Adrenal hypersecretion

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Hyperactivity of adrenal cortex may be due to primary defect in adrenal gland itself (Cushing’s syndrome) or,
Secondarily, by excessive production of ACTH from pituitary (Cushing’s disease) or ectopic ACTH production by other malignant tumors.

Cushing’s syndrome

Cushing’s syndrome is the term used to describe the clinical state of increased free circulating glucocorticoids.
It occurs most often following the therapeutic administration of synthetic steroids or ACTH.

Symptoms

• Central weight gain
• Change in appearance
• Depression
• Insomnia
• Amenorrhea / oligomenorrhea
• Poor libido
• Thin skin / easy bruising
• Hair growth / acne
• Muscular weakness
• Growth arrest in children
• Back pain
• Polyuria, polydipsia
• Psychosis

Signs

• Moon face
• Plethora
• Depression / psychosis
• Acne hirsutism frontal balding in females
• Thin skin
• Bruising
• Poor wound healing
• Pigmentation
• Skin infections
• Hypertension
• Osteoporosis
• Pathological fractures (especially in vertebrae and ribs)
• Kyphosis
• ‘Buffalo hump’ – dorsal fat pad
• Central obesity
• Striae (purple or red)
• Rib fractures
• Oedema
• Proximal myopathy
• Proximal muscle wasting
• Glycosuria