| Posttraumatic hypertension secondary to adrenal hemorrhage mimicking pheochromocytoma: case report. | |
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MedLine Citation:
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PMID: 10338428 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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We report the case of a 68-year-old man who presented with a mass 3 x 4 cm in size located in the right adrenal gland together with extreme hypertension, tripled urine levels for normetanephrine, and normal plasmatic levels of metanephrines. The patient had suffered a fall from a height of 2.5 meters before hospitalization. [123I]MIBG-scan was repeatedly positive in the area of the right adrenal gland. At laparotomy under alpha-adrenergic blocking agents, the suspected pheochromocytoma was histologically confirmed as hematoma. After resection of the adrenal gland, blood pressure returned to normal without drug therapy as did metanephrine levels in urine. Although adrenal insufficiency after distension of the gland caused by hemorrhage has been reported, there are no data available regarding the mimicking of a hormonally active pheochromocytoma. We conclude that intra-adrenal pressure rise caused by hematoma may cause partial ischemic necrosis to the gland but may also induce reactive hyperplasia with periodic excessive secretion of catecholamines. This interpretation is consistent with the finding that plasma levels of catecholamines were normal in contrast to the urinary normetanephrines in the presented case. It might be worthwhile to investigate patients with intra-adrenal hemorrhage immediately after sustaining multiple injuries and in the posttraumatic course of several months up to 1 or more years together with verification of abnormal urinary excretion of metanephrines as a sign of impaired adrenal function. |
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Authors:
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J Schmidt; V D Mohr; P Metzger; H Zirngibl |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: The Journal of trauma Volume: 46 ISSN: 0022-5282 ISO Abbreviation: J Trauma Publication Date: 1999 May |
Date Detail:
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Created Date: 1999-06-08 Completed Date: 1999-06-08 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0376373 Medline TA: J Trauma Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 973-5 Citation Subset: AIM; IM |
Affiliation:
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Department of Surgery, University Witten-Herdecke, Wuppertal, Germany. johannes.schmidt@klinikum-wuppertal.de |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adrenal Gland Diseases
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diagnosis* Adrenal Gland Neoplasms / diagnosis* Adrenal Glands / injuries* Aged Diagnosis, Differential Hemorrhage / diagnosis*, etiology Humans Hypertension / etiology* Male Pheochromocytoma / diagnosis* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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