The adrenal glands sit atop the kidneys. Through complex reactions, these glands lead to the production of cortisol (glucocorticoid) and androgens (male sex hormones). The adrenal glands are carefully regulated by the hypothalamus and pituitary gland through feedback mechanisms. Here, the end product, or cortisol, stimulated the brain and pituitary gland to secrete less ACTH. When there are enzymatic defects in the production of cortisol, the feedback mechanism does not work appropriately. The levels of ACTH remain high, overstimulating the production of androgens.
Causes of Adrenal Hyperplasia
Congenital forms of adrenal hyperplasia usually are a consequence of enzymatic defects the cells of the adrenal gland. Since the adrenal glands produces both glucocorticoids and some sex hormones, the production of both may be affected. The adrenal gland is regulated by ACTH, or adrenocorticotrophic hormone, that is secreted by the pituitary gland and regulated by the hypothalamus. Deficient production of cortisol due to enzyme problems leads to increased levels of ACTH. These serve to stimulate the production of the adrenal gland. Similar types of changes may occur with adenomas or carcinomas of the adrenal gland. These types of tumors need to be excluded.
Signs and Symptoms of Adrenal Hyperplasia
Overproduction of male sex hormones by the overactive adrenal gland leads to hirsutism, or increased hair in the distribution of the male. Women affected by this disorder develop irregular or absent menstrual periods. Acne develops. Virilization occurs, with deepening of the voice. When this disorder is manifest in early childhood, it can lead to ambiguous genitalia.
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Medical Content Last Updated on 07/12/2008
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