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)

We studied a 59-year-old man with transient paroxysms of hypertension, tachycardia, and flushing in whom pheochromocytoma was excluded. Although catecholamine excretion was normal, plasma catecholamine levels rose from normal basal levels (282 +/- 14 pg/ml) to increased levels (585 +/- 67 pg/ml; x +/- SEM; n = 4) at the peak of spells. Other hormones or substrates expected to rise with nonspecific "stress" did not increase after paroxysms. Therapy with clonidine (0.2 to 0.4 mg/day) suppressed basal catecholamines to undetectable levels and markedly reduced peak levels during spells (80 pg/ml). An epileptic pathogenesis was suggested by stereotypic olfactory and epigastric prodromata before spells, and abolition of paroxysms with the anticonvulsant carbamazepine. This patient represents a rare case of autonomic epilepsy with the seizure focus in the temporal lobe.
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PMID:Autonomic epilepsy: clonidine blockade of paroxysmal catecholamine release and flushing. 62 48

In a patient with paraganglioma, severe hypertension due to high levels of plasma norepinephrine was easily controlled with prazosin hydrochloride, 6 to 8 mg/day for 19 days before surgery. A prolonged antihypertensive response to the first two 1-mg doses suggested the presence of pheochromocytoma. This experience dramatizes the remarkable effectiveness of prazosin as a postsynaptic alpha-adrenergic receptor blocker and invites further trials of the drug for both the diagnosis and treatment of pheochromocytoma.
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PMID:Prazosin in the diagnosis and treatment of pheochromocytoma. 71 11

Foremost in the differential diagnosis of hypertension is the identification of surgically correctable lesions. Increased plasma renin activity in a hypertensive patient suggests the presence of a renovascular or renal etiology. We have recently seen two adolescent patients whose hyperreninemia was cuased by a pheochromocytoma. Secondary hyperaldosteronism was an associated finding.
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PMID:Hyperreninemia and secondary hyperaldosteronism in pheochromocytomas. 76 9

In industrial countries the symptoms "headache" has an incidence of about 10%, and hypertension between 20 and 25%. Both terms are summary and may be pointers to and warning signals of the most varied disease processes. While, in malignant hypertensions, and pheochromocytoma, headache is a cardinal symptom, its causal connection with permanently raised blood pressure in the "benign" forms is viewed with scepticism. The observation that hypertensives frequently complain of headaches with a maximum intensity in the early hours of the morning is connected with the fall in blood pressure with accumulation of CO2 in shallow breathing. Headache as a symptom characteristic of hypertension is frequently only facultative in nature and must be classified among the series of symptoms of sequelae. But it offers a sufficient reason to institute a selective examination programme, especially as hypertension is still the most common cause of death even today.
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PMID:[Headache associated with hypertension from the internist's and neurologist's point of view (author's transl)]. 81 25

The authors present a case of pheochromocytoma observed in a 49 year old man suffering from the cutaneous form of von Recklinghausen's disease. In this patient, they noted the constant absence of the inferior abdominal cutaneous reflex on the right side, contrasting with the briskness of the other abdominal cutaneous relexes. From this they concluded that the chromaffin tumor was very probably situated in the right adrenal region. This hypothesis was confirmed by retro-pneumoperitoneum, selective arteriography and finally surgical intervention. After having reviewed the essential medical data from the literature concerning the conditions associated with pheochromocytoma and especially phacomatosis, and having looked at the problem of hypertension related to neurofibromatosis, they make a critical study of the behaviour of the abdominal reflexes in case of pheochromocytoma and emphasize the part that it is possible to draw from this in view of its' topographic diagnosis. The present case is the fourth in which one of the authors has noted the abolition of the inferior abdominal reflex on the side corresponding to the site of the pheochromocytoma.
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PMID:[Pheochromocytoma and Recklinghausen's cutaneous neurofibromatosis. Localizing value of abdominal reflexes in a case]. 82 54

An 8-year-old boy presented at UCLA Hospital with a one month history of hypertension prior to suffering a sudden onset of acute abdominal pain, rectal bleeding, peritonitis, and shock. Sigmoidoscopy showed diffuse mucosal friability. At laparotomy, inflammation and edema of the entire colon and terminal ileum were detected with two necrotic areas on the cecum. A 5 cm right adrenal pheochromocytoma with a hemorrhagic center was removed and a diverting loop ileostomy with inversion of the necrotic cecal areas was performed. Postoperatively, the blood pressure gradually returned to normal, and the colitis improved. Serum calcium and T3 T4 levels were normal. Review of the literature demonstrates that in patients with pheochromocytoma, progression from colitis to necrosis can be precipitated by a hypotensive episode. This patient suggests an example of catecholamine induced enterocolitis.
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PMID:Enterocolitis with peritonitis in a child with pheochromocytoma. 84 39

A 28-year-old woman was admitted to hospital with acute pulmonary edema, mild abdominal discomfort and hyperamylasemia. From the 2nd hospital day hypertensive episodes occurred daily. The furosemide screening test for renovascular hypertension revealed elevated plasma renin activity (PRA) but an intravenous pyelogram revealed a right suprarenal mass and no evidence of renovascular compression. Elevated values of plasma and urinary catecholamines indicated a pheochromocytoma, and a single chromaffin tumour was resected. It is important to monitor left ventricular filling pressure during operative removal of a pheochromocytoma. Postoperatively the patient had normal blood pressure and PRA. Decreased urinary amylase clearance and abnormal pancreatic and salivary amylase isoenzymes were found.
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PMID:Pheochromocytoma presenting with pulmonary edema and hyperamylasemia. 84 16

A 56-year-old woman had a 22-year history of hypertension. Investigation showed hypokalemia and kaliuresis without pronounced suppression of plasma renin activity or elevation of urinary aldosterone excretion. There was biochemical evidence of catecholamine metabolite excess but the usual clinical features of pheochromocytoma were absent. Laparotomy revealed a pheochromocytoma and adrenal adenoma in the right adrenal gland. Excision of the tumours was followed by resolution of the hypertension and metabolic abnormalities.
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PMID:Coexistence of pheochromocytoma, adrenal adenoma and hypokalemia. 84 17

To reduce the high maternal and fetal mortality in pheochromocytoma of pregnancy, therapy is advocated with phenoxybenzamine and propranolol to obtain adequate alpha- and beta-adrenergic receptor blockade. In early pregnancy control of symptoms may be difficult, but the patient may be carried to term with such medical therapy. Delivery should be by cesarean section before the onset of labour, with, if possible, simultaneous removal of the tumour. Additional preoperative preparation with phenoxybenzamine and propranolol and careful intraoperative management are essential. During her third pregnancy a 29-year-old woman was found to have a pheochromocytoma of the left adrenal gland. After the medical therapy and preparation described, the infant was delivered by cesarean section and the mother's left adrenal gland excised. Eight-year follow-up, including during a fourth pregnancy, showed no recurrence of tumour in the mother and only mild hypertension. The infant developed normally.
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PMID:Management of pheochromocytoma during pregnancy. 84 20

Patients with hypertension due to the release of large amounts of NE from a pheochromocytoma and patients with PAD and postural hypotension due to diminished NE release from adrenergic axon terminals represent the extremes of the spectrum of adrenergic pathophysiolgic findings. It is reasonable to suspect that some more common disorders lie between these extremes and to anticipate that potential roles of the adrenergic nervous system in the pathogenesis of these disorders will be extensively studied with the availability of sensitive isotope-derivative methods for the measurement of catecholamine levels in plasma and in tissue.
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PMID:Pheochromocytoma and autonomic dysfunction. 86 50


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