Adrenomedullary Hyperfunction

Adrenomedullary hyperfunction is excessive catecholamine (epinephrine/norepinephrine) secretion, most often from an adrenal pheochromocytoma or extra-adrenal paraganglioma. Classic triad: paroxysmal hypertension, headache, profuse sweating, palpitations, tremor, pallor. Untreated causes hypertensive crisis, arrhythmia, myocarditis. Diagnosis: plasma free metanephrines / 24-h urinary fractionated metanephrines; imaging localizes tumor. Treatment: surgical resection after alpha-adrenergic (and then beta-) blockade.

Common Symptoms

Paroxysmal hypertension; severe headache; profuse sweating; palpitations; tremor; pallor; anxiety/panic attacks; orthostatic hypotension

Causes and Pathogenesis

Catecholamine-secreting chromaffin-cell tumor (pheochromocytoma/paraganglioma) episodically releases epinephrine/norepinephrine, causing vasoconstriction, hypertension and arrhythmias.

Treatment

Phenoxybenzamine/doxazosin alpha-blockade, then beta-blockade; surgical resection; MIBG/chemotherapy for malignant metastatic disease

Preventive Measures

Screen family members (MEN2, VHL, NF1); avoid beta-blockade before alpha-blockade; careful perioperative BP control.

Department to Visit

It is recommended to visit the Endocrinology department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.