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Adrenal disorders encompass a spectrum of conditions affecting cortisol production, with Cushing's syndrome representing excess cortisol and Addison's disease indicating cortisol deficiency. These conditions result from dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis and can be life-threatening if not properly diagnosed and managed.
Cushing's syndrome occurs due to prolonged exposure to elevated cortisol levels, commonly from pituitary adenomas (Cushing's disease), adrenal tumors, or exogenous corticosteroid use, leading to metabolic, cardiovascular, and immunologic dysfunction. Addison's disease results from primary adrenal insufficiency due to autoimmune destruction of the adrenal cortex, infections, or other causes, resulting in deficient cortisol and aldosterone production.
Cushing's syndrome presents with central obesity, purple striae, moon facies, buffalo hump, hypertension, and glucose intolerance, requiring dexamethasone suppression tests and imaging for diagnosis. Addison's disease manifests with fatigue, hyperpigmentation, hypotension, hyponatremia, and hyperkalemia, necessitating morning cortisol levels, ACTH stimulation tests, and immediate hormone replacement therapy to prevent adrenal crisis.