What is Hyperadrenocorticism?

Hyperadrenocorticism is a disorder in which too much adrenocorticotropic hormone (ACTH) is present in the body, leading to a range of physical symptoms. In most cases, excess ACTH is a result of a benign tumor or another abnormality within the pituitary gland. The condition is most commonly seen in adults around the age of 40, but a tumor can potentially develop and cause symptoms at any age. Patients who are diagnosed with hyperadrenocorticism usually need to undergo surgery to remove tumors and repair damaged internal structures.

In normal amounts, ACTH regulates the production of cortisol by the adrenal glands. Cortisol is essential in controlling physical reactions to stress, anxiety, and illness. Excess ACTH results in the overproduction of cortisol, a condition known as Cushing's disease. When a pituitary gland tumor develops, it can produce extremely large amounts of ACTH. Less commonly, a tumor in the lungs or elsewhere in the body may begin to produce ACTH independent of the pituitary gland.

A person who suffers from hyperadrenocorticism is likely to experience uncontrollable weight gain that may be restricted to the upper body. The torso, neck, and face often become noticeably bigger and rounder, while the legs stay relatively small. Muscle pain and weakness are common with hyperadrenocorticism, as are changes in skin complexion, acne, and easy bruising. Women often have irregular menstrual cycles and men become infertile or impotent.

Without treatment, hyperadrenocorticism can lead to high blood pressure, kidney stone formation, and bone thinning. Bones can become weak enough to fracture with minimal pressure. In addition, changes in mood, behavior, and cognition are common when the condition is left untreated for several months or years.

A doctor can usually diagnose hyperadrenocorticism by evaluating physical symptoms and taking a blood sample to check for excess ACTH. Magnetic resonance imaging or computerized tomography scans may be performed to identify a tumor in the pituitary gland. A doctor may decide to extract a small sample of tissue from the tumor to make sure it is not cancerous. Treatment decisions are generally made based on the severity of symptoms.

In most cases, symptoms of hyperadrenocorticism can be relieved by surgically excising the mass in the pituitary gland. The gland can recover, but it may take years before it returns to its normal level of functioning. A patient may need to take supplements or receive regular hormone replacement injections throughout the recovery phase to establish normal ACTH and cortisol levels.