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)

Sarcoidosis lesions in the brain are relatively rare and can remain latent, or become evident in various forms: meningitic, encephalitic, neuro-endocrinian, vascular, or tumoral. A case is reported of an Antilles patient aged 35 years, in whom the diagnosis was made by examination of an operation specimen, following the discovery of an apparently isolated intracranial hypertension.
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PMID:[Cerebral manifestations of sarcoidosis (author's transl)]. 43 31

Hypertension is an uncommon complication of renal tuberculosis, and the association of accelerated hypertension with renal tuberculosis has not hitherto been documented in the literature; we present such a case. The diagnosis of renal tuberculosis may be difficult, particularly in the early stages of the disease, and in this case diagnosis was made by renal biopsy. The subsequent course of the patient was also particularly interesting, in that one year after starting treatment with anti-tuberculosis and anti-hypertensive medication, he developed sarcoidosis.
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PMID:Renal tuberculosis presenting with accelerated hypertension. 70 5

Intraocular lesions occurred in 55 of 70 sarcoidosis patients (78.6%) and their intraocular findings were biomicroscopically analyzed. Intraocular lesions were observed bilaterally in 54 of 55 patients (98.0%) and these various lesions occurred simultaneously or within a short period in almost all tissues of the eyeball. From these characteristics a new attempt was made to correlate the presence of sarcoidosis with intraocular findings. A gross positive correlation was revealed between the number of active intraocular lesions and the presence of sarcoidosis. Four to six active, bilateral intraocular lesions were found only in sarcoidosis. Although the correlation was not statistically tested, it should be clinically very useful in managing patients with suspicious intraocular lesions. Among the causes of visual disturbances secondary glaucoma was the most frequent. In 41 (37.2%) eyes various degrees of intraocular hypertension were observed. Impairment of aqueous outflow due to nodular infiltration of trabeculae was the fundamental mechanism in the rise of intraocular pressure. It should be emphasized that this peculiar trabecular finding can be identified only by a trained ophthalmologist and is very frequent in and characteristic of ocular sarcoidosis.
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PMID:Ocular sarcoidosis: evaluation of intraocular findings. 106 30

A native of the Western Caroline Islands presented with a granulomatous aneurysm of the right common carotid artery measuring 7 to 8 cm, which was resected and replaced with a reversed segment of saphenous vein. Adequacy of the collateral circulation to the brain was established by occlusion of the common carotid artery with local anesthesia. This was followed by definitive operation with general endotracheal anesthesia and induced hypertension. Although tuberculosis was the most likely etiologic agent, sarcoid could not be ruled out. Granulomatous aneurysms of the common carotid are extremely rare, and if this case was sarcoid in origin, it is the first such case reported. Only one other similar aneurysm could be found in the literature. Of the various methods of reconstruction of the common carotid artery reported, autogenous reversed saphenous vein is recommended strongly.
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PMID:Carotid artery aneurysm of granulomatous origin. 117 4

We report a clinico-pathological case of neurosarcoidosis characterized by chronic meningitis, intracranial hypertension, bilateral optic atrophy, arthritis and enlargement of liver and lung hilar nodes. Synovial and supraclavicular node biopsies showed multiple non caseating nodules without tubercle bacilli, Candida albicans and Cryptococcus neoformans. Post-mortem examination showed a severe meningeal lymphoplasmocytic infiltration with numerous non-caseating nodules, several giant cells and presence of Candida albicans. There were also a periventricular infiltration of similar cells and numerous cerebral and cerebellar infarctions. We think that the Candida albicans meningitis was a consequence of the immunodepression of sarcoidosis and of corticosteroid therapy.
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PMID:[Candida albicans meningitis and neurosarcoidosis]. 130 70

In order to estimate left ventricular diastolic function in systemic sarcoidosis, Doppler echocardiography was utilized in 10 normal female subjects (aged 45 +/- 13 years) and in 10 female patients (aged 48 +/- 14 years), with biopsy proven sarcoidosis and without any clinical evidence of other cardiac disease or hypertension. Left ventricular systolic function assessed by two-dimensional echocardiography was normal in both groups (ejection fraction greater than 60%). The following Doppler echocardiographic parameters were measured: peak early diastolic flow velocity (E), peak late atrial diastolic flow velocity (A), the ratio (E/A) and deceleration of the flow velocity in early diastole (E-F slope). The results showed that 5 patients had two or more abnormal Doppler diastolic indexes, indicating impaired left ventricular relaxation, while the remaining 5 patients had values within or just outside normal limits. The mean values for the patients as a whole showed increased A velocity (0.77 +/- 0.11 m/s versus 0.61 +/- 0.10 m/s; P + 0.05), decreased E/A ratio (1.05 +/- 0.32 versus 1.4 +/- 0.30; P + 0.01), normal E velocity and normal E-F slope, compared with the mean values of the normal group. We concluded that a large percentage (50%) of patients with systemic sarcoidosis, had reduced diastolic performance of the left ventricle, at a stage of the disease when systolic dysfunction is not yet evident.
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PMID:Doppler echocardiographic evaluation of left ventricular diastolic function in patients with systemic sarcoidosis. 140 17

Angiotensin I-converting enzyme (ACE) is a peptidyldipeptide hydrolase that is located mainly on the luminal surface of vascular endothelial cells but also in cells derived from the monocyte-macrophage system. Physiologically, ACE is a key enzyme in the renin-angiotensin system, converting angiotensin I into the potent vasopressor angiotensin II and also inactivating the vasodilator bradykinin. Increased serum ACE activity (SACE) has been reported in pathologies involving a stimulation of the monocytic cell line, primarily granulomatous diseases. Sarcoidosis is the most frequent and the better studied of these diseases; high SACE is not only a well-established marker for the diagnosis but is also a useful tool for following its course and evaluating the effect of therapy. SACE can also be increased in nonsarcoidotic pulmonary granulomatous diseases such as silicosis and asbestosis, in extrathoracic granulomatous pathologies such as Gauchers disease and leprosis, and, to a lesser extent, in nongranulomatous disorders such as hyperthyroidism or cholestasis. On the other hand, monitoring sarcoidosis obviates the measurement of ACE activity in other biological fluids, e.g., broncho-alveolar and cerebrospinal fluids, in the search of a locoregional dissemination or dis-simulation of the disease. Decreased SACE has been reported in vascular pathologies involving an endothelial abnormality, e.g., deep vein thrombosis, and in endothelium dysfunctions related to the toxicity of chemo- and radiotherapy used in cancers, leukemias, and hematopoietic or organ transplantations. SACE is also of interest for monitoring arterial hypertension treated with specific synthetic ACE inhibitors. These various reasons for determining ACE activity have led to the development of numerous methods. The most widely used is the spectrophotometric assay using hippuryl-histidyl-leucine as substrate. Fluorimetric and radiochemical assays using both classic and novel substrates have been proposed, but they are time consuming, require special apparatus, and are not suited to automation. Kinetic spectrophotometry of furylacryloyl-phenylalanyl-glycyl-glycine hydrolysis is now used extensively because it is easy to automatize. Efforts are now required to standardize one or more of these assays. Indeed, "normal" plasma values differ not only according to the substrate, but also to the method of determination and to sex and age.
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PMID:Angiotensin-converting enzyme: clinical applications and laboratory investigations on serum and other biological fluids. 166 62

Sarcoidosis is being increasingly recognised in Kuwait. Twenty patients were studied over three years and the clinical, biochemical and radiological data were analysed. The clinical profile revealed thoracic involvement in all the patients as well as constitutional symptoms (50%), arthralgia (55%), arthritis (15%), chest infection (35%), tuberculosis (10%), hypercalcaemia (5%), angina (15%) and hypertension (20%). None had central nervous system manifestations. Other clinical signs were erythema nodosum (25%), hepatomegaly (30%) splenomegaly (15%) and chest signs (25%), together with salivary gland (15%), skin (15%), eye (15%), and cardiac involvement (5%). The tuberculin test was negative in all those tested. The patients were classified radiologically into stage I (55%), stage II (40%) and stage III (5%) of the disease. The clinical profile was similar to the Western pattern of the disease, but there were several differences including an older age group, more frequent constitutional symptoms, the rarity of ocular and central nervous system involvement, and initial presentation as a chest infection. Therapy with steroids alone or steroids and azathioprine was used when appropriate and the response to therapy monitored.
Sarcoidosis 1991 Mar
PMID:Sarcoidosis in Arabs: the clinical profile of 20 patients and review of the literature. 166 42

Severe uveitis is a relatively common and difficult clinical management problem in ophthalmology. Recently, cyclosporine-A (Cs-A) has been shown to be of therapeutic benefit in the management of sight threatening inflammatory eye disease. In order to examine the efficacy and long term safety of Cs-A, we conducted an open uncontrolled study in 22 patients with sight threatening uveitis whose disease had previously been refractory to treatment with systemic corticosteroids (22 patients), azathioprine (5 patients) and cyclophosphamide (2 patients). Uveitis was idiopathic in 16 cases, one patient had Reiter's syndrome, two had Vogt Koyanagi Harada disease and one patient had sarcoidosis. There were twelve males and ten females with a mean age of 40.5 years (range 22-67 yrs). Nineteen patients (86%) showed significant clinical improvement after treatment with Cs-A (10 mgm/kg/day) with decreased inflammatory activity and improved visual acuity. Three patients failed to respond to Cs-A therapy, while 4 subjects whose disease had initially responded to Cs-A relapsed on attempted withdrawal of this medication. Side effects were common in patients receiving Cs-A [5 mgm/kg/day (or greater)], with hypertension, tremor, hirsutism and raised serum creatinine being most frequent. We conclude that CS-A is an effective immunosuppressive agent in the treatment of patients with uveitis; however, its usefulness is limited by frequent side effects and disease relapse on attempted drug withdrawal.
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PMID:Cyclosporine: a therapy in inflammatory eye disease. 178 55

Cyclosporine is known to be effective in the treatment of psoriasis. In this study, we have used oral cyclosporine (6 mg/kg per day) given for 5 to 30 weeks to 24 patients for the treatment of 12 different dermatoses. Patients with the following diseases demonstrated a marked response or total clearing: 1 patient each with pyoderma gangrenosum, pityriasis lichenoides chronica, and psoriasis of the acrodermatitis continua of Hallopeau type. Moderate to marked response occurred in both patients with epidermolysis bullosa acquisita and the patient with hidradenitis suppurativa. Minimal to moderate responses were obtained in both patients with granuloma annulare, 1 of 2 with acrodermatitis continua of Hallopeau, both patients with Darier's disease, and 1 of 6 patients with vitiligo. Little or no response was noted in both patients with sarcoidosis, all 3 patients with pityriasis rubra pilaris, 5 of 6 patients with vitiligo, 1 patient with pemphigus foliaceous, and 1 with pemphigus vulgaris. Clinical side effects were mild and transient and included dysesthesia, fatigue, hypertrichosis, nausea, and flushing. The most frequent clinically significant abnormalities were hypertension and renal dysfunction, with all factors normalizing within 1 month of discontinuation of cyclosporine therapy.
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PMID:Oral cyclosporine in the treatment of inflammatory and noninflammatory dermatoses. A clinical and immunopathologic analysis. 217 58


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