PEDIATRICS Vol. 32 No. 5 November 1963, pp. 825-840
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THE JUXTAGLOMERULAR CELLS OF THE KIDNEY AND THE ZONA GLOMERULOSA OF THE ADRENAL CORTEX IN THE SODIUM-LOSING AND THE HYPERTENSIVE FORMS OF VIRILIZING ADRENAL HYPERPLASIA

José Cara M.D.1 and Lytt I. Gardner M.D.1

1 Department of Pediatrics, State University of New York, Upstate Medical Center, Syracuse, New York

Pathological and biochemical observations are presented in two cases of virilizing adrenal hyperplasia: one of the sodium-losing type and the other of the hypertensive type. Examination of the kidneys revealed hypertrophy of the juxtaglomerular cells in the case exhibiting excessive sodium loss. The adrenal cortex showed hypertrophy of the zona glomerulosa. It is hypothesized that the chronic state of sodium loss caused changes in the intravascular compartment which led to compensatory activity of the juxtaglomerular cells with resultant stimulation of the zona glomerulosa.

Examination of the hypertensive case (known to involve a different enzyme deficit) showed hypertrophy of the zona glomerulosa without hypertrophy of the juxtaglomerular cells. The intrinsic overproduction of sodium-retaining steroids associated with the genetic defect in this clinical form could account for both the hypertension and the absence of hypertrophy of the juxtaglomerular apparatus.

Submitted on February 4, 1963
Accepted on May 20, 1963