Diagnosis is based on clinical suspicion followed by
measurement of plasma cortisol (5-25 ng/dl) a loss of diurnal variation (high
value in the evening). A detailed evaluation is then required to differentiate
between Hyperplasia or tumours of adrenal and ectopic ACTH syndrome the details
of this differentiation are given in Table 3
The treatment ofendogenous cushings excess secretion of
cortisol from adrenals is bilateral adrenalectomy
Minimal access route is used
NELSON’S SYNDROME
Patients of
Cushing’s Syndrome treated with total adrenalectomy later develop deep
pigmentation of the skin and evidence of tumour in the pituitary. This is
probably due to high levels of Melanin Secreting Hormone (M.S.H.) along with
high ACTH.
2.5 CONN’S SYNDROME (PRIMARY ALDOSTERONISM)
This syndrome is
caused by an excess secretion of aldosterone by a secreting adrenal
adenoma(70%). Bilateral adrenal hyperplasia (30%) and adenocarcinoma can also
produce primary aldosteronism.
The symptoms are
due to hypertension, hypokalaemia and alkalosis. There is a weakness polydipsia
intermitent paresthesia. Tetany and occasional paralysis also occur
additional information at Distance Learning Support Tryselfcare
Any questions be sent to drmmkapur@gmail.com
All older posts are stored in archives for access and review.
Visitors that follow may post contributions to the site,please write to address above.
To create consumer/provider engagement visit www.otmanage.blogspot.com
Now also available on android &smart phones same internet address.
additional information at Distance Learning Support Tryselfcare