A case of sleep apnea syndrome manifesting severe hypertension with high plasma norepinephrine levels

摘要: A 55-year-old female was admitted to our hospital with severe hypertension (274/140 mmHg). Endocrinological examination revealed that her plasma levels of norepinephrine (NE) elevated high urinary NE, normetanephrine and vanillylmandelic acid (VMA), suggesting the presence pheochromocytoma. However, neither computed tomography nor MIBG scintigraphy detected any catecholamine-producing tumor in or outside adrenal glands. She screened full polysomnography because heavy snoring, diagnosis obstructive sleep apnea syndrome (OSAS) made. treated calcium channel blocker for three weeks, but persisted. After treatment nasal continuous positive airway pressure (CPAP) added, blood gradually lowered week by week. Concomitantly, VMA were normalized following CPAP therapy 2 weeks. Additional treatments alpha-adrenergic further decreased home pressure. a year, she continued nearly below 160/100 mmHg. Urinary NE level slightly above normal range other catecholamines stayed within range. This case shows patients OSAS could develop through sympathetic tone, mimicking Nasal is recommended not only improve catecholamine excess also distinguish condition from