REFRACTORY HYPERTENSION IN A YOUNG PATIENT: A CASE REPORT

Abstract

Introduction: Pheochromocytoma, a rare tumor originating from the chromaffin tissue of the adrenal medulla, has a prevalence of about 0.1-0.6% in patients with hypertension. Usually benign, its surgical removal can be curative. However, delays in diagnosis and inadequate treatment can lead to high mortality and morbidity rates. Case Report: A 23-year-old man with a history of resistant hypertension since December 2022 presented with symptoms of headache, palpitation, sweating, and anxiety. Tests revealed elevated levels of metanephrines and catecholamines, leading to the suspicion of pheochromocytoma. An MRI of the abdomen identified an expansive lesion in the right adrenal gland. Treatment included clinical management with alpha- and beta-blockers, followed by successful adrenalectomy, resulting in improvement of symptoms and hypertension. Discussion: The case illustrates the complexity inherent in the diagnosis of pheochromocytoma, a condition that often manifests surreptitiously in hypertensive patients. Resistance to conventional antihypertensive therapy, combined with symptoms such as headache, palpitations, and sweating, should raise suspicions of secondary hypertension and, consequently, pheochromocytoma. This case underlines the importance of a meticulous diagnostic evaluation in patients with refractory hypertension. Conclusion: Pheochromocytoma, despite being a rare cause of hypertension, represents a crucial differential diagnosis in secondary hypertension. Early diagnosis and appropriate surgical intervention are essential to prevent associated morbidity and mortality. This case reinforces the need for clinical surveillance for suggestive symptoms and the importance of appropriate diagnostic investigations in patients with resistant hypertension, particularly in young people.