Acute Transient Stress Induced Adrenal Hypertrophy and Adrenal Medullary Hyperactivity

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.