Adrenocortical Obesity in Children

Abstract

The adrenogenital syndrome in children has been described and reviewed repeatedly (Bullock and Sequeria;1 Glynn;2 Reilly, Lisser and Hinman3). Most observers have been especially interested in the sexual precocity or pseudoprecocity caused by hypertrophy, adenoma or cancer of the adrenal cortex. Useful hypotheses have been advanced to explain the syndrome (Krabbe,4 Grollman5), and progress has been made in its early diagnosis and treatment; but with few exceptions (Weber;6 Guthrie and Emery 7) little attention has been given to other symptoms which frequently accompany this form of precocity or pseudoprecocity.Obesity and elevation of blood pressure were the outstanding symptoms in a child with an adrenocortical tumor observed by us. It seems worth while to direct special attention to these symptoms, in view of the physiologic, pathologic and diagnostic problems involved.

Bilateral adrenocortical hyperplasia in children with Cushing's syndrome

“…This may be due to the better diagnostic techniques now available to detect the condition in children, who may be relatively asymptomatic (Schletter et al, 1967). In children, as in adults, bilateral adrenocortical hyperplasia occurs in one of three forms (Neville and Symington, 1967): simple hyperplasia, nodular hyperplasia or hyperplasia associated with " non-endocrine " tumours that secrete ACTH or an " ACTH-like " peptide (table 111) previously considered to be bilateral adrenocortical adenomas or adenomas with attached hyperplastic glands (Lightwood, 1932;Marks, Thomas and Warkany, 1940;Powell, Newman and Hooker, 1955). Hyperplasia with so-called " nonendocrine " tumours was detected in three boys (table 111); a thymoma, neuroblastoma and islet-cell carcinoma were the sources of ACTH.…”