Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0001430 (adenoma)
 21,222 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In a Zurich outpatient clinic in 1975 hypertension was found in 10.4% of 8228 patients (3657 females and 4571 males). Essential (primary) hypertension was found in 92.9% of all hypertensives. Among secondary forms of hypertension (7.1%) renal hypertension was the most common (5.8%) with 4.9% for hypertension of renal parenchymatous origin, .8% renovascular hypertension, and .1% hypertension associated with unilateral hydronephrosis. In 2 patients (.2%) the underlying disease was primary aldosteronism and in 5 (.6%) coarctation of the aorta. In 4 females (.5%) hypertension was caused by oral contraceptives. Patients with essential hypertension had higher body weight than those with normal blood pressure. These differences were statistically significant in young and middle-aged patients. The percentage of primary hypertension was significantly high. In only 18 (2.1%) of 854 hypertensives was a curable form of high blood pressure found (hypertension caused by renal artery stenosis, hydronephrosis, aldosterone-producing adenoma of the adrenal gland, and oral contraceptives). The very low percentage of curable forms of high blood pressure should be kept in mind when deciding on expensive procedures in a search for secondary forms of high blood pressure.
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PMID:[Primary and secondary hypertension in polyclinical patients]. 85 17

We reviewed the records at the Mayo Clinic for the years 1973, 1974, and 1975 to determine the number of patients with hypertension who had had operations for repair of renal artery stenosis, excision of pheochromocytoma, or resection of aldosterone-producing adenoma. During the years studied, the average numbers of procedures per year were, respectively, 46.7, 10.3, and 2.7. For the purpose of estimating the frequency of each one of these three conditions among the population of hypertensive patients examined at the Mayo Clinic, we applied age- and sex-specific incidence figures from the US National Health Survey to the 162-273 patients examined who were more than 15 years old in 1974. We estimate that there were 26,589 patients who had diastolic blood pressures equal to or greater than 95 mm Hg. The indices generated estimated that renal artery stenosis repair was done in 18/10,000 (0.18%) hypertensive patients, pheochromocytoma excision in 4/10,000 (0.04%), and aldosterone-producing adenoma resection in 1/108000 (0.01%). These indices are strikingly lower than those frequently reported elsewhere, suggesting that these conditions are truly rare among hypertensive patients seen in clinical practice.
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PMID:Frequency of surgical treatment for hypertension in adults at the Mayo Clinic from 1973 through 1975. 89 97

A case of adrenal aldosterone-secreting adenoma concomitant with active renal artery stenosis in a hypertensive middle-aged woman is reported. The concomitance of the two lesions was previously reported in the literature only in five more reports, that are mentioned and commented here. This association is thought to be almost anecdotal, but some remarks must be done in order to rule out the risk of leaving an ignored lesion at the time of the definitive treatment. The widespread use of noninvasive imaging techniques is effective to find unsuspected adrenal adenoma in the presence of renovascular hypertensive disease, whereas unknown renal artery stenosis can be revealed by more aggressive diagnostic attitude, that is justified only in well selected cases of Conn's disease.
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PMID:The concomitance of renal artery stenosis and Conn's adenoma in a hypertensive woman. 187 55

The simultaneous occurrence of renovascular hypertension and an adrenocortical adenoma is a rare entity. The case of a 64-year-old woman who underwent an aortorenal bypass graft for renovascular hypertension requiring a multidrug antihypertensive regimen is presented. Persistently elevated blood pressures in the postoperative period prompted further workup for other causes of hypertension. Laboratory evaluation showed hyperaldosteronism and hyporeninemia despite enalapril administration. Abdominal computerized tomography (CT) revealed a left adrenal mass which, on surgical removal, was found to be a cortical adenoma. Subsequently, her antihypertensive therapy has been reduced to a single agent. Previous authors have described only four patients with malignant hypertension who had the rare clinical combination of renal artery stenosis and an aldosteronoma. This case reemphasizes the critical need for a thorough search for other surgically correctable lesions in those patients who remain severely hypertensive after the "definitive" operation.
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PMID:The simultaneous occurrence of renal artery stenosis and an aldosteronoma in a patient with hypertension. 268 7

1. Plasma atrial natriuretic peptide (ANP) levels were positively correlated with plasma renin activity (PRA) levels, when blood volume and blood pressure (BP) were not raised in normal subjects (NLS) or patients with postoperative aldosterone-producing adenoma (APA), Bartter's syndrome (BS), Addison's disease, anorexia nervosa, diuretic abuse or salt-losing congenital adrenal hyperplasia. 2. Angiotensin II infusion raised ANP levels in NLS, and patients with BS, pre- and postoperative APA, only when BP rose, suggesting that this effect might be mediated by the rise in BP. 3. Captopril lowered aldosterone and ANP levels in renal artery stenosis, but falling BP levels could mediate this effect. Captopril lowered aldosterone and BP in BS, but did not lower ANP, perhaps because angiotensin remained elevated. 4. Indomethacin lowered ANP when PRA was initially normal or raised (NLS and BS), but not when PRA was suppressed (APA). This effect could not be mediated by BP, which rose, but could be mediated by renin-angiotensin, which fell. 5. Factors other than central blood volume and atrial stretch may modulate ANP levels. Plasma angiotensin II may be such a factor, and may exert an important influence at high levels, especially when blood volume is low.
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PMID:Altering angiotensin levels by administration of captopril or indomethacin, or by angiotensin infusion, contributes to an understanding of atrial natriuretic peptide regulation in man. 297 45

In order to evaluate whether changes in the plasma concentration of aldosterone (PA) following the administration of captopril, an inhibitor of angiotensin-converting enzyme, will establish the diagnosis of primary aldosteronism we have used this test in 9 healthy subjects and in 22 patients with various forms of hypertension, including 5 patients with primary aldosteronism due to idiopathic adrenal hyperplasia (n = 4) or aldosterone-producing adenoma (n = 1). The response of PA to captopril (25 mg orally) was investigated on an outpatient basis, following a rest period of 120 minutes in the supine position. In healthy subjects PA decreased from a mean basal value of 11.5 +/- 5.9 ng/dl to less than 6.4 ng/dl (4.9 +/- 1.4 ng/dl [p less than 0.01]). Similarly, captopril induced a fall in PA concentration to less than 6.4 ng/dl in patients with essential hypertension, with renal artery stenosis or with an afunctional kidney. Post-captopril concentrations of plasma aldosterone were about twice the normal level in 3 of 4 patients with idiopathic adrenal hyperplasia and about four-fold raised above normal in the patient with an aldosterone-producing adenoma. In spite of a false-negative result in one patient with idiopathic adrenal hyperplasia, the administration of captopril appears to be of use in recognizing patients with primary aldosteronism on an outpatient basis.
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PMID:[Detection of primary aldosteronism using the captopril test]. 331 69

A new variety of intravascular ultrasound examination,--using mainly ultrasound probes with 12.5 MHz, in a few cases 20 MHz--via the inferior vena cava or the aorta was used to image small lesions in paravascular organs (adrenals, lymph nodes etc.). This is difficult with other diagnostic methods. The examinations were performed during selective blood sampling for hormone determination or during angiography, practically without additional burden for the patient. To demonstrate that this ultrasound method can be successfully used, we obtained an image of a small adenoma of the right adrenal, which in this case was also seen by CT and angiography. In another patient we identified a paracaval lymph node 4 mm in diameter. Another application of this method could be the diagnosis of renal artery stenosis in patients hypersensitive to contrast media. As an example, we demonstrated the difference in diameter of the ostia of the renal arteries of a patient with an anatomic variant on the left side. To improve this method it is recommended to use a 7.5-MHz probe with better beam penetration.
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PMID:[Preliminary studies in diagnosis of lesions in paravascular organs with intravascular ultrasound]. 767 26

A 58 year-old man with end-stage renal disease who had received a cadaveric renal transplant presented with persistent hypertension and hypokalemia. Allograft renal artery stenosis, rejection, and cyclosporine effects were excluded. Hypokalemia persisted despite potassium supplementation and antihypertensive medications with hyperkalemic effects. The biochemical findings of primary hyperaldosteronism with a normal adrenal anatomy imaged by magnetic resonance imaging (MRI) necessitated adrenal vein sampling to lateralize a left adrenal adenoma. His hypokalemia was cured by the removal of the adenoma, and his blood pressure (BP) control was easily achieved with a less complex regimen of antihypertensives. We suggest that the concomitant existence of resistant hypokalemia and posttransplantation hypertension, especially in the cyclosporine era, should stimulate a search for hyperaldosteronism; once transplant renal artery stenosis has been excluded, the patient should be investigated for primary hyperaldosteronism. When imaging studies fail to show adrenal pathology, adrenal vein sampling will likely do so.
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PMID:Primary hyperaldosteronism causing posttransplantation hypertension: localization by adrenal vein sampling. 959 Jan 97

Three patients diagnosed with primary hypertension suddenly developed hard-to-treat blood pressure after several years of stable blood pressure. One patient, a man aged 48 years, had developed a renal artery stenosis, which had not been present five years earlier. The other two patients, a man aged 57 years and a woman aged 27 years, were diagnosed with an aldosterone-producing adenoma of the left adrenal gland and a pheochromocytoma, respectively. In patients with previously stable blood pressure, sudden derangement may be due to secondary hypertension on top of the pre-existing primary hypertension. A thorough history and physical examination together with limited laboratory investigations usually leads the way to the correct diagnosis.
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PMID:[Hypertension: once primary, always primary?]. 1191 6

We describe a case of secondary hypertension in which aldosterone-producing adenoma (APA) and renal artery stenosis (RAS) coexisted. RAS caused a significant pressure gradient, and successful angioplasty of it improved the affected renal function but did not reduce the systemic blood pressure (SBP). Surgical resection of APA performed several months later reduced SBP. In cases of suspected secondary hypertension, other cause(s) of hypertension should be considered, if hypertension persists after correction of one possible cause.
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PMID:Aldosterone-producing adenoma accompanied with renal artery stenosis. 1704 16


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