Polymyalgia Rheumatica
Giant Cell Arteritis
Prednisolone
Temporal Arteries
Sternoclavicular Joint
Synovitis
Health Resorts
Prednisone
Tenosynovitis
Glucocorticoids
Arthritis, Rheumatoid
C-Reactive Protein
MedlinePlus
Adrenal Cortex Hormones
Disease pattern in cranial and large-vessel giant cell arteritis. (1/201)
OBJECTIVE: To identify variables that distinguish large-vessel giant cell arteritis (GCA) with subclavian/axillary/brachial artery involvement from cranial GCA. METHODS: Seventy-four case patients with subclavian/axillary GCA diagnosed by angiography and 74 control patients with temporal artery biopsy-proven GCA without large vessel involvement matched for the date of first diagnosis were identified. Pertinent initial symptoms, time delay until diagnosis, and clinical symptoms, as well as clinical and laboratory findings at the time of diagnosis, were recorded by retrospective chart review. Expression of cytokine messenger RNA in temporal artery tissue from patients with large-vessel and cranial GCA was determined by semiquantitative polymerase chain reaction analysis. Distribution of disease-associated HLA-DRB1 alleles in patients with aortic arch syndrome and cranial GCA was assessed. RESULTS: The clinical presentation distinguished patients with large-vessel GCA from those with classic cranial GCA. Upper extremity vascular insufficiency dominated the clinical presentation of patients with large-vessel GCA, whereas symptoms related to impaired cranial blood flow were infrequent. Temporal artery biopsy findings were negative in 42% of patients with large-vessel GCA. Polymyalgia rheumatica occurred with similar frequency in both patient groups. Large-vessel GCA was associated with higher concentrations of interleukin-2 gene transcripts in arterial tissue and overrepresentation of the HLA-DRB1*0404 allele, indicating differences in pathogenetic mechanisms. CONCLUSION: GCA is not a single entity but includes several variants of disease. Large-vessel GCA produces a distinct spectrum of clinical manifestations and often occurs without involvement of the cranial arteries. Large-vessel GCA requires a different approach to the diagnosis and probably also to treatment. (+info)Cyclical etidronate increases bone density in the spine and hip of postmenopausal women receiving long term corticosteroid treatment. A double blind, randomised placebo controlled study. (2/201)
OBJECTIVE: To study the effect of cyclic etidronate in secondary prevention of corticosteroid induced osteoporosis. METHODS: A double blind, randomised placebo controlled study comparing cyclic etidronate and placebo during two years in 37 postmenopausal women receiving long term corticosteroid treatment, mainly for polymyalgia rheumatica (40% of the patients) and rheumatoid arthritis (30%). Bone density was measured in the lumbar spine, femoral neck, and femoral trochanter. RESULTS: After two years of treatment there was a significant difference between the groups in mean per cent change from baseline in bone density in the spine in favour of etidronate (p = 0.003). The estimated treatment difference (mean (SD)) was 9.3 (2.1)%. Etidronate increased bone density in the spine (4.9 (2.1)%, p < 0.05) whereas the placebo group lost bone (-2.4 (1.6)%). At the femoral neck there was an estimated difference of 5.3 (2.6)% between the groups (etidronate: 3.6% (1.4)%, p < 0.05, placebo: -2.4 (2.1)%). The estimated difference at the trochanter was 8.2 (3.0) (etidronate: 9.0 (1.5)%, p < 0.0001, placebo: 0.5 (2.3)%). No significant bone loss occurred in the hip in placebo treated patients. CONCLUSIONS: Cyclic etidronate is an effective treatment for postmenopausal women receiving corticosteroid treatment and is well tolerated. (+info)HLA-DRB1 alleles associated with polymyalgia rheumatica in northern Italy: correlation with disease severity. (3/201)
OBJECTIVE: To examine the association of HLA-DRB1 alleles with polymyalgia rheumatica (PMR) in a Mediterranean country and to explore the role of HLA-DRB1 genes in determining disease severity. METHODS: A five year prospective follow up study of 92 consecutive PMR patients diagnosed by the secondary referral centre of rheumatology of Reggio Emilia, Italy was conducted. HLA-DRB1 alleles were determined in the 92 patients, in 29 DR4 positive rheumatoid arthritis (RA) patients, and in 148 controls from the same geographical area by polymerase chain reaction amplification and oligonucleotide hybridisation. RESULTS: No significant differences were observed in the frequencies of HLA-DRB1 types and in the expression of HLA-DRB 70-74 shared motif between PMR and controls. The frequency of the patients with double dose of epitope was low and not significantly different in PMR and in controls. No significant differences in the distribution of HLA-DR4 subtypes were observed between DR4+ PMR, DR+ RA, and DR4+ controls. Results of the univariate analysis indicated that an erythrocyte sedimentation rate (ESR) at diagnosis > 72 mm 1st h, the presence of HLA-DR1, DR10, rheumatoid epitope, and the type of rheumatoid epitope were significant risk factors associated with relapse/recurrence. Cox proportional hazards modelling identified two variables that independently increased the risk of relapse/recurrence: ESR at diagnosis > 72 mm 1st h (RR=1.5) and type 2 (encoded by a non-DR4 allele) rheumatoid epitope (RR=2.7). CONCLUSION: These data from a Mediterranean country showed no association of rheumatoid epitope with PMR in northern Italian patients. A high ESR at diagnosis and the presence of rheumatoid epitope encoded by a non-DR4 allele are independent valuable markers of disease severity. (+info)Biopsy proven and biopsy negative temporal arteritis: differences in clinical spectrum at the onset of the disease. Groupe de Recherche sur l'Arterite a Cellules Geantes. (4/201)
OBJECTIVES: To assess the clinical features of biopsy proven and negative biopsy temporal arteritis at the time of diagnosis and during a three year follow up. METHODS: Newly diagnosed cases of giant cell arteritis were included in a prospective, multicentre study. Initial clinical and biological features, season of diagnosis, and cardiovascular events occurring during the follow up were recorded. Biopsy proven and negative biopsy cases were compared. RESULTS: Two hundred and seven biopsy proven, and 85 negative biopsy cases were included from 1991 to 1997. Fifty eight per cent of the biopsy proven cases, compared with 39.29% of the negative biopsy cases, were diagnosed during the autumn or winter (p = 0.003). Visual problems (31.5%, v 19.1%, p = 0.031), blindness (9.7% v 2.38%, p = 0.033), jaw claudication (40.8%, v 28.243%, p = 0.044), and temporal artery palpation abnormalities (61.3% v 29.5%, p = 7.10(-7)) were more frequent in the biopsy proven than in the negative biopsy group. Less specific symptoms, such as headache (82.5% v 92. 9%, p = 0.021), or associated polymyalgia rheumatica (40.1% v 65.9%, p = 9 x 10(-5)) were more prevalent in the negative biopsy cases. Biological markers of inflammation were significantly more increased in the biopsy proven group. All cases of blindness occurring after treatment belonged to the biopsy proven group. CONCLUSION: Biopsy proven cases seem to be more severe than biopsy negative cases at the time of diagnosis and during follow up. Seasonal difference at diagnosis may suggest a different aetiological pattern. (+info)Giant cell arteritis and polymyalgia rheumatica: are pregnancies a protective factor? A prospective, multicentre case-control study. GRACG (Groupe de Recherche sur l'Arterite a Cellules Geantes). (5/201)
OBJECTIVE: To assess the potential role of allo-immunization, either by former pregnancies, or by a history of blood transfusion, in the pathogenesis of giant cell arteritis and polymyalgia rheumatica. METHODS: Two hundred and eighty-five incident female cases and 186 age-matched, population-based female controls were prospectively included in a multicentre case-control study. RESULTS: The number of pregnancies was significantly lower in cases than in controls (nulliparous: 21.55% vs 12.90%; > or =4 pregnancies: 16.25% vs 27.42%; Wilcoxon rank sum test: P = 0.0019) in biopsy-proven or negative temporal arteritis and, to a lesser extent, in polymyalgia rheumatica. No difference was found for history of blood transfusion. Pregnancies remained negatively associated with the disease in a multivariate analysis including cardiovascular risk factors such as smoking or a pre-existing peripheral vascular disease. CONCLUSION: Former pregnancies are not a risk factor for giant cell arteritis. Pregnancies may be protective thanks to an effect of the associated hyperoestrogenic state against alterations of the artery wall, as suggested in animal models. (+info)Bronchiolitis obliterans organizing pneumonia associated with polymyalgia rheumatica. (6/201)
The association of bronchiolitis obliterans organizing pneumonia (BOOP) with polymyalgia rheumatica is rare, and only one case has previously been described. This study reports on the case of an 80 yr-old male who presented with malaise, nonproductive cough and exertional dyspnoea for several weeks, along with a history of bilateral shoulder and pelvic girdle pain of several months' duration. The chest radiograph revealed a pneumonic infiltrate in the right lower lobe, which was unresponsive to antibiotics. Bronchoscopy, bronchoalveolar lavage and a transbronchial lung biopsy established the diagnosis of BOOP. The patient improved consistently on steroids. As in other connective diseases, organizing pneumonia may be one of the early manifestations of polymyalgia rheumatica. (+info)Remitting seronegative symmetrical synovitis with pitting oedema (RS3PE) syndrome: a prospective follow up and magnetic resonance imaging study. (7/201)
OBJECTIVE: To determine the clinical characteristics of patients with "pure" remitting seronegative symmetrical synovitis with pitting oedema (RS3PE) syndrome, and to investigate its relation with polymyalgia rheumatica (PMR). Magnetic resonance imaging (MRI) was used to describe the anatomical structures affected by inflammation in pure RS3PE syndrome. METHODS: A prospective follow up study of 23 consecutive patients with pure RS3PE syndrome and 177 consecutive patients with PMR diagnosed over a five year period in two Italian secondary referral centres of rheumatology. Hands or feet MRI, or both, was performed at diagnosis in 7 of 23 patients. RESULTS: At inspection evidence of hand and/or foot tenosynovitis was present in all the 23 patients with pure RS3PE syndrome. Twenty one (12%) patients with PMR associated distal extremity swelling with pitting oedema. No significant differences in the sex, age at onset of disease, acute phase reactant values at diagnosis, frequency of peripheral synovitis and carpal tunnel syndrome and frequency of HLA-B7 antigen were present between patients with pure RS3PE and PMR. In both conditions no patient under 50 was observed, the disease frequency increased significantly with age and the highest frequency was present in the age group 70-79 years. Clinical symptoms for both conditions responded promptly to corticosteroids and no patient developed rheumatoid arthritis during the follow up. However, the patients with pure RS3PE syndrome were characterised by shorter duration of treatment, lower cumulative corticosteroid dose and lower frequency of systemic signs/symptoms and relapse/recurrence. Hands and feet MRI showed evidence of tenosynovitis in five patients and joint synovitis in three patients. CONCLUSION: The similarities of demographic, clinical, and MRI findings between RS3PE syndrome and PMR and the concurrence of the two syndromes suggest that these conditions may be part of the same disease and that the diagnostic labels of PMR and RS3PE syndrome may not indicate a real difference. The presence of distal oedema seems to indicate a better prognosis. (+info)New arguments for a vasculitic nature of polymyalgia rheumatica using positron emission tomography. (8/201)
OBJECTIVE: To study the possible contribution of fluorodeoxyglucose (FDG)-positron emission tomography (PET) in the diagnosis of giant cell arteritis and polymyalgia rheumatica. METHODS: A consecutive case series consisting of five patients with polymyalgia rheumatica, six patients with temporal arteritis and 23 age-matched patients with other inflammatory conditions were evaluated with FDG-PET. Studies were performed before therapy with steroids was started. RESULTS: A total of 4/6 patients with giant cell arteritis and 4/5 patients with polymyalgia had increased FDG uptake in their thoracic vessels, compared to 1/23 controls (P < 0.001). Increased vascular FDG uptake in the upper legs was seen in 8/11 patients with giant cell arteritis or polymyalgia compared to 8/23 control patients (P < 0.05), and in the lower legs in 6/11 patients compared to 6/23 controls (P = not significant). CONCLUSIONS: FDG-PET scan is the first non-invasive technique which may indicate large-vessel vasculitis and which can show its extension throughout the body. It strongly suggests that polymyalgia rheumatica is a form of vasculitis. (+info)Polymyalgia Rheumatica (PMR) is a geriatric rheumatic disease characterized by widespread musculoskeletal pain and stiffness, particularly affecting the neck, shoulders, hips, and thighs. It is often accompanied by symptoms such as fatigue, weakness, loss of appetite, and low-grade fever. The onset of PMR can be sudden or gradual, and it tends to affect individuals over 50 years of age, more commonly women than men.
The exact cause of Polymyalgia Rheumatica remains unknown; however, it is believed to involve an autoimmune response leading to inflammation in the affected areas. Diagnosis typically involves a combination of clinical evaluation, laboratory tests (such as elevated erythrocyte sedimentation rate or C-reactive protein), and sometimes imaging studies. Treatment usually includes corticosteroids to reduce inflammation and manage symptoms, along with monitoring for potential side effects from long-term steroid use. In many cases, PMR can be successfully managed with appropriate treatment, allowing individuals to return to their normal activities.
Giant Cell Arteritis (GCA), also known as Temporal Arteritis, is a chronic inflammatory disease affecting large and medium-sized arteries, most commonly the temporal artery. It primarily occurs in people over 50 years old. The condition is characterized by the infiltration of the artery walls with immune cells, leading to inflammation, swelling, and damage. This can restrict blood flow, causing various symptoms.
The key feature of GCA is the presence of multinucleated giant cells, which are large collections of fused immune cells, in the affected artery walls. These cells are a hallmark of this condition when viewed under a microscope.
Common symptoms include new onset of severe headaches, scalp tenderness, jaw pain while chewing (called jaw claudication), vision problems, and systemic symptoms such as fever, fatigue, and weight loss. If left untreated, GCA can lead to serious complications like blindness or stroke. Treatment typically involves high-dose corticosteroids to reduce inflammation and prevent further damage.
Blood sedimentation, also known as erythrocyte sedimentation rate (ESR), is a medical test that measures the rate at which red blood cells settle at the bottom of a tube of unclotted blood over a specific period of time. The test is used to detect and monitor inflammation in the body.
During an acute inflammatory response, certain proteins in the blood, such as fibrinogen, increase in concentration. These proteins cause red blood cells to stick together and form rouleaux (stacks of disc-shaped cells). As a result, the red blood cells settle more quickly, leading to a higher ESR.
The ESR test is a non-specific test, meaning that it does not identify the specific cause of inflammation. However, it can be used as an indicator of underlying conditions such as infections, autoimmune diseases, and cancer. The test is also used to monitor the effectiveness of treatment for these conditions.
The ESR test is usually performed by drawing a sample of blood into a special tube and allowing it to sit undisturbed for one hour. The distance that the red blood cells have settled is then measured and recorded as the ESR. Normal values for ESR vary depending on age and gender, with higher values indicating greater inflammation.
Prednisolone is a synthetic glucocorticoid drug, which is a class of steroid hormones. It is commonly used in the treatment of various inflammatory and autoimmune conditions due to its potent anti-inflammatory and immunosuppressive effects. Prednisolone works by binding to specific receptors in cells, leading to changes in gene expression that reduce the production of substances involved in inflammation, such as cytokines and prostaglandins.
Prednisolone is available in various forms, including tablets, syrups, and injectable solutions. It can be used to treat a wide range of medical conditions, including asthma, rheumatoid arthritis, inflammatory bowel disease, allergies, skin conditions, and certain types of cancer.
Like other steroid medications, prednisolone can have significant side effects if used in high doses or for long periods of time. These may include weight gain, mood changes, increased risk of infections, osteoporosis, diabetes, and adrenal suppression. As a result, the use of prednisolone should be closely monitored by a healthcare professional to ensure that its benefits outweigh its risks.
Temporal arteries are the paired set of arteries that run along the temples on either side of the head. They are branches of the external carotid artery and play a crucial role in supplying oxygenated blood to the scalp and surrounding muscles. One of the most common conditions associated with temporal arteries is Temporal Arteritis (also known as Giant Cell Arteritis), which is an inflammation of these arteries that can lead to serious complications like vision loss if not promptly diagnosed and treated.
The sternoclavicular joint is the joint where the clavicle (collarbone) meets the sternum (breastbone). It is the only joint that connects the upper limb to the trunk of the body. This joint allows for movement in multiple directions, including elevation and depression of the shoulder, as well as some degree of protraction and retraction. The sternoclavicular joint is supported by several ligaments, which provide stability and strength to the joint.
Synovitis is a medical condition characterized by inflammation of the synovial membrane, which is the soft tissue that lines the inner surface of joint capsules and tendon sheaths. The synovial membrane produces synovial fluid, which lubricates the joint and allows for smooth movement.
Inflammation of the synovial membrane can cause it to thicken, redden, and become painful and swollen. This can lead to stiffness, limited mobility, and discomfort in the affected joint or tendon sheath. Synovitis may occur as a result of injury, overuse, infection, or autoimmune diseases such as rheumatoid arthritis.
If left untreated, synovitis can cause irreversible damage to the joint and surrounding tissues, including cartilage loss and bone erosion. Treatment typically involves a combination of medications, physical therapy, and lifestyle modifications to reduce inflammation and manage pain.
Anti-inflammatory agents are a class of drugs or substances that reduce inflammation in the body. They work by inhibiting the production of inflammatory mediators, such as prostaglandins and leukotrienes, which are released during an immune response and contribute to symptoms like pain, swelling, redness, and warmth.
There are two main types of anti-inflammatory agents: steroidal and nonsteroidal. Steroidal anti-inflammatory drugs (SAIDs) include corticosteroids, which mimic the effects of hormones produced by the adrenal gland. Nonsteroidal anti-inflammatory drugs (NSAIDs) are a larger group that includes both prescription and over-the-counter medications, such as aspirin, ibuprofen, naproxen, and celecoxib.
While both types of anti-inflammatory agents can be effective in reducing inflammation and relieving symptoms, they differ in their mechanisms of action, side effects, and potential risks. Long-term use of NSAIDs, for example, can increase the risk of gastrointestinal bleeding, kidney damage, and cardiovascular events. Corticosteroids can have significant side effects as well, particularly with long-term use, including weight gain, mood changes, and increased susceptibility to infections.
It's important to use anti-inflammatory agents only as directed by a healthcare provider, and to be aware of potential risks and interactions with other medications or health conditions.
Health resorts, also known as wellness retreats or spa towns, are places that offer a combination of medical treatments, therapies, and recreational activities to promote health, relaxation, and well-being. They are often located in areas with natural mineral springs, sea air, or other beneficial environmental factors.
Health resorts may provide various services such as:
1. Hydrotherapy: using water in the form of baths, showers, or wraps to promote relaxation and healing.
2. Balneotherapy: utilizing natural mineral waters for therapeutic purposes.
3. Massages and bodywork: providing different types of massages and manual therapies to relieve tension, improve circulation, and reduce stress.
4. Exercise programs: offering activities like yoga, Pilates, swimming, or hiking to enhance physical fitness and flexibility.
5. Nutritional counseling: providing guidance on healthy eating habits and personalized meal plans.
6. Mental health support: offering services like psychotherapy, mindfulness training, or stress management techniques.
7. Educational workshops: conducting seminars on topics related to health, wellness, and self-care.
8. Aesthetic treatments: providing beauty and skincare services such as facials, peels, or makeup consultations.
Health resorts can be an excellent option for individuals seeking a holistic approach to improving their physical, mental, and emotional well-being in a peaceful and supportive environment.
Arteritis is a medical condition characterized by inflammation of the arteries. It is also known as vasculitis of the arteries. The inflammation can cause the walls of the arteries to thicken and narrow, reducing blood flow to affected organs or tissues. There are several types of arteritis, including:
1. Giant cell arteritis (GCA): Also known as temporal arteritis, it is a condition that mainly affects the large and medium-sized arteries in the head and neck. The inflammation can cause headaches, jaw pain, scalp tenderness, and vision problems.
2. Takayasu's arteritis: This type of arteritis affects the aorta and its major branches, mainly affecting young women. Symptoms include fever, weight loss, fatigue, and decreased pulse in the arms or legs.
3. Polyarteritis nodosa (PAN): PAN is a rare systemic vasculitis that can affect medium-sized arteries throughout the body. It can cause a wide range of symptoms, including fever, rash, abdominal pain, and muscle weakness.
4. Kawasaki disease: This is a type of arteritis that mainly affects children under the age of 5. It causes inflammation in the blood vessels throughout the body, leading to fever, rash, swollen lymph nodes, and red eyes.
The exact cause of arteritis is not fully understood, but it is believed to be an autoimmune disorder, where the body's immune system mistakenly attacks its own tissues. Treatment for arteritis typically involves medications to reduce inflammation and suppress the immune system.
Prednisone is a synthetic glucocorticoid, which is a type of corticosteroid hormone. It is primarily used to reduce inflammation in various conditions such as asthma, allergies, arthritis, and autoimmune disorders. Prednisone works by mimicking the effects of natural hormones produced by the adrenal glands, suppressing the immune system's response and reducing the release of substances that cause inflammation.
It is available in oral tablet form and is typically prescribed to be taken at specific times during the day, depending on the condition being treated. Common side effects of prednisone include increased appetite, weight gain, mood changes, insomnia, and easy bruising. Long-term use or high doses can lead to more serious side effects such as osteoporosis, diabetes, cataracts, and increased susceptibility to infections.
Healthcare providers closely monitor patients taking prednisone for extended periods to minimize the risk of adverse effects. It is essential to follow the prescribed dosage regimen and not discontinue the medication abruptly without medical supervision, as this can lead to withdrawal symptoms or a rebound of the underlying condition.
Tenosynovitis is a medical condition characterized by inflammation of the lining (synovium) surrounding a tendon, which is a cord-like structure that attaches muscle to bone. This inflammation can cause pain, swelling, and difficulty moving the affected joint. Tenosynovitis often affects the hands, wrists, feet, and ankles, and it can result from various causes, including infection, injury, overuse, or autoimmune disorders like rheumatoid arthritis. Prompt diagnosis and treatment of tenosynovitis are essential to prevent complications such as tendon rupture or chronic pain.
Glucocorticoids are a class of steroid hormones that are naturally produced in the adrenal gland, or can be synthetically manufactured. They play an essential role in the metabolism of carbohydrates, proteins, and fats, and have significant anti-inflammatory effects. Glucocorticoids suppress immune responses and inflammation by inhibiting the release of inflammatory mediators from various cells, such as mast cells, eosinophils, and lymphocytes. They are frequently used in medical treatment for a wide range of conditions, including allergies, asthma, rheumatoid arthritis, dermatological disorders, and certain cancers. Prolonged use or high doses of glucocorticoids can lead to several side effects, such as weight gain, mood changes, osteoporosis, and increased susceptibility to infections.
Myositis is a medical term that refers to inflammation of the muscle tissue. This condition can cause various symptoms, including muscle weakness, pain, swelling, and stiffness. There are several types of myositis, such as polymyositis, dermatomyositis, and inclusion body myositis, which have different causes and characteristics.
Polymyositis is a type of myositis that affects multiple muscle groups, particularly those close to the trunk of the body. Dermatomyositis is characterized by muscle inflammation as well as a skin rash. Inclusion body myositis is a less common form of myositis that typically affects older adults and can cause both muscle weakness and wasting.
The causes of myositis vary depending on the type, but they can include autoimmune disorders, infections, medications, and other medical conditions. Treatment for myositis may involve medication to reduce inflammation, physical therapy to maintain muscle strength and flexibility, and lifestyle changes to manage symptoms and prevent complications.
Rheumatoid arthritis (RA) is a systemic autoimmune disease that primarily affects the joints. It is characterized by persistent inflammation, synovial hyperplasia, and subsequent damage to the articular cartilage and bone. The immune system mistakenly attacks the body's own tissues, specifically targeting the synovial membrane lining the joint capsule. This results in swelling, pain, warmth, and stiffness in affected joints, often most severely in the hands and feet.
RA can also have extra-articular manifestations, affecting other organs such as the lungs, heart, skin, eyes, and blood vessels. The exact cause of RA remains unknown, but it is believed to involve a complex interplay between genetic susceptibility and environmental triggers. Early diagnosis and treatment are crucial in managing rheumatoid arthritis to prevent joint damage, disability, and systemic complications.
C-reactive protein (CRP) is a protein produced by the liver in response to inflammation or infection in the body. It is named after its ability to bind to the C-polysaccharide of pneumococcus, a type of bacteria. CRP levels can be measured with a simple blood test and are often used as a marker of inflammation or infection. Elevated CRP levels may indicate a variety of conditions, including infections, tissue damage, and chronic diseases such as rheumatoid arthritis and cancer. However, it is important to note that CRP is not specific to any particular condition, so additional tests are usually needed to make a definitive diagnosis.
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The adrenal cortex hormones are a group of steroid hormones produced and released by the outer portion (cortex) of the adrenal glands, which are located on top of each kidney. These hormones play crucial roles in regulating various physiological processes, including:
1. Glucose metabolism: Cortisol helps control blood sugar levels by increasing glucose production in the liver and reducing its uptake in peripheral tissues.
2. Protein and fat metabolism: Cortisol promotes protein breakdown and fatty acid mobilization, providing essential building blocks for energy production during stressful situations.
3. Immune response regulation: Cortisol suppresses immune function to prevent overactivation and potential damage to the body during stress.
4. Cardiovascular function: Aldosterone regulates electrolyte balance and blood pressure by promoting sodium reabsorption and potassium excretion in the kidneys.
5. Sex hormone production: The adrenal cortex produces small amounts of sex hormones, such as androgens and estrogens, which contribute to sexual development and function.
6. Growth and development: Cortisol plays a role in normal growth and development by influencing the activity of growth-promoting hormones like insulin-like growth factor 1 (IGF-1).
The main adrenal cortex hormones include:
1. Glucocorticoids: Cortisol is the primary glucocorticoid, responsible for regulating metabolism and stress response.
2. Mineralocorticoids: Aldosterone is the primary mineralocorticoid, involved in electrolyte balance and blood pressure regulation.
3. Androgens: Dehydroepiandrosterone (DHEA) and its sulfate derivative (DHEAS) are the most abundant adrenal androgens, contributing to sexual development and function.
4. Estrogens: Small amounts of estrogens are produced by the adrenal cortex, mainly in women.
Disorders related to impaired adrenal cortex hormone production or regulation can lead to various clinical manifestations, such as Addison's disease (adrenal insufficiency), Cushing's syndrome (hypercortisolism), and congenital adrenal hyperplasia (CAH).