• Am. J. Med. Sci. · Jan 2022

    Review Case Reports

    Adrenal Medullary Hyperplasia, An Under the Radar Cause of Endocrine Hypertension.

    • Ana M Rivas Mejia, Jose M Cameselle-Teijeiro, Subhanudh Thavaraputta, and Joaquin Lado-Abeal.
    • Division of Endocrinology, Department of Internal Medicine, Texas Tech University Health Sciences Center School of Medicine, Lubbock, Texas. Electronic address: Marcella.rivas@ttuhsc.edu.
    • Am. J. Med. Sci. 2022 Jan 1; 363 (1): 64-68.

    AbstractAdrenal medullary hyperplasia is a cause of increased secretion of catecholamines by the adrenal gland that is rarely considered among the differential diagnoses of endocrine hypertension. We report the case of a 48-year-old Hispanic woman who presented for evaluation of resistant hypertension with several episodes of hypertensive crisis. The clinical presentation, biochemical results, and abdominal computed tomography scan suggested the possibility of a pheochromocytoma; however, an iodine-123-meta-iodobenzylguanidine (123I-MIBG) uptake study combined with single-photon emission computed tomography (SPECT) and computed tomography (CT) scan showed diffusely increased metabolic activity in both adrenal glands. The patient underwent left adrenalectomy, and the pathology study revealed the presence of adrenal medullary hyperplasia. After surgery, blood pressure control was achieved with one antihypertensive drug, and the patient did not have recurrent hypertensive crisis. Relevant findings obtained from a whole genomic sequence done on a whole blood DNA sample from the patient are discussed.Copyright © 2020 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

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