Professional Documents
Culture Documents
I. Overproduction
II. Underproduction
- Respond to stress
- anti-inflammatory &
immunosuppressive properties
Hypothalamic-pituitary-adrenal axis.
(CRH = corticotropin-releasing hormone;
ACTH = adrenocorticotropin hormone)
http://www.aafp.org/afp/20000901/1119.html
Cushing syndrome
Cushing disease
ACTH dependent
Cushing's disease
Ectopic ACTH syndrome
Ectopic corticotropin-releasing
hormone syndrome*
ACTH independent
Iatrogenic
Adrenal adenoma
Micronodular hyperplasia*
Macronodular hyperplasia*
• 24-hr urine
ACTH-producing tumors
Once hypersecretion of cortisol is confirmed, the
ACTH & cortisol before CRH injection, 15, 30, 45, 60, 90, 120 min
• if cortisol rise > 20% or ACTH rise at least 50% above basal level:
Pituitary adenoma
Adrenal tumor
- surgery
Addison’s disease
• 1 in 100,000
- lack of ACTH
- long time taking ‘prednisone’,then abruptly stop
- surgical removal of ACTH-producing tumor of
pituitary gland
30-60 min
48-72 hr