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)

89 patients were operated upon for pheochromocytoma. 61 patients (37 women and 24 men) were available for follow-up. Mean age at operation was 39 +/- 12.3 yrs. Before operation paroxysmal and sustained hypertension were observed in 34 (55.7%) and 27 (44.3%) patients, respectively. Postoperatively permanent normalization of blood pressure was achieved in 38 cases (62.3%). All patients were divided into four groups. Group I with increased urine excretion of noradrenaline (NA) and adrenaline (A) consisted of 19 (31.1%) patients. Group II (increased NA excretion) included 27 (44.3%) patients. Group III comprised 3 (4.9%) cases with elevated A excretion. 12 (19.7%) patients with normal urinary excretion of catecholamines and increased excretion of methoxycatecholamines were alloted to group IV. Permanent normalization of blood pressure predominantly was observed in group IV--91.6%, whilst in group I, II and III this hypotensive effect was noted in 57.9%, 51.8% and 2/3, respectively. Permanent normalization of blood pressure can be mainly expected in patients with pheochromocytoma in whom catecholamines are rapidly inactivated within the tumor.
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PMID:[Does hormonal activity of pheochromocytoma affect long-term prognosis in surgically treated patients?]. 152 57

Nineteen cases of pheochromocytoma were experienced at our department between 1979 and 1990. Nine patients were males and 10 females with an average of 42.4 years old. In 18 patients the tumor was located in the adrenal gland (9 in right, 5 in left and 4 in bilateral adrenal gland), while in one patient whose original tumor had been resected 15 years earlier, the tumor had recurred in the extra-adrenal gland and was surgically extirpated revealing a malignant pheochromocytoma by histological examination. Hypertension was seen in 16 patients; 14 had paroxysmal and 2 had sustained hypertension. In 3 patients, hypertension was not observed. Familial pheochromocytoma was seen in 5 patients. Three patients had Sipple syndrome. Computed tomographic scan and magnetic resonance imaging were very useful techniques in preoperatively localizing the tumor. Even in the cases treated with alpha- or beta-blocker agents preoperatively, significant hypotension was observed immediately after resection of the tumor and treatment with norepinephrine or rapid blood transfusion or both was needed. Although meticulous care with alpha- and beta-blockers is important, surgical treatment of pheochromocytoma should spare the surgeon of unnecessary anxiety.
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PMID:[A clinical review of 19 patients with pheochromocytoma]. 152 99

The diagnostic value of electrocardiographic P wave analysis in the frontal plane was assessed with respect to previously reported abnormalities: right atrial hypertrophy-dilatation; an enlarged, crenalleted summit without criteria of right atrial hypertrophy. Two observers studied the ECG recordings of 20 hypertensive patients with pheochromocytomas: 10 men and 10 women, aged 45.5 +/- 16 years, and in 30 patients with essential hypertension, 15 men and 15 women, aged 48.9 +/- 9 years (NS). The duration of hypertension was 2.6 +/- 2 years versus 4.7 +/- 4 years (p = 0.02). Right atrial hypertrophy-dilatation was observed in 5 patients in the pheochromocytoma group and in none of the essential hypertensive patients: an isolated abnormality of the summit of the P wave was observed in 5 other cases of pheochromocytoma and by 1 observer in 1 of the essential hypertension. These abnormalities disappeared after ablation of the tumour. These changes were not recorded in 3 patients who had predominant noradrenaline hypersecretion; nevertheless, comparison of the urinary adrenaline, noradrenaline, normeta- and metanephrine levels were inconclusive. No relationship was established between these concentrations, global urinary catecholamines and meta block, the duration of hypertension, the frequency and level of hypertensive crises, or the presence of "ischaemic" ST-T wave changes. P wave changes are thought to be related to high plasma catecholamine levels irrespective of the clinical impact; the sensitivity of these changes is modest (10/20) but the specificity is better within a group of hypertensive patients. An experienced observer can orient the diagnostic investigations to the search for a pheochromocytoma or to a secondary recurrence of the tumour from the surface ECG. The role of marker of a very high noradrenaline or adrenaline secretion cannot be confirmed from a series limited in separated plasma concentration measurements.
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PMID:[Value of the study of electrocardiographic P wave in pheochromocytoma]. 153 1

The pheochromocytoma syndrome, caused by an abnormal secretion of catecholamines, is a rare pathology responsible for 0.1-2% cases of hypertension in the overall population considered. Although in the past we deemed the pheochromocytoma could cause prevalently the typical syndrome characterized by paroxysmal hypertensive crises, now we think that the usual clinical presentation is a continue or subcontinue hypertensive state (65%). In this paper the authors refer the clinical experience acquired in 25 years in the General and Cardiovascular Institute of the University of Milan (head: Prof. Ugo Ruberti), analyzing epidemiological aspects and pathogenesis of pheochromocytoma, with particular care to diagnostic methodologies and referring the therapeutic choices. From 1965 until today 40 patients have been surgically treated for pheochromocytoma mono or bilateral. 43 operations have been done, carrying out 46 adrenalectomy. Two complication must be referred: an ictus cerebri consequent upon an hypertensive crisis and one death caused by intraoperative ventricular fibrillation. Normalization of arterial pressure has been obtained in all patients.
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PMID:[The clinical picture and surgery of pheochromocytomas. Our experience over 25 years]. 155 46

We present an interesting case of paroxysmal hypertension in a young male caused by malignant pheochromocytoma. This patient, who had history of paroxysms of abdominal pain with severe hypertension, developed osseous metastasis in the first lumbar vertebra resulting in collapse of the vertebra and it caused paraplegia. The diagnosis of pheochromocytoma was confirmed on histopathology.
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PMID:Malignant pheochromocytoma. 156 60

Few disorders of endocrine function are so sudden and dramatic in their presentation as those caused by a pheochromocytoma. This chromaffin cell tumor arises within the adrenal medulla or within the sympathetic nervous system and causes wide fluctuations in blood pressure, tachydysrhythmias, and manifestations of intense anxiety. The patient experiences explosive paroxysms of catecholamine overload. The diagnoses of accelerated hypertension or panic disorder often are prematurely adopted. The condition kills, with deaths primarily attributed to irreversible cardiovascular and end-organ damage caused by profound hypertension. For those with a pheochromocytoma, the disorder caused by the tumor is a terrifying constellation of symptoms. Although pheochromocytoma is rare, it must be considered in the treatment of any patient with sudden, extreme hypertension and accompanying hypermetabolism. A cure is possible, but only with early diagnosis and treatment.
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PMID:Pheochromocytoma: a clinical review. 157 30

Neuroblastoma is the most common solid tumour in infancy and childhood. The tumour usually produces large amounts of catecholamines. Few patients with neuroblastoma, however, were reported to have become hypertensive because of catecholamine metabolism within the tumour itself. This is one of the most important differences compared with pheochromocytomas. We experienced a hypertensive crisis accompanied by tachycardia and an increase in the plasma catecholamine concentration during surgery in a patient with neuroblastoma. The plasma catecholamine level was comparable to that of pheochromocytoma. Phentolamine and propranolol were effective to control the hypertension and tachycardia.
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PMID:[A hypertensive crisis during surgery in a patient with neuroblastoma]. 157 28

A 42-year-old patient with acute left-ventricular failure is described in whom pheochromocytoma was diagnosed only after prolonged and fruitless efforts. Pheochromocytoma may present without the typical features of paroxysmal or sustained hypertension, headache, increased sweating, and palpitations. Therefore, in cases of acute left-sided cardiac failure of primarily undetermined origin, pheochromocytoma should be considered in differential diagnosis.
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PMID:[Acute left heart insufficiency: possible leading symptom of a pheochromocytoma]. 157 67

Pheochromocytomas are potentially curable causes of hypertension. These tumors are currently located by functional imaging with meta-iodobenzylguanidine (MIBG), usually labeled with 131I, or anatomic imaging (computed tomography, magnetic resonance). Hydroxyephedrine (HED) is a newly developed radiotracer that concentrates in adrenergic nerve terminals. When HED is labeled with 11C, its distribution can be mapped in vivo using PET. The purposes of this investigation were to characterize the uptake of 11C-HED in pheochromocytoma and to determine the feasibility and advantages of utilizing this compound as a tumor imaging agent. Ten patients with known or suspected pheochromocytoma were studied. Each patient underwent PET scanning with 11C-HED and conventional scintigraphy with MIBG. Pheochromocytomas were localized by PET scanning in 9 of the 10 patients. Image quality was excellent and superior to that obtained from planar and tomographic MIBG studies. The uptake of 11C-HED into pheochromocytomas was rapid; tumors were evident within 5 min following intravenous injection. All lesions within the field of view that were identified by MIBG scintigraphy were readily apparent. PET scanning with 11C-HED localizes pheochromocytoma using a specifically designed radiotracer and advanced imaging technology. The method has promise for locating the more elusive tumors.
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PMID:PET scanning with hydroxyephedrine: an approach to the localization of pheochromocytoma. 159 27

A 29-year-old woman was referred to our hospital at the 34th week of her first pregnancy with a diagnosis of severe pregnancy-induced hypertension. A diagnosis of pheochromocytoma was made by elevated values of serum and urinary noradrenaline. Ultrasonography and computed tomography revealed a left adrenal tumor. Caesarean section combined with removal of the tumor at the 36th week of gestation was performed with a satisfactory result obtaining a healthy mother and an infant. Current management of patients with a pheochromocytoma during pregnancy is discussed.
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PMID:[A case of pheochromocytoma in pregnancy]. 161


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