Cushing – any cha -particle or mixed increasing function of the adrenal cortex.
Hypercorticism can be primary and secondary.
- Primary hypercortisolism in the majority of cases, s occurs on the basis corticosteroma and rarely adrenal hyperplasia.
- Secondary hypercortisolism arises because of Vyshen hypothalamus AKTG- RF isolation with subsequent higher Niemi ACTH secretion. In secondary hypercorticoidism adrenal hyperplasia develops, to Thoraya ACTH during prolonged exposure in large quantities may degenerate into neoplasm of adrenal
According to the classification OV Nikolaeva, Primary hypercortisolism de divisible by:
- partial;
- total – when corticosteroids produce both mineralocorticosteroids and glucocorticosteroids .
The clinical picture proceeds as Itsenko- Cushing’s syndrome .
Partial hypercorticism, in turn, happens:
- a) adrenal-cortical virile (or adrenogenital) syndrome (or adrenosteroma );
- b) adrenal-cortical (or estrogen- genital) syndrome with feminism associated with an excess of estrogens secreted by corticoesteroma ;
- c) Adrenal cortical syndrome- aldosteronism (primary aldosteronism Conn – aldosteronism primary);
- d) mixed ( corticoandrosteromas , corticoaldosteromas ) and rare monosymptomatic forms of hypercorticism .
Mixed and rare forms of hypercorticism .
Many forms of hypercorticism can be attributed to this group , since classically pure hypercorticism is extremely rare. For example, when aldosteroma somewhat increased secretion of glucocorticoids , and the syndrome Itsenko- Cushing at which mainly Witzlaus excretion glucocorticoids also increases secretion of androgens and mineralocorticoids . However, methodological and clinical point of view to define them better for the various groups, taking into account the main hormone that you fissile in large quantities.
Not looking at it, though mixed form is released, as in the department GOVERNMENTAL cases, hormones, producing mye pathological changes of the adrenal glands, in the Features to its py nearly equal, with a slight predominance of one or another of the mountains Mona, which gives the corresponding clinic; for example, Itsenko- Cushing’s syndrome with aldosteronism or sharp virilization, etc.
Rare forms include hypercortisolism arising not from GTC Hawley adrenal, and other ectopic tumors, producing constituents ACTH or adrenal hormones.