Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2015) 37 GP03.08 | DOI: 10.1530/endoabs.37.GP.03.08

ECE2015 Guided Posters Adrenal (2) (8 abstracts)

Obstructive sleep apnea presenting as pseudophaeochromocytoma

Hela Marmouch 1, , Sondes Arfa 1 , Tasnim Slim 1 , Fadia Boubaker 1 , Manel Jmal 1, , Hanene Sayadi 1, & Ines Khochtali 1,


1Department of Internal Medicine–Endocrinology, Monastir, Tunisia; 2Faculty of Medicine, Monastir, Tunisia.


Introduction: The obstructive sleep apnea syndrome (OSAS) has a well-documented association with increase cardiovascular morbidity and mortality. The patients with OSAS have a high prevalence of hypertension (HTA).

Case report: A 52-year-old female with a history of poorly controlled resistant HTA was admitted to our hospital with severe HTA. She had a history of fatigue and intermittent episodes of palpitations. Laboratory evaluation was significant for elevated 24-h urinary catecholamine levels (CU=3.5×). This case was presenting with a clinical and biochemical picture indistinguishable from that of phaeochromocytoma. However, neither computed tomography nor MIBG scintigraphy detected any catecholamine-producing tumor in or outside the adrenal glands. Our patient was screened with full polysomnography because of heavy snoring, daytime somnolence, and obesity. It revealed severe (OSAS). After three months of continuous positive airway pressure therapy, the patient experienced resolution of his presenting symptoms, improved blood pressure control and normalisation of his CU. This case highlights sleep disordered breathing as a potentially reversible cause of pseudo phaeochromocytoma (PPH).

Discussion: The OSAS can elevate catecholamine secretion and increased sympathetic activity which may mimic the biochemical profile of PPH. Treatment of OSAS may normalise the effects of this sympathetic overdrive and resolve excessive CU secretion. In this observation, we report a case of PPH caused by OSAS; a common medical condition which is less recognised as a cause of raised catecholamines.

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