of extremities
Thinning of skin due to protein depletion caused by
increased catabolism of proteins
Skin disease characterized by darkened skin
patches in certain areas such as axilla, neck and
groin
Pigmentation of skin, especially in ACTH dependent
Facial plethora: Facial redness
Hirsutism: Heavy growth of body and facial hair
9. HYPOSECRETION- ADDISON’S DISEASE
Addison disease is the failure of adrenal cortex to
secrete corticosteroids.
Types of Addison Disease
i. Primary Addison disease due to adrenal cause
ii. Secondary Addison disease due to failure of
anterior pituitary to secrete ACTH
iii. Tertiary Addison disease due failure of
hypothalamus to secrete corticotropin-releasing
factor (CRF).
10. SIGNS AND SYMPTOMS
Signs and symptoms develop in Addison disease because of
deficiency of both cortisol and aldosterone.
Common signs and symptom are:
i. Pigmentation of skin and mucous membrane due to excess
ACTH secretion, induced by cortisol deficiency. ACTH causes
pigmentation by its melanocyte-stimulating action
ii. Muscular weakness
iii. Dehydration with loss of sodium
iv. Hypotension
v. Decreased cardiac output and decreased workload of the
heart, leading to decrease in size of the heart
vi. Hypoglycemia
vii. Nausea, vomiting and diarrhea. Prolonged vomiting and
diarrhea cause dehydration and loss of body weight
viii. Susceptibility to any type of infection
ix. Inability to withstand any stress, resulting in Addisonian crisis
11. SYMPTOMS
In boys
Adrenal hyperplasia produces a
condition known as
macrogenitosomia praecox
Features of macrogenitosomia
praecox:
i. Precocious body growth, causing
stocky appearance called infant
Hercules
ii. Precocious sexual development
with enlarged penis even at the age
of 4 years.
In girls
In girls, adrenal hyperplasia produces
masculinization.
It is otherwise called virilism. In
some cases of genetic disorders,
the female child is born with external
geni talia of male type. This condition
is called pseudohermaphroditism.
