Assignment Task:
Response to 2 peer posts
1. The endocrine system controls hormone levels, maintains homeostasis, and affects tissue growth and reproductive capabilities (Huether et al., 2020). When the endocrine system balance is disrupted, hypersecretion or hyposecretion of hormones occurs, resulting in dysfunction in various parts of the body.
Cushing syndrome, hypercortisolism, is an endocrine disorder characterized by prolonged elevated cortisol levels(Chaudhry & Singh, 2023). Cortisol is a steroid hormone that affects the transcription and translation of enzyme proteins, fat metabolism, and the production of free glucose in the body. Adrenocorticotropic hormone(ACTH) is produced at the pituitary gland, which controls how much cortisol the body makes.
There is endogenous hypercortisolism and exogenous hypercortisolism. Exogenous hypercortisolism is caused by prolonged use of glucocorticoids, which increases cortisol levels in the bloodstream(Chaudhry & Singh, 2023). It is the most common cause of Cushing syndrome.
Endogenous hypercortisolism is caused by excessive production of cortisol by adrenal glands, and there are two types: ACTH-dependent hypercortisolism and ACTH-independent hypercortisolism.
About 80% of Cushing disease cases are caused by ACTH-dependent hypercortisolism, which is caused by the overproduction of pituitary ACTH due to pituitary adenoma or nonpituitary tumors like small cell carcinoma.
ACTH-independent hypercortisolism can be caused by a rare benign or malignant tumor in one or both adrenal glands. Malignancy or adrenal hyperplasia increases cortisol production without stimulation from ACTH.
Clinical manifestations include accumulation of fatty tissue in the trunk, facial, and cervical areas, such as truncal obesity, moon face, and buffalo hump, which are caused by increased lipolysis and redistribution of fatty tissues. Also, skin atrophy, dark pigmentation, purple stretch marks, weak muscles, increased hair growth, acne, and voice changes are seen in this disorder. If this is not treated, it can lead to complications such as secondary hypertension due to fluid retention, arteriosclerosis, uncontrolled diabetes from hyperglycemia, pathological fractures from osteoporosis,
To determine the disease, 24-hour urine-free cortisol collection was used to detect endogenous overproduction of cortisol. It is essential to avoid licorice chewing or smoking tobacco or conditions such as anxiety, depression, uncontrolled diabetes mellitus, alcoholism, and obsessive-compulsive syndrome since these can result in false positives. A high-dose dexamethasone suppression test can differentiate pituitary ACTH and ectopic ACTH sources. Pituitary MRI and CT scan of adrenal glands can be used for diagnostic purposes.
Treatments include slow tapering down steroid dosage, surgical intervention for removal of tumor or malignancy, and radiotherapy if there is a possibility of invasion of the surroundings.
Healthcare providers play a critical role in identifying the clinical manifestations that require early intervention and providing appropriate education to manage the disease and improve the quality of life. Need Online Help?
2. Endocrine disorders happen when hormone levels are too high or too low, or the body doesn't respond to hormones as expected. The endocrine system is a network of glands that produce and release hormones. These hormones control many essential body functions, including turning calories into energy for cells and organs. The endocrine system affects heartbeats, bone and tissue growth, and the ability to have a baby. Treatment for endocrine disorders may involve medication to rebalance hormones and treat symptoms, chemotherapy, and radiation therapy for patients with cancerous tumors of the endocrine gland, or surgery to remove a tumor on a gland that is affecting hormone production.
Acromegaly is a condition that causes certain body parts to grow too much because of too much growth hormone. The first sign is that the hands and feet get more prominent, which someone may notice as fingers and feet grow in width. The forehead, jaw, and nose can also get more prominent. It often affects middle-aged people. If found early, it can be treated. In children, too much growth hormone can cause gigantism, making the bones and height grow too much. Acromegaly signs appear slowly. If not treated, it can cause severe problems and could be deadly. Acromegaly can cause headaches, excessive sweating, body odor, muscle weakness, fatigue, an enlarged tongue, loss of interest in sex, enlarged organs including the heart, achy joints, limited joint mobility, vision impairment, skin tags, coarse, thickened, and oily skin, erectile dysfunction in men, and menstrual irregularities in women. The healthcare provider may request GH and IGF-1 measurement, a growth hormone suppression test, and an MRI to diagnose acromegaly.
In conclusion, surgery is often effective and can completely cure acromegaly. However, if the tumor is too large to be removed entirely, another operation or further treatment with medication or radiotherapy may be necessary. Radiation therapy can destroy any remaining tumor cells and gradually reduce GH levels, but it may take years to notice an improvement in acromegaly symptoms.