CLINICAL CASES
441
B IO C H E M IS T R Y PE A R L S
Most cases of Addison disease are because of idiopathic atrophy of
the adrenal cortex induced by autoimmune responses.
Cortisol interacts with intracellular receptors to trigger their binding
to specific response elements in the promoters of target genes to
influence transcription of their mRNAs.
Under separate positive control by norepinephrine, the intermediate
pituitary converts ACTH to melanocyte-stimulating hormone,
which accounts for the “well tanned” appearance.
Aldosterone insufficiency produces severe dehydration, plasma
hypertonicity, acidosis, decreased circulatory volume, hypoten-
sion, and circulatory collapse.
REFERENCES
Litwack G, Schmidt TJ. Biochemistry of hormones I: polypeptide hormones. In:
Devlin TM, ed. Textbook of Biochemistry with Clinical Correlations, 5th ed.
New York: Wiley-Liss, 2002.
Pathophysiology of the endocrine system. An online textbook from Colorado State
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