Overactive Adrenal Glands in Children

What causes overactive adrenal glands in a child?

Overactive adrenal glands are caused by diseases that affect the adrenal glands. The diseases may be present at birth (congenital). Or they may occur anytime after birth (acquired). The types of diseases include tumors on the adrenal glands and genetic disorders. In some cases, there may be no known cause.

What are the symptoms of overactive adrenal glands in a child?

The signs and symptoms depend on which hormones are being overproduced.

Excess androgens can cause:

• Excess hair on the face and body
• Loss of hair on the head
• Acne
• Deeper voice
• Increased muscle mass
• In boys: Fast height growth that ends early, resulting in short adult height
• In girls: Genitals that don’t form normally

Excess aldosterone can cause:

• High blood pressure
• Symptoms of low potassium, such as muscle weakness, muscle aches, spasms, and paralysis

Excess corticosteroids (Cushing syndrome) can cause:

• Weight gain
• Delay in growth
• High blood pressure
• Upper body obesity
• Very round face
• Increased fat around neck
• Thin arms and legs
• Fragile and thin skin
• Darkened color of the skin
• Acne
• Bruising
• Stretch marks on abdomen, thighs, buttocks, arms, and breasts
• Bone and muscle weakness
• Severe fatigue
• High blood sugar
• Irritability and anxiety
• In girls: Excessive hair growth and irregular or no menstrual period
• In boys: Low sex drive and infertility

The signs and symptoms of overactive adrenal glands may be like other health conditions. Make sure your child sees his or her healthcare provider for a diagnosis.

How are overactive adrenal glands diagnosed in a child?

The healthcare provider will ask about your child’s health history, and give him or her a physical exam. Your child may also need tests such as:

• Blood tests. These are done to measure levels of hormones.
• Urine tests. These are also done to measure levels of hormones.
• X-ray. This test uses small amounts of radiation to make images of the inside of the body.
• 24-hour urinary test. Urine is collected over a 24-hour period to test for corticosteroid hormones.
• CT scan. This test uses a series of X-rays and a computer to make detailed images of the inside of the body. A CT scan shows images of any part of the body, including the bones, muscles, fat, and organs.
• MRI. This test uses large magnets, radio waves, and a computer to make detailed images of the inside of the body.
• Dexamethasone suppression test. This test shows if the excess corticotropins are from the pituitary gland or from tumors in other places.
• Corticotropin-releasing hormone (CRH) stimulation test. This test shows if the cause is a pituitary tumor or an adrenal tumor.

How are overactive adrenal glands treated in a child?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.

Treatment may include:

• Surgery to remove growths on the adrenal gland(s), or remove one or both glands
• Medicines that block the excess production of hormones                                                                                                                                     

What are the possible complications of overactive adrenal glands in a child?

Untreated overactive adrenal glands may cause:

• Abnormal growth and development, especially sexual development
• High blood pressure
• An impaired immune system
• Diabetes
• Infertility

How can I help my child live with overactive adrenal glands?

Overactive adrenal glands can affect a child's growth, development, and self-esteem. Getting treatment as soon as possible can help lessen problems. Make sure to work with your child's healthcare providers on a care plan that works for your child.

When should I call my child's healthcare provider?

Call your child's healthcare provider if your child has any signs or symptoms of overactive adrenal glands.

Key points about overactive adrenal glands in children

• Adrenal glands make androgens, corticosteroids, and aldosterone.
• Overactive adrenal glands make too much of any of these hormones.
• Symptoms and treatment depend on which hormone is being overproduced.
• Symptoms may include high blood pressure, abnormal growth and sexual development, and obesity.

Overactive adrenal glands can affect a child's self-esteem, growth, and development.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

• Know the reason for the visit and what you want to happen.
• Before your visit, write down questions you want answered.
• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
• Ask if your child’s condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if your child does not take the medicine or have the test or procedure.
• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.