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Revista Cubana de Pediatría
versión On-line ISSN 1561-3119
Resumen
GONZALEZ CASTILLO, Yoala y HERNANDEZ, Julio Andrés. Diverse presentation of diseases of the adrenal cortex. Rev Cubana Pediatr [online]. 2021, vol.93, n.4 Epub 01-Mar-2022. ISSN 1561-3119.
Introduction:
The adrenal glands are divided into cortex and marrow. The cortex secretes three different classes of hormones: glucocorticoids, mineralocorticoids and androgens; the marrow produces catecholamines. All of them are involved in multiple corporal functions.
Objective:
Show different forms of presentation of some of the diseases of the adrenal cortex.
Presentation of cases:
Patient 1: 7-year-old school boy, history of controlled hypothyroidism, and presenting decay and poor pondostatural growth. Cortisol level in fasting 86 nmol/L and ACTH 154 pg/ml. Primary adrenal insufficiency is diagnosed. Re-admitted at age 9 for maintaining little growth. Bone age: 2 years and 8 months. Clonidine test: altered, it confirms growth hormone deficiency. Patient 2: 8-year-old schoolboy, history of congenital adrenal hyperplasia due to 21 hydroxylase deficiency, simple virilizing form. He presents acceleration of genital development. Hydrocortisone treatment was missed for 5 years. 17 hydroxyprogesterone was found to be elevated to 189 ng/dl. Peripheral precocious puberty and virilization of the genitals were diagnosed. Patient 3: 5-month-old infant with obesity of 3 months of evolution. Contrasted computed axial tomography of the abdomen confirms tumor lesion of 5 cm in projection of the right adrenal. Cortisol level in fasting 892 nmol/L, cortisol 11 pm 920 nmol/L. Surgery was performed and Cushing's syndrome was diagnosed due to cortisol-producing adrenal carcinoma.
Conclusions:
In daily clinical practice we can find patients with symptoms and signs as common as decay, vomiting or sudden weight gain and they are secondary to diseases of the adrenal gland.
Palabras clave : Diseases of the adrenal cortex; adrenal insufficiency; congenital adrenal hyperplasia; adrenal carcinoma.