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

Macroscopic and light microscopic features of regional ischemic infarcts of retina in autopsy eyes are described. Lesions were found throughout life span, most patients having significant primary or secondary vascular disease (younger had systemic hypertension, rheumatic heart disease, vasculitis or sickle hemoglobinopathy; most older patients had arteriosclerosis). Diabetes mellitus and infarction of other organs (including brain) also were common. Topographically almost all lesions were found in posterior fundus; most were temporal and involved anatomical macula. Microscopically there was destruction of inner retinal layers with preservation of outermost cells of inner nuclear layer; occasionally ganglion cell layer was relatively spared.
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PMID:Regional ischemic infarcts of the retina. 108 10

The vasculitis nodularis belongs to the group of the allergic-hyperergic vascular diseases of the skin, which above all the small veins are affected at. The participation of internal organs is unusual. It is reported on a 31-year-old Syrian patient in whom a participation of the liver in form of a granulomatous hepatitis and of the kidneys appeared. A hypertension might be attributed to the participation of the kidneys. The incorporation of a thrombosis of the central vein of the right eye in this disease is probable. The main symptoms of the disease were nodes of the size of a bean occurring in batches, lying subcutaneously, and were paraclinical signs for inflammation. The permanently increased absorption-antistreptolysin titre spoke for an allergic-hyperergic vascular process induced by streptococci.
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PMID:[Vasculitis nodularis with participation of inner organs]. 119 84

Nonsyphilitic interstitial keratitis with vestibuloauditory dysfunction (Cogan's syndrome) is a rare clinical entity. We have reviewed 53 cases (including one of our own) of this disease. In 72 per cent of the affected patients there was an underlying systemic process, often a vasculitis. Ten per cent had fatal or near fatal aortic valvular disease, which has been shown to be amenable to surgical intervention. Other systemic manifestations have included congestive heart failure, gastrointestinal hemorrhage, adenopathy, splenomegaly, hypertension, musculoskeletal involvement and eosinophilia. The clinical course is extremely variable, ranging from months to over 15 years with a minimal five year survival of 28 per cent. Medical therapy with corticosteroids has been beneficial but has only limited effect on symptoms of vestibuloauditory dysfunction. Cogan's syndrome appears to be a manifestation of a systemic disorder which is often apparent only after long-term follow-up.
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PMID:Cogan's syndrome: a systemic vasculitis. 127 89

Dementia is in addition to cerebral haemorrhage major symptom of cerebral amyloid angiopathy (CAa). In order to explore the pathological basis for dementia in CAa-related conditions, we made a clinicopathological analysis of CAa, with special attention to dementia. Among 150 patients (mean age 78.6 years) with autopsy-proven intracranial haemorrhage in Tokyo Metropolitan Geriatric Medical Center, CAa with cerebral haemorrhage accounted for 8.0% (12 cases), associated with hypertension and metastatic brain tumour. Among 38 patients with lobar haemorrhage, CAa represented the second most common cause (21.1%) of intracranial haemorrhage after hypertension. A total of 20 patients with CAa (mean age 82.5 years) were studies clinically and pathologically. Hypertension was present in 50%. Thirteen had a history of stroke and others had either ill-defined or no strokes. The average number of strokes 2.9. Fifteen patients (75%) had dementia. Based on the clinicopathological grounds for dementia, CAa-related conditions could be divided into three subtypes: "haemorrhagic", "dementia-haemorrhagic" and "dementia" type. Haemorrhagic type (30%, 6 cases) showed multiple recurrent lobar haemorrhages caused by CAa. Hypertension was present in only 1 patient. The incidence of senile plaques and neurofibrillary tangles was generally correlated with age. Only 1 patient had dementia. The dementia-haemorrhagic type (40%, 8 patients) had recurrent strokes with cerebral haemorrhage after preceding dementia. There were two different neuropathological subsets: CAa with atypical senile dementia of Alzheimer type (SDAT) and CAa with diffuse leucoencephalopathy. Patients with CAa with atypical SDAT had multiple cerebral haemorrhages caused by CAa combined with atypical Alzheimer-type pathology. Patients with CAa with diffuse leucoencephalopathy had cerebral haemorrhages in combination with diffuse white matter damage like Binswanger's subcortical vascular encephalopathy (BSVE). The incidence of senile changes correlated with age. Patients with the dementia type (30%, 6 patients) showed progressive dementia with or without haemorrhage. All had hypertension. They had a combined condition of Alzheimer-type pathology with conspicuous CAa with BSVE. Dementia in CAa-related conditions may be responsible for multiple factors including not Alzheimer-type degeneration, but also diffuse leucoencephalopathy like Binswanger's disease. We also found an asymptomatic type, an ischaemic type, a vasculitis type and an hereditary type in this condition.
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PMID:Dementia in cerebral amyloid angiopathy: a clinicopathological study. 144 72

A 43-year-old man presented with oliguria and hypertension. Renal arteriography showed bilateral renal artery occlusion. Circulating antiphospholipid antibodies were found together with a change in natural anticoagulant plasma levels. Immunofluorescence of examined vessels showed immune complex vasculitis. We discuss the pathogenetic mechanism leading to the development of this rare occlusive event.
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PMID:Bilateral renal artery occlusion in a patient with primary antiphospholipid antibody syndrome: thrombosis, vasculitis or both? 149 6

A young woman with Still's disease sustained a small myocardial infarction 12 weeks after the delivery of a healthy male infant. This pregnancy was complicated by late onset proteinuric hypertension. Coronary angiography nine days after infarction revealed intracoronary thrombus which had resolved by 3 months with antithrombotic therapy. The angiographic appearances at 3 months suggested that a local vasculitis may have been the precipitating cause.
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PMID:Coronary thrombosis postpartum in a young woman with Still's disease. 156 36

Patients with mixed connective tissue disease (MCTD) exhibit clinical features of systemic lupus erythematosus (SLE), progressive systemic sclerosis or scleroderma (PSS), and polymyositis-dermatomyositis (PM-DM). In their sera is an unusually high titer of a circulating antinuclear antibody with specificity for a nuclear ribonucleoprotein antigen. Pleuropulmonary manifestations are common in MCTD and the incidence varies from 20% to 85%. The pleuropulmonary complications include pleural effusion, interstitial pulmonary processes, pulmonary arterial hypertension (PAH), pulmonary vasculitis, pulmonary thromboembolic phenomena, aspiration pneumonia, and hypoventilatory failure. Pulmonary vascular pathology with progressive PAH and cor pulmonale is the most serious complication of MCTD. The pleuropulmonary manifestations in MCTD are similar to the respiratory problems well recorded in SLE, PSS, and PM-DM. Even though the pleuropulmonary complications are common in MCTD, they may remain clinically inapparent until fatal complications ensue.
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PMID:Lungs in mixed connective tissue disease. 157 26

A 13-year old boy is described with painful joints, papular skinlaesions, malaise and haematuria. Impaired renal function and hypertension were found. In the past he frequently suffered of otitis media. Biopsies of kidney and skin lesions showed a vasculitis, furthermore the C-ANCA-titer (anti-neutrophil cytoplasm antibodies) was strongly elevated which justified the diagnosis Wegener's granulomatosis (WG). This disease is seldom seen in childhood. It is a necrotizing vasculitis with granulomas of mostly the respiratory tract and kidneys. Autoantibodies directed against intracellular antigens of neutrophils were first associated with vasculitis in 1982. Since 1988 two ANCA-subtypes have been recognized: C-ANCA and P-ANCA. The C-ANCA appear to be highly specific for diagnosis and follow-up of WG, and to differentiate of other forms of vasculitis (with P-ANCA). If children present with frequent and serious upper respiratory tract infections, with suspicion of a systemic disease it is important to perform the ANCA-test to differentiate between WG and other forms of vasculitis. The patient was treated with prednisone and cyclophosphamide, after which the symptoms and the ANCA-titer decreased.
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PMID:[A child with Wegener's granulomatosis]. 164 47

During a 10-year period, intraparenchymal aneurysms were found in 38 of 748 patients at selective abdominal angiography with magnification technique. According to strict criteria, 17 patients were classified as suffering from necrotizing vasculitis of the polyarteritis nodosa group (PAN), 7 from severe arterial hypertension, and 3 from rheumatoid arthritis. The diagnoses of 5 patients remained to be confirmed, and each of the remaining 6 patients suffered from various other diseases. PAN was diagnosed histopathologically in 2 patients without angiographic aneurysms. Based on the 156 patients in whom the indication for angiography was suspicion of arteritis, the angiographic diagnosis of PAN had a sensitivity of 89 percent and a specificity of 90 percent, a positive predictive value of 55 percent and a negative predictive value of 98 percent. The mean number of both renal and hepatic aneurysms was higher in patients with PAN than in the other patients (p less than 0.01 and p less than 0.05, respectively). Five PAN patients had numerous and large aneurysms, whereas the aneurysms of the other 12 PAN patients did not differ from those of patients with other diseases. Patients with PAN had renal infarcts more often than the other patients (p less than 0.05). Our findings suggest that visceral angiography is useful in establishing the diagnosis of PAN, but the angiographic finding of aneurysms is not pathognomonic.
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PMID:Diagnostic significance of angiographically observed visceral aneurysms with regard to polyarteritis nodosa. 167 24

Cholesterol crystal embolization is an often fatal disorder in the elderly. Clinical manifestations consist of skin lesions arterial hypertension and renal failure. In some cases the clinical picture is suggestive of vasculitis. The most frequent predisposing factors are operative and radiological vascular procedures and the use of anticoagulants. The diagnosis can be confirmed by skin, muscle or kidney biopsy. Data concerning management are scarce and contradictory. A review of the literature has revealed some controversy as to how and when cholesterol crystal embolization should be treated, and controlled studies are lacking. We discuss the use of various drugs such as anticoagulants, antiplatelet agents and corticosteroids. In practice, the usual treatment is symptomatic and includes therapy of the peripheral vascular disease, adequate control of blood pressure and appropriate management of renal insufficiency. The most effective measure is prevention.
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PMID:[Medical treatment of cholesterol crystal embolism]. 182 52


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