Pediatric Adrenal Disorders | Adrenal Disease in Babies
Adrenal glands, which are likewise called suprarenal glands, are small, triangular glands found on top of both kidneys. An adrenal gland is made of two parts: the outer area, called the adrenal cortex, and the inner area, called the adrenal medulla. The adrenal glands work interactively with the hypothalamus and pituitary gland, in addition to secrete hormonal agents that impact metabolic process, blood chemicals, and specific body qualities. Adrenal glands likewise secrete hormonal agents that help a person cope with both physical and emotional stress.
Hormones produced by the adrenal glands consist of the following:
- Adrenal cortex
- Corticosteroid hormonal agents (hydrocortisone or cortisol) help manage the body’s use of fats, proteins, and carbohydrates, suppress inflammatory responses in the body, and impact the body immune system function
- Aldosterone hinders the level of sodium excreted into the urine, and maintains blood volume and blood pressure
- Androgenic steroids (androgen hormones) have a result on the advancement of male characteristics
- Adrenal medulla
- Epinephrine (adrenaline) increases the heart rate and force of heart contractions, assists in blood circulation to the muscles and brain, causes relaxation of smooth muscles, helps with conversion of glycogen to glucose in the liver, and other activities
- Norepinephrine (noradrenaline) has little impact on smooth muscle, metabolic processes and heart output, however has strong vasoconstrictive results (narrowing of the capillary), thus, increasing high blood pressure
Certain adrenal gland conditions are characterized by a failure of the adrenal glands to produce cortisol (likewise called hydrocortisone hormone) and aldosterone, often due to specific missing enzymes (proteins that accelerate or cause chemical reactions). The outcome is enlarged adrenal glands due to overstimulation from the hypothalamus, which finds the low levels of hormonal agents. The hypothalamus, in turn, stimulates the pituitary gland to stimulate the adrenal glands. Overstimulation of the adrenal glands can lead to overproduction of androgens, which can lead to masculinization. Disorders of the adrenal glands require medical care by a physician or other health care professional.
Adrenal insufficiency (Addison disease) can be categorized as main, which happens when the adrenal gland itself is inefficient, or secondary, likewise called main adrenal deficiency, which occurs when a lack of secretion of corticotropin-releasing hormonal agent (CRH) from the hypothalamus or of adrenocorticotropic hormone (ACTH) from the pituitary causes hypofunction of the adrenal cortex.
Underactive Adrenal Glands/ Addison’s DiseaseWhat is Addison’s disease?
Addison’s disease is the result of an underactive adrenal gland. An underactive adrenal gland produces inadequate amounts of cortisol (a steroid hormone that assists to control the body’s use of fats, proteins and carbohydrates, reduces inflammatory reactions in the body, and affects body immune system functions) and aldolsterone (a steroid hormone that controls sodium and potassium in the blood). One in every 100,000 people have Addison’s disease. Onset of the disease might take place at any age.
What causes Addison’s disease?
Most of the time, the cause of the disease is unidentified (idiopathic). About one-third of Addison’s disease cases are triggered by the real damage of the adrenal glands through cancer, infection, an autoimmune procedure, or other illness. Other causes might include:
Use of corticosteroids as a treatment (such as prednisone) may cause a downturn in production of natural corticosteroids by the adrenal glands
Certain medications used to treat fungal infections may obstruct production of corticosteroids in the adrenal glands
Rarely, Addison’s disease is inherited as an X-linked trait where the gene responsible for the condition lies on the X chromosome and gave from a healthy female carrier to her kids (50/50 chance), who are impacted. In this type, symptoms generally start in youth or teenage years.
What arise from insufficient corticosteroid production?
Lack of adrenal hormones may cause:
- Raised levels of potassium
- Severe sensitivity to the hormone insulin, which typically is present in the bloodstream, and might result in low blood sugar level levels
- Increased risk during difficult durations, such as surgery, infection, or injury
What are the symptoms of Addison’s disease?
Mild Addison’s disease symptoms might only appear when the child is under physical stress. The following are the most common symptoms of Addison’s disease. Nevertheless, each child may experience symptoms in a different way.
- Rapid pulse
- Dark skin (first kept in mind on hands and face)
- Black freckles
- Bluish-black discoloration around the nipples, mouth, anus, scrotum, or vaginal area
- Weight loss
- Anorexia nervosa
- Intense salt yearning
- Muscle aches
- Intolerance to cold
If not treated, Addison’s disease might lead to severe abdominal pain, severe weak point, low high blood pressure, kidney failure, and shock – especially when the child is experiencing physical stress. The symptoms of Addison’s disease may look like other problems or medical conditions. Constantly consult your child’s doctor for a diagnosis.
How is Addison’s disease diagnosed?
In addition to a total medical history and health examination, diagnostic treatments for Addison’s disease may consist of blood tests to determine corticosteroid hormonal agent levels.
Treatment of Addison’s disease
The objective of treatment is to bring back the adrenal glands to typical function, producing regular levels of corticosteroid hormones. Considering that Addison’s disease can be harmful, treatment frequently starts with administration of corticosteroids. Corticosteroids, such as prednisone, might be taken orally or intravenously, depending on the child’s condition. Generally the child must continue taking the corticosteroids for the rest of his/her life. Treatment might likewise consist of taking a medication that assists restore the body’s level of sodium and potassium.
Overactive Adrenal Glands/ Cushing’s SyndromeWhat are overactive adrenal glands?
When adrenal glands produce extreme amounts of certain hormonal agents, they are called overactive. Symptoms and treatment depend upon which hormonal agents are being overproduced, consisting of the following:
- Androgenic steroids (androgen hormones) – an overproduction of androgenic steroids (such as testosterone) can lead to overstated male qualities in both men and women, such as excess hair on the face and body, baldness, acne, deeper voice, and increased muscle mass. If a female fetus is exposed to high levels of androgens early in pregnancy, her genital areas might develop abnormally. Young boys who experience high levels of androgen levels might grow quicker, however bones might likewise grow faster and stop growing too soon.
- Corticosteroids – an overproduction of corticosteroids can result in Cushing’s syndrome.
- Aldosterone – an overproduction of the aldosterone hormonal agent can cause high blood pressure and to those symptoms related to low levels of potassium (i.e., weak point, muscle aches, convulsions, and, sometimes, paralysis.)
The symptoms of overactive adrenal glands may resemble other issues or medical conditions. Constantly consult your child’s doctor for a medical diagnosis.
How are overactive adrenal glands diagnosed?
In addition to a complete medical history and physical exam, diagnostic procedures to determine levels of hormonal agents for overactive adrenal glands may include:
- Particular blood tests
- Urine tests
Treatment of overactive adrenal glands
Treatment of overactive adrenal glands depends upon the cause of the disease. Particular treatment for overactive adrenal glands will be identified by your child’s doctor based upon:
- Your child’s age, overall health, and medical history
- Extent of the disease
- Your child’s tolerance for particular medications, procedures, or therapies
- Expectations for the course of the disease
- Your viewpoint or choice
Treatment may consist of surgical removal of developments on the adrenal gland( s), or the adrenal gland( s) itself. Medications that block the excessive production of particular hormonal agents may also be administered.
What is Cushing’s syndrome?
Cushing’s syndrome is myriad abnormalities that are the result of hypersecretion of corticosteroids by the adrenal cortex. An overproduction of cortisol, the hormonal agent that controls the adrenal gland may be one cause. In addition, certain lung cancers and other growths outside the pituitary gland may produce corticotropins. Other causes include benign (non-cancerous) or cancerous growths on the adrenal glands. Cushing’s syndrome is rare in children and more commonly seen in adults.
What are the symptoms of Cushing’s syndrome?
The following are the most common symptoms of Cushing’s syndrome. However, each child might experience symptoms in a different way. Children and teenagers with Cushing’s syndrome mainly experience weight gain, development retardation, and hypertension (hypertension).
- Upper body obesity
- Round or moon-shaped face
- Increased fat around neck
- Thinning arms and legs
- Delicate and thin skin
- Dark pigmentation of the skin
- Stretch marks on abdominal area, thighs, buttocks, arms, and breasts
- Bone and muscle weakness
- Severe tiredness
- High blood glucose
- Irritation and stress and anxiety
- Extreme hair development in women
- Irregular or stopped menstrual cycles in females
- Lowered libido and fertility in males
The symptoms of Cushing’s syndrome may look like other conditions or medical problems. Always consult your child’s physician for a diagnosis.
How is Cushing’s syndrome detected?
In addition to a complete medical history and physical examination, diagnostic treatments for Cushing’s syndrome might include:
- 24-hour urinary test( urine is gathered over a 24-hour period to measure for corticosteroid hormonal agents)
- Computed tomography scan( CT scan)
- Magnetic resonance imaging (MRI)
- Dexamethasone suppression test( to separate whether the excess production of corticotropins are from the pituitary gland or growths elsewhere)
- Corticotropin-releasing hormone( CRH) stimulation test( to differentiate whether the cause is a pituitary growth or an adrenal growth)
Treatment for Cushing’s syndrome
Treatment for Cushing’s syndrome depends upon its cause. Surgery might be had to remove tumors of the adrenal glands.
What is a pheochromocytoma?
A pheochromocytoma is an adrenal gland growth that produces epinephrine and norepinephrine hormones. These hormonal agents are accountable for regulating heart rate and blood pressure, among other functions. Pheochromocytomas occur most frequently in young to middle-aged adults between the ages of 30 and 60. Ten percent of individuals impacted are children who generally develop symptoms in between the ages of 6 and 14.
What causes pheochromocytomas?
The causes of pheochromocytoma are multifactorial. Most of the times, both genetic and ecological factors contribute. The condition can take place alone or in mix with other disorders. The following are the most common conditions associated with pheochromocytoma:
- Von Hippel-Lindau disease
- Several endocrine neoplasia( MEN) syndromes
- Tuberous sclerosis
- Sturge-Weber syndrome
- A taxia-telangiectasia
What are the symptoms of pheochromocytoma?
The most typical symptom of pheochromocytoma is hypertension, which is in some cases severe. Each child may experience symptoms differently.
- Rapid pulse
- Heart palpitations
- Poor weight gain regardless of good hunger
- Growth failure
- Abdominal pain
- Pale skin
- Clammy skin
The symptoms of pheochromocytoma might resemble other problems or medical conditions. Constantly consult your child’s doctor for a diagnosis.
How is pheochromocytoma diagnosed?
In addition to a total case history and physical exam, diagnostic procedures for pheochromocytoma might include:
- Blood and urine tests (to determine hormonal agent levels)
- Computed tomography scan (CT scan)
- Radioisotope scan – uses radioactive substances introduced into the body to create a picture of the operating adrenal gland.
Treatment for pheochromocytoma normally consists of removing the tumor. Before eliminating the growth, however, your child’s physician may recommend medications to manage high blood pressure. In children, there may be several tumors. A comprehensive examination to find them will be required before surgery.
Continuous medical follow-up might be needed to monitor the advancement of future growths.
Family members might likewise want to think about evaluating to rule out the existence of the growths, as genes does appear to contribute in many cases.