The adrenal glands are organs located above the kidneys and participate in the endocrine system.

Position. The adrenal glands are paired and unsymmetrical glands (1). Each of the adrenal glands is located above a kidney (2).

Structure. The adrenal glands are made up of two structures (1):

• the adrenal medulla, or medulla, located in the center;
• the adrenal cortex, or cortex, located at the periphery.

The whole is enveloped by a dense fibrous tissue, the capsule (2).

Production d’hormones. Within the medulla and cortex, the adrenal glands produce hormones essential for the proper functioning of the body:

• Within the medulla. The cells of the medulla synthesize catecholamines, and more particularly adrenaline and noradrenaline. These hormones intervene in particular in times of stress or anxiety by increasing blood pressure.
• Within the cortex. The cells of the cortex synthesize different corticosteroids. In this family of hormones, we find in particular:

  – mineralocorticoids which act on the kidneys to control the potassium and sodium concentrations in the water.

  – glucocorticoids which act on the metabolism of proteins, lipids and carbohydrates. They also have a role in certain immune reactions.

  – sex hormones such as androgens in men and estrogen in women.

Adrenal insufficiency pathologies. (3) They designate pathologies linked to a deficiency during the secretion of hormones in the adrenal cortex zone. They are manifested by digestive disorders, hypotension, dizziness, or even brownish skin pigmentation. The causes of these pathologies are varied. For example, Addison’s disease is adrenal insufficiency that is primarily of autoimmune origin, but can also be infectious or genetic in origin.

Pathologies of excess secretion. (3) They correspond to pathologies linked to an excess of hormonal secretion. They can occur at the level of the two structures of the adrenal glands: the cortex and the medulla. For example, hypercorticism or Crushing’s syndrome, affecting the cortex, corresponds to an excess of cortisol secretion. These pathologies are manifested in particular by the appearance of hematomas and stretch marks, arterial hypertension and the onset of diabetes.

Tumors. Both benign (non-cancerous) and malignant (cancerous) tumors can develop in the adrenal glands, both in the cortex and in the medulla (2).

Drug treatments. Depending on the pathology diagnosed, certain drugs may be prescribed to compensate and restore hormonal concentrations in the body, especially in cases of insufficient or excess secretion of hormones.

Surgical treatment. Depending on the pathology and its evolution, surgery may be performed.

Chemotherapy, radiotherapy, targeted therapy. Depending on the type and stage of the tumor, chemotherapy, radiotherapy or even targeted treatment may be used to treat the cancer.

Physical examination. First, a clinical examination is performed to assess the symptoms perceived by the patient.

Medical imaging exams Ultrasound, CT, scintigraphy or MRI can be performed to identify and assess a pathology.

Biological examinations. Blood and urine tests can be done to analyze the level of certain hormones in the body.

In 1849, Thomas Addison, a 19th century English physician and scientist, was the first to describe slow adrenal insufficiency, now known as Addison’s disease (4).