Adrenal hormones symptoms. Adrenal glands: symptoms and causes of the disease, their diagnosis and treatment

The adrenal glands are vital important bodies, without their participation in the body can begin serious problems which will lead to rapid death. In some cases, during the examination, the patient is told that his adrenal glands are enlarged. The reasons for this condition may be different, but in any case, they require the adoption of certain measures.

Features of the structure of the adrenal glands

The adrenal glands consist of two layers, each of which actively produces hormones. The medulla is located closer to the upper pole of the kidney, and produces norepinephrine and adrenaline - substances that help the body adapt to stress.

The cortical part of the organs produces glucocorticoids and mineralocorticoids. These substances take part in many metabolic processes, help regulate systemic pressure, and maintain electrolyte balance in organism. The process of total or local enlargement of the adrenal glands in some cases leads to changes in their hormonal activity.

Reasons for the increase

All causes of adrenal enlargement can be divided by localization pathological process. In the cortical layer, this can be:

hyperplasia;

single or multiple cysts;

adenoma;

hemorrhage;

fibroma;

angioma.

In the brain:

ganglioma;

neuroblastoma;

pheochromocytoma.

Adenoma and carcinoma may underlie a total change in the size of the adrenal glands (enlargement).

Clinical symptoms

With a pathology such as an increase in the adrenal glands, symptoms may be absent. In some cases, this phenomenon is detected during a random examination of the kidneys on ultrasound. But if the process of increase proceeds long time, and the patient does not take any measures to eliminate the problem, then there is a violation of the production of substances, most often in the direction of their increase. Therefore, there are signs that are directly related to hyperproduction of the adrenal glands. But they all depend on what kind of substance enters the blood in large quantities.

If the level of cortisol increases, then Itsenko-Cushing's syndrome develops. A person begins to gain weight, and obesity is mainly localized in the upper body. Blue stripes (stretch marks) appear on the skin, blood pressure rises. In men, potency decreases, and in women, libido and the menstrual cycle are disturbed. Under the influence of excess cortisol, gradual depletion occurs thyroid gland the patient is experiencing constant fatigue, depression and muscle weakness.

Excess aldosterone leads to a pathology called Conn's disease. At the same time, the changes in the appearance of the patient are practically not reflected. Potassium and sodium begin to be excreted from the body. Hypokalemia leads to the development of convulsive syndrome, muscle weakness, paralysis. Urination becomes more frequent, nocturia occurs. The patient experiences constant thirst and muscle weakness.

Virilization occurs as a result of tumor processes. If it starts at childhood, then the baby begins early puberty in the form of secondary sexual characteristics. As a result, the voice of the boys becomes coarse early, hair growth occurs. In girls, as a result of an excess of androgen, the clitoris enlarges and menstrual cycle may even develop amenorrhea. mental development usually lags behind the physical in this case. Women have problems with the cycle. In adult males, androgen excess is usually not symptomatic.

Feminization as a result of an increase in the adrenal glands occurs when estrogens enter the body in excess with an increase in the adrenal glands. This happens quite rarely. In men and boys, the vegetation on the face disappears, the mammary glands increase, testicular atrophy occurs. With a pronounced increase in the level of estrogen in women, there is a thickening of the blood, a violation of the menstrual cycle, develops anxiety state or depression, weight gain.

These symptoms with an increase in the adrenal glands rarely occur in isolation. Most often, one person may experience several symptoms associated with an increase in the adrenal glands. Cases of the course of diseases in a mild or erased form are described.

According to statistical data, cases of hyperproduction of hormones associated with pheochromocytoma predominate in the practice of a doctor. In this pathological condition, there is an increase in dopamine, adrenaline and norepinephrine. Clinically it looks like this:

The patient has frequent rises in pressure, which are in the nature of crises, and they can stop on their own, without the use of antihypertensive drugs. The patient has pallor of the skin, headaches, nausea. After a hypertensive crisis, hypotension is often recorded.

A direct link between high blood pressure and the use of certain foods (chocolate, mustard, cheese). Sometimes the cause may be some medicines containing ephedrine, or antidepressants.

Crises develop after stressful situation, physical activity and even overeating.

Severe deviations in the work of the autonomic nervous system. Excessive sweating, tachycardia, tremor of the upper extremities.

With the development of a severe form of pathology, complications arise in the form of a violation in the work of the heart muscle, kidneys, the development of psychosis, changes in the vessels of the eyes. Sometimes there is an increase in blood sugar.

Diagnostics

The enlargement of the left adrenal gland, as well as that of the right, can be well defined by ultrasound. But in order to reliably determine the degree of tumor damage and the localization of the process, it is necessary to do an MRI.

Any formation that is found in the adrenal glands is hormonally active and inactive. In order to understand this, you should take a blood test for some substances, as well as determine the remains of their metabolism and the level of electrolytes in the urine.

Treatment

With such a pathology as an increase in the adrenal glands, treatment is prescribed only after passing a full study and obtaining the results of the tests.

There are conservative and operational methods problem solving. In the absence of symptoms and an increase in the adrenal glands, dynamic surveillance for the state of education. If pains, dysuric phenomena and some other signs begin, then they are stopped with the help of medicines. Indications for surgical treatment are:

accelerated growth in education;

all objective and subjective signs of overproduction of adrenal hormones;

suspicion of malignancy;

lack of efficacy medicines and progression of the pathology.

Surgical operation with an increase in the adrenal glands is contraindicated in the following cases:

severe hypertension;

development of organ failure (heart, kidney, liver);

cancer in the last stage;

acute inflammatory processes;

significant psychical deviations.

The choice of intervention for adrenal enlargement depends on many factors. This takes into account general state patient, the severity of the disease, the area of the lesion. With total germination of the formation, the adrenal gland is completely removed, followed by a transition to hormone replacement therapy. In the presence of a malignant tumor, not only an adrenalectomy is performed, but nearby lymph nodes are also removed.

In some cases, an organ-preserving operation is used, which allows a person to lead a former lifestyle after it, without switching to a constant intake of drugs. Access is carried out laparoscopically or classically.

Most serious condition that requires a special approach is pheochromocytoma with an increase in the adrenal glands. The operation to remove it can lead to severe hemodynamic disturbances. Often practiced in this tumor is the introduction of a radioactive isotope intravenously. This allows you to slow down the development of the process and the spread of metastases to neighboring organs.

With the development of a crisis against the background of an increase in catecholamines, the introduction of sodium nitroprusside or nitroglycerin intravenously is used. In the absence of the effect of these drugs, the patient's life is saved only by an emergency operation.

The role of the adrenal glands normal operation of the whole organism cannot be underestimated. These endocrine glands necessary for the synthesis of various hormones - adrenaline, corticosteroid hormones, norepinephrine. In addition, the function of the adrenal glands in the body is also to regulate metabolic processes The adrenal glands help a person adapt to conditions environment which are often unfavorable.

The cortical layer of these paired organs is responsible for water-salt metabolism and is involved in the process of converting protein structures into carbohydrate structures, while the medulla affects the heart rhythm, carbohydrate metabolism, and an increase in pressure in the arteries. Violation of the adrenal glands leads to an imbalance of the entire vital activity of the body. Next, we will consider what the adrenal glands are, the symptoms of their adrenal disease in men, as well as what therapeutic and preventive measures necessary for normal function adrenal glands.

The human endocrine system is a rather complex system that is responsible for the state of the human hormonal background. This system consists of glands and organs, all of which are certainly important for the life of the body, however, the most important glands are the pancreas, thyroid and the zone of our interest is the adrenal glands. Most people know, or at least have heard, about the first two glands, but not everyone has an idea about the function and significance of the adrenal glands.

This is a very big omission, since as a result of a malfunction in the work of this paired gland, enough severe pathologies. The glands discussed in this article are located in the retroperitoneal space above top kidneys. As already mentioned, the function of the adrenal glands is hormonal synthesis and participation in metabolic processes.

It is safe to say that the adrenal glands are very powerful reserves of the human body. If they function normally, then when stress occurs, a person does not feel weak and tired, that is, he can cope with stress without compromising health. If a person after stress for a long time cannot calm down, is nervous, he develops great weakness, panic attacks and so on, it means that the work of the adrenal glands is incorrect. In this case frequent stress will lead to an increase in these glands in size, and if a person develops prolonged depression, then the adrenal glands may completely stop working properly, which will lead to various diseases associated with deficiency of enzymes and hormones.

The hormones produced by the adrenal glands are very importance for human life and are responsible for almost all processes occurring in the body:

Adrenaline is the main hormone that fights stress. Its concentration in the blood increases both with negative emotions and joyful and positive events. When adrenaline is released, the pupils of a person expand, breathing quickens, strength appears, the body becomes less vulnerable to pain, it becomes more resilient and stronger.
Norepinephrine is a precursor to adrenaline, in other words, it is a stress hormone. What is he responsible for? Although it has less effect on the body than adrenaline, it increases pressure in the arteries, which allows the heart to work harder.
Corticosteroid hormones can be of three types - glomerular, fascicular and reticular hormones.
In the glomerular zone of the gland, aldosterone, corticosterone, deoxycorticosterone are produced.
Synthesis of cortisol and coricosterone occurs in the fascicular zone.
The reticular zone produces sex hormones - androgens. They wag on sex drive human, fat levels, increase in fat and muscle mass.

All of the above suggests that the adrenal glands perform an important and irreplaceable function in the human body; if their work fails, hormones begin to be produced either in insufficient or in excess, which leads to various pathologies in organism.

Causes of diseases

The main cause of malfunction of the gland are diseases and injuries of the brain. In addition, insufficient blood circulation in the glands can provoke a malfunction of these jellies, congenital pathology, severe infectious diseases. In some cases, various tests are needed to identify incipient adrenal disease. diagnostic measures because the disease is early stage does not cause any significant disturbance in the hormonal background. Therefore, disorders in the work of the adrenal glands, as a rule, appear only when the gland becomes affected.

What diseases can be

Diseases of the adrenal glands in men can be manifested by an increase or decrease in hormonal activity. Among them are:

formations (benign) with a lack of hormonal activity;
formations (malignant) with a lack of hormonal activity;
formations with hormonal activity;
hypertrophy (enlargement) of the cortex of the gland with hormonal activity;
dysfunction of the gland of a hereditary nature;
decreased function of the adrenal glands.

Formations in which there is no hormonal activity are tumors that do not synthesize substances that have biological activity. They are called incidentalomas. Such tumors can be malignant or benign. Most often they are discovered during a random examination. CT can provide the most information, but such tumors can also be visualized on ultrasound, although this method is less accurate than CT. Usually, benign tumors of this order are not clinically manifested in any way, in the case of oncological process, there is a decrease in the weight of a person, disruption of the work of other systems and organs, intoxication.

Formations that have hormonal activity can be detected by the results of hormone tests. They can cause various symptoms - the manifestation in the appearance of a man of traits of the opposite sex, the development various syndromes(Itsenko-Cushing's syndrome, Conn's syndrome and others). Since the symptoms of such formations depend on what kind of tumor is present, it is necessary to consider them individually.

Pheochromocytomas. This tumor is formed from the brain cells of the adrenal glands. It can be located both in the area of the gland itself, and outside it. In most cases this malignant neoplasm, which releases catecholamines into the blood, the main symptom is persistent hypertonic disease. The pressure can rise to critical levels when physical activity, after eating, with positive or negative emotions. In addition, the patient has an increased pulse, trembling in the limbs, a feeling of fear. When the pressure drops, there is increased urination. If hypertension does not respond to standard therapy in any way, then a man is recommended to undergo examinations for pheochromocytoma.

Aldosteroma. This formation in its composition has cells that are located on top of the adrenal cortex. This tumor produces certain substances, with an increase in the concentration of which develops Conn's syndrome. Steady growth again comes to the fore blood pressure, but also observed:

muscle weakness;
the appearance of seizures;
headache;
rapid pulse;
constant feeling thirst;
violation of the kidneys.

This symptomatology is due to the fact that with aldosterone, potassium is washed out of the body.

Corticosteroma- This is a formation that is formed from the cells of the bundle layer. The tumor produces too many glucocorticoids, and, consequently, Itsenko-Cushing's syndrome develops. This:

obesity, and fat is deposited on the face, as well. In this case, the face becomes moon-shaped, and the skin on it turns red,
fatty deposits may form on the back of the neck;
thin legs with atrophied muscles;
on back side palm skin becomes thin and transparent;
the skin can become covered with pustules and other rashes;
limbs may be swollen;
purple-colored stretch marks appear on the skin of the abdomen and in the chest area.

With androsteroma and corticosteroma, a man's appearance changes - feminine features appear. This is due to the fact that the tumor is formed from the cells of the lower layer of the gland, which is responsible for the synthesis of androgens. These tumors are rarely diagnosed.

Disease symptoms

So, summing up, we can list all the symptoms. Diseases of the adrenal glands in men may be accompanied by the following symptoms:

Cushing's Syndrome: high pressure, excess weight, the face becomes lens-like, glucose metabolism is disturbed, atrophic processes in the muscles, osteoporosis, lack or decrease in potency, pustular formations, depression, migraines.
Addison's disease: severe fatigue, poor appetite, frequent respiratory diseases, intense staining of the lips, nipples and cheeks, low blood pressure, vomiting, dyspeptic disorders, increased nighttime urination, decreased concentration, depression, hypocorticism, low libido.
Hyperaldosteronism: migraines, polyuria, convulsive syndrome, puffiness, tachycardia, hypervolemia, constipation.
Tumors of the adrenal glands: high blood pressure, arrhythmia, muscle weakness, sweating, panic states, convulsions, female signs, limb tremor.
Nelson's syndrome: low blood pressure, heart failure, mental disorders, dyspepsia, weight loss, nocturia, skin pigmentation, confusion, fainting.
Androgenital syndrome: excess potassium in the body, failure in the rhythm of the heart, acne, early hair growth of the pubic area.

Principles of treatment

If a man has at least some of the above signs, and if he has adrenal gland pain, he needs to make an appointment with an endocrinologist. Treatment of the adrenal glands should be carried out only after consultation with a doctor and under his close supervision.

Therapy is primarily aimed at improving the hormonal background, with minor manifestations of the disease, synthetic analogues of hormones are prescribed, which will eliminate the deficiency or excess of natural hormones. In addition, it is very important to find the cause of the malfunction of the adrenal glands and treat the underlying ailment. In case of inefficiency therapeutic methods, doctors may suggest removal of the gland.

Concerning preventive action, then due to the fact that most adrenal diseases are associated with depression, it is recommended to avoid stressful situations, to be active and rational image life, eat right, and timely visit an endocrinologist for preventive purposes.

adrenal glands play essential role V hormonal regulation organism. If a woman is diagnosed with severe adrenal pathology, then it is likely that the patient will be on replacement hormone therapy for the rest of his life, and will even be issued for "disability due to a general disease."

Unfortunately, at present, getting to an endocrinologist is becoming increasingly difficult. The notorious "optimization of health care" has led to the fact that the therapist of the polyclinic has turned into a "dispenser of coupons" to narrow specialists. He fills out a lot of paperwork, is engaged in medical examinations, and often simply cannot take the time to collect the necessary symptoms.

Therefore, there is a need for every person to have a minimum necessary knowledge just to figure out which specialist you need to sign up for a paid medical Center not to pay twice. Today we’ll talk about the adrenal glands: how they are arranged, why they exist and what symptoms of their defeat occur in women.

Adrenal glands: what are they and where are they located?

The adrenal glands are small paired glands in the form of a "squeeze" on top of each kidney. The adrenal glands, like the kidneys, are located in the retroperitoneal space. The size of each does not exceed 6 cm by 3 cm. The color is light brown, and slightly different from the yellowish fatty tissue.

The internal structure of these small glands very interesting. They consist of two sharply different, even in appearance, layers - bark and medulla:

The adrenal cortex is divided into four zones (fascicular, sudanophobic, glomerular and reticular) and produces hormones.

The glomerular zone synthesizes aldosterone, corticosteroid hormones (corticosterone, cortisol and cortisone) are produced in the fascicular zone, and inactive forms of androgens (that is, male sex hormones) are produced in the reticular zone. The Sudanophobic zone produces cells that "specialize" and go to other parts of the cortex.

The medulla produces adrenaline and norepinephrine.

Thus, the adrenal glands are completely "dedicated" to the production of hormones, and this is their main function. What effects do adrenal hormones produce?

The function of the adrenal glands in the human body

Hormones of the cortex and medulla of the adrenal glands are vital. Removal of these organs from both sides leads to death, and total replacement therapy too complicated, and also soon leads to lethal outcome, because it cannot compete with fine natural feedback regulation.

The functions of the adrenal glands are numerous, and are built depending on the production of hormones, of which there are about fifty species in total:

Aldosterone and the hormones of its group support normal water - salt metabolism, increasing the excretion of potassium and protons in the urine, and reducing the excretion of sodium, chlorine and sodium bicarbonate;
Corticosteroid hormones are synthesized from cholesterol, and if only for this reason, it can be considered a vital compound.

These substances adapt the body to the stressful effects of the surrounding world. They protect us from infection and injury, suppress inflammation and allergic reactions, block the occurrence of autoimmune diseases. Adrenal hormones promote blood sugar and increase glycogen stores in the liver.

They affect fat metabolism, and at the same time in some parts of the body fat reserves decrease, but in others they increase. Exactly ( fat people with thin arms and legs) look like patients with damage to the adrenal glands, when the synthesis of these hormones increases.

Androgens of the adrenal cortex female body are a source of testosterone. In women, about 65% of this substance is produced precisely through the “processing” of androgens of the adrenal cortex;
Adrenaline and norepinephrine maintain vascular tone, and "vasoconstriction". Norepinephrine needed for shock sharp drop blood pressure caused by expansion peripheral vessels(i.e. no fluid loss). Adrenaline helps to quickly break down fat, cause glucose from the depot into the blood, prepare muscles for physical activity, and is a “stress preparation” hormone.

But this is all theory. What do diseases that affect the adrenal glands look like?

Symptoms of adrenal disease, can they hurt?

Obesity is one of the symptoms of adrenal dysfunction.

Signs of adrenal disease are quite diverse. Here is an example from "another opera". For example, everyone knows that the stomach, intestines, gallbladder and liver are all digestive organs located in the abdominal cavity. That's why common symptom is abdominal pain. The adrenal glands cannot hurt.

More precisely, they can hurt, just like any internal organs, for example, with suppuration, with a rapid increase in the tumor of the adrenal glands, with phlegmon of the retroperitoneal tissue. But these pains are not a specific sign of their defeat, since such a symptom is a violation caused by a lack or excess of hormone synthesis.

Symptoms of adrenal disease in women may seem completely different bound friend with a friend. We list the main lesions of these important glands.

Conditions associated with increased hormone production

Adrenal diseases include Itsenko-Cushing's disease and Cushing's syndrome, primary hyperaldosteronism (with increased production mineralocorticoids), androsteroma (a tumor that produces androgens). There may also be corticoestroma (occurs in men), as well as mixed tumors producing various hormones.

That is why the very concept of "adrenal adenoma in women" can include the most different symptoms. After all, an "adenoma" is a tumor of the gland, and as we already know, the adrenal gland synthesizes more than 50 different hormones.

Also, the patient may develop pheochromocytoma, or a tumor of the adrenal medulla, producing adrenaline and norepinephrine in large quantities.

About Cushing's Syndrome and Disease

This is a condition in which excessive amounts of corticosteroid hormones are produced. In the event that the pituitary gland produces an excess of ACTH - adrenocorticotropic hormone (hormone - "boss" for the adrenal glands), then this condition is called Itsenko-Cushing's disease, and refers to the pathology of the pituitary gland. In addition, ACTH can be produced by tumors of the lungs and mediastinum.

Sometimes this state of hypercortisolism develops without any connection with ACTH. In this case we are talking about a tumor of the adrenal cortex in a woman, and then called Cushing's syndrome. It can be either corticosteroma or carcinoma ( malignant tumor). The symptoms of adrenal damage are as follows:

Obesity with the deposition of fat on the face, neck, chest, back and on the “nape”. The face is moon-shaped, the arms and legs are thin, there is muscle hypotrophy on them;
The complexion is purplish, puffy, sometimes with a bluish tint;
The skin is thin, dry, "marble", the vessels are clearly visible on it;
Violet and crimson long striae appear on the abdomen, thighs, mammary glands, shoulders;
Expressed areas of hyperpigmentation;
Violated sebum secretion, acne and hemorrhages under the skin are visible;
Very severe osteoporosis pathological fractures vertebrae, femoral neck;
There is myocardial dystrophy, heart rhythm disturbances;
Diabetes often joins - after all, an excess of hormones increases blood sugar levels (in 10 - 15% of all cases);

There are other symptoms - often, along with glucocorticosteroids, an excess of androgens increases. Hair growth occurs male type(hirsutism), menstruation decreases and amenorrhea occurs. Such a tumor, predominantly releasing testosterone precursors, is called an androsteroma.

Hyperaldosteronism

This is the name of a complex of symptoms caused by increased production of aldosterone and other mineralocorticoids. As usual, the disease has a primary form (most often, a tumor of the adrenal gland in the region of the cortical zone responsible for the production of aldosterone). This disease is called Conn's syndrome.

It happens and secondary hyperaldosteronism, in which there is no tumor, and aldosterone rises on command from the "center" - this is due to disturbances in water-electrolyte metabolism, with narrowing renal arteries, nephrotic syndrome, or congestive heart failure. The renin - angiotensin - aldosterone system is included in the matter, but we will not dwell on this. What is the manifestation of this pathology? Here are the main symptoms:

Increased blood pressure and the ineffectiveness of drugs to reduce it;
Muscle weakness, cramps, as signs of a decrease in potassium levels (you just need to take a blood test for electrolytes);
In severe cases, polyuria develops (urination per day more than 1.5 - 2 liters) and nocturia (the predominance of nighttime urination over daytime).

Pheochromocytoma

Until now, we have written about the increased production of cortical hormones. Pheochromocytoma is a tumor of the medulla that secretes adrenaline and norepinephrine. Clinically, it manifests as malignant arterial hypertension that comes with crises.

Every woman knows what sensations there are during the production of these hormones. If suddenly there was an explosion or a shot, an iron basin suddenly fell in the house - then fear arises, then it throws you into a sweat, pressure jumps, and you have to “depart” from what you have experienced. Imagine this state repeatedly accelerated and multiplied.

In many cases, if a woman is not in a hurry to see a doctor, an adrenal tumor will lead to heart attacks, strokes, pulmonary edema, and encephalopathy. The main symptoms of pheochromocytoma are as follows:

Periodic "off-scale" pressure: the level of blood pressure rises above 250 mm. rt. Art. (upper);
Between attacks (which correspond to the release of hormones by the tumor) often the pressure is reduced, and fainting occurs when standing up;
There are complaints of interruptions in the heart, fever, shortness of breath, constipation;
Sometimes attacks proceed as panic attacks, with the expressed excitement and fear. Arises headache, blurred vision;
If the tumor is malignant, then it can give rapid metastases to other organs and manifest itself with an appropriate clinic (jaundice, anemia, malnutrition, bone pain, etc.).

Decreased production of adrenal hormones

Hypocorticism is a condition in which the production of corticosteroids is reduced. It can be either primary or secondary. Often to blame autoimmune diseases, and the pathology is called Addison's disease. With this disease of the adrenal glands, due to a deficiency of both aldosterone and cortisol, dehydration, loss of electrolytes and a change in their ratio come to the fore. Decreased adrenal function is characterized by:

The appearance of dark pigment on the skin (nipples, genital area), exposed parts of the body. It is important that darkening ("bronze") occurs where the sun does not hit - in skin folds, and even on mucous membranes;
Against the background of "bronze" there may be pale spots of depigmentation - vitiligo;
There is a pronounced decrease in body weight - from 3 to 15 kg;
There is asthenia, severe weakness, depression develops;
Decreased sex drive;
An important symptom is a decrease in blood pressure, which can be manifested by fainting when standing up and during stress;
Appetite decreases, epigastric pain appears, unstable stool occurs;
The loss of sodium leads to an excess craving for salty foods.

The danger of Addison's disease is that it can develop acute insufficiency adrenal gland, which can mimic a heart attack, " acute abdomen”, stroke or meningitis.

What are eucorticism and incidentalomas?

Eucorticism - these are tumors of the adrenal glands that originate from indifferent, non-hormonal tissue, and are completely unable to produce hormones. Therefore, their growth is often imperceptible - they retain hormonal background women (created by the adrenal glands) are normal.

Therefore, it is necessary to look for a tumor in other ways, and often they are found by chance - with CT or MRI. Due to the frequent randomness in finding dangerous tumor they are called "incidentalomas" - they can cause stress and depression, more precisely - the fact of detection. After all, everyone is afraid of cancer.

But, in 98% of all cases, this is benign formations, and are found in 5% healthy people, and according to autopsy - even in 10% of the population.

Which doctor treats the adrenal glands?

Which doctor should I contact?

Since the adrenal glands are endocrine organ, then even if a hormonally inactive tumor has arisen, then this must be proven.

Therefore, a doctor is needed - an endocrinologist who will conduct appropriate studies, tests, determine the level of hormones in the blood and the symptoms caused by them. In some cases (for example, with hormonally inactive non-growing tumors), not treatment is needed, but simple observation by an endocrinologist.

In case of confirmation of the need surgical intervention, the patient is transferred to the department of pure surgery (from the department of endocrinology), and in the presence of a malignant tumor, the endocrinologist and the surgeon-oncologist or a specialist in radiation therapy are jointly treated.

Symptoms may be accompanied by panic attacks

Treatment of adrenal glands in women depends on the disease. So, with the syndrome and Cushing's disease, drugs are prescribed that reduce the production of steroids. In the case of a pituitary adenoma that secretes ACTH, it is removed. The pituitary gland is also irradiated, and in severe cases the adrenal gland is removed (on the one hand), when it comes to central reason. In the case of a tumor of the adrenal gland and secondary hypercortisolism, they act according to the nature of the tumor - remove, irradiate, or conduct courses of chemotherapy.

With hypocorticism, lifelong therapy is prescribed, which “replaces” the lack of hormones. Usually, when hormones are prescribed, there is a sharp and fast improvement states.

In the case of hyperaldosteronism associated with a tumor, it is removed, sometimes along with the adrenal gland. If this is a bilateral process, unrelated to the tumor, then long-term treatment with diuretics, calcium antagonists, ACE inhibitors is indicated.

If pheochromocytoma is diagnosed, then death is inevitable without treatment. It is necessary to remove the adrenal gland, in which there is a tumor. While the patient is preparing for surgery, alpha-blockers (doxazosin, prazosin) and beta-blockers (propranolol) are prescribed as protection against crises.

If an incidentaloma is diagnosed, then it is removed if it is larger than 6 cm, as well as with progressive growth or hormonal activity that has begun. In the case of stability, observation and MRI are indicated after 6, 12, and 24 months.

What is the bottom line?

The prognosis depends on the diagnosis. So, with stable incidentalomas, you can generally “forget” about them. But with pheochromocytoma, if it is not treated, sooner or later there will be a heart attack, stroke, repeated strokes against the background hypertensive crises, with inevitable death.

And in case timely treatment more than 95% of patients successfully overcome the threshold of 5-year survival, and only in the case of a malignant recurrent form, this percentage does not exceed 40%.

In general, with timely diagnosis and treatment of diseases of the adrenal glands, the prognosis is almost always favorable. Only when malignant tumors are detected, the consequences should be calculated in accordance with oncological standards.

The adrenal glands are paired glands located above the kidneys. Any disease of the adrenal glands can lead to malfunctions in all organs and systems, which entails irreparable consequences for health, and in advanced cases - death. Key aspects include:

hormone production;
participation in metabolic processes;
stimulation correct reactions for stressful situations;
maintenance of constancy internal environment organism.

Diseases of the glands, their causes

Pathologies of the adrenal glands significantly reduce the quality of life of an individual. The course of each of them is severe, requires timely diagnosis and treatment. All of them are conditionally divided into two groups according to the root cause of education:

diseases associated with insufficient production of hormones;
diseases that occur against the background of increased functionality of this organ.

Hyperaldosteronism

The cause of the disease may be inflammatory processes in the kidneys.

Kohn's syndrome or hyperaldosteronism - special condition in which aldosterone is excessively produced by the cortex of these glands. Its main task is to regulate the amount of blood and the level of sodium and potassium in it. There are primary and secondary forms of pathology. Among the reasons for this condition are the following:

cirrhosis of the liver;
chronic inflammation of the kidneys (eg, nephritis);
heart failure;
sometimes a secondary form of such a lesion occurs if the primary is not completely cured.

Symptoms of the disease look like this:

severe migraines;
increased fatigue due to muscle and general weakness;
seizures, which can cause temporary paralysis;
some parts of the body may become numb;
swelling is possible;
excessive thirst;
the level of calcium in the blood is lowered;
cardiopalmus;
increase in daily urine volume;
sometimes there are constipations.

Insufficiency of the adrenal cortex

Failure of the release of hormones by the adrenal glands leads to increased skin pigmentation.

This is an autoimmune disorder of the adrenal glands, or rather, their cortex, which is accompanied by a considerable number of other pathologies. There are two types of insufficiency: acute and chronic. The first develops against the background chronic form, independent development is rare, possibly with a sudden hemorrhage in the organ or sepsis. The second subspecies is possible with destructive changes in the tissues of the glands or in the absence of stimulation by the adrenocorticotropic hormone.

Symptoms include loss of energy, poor appetite (resulting in weight loss), increased skin pigmentation, low blood glucose levels, a steady decrease in blood pressure, vomiting with nausea, frequent urination, and uncharacteristic stools. Among the main reasons for the development given state allocate:

oppression of the anterior pituitary gland or necrosis;
infectious diseases;
the presence of a tumor (macroadenomas).

Hyperplasia of the adrenal cortex

Acne This is a consequence of a violation of the synthesis of cortisol.

This is a whole group of congenital anomalies that cause disruptions in the synthesis of cortisol, which leads to excessive production of androgens. The root cause is an anomaly in the development of the gene. There are 3 forms of hyperplasia: simple virilizing, with salt loss syndrome, hypertonic. To be treated, you must first eliminate the lack of cortisol. Symptoms of hyperplasia include:

late onset of menstruation;
acne;
virilization;
pubic and underarm hair appears early;
hyperpigmentation appears on the external genitalia.

Addison's disease

This endocrine pathology It is characterized by the destruction of organ tissues, a decrease in the amount of cortisol production, which, if patients are not treated, will completely cease to be synthesized. The reasons for the development of this condition are:

adrenal tuberculosis;
negative impact of chemicals;
insufficiency of the endocrine glands;
autoimmune processes.

Typical symptoms:

loss of strength, depression;
frequent colds;
poor swallowing ability;
increased pigmentation;
low pressure;
tachycardia;
refusal to eat;
the kidneys and adrenal glands do not work well;
memory impairment, inattention;
failures of the menstrual cycle with all the resulting consequences in women;
intolerance to sunlight;
sudden changes of constipation and diarrhea;
improper blood circulation;
nausea with vomiting;
thirst;
tremor of the limbs.

Inflammation of the adrenal glands

Inflammatory processes affect the adrenal cortex.

Inflammatory processes occur with tuberculous lesions of the adrenal cortex. The disease proceeds slowly and is accompanied by excessive fatigue, low stress resistance, constant aching headache. In a neglected state, it is possible to develop chronic inflammation, which can turn into an adsiconic crisis. Then there are signs such as:

vomit;
harsh bad smell from the oral cavity;
unpleasant pain sensations.

Pheochromocytoma

This tumor of the brain part of the paired glands with high hormonal activity, which causes excessive synthesis of adrenaline, dopamine and norepinephrine. Reasons for this hyperactivity:

thyroid cancer;
a systemic disease accompanied by a hereditary anomaly of the vessels of the brain and skin, shells of the eye;
hyperparathyroidism, which disrupts the functioning of the adrenal glands in terms of overproduction parathyroid hormone.

Dangerous tumors

In most cases, corticoestroma is diagnosed in men.

The functioning of the considered paired organs can be disrupted by the formation of tumors in them, which can be both benign and malignant. Most often, patients are affected by the first type. Each of these neoplasms has its own name, the most common are:

corticoestroma;
aldosteroma;
glucocorticosteroma;
andosteroma.

The exact cause of the disease has not yet been established, but the hormonal activity of the tumor increases under the influence of such provoking factors as:

an excess of hormones produced by organs;
proliferation and inflammation of gland cells;
thyroid cancer;
pathology with congenital anomalies vessels of the brain, membranes of the eyes, skin.

The tumor can be localized both in the cortical layer and the brain, manifesting itself with such symptoms:

high pressure;
pain in the chest and abdomen;
inhibition of sexual development;
the skin on the face acquires a bluish tint, the face is redder or, conversely, turns pale;
frequent nausea with vomiting;
increased excitability, irritability and constant feeling of fear;
change appearance both men and women;
a sharp change in blood sugar levels;
dry mouth, muscle tremors, convulsions.

Adrenal cyst

Rupture of the cyst can cause irreparable harm to the entire body.

A formation that fills the liquid, with a benign nature, is called a cyst. It is a rare pathology that is poorly diagnosed. A cyst is highly dangerous if it has a predisposition to developing into a malignant one. Symptoms appear only with an increase in the size of the formation, its rupture is a threat to the entire body. The main features are:

pain in the back, in the side and lower back;
disorders in the work of the kidneys;
enlargement of the adrenal glands;
feeling of pressure in the abdomen;
increased blood pressure due to squeezing of the renal artery.

Tuberculosis

This is a rare, severe form of adrenal insufficiency that does not interfere with the functionality of the glands at first, so it is most often diagnosed incidentally when calcification is found in the adrenal region in children and adolescents. Tuberculosis is observed with extensive modifications in the lungs, bacteria enter the adrenal glands by hematogenous route. Deficiency symptoms include:

weakness of the body;
pigmentation on the elbows and lower chest;
vomiting and diarrhea, provoking a decrease in sodium levels and an increase in potassium in the blood;
low pressure;

pressure drops;
nervousness;
"allergic" to the world, apathy towards everything;
insomnia or, conversely, too many dreams;
general weakness;
dry skin, hair loss;
problems with gums, teeth, bones;
pain in the knees, lower back;
anxiety;
reduced concentration;
weakening of the immune system.

Adrenal insufficiency refers to a pathology that can occur as a primary process with a decrease in the secretion of the organs themselves, or due to a violation of their regulation. The disease wears pronounced manifestations in the form of hyperpigmentation of the skin and mucous membranes, muscle weakness, diarrhea and vomiting. With this pathology, an imbalance of electrolytes occurs. With such a phenomenon as acute disorder adrenal function, treatment is required immediately, as it can lead to the death of the patient.

Adrenal insufficiency has several variants of hypocorticism, and they can manifest themselves symptomatically in different ways, have different etiology and pathogenesis.

Causes of dysfunction

As already noted, insufficiency may occur initially. Symptoms of pathology develop after about 85% of all cells of these organs cease to function. It develops as a result of the following processes:

Idiopathic. It happens in most cases from all the phenomena of hypocorticism. For reasons still unknown to science, the human body begins to produce antibodies that infect its own cells. It has been observed that these patients have autoimmune disorders and in other organs.

In second place (2% of all cases) of the decrease in the function of the adrenal glands, cell atrophy is noted under the influence of tuberculosis infection. This usually occurs in those individuals who suffer from pulmonary tuberculosis.

In last place is the rare hereditary disease, in which there is an accumulation in the adrenal cortex of excess fatty acids, they cause dystrophic changes in it.

Very rarely can cause a decrease in adrenal function, some pathological conditions in organism:

coagulopathy;

metastases from other foci;

infarction of the adrenal cortex;

operation on these organs.

Predisposition to decrease in function may occur as a result of taking certain drugs (barbiturates, ketoconazole, anticoagulants). Sometimes a malignant tumor or severe infections can provoke the process.

Reasons for development secondary insufficiency adrenal glands are as follows:

tumors of the central nervous system;

hemorrhages and aneurysms;

surgery on the brain;

radiation therapy.

Pathogenesis of hypocorticism

Primary pathology is manifested by a decrease in the production hormonal substances adrenal cortex. The body begins to receive less cortisol and aldosterone, so there is an imbalance in a number of metabolic processes and the presence of water and salts. Severe aldosterone deficiency leads to dehydration, as potassium levels rise and fluid begins to be excreted by the kidneys. Symptomatically, this is expressed in disorders of the digestive organs and adversely affects the work of the heart.

With a lack of cortisol, blood sugar levels decrease, since it is responsible for the synthesis of glycogen in the liver cells. The regulatory mechanisms give a signal to the central nervous system, and the pituitary gland begins to increase the production of adrenocorticotropic and melanocyte-stimulating hormone, therefore, in such a patient, darkening occurs. individual sections skin and mucous membranes. With the development of a stressful situation, or a serious illness, the symptoms of primary hypocorticism progress.

In the secondary variant of the pathology, only the production of cortisol is disturbed. Therefore, the disease proceeds with less severe manifestations for the patient.

Main symptoms of adrenal insufficiency

With a condition such as adrenal insufficiency, the symptoms can be different, but most often it is noted:

hyperpigmentation;

decreased tone and mood;

hypotension;

violations of the digestive processes;

hypoglycemia.

The intensity of the increase in pigmentation directly depends on the severity and duration of the disease. First of all, an increase in pigment is noted in the area of \u200b\u200bopen skin areas that are exposed to sunlight and those places that originally had pigment - nipples, genitals, armpits. Very hallmark is the darkening of the folds in the palm of the hand, which begin to stand out noticeably in the patient on a white background, and places on the skin that are subject to friction as a result of contact with clothing. Mucous membranes with such a deviation can acquire an almost black tint.

Against the background of pronounced pigmented areas, the patient often develops zones total absence pigment called vitiligo. These white patches are variable in size and are pathognomonic of a chronic autoimmune disease of the adrenal glands.

Violation of the functions of the adrenal glands in the direction of its reduction leads to weight loss. Sometimes it can be a slight weight loss, but in some patients there is a pronounced dystrophy (weight loss is 15-25 kg or more).

The patient's pressure decreases, if before the onset of adrenal insufficiency he was hypertensive, his blood pressure becomes within the normal range. With any psycho-emotional shocks, the body may react with a faint. Very characteristic symptom with this pathology is orthostatic collapse.

Often there are disorders of the digestive system. There is a decrease in appetite, impaired stool, pain in the stomach.

Complications of adrenal insufficiency

Most serious complication, which occurs with such a disease is the development of an Addissonian crisis. Given sharp violation adrenal function in women and men develops rapidly, and the patient falls into coma. The symptoms of this crisis are:

sudden onset of weakness, meningeal pain, lethargy;

drop in blood pressure to collapse;

severe dehydration through loss of fluid due to vomiting and diarrhea that cannot be stopped;

development of a convulsive syndrome;

rapid increase in heart failure.

The severity of manifestations can be different, the crisis often occurs in the form of a predominance of one or another symptomatology. But in the absence emergency assistance in a specialized department, it ends with the death of a person.

Treatment

In case of insufficient adrenal function, help lies in the elimination or reduction of the influence of the causes that can cause this condition, as well as in the use of hormone replacement therapy.

Treatment is used to help chronic infections, operations to remove neoplasms and aneurysms. If the processes causing insufficiency adrenal glands are irreversible, the patient must receive lifelong replacement therapy to compensate.

In the absence of crises, and the timely intake of glucocorticoids and mineralocorticoids, the prognosis for recovery is quite favorable. In the event that the patient disciplinedly follows the instructions of the doctor, his pressure and digestion are normalized, normal mass body.