Cortisol decrease is characteristic of which adrenal condition?

Cortisol decrease is characteristic of which adrenal condition?

• A. Addison disease
• B. Cushing disease
• C. Pheochromocytoma
• D. Adrenogenital Syndrome

Answer: (A)

Cortisol decrease points to Addison disease, which is primary adrenal insufficiency due to destruction or dysfunction of the adrenal cortex. When the adrenal glands fail to produce cortisol, the body loses a key stress hormone and regulator of metabolism, blood pressure, and electrolyte balance. Clinically this causes fatigue, weakness, low blood pressure, hyponatremia, and sometimes hyperkalemia; hyperpigmentation can occur from increased ACTH stimulation. On imaging, chronic Addison’s often shows atrophic or small adrenal glands, reflecting loss of cortex. The other conditions don’t fit because they either cause increased cortisol (Cushing disease), involve the adrenal medulla and catecholamines (pheochromocytoma), or present with androgen excess with variable cortisol effects (adrenogenital syndrome), whereas the hallmark characteristic described here is decreased cortisol from Addison disease.

Cortisol decrease points to Addison disease, which is primary adrenal insufficiency due to destruction or dysfunction of the adrenal cortex. When the adrenal glands fail to produce cortisol, the body loses a key stress hormone and regulator of metabolism, blood pressure, and electrolyte balance. Clinically this causes fatigue, weakness, low blood pressure, hyponatremia, and sometimes hyperkalemia; hyperpigmentation can occur from increased ACTH stimulation. On imaging, chronic Addison’s often shows atrophic or small adrenal glands, reflecting loss of cortex. The other conditions don’t fit because they either cause increased cortisol (Cushing disease), involve the adrenal medulla and catecholamines (pheochromocytoma), or present with androgen excess with variable cortisol effects (adrenogenital syndrome), whereas the hallmark characteristic described here is decreased cortisol from Addison disease.