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

Endocrine function was studied in a 24 year old female with lipoatrophic diabetes (LD). Baseline endocrine studies (serum triglycerides: 2600 mg/dl) demonstrated hyperprolactinemia (serum prolactin 51 ng/ml), increased ACTH levels, absence of suppression of ACTH to a high dose of dexamethasone which suppressed serum cortisol normally and, hyperresponsiveness of TSH to stimulation with TRH. Thyroid hormone levels (total and free fraction) were essentially normal. Major metabolites of thyroid hormone (T3, rT3, 3, 3'-T2, and 3', 5'-T2) were also normal and exhibited a normal response to the administration of L-thyroxine and propylthiouracil. Exchange of 84% of the patient's plasma resulted in a decrease in serum triglycerides (700 mg/dl) which was followed by a rebound to the original level in seven days. After the sixth plasmapheresis serum triglycerides stabilized at less than 1000 mg/dl. Plasmapheresis was associated with the appearance of amenorrhea and galactorrhea; also hypertension and proliferative retinopathy developed during this therapy. Repeat endocrine function studies (serum triglycerides: 700 mg/dl) showed a further rise in serum prolactin (greater than 160 ng/ml), persistence of abnormal ACTH secretion and normalization of TSH responsiveness. Lipoatrophic diabetes is associated with abnormal central endocrine function but appropriate peripheral target gland secretion. A course of plasmapheresis improves the hypertriglyceridemia but not the endocrine dysfunction. In this patient with LD the most important side effect of plasmapheresis was the development of cardiovascular complications.
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PMID:Lipoatrophic diabetes: endocrine dysfunction and the response to control hypertriglyceridemia. 628 8

The effects of direct administration of TRH, TSH, LHRH, LH, ACTH, GH, FSH and prolactin into cerebral ventricle system on metabolic, respiratory, cardiovascular and behavioral responses were assessed in unanesthetized rats, Intraventricular administration of TRH, TSH, LHRH or LH caused hypothermia, decreased metabolism and/or cutaneous vasodilation at room temperature (22 degrees C). Intraventricular administration of FSH, ACTH or prolactin caused hyperthermia, increased metabolism and/or cutaneous vasoconstriction. Intraventricular administration of GH caused an insignificant change in thermoregulatory responses. There was no change in respiratory evaporative heat loss in response to either of the drugs tested. In addition, intraventricular administration of TRH, LHRH or LH caused tachycardia, hypertension and a reduction in the epinephrine-induced reflex bradycardia. In contrast, intraventricular administration of prolactin caused bradycardia, hypotension and an enhancement in the epinephrine-induced reflex bradycardia in conscious rats. There was no change in cardiovascular function in response to intraventricular administration of TSH, FSH, ACTH or GH. Furthermore, following intraventricular administration of TRH, but not TSH, LHRH, LH, FSH, GH, ACTH or prolactin three main categories of behavior were provoked: activity of normal type--forward locomotion stimulation, head and body rearing; stereotype activity--increased grooming and head swaying; and abnormal type behavior--tail elevation and piloerection in rats. The data indicate that most of the anterior pituitary hormones and their releasing hormones act through a central mechanism to influence physiological and/or behavioral functions.
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PMID:Effects of anterior pituitary hormones and their releasing hormones on physiological and behavioral functions in rats. 635 Jul 20

With a view of the prevention as well as treatment of cancer and other diseases, it is important to quantify health positively and on an individual basis by chronobiologic methods. These include the assessment of the characteristics of certain circadian, circannual and other endocrine rhythms and trends, for the recognition of risk (prior to the occurrence of a given disease) by an alteration of the same rhythm characteristics and even by a time-specified single sample. With this aim in mind, a small number of selected (rather than randomly picked) women of 3 age groups was extensively sampled for 12 plasma hormones around the clock and the calendar, in 2 geographic locations. Such data revealed correlations of the familial risk of developing breast cancer with the circannual amplitudes of circulating prolactin and TSH. The risk of several other conditions was also correlated with hormonal rhythm characteristics; for example, the risk of developing diseases associated with a high blood pressure was correlated with the circannual amplitude of plasma aldosterone. The mapping of circannual characteristics, however, is time-consuming and costly and may not be warranted as a first step, for example when a physician is not in a position to wait for a year to make a diagnosis. With the possibility in mind that sampling requirements may be reduced to one or at most two samples, a chronobiologic pattern discrimination analysis was undertaken on the original data from young adults. The results are presented to indicate the method and to suggest the singling-out of certain variables for further testing on a larger, properly stratified and randomized sample, rather than as definitive results. Different classifiers and different corresponding reference values from variables that undergo circadian and circannual rhythms may perhaps withstand the test (and, with Vergil, the tooth) of time. If so, reference values that are time-specified may well prove to be a sine qua non in the assessment of certain neuroendocrine aspects of developing certain diseases, including breast cancer.
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PMID:Toward chronobiologic pattern discrimination of the risk of developing breast cancer and other diseases. 676 84

The authors have observed a case of phaeochromocytoma revealed by fever and poor general condition without hypertension. Urinary catecholamine assays showed predominant dopamine secretion. Only 13 cases of dopamine-secreting phaeochromocytoma have been published so far, including 4 with clinical symptoms resembling those of this patient. The metabolic and hormonal effects of high plasma dopamine levels were studied, and responses similar to those observed with TRH stimulation by dopamine infusions were obtained: TSH and prolactin responses were inhibited, and GH was increased. This case underlines the need for catecholamine assays, including dopamine, in patients with unexplained fever and apparently non-secretory adrenal tumour.
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PMID:[Dopamine-secreting phaeochromocytoma. A little known clinical and biochemical entity (author's transl)]. 680 62

In order to study the prognosis of Graves' disease, 236 patients, who had been diagnosed as having had Graves' disease more than 10 years before, were examined. Although one patient had died of leukemia and 2 patients had been operated on for breast cancer after 131I therapy, and another 6 patients had died between the ages of 20 and 50, the patients were doing quite well. Generally, the prognosis of Graves' disease is not considered to be serious if the thyroid function is controlled. Among the 72 patients who had been treated with 131I therapy, 15 patients (21%) showed low serum levels of both T3 and T4 and were considered to be suffering from late-onset hypothyroidism. About 67% of the 131I-treated patients were considered to be almost euthyroid, but serum TSH levels were high in half of them, suggesting latent hypothyroidism. The incidence of hypertension seemed to be significantly higher in the TSH-elevated euthyroid group compared with the TSH-nonelevated patients. An excessive reaction of the hypothalamus and/or pituitary gland might have an unfavorable effect not only on the apparent hypothyroidism, but also on the latent hypothyroidism after the therapy for Graves' disease.
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PMID:[Primary hypothyroidism as a possible cause of hypertension from long-term follow-up studies of patients with Graves' disease (author's transl)]. 689 8

An increase in the weight of the thyroid gland, accompanied by reductions in uptake and release of 1311, serum T3 and reverse T3 concentrations and an increase in serum TSH concentration, occurs during the development of renal hypertension in rats. Renal function, as assessed by BUN, serum and urinary creatinine concentrations, and ability to concentrate urine during dehydration, is depressed. The kidneys of both normotensive and renal hypertensive rats contain a thyroid depressing factor (TDF) which inhibits uptake of 131I both in vivo and in vitro as well as inhibiting the lactoperoxidase enzyme in vitro. The kidneys of renal hypertensive rats contain less, and the serum more, TDF than those of normotensive rats. Whether TDF is produced as a result of hypertension per se or as a result of renal damage accompanying hypertension remains for further study. TDF appears to be a peptide with a molecular weight in the range of 400 to 419 daltons.
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PMID:Renal-thyroid interrelationship in normotensive and hypertensive rats. 707 Feb 20

Described here is a 27-year-old female, who had centripetal obesity, broad reddish-purple striae on the lower abdomen and hypertension. Serum cortisol levels, the results of a dexamethasone suppression test and an adrenal scintigram with 131I-19-iodocholesterol were all compatible with Cushing's syndrome due to an adrenal adenoma that secretes cortisol autonomously. This was confirmed by gross and microscopic examination of the removed adrenal tumor. In addition, the patient had markedly diminished T4 and T3 concentrations in serum. Basal TSH levels were not elevated and did not rise significantly after TRH injection. Serum T4 and T3 concentrations were elevated to the normal range when the hyperadrenocorticism was corrected. The results indicate that the patient had "'corticogenic hypothyroidism."
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PMID:Cushing's syndrome associated with corticogenic hypothyroidism: a case study. 730 57

Fourteen patients (six males and eight females) have been treated with chronic hemofiltration three times weekly for three to 27 months with the post-dilution technique. All patients had previously been on regular dialysis treatment. Patients were selected for hemofiltration because of dialysis-resistent hypertension (eight), symptoms of dialysis discomfort (five), hypertriglyceridemia (five) and polyneuropathy (seven). Hypertension improved in six of eight patients, symptoms of dialysis discomfort markedly diminished in all five patients, hypertriglyceridemia did not change consistently, polyneuropathy improved in six of seven patients. Balance studies of Na, Ca and Mg revealed a positive correlation to fluid balance. Phosphate, BUN, creatinine and uric acid increased. Loss of amino acids and protein is negligible. Hormone studies showed a decrease of T3, T4 and TSH though the pituitary-thyroid axis is intact, possibly indicating a decreased TRH activity. Vitamin D remained unchanged, PTH levels increased, possibly related to a diminished excretion of phosphate and diminished intake of calcium, respectively, during hemofiltration treatment as compared to hemodialysis.
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PMID:Chronic hemofiltration treatment. 736 95

Primary empty sella syndrome (ESS) is an anatomo-radiological picture characterized by the presence of an arachnoid herniation filled with liquor that compresses the pituitary against the sellar wall. ESS occurs particularly in obese, hypertensive, cephalalgic women. It is often asymptomatic but may be associated with ophthalmologic, neurologic and non-characterizing endocrine disorders. We report here 43 cases of primary ESS observed and assessed in our Departments of Internal Medicine from June 1983 to May 1993. The following endocrinological diagnostic procedures were carried out: hormonal (RIA) basal profile: FT3, FT4, TSH, PRL, ACTH, FSH, LH, 8.00 a.m. and p.m., blood cortisol, aldo, PRA, DHEA-S, FTe, E2, P, PTH, CT, and calcemia and phosphoremia; provocative tests: TRH, GnRH, etc.; inhibition tests: high dose dexamethasone. Clinical, neurologic (skull radiographs, sellar stratigraphy, computed tomography scan and magnetic resonance), and ophthalmologic (fundus, visual fields) assessments were also made. Our findings fit with the data in the literature concerning common symptoms of ESS, associated endocrinopathies and other illness. We found obesity (62.7%), oligo-amenorrhea (16.6%), galactorrhea (14.6%), hyperPRL (11.6%), hypopituitarism (9.3%), hypogonadism (4.6%), diabetes insipidus (2.3%), (micro-)polycystic ovary syndrome (19%), hyperACTH (2.3%). In 9.3% of the cases, endocrinopathy referred to pituitary adenomas. Moreover, we noted a high frequency of psychological disorders, to our knowledge not previously reported in the literature, including anxiety or dysthymic disorders with altered behavior (chiefly oral compulsion). We also make the hypothesis that obesity (occurring in 62.7% of our patients) and hypertension (62.7%) may be related to hypothalamic alterations.
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PMID:[43 cases of primary empty sella syndrome: a case series]. 761 55

A report is given on a 28 years old women with congenital aplasia of the thyroid gland. She was substituted with thyroxine (300 micrograms per day). Her first pregnancy was complicated by gestational hypertension and pre-eclampsia. Delivery was by forceps. During the first trimester of her second pregnancy, bleedings occurred. The thyroid-stimulating hormone level (TSH-level) was increased (18.3 microU/ml). The patient did not show clinical signs of manifested hypothyroidism. The thyroxine dosis was increased. Bleedings disappeared. Labour was terminated and induced. Labour intra partum was hypoactive. The delivery was again by forceps. The newborn did not show any signals of hypothyroidism. Dysfunction of thyroid gland is associated with reduced fertility. Hypothyroidism in pregnancy is associated with an adverse outcome in fetal health as well as an increase in obstetric complications. Thyroid hormones play a vital role in fetal development and maturation of brain. Women with a hypothyroidism have a lower rate of pregnancy and a higher rate of spontaneous miscarriages compared to a normal population. Recognition and treatment of thyroid disorders in reproductive age occur before conception. Iodoprophylaxis is necessary for prevention of congenital hypothyroidism (cretinism). Iodoprophylaxis is necessary to prevent endemic goiter in pregnancy. Euthyroid goiter is an indication for a combined treatment with jodid and levothyroxine. Treatment should be individualized. Assessment of efficacy of treatment is based on measurement of TSH- and free thyroid hormone (fT4)-levels.
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PMID:[The course of pregnancy in congenital thyroid gland aplasia. Case report with special reference to maternal hypothyroidism]. 797 62


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