AMA Criteria for Permanent Impairment Associated with Hyperadrenocorticism

 

The syndrome may arise with disorders of the:

(1) pituitary adenoma

(2) adrenocortical hyperplasia, adenoma or carcinoma

(3) treatment with glucocortiosteroids

 

Parameters:

(1) signs and symptoms

(2) cause for the hyperfunction

 

Signs and symptoms of hyperfunction:

(1) "moon" facies

(2) truncal obesity with "buffalo hump"

(3) muscle wasting and weakness

(4) skin atrophy

(5) poor wound healing

(6) easy bruisability

(7) abdominal striae

(8) hypertension

(9) osteoporosis

(10) glucose intolerance

(11) menstrual irregularities in women

(12) growth retardation in children

 

Signs and Symptoms	Cause	Impairment of the Whole Person
none	short term low dose glucocorticoid therapy	0%
minimal	surgically removable pituitary or adrenal adenoma; moderate dose glucocorticoid therapy	0 - 14%
moderate	bilateral adrenal hyperplasia; unresectable pituitary or adrenal adenoma; high doses glucocorticoid therapy	15 – 39%
severe	metastasizing carcinoma	>= 40%; depends on end-organ damage

 

where:

• Impairment with a metastasizing adrenocortical carcinoma would be based on the involvement of other sites.