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

A case of polyarteritis nodosa (PAN) in a 54 year-old man is presented. The clinical picture showed a 6-month history of mixed sensorimotor distal symmetrical polyneuropathy in all limbs together with anorexia, weight loss, fatigue, arthralgia, myalgia, mild fever and hypertension. The laboratory studies showed leucocytosis, elevated ESR, positive HBsAg and presence of cryoglobulins. Selective renal, celiac and mesenteric angiography was performed by femoral approach and has showed innumerable aneurysms most of them in hepatic and renal circulation. After about two weeks death has occurred. A brief discussion is done on clinical aspects of PAN pointing out the importance of HBsAg determination on etiopathogenesis and angiographic study on diagnosis.
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PMID:[Polyarteritis nodosa: report of a case with angiographic study]. 287 24

A 22-year-old familial Mediterranean fever (FMF) patient was hospitalized for continuous fever, myalgia, hypertension, vertigo and a petechial rash. Laboratory findings revealed hyperglobulinaemia, thrombocytosis and a leukaemoid reaction. While on steroid therapy the patient sustained a haemorrhage into a renal aneurysm which responded to gel foam embolization. After 12 months of follow-up his condition remained stable under treatment with cyclophosphamide, prednisone and antihypertensive medications. This case provides the fourth example of polyarteritis nodosa associated with FMF.
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PMID:Polyarteritis nodosa and familial Mediterranean fever. 288 91

A statistical association between hypertension and hyperparathyroidism has been repeatedly reported, but the underlying pathogenetic mechanism has not been elucidated. A 51-year-old woman was hospitalized because of increasing motor disability caused by multiple bone and muscle aches with generalized weakness. She was found to have marked hypercalcemia and hypophosphatemia, increased parathyroid hormone secretion, but normal renal function and blood pressure level. After the identification and removal of a single parathyroid adenoma, the calcium/phosphate metabolism normalized in a relatively short time during which, however, hypertension developed in the absence of any other endocrine or renal dysfunction. A positive, highly significant relationship was observed between the progressive rise in blood pressure and the gradual increase in serum phosphate concentration occurring after the operation, suggesting that, in the hyperparathyroid phase, an underlying trend to hypertension could have been masked by the phosphate depletion, probably through its effects on cardiac and vascular smooth muscle function.
Hypertension 1988 Mar
PMID:Development of hypertension after correction of primary hyperparathyroidism. 335 May 90

Fifty patients with mild essential (primary) hypertension entered a double-blind, parallel-group study with either nicardipine 30 mg three times daily or placebo, randomly assigned as monotherapy for 6 weeks. At the end of 6 weeks, the nicardipine-treated group had a statistically significant reduction in mean supine systolic/diastolic pressure of 21.2/15.0 mm Hg (P less than 0.001) compared with the nonsignificant reduction of 0.7/2.9 mm Hg in the placebo-treated group. The difference in mean response between the nicardipine- and placebo-treated groups was significant (P less than 0.001). In the nicardipine-treated group, the reduction in mean standing systolic/diastolic blood pressure, 17.9/13.8 mm Hg, was significant (P less than 0.001), whereas in the placebo-treated group the change was +3.0/-1.5 mm Hg. The difference between the two treatment groups was significant (P less than 0.001). In both treatment groups, changes in pulse rate were minor, and there was no evidence of tachyphylaxis occurring with nicardipine. Adverse experiences were minor in all cases except for one patient with muscle pain during treatment with nicardipine. Patients who received nicardipine showed a mean increase of 52% in plasma renin activity (PRA) after 6 weeks (P less than 0.01). Initial basal or stimulated PRA did not correlate with blood pressure reduction on nicardipine. Nicardipine 30 mg three times daily is a well-tolerated and effective antihypertensive agent.
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PMID:Nicardipine hydrochloride in essential hypertension--a controlled study. 389 78

We report two pediatric cases of rhabdomyolysis. This disease involves the destruction of skeletal muscle, which can present with myalgia and a brown-pigmented urine. The first patient presented with acute renal failure, hypertension, and hyponatremia. The second patient was pyrexic, hypernatremic, and hypokalemic, and later developed hypertension. Evidence of rhabdomyolysis in both patients included dark, o-tolidine-positive urine, granular casts in the urinary sediment, and grossly increased activities of creatine kinase (greater than 60 000 U/L) in serum. An uncommonly recognized entity in the pediatric age group, rhabdomyolysis often presents as an acute disease with severe onset but can be diagnosed with relatively simple laboratory tests.
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PMID:Rhabdomyolysis: two pediatric case reports. 396 73

In 3 patients with low-grade astrocytomas clinical pharmacology of interferon-beta (10(7) U/mg protein) was investigated. Interferon-beta with escalating dosage (2.3, 6.9, 23, 69 X 10(6) U/patient) was given to each patient in 4 infusions at weekly time intervals. In these patients dose-dependent plasma-levels of interferon-beta of up to 5800 IU/ml were achieved. Plasma concentrations showed a biphasic decline (T1 1/2:0.095-0.49 hrs and T2 1/2: 5-14.5 hrs). Side effects were: mild fatigue, myalgia, tachycardia, hypertension, and fever; the latter was well controlled by pretreatment application of paracetamol. Hematological changes included lymphopenia (2-6 hrs after infusion) and granulocytosis (3-6 hrs after infusion). Natural Killer cell activity was also monitored: 6 hours after infusion a drop of activity - not clearly dose dependent - was observed to a minimum of 1% pretreatment activity; 24 hrs after infusion activity increased up to a maximum of 400%. In this phase I study high biological activity of interferon-beta could be detected in plasma of astrocytoma patients - clinical tolerance was good and only mild toxicity was observed.
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PMID:Interferon-beta in patients with low-grade astrocytomas--a phase I study. 403 71

The initial symptoms of a new multisystem disease probably caused by ingestion of denatured rapeseed oil were acute pleuropneumopathy, fever, headache, exanthems, myalgia, and eosinophilia. Later features were severe myalgia and thromboembolic accidents. The present phase of the illness is typified by scleroderma-like involvement, pulmonary arterial hypertension, and a neuromuscular syndrome. Nearly all the patients with these late changes are women. The pathological lesion is a peculiar form of non-necrotising vasculitis which primarily affects the intima.
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PMID:Toxic epidemic syndrome, Spain, 1981. Toxic Epidemic Syndrome Study Group. 612 35

Seven cases of acute renal failure consecutive to haemorrhagic fever with renal syndrome (HFRS) due to the Hantaan virus or to a serologically related virus are reported. These cases were observed in north-eastern France between March, 1983 and January, 1984. All patients were of rural origin and had been in contact with field mice. The predominant initial clinical symptoms were signs of infection and diffuse muscle pain, without evidence of haemorrhage. However, massive proteinuria was noted, and acute anuric renal failure unaccompanied by oedema or arterial hypertension developed. Renal biopsy performed in 2 patients showed tubular and interstitial nephritis but no glomerular or vascular lesions. Two patients only required haemodialysis. All patients recovered within 2 to 8 weeks without sequelae. Antibodies directed against the Hantaan virus were detected by indirect immunofluorescence tests, and seroconversion could be demonstrated in 2 patients seen at a sufficiently early stage. The risk of epidemics suggested by this small outbreak of HFRS can only be evaluated after an exhaustive epidemiological study.
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PMID:[Hemorrhagic fever with renal syndrome due to Hantaan virus or a serologically related virus]. 615 Nov 76

Eleven patients with severe, treatment-resistant essential or renovascular hypertension were treated with captopril after withdrawal of various multiple drug regimes. If supine diastolic blood pressure remained greater than 90 mm Hg on a maximum daily dose of 450 mg captopril, a diuretic and then a beta-adrenoceptor blocker were added. Patient-volunteered complaints were carefully noted. Mean (+/- SE) systolic and diastolic blood pressures fell from 225 +/- 6.8/131 +/- 4.4 mm Hg on various multiple drug regimes to 182 +/- 9.0/105 +/- 5.0 mm Hg on a regime including captopril. The reported and observed incidence of adverse effects were as follows: maculopapular rash (one patient); urticaria and pruritus (three patients); loss of taste (one patient); tachycardia (four patients); increased frequency of trivial infections (three patients); severe myalgia (one patient); and deterioration in renal function (one patient). However, these patients were able to continue captopril after either temporary withdrawal or dose reduction. Captopril was discontinued permanently in five patients, in two because of poor blood pressure control, in one who developed persistent severe urticaria, and in one because of marked proteinuria. In the fifth patient intractable diarrhoea occurred. Captopril lowers blood pressure very effectively in patients with severe hypertension refractory to other agents. Adverse effects are common but acceptable in this situation where prognosis is poor if blood pressure is not adequately controlled.
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PMID:Efficacy and adverse effects of captopril in severe refractory hypertension. 617 29

A case of exogenous hypermineralocorticism secondary to absorption of an alcohol-free liquorice beverage is reported here. The patient was a 53 year old man with known alcoholic liver cirrhosis who had stopped drinking alcohol one year earlier. He was admitted to the hospital for fever and myalgia without hypertension. Laboratory tests showed severe hypokalemia (1.7 mmol/l), metabolic acidosis and enzyme abnormalities compatible with rhabdomyolysis. Urinary potassium excretion was high. Plasma renin activity and aldosterone levels were low. Symptoms were those of exogenous hypermineralocorticism. One month earlier, the patient had drunk 0,25 1 per day of an alcohol-free licorice beverage for two weeks. Clinical and biological symptoms disappeared with potassium loading alone. Three weeks later, when serum potassium levels remained normal, the ingestion of the same amounts of the same beverage produced an important decrease in serum potassium levels. Intoxication by liquorice is a well-known cause of pseudoprimary hyperaldosteronism. But the case reported here has some unique features. It is, to our knowledge, the first case reported in the literature, although a few cases have been brought to the attention of the poison center in Marseille. The amount of beverage ingested was small (0.35 g/day of glycyrrhizinic acid) as compared to the usual threshhold of toxicity (0.7 g/day). The toxic effects lasted two weeks after discontinuing ingestion. Cirrhotic patients may be more susceptible than others but the main consumers of this type of beverage are presumably ex-alcoholics.
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PMID:[Major hypokalemia with rhabdomyolysis secondary to the intake of a nonalcoholic aniseed aperitif]. 647 67


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