Overactive adrenal glands (Cushing's syndrome)

Overview

If your child’s adrenal glands produce excessive amounts of certain hormones, they are said to be overactive. The symptoms (and treatment) of overactive adrenal glands depends on which hormone is being overproduced.

Some of the most commonly overproduced hormones are:

• Androgenic steroids (also known as androgen hormones)
  • Testosterone is one of the most well-known androgen hormones. Excessive production of this or other androgen hormones can lead to exaggerated male characteristics in both men and women (like excess hair on the face and body, baldness, acne, a deeper voice and increased muscle mass).
  • If a female fetus is exposed to high levels of androgens early during a mother’s pregnancy, her genitals may develop abnormally. Young boys who experience high levels of androgen levels may grow faster, but their bones may also mature faster and stop growing too soon.
• Aldosterone hormone
  • Overproduction of aldosterone hormone can lead to high blood pressure and to symptoms associated with low levels of potassium (like weakness, muscle aches, spasms and sometimes paralysis).
• Corticosteroids
  • An overproduction of corticosteroids leads to the condition known as Cushing’s syndrome. Rare in children, it’s more commonly seen in adults.

What causes Cushing’s syndrome?

Cushing’s syndrome—the overproduction of corticosteroids—may be caused by an overproduction of cortisol (the hormone that controls the adrenal gland) by the pituitary gland. Other causes of Cushing’s syndrome include:

• certain lung cancers and other tumors outside the pituitary gland
• benign (non-cancerous) or cancerous tumors on the adrenal gland(s)

What are the symptoms of Cushing’s syndrome?

Children and adolescents with Cushing's syndrome experience weight gain, growth retardation and hypertension (high blood pressure). Other symptoms may include:

• upper body obesity
• round or moon-shaped face
• increased fat around neck
• thinning arms and legs
• fragile and thin skin
• darkened pigmentation of the skin
• acne
• bruising
• stretch marks on abdomen, thighs, buttocks, arms, and breasts
• bone and muscle weakness
• severe fatigue
• high blood sugar
• irritability and anxiety
• excessive hair growth in females
• irregular or stopped menstrual cycles in females
• reduced sex drive and fertility in males

How do doctors diagnose an overactive adrenal glands?

In addition to a complete medical history and physical examination, your child’s doctor will order specific blood and/or urine tests to measure hormone levels.

How can doctors tell if my child has Cushing’s syndrome?

In addition to a complete medical history and physical examination, your child’s doctor may request some or all of the following procedures:

• x-ray - a diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones and organs onto film
• 24-hour urinary test (urine is collected over a 24-hour period to measure corticosteroid hormones)
• computerized tomography scan (Also called a CT or CAT scan) - a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body
• magnetic resonance imaging (MRI) - a diagnostic procedure that uses a combination of large magnets, radiofrequencies and a computer to produce detailed images of organs and structures within the body
• dexamethasone suppression test (to differentiate whether the excess production of corticotropins originates from the pituitary gland or tumors elsewhere)
• corticotropin-releasing hormone (CRH) stimulation test (to differentiate whether the cause is a pituitary tumor or an adrenal tumor)

How are overactive adrenal glands/Cushing’s syndrome treated?

Treatment for overactive adrenal glands may include surgical removal of growths on the adrenal gland(s) or the adrenal gland(s) itself. Your doctor may also prescribe medications that block the excessive production of certain hormones.

 

From https://web1.tch.harvard.edu/az/Site1405/mainpageS1405P0.html