Transient Hypertension due to Adrenal Hemorrhage in a Patient with von Recklinghausen's Disease.

Abstract

A 29-year-old man with von Recklinghausen's disease suddenly developed severe epigastric pain and was admitted to hospital. Physical examination revealed elevated blood pressure (200/130 mmHg) and tachycardia (162 bpm). Initially, he was suspected to have appendicitis, and appendectomy was performed immediately; however, appendicitis was not demonstrable pathologically. Retroperitoneal hematoma was found incidentally during the operation. Further clinical and laboratory examination demonstrated a markedincrease in the urinary excretion ofcatecholamines. Therewasno evidence of pheochromocytoma on computedtomographyor magneticresonance imaging; however, these imaging studies simply showed a hematoma at the right adrenal gland. Transient hypertension and tachycardia, resembling pheochromocytoma,was caused by adrenal hemorrhage. (Internal Medicine 36: 289-292, 1997)

Elevated urinary catecholamines and adrenal haemorrhage mimicking phaeochromocytoma

“…However, false positive results are reported, being described in conjunction with the use of drugs such as labetolol together with foods such as fruits and nuts 3 4. Rarely, elevated catecholamine concentrations are reported in association with adrenal haemorrhage/infarction and in some cases this has prompted surgical removal of the gland for suspected phaeochromocytoma 5 6. In our case, phaeochromocytoma was postulated as a diagnosis and surgical opinion was sought.…”