An Unusual Case of Adrenal Hemorrhage

Adrenal hemorrhage is an uncommon diagnosis, with nonspecific clinical findings. It can present with elevated blood pressure and arrhythmia in the setting of elevated catecholamine levels. Although overproduction from an adrenal mass such as pheochromocytomas is typically suspected, severe physiologic stress is also associated with increased catecholamine release. This report details a case of acute clinical deterioration and biochemical evidence of marked excess of catecholamines in a patient with unilateral adrenal hemorrhage. Initial suspicion was high for a hemorrhagic pheochromocytoma. However, follow-up evaluation revealed resolution of the hemorrhagic collection, evidence of an adrenal mass, and normalization of catecholamine levels.