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)

Reports of adults with Williams syndrome (WS) have been rare. We have evaluated 13 adult WS patients and reviewed 16 case reports of WS in patients older than age 16 years. Adults in our study had progressive multisystem medical problems. Cardiovascular complications were common (12/13) including hypertension (8), supravalvular aortic stenosis (9), aortic hypoplasia (3), pulmonic artery stenosis (4), peripheral stenoses (3), and mitral valve prolapse (2). Joint limitation (12/13) was progressive, often accompanied by kyphoscoliosis and lordosis. Recurrent urinary tract infections in 6 individuals led to radiologic studies showing urethral stenosis in 2, and bladder diverticula and vesicoureteral reflux in 3. Gastrointestinal problems included obesity (5), chronic constipation (7), diverticulosis (3), and cholelithiasis (4). Hypercalcemia was documented in 5 patients, although others had hypercalcemic symptoms (abdominal pain, polyuria, and constipation). One 45-year-old man had parathyroid hyperplasia. Previous reports likewise document significant morbidity. Thus, Williams syndrome in an adult appears to dictate aggressive evaluation and monitoring. Investigation of calcium metabolism should be undertaken in each adult WS patient.
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PMID:Adults with Williams syndrome. 189 83

The glomerular size-selective properties in a patient with "hyponatremic hypertensive syndrome" were investigated before and after administration of the angiotensin-converting enzyme inhibitor enalapril. Hyponatremic hypertensive syndrome is a rare condition of renovascular hypertension characterized by electrolyte abnormalities (hyponatremia, hypokalemia), polyuria, and high renin activity. In this patient a marked increase in urinary protein excretion was observed. Treatment with enalapril normalized BP, corrected electrolyte abnormalities, and reduced proteinuria. Glomerular filtration rate (GFR), renal plasma flow (RPF), and the clearance of neutral dextrans of graded sizes were measured before and after 6 months of enalapril (20 mg/d) administration. Theoretical analysis of dextran and inulin clearance data with a model of glomerular size selectivity were adopted to separate effects of hemodynamic changes on macromolecule filtration from changes of intrinsic membrane selective properties. After enalapril urinary protein excretion decreased, GFR was unchanged and RPF almost doubled. Fractional clearance values of dextran molecules were markedly elevated in comparison with the corresponding values measured in a group of normal controls and were normalized by enalapril. Theoretical calculation of membrane pore characteristics showed that enalapril treatment reduced the radius of all membrane pores by approximately 1 nm. Altogether these results indicate that enalapril normalized glomerular filtration of neutral macromolecules and circulating proteins in a human condition of angiotensin II-induced proteinuria. Enalapril effectively restored glomerular size-selective function, reducing dimensions of membrane pores, independently of its effect on renal hemodynamics.
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PMID:Angiotensin-converting enzyme inhibition ameliorates the defect in glomerular size selectivity in hyponatremic hypertensive syndrome. 247 29

A 69-year-old female was treated for hyperthyroidism and hypertension. In August 1984, she suddenly began suffering from polyuria and polydipsia. In October, she exhibited fever, headache, vertigo, and poor appetite, probably due to pituitary apoplexy. Her endocrine function was normal, except for partial diabetes insipidus. A contrast-enhanced CT brain scan revealed a pituitary adenoma with a ring-enhanced outer edge and a central low-density area. The MRI scan also indicated cystic adenoma. A CT scan examination repeated 6 months later showed an empty sella with a markedly decreased pituitary adenoma. This case report demonstrates that some empty sella are the final result of pituitary adenoma bleeding or infarction.
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PMID:Pituitary adenoma results in the empty sella syndrome. 258 92

The case of a 17 year old patient with severe course of toxocariasis is reported. Over a period of 6 months the patient developed signs of serious systemic condition with fever, respiratory infections, diarrhea, urticaria, weight loss, and muscular atrophies. The most remarkable organ derangements involved bilateral exudative neuroretinitis, severe degree of peripheral motoneuron derangement, and grave kidney damage with developing polyuria, hypokalemia, metabolic alkalosis and therapeutically hardly tractable hypertension. The most important laboratory findings were high erythrocyte sedimentation, absolute and relative eosinophilia, and hypergammaglobulinemia. Serological examination exhibited weak larval toxocariasis positivity. Treatment with Mintezol and subsequent administration of prednisone resulted in complete restoration of the clinical state, including organ and laboratory manifestations. The reported case documents the occurrence of larval toxocariasis in our population as well as the possibility of a very severe course of this parasitic infection in man. The therapeutic effect is remarkable since literary data have so far reported mostly unsatisfactory results of toxocariasis treatment.
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PMID:[Larval toxocariasis--a severe course of the manifest infection]. 259 Aug 55

A boy, aged 14 1/2 years, presented with Burkitt leukemia. His renal status was normal before treatment. Chemotherapy (SFOP LMB 86 protocol) was begun Oct. 9, 1986. After the first 2 courses of chemotherapy, the patient had Gram negative sepsis treated with cefotaxime, netilmycine, Vancomycin and ornidazole. During sepsis, nephrotic syndrome developed (albumin 25 g/l, non selective proteinuria 15 g/24 h), with moderately high blood pressure, functional renal failure (creatinine 141 mumols/l, U/P urea = 20), polyuria and tubular damage. Kidney ultrasonography was normal. Needle biopsy showed minimal glomerular lesions, acute tubular lesions, and no deposits in immunofluorescence. The nephrotic syndrome disappeared within 3 weeks, with treatment of leukemia. He is at present in complete remission with a follow-up of 25 months.
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PMID:[Nephrotic syndrome and B leukemia]. 262 44

Over a 15-year period we observed seven children (four girls, three boys) who presented within the first months of life with severe renal failure and acidosis, associated with hypertension in five patients and polyuria in four. In addition, one patient had a severe cholestatic liver disease. In two families, a similarly affected sibling had died previously. Four patients were referred with the clinical diagnosis of polycystic kidney disease because of moderate enlargement of kidneys, but renal imaging (intravenous pyelography and ultrasonography) did not confirm this diagnosis. A renal biopsy, performed in all patients, showed similar features characterized by a diffuse chronic tubulo-interstitial nephritis (TIN) and particularly by the presence of microcystic dilatation of proximal tubules and Bowman's space. Liver pathology was normal in two patients, including one with hepatomegaly. However, in the patient with cholestasis there was inflammatory portal fibrosis with mild duct proliferation. Progression of the renal disease was extremely rapid and all patients reached end-stage renal failure (ESRF) before the age of 2 years (11-22 months). Two children had successful renal transplants. Although this chronic TIN shares some features with nephronophthisis, we suggest that it represents a distinct entity both on clinical and morphological grounds. The specific clinical features of this disease are its early onset and rapid progression to ESRF. Pathologically, it differs from nephronophthisis by the absence of medullary cysts and thickened tubular basement membranes and by the presence of cortical microcysts.
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PMID:Infantile chronic tubulo-interstitial nephritis with cortical microcysts: variant of nephronophthisis or new disease entity? 270 88

A child with nephroblastoma, severe hypertension, polydipsia, and polyuria is presented. Previous reports of this association describe great difficulty in controlling the hypertension by medical means. Captopril provided prompt and continuing control of this child's hypertension and allowed for optimal preparation prior to surgery.
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PMID:Control of nephroblastoma: associated hypertension and polydipsia by captopril. 282 17

Chronic subcutaneous (s.c.) infusion (osmotic minipump) of L-5-hydroxytryptophan (L-5-HTP, 4.2 to 12.6 mg/day) to uninephrectomized, deoxycorticosterone acetate-salt-treated (DOCA) rats (1.36 mg/kg per day via s.c. silastic implants) reduced their exaggerated intake of isotonic saline significantly (12.6 mg/day), prevented the elevation of blood pressure (4.2 to 12.6 mg/day), prevented cardiac hypertrophy (12.6 mg/day), and provided modest protection against reduction of urinary concentrating ability, characteristic of DOCA-treated rats during a 24-h dehydration. The exaggerated dipsogenic response of DOCA-treated rats to administration of angiotensin II (AII, 50 and 100 micrograms/kg, s.c.) was also reduced by treatment with L-5-HTP (4.2 and 8.4 mg/day). The specific binding of AII to its receptors in membranes from the diencephalon of the brain was increased significantly above control level by chronic treatment with DOCA, but was returned to control level by concomitant treatment with L-5-HTP. Daily urinary excretion of dopamine, increased by treatment with DOCA, was unaffected by treatment with L-5-HTP (6.3 mg/day). Daily urinary excretion of epinephrine was increased by treatment with L-5-HTP (6.3 and 12.6 mg/day). These results suggest that chronic administration of L-5-HTP provides significant protection against the development of DOCA-induced hypertension, polydipsia, polyuria, and cardiac hypertrophy in rats. The mechanism by which L-5-HTP protects is unclear and remains to be established.
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PMID:Chronic treatment with L-5-hydroxytryptophan prevents the development of DOCA-salt-induced hypertension in rats. 296 66

We characterized altered adenosine 3',5'-cyclic monophosphate (cAMP) regulation in deoxycorticosterone acetate (DOCA)-Na hypertensive rats using endogenous cAMP accumulation in the intact cell system of microdissected renal tubule fragments. Increased cAMP accumulation in response to vasopressin (VP) in cortical collecting tubules (CCT) began on day 5 (67%) after exposure to DOCA-Na and increased by 320% on day 42. Increased blood pressure began after day 7 and polyuria after day 17. The increased response to VP was DOCA dependent and appears to be exaggerated by dietary NaCl. Anatomic and hormone specificity studies were done on days 21-30. These included cAMP responses to prostaglandin E2, parathyroid hormone, thyrocalcitonin, VP, and isoproterenol in the CCT. The cAMP response to VP was measured in the glomerulus, proximal convoluted tubule, thin descending limb of Henle, medullary thick ascending limb of Henle, cortical thick ascending limb of Henle, medullary collecting tubule, and CCT. The supersensitivity occurred only to VP and only in the CCT. Thus this alteration in the VP response is anatomic and hormone specific and does not appear to be an acute effect of DOCA, since it was not present on day 1 and on day 3 of DOCA exposure. DOCA-Na hypertension is VP dependent. A specific exaggerated cAMP response to this hormone in the CCT would be expected to cause increased sodium retention. Whether increased sodium retention at this site contributes to hypertension in the DOCA-Na rat is unknown.
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PMID:Enhanced cAMP response to vasopressin in the CCT of DOCA-Na hypertensive rats. 302 5

Records of 86 patients in Ruhengeri Hospital North of Rwanda (east Africa) during nine months, revealed that diabetes was present in about 4% of all these patients. First of all, malnutrition was noted in about 9% of these diabetics. But, features of the diabetes mellitus were usually as described by Sankale as the "Cosmopolitan Diabetes".--67% of all the patients were male persons from 31 to 49 years old--Typical symptoms as: thirst, polyuria and weight loss were noted in most all patients,--Insulin requirement was noted in 65% of the patients,--Only few patients were diabetic for more than 10 years,--Neuropathy, retinopathy were usually shown,--17.5% of the patients had abnormally high blood pressure (Hypertension). Diabetes mellitus cannot be considered as a preferred share in Africa but malnutrition and obesity, at the opposite side of the nutritional spectrum, are the striking originality of this disease in developing countries.
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PMID:[Clinical study of diabetes mellitus in hospital practice in Northern Rwanda (apropos of 86 case reports)]. 318 67


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