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PubMed1999

Adrenal insufficiency in the term and preterm neonate.

The adrenal gland is part of the endocrine system and produces hormones that are essential for survival. The adrenal cortex, the largest part of the adrenal gland, produces three major hormones. Glucocorticoids regulate metabolism of glucose, protein, and fat and allow the body to respond to stress by increasing blood glucose levels and cardiac output. Mineralocorticoids regulate fluid and electrolyte balance and help maintain blood pressure. Androgens are responsible for sexual differentiation in the fetus. Insufficient production of these hormones can occur for many reasons and can have a profound effect on the newborn. It is important for neonatal nurses to be familiar with signs and symptoms and appropriate treatment of adrenal insufficiency. This article explores causes, signs and symptoms, and treatment of adrenal insufficiency in the newborn.

Adrenal Cortex Hormones↗
PubMed1998

[Rapid ACTH test to judge recovery of adrenal function in patients with Cushing's syndrome].

BACKGROUND: Steroid hormone replacement and recovery of adrenal function after unilateral adrenalectomy were studied in 12 patients with Cushing's syndrome due to adenocortical adenoma. PATIENTS AND METHOD: The patients were 3 males and 9 females aged 19 to 61 years old (mean 34.3 years old). Recovery of adrenal function was judged by plasma cortisol level and rapid ACTH test peridocally. RESULTS: Plasma cortisol level was 13.7 to 20.8 micrograms/dl without diurnal rythme before adrenalectomy. Average replacement period with low dose hydrocortisone was 15 +/- 9.2 months after adrenalectomy. Plasma ACTH and cortisol concentration was recovered to normal range after 3.4 +/- 2.9 months and 12.2 +/- 8.2 after adrenalectomy, respectively. Plasma ACTH concentration was recovered to normal range earlier than plasma cortisol level in all patients. Sufficient response of plasma cortisol concentration in rapid ACTH test was seen a little later than recovery of plasma cortisol level. CONCLUSION: Present data suggest that it is insufficient to judge recovery of adrenal function only by the rise of plasma ACTH and/or cortisol concentrations. Therefore rapid ACTH test is useful to judge sufficient recovery of adrenal function during and after steroid hormone replacement.

Adenoma↗