On top of each kidney sits an adrenal gland, which is responsible for secreting important hormones and substances that regulate the body. In growing children, adrenal glands help to control the balance of some electrolytes and are responsible for the development of sexual characteristics and maturation. Children also need working adrenal glands to regulate their responses to stress.
Identification
Each adrenal gland contains two parts: the adrenal cortex and the adrenal medulla. The adrenal cortex secretes corticosteroids, which are important hormones that help boost immune function. The pituitary gland, located in the brain, is what actually tells the adrenal cortex to secrete corticosteroids and how much to secrete. The adrenal cortex also secretes aldosterone, which regulates electrolytes in the bloodstream; and androgens, which are male sex hormones. The adrenal medulla secretes substances called epinephrine and norepinephrine, which are responsible for the body's reaction to stressful events.
Cushing's Syndrome
Overactive adrenal glands in children may lead a condition known as Cushing's syndrome. A child with Cushing's syndrome may become overweight and have high blood pressure. Excess fat may develop around the neck and a child may have a facial appearance called a moon-shaped face. A child may also have skin and hair changes such as stretch marks, thin skin and dark pigmentation. The condition is diagnosed by lab work to detect the presence of excess corticosteroids in the body. Radiographic images can look at the adrenal glands and the pituitary gland to check for abnormalities.
Addison's Disease
According to the Children's Hospital of Pittsburgh, Addison's disease can occur because of damage to the adrenal glands, such as through infection or trauma. In some cases, underactive adrenal glands may be an inherited trait. Children with Addison's disease may have nausea and vomiting, muscle weakness, blue or black skin discolorations, a loss of appetite or a strong craving for salt. The condition is diagnosed by taking a medical history of the child and checking blood and urine to evaluate levels of corticosteroids.
CAH
A child with congenital adrenal hyperplasia, also called CAH, produces too little aldosterone and cortisol, but excess amounts of male sex hormones. Congenital means a condition that appears at birth, and children may develop CAH because it runs in families. A child with CAH may have a short stature and high blood pressure. Girls with CAH can develop facial hair and have irregular menses. Some girls born with CAH have genitalia that may look more like that of a boy. Boys with CAH may enter puberty early or develop very masculine features at a young age.
Treatment
Treatment of adrenal problems includes identifying alterations in hormone levels and providing medication or hormones to restore the balance. Underactive adrenal production involves lifelong steroid therapy to maintain hormone levels and reduce negative symptoms. Surgery may be indicated if adrenal problems are caused by a tumor. Other medications, such as electrolyte supplements or blood pressure medications may be necessary to correct symptoms associated with disease.
References
- Oregon Health and Science University: Overactive Adrenal Glands/Cushing's Syndrome in Children
- Children's Hospital of Pittsburgh: Underactive Adrenal Glands/Addison's Disease
- Family Doctor.org: Congenital Adrenal Hyperplasia: What it is and How it's Treated
- Newport Children's Medical Group: Adrenal Glands
