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2021, Number 4

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Rev Cubana Pediatr 2021; 93 (4)

Diverse presentation of diseases of the adrenal cortex

González CY, Hernández JA

Language: Spanish
References: 17
Page: 1-11
PDF size: 373.49 Kb.


ABSTRACT

Introduction: The adrenal glands are divided into cortex and marrow. The cortex secretes three different classes of hormones: glucocorticoids, mineralocorticoids and androgens; the marrow produces catecholamines. All of them are involved in multiple corporal functions.
Objective: Show different forms of presentation of some of the diseases of the adrenal cortex.
Presentation of cases: Patient 1: 7-year-old school boy, history of controlled hypothyroidism, and presenting decay and poor pondostatural growth. Cortisol level in fasting 86 nmol/L and ACTH 154 pg/ml. Primary adrenal insufficiency is diagnosed. Re-admitted at age 9 for maintaining little growth. Bone age: 2 years and 8 months. Clonidine test: altered, it confirms growth hormone deficiency. Patient 2: 8-year-old schoolboy, history of congenital adrenal hyperplasia due to 21 hydroxylase deficiency, simple virilizing form. He presents acceleration of genital development. Hydrocortisone treatment was missed for 5 years. 17 hydroxyprogesterone was found to be elevated to 189 ng/dl. Peripheral precocious puberty and virilization of the genitals were diagnosed. Patient 3: 5-month-old infant with obesity of 3 months of evolution. Contrasted computed axial tomography of the abdomen confirms tumor lesion of 5 cm in projection of the right adrenal. Cortisol level in fasting 892 nmol/L, cortisol 11 pm 920 nmol/L. Surgery was performed and Cushing's syndrome was diagnosed due to cortisol-producing adrenal carcinoma.
Conclusions: In daily clinical practice we can find patients with symptoms and signs as common as decay, vomiting or sudden weight gain and they are secondary to diseases of the adrenal gland.


REFERENCES

  1. Stewart PM, Newell-Price JDC. Corteza suprarrenal. En: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM. Williams, editores. Tratado de Endocrinología. Barcelona: Elsevier; 2017. p. 490-556.

  2. Forest MG, Audi Parera L, Fernanadez Cancio M. Hipofuncion suprarrenal. En: Pombo M, Audi L, Bueno M, Calzada R, Cassorla F, Dieguez C, editores. Tratado de Endocrinología Pediátrica. 4ta ed. Madrid: McGraw-Hill Interamericana; 2009. p. 647-72.

  3. Herndon J, Nadeau AM, Davidge-Pitts CJ, Young WF, Bancos I. Primary adrenal insufficiency due to bilateral infiltrative disease. Endocrine. 2018;62:721-8.

  4. Kahaly GJ, Frommer L. Polyglandular autoimmune syndromes. Eur J Endocrinol. 2009;161(1):11-20. DOI: 10.1530/EJE-09-0044. Epub 2009 May 1.

  5. Kahaly GJ, Frommer L. Polyglandular autimmune syndromes. J Endocrinol invest. 2018;41(1):91-98. DOI: 10.1007/s40618-017-0740-9. Epub 2017 Aug 17. PMID: 28819917.

  6. Barrueta Ordoñez T, Collazo Mesa T, Lantigua Cruz P, Gonzalez Navarro A, Espinosa Reyes T. Deteccion de la mutacion I172N en pacientes cubanos con hiperplasia adrenal congénita por deficiencia de 21 hidroxilasa. Rev Finlay. 2019 [acceso 18/09/2020];9(1):36-45. Disponible en: Disponible en: http://scielo.sld.cu/scielo.hph?scrip=sci_arttext&pid=S222124342019000100036&ing=es

  7. Brito Garcia AB, Álvarez Navarro R, Castañeda Betancourt O, Manso Álvarez I. Hiperplasia adrenal congenita. Presentación de un caso. Gac. Méd. Espirit. 2016 [acceso 13/02/2021];18(3):47-53. Disponible en: Disponible en: http://scielo.sld.cu/scielo.hph?scrip=sci_arttext&pid=S1608-89212016000300007&ing=es&tIng=es

  8. Avaria J, Vargas MJ, Triviño L, Gleisner A. Hiperplasia Suprarrenal Congénita: Reporte de un caso clínico. Rev ANACEM, 2013 [acceso 17/09/2020];7(1):38-40. Disponible en: Disponible en: http://searc.ebscohost.com/login.aspx?direct=true&db=a9h&AN=130824059&lang=es&site=ehost-live

  9. Speiser P, White P. Review Congenital Adrenal Hyperplasia. N Engl J Med. 2003;349(8):76-88.

  10. Witchel SF. Review nonclassic congenital adrenal hyperplasia. Curr Op Endocrinol Diabetes Obes. 2012;19(3):151-8.

  11. Ribeiro RC, Pinto EM, Zambeti GP, Rodriguez Galindo C. The international Pediatric Adrenocortical Tumor registry initiative: Constributions to clinical, biological, and treatment advances in pediatric adrenocortical tumors. Mol Cell Endocrinol. 2012;351:37-43.

  12. Albero R, Sanz A, Trincado P, Monreal M. Manejo terapéutico del carcinoma de la corteza suprarrenal. Endocrinol Nutr. 2006;53(7):458-66.

  13. Solari Moro A, Felizzia G, Glembocki A, Gil S, Iglesias V, Messina J, et al. Cómo crecen los niños. Med infantil. 2017;24(3):268-74.

  14. Betancourt Vd, Archila EI. Tumores suprarrenales. Revisión bibliográfica. Acta médica del centro. 2014 [acceso 24/04/2021];8(1). Disponible en: Disponible en: http://www.revactamedicacentro.sld.cu/index.php/amc/article/view/59

  15. Cambiaso P, Bottaro G, Cianfarani S, Tomà P, Vito RD, Cappa M. An incidental finding of bilateral adrenal lymphoma. Am J Med Sci. 2016;352:80.

  16. Ribeiro RC, Michalkiewicz EL, Figueiredo BC, DeLacerda L, Sandrini F, Pianovsky MD, Sampaio G, Sandrini R. Adrenocortical tumors in children. Braz J Med Biol Res. 2000;33(10):1225-34. DOI: 10.1590/s0100-879x2000001000013. PMID: 11004724.

  17. Solís-Guadarrama MA, Solís-Cano DG, Amador-Martínez AC, Baquera-Heredia J, Molinar-Flores G. Carcinoma adrenal pediátrico: presentación de un caso y revisión de la literatura. An Radiol Méx. 2019;18:136-41.




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