PSUN09 An Unusual Presentation of Pheochromocytoma with Persistent Hypoglycemia, A Case Report

• Published in: Journal of the Endocrine Society 2022-11, Vol.6 (Supplement_1), p.A120-A120
• Main Authors: Alnahas, Zeinab, Horani, Mohamad H
• Format: Article
• Language: English
• Subjects: Adrenal
• ISSN: 2472-1972; 2472-1972
• DOI: 10.1210/jendso/bvac150.244

Abstract Introduction Pheochromocytoma is a rare chromaffin cells tumor of the adrenal medulla characterized by excessive catecholamines production. It can be manifested by various clinical presentations, ranging from being asymptomatic to having sustained or paroxysmal hypertension, or the classical triad of paroxysmal headache, palpitations, and sweating. It may be sporadic or inherited as part of other familial syndromes, including hereditary paraganglioma syndromes, and multiple endocrine neoplasia 2. This case report shows an unusual presentation of pheochromocytoma in a patient with neurofibromatosis type 1. Case Presentation A 27-year-old normotensive woman with a past medical history significant for neurofibromatosis type 1 diagnosed at age 16 was involved in a single-vehicle rollover collision. She experienced a sudden episode of dizziness and presyncope associated with nausea while she was driving. She was found with altered mental status and a serum glucose level of 31 mg/dl (reference value 70-99mg/dL), indicating hypoglycemia which remained persistent after administering a glucose drip. The patient denied any recent febrile illness, previous episodes of dizziness, vertigo, syncope, or known hypoglycemia. Her CT abdomen with intravenous contrast showed a 4.8 cm lobulated heterogeneous mass involving the right adrenal glands concerning for pheochromocytoma. Her laboratory workup revealed HbA1C of 4.9%, serum-free insulin of 6 mcU/mL (reference range