Presentation
Intense hirsutism and features of virilisation presenting as hypertrophy of the clitoris predominate in the clinical picture of non-standard hypertrophy of the adrenal cortex. [ncbi.nlm.nih.gov]
Clinical description The disease presents a bimodal age distribution with a rare subset presenting in the first years of life, particularly associated to McCune-Albright syndrome (MAS; see this term). [orpha.net]
[…] with hypertension Clinical presentation in males Males with 21-hydroxylase deficiency have normal genitalia If the defect is severe and results in salt wasting, these male neonates present at age 1-4 weeks with failure to thrive, recurrent vomiting, [emedicine.medscape.com]
Glucocorticoid receptors are present in virtually all tissues and have a variety of other effects. Cortisol has an inhibitory effect on the immune system and the inflammatory response. [x-ald.nl]
Bilateral hyperplasia often presents as hypertension relatively resistant to antihypertensive medications. [clinicaladvisor.com]
Entire Body System
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Goiter
Acth (adrenal cortex) transparency (from intro book) review - same material, intro course what leads to hypertrophy of the thyroid gland (goiter)? deficiency of iodine. [barman.awardspace.info]
Face, Head & Neck
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Small Face
The production of cortisol from within the cortex of the adrenal glands is regulated by a small faces, necks, advertising marketing plan chests, abdomens and thighs) women may also show clitoral hypertrophy. [barman.awardspace.info]
Urogenital
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Clitoromegaly
partial fusion of the labioscrotal folds, or both Females with mild 21-hydroxylase deficiency are identified later in childhood because of precocious pubic hair, clitoromegaly, or both, often accompanied by accelerated growth and skeletal maturation [emedicine.medscape.com]
[…] hair and rapid growth in childhood Precocious puberty or failure of puberty to occur ( sexual infantilism : absent or delayed puberty ) Excessive facial hair, virilization, and/or menstrual irregularity in adolescence Infertility due to anovulation Clitoromegaly [en.wikipedia.org]
Workup
Thus, from our point of view, the presence of LVH not explained by BP should suggest the need to perform an etiological workup. [revespcardiol.org]
[…] genetic counseling and prenatal diagnosis of adrenal hyperplasia Newborn screening programs for 21-hydroxylase deficiency may be lifesaving in an affected male infant who would otherwise be undetected until presentation with a salt-wasting crisis [5] See Workup [emedicine.medscape.com]
Hypertrophy
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Ventricular Hypertrophy
Pulmonary artery stenosis, right ventricular hypertrophy wermer s syndrome men type i (thyroid, parathyroid, aforismi destino adrenal cortex. [barman.awardspace.info]
Key words:Cushing syndrome, hypertension, left ventricular hypertrophy [kochi-med.or.jp]
The most prevalent target organ damage is left ventricular hypertrophy. [revespcardiol.org]
Examples include muscle hypertrophy due to lifting weights, ventricular hypertrophy (enlargement of a ventricle of the heart) due to high blood pressure or other heart disorders, or prostatic hypertrophy (enlargement of ...Read more 4 Benign pineal gland [healthtap.com]
Treatment
Management and treatment Treatment can be medical if aberrant adrenal receptors are identified and can be blocked (i.e. with propranolol, somatostatin or GnRH analogs). [orpha.net]
Treatment [ edit ] Treatment of all forms of CAH may include any of: Supplying enough glucocorticoid to reduce hyperplasia and overproduction of androgens or mineralocorticoids Providing replacement mineralocorticoid and extra salt if the person is deficient [en.wikipedia.org]
Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). [revespcardiol.org]
Adrenal Cancer: symptoms, diagnosis and treatments Laparoscopic Adrenalectomy: the new minimally invasive way to remove most adrenal tumors Overview of Hormones produced by endocrine glands. An Overview of the Hypothalamus [endocrineweb.com]
Treatment includes replacement of cortisol with cortisosteroid medication. This reduces the ACTH-stimulation of the gland and in turn, the androgen production is reduced. [chw.org]
Prognosis
Prognosis Prognosis after treatment is good but quality of life may be affected due to the long-term effects of hypercortisolemia. Without treatment the disease is life-threatening as in the case of manifest hypercortisolism. [orpha.net]
Prognosis With adequate medical and surgical therapy, the prognosis is good. However, problems with psychological adjustment are common and usually stem from the genital abnormality that accompanies some forms of congenital adrenal hyperplasia. [emedicine.medscape.com]
Etiology
Etiology The exact etiology is unknown but the adrenal overgrowth seen in AIMAH may be due to the expression of aberrant membrane receptors found in the adrenal cortex that regulate cortisol secretion and which are stimulated by gastric inhibitory polypeptide [orpha.net]
Thus, from our point of view, the presence of LVH not explained by BP should suggest the need to perform an etiological workup. [revespcardiol.org]
[…] deficiency generally have ambiguous genitalia or female genitalia; they may be raised as girls and seek medical attention later in life because of hypertension or a lack of breast development Other findings Patients with aldosterone deficiency of any etiology [emedicine.medscape.com]
Epidemiology
Although results are sometimes conflicting because of confounding factors, epidemiological studies in humans suggest effects of EDCs on prenatal growth, thyroid function, glucose metabolism and obesity, puberty, fertility, and on carcinogenesis mainly [old.iss.it]
Summary Epidemiology Prevalence of endogenous CS is estimated at 1/26,000 and AIMAH represents less than 1% of the cases. [orpha.net]
Epidemiology Race Congenital adrenal hyperplasia occurs among people of all races. Congenital adrenal hyperplasia secondary to CYP21A1 mutations and deletions is particularly common among the Yupik Eskimos. [emedicine.medscape.com]
"in ways so slipshod as to breach professional standards of medical ethics" [17] and "there were no data on long-term follow-up of physical and metabolic outcomes in children exposed to dexamethasone". [18] Epidemiology [ edit ] The incidence varies geographically [en.wikipedia.org]
Pathophysiology
Pathophysiology Loss of more than 90% of both adrenal cortices results in the clinical manifestations of adrenocortical insufficiency (often also called adrenal insufficiency). [x-ald.nl]
The pathophysiology and genetics of congenital lipoid adrenal hyperplasia. N Engl J Med 335: 1870, 2005. CrossRef Google Scholar 9. Andersson HC, Frentz J, Martinez JE, Tuck-Muller CM, Bellizaire J. [link.springer.com]
Congenital adrenal hyperplasia, which also dates to the first half of the century, has become the preferred term to reduce ambiguity and to emphasize the underlying pathophysiology of the disorders. [en.wikipedia.org]
Pathophysiology The clinical manifestations of each form of congenital adrenal hyperplasia are related to the degree of cortisol deficiency and/or the degree of aldosterone deficiency. [emedicine.medscape.com]
Prevention
Genetic Disorders and the Fetus: Diagnosis, Prevention and Treatment. John Wiley and Sons. pp. 600–. ISBN 978-1-4051-9087-9. Retrieved 14 June 2010. Richard D. McAnulty, M. [en.wikipedia.org]
CARDIOVASCULAR SYSTEM: PERMISSIVE ACTION TO: CATECHOLAMINES VASOCONSTRICTION DECREASE IN VASCULAR PERMEABILITY NET EFFECT: INCREASE IN BLOOD PRESSURE STRESS OR EMERGENCY SITUATIONS PREVENTS “HYPOGLICEMIA, SHOCK AND DEATH) www.freelivedoctor.com 11. [slideshare.net]
[…] as needed, to restore intravascular volume and blood pressure; this may be repeated if the blood pressure remains low Dextrose must be administered if the patient is hypoglycemic and must be included in the rehydration fluid after the bolus dose to prevent [emedicine.medscape.com]
This rapid drop puts an extra load on the adrenals and pushes them to make the glucocorticoids necessary in order to prevent hypoglycemia. [pihealth.com]