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Pathology of endocrine disorders of adrenal gland (Multiple locations…
Pathology of
endocrine disorders
of adrenal gland
Zona glomerulosa
Primary increase
Conn's syndrome
cause: adenoma
of the zona glomerulosa
Secondary increase
Secondary hyperaldosteronism
general cause: activation of RAAS by any
condition that reduces renal perfusion
specific causes: CHF, renal artery stenosis,
excessive diuretic therapy, nephritic syndrome,
cirrhosis
Zona fasiculata
Primary increase
Cushing's disease
cause: adenoma of the anterior
pituitary producing excess ACTH
Secondary increase
Cushing's syndrome
general cause: anything that causes a chronic
increase in serum cortisol levels
specific causes: glucocorticoid medication,
(Cushings disease), ectopic ACTH producing tumors,
adrenal adenomas
Zona reticularis
Nope.
Medulla
Primary increase
Phaeochromocytoma
cause: tumor of the catecholamine producing
cells of the adrenal medulla
Multiple locations
Primary increase
Congenital adrenal hyperplasia (CAH)
cause: autosomal recessive 21-hydroxylase deficiency (95%)
pathogenesis: 21-hydroxylase is required for aldosterone and
cortisol production. Without cortisol, there is no -'ve feedback
on the anterior pituitary, and ACTH ↑, causing hyperplasia
of the adrenal cortex.
Primary decrease
Addison's disease
definition: primary insufficiency of the adrenal cortex
causes: autoimmune (80%), tuberculosis, mets
Secondary decrease
Secondary adrenocortical insufficiency
causes: non-functional adenoma of the anterior pituitary