Childhood Adrenal Gland Disorders: Underactivity

Introduction

Adrenal gland disorders are due to either underactive or overactive adrenal glands. Also, adrenal gland disorders vary according to the actual hormones involved.
First we will look at the case of underactive adrenal glands ( Addison's Disease ). This section also contains information on overactive adrenal glands , including Cushing's syndrome and adrenal tumours .

Description

Addison's disease is the result of an underactive adrenal gland, producing insufficient amounts of corticosteroid hormones (e.g. cortisol and aldosterone ). Corticosteroids help the body respond to stress. 4 in every 100,000 people have Addison's disease. The causes of Addison's disease include:

• Actual destruction of the adrenal glands through cancer, infection, or other diseases. This accounts for about one-third of Addison's disease cases.
• Use of corticosteroids as a treatment causes a slow down in production of natural corticosteroids by the adrenal glands.
• Certain drugs used to treat fungal infections may block production of corticosteroids in the adrenal glands.
• Usually, the cause is unknown.

Symptoms and Signs

Mild Addison's disease symptoms may only be apparent when the patient is under physical stress. The most common symptoms include:

Weakness Fatigue Dizziness Dark skin Black freckles Bluish-black discoloration around the nipples, mouth, rectum, scrotum, or vagina

Lack of appetite Weight loss Muscle aches Nausea Vomiting Diarrhoea Intolerance to cold Dehydration

However, each individual may experience symptoms differently.
If not treated, Addison's disease may lead to severe abdominal pain, extreme weakness, low blood pressure, kidney failure, and shock, especially when the patient is experiencing physical stress. For more information on the health repercussions of inadequate corticosteroid production, click here .

Diagnosis and Treatment

In addition to a complete medical history and medical examination, diagnostic procedures for Addison's disease may include blood tests to measure corticosteroid hormone levels and kidney function tests to determine if urine is concentrated.
Since Addison's disease can be life threatening, treatment often begins with administration of corticosteroids. Corticosteroids, such as prednisone, may be taken orally or intravenously, depending on the patient's condition. Usually the patient has to continue taking the corticosteroid the rest of his/her life. Treatment may also include taking fludrocortisone , a drug that helps restore the body's level of sodium and potassium.

The information in this page is presented in summarised form and has been taken from the following source(s):
1. From The Merck Manual of Medical Information – Home Edition , edited by Mark H. Beers and Robert Berkow. Copyright 1997 by Merck & Co., Inc., Whitehouse Station, NJ: http://www.merck.com/mmhe/index.html
2. University of Maryland Medical System Online Health Guides: http://www.umm.edu/