1. Cushing’s Syndrome: Most commonly occurs as a side effect of steroid (glucocorticoid) therapy for kidney disease, rheumatoid arthritis, asthma and other respiratory diseases, ulcerative colitis, etc.
Other rare causes are pituitary tumors secreting ACTH, ectopic ACTH secretion (most commonly from tumors of lungs), adrenal adenoma and carcinoma.
Symptoms include rapid weight gain, particularly of the trunk and face with sparing of the limbs (central obesity). A common sign is the growth of fat pads along the collar bone and on the back of the neck (buffalo hump) and a round face often referred to as a “moon face.”
2. Adrenal Insufficiency: May result in loss of appetite, abdominal pain, diarrhea, vomiting, profound muscle weakness and fatigue, extremely low blood pressure, weight loss, electrolyte imbalance (hyponatremia and hyperkalemia) and shock. Most common cause is sudden withdrawal of steroids. Other causes are tuberculosis, fungal infection, autoimmune, genetic causes, sepsis, etc.
3. Primary hyperaldosteronism: A condition associated with secretion of mineralocorticoid hormone called aldosterone. Results in resistant hypertension, often associated with hypokalemia.
4. Pheochromocytoma: A tumor of adrenal medulla causing hypertension and paroxysms of headache, palpitation and sweating.
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