Acute Transient Stress Induced Adrenal Hypertrophy and Adrenal Medullary Hyperactivity

Abstract

Objectives: Adrenal gland hypertrophy can be related to acute stress with abnormal adrenal function tests. It may not always need treatment.

Material and methods: An acute presentation of adrenal gland hypertrophy following an abdominal emergency, with subsequent hypoadrenalism was investigated.

Results: Adrenal medullary and cortical function fully recovered without treatment.

Conclusions: We postulate that the adrenal glands became enlarged and hypertrophied during an acute stress event, possibly caused by acute adrenal medullary hypersecretion and subsequent cortical hyposecretion. A wait and watch policy should be followed if no other clinical symptoms and signs of adrenal disease are present. CT scan remains an important diagnostic tool.

Learning points: Abnormal adrenocortical function tests and hypertrophy can occur in an acutely ill patient as a stress response.It is possible to have both hypersecretion and hyposecretion of adrenal hormones.A wait and watch policy should be followed if no other clinical symptoms and signs of adrenal disease are present in an acutely ill patient.

Keywords: Adrenal gland hypertrophy; reversible adrenal dysfunction; stress related hypertension; transient adrenal insufficiency; transient adrenal medullary hyperactivity.