[classicgirl29]

which ones are common with lupus? the rheumy is sending me to an endocrinologist and i've never been to one before. what can i expect this doctor to look at/for?

but you all know how it is...i'll probably go to this doctor and he'll say "umm, everything looks fine to me. i don't know what's wrong, you should go see "X" kind of doctor". har har har har!!

 

[mmair]

Hello Classicgirl,

I am not sure what your doctor suspects for an Adrenal problem. Possibilities are over or under function. An over function of the adrenal cortex leads to hypercortisolism (Cushing's syndrome). Where an underfunction in this part causes adrenal hypocortisolism (Addison's disease). Depending on which of these is suspected, tests would include measuring the blood levels of certain hormones (cortisol, 17-hydroxyprogesterone, Renin-angiotensin, ACTH) as well as Calcium, potassium, sodium. Adrenal stimulation/supression tests may also be done. First levels of cortisol would be measured then you are given an injection of a stimulating hormone (ACTH) after 30 min cortisol levels are again measured, and possibly again after 1 hr. a failure of cortisol to reach a certain level after the injection indicates an adrenal underfunction. Supression tests work simular.

An overfunction of the adrenal medulla (the inner part of the gland) would be associated with over production of epinepherine (adrenaline). Symptoms would be much like that of a "panic attack", heart racing, sweating, dilated pupils etc.

You can probably also expect a bodily examination, including height, weight, blood pressure. And likely an ultrasound examination of the kidneys/adrenals.

I myself have adrenal insufficiency (Addison's). On ultrasound the doc can see that my adrenals are shrunken (too small) and after stimulation my cortisol level is still not measurable. I have to take cortison lifelong (simular to someone with diabeties, or hypothyroid, that has to replace the missing hormones).

I wish you lots of luck, and I hope that truly nothing is wrong here, and whatever is found can be treated and cured!

Grüß,
Monique

 

[Judy64]

Adrenal problems

Hi Classicgirl: I don't know if this is common among folks with lupus, but I have a phaeochromocytoma (tumor) on my left adrenal gland. I get symptoms that come and go. Panic attack like symptoms, chest pain, heart racing, and my blood pressure goes up rapidly and then drops just as rapidly. Was sent to ER (thought I was having another heart attack) and they did a variety of testing including a cat scan of my abdominal area. The next tests were blood tests and a 24 hour urine test. I had to go on special diet for a couple of days and then save urine samples in a 1/2 gal jug for 24 hours. Since they found the tumor, I have to go in every 6 mo to see if the tumor is growing and keep a record of when I have the attacks. They do not happen all the time and are quite intermittant. I take meds to control panic attack symptoms, but I still get them, occasionally, but it sure helps now that I know what is going on.
If it gets to a point where the blood pressure spikes get worse or if the tumer starts to grow, they said that surgery might be in order. Go through the tests, no painful things involved. Good luck to you