Medullary adrenal hyperfunction – symptoms and treatment

The paroxysmal hypertension syndrome occurs when there is a lumpy growth of a specific type of glandular tissue in the area of ​​the medullary adrenal gland and its hormonal hyperactivity, related to the secretion of the so-called catecholamines, e.g. dopamine, adrenaline. This set of symptoms is usually also called pheochromocytoma syndrome.

Medullary adrenal hyperfunction – definition

An overactive part of the medullary adrenal gland is also known as a phaeochromocytoma. The disease occurs when glandular tissues grow in the area of ​​the medullary adrenal glands and their hormonal hyperactivity occurs (e.g. in the release of adrenaline and dopamine). The disease usually occurs between the ages of 20 and 50.

What are the adrenal glands?

The adrenal glands produce hormones which help our organs and tissues function properly. When the adrenal glands become overactive, many processes are disturbed. The appearance of this condition, and thus a phaeochromocytoma, causes the adrenal glands to secrete hormones that raise blood pressure. Ignoring this ailment may seriously threaten health and life as a result of damage to other body systems (e.g. cardiovascular system).

The causes of hyperfunction of the medullary adrenal glands

In fact, the cause of the disease is not fully known, it is not known why pheochromocytoma occurs, because it arises from specific cells located in the central part of the adrenal gland. They produce hormones such as adrenaline and norepinephrine. Thanks to these hormones, our body is prepared to react in an emergency. The rapid increase in blood pressure, accelerated heart rate and the functioning of other body systems allow us to react quickly and increase energy. The presence of a phaeochromocytoma may cause a similar reaction in the body for no apparent reason.

The elements that increase the risk of hyperfunction of the medullary adrenal glands are mainly genetic disorders and neoplasms in the form of:

1. hereditary paraganglioma syndrome,
2. sclerosis of type II hormonal neoplasia,
3. von Hippel-Lindau diseases,
4. neurofibromatosis.

When the medullary adrenal gland is overactive, certain complications may arise due to poor treatment of hypertension. They are in the form of:

1. strike,
2. heart disease
3. malignant tumors,
4. acute respiratory failure,
5. kidney failure
6. eye damage.

Symptoms of an overactive part of the medullary adrenal glands

During the hyperfunction of the adrenal medulla, we can observe a syndrome of so-called paroxysmal hypertension, characterized by sudden, short-term, but very large increases in blood pressure as a result of periodic secretion of more hormones into the blood.

An increase in blood pressure is usually accompanied by:

1. anxiety,
2. fast heartbeat,
3. pain in the heart area,
4. feeling short of breath
5. turning pale, especially the face
6. dizziness,
7. nausea,
8. vomiting,
9. stomach pain,
10. a feeling of tingling and numbness in the limbs.

Paroxysmal increases in blood pressure are usually accompanied by:

1. intense headache,
2. faster metabolism,
3. elevated blood glucose levels,
4. pale face,
5. the appearance of sugar in the urine temporarily,
6. there may also be pain in the lumbar region from time to time.

Additional factors influencing the occurrence of symptoms

Factors that often contribute to the appearance of symptoms of an overactive part of the medullary adrenal glands are:

1. childbirth – in women;
2. physical effort;
3. exposure to intense stress and anxiety;
4. changing body position abruptly and abruptly;
5. taking certain medications that raise blood pressure;
6. taking decongestants;
7. the use of stimulants, e.g. amphetamines, cocaine;
8. eating foods that contain tyramine to increase blood pressure, e.g. certain wines, beers or cheeses, smoked meats, beans, bananas, sauerkraut.

Symptoms associated with an overactive medullary adrenal gland can be caused by a variety of factors, so timely diagnosis is very important.

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Diagnosis of hyperfunction of the medullary adrenal glands

Diagnosing a pheochromocytoma of the adrenal medulla is not an easy task, additionally it is possible only in highly specialized clinical centers, on the basis of pharmacological and functional diagnostic tests and the results of diagnostic-biochemical and radiological-contrast tests.

At the beginning, tests are performed to find the cause of the disease, i.e. laboratory tests to determine the level of norepinephrine, adrenaline and by-products of these hormones in the body. Suspicion of a phaeochromocytoma suggests sudden increases in blood pressure, which appear despite the use of antihypertensive treatment in a relatively young patient. For this purpose, the following are performed:

1. blood test,
2. 24-hour (so-called) urine collection,
3. imaging tests in the form of computed tomography, magnetic resonance imaging, scintigraphy.

There are situations in which the overactive part of the medullary adrenal gland is detected accidentally during the diagnosis of other diseases. In some patients, genetic testing is suggested to determine if the disease is related to heredity.

Treatment of hyperfunction of the medullary adrenal glands

Surgical removal of the hormonally overactive nodule is most effective before the occurrence of secondary, usually irreversible changes in the kidneys and the circulatory system. Before the procedure is performed, the patient is pharmacologically appropriate to protect him against sudden pressure surges. Usually alpha blockers are used 2-3 weeks before the surgery. Most procedures are now performed laparoscopically. The final confirmation of the diagnosis of pheochromocytoma is established after the histopathological examination of the removed lesion.

The operation may have some side effects, such as:

1. dizziness
2. fatigue,
3. irregular heartbeat
4. trouble with eyesight,
5. problems in men with sexual activity (sexual dysfunction),
6. swelling / edema in limbs.

Depending on what caused the disease, doctors may also order other medications and other treatments and methods such as cancer therapy (if the lesions turn out to be cancerous). Suspicion of phechromocytoma in a patient is a contraindication to performing a tumor biopsy.