The clinical manifestations of adrenal disease include weakness and fatigue, weight loss, pigmentation, hypoglycemia, and sexual dysfunction, and the specific manifestations are described as follows.
1Weakness and fatigue: The main symptom in the early stage, the degree of fatigue is proportional to the severity of the disease. In severe cases, it may be difficult to turn over or reach for objects. Severe muscle spasms may also occur, especially in the legs. These muscle lesions may be related to the-Disorder of sodium and potassium balance at the muscle endplate.
2Weight loss: Due to gastrointestinal dysfunction caused by cortisol deficiency, such as loss of appetite, nausea and vomiting, abdominal distension, and diarrhea; factors such as reduced fat storage and muscle consumption can lead to weight loss, and progressive significant weight loss may indicate an adrenal crisis.
3Pigmentation: Due to the weakened feedback inhibitory effect of cortisol deficiency on pituitary adrenocorticotropic hormone (ACTH), melanocyte stimulating hormone (MSH), and lipotropin (LPH), these hormones are secreted in greater amounts, and ACTH and LPH also contain α and β-MSH structure, hence pigmentation in the skin and mucous membranes, especially at friction sites, palm prints, areolas, scars, and the like are particularly evident. Pigmentation is one of the main criteria for distinguishing primary and secondary adrenal cortex insufficiency, and a sudden deepening of pigmentation may预示病情恶化.
4、Cardiovascular symptoms: Due to weakened pressor response to catecholamines, leading to hypotension, orthostatic hypotension is most common. X-ray shows shrinkage of the heart shadow, electrocardiogram shows low voltage, P-R and Q-T interval prolongation. Patients often have dizziness, blurred vision, and orthostatic syncope.
5、Hypoglycemia: Patients have increased sensitivity to insulin, both endogenous and exogenous, and are prone to hypoglycemia in situations such as hunger, gastrointestinal dysfunction, infection, etc.
6、Neurological symptoms: such as apathy, drowsiness, even mental disorders.
7、Reduced resistance to various stresses such as infection and trauma, which are prone to cause adrenal crisis. It is extremely sensitive to anesthetics, sedatives, and hypoglycemic drugs, and a small amount can cause coma.
8、Sexual dysfunction: Both male and female patients can have sexual dysfunction. Female adrenal-derived androgens are related to the maintenance of body hair and libido, so female armpit hair and pubic hair may be sparse or fall out, menstrual disorders or amenorrhea, libido decline. If it is due to autoimmune causes, there may also be early failure of ovarian and testicular function.
