A 44 year old woman with episodic sweating and hypertension
BMJ 2019; 367 doi: https://doi.org/10.1136/bmj.l5879 (Published 31 October 2019) Cite this as: BMJ 2019;367:l5879
- Mehdi Mirzazadeh, consultant in metabolic medicine1,
- Ehsan Alijani, consultant physician2,
- Mahdieh Fani, clinical educator3,
- Shahin Jamili, consultant surgeon2
- 1Epsom and St Helier Hospital University Hospital NHS Trust, London, UK
- 2Noor Hospital,Tehran, Iran
- 3Cardiff University, Cardiff, UK
- Correspondence to M Mirzazadeh mehdi.mirzazadeh{at}nhs.net
A 44 year old woman with hypertension and type 2 diabetes (treated with insulin) presented with recurrent 10-15 minute episodes of sweating, tachycardia with regular pulse (110-120 beats/minute), pallor, and occasional increase in blood pressure (from ~130/90 mmHg to ~175/120). These episodes happened two to three times a week over eight months.
Glucose readings during these episodes were always greater than 8 mmol/L, ruling out hypoglycaemia.
Her medications included doxazosin, metformin, and insulin. She had a body mass index of 32 kg/m2. Physical examination, baseline blood tests, and renal artery doppler were normal.
Further investigations were carried out as outlined …
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