Hyperadrenocorticism

Abstract

The most classic manifestations of hyperadrenocorticism are found in Cushing's syndrome and the adrenogenital syndrome. Dramatic results can be obtained in the treatment of these patients when the main pathogenetic factor is an adrenal tumor, which is satisfactorily removed in its entirety. In Cushing's syndrome due to adrenal hyperplasia excellent results have been obtained in some patients following bilateral subtotal adrenalectomy. The prospects of surgical therapy for hyperadrenocorticism loom much brighter with the provision of an abundant supply of cortisone for the treatment of acute and chronic adrenal insufficiency that may be complications of surgery. Testosterone therapy is of some advantage in the treatment of Cushing's syndrome and cortisone in the adrenogenital syndrome. Far more common than either of these syndromes is a miscellaneous group of patients with certain manifestations, but with a course that is quite different. The pathogenesis, pathologic physiology and rationale of therapy for this larger group of patients is much less clearly understood.