Adrenal disorders: know when to act and what tests to give.
Adrenal diseases are uncommon in older patients but can present insidiously. Adrenal masses are often discovered incidentally on abdominal CT scans and are usually benign, but they should be assessed for hormone production. Cushing's syndrome, or cortisol excess, is usually due to exogenous corticosteroids or a hormonally active tumor. The overnight dexamethasone suppression test is an excellent screening test. Adrenal insufficiency can be caused by hemorrhage, tuberculosis, or metastatic cancer. Maintaining a high index of suspicion of hidden adrenal disease, the primary care physician should apply an efficient approach to the diagnosis and initial management of adrenal diseases in older patients.
Department of Family and Community Medicine, School of Medicine, Mercer University, Macon, GA.
R J
RJ
Ackermann
D000307:Adrenal Gland Diseases / Q000175:diagnosis* / Q000503:physiopathology*; D000310:Adrenal Gland Neoplasms / Q000175:diagnosis / Q000503:physiopathology; D000311:Adrenal Glands / Q000502:physiology*; D000309:Adrenal Insufficiency / Q000175:diagnosis / Q000503:physiopathology; D000324:Adrenocorticotropic Hormone / Q000097:blood / Q000502:physiology; D000368:Aged; D000375:Aging / Q000378:metabolism; D003480:Cushing Syndrome / Q000175:diagnosis; D003937:Diagnosis, Differential; D006801:Humans; D006854:Hydrocortisone / Q000096:biosynthesis / Q000502:physiology
D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone