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

Pheochromocytoma is a rare disease that may occur during pregnancy. Only a few hundred cases have been published in the literature. Manifestations include hypertension with various clinical presentations, possibly resembling those of pregnancy-induced hypertension, or pre-eclamptic toxemia. Differentiation of these conditions is not always feasible, thus creating a serious risk, because fetal and maternal morbidity and mortality are far higher with pheochromocytoma. Biochemical measurements of catecholamines and their metabolites are apparently a convenient way to establish diagnosis during pregnancy, inasmuch as interpretation of radiological evaluation is complicated by the gravid uterus, and might even be potentially dangerous due to the use of ionizing radiation. More sophisticated methods for evaluation are not always practical during pregnancy. Medical treatment aims at controlling symptoms, mandating the use of alpha- and beta-receptors blockade medication. Surgical intervention is the only possible curative method available, but the critical issue is probably to identify the exact timing during the course of pregnancy for such intervention, or the ability to control symptoms until delivery. Although malignant transformation of pheochromocytoma have been reported, it is extremely uncommon. The overall prognosis is mainly affected by early diagnosis, and multidisciplinarian management.
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PMID:Pheochromocytoma in pregnancy: case report and review of the literature. 778 99

We review the 35 cases with pheochromocytoma associated with pregnancy including our own 3 cases in the Japanese literature from 1958 to 1993. In a total of 35 cases, the overall maternal mortality rate was 11% and the fetal loss 22%. Recently, after 1981, the maternal mortality rate and the fetal loss were significantly reduced to one patient (6%). Although antepartum diagnosis of pheochromocytoma was made in only 32% of the patients, maternal mortality was reduced to zero and fetal loss to 18%. An initial diagnosis of toxemia of pregnancy was made in 17 patients (49%) and of pheochromocytoma in 10 patients (29%). A diagnosis of pheochromocytoma was made before delivery in 11 patients (31%), after delivery in 22 patients (63%), at autopsy in one patient (3%), and unknown in one patient (3%). The symptoms mostly suggestive of pheochromocytoma were paroxysmal hypertension in 27 (77%) of the 35 patients. The clinical symptoms generally appeared in the third trimester in 23 patients (66%). Pheochromocytoma is a rare disease, but a high index of clinical suspicion must be kept in mind and pheochromocytoma must be listed in the differential diagnosis of hypertension associated with pregnancy. Recently, abdominal ultrasound study and MR imaging can be used to localize the tumor during the antepartum period. Once the diagnosis is confirmed, alpha-blockade is essential and beta-blockade may be required. In the first and second trimesters, tumor resection has a good fetal outcome; in later pregnancy, delivery by elective caesarean section followed by tumor resection is recommended.
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PMID:Pheochromocytoma in pregnancy: a review of the Japanese literature. 795 72

Functioning paraganglioma of the mediastinum is an uncommon tumor of the paraganglion system. We report a case of a 26 year-old woman with a 6 month history of hypertension refractory to therapy. Urinary catecholamine excretion and plasma noradrenaline concentration were elevated. Chest radiograph and computed tomography (CT) scan revealed high-density mass located on the posterior mediastinum. An mIBG scan showed uptake by the mediastinal tumor. At thoracotomy a 5 cm lesion was resected. Histological examination confirmed that it was a paraganglioma. Authors refer on the clinical finding and diagnostic procedures of this rare disease.
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PMID:[Mediastinal functioning paraganglioma. A case report]. 817 51

The authors describe their experience with the treatment of nine patients where "essential" mixed cryoglobulinaemia was diagnosed. In addition to extrarenal symptoms all suffered from proliferative glomerulonephritis, most frequently mesangiocapillary. The latter was manifested in most instances during the first examination by nephrotic syndrome and reduced glomerular filtration. Two patients had only asymptomatic proteinuria with erythrocyturia. The majority suffered from arterial hypertension. The patients were treated with prednisone and cyclophosphamide, using initial doses after which the extrarenal symptoms receded promptly. Regression of proteinuria and normalization of glomerular filtration developed more slowly. Only in one patient the glomerulonephritis had a progressive course and terminated by chronic renal failure. One patient died from septicaemia and one from cardiac failure. The authors assume that early diagnosis and effective combined immunosuppression can ensure a favourable course of this rare disease.
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PMID:[Essential mixed cryoglobulinemia and the kidneys]. 837 67

Spinal cord arterial-venous malformation (SCAVM) is a kind of rare disease only accounting for 2%-4% of all spinal diseases. This article reports 41 cases of SCAVM out of 300 times of spinal angiography. The recent classification indicates that out of the 41 cases of SCAVM there are 26 cases of intramedullary AVM. 5 cases of perimedulla AVF. 5 cases of spinal dural AVF. 3 cases of Cobb's syndrome and 2 cases of vertebral angioma. They were treated in three ways: embolization only, embolization plus operation and operation only. As a result, the 5 paralyzed patients (3 cases of Cobb's syndrome and 2 cases of vertebral angioma) recovered totally. The factors influencing satisfactory recovery after SCAVM treatment are as follows: (1) Pure steal flow as the main cause is cured. (2) Intravertebral venous hypertension is alleviated. (3) Intravertebral occupied lesion is solved. The factors for unsatisfactory recovery after SCAVM treatment are as follows: (1) The feeding artery and parenchymal artery are embolized. (2) Drainage vein is damaged or thrombosed. (3) Intramedullary hemomyelia and spinal cord is damaged. (4) There is prolonged ischemia and spinal cord atrophy.
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PMID:[Classification and embolization of spinal cord arterial--venous malformation]. 840 34

Ischemic heart disease in young women is a rare disease, but nowadays it is more frequently detected. The investigation involved 83 women up to the age of 19 with ischemic heart disease. The most frequent risk factors were as follows: hypertension, hyperlipoproteinaemia, smoking, stress and obesity. The association of three factors was most often observed. Electrocardiogram at rest pointed to the changes as follows: anteroseptal region, the whole anterior wall, postero-inferior region and subendocardial localization. Out of 11 exercise tests 36 (81.81%) of them were positive. Coronary arteriography was performed in 72 (86.71%), with positive changes in 61 (81.72%) patients. Occlusive changes were most frequently found on anterior descendent artery. Since a great number of risk factors in women may be easily corrected by an adequate diet and healthier way of life, their detection and implementation of measures of primary and secondary prevention have been attached a great importance.
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PMID:[Ischemic heart disease in young women. Its importance and possibilities of prevention]. 852 99

Polyarteritis Nodosa (PAN) is a rare disease in childhood. No single pattern of clinical presentation characterizes this disease, but abdominal pain, central or peripheral nervous system disease, arthritis, myalgia and skin lesions occur at some time during the course of the illness. In this case a 16-year-old boy who presented with abdominal pain, elevated sedimentation rate associated with hypertension, and a high level of renin, all of which were detected during his hospitalization, suggested the diagnosis of PAN, and renal angiography was performed. Characteristic renal aneurysms were visualized and the diagnosis was confirmed.
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PMID:Diagnostic value of renal arteriography in polyarteritis nodosa. 881 29

Primary pulmonary hypertension is a rare disease of unknown etiology which relates to the precapillary form of the hypertension. The review of the literature and authors' data on the changes of pulmonary vessels and the heart weight are presented. So-called plexiform structure characteristics for this pathology are considered by the authors as glomus anastomoses developing as a compensation of pulmonary circulation disturbances.
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PMID:[Primary pulmonary hypertension in adults]. 896 53

The 14-year follow-up of a female patient with Liddle's syndrome (LS), a rare disease characterized by hypertension, hypokalemic alkalosis, and negligible aldosterone secretion due to renin suppression, is described. The disease was diagnosed at the age of 10 months (youngest identification). The patient was repeatedly investigated during follow-up for plasma renin activity (PRA), plasma aldosterone concentration (PA), serum sodium and potassium (K) concentration, blood pressure (BP), somatic anthropometry, and mental development. Noteworthy results included: persistent low circulating K, PRA, and PA and high BP, coinciding with unauthorized withdrawal of the triamterene therapy. These findings are in keeping with the hypothesis that LS results from a pathogenetic disorder which is not correctable with age. The triamterene therapy was effective in correcting the endocrine and metabolic disorders as well as arterial hypertension, but did not prevent a deficit in mental and physical development. However, the information derived from this study allows further clarification of the clinical picture of the disease.
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PMID:Liddle's syndrome: a 14-year follow-up of the youngest diagnosed case. 903 63

The hypothesis that sodium chloride deficiency, and not its overuse, is prime cause of hypertension and arteriosclerosis is presented. In the author's home town--a farflung part of northern China--hypertension is a rare disease and arteriosclerosis is a virtually unknown condition. The average intake of sodium chloride for these people is > 30 g/day compared with the typical sodium chloride intake of 10-12 g per day in the USA. When the 10-12 g salt ingested is mixed with the average daily water intake (2100 ml), 0.47% to 0.57% saline mixture is produced, which is hypotonic to extracellular fluid in salt content. Thus sodium conservation becomes necessary. All the hormones and ions involved in sodium conservation are inducers of hypertension; these include aldosterone, angiotensin 11, glucocorticoids, catecholamine, and vasopression. Plus, potassium waste, induced under the influence of aldosterone excess, participates in the development of hypertension.
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PMID:Sodium chloride and hypertension. 929 66


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