adrenal dysmorphism
Introduction
Introduction to adrenal gland abnormalities Adrenal gland abnormalities are syndromes in which the androgen cortex produces an androgen excess, which leads to sexual organ morphology and functional lesions. Congenital adrenal dysfunction is genetically related. The underlying lesion is a defect in the adrenal cortical enzyme system, and the synthesis of corticosteroids is reduced (because the feedback inhibition of the pituitary gland is weakened, the production of glucocorticoids is compensated). The body substance is converted into androgen, so it is characterized by too little corticosteroid production, excessive androgen production, and excessive androgen, which causes the female genitalia and external genitalia to be deformed (masculine, pseudo-hermaphroditism). The genitals of male fetuses are normal at birth, and pseudo-precocious puberty can occur (premature birth of the penis, and secondary sexual characteristics are formed in advance). basic knowledge The proportion of illness: 0.0025% Susceptible people: no specific population Mode of infection: non-infectious Complications: amenorrhea, impotence, loss of libido
Cause
Causes of adrenal gland abnormalities
Congenital adrenal gland abnormalities are genetically related, and acquired adrenal gland abnormalities are caused by adrenal cortical reticular symmetry or tumors.
Prevention
Adrenal gland abnormality prevention
There are currently no effective preventive measures.
Complication
Adrenal gland abnormalities complications Complications, amenorrhea, impotence, libido
Often accompanied by gonadal atrophy, sexual dysfunction, female amenorrhea, male impotence and loss of libido.
Symptom
Symptoms of adrenal gland abnormalities Common symptoms Male adrenal hyperfunction hypersensitivity
It is not easy to diagnose this disease. Sometimes it can not be concluded after thorough, meticulous and time-consuming examination. However, without proper diagnosis and reasonable treatment, it is impossible to decide which type of patient needs thorough examination. Generally speaking, it is clinical. If the performance is obviously in need of treatment, it needs to be fully examined. Of course, it may be necessary for the tumor to be examined. On the other hand, if the symptoms appear in childhood or the sudden onset of adulthood, the tumor should be suspected:
1. In women: for female pseudohermaphroditism, the diagnosis can be confirmed according to the following examination:
(1) Microscopic examination of the nucleus, showing chromatin positive, chromosome count, sex chromosome karyotype is XX type.
(2) check the genitourinary sinus, visible vagina, such as vaginal vaginal examination of the vagina, visible cervix, through the cervix into the catheter can be used for uterine and fallopian tube angiography.
(3) Biochemical test, excessive sterol excretion in the urine.
Female pseudohermaphroditism can also be seen as a result of maternal androgen-induced androgen in the placenta during pregnancy. This androgen can be derived from masculinizing ovarian tumors, or from maternal gestational corticosteroids or synthesis. Progesterone medication.
2. In males: nuclear chromatin is negative, its hereditary type is XY, and steroids excreted in the urine increase, such as women.
3. Differential diagnosis of hyperplasia and tumor: often not easy, a large tumor can be paralyzed, bilateral hyperplasia of the adrenal gland can also be found at birth, dexamethasone may be helpful in the inhibition test of the hypothalamus, urine The determination of sterols is helpful for the diagnosis of cancer, hyperplasia, or tumor. The biggest difficulty is that the discharge of 11-OXOS in the urine can be normal in the tumor. Fortunately, one of the total steroids has an increased value, and X-ray examination sometimes It is helpful. If the tumor cannot be excluded after multiple examinations, surgical exploration is necessary.
Examine
Examination of adrenal gland abnormalities
(1) The nucleus was examined by microscopy. In females, chromatin was positive. In males, chromatin was negative, chromosome count, female chromosome karyotype was XX, and male was XY.
(2) Biochemical test, excessive sterol excretion in the urine.
(3) Women check the genitourinary sinus, visible vagina, such as vaginal vaginal examination of the vagina, visible cervix, can be used for uterine and fallopian tube angiography through the cervix into the catheter.
Diagnosis
Diagnosis and diagnosis of adrenal gland abnormalities
It is easier to make a diagnosis in combination with clinical symptoms and related examinations without identification.
