Congenital adrenal cortex dysfunction is also known to physicians as congenital adrenogenital syndrome. In recent years, the disease has been described more often under the name "congenital virilizing hyperplasia of the adrenal cortex," emphasizing the action of adrenal androgens on the external genitalia.
Hypoaldosteronism is one of the least studied issues of clinical endocrinology. Information about this disease is absent in both manuals and textbooks of endocrinology, despite the fact that isolated hypoaldosteronism as an independent clinical syndrome was described more than 30 years ago.
Common to all forms of primary hyperaldosteronism is low plasma renin activity (PRA), and different are the degree and nature of its independence, i.e. the ability to be stimulated as a result of various regulatory effects. Aldosterone production in response to stimulation or suppression is also differentiated.
Primary aldosteronism (Conn's syndrome) is aldosteronism caused by autonomous production of aldosterone by the adrenal cortex (due to hyperplasia, adenoma, or carcinoma).
Treatment of chronic adrenal insufficiency is aimed, on the one hand, at eliminating the process that caused damage to the adrenal glands and, on the other hand, at replacing the lack of hormones.
The most common causes of primary destruction of the adrenal glands include autoimmune processes and tuberculosis, while rare causes include tumors (angiomas, ganglioneuromas), metastases, and infections (fungal, syphilis).
A distinction is made between primary and secondary chronic adrenal insufficiency. The first is caused by damage to the adrenal cortex, the second occurs when the secretion of ACTH by the pituitary gland decreases or ceases.
In acute adrenal insufficiency, it is necessary to urgently use replacement therapy with synthetic drugs of glucocorticoid and mineralocorticoid action, as well as take measures to bring the patient out of a state of shock.
Adrenal or Addisonian crises develop more often in patients with primary or secondary adrenal disease. They are less common in patients without previous adrenal disease.
Acute adrenal insufficiency is a serious condition of the body, clinically manifested by vascular collapse, severe adynamia, and gradual clouding of consciousness. It occurs with a sudden decrease or cessation of secretion of hormones of the adrenal cortex.
