Nelson's syndrome
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Phone:617-632-7753
Overview
Nelson's syndrome is the rapid enlargement of a pituitary adenoma that occurs after the removal of both adrenal glands.[1]
Historical Perspective
Classification
Pathophysiology
Removal of both adrenal glands, or bilateral adrenalectomy, is an operation for Cushing's Disease. Removal of both adrenals eliminates production of cortisol, and the lack of cortisol's negative feedback can allow any preexisting pituitary adenoma to grow unchecked. Continued growth can cause mass effects due to physical compression of brain tissue, along with increased production of adrenocorticotrophic hormone (ACTH) and melanocyte stimulating hormone (MSH).
Causes
Differentiating Nelson's syndrome from Other Diseases
Epidemiology and Demographics
Nelson's syndrome is rare because bilateral adrenalectomy is now only used in extreme circumstances.
Risk Factors
Screening
Natural History, Complications, and Prognosis
Natural History
Complications
Prognosis
Diagnosis
Diagnostic Criteria
History and Symptoms
Physical Examination
- Skin hyperpigmentation due to excess MSH.