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

Acute porphyria afflicts a large kindred in Chester that stems from a marriage in 1896 that has produced 200 descendants; this is the largest porphyric kindred to be identified in the United Kingdom. Six members aged 51 or under died from the condition over the past eight years. The diagnosis of porphyria was overlooked in some as the symptoms may mimic those of other acute illnesses, so that incomplete or incorrect death certificates have been issued. Psychosis, hypertension, and renal complications are particularly common. The porphyric members of the kindred show a previously undescribed hereditary disorder in which the characteristic enzymatic defects of acute intermittent porphyria and variegate porphyria coexist in the same subject. Acute porphyria is poorly understood by hospital and general practitioners, and this has caused anxiety in the kindred. A register of the kindred has been established, and families at risk should be offered biochemical screening, education, and genetic counselling.
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PMID:Chester porphyria: a clinical study of a new form of acute porphyria. 308 Nov 25

The authors present a case report on a 60-year-old female patient suffering from benign mediastinal cyst, arterial hypertension and porphyria. CT-guided transparietal fine-needle punction was done simultaneously as a diagnostic and a therapeutic procedure. Partial regression of the cyst was still apparent at the check CT investigation after six months. The examination of the level of immunoglobulins in the fluid obtained during transparietal punction confirms the diagnosis of bronchogenic cyst.
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PMID:Diagnosis and treatment of mediastinal cyst using transparietal needle aspiration. 368 7

In four young adult patients with acute attacks of acute intermittent porphyria tachycardia and hypertension were prominent features of the illness. Urinary catecholamine excretion was increased in both patients in whom it was measured. The effect of the beta-adrenergic blocking drug propranolol was assessed in each case. The dose varied from 40 to 240 mg daily. A response in the form of a reduction in heart rate and blood pressure was noted in each case, and in one case a marked alleviation of abdominal pain followed administration of the drug.Propranolol, when given in high dosage to rats, did not induce an increase in hepatic delta-aminolaevulic acid synthetase, an enzyme which is raised in human and drug-induced animal porphyria. The use of propranolol is therefore unlikely to aggravate or precipitate an attack of acute intermittent porphyria.
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PMID:Acute intermittent porphyria: response of tachycardia and hypertension to propranolol. 472 62

In a retrospective survey of patients who have had a proven attack of acute intermittent porphyria (AIP) in the West of Scotland a highly significant association (p less than 0.001) was observed between AIP and the development of early-onset chronic renal failure. Six patients with AIP and chronic renal failure arising in early middle-age are described. As no other cause could be attributed to the renal failure three possible causal links between these two conditions were considered, namely, enhanced susceptibility to analgesic nephropathy, porphyria-induced hypertension, and nephrotoxic effects of porphyrins and their precursors. We suggest that porphyria-induced hypertension is the most important factor in causing early-onset chronic renal failure in acute intermittent porphyria.
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PMID:Early-onset chronic renal failure as a complication of acute intermittent porphyria. 687 21

Minoxidil was used in 25 patients with severe hypertension whose blood pressure (BP) could not be controlled with conventional treatment or who suffered from intolerable side effects during treatment with other drugs. In 6 patients minoxidil was withdrawn after a short time owing to side effects or because hypertension could be controlled by regular dialysis treatment. The remaining 19 patients were treated with minoxidil for 0.5-4.5 years. The hypotensive effect of minoxidil in combination with beta-blockers and diuretics was good or acceptable in all patients. Neither orthostatic hypotension nor development of resistance was observed. Minoxidil was well tolerated in one patient with porphyria and in two patients who have had the hydralazine syndrome. Eighteen patients had kidney failure with elevated serum creatinine. With one exception the uraemia progressed if the serum creatinine level was above 300 mumol/litre at the start of the treatment. All patients tended to develop oedema, but this was controlled by concomitant diuretic therapy. Eighteen patients developed hypertrichosis. No other significant side effects were observed. One patient died and two patients developed pericarditis in the highly uraemic phase in connection with the start of dialysis. Neither the death nor the cases of pericarditis can be attributed to minoxidil. Minoxidil was found to be effective in severe hypertension in connection with advanced renal disease and can be considered as a valuable addition to the established therapeutic arsenal for treatment of severe hypertension.
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PMID:Clinical experience of long-term treatment with minoxidil in severe arterial hypertension. 708 94

It is stimulating to ascertain the comparative risk to the woman of hormonal contraceptives of the various kinds used today: combination preparations, which rely on blocking the secretion of gonadotropic hormones by the hypothesis; sequential preparations, which rearrange the physiological relationships of the menstrual cycle; gestagen preparations (minipills), which heighten the viscosity of the cervical mucus; longterm injectable preparations, which initially block ovulation and then act on the cervical mucus; postcoital preparations, which act by inducing abortion of the fertilized egg. Of these the most reliable are the fixed combinations, while sequential preparations are somewhat less so. The minipills are the least reliable. Interaction with other medications can reduce the reliability of these preparations; for instance, women on contraceptives have become pregnant after taking antiepileptic medications containing phenobarbitol and hydantoin. As far as risk is concerned, we must distinguish between those that merely harm the woman and those that pose a threat to life. Some of the former are: bleeding between cycles, failure of menses to appear after cessation of contraception, depression, breast-pains, hypertension, thrombophlebitis, and reduced libido. Hormonal contraceptives also have a series of beneficial effects, especially in women who ordinarily have menstrual difficulties. Among the more serious side effects are: risk of teratogenicity, carcinogenicity, liver problems, thromboses, and infarctions. To reduce the risks of these various side effects, the physician should observe carefully the contraindications: these are both absolute (cerebrovascular and retinal problems, thrombo-embolisms, hepatic disease, diabetes, porphyria, and sickle-cell anemia and relative (migraines, cardiac pains, hyperlipemia, epilepsy, and multiple sclerosis).
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PMID:[Safety and risks of hormonal contraceptives]. 712 52

The acute porphyric crisis is a characteristic clinical feature common to all hereditary hepatic porphyrias (acute intermittent porphyria [AIP], porphyria variegata and hereditary coproporphyria). The crisis is marked by an acute disorder of the central, peripheral and autonomic nervous system. Autonomic disorders may play a major part and may provoke severe cardiovascular symptoms. According to the literature our findings support data describing supraventricular tachycardia as the most important sign, followed by hypertension--or, rarely, hypotension--cardioarrhythmias and cardiomyopathy. While tachycardia, blood pressure disturbances and cardioarrhythmia indicate sympathetic overactivity, cardiomyopathic alterations suggest functional or structural coronary dysfunction. The existence of a specific "angiopathia porphyrica"--based on functional, angiospastic or secondary hypertensive disorders--has been discussed for a long time. Recent results concerning a 20-year follow-up study of AIP patients revealed chronic hypertension as being the most significant disorder and seem to support a hypertensive aetiology.
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PMID:[Cardiovascular disorders in acute intermittent porphyria (AIP) (author's transl)]. 730 4

This paper reviews both minor and major adverse reactions caused by estrogenic substances (natural and synthetic, steroidal and nonsteroidal) of which diethylstilbestrol is the prototype of nonsteroidal synthetic estrogen. Minor side effects include nausea, breast tenderness, and excessive cervical secretions (most common), headache, and water and salt retention (less common and often eradicated by lowering estrogen dosage). Vertigo, yeast infections, depression, and photosensitivity are other minor effects. Major side effects are discussed in some detail. Major effects include those on the endocrine system (e.g., feminization in boys and men and precocious puberty in girls); breast tumors; endometrial carcinoma; ovarian tumors; hypertension; thromboembolism; blood clotting excesses; various metabolic effects (including lipid metabolism and carbohydrate metabolism alterations); liver changes (bile alterations and neoplasms); porphyria; melanoma; and effects on a fetus in situ during maternal estrogen administration. In general, lowering doses of estrogen should help eradicate or alleviate most of these effects.
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PMID:Clinical toxicology of estrogens. 741 28

A case of polyarteritis nodosa is presented in view of diagnostic difficulties which it caused. In a 47-year-old patient, in the clinical picture the following predominated: paroxysmal abdominal pain, symptoms and signs of polyneuropathy, and paralysis of the left peroneal and left radial nerves. Besides that, hypertension, tachycardia, sub-febrile states, significant body weight loss, and skin lesions were observed. In laboratory investigations high ESR, leucocytosis, HBe antigenaemia with the presence of all antibodies, and significant hypergammaglobulinaemia were found. In the differentiation, apart from polyarteritis nodosa, the following was taken into account: porphyria, neoplastic abdominal diseases with polyneuropathy, neurological diseases. Of decisive importance for making the diagnosis was microscopic examination of calf muscle biopsy specimen.
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PMID:[Diagnostic difficulties in a case of polyarteritis nodosa]. 797 9

A 23-year-old man with epilepsy and a past history of abdominal pain and ileus, developed hypertension and arm and bulbar weakness when valproic acid and carbamazepine were reinitiated. Electrophysiologic studies demonstrated a peripheral neuropathy with features of axonal degeneration and demyelination. Axonal degeneration was documented by sural nerve biopsy. Markedly elevated urinary delta-aminolevulinic acid and porphobilinogen indicated a diagnosis of acute porphyria. Other laboratory studies were most consistent with hereditary coproporphyria. Motor function improved considerably but incompletely over 1 year. An acute, primarily motor neuropathy can occur in several forms of porphyria, including acute intermittent porphyria, variegate porphyria, and hereditary coproporphyria, sometimes even in the absence of concomitant gastrointestinal symptoms.
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PMID:Acute peripheral neuropathy due to hereditary coproporphyria. 800 8


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