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Related Concept Videos

Adrenal Gland Disorders01:27

Adrenal Gland Disorders

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Adrenal gland disorders manifest when the production of adrenal hormones deviates from the norm, resulting in either excessive or insufficient concentrations.
Adrenal insufficiency, characterized by insufficient cortisol and aldosterone production, leads to conditions like Addison's disease. This disorder, affecting the adrenal cortex, exhibits symptoms such as skin bronzing, dehydration, low blood pressure, fatigue, and weight loss. Congenital adrenal hyperplasia, a genetic ailment causing...
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Anatomy of the Adrenal Glands01:17

Anatomy of the Adrenal Glands

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The adrenal or supra-renal glands, situated above the kidneys and aligned with the twelfth rib, are paired pyramid-shaped structures crucial for the body's stress response. During stress, these glands secrete hormones vital for adaptive physiological reactions.
These glands possess a distinctive yellow tinge due to the stored cholesterol and fatty acids required for hormone synthesis. They are encased in a fibrous capsule and cushioned by fat.
The adrenal gland comprises two distinct...
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Hormones of the Adrenal Glands01:31

Hormones of the Adrenal Glands

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Adrenal hormones play a pivotal role in maintaining the body's electrolyte balance and orchestrating responses to stress, showcasing the intricate functions of the adrenal cortex and medulla.
The adrenal cortex, a powerhouse of hormone synthesis, generates over two dozen corticosteroid hormones. The zona glomerulosa produces mineralocorticoids, exemplified by aldosterone, influencing the electrolyte composition of body fluids. The synthesis of glucocorticoids such as cortisol and...
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Hypothalamic-Pituitary Axis01:37

Hypothalamic-Pituitary Axis

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The response to stress—be it physical or psychological, acute or chronic—involves activation of the Hypothalamic-Pituitary-Adrenal (HPA) axis. The HPA axis is part of the neuroendocrine system because it involves both neuronal and hormonal communication. Its function is to regulate homeostatic systems—metabolic, cardiovascular, and immune—providing the necessary means to respond to a stressor.
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Sympathetic Pathways: Collateral Ganglia and Adrenal Medulla01:27

Sympathetic Pathways: Collateral Ganglia and Adrenal Medulla

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The sympathetic pathways of the collateral ganglia and adrenal medulla serve unique but interconnected roles in the sympathetic response.
Collateral Ganglia
Sympathetic preganglionic axons reach the collateral ganglia along the route of splanchnic nerves. These nerves bypass the sympathetic trunk and communicate with sympathetic postganglionic neurons housed in the prevertebral ganglia. These ganglia supply the organs of the abdominopelvic cavity.
The greater splanchnic nerve, formed by the...
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Adrenergic Receptors: β Subtype01:26

Adrenergic Receptors: β Subtype

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β-adrenoceptors have varied sensitivities towards adrenaline, noradrenaline, and isoprenaline. The order of agonist potency is as follows:
Isoprenaline > Adrenaline > Noradrenaline
Neurotransmitter binding to these receptors causes activation of adenylyl cyclase resulting in increased concentrations of cAMP and modulation of calcium ion channels within the cell. They are further classified into β1, β2, and β3 subtypes.
β1-adrenoceptors: β1-adrenoceptors...
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Temporal changes in cortisol secretion and their association with long-term outcomes in benign adrenal incidentalomas: a retrospective cohort study.

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Updated: Sep 18, 2025

A Novel Method: Super-selective Adrenal Venous Sampling
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Bilateral Adrenal Nodules Presenting With Mild Autonomous Cortisol Secretion.

Rashi Sandooja1, Oksana Hamidi2, Catherine D Zhang3

  • 1Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, Minnesota; Division of Diabetes, Endocrinology, and Metabolism, Department of Medicine, University of Nebraska Medical Center, Omaha, Nebraska.

Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
|June 26, 2025
PubMed
Summary

Bilateral adrenal nodules can present with mild autonomous cortisol secretion (MACS). Differentiating unilateral from bilateral MACS is crucial for guiding treatment and improving patient outcomes, as surgical intervention can lead to remission.

Keywords:
MACSadenomaadrenalectomydiagnosismacronodular hyperplasia

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Primary Culture of Rat Adrenocortical Cells and Assays of Steroidogenic Functions
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Area of Science:

  • Endocrinology
  • Adrenal Gland Disorders
  • Medical Imaging

Background:

  • Benign adrenocortical adenomas are common incidental findings on imaging.
  • Bilateral adrenal nodules occur in 15-20% of cases, indicating bilateral adenomas or hyperplasia.
  • Mild autonomous cortisol secretion (MACS) affects 19-44% of patients with adrenal adenomas.

Purpose of the Study:

  • To review the presentation, diagnosis, and management of patients with bilateral adrenal nodules and MACS.
  • To highlight the importance of distinguishing unilateral from bilateral MACS.
  • To discuss therapeutic implications for patients with bilateral MACS.

Main Methods:

  • Review of clinical presentation and diagnostic approaches for bilateral adrenal nodules and MACS.
  • Emphasis on imaging phenotype and adrenal vein sampling for differentiating unilateral vs. bilateral MACS.
  • Discussion of treatment outcomes following unilateral adrenalectomy in patients with bilateral MACS.

Main Results:

  • MACS is linked to significant cardiovascular morbidity, reduced quality of life, frailty, and increased mortality.
  • Reversal of MACS through interventions can improve associated health outcomes.
  • Unilateral adrenalectomy offers potential for remission or improvement in MACS degree, depending on laterality.

Conclusions:

  • Management of bilateral MACS in the context of bilateral adrenal nodules presents therapeutic challenges.
  • Accurate diagnosis of MACS laterality is essential for effective treatment strategies.
  • Further research into medical therapies for MACS is warranted given the lack of approved treatments.