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)

An Amerindian girl with Friedreich's ataxia presented at the age of 14 years with intermittent bifrontal headaches and abdominal aching, often associated with nausea and recurrent vomiting and an evanescent pink, blotchy rash on the upper trunk. In these attacks she also had hypertension up to 210/160 mm Hg. Renal function studies, including intravenous pyelogram and angiography, were normal. Plasma renin activity (2.5 ng/ml/hr) was also normal. Total body CT scan was negative for phaeochromocytoma, and repeated estimations of 24-hour excretion of urinary VMA were normal or borderline high. Levels of total catecholamines in 24-hour urine were normal twice, but two random specimens during the paroxysmal episodes contained abnormally high levels of norepinephrine and dopamine. Plasma catecholamine concentrations were increased but not as high as with phaeochromocytoma. Blood pressure monitoring demonstrated marked fluctuations with position and temperature. A clonidine suppression test showed a substantial fall of plasma catecholamine levels, consistent with dysautonomia and not with phaeochromocytoma. It is concluded that the patient has dysautonomia of central origin, probably as a manifestation of Friedreich's ataxia. These findings are discussed in relation to the recent demonstration of increased levels of plasma catecholamines in that disease.
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PMID:Friedreich's ataxia with dysautonomia and labile hypertension. 670 98

The association of malignant pheochromocytoma and poorly differentiated lymphocytic lymphoma has not previously been reported. A case is presented of a 58-year old man with a 20-year history of malignant pheochromocytoma well controlled on Dibenzyline who was found to have poorly differentiated lymphocytic lymphoma. During lymphoma chemotherapy with cyclophosphamide, vincristine and prednisone (VCP) he developed tachycardia and syncope accompanied by severe hypertension. During the next course of chemotherapy one month later, 24-hour urinary VMA, metanephrine and catecholamine values were determined before, during and after the chemotherapy and were found to have increased two- to ten-fold. This suggests that VCP caused tumor lysis with release of catecholamines into the circulation.
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PMID:Malignant pheochromocytoma. Severe clinical exacerbation and release of stored catecholamines during lymphoma chemotherapy. 689 44

A subgroup of essential hypertensive (EH) patients with high sympathetic tone had low plasma conjugated norepinephrine (NE) and epinephrine (E), but elevated free NE and E and a hyperresponsiveness to various stimuli to the autonomic nervous system. Pheochromocytoma patients could also be divided according to conjugated NE + E levels, this time into normal and elevated conjugated groups. The latter seem to be somewhat protected by the conjugation, showing less free NE and E 'flooding' during hypertensive crises and lower VMA excretion. The degree of catecholamine conjugation can thus modify the sympathetic tone in hypertension.
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PMID:Conjugation of catecholamines, a variable to be accounted for in human hypertension. 693 81

This report concerns two pheochromocytomas of renal vasculary pedicle. Diagnosis is made on clinical features and urinary vanylmandelic acid excretion rate. Localisation is made by arteriography. In one case, there is a renal artery compression, and in the other the tumor is vascularised by lombar artery with hypoplasic ipsilateral kidney. These two cases stress the problem of the respective responsibility of both pheochromocytoma and renovascular disease in hypertension genesis. Beside the clinical and biological context pre-operatively, the sulpiride and propranolol tests may have a discrimination value. Excision of the tumor afforded complete relief of symptoms, the two patients remained normotensive three years later.
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PMID:[Pheochromocytoma with compression of renal vasculary pedicle and hypoplastic kidney: interest of sulpiride and propranolol tests (author's transl)]. 710 2

The influence of stress on the metabolism of adrenaline (A) and noradrenaline (NA) in the prosencephalon (PC) and rhombencephalon (RC) of SHR and normotensive Wistar rats (WR) was studied. After intraperitoneal injection of 3H-tyrosine, radioactivity of 3H-adrenaline (3H-A), 3H-noradrenaline (3H-NA), total 3H-3-methoxy-4-hydroxyphenylglycol (3H-MHPG), total 3H-3,4-dihydroxyphenylglycol (3H-DHPG) and 3H-vanillylmandelic acid (3H-VMA) was measured in PC and RC of SHR and WR, non-stressed or subjected to running stress. Stress induced a significant decrease of 3H-A level in PC and RC of 8-week-old SHR while no stress-related changes in 3H-NA level were found in either part of the brain of SHR. In RC, 3H-A level was lower in older than in younger non-stressed SHR and decreased further after stress. In all SHR, stress enhanced formation of total 3H-MHPG and/or 3H-DHPG in PC, while increased 3H-VMA level was found only in PC of 24-week-old and in RC of 8-week-old stressed SHR. The results suggest that the decrease of the level of 3H-A in the brain of SHR is involved in their reaction to stress and may depend on increased metabolism mainly to glycols but also to VMA. The lower 3H-NA and 3H-A levels in the prosencephalon of non-stressed young and older SHR, concomitant with unaltered or elevated formation of their metabolites, may suggest higher release of the transmitters involved in the pathogenesis of spontaneous hypertension.
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PMID:Metabolism of 3H-catecholamines in the brain of spontaneously hypersensitive rats (SHR) after running stress. 724 96

The metabolism of 3H-catecholamines after i.p. injection of 3H-tyrosine was studied in the heart and adrenals of spontaneously hypertensive (SHR) and normotensive Wistar (NCR) rats at rest and following running stress. In the heart of 8-week-old NCR a sharp stress-induced increase of the levels of 3H-A and 3H-DA with an elevation of the levels of their metabolites was observed. In contrast, there was no stress-related change in the levels of 3H-NA, 3H-A and 3H-VMA in the hearts of young SHR, while the 3H-DA level, though increased after stress, remained still lower than in the age-matched NCR. In the phase of established hypertension (24 weeks) lower levels of 3H-NA and 3H-A in the heart already present at rest, as compared with NCR, remained lower after stress but the elevation of the level of their metabolites 3H-VMA and 3H-MA, was similar in both strains. In the adrenals of 8-week-old SHR the basal 3H-A level was already higher than in NCR. Stress provoked a marked decrease of adrenal 3H-A accompanied by increased formation of 3H-MA and an increase in the levels of 3H-NA and 3H-DA, more pronounced in SHR than NCR. In the phase of advanced hypertension a further elevation of 3H-A and 3H-MA and an increase of basal 3H-DA level in the adrenals were found at rest. The decreased levels of 3H-catecholamines in the heart of stressed young and non-stressed older SHR may indicate an increase in their rate of release and/or their impaired synthesis. An increased basal level of 3H-A in the adrenals of SHR concomitant with the development of hypertension, may reflect an increased synthesis and/or decreased release, as evidenced by the proportionally lower increase of its extraneuronal metabolite 3H-MA. The adrenal response to stress, more intense in SHR than in NCR, may be considered as due to enhanced release of 3H-A from the gland.
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PMID:Metabolism of 3H-catecholamines in the heart and adrenals of spontaneously hypertensive rats (SHR) after running stress. 727 Feb 17

Using randomly voided 1-h urine samples, levels of excretion of catecholamines (CA) and 4-hydroxy-3-methoxymandelic acid (vanillylmandelic acid; VMA) were determined in order to save time in and simplify the diagnostic work-up of pheochromocytoma, particularly in out-patient hypertension clinics. Twenty-nine patients with surgically verified pheochromocytoma (15 paroxysmal and 14 sustained type), 56 patients with essential hypertension (26 labile and 30 fixed type) and 14 normal volunteers were studied. Abnormally high excretion of CA and VMA was found in all patients with pheochromocytoma when compared to those with essential hypertension or to normal controls after duly considering the influence of external factors such as food and exercise. From these results, we concluded that assays of CA and VMA even in random 1-h urine samples are useful in separating patients with pheochromocytoma from those with other types of hypertension.
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PMID:Random one-hour urine catecholamine and 4-hydroxy-3-methoxymandelic acid assays for diagnosis of pheochromocytoma. 739 76

Eight cases of pheochromocytoma in children were managed between 1958 and 1978. Headache, visual blurring, sweating, and hypertension were the most common findings. One patient presented with a hypertensive crisis during appendectomy. Three other children had a family history of pheochromocytoma and Hippel-Landau disease, thyroid carcinoma, and renal stones. The diagnostic approach was based on a high suspicion of the disease from the clinical picture. The most reliable laboratory investigations were urinary VMA, metanephrine, and catecholamines. I.V.P. and angiography were successful in localizing the tumor. In 4 cases, CT scan localized the tumor, although a second tumor was not seen in 1 case. Preoperative control of hypertension was achieved with phenoxybenzamine, propanolol, apresoline and reserpine in seven cases. The main anesthetic drugs used were pentothal, methoxyflurane, nitrous oxide, Innovar, and pancuronium. Tumors were located in the right adrenal in four, the left adrenal in two, both adrenals in one, and bilateral para-aortic sites in one. In two cases, hypertensive episodes during manipulation of the tumor were controlled with phentolamine. Ligation of the venous drainage from a tumor was associated with a sudden sustained fall in systemic blood pressure in six cases. In two, blood pressure remained elevated until a second tumor was found and removed. Hypotension was then corrected by the rapid infusion of fluid and blood, and vasopressors were not used. There were no postoperative complications and all children remained normotensive during the follow-up. The tumors of seven of the patients were benign. One tumor showed a low grade malignancy.
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PMID:Pheochromocytoma in children--an update. 741 63

Between 1981 and 1993, 14 patients with tumoral adrenal disease were diagnosed and treated in the Urology Services of both Hospitals. Nature of the adrenal disease was functional in 8 patients (two carcinomas and six pheochromocytomas) and non-functional in the rest (three carcinomas, two adenomas and one myelolipoma). Reference is made to the clinical manifestations and laboratory tests related to hormonal activity, depending on whether the tumour is functional or non-functional, chromaffin or non-chromaffin. Patients with functional carcinomas had Cushing's syndrome, with very clear virtilization signs. Urine 17-hydroxycorticosteroid, 17-cetosteroides and cortisol were all increased, same as plasma cortisol. Patients with pheochromocytomas had hypertension and headaches (six patients), sweating (five patients), anxiety (four patients) and loss of weight (two patients). All of them had increased urine vainillylmandelic acid and catecholamines. Clinical signs and symptoms of non-functional tumours were related to bulk growth and size (in the three carcinomas), and sometimes was highly anodyne, or even absent (in the two adenomas and the myelolipoma), the cause of discovery being accidental during an ultrasound examination. An analysis is made of the different imaging diagnostic procedures performed, such as IVU (performed in 13 patients) with a 38.4% resolutory power; ultrasound (performed in 11 patients) with an 81.8% resolution; CAT (performed in 6 patients) with a 100% resolution capacity and arteriography (performed in 3 patients) with a 100% resolution power, although patients had previously undergone ultrasound and CAT.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Clinical features, diagnosis, and treatment of tumor lesions arising in the adrenal gland]. 777 Dec 35

In clinical practice, the coincidence of nephrotic syndrome with pheochromocytoma is very rare. The case is described of a 23-year-old woman who in June 1988 presented with recurrent hypertensive crises, severe asthenia, abundant sweats, orthostatic hypertension and massive proteinuria. Diagnostic tests performed (abdominal ultrasound and CT, urinalysis, renal function tests, plasma levels of metanephrine and normetanephrine, as well as urinary VMA determination) revealed the presence of a pheochromocytoma of the left adrenal gland combined with nephrotic syndrome. Surgical removal of the left adrenal led to immediate normalization of blood pressure and absence of urinary abnormalities. The authors therefore suggest either an immunological pathogenesis or one due to glomerular hyperfiltration.
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PMID:[The nephrotic syndrome and pheochromocytoma. A report of a rare clinical case]. 781 65


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