Adrenal Disorders

Cushing26 syndrome is excess cortisol secretion owing to any of several causes: ACTH hypersecretion by the pituitary, ACTH-secreting tumors, or hyperactivity of the adrenal cortex independently of ACTH. Cushing syndrome disrupts carbohydrate and protein metabolism, leading to hyperglycemia, hypertension, muscular weakness, and edema. Muscle and bone mass are lost rapidly as protein is catabolized. Some patients exhibit abnormal fat deposition between the shoulders ("buffalo hump") or in the face ("moon face") (fig. 17.26). Long-term hydrocortisone therapy can have similar effects.

Adrenogenital syndrome (AGS), a state of adrenal androgen hypersecretion, commonly accompanies Cush-ing syndrome. In children, AGS often causes enlargement of the penis or clitoris and the premature onset of puberty. Prenatal AGS can result in newborn girls exhibiting masculinized genitalia and being misidenti-fied as boys (fig. 17.27). In women, AGS produces such masculinizing effects as increased body hair, deepening of the voice, and beard growth.

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