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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The diurnal variation of urinary vanillylmandelic acid (VMA) and metanephrine-normetanephrine levels was studied in six patients with phechromocytoma and 32 patients with essential hypertension. Despite variable degrees of day-night differences, urinary excretion of VMA and metanephrines, per unit of time or per gram of urinary creatinine, was invariably higher in patients with pheochromocytoma than in controls whether the collection was 7 AM through 7 PM or 7 PM through 7 AM. Thus, shorter study periods are sufficient to exclude the presence of a chromaffinoma in most patients with hypertension.
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PMID:The diagnosis of pheochromocytoma. Overnight excretion of catecholamine metabolites. 117 46

Quantitative analytical methods for plasma catecholamines and their conjugates by the use of gas-liquid chromatography have been developed. Epinephrine and dopamine have also been determined by mass fragmentography. The contents of catecholamines in the plasma of normal adults and patients with hypertension, neuroblastoma and pheochromocytoma have been demonstrated.
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PMID:Gas-liquid chromatographic and mass fragmentographic determination of catecholamines in human plasma. 117 83

Plasma 3-O-methylated catecholamines, i.e. 3-methoxytyramine, normetanephrine and metanephrine, were separated from catecholamines by passing through alumina and further purified by adsorbing on weakly acidic resin and Amberlite XAD-4. The amines were trifluoroacetylated and determined by gas chromatography or mass fragmentography. Tracer quantities of tritiated 3-MT, NMN or MN were used as internal standards for total recovery estimations. The contents of 3-O-methylated catecholamines in the plasma of normal persons and patients with hyperthyroidism, hypertension, neuroblastoma and pheochromocytoma were measured.
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PMID:Gas-liquid chromatographic and mass fragmentographic determination of 3-O-methylated catecholamines in human plasma. 117 84

Hypertension in endocrine disorders (Cushing's syndrome, Conn's syndrome, Pheochromocytoma) is frequently accompanied by a confusing clinical symptomatology. The underlying pathology is a cortical hyperplasia or a tumor of the adrenal cortex or medulla. The differentiation from other causes of hypertension is primarily based upon laboratory findings (plasma and urinary concentration of cortico-steroids, Renin, Angiotensin and catecholamines as well as their derivates). The preoperative tumor localization by urography, arteriography and adrenal venography as well as the visualization of glandular hypertrophy by adrenal venography is of fundamental importance with regard to treatment of these disorders.
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PMID:[Radiology of suprarenal glands (author's transl)]. 117 39

An unusual case of pheochromocytoma is described in this communication. Besides a chain of typical clinical pictures and laboratory findings which suggested a catecholamine-producing tumor, the left renal artery stenosis was demonstrated by an aortography and the plasma renin activity was consistently elevated. Surgery revealed the left renal artery was embedded in the tumor mass, originated from the left adrenal gland, resulting in a high degree of constricture of the vessel. Following the removal of the tumor, blood pressure immediately returned to normal, however, plasma renin activity remained elevated as long as 9 months of the follow-up study. The second aortography performed 14 months after the operation failed to demonstrate the left renal artery stenosis and subsequent studies revealed that plasma renin activity was gradually declining to upper normal levels. It is suggested that an excess of catecholamines secreted by the tumor was responsible for hypertension in this case, and that another factor, probably renal artery stenosis, was involved in the elevation of plasma renin activity, although this high renin activity was maintained for more than 9 months following the tumor extirpation.
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PMID:Pheochromocytoma with renal artery stenosis and high plasma renin activity. 118 93

The authors have taken the opportunity presented them by having a case of pheochromocytoma observed and diagnosed in the puerperium, of reviewing the various clinical and diagnostic features appropriate to this chromaffin tissue tumour. They also review the cardinal points in the differential diagnosis of any case of arterial hypertension discorvered in connection with pregnancy. A study of the literature shows that failure to recognise pheochromocytomata in pregnant women is accompanied by particularly hight maternal and fetal mortality. This complication of pregnancy, although rare, should be recognised by the obstetrician, who will be in a much better position early to combat and palliate the very grave threat to the mother and her baby.
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PMID:[Pheochromocytoma and pregnancy]. 120 8

We have presented the case history of a patient with unilateral pyelonephritis and elevated peripheral venous renin, an obvious cause of renal hypertension. However, a complete evaluation revealed pheochromocytoma as the primary cause of the hypertension. It is assumed that the increase in renin is secondary to catecholamine stimulation. Since surgery or diagnostic procedures may be disastrous in a patient with unsuspected pheochromocytoma, we urge all physicians to make a special effort to detect the presence of a tumor in the hypertensive patient.
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PMID:The unexpected pheochromocytoma. 125 35

In a series of 27 patients with proved pheochromocytoma, differential analysis of catecholamines in blood, urine, and tumor specimens of 19 patients enabled grouping of subjects into those whose tumors produced predominantly norepinephrine (NE) (11 patients), predominantly epinephrine (E [Two patients]) and approximately equal amounts of both (six patients). Sustained hypertension was more common in the first group and pallor and tremor in the latter two groups, but no distinctive syndrome could be recognized as signifying the secretion of NE or E. Headache was a symptom in 20 of 27 patients and was related to sudden, transient elevation of the blood pressure, rather than sustained hypertension. The variable duration and intensity of the headache in different patients can be explained by the pressor and cranial vasoconstrictor effects of the secreted amines, which respectively enhance and diminish vascular headache.
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PMID:Symptoms of pheochromocytoma, with particular reference to headache, correlated with catecholamine production. 125 42

Angiotensin-converting enzyme (ACE) inhibitors are now widely used as first-line treatment of essential hypertension. Their effectiveness is potentiated by a low-salt diet and, above all, by the simultaneous prescription of diuretics. When secondary hypertension is suspected, ACE inhibitors are a good pharmacological tool to study the renin-angiotensin system. Since activation of this system is the main mechanism responsible for renovascular hypertension, ACE inhibitors are very useful for diagnosis. Conversely, blood pressure is not influenced by ACE inhibitors in primary hyperaldosteronism because of the low plasma renin and angiotensin II levels. Pheochromocytoma activates the renin-angiotensin system, and ACE inhibitors combined with beta-blockers enable the hypertension to be controlled prior to surgical treatment of the tumour. Finally, ACE inhibitors can be used to explore the renin-angiotensin system in the experimental model of renovascular hypertension and therefore contribute to our knowledge of the complex pathophysiology of this most frequent type of secondary hypertension.
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PMID:[Usefulness of converting enzyme inhibitors in the diagnosis of arterial hypertension]. 129 39

We report a rare case of extrahepatic growing hepatocellular carcinoma which was clinically diagnosed as right adrenal tumor. A 61-year-old woman was admitted for further examination of right flank pain and hypertension. Abdominal computed tomographic scan and echogram revealed a suprarenal mass. Hypercatecholaminemia was suspected from urinary analysis. Preoperative diagnosis was right adrenal tumor; suspected pheochromocytoma. On operation, we found the tumor was pedunculated from right lobe of liver and compressing normal right adrenal gland. Its clinical diagnosis was hepatocellular carcinoma. Ten months after operation she is still alive. We discuss the difficulty of differential diagnosis between extrahepatic growing hepatocellular carcinoma and adrenal tumor.
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PMID:[Pedunculated hepatocellular carcinoma suspected of right adrenal tumor: a case report]. 132 50


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