Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Angiotensin-converting enzyme in the blood serum was assayed with Friedland's and Silverstein's Technique in 24 female patients with untreated hyperthyroidism accompanying Graves-Basedow disease. Mean ACE activity was significantly higher in patients than that in the group of healthy individuals of the same age. Increased ACE activity noted in patients with Graves-Basedow disease may, therefore, indicated a significant role of renin-angiotensin-aldosterone system in the etiopathogenesis of hypertension in this disease.
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PMID:[Activity of angiotensin-converting enzyme in women with hyperthyroidism accompanying Graves-Basedow disease]. 133 53

Catecholamines stimulate thyroid hormone synthesis as well as release of thyroid hormone and cause immunologic disturbances that possibly contribute to the manifestations of Graves' disease. This has led to repeated speculations about the possible role of catecholamines in the initiation and maintenance of hyperthyroidism. We describe a patient with Graves' disease who was treated with antithyroid drugs for 2 years. After withdrawal of antithyroid drugs, the patient was in remission for 5 years. After the antithyroid drug treatment and the long remission, the probability of relapse of Graves' disease was very low. Nonetheless, a relapse did occur. Two years after subtotal thyroid resection, further investigation because of persistent hypertension revealed a pheochromocytoma. Retrospective anamnestic data suggest that this pheochromocytoma had been present 2 years before the patient's relapse of Graves' disease. This sequence of diseases has not been described previously. The low probability for a Graves' disease relapse in this patient and the association of this patient's relapse with the manifestation of a pheochromocytoma suggest a possible etiologic role of excess catecholamine production in the relapse of Graves' disease.
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PMID:Relapse of Graves' disease following development of a pheochromocytoma. 142 32

Three different cases of cerebral embolism occurring in combination with hyperthyroidism are reported. Case 1; a healthy 37-year-old woman presented with sudden onset of left hemiparesis and left sided hypoesthesia of all modalities. Embolism in area of the right middle cerebral artery was confirmed by angiography and CT scan. Laboratory examination revealed hyperthyroidism and anemia. Antithyroid treatment brought about euthyroid function while slight hemiparesis remained present. Case 2; a 79-year-old woman who suffered from hypertension for one year had sudden onset of disorientation and left hemiparesis. Electrocardiogram showed atrial fibrillation. The CT scan indicated infarction in the right anterior and middle cerebral artery. The patient was diagnosed as having masked hyperthyroidism. Although antithyroid medication reduced it to euthyroid condition, the patient is now bedridden with hemiparesis. Case 3; a 45-year-old man who had partial thyroidectomy for Basedow's disease and had been treated with antithyroid and antiarrhythmic therapy for 10 years. Suddenly, he was in coma with dilated right pupil and left hemiplegia. Atrial fibrillation and hypothyroid function were observed. CT scan indicated hemorrhagic infarction in the territory of the middle cerebral artery with transtentorial herniation. He died on the 59th day of hospitalization following an episode of bronchopneumonia. On the basis of the cases presented here as well as on the basis of those described in the literature it appears that thyrotoxic patients with atrial fibrillation exhibit high incidence of cerebral embolism, and prophylactic anticoagulant therapy may be recommended.
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PMID:Cerebral embolism and hyperthyroidism. 277 Feb 20

The standardized A-scan (Kretztechnik 7200 MA) supplemented by contact B-scan and Doppler ultrasound is a time-tested, highly reliable, and noninvasive tool for the evaluation of patients presenting with signs or symptoms suggesting an orbital lesion. Diseases of the orbital adipose tissue, extraocular muscles, optic nerves and periorbital sinuses are detectable within minutes by the experienced examiner. More than 60 types of orbital lesions can then be differentiated, localized, measured, and schematized. While the value of orbital CT scanning has been widely accepted, standardized echography is now also being recognized as an important modality in the diagnosis and management of orbital and periorbital disease. The use of standardized echography results in more frequent and more accurate tissue differentiation, specifically: (1) standardized tumor patterns closely correlate with histologic diagnoses, (2) vascular flow detection and compression testing (hard or soft), (3) detection and diagnosis of optic nerve sheath distention due to increased subarachnoid fluid (eg, benign intracranial hypertension), and (4) greater sensitivity in detecting mild extraocular muscle thickening (eg, Graves' disease). Additional advantages are the noninvasive nature of the procedure (no radiation) and portability of the equipment.
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PMID:Orbital tissue differentiation with standardized echography. 668 63

In order to study the prognosis of Graves' disease, 236 patients, who had been diagnosed as having had Graves' disease more than 10 years before, were examined. Although one patient had died of leukemia and 2 patients had been operated on for breast cancer after 131I therapy, and another 6 patients had died between the ages of 20 and 50, the patients were doing quite well. Generally, the prognosis of Graves' disease is not considered to be serious if the thyroid function is controlled. Among the 72 patients who had been treated with 131I therapy, 15 patients (21%) showed low serum levels of both T3 and T4 and were considered to be suffering from late-onset hypothyroidism. About 67% of the 131I-treated patients were considered to be almost euthyroid, but serum TSH levels were high in half of them, suggesting latent hypothyroidism. The incidence of hypertension seemed to be significantly higher in the TSH-elevated euthyroid group compared with the TSH-nonelevated patients. An excessive reaction of the hypothalamus and/or pituitary gland might have an unfavorable effect not only on the apparent hypothyroidism, but also on the latent hypothyroidism after the therapy for Graves' disease.
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PMID:[Primary hypothyroidism as a possible cause of hypertension from long-term follow-up studies of patients with Graves' disease (author's transl)]. 689 8

Two of thousand pregnancies are complicated by a Graves' disease. The circumstances of diagnosis are usually maternal disorders (tachycardia, exophthalmia, loss of weight...), also fetal disorders (tachycardia, intra-uterine growth retardation, stillborn...). The discovery of fetal tachycardia (160 beats per minute), and maternal tachycardia (120 beats per minute) associated with high blood pressure, allowed us to suspect, in this case, a Graves' disease, responsible of fetal hyperthyroidism by autoantibodies crossing the placenta. The measuring of T3, T4, TSH and autoantibodies confirmed the diagnosis. The drug of choice is the PTU (propylthiouracil). It prevents synthesis of thyroid hormones and inhibits peripheral deiodination of T4 to T3. It treats simultaneously mother and fetus; the surveillance must allow us to adjust treatment to avoid fetal hypothyroidism, maternal thyrotoxicosis of peripartum and neonatal thyrotoxicosis.
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PMID:[Isolated fetal tachycardia, a diagnostic event of Basedow's disease. Apropos of a case]. 805 73

We describe the case of a young man with Graves Basedow's Disease as the unique cause of congestive heart failure, which after several months of antihyperthyroid therapy not very strictly followed, underwent heart transplantation due to severe ventricular and diastolic disfunction. The relationship between thyroid hypertension and cardiomyopathy is reviewed.
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PMID:[Hyperthyroidism as a cause of irreversible dilated myocardiopathy]. 821 88

Physiologic changes in metabolism may make thyroid diseases difficult to diagnose during pregnancy. Such diagnoses depend principally on clinical acumen and an understanding of the alterations of laboratory values, particularly thyroid-stimulating hormone (TSH), induced by pregnancy. Untreated thyrotoxicosis may lead to abortion, stillbirth, neonatal death and low birth weight. The principal cause of thyrotoxicosis in pregnancy is Graves' disease, which may be treated with antithyroid drugs or surgery. The use of radioactive iodine is absolutely contraindicated during pregnancy. Hypothyroidism during pregnancy is associated with hypertension and premature labor. The goal of thyroxine replacement therapy is to maintain serum TSH levels in the normal range. Many thyroid conditions and treatments directly affect the fetus and the principal antithyroid drugs are secreted in breast milk. Both the mother and neonate require monitoring. In addition, autoimmune postpartum thyroiditis may recur following each pregnancy in susceptible patients.
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PMID:Thyroid disease during pregnancy. 854 48

Hyperthyroidism is well known to be associated with cardiovascular manifestations. The authors have noted that patients of well controlled Graves' Disease often pose problems due to intrapoperative cardiovascular instability. Retrospective analysis of 137 case records of patients with Graves' disease (n = 35), toxic nodular goitre (n = 42) and those with euthyroid benign goitre (n = 60) were studied. In Graves' disease cardiovascular instability was found in the form of hypertension (n = 9) associated with tachyarrhythmia (n = 8) and bradycardia (n = 3). The incidence of first 2 of the above mentioned 3 problems was significantly higher in Graves disease (n = 9/35 patients) in contrast to a comparable group of patients with toxic nodular in (3/42 patients; P value 0.05) and euthyroid goiter (2/60 patients; P value < 0.001). Certain parameters such as high T3, T4 at the time of presentation were associated with higher incidence of these complications, in spite of very well controlled thyrotoxicosis. Whether heightened receptor sensitivity to catecholamines and higher renin-angiotensin activation explain these findings in Graves' disease, remains to be ascertained.
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PMID:Intraoperative hypertension during thyroidectomy for Graves' disease. 908 63

We tested the hypothesis that a subset of the Farnsworth-Munsell 100-hue test (FM-100) would be a sensitive, specific, and practical means of monitoring color vision in patients with chronic optic nerve disorders. We retrospectively analyzed the records of 1,113 patients affected with optic neuritis (ON), Graves' ophthalmopathy with suspected optic neuropathy, or idiopathic intracranial hypertension with suspected optic neuropathy (IIH). One hundred six records of patients showed that an FM-100 had been performed (23 ON, 46 Graves', 37 IIH). Forty additional patients were studied prospectively (11 ON, 17 Graves', 12 IIH). The sensitivity and specificity of all possible 21 chip subtests were compared against the same statistics for the entire test. We found that for these three optic nerve disorders, a test consisting of chips 22-42 had nearly the same sensitivity and specificity as the entire test when compared with the clinical diagnosis. At 90% specificity, the ratio of sensitivities of the short version to the original version of the test were IIH, 53%/45%; optic neuritis, 85%/79%; and Graves', 67%/70%. The majority of the clinical value of the test can be achieved in one fourth of the original examination time.
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PMID:Evaluation of a significantly shorter version of the Farnsworth-Munsell 100-hue test in patients with three different optic neuropathies. 909 53


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