Adrenal Cushing 2 diagnoss treatment other syndromes

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

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