Which condition is commonly associated with underproduction of adrenocortical hormones?

Which condition is commonly associated with underproduction of adrenocortical hormones?

• A. Cushing's syndrome
• B. Addison's disease
• C. Hyperthyroidism
• D. Sjögren's syndrome

Answer: (B)

Underproduction of adrenocortical hormones means the adrenal cortex isn’t making enough cortisol and aldosterone, leading to adrenal insufficiency. Addison’s disease is the classic example of primary adrenal insufficiency, usually from autoimmune destruction of the adrenal cortex, causing low cortisol and low aldosterone. This results in symptoms like fatigue, weakness, weight loss, abdominal pain, low blood pressure, and salt cravings. Because aldosterone is low, there’s impaired sodium reabsorption and potassium excretion, which can lead to hyponatremia and hyperkalemia. The lack of cortisol also contributes to hypoglycemia and poor stress response. Hyperpigmentation can occur due to increased ACTH stimulating melanocytes. Lab patterns support the diagnosis: cortisol is low, and ACTH is elevated because the pituitary is trying to stimulate the adrenals. Mineralocorticoid deficiency adds to volume depletion and electrolyte abnormalities. Treatment involves replacing glucocorticoids (like hydrocortisone) and, if needed, mineralocorticoids (like fludrocortisone), along with education on stress dosing during illness or surgery. Other options don’t fit because they involve excess cortisol (Cushing’s), thyroid overactivity (hyperthyroidism), or an autoimmune gland condition unrelated to the adrenal cortex (Sjögren’s).

Underproduction of adrenocortical hormones means the adrenal cortex isn’t making enough cortisol and aldosterone, leading to adrenal insufficiency. Addison’s disease is the classic example of primary adrenal insufficiency, usually from autoimmune destruction of the adrenal cortex, causing low cortisol and low aldosterone.

This results in symptoms like fatigue, weakness, weight loss, abdominal pain, low blood pressure, and salt cravings. Because aldosterone is low, there’s impaired sodium reabsorption and potassium excretion, which can lead to hyponatremia and hyperkalemia. The lack of cortisol also contributes to hypoglycemia and poor stress response. Hyperpigmentation can occur due to increased ACTH stimulating melanocytes.

Lab patterns support the diagnosis: cortisol is low, and ACTH is elevated because the pituitary is trying to stimulate the adrenals. Mineralocorticoid deficiency adds to volume depletion and electrolyte abnormalities. Treatment involves replacing glucocorticoids (like hydrocortisone) and, if needed, mineralocorticoids (like fludrocortisone), along with education on stress dosing during illness or surgery.

Other options don’t fit because they involve excess cortisol (Cushing’s), thyroid overactivity (hyperthyroidism), or an autoimmune gland condition unrelated to the adrenal cortex (Sjögren’s).