Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0031511 (pheochromocytoma)
 14,622 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The case of a 47-year-old woman affected with right adrenal pheochromocytoma and right renal artery stenosis is presented. The concurrence of these two diseases is rarely reported in the literature, as shown by the review presented. Nevertheless, this association carries some problems as far as diagnosis is concerned, because missing renal artery lesion can lead to the maintenance of the hypertensive disease after surgical excision of the adrenal pheochromocytoma. Anyway, the extensive use of angiography is not justified for pheochromocytoma alone, because an excellent imaging of the mass can be achieved by means of non-invasive technologies, such as CT, echo B-mode, NMR. A careful evaluation of clinical features and non-invasive imaging and the presence of elevated plasma renin activity, although not determinant in surgical decision making, can support the suspicion of renovascular hypertension in the presence of pheochromocytoma and suggest to carry out renal angiogram and selective renal veins reninemia.
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PMID:[Association of pheochromocytoma and renovascular hypertension]. 176 62

A total of 50 patients with arterial hypertension were examined. Group 1 included 28 patients with renovascular hypertension, 18 of them had unilateral renal artery stenosis, the remaining 10 had bilateral renal artery stenosis. Group 2 consisted of 16 patients with primary aldosteronism. Group 3 comprised 6 patients with pheochromocytoma. The examination was made with echocardiograph. Changes in left ventricular myocardial mass (LVMM) were studied 1 and 6 months after surgical intervention. The maximum hypertrophy was observed in the patients with primary aldosteronism, no changes occurred in any of the groups examined 1 month after surgical management. The LVMM was found to be significantly diminished by 13% in the patients with renovascular hypertension and by 23% in patients with adrenal tumors (pheochromocytoma, aldosteroma).
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PMID:[Effects of surgical treatment on hypertrophy of the myocardium of the left ventricle in patients with symptomatic arterial hypertension]. 182 71

Sixty children with renal artery stenosis (unilateral in 44, bilateral in 16) underwent surgical treatment. Ten nephrectomies and 69 vascular repair procedures were performed. Postoperative follow-up ranged from one to 14 years. After surgery, blood pressure returned to normal and subsequently remained so in 54 patients without any antihypertensive medication. This represents a 90% cure rate. In six patients blood pressure remained high due to lesions of the renal parenchyma. Fibrous dysplasia of the renal artery was the prevailing pathologic finding. In children, associated lesions are especially frequent: coarctation of the abdominal aorta, stenosis, occlusion, aneurysms of the splanchnic arteries, pheochromocytoma. Postoperative prognosis of renovascular hypertension in children is good since atheroma and visceral or renal lesions are usually lacking.
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PMID:[Surgical treatment of renal artery stenosis in children 60 surgically treated cases]. 184 22

This paper deals with the following hypertension diagnoses: essential hypertension and five types of secondary hypertension: fibrodysplasic renal artery stenosis, atheromatous renal artery stenosis, Conn's syndrome, renal cystic disease, and pheochromocytoma. Only blood pressures, general information and general biochemical data are taken into account. Nineteen items were finally selected, by statistical investigation of experimental data, as being both discriminative and independent. The marginal density distributions of every item, and then joint density distribution functions were determined within six types of hypertension. The frequency of a given hypertension type within the hypertensive patients was used as prior probability of this state. The loss matrix was established by medical arguments. The expected loss corresponding to six possible decisions could thus be calculated for all cases. Both the ratio of secondary hypertensions that could be inferred from our set of data (not including the results of complementary tests) and that of correct "essential" hypertension diagnosis proved to be satisfactory.
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PMID:Bayesian statistics as applied to hypertension diagnosis. 187 63

A typical diurnal variation in blood pressure is observed in patients with essential hypertension. Attenuation or lack of circadian periodicity might be expected in patients with secondary hypertension. Therefore, non invasive ambulatory blood-pressure monitoring was performed in 172 patients with secondary hypertension and in 201 patients with essential hypertension. The following patients with secondary hypertension were investigated: renoparenchymatous nephropathy (n = 29), diabetic nephropathy (n = 24), morbus Conn (n = 6), renal artery stenosis (n = 32), pheochromocytoma (n = 5), hemodialysis patients (n = 30), and patients after kidney transplantation (n = 44). In addition, 36 pregnant women (17 normotensives, 19 hypertensives) were studied. 98.5% of patients with essential hypertension showed a nightly decline in blood pressure of at least 15 mmHg (systolic + diastolic), whereas 70% of patients with secondary hypertension showed either an attenuated circadian rhythm or no circadian rhythm. Patients with pheochromocytoma who had a nighttime increase in blood pressure demonstrated the greatest difference in the essential hypertension collective, followed by patients with diabetic nephropathy and patients after kidney transplantation. After successful treatment of the condition leading to hypertension, circadian periodicity returned in some patients. In summary, these results suggest that the absence of a nighttime decline in blood pressure during 24-h-ambulatory monitoring is an indication of secondary hypertension, which should be further investigated. As a practical consequence, antihypertensive drugs should also be applied in an evening dose in secondary hypertensives. Noninvasive ambulatory blood-pressure monitoring is recommended for treatment control, especially in patients who need an efficient blood-pressure control.
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PMID:[Importance of 24-hour blood pressure monitoring in secondary hypertension]. 202 30

Extra-adrenal pheochromocytoma causing renal artery stenosis is very uncommon. We describe a patient who had hypertension from this entity. Surgical excision of the mass corrected the renal artery stenosis without the need for bypass grafting, and the patient has remained normotensive. Magnetic resonance imaging (MRI) showed an extremely bright lesion on T2 weighted image, which is virtually pathognomonic. MRI is the most sensitive modality for the detection of an extra-adrenal or unsuspected multiple pheochromocytoma. This should obviate the need for routine abdominal exploration in the evaluation and treatment of pheochromocytoma. Therefore we strongly recommend magnetic resonance imaging in the management of adrenal masses in general and pheochromocytomas in particular.
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PMID:Extra-adrenal pheochromocytoma causing renal artery stenosis and implications of magnetic resonance imaging as diagnostic tool. 231 96

Fifty six children with renal artery stenosis (unilateral in 42, bilateral in 14) underwent surgical treatment. Ten nephrectomies and 63 vascular repair procedures were performed. Postoperative follow-up varied from 1 to 14 years. After surgery, blood pressure returned to normal and subsequently remained so in 51 patients without any antihypertensive medication. This represents a 91% success rate. In five patients blood pressure remained high due to lesion of the renal parenchyma. Fibrous dysplasia of the renal artery was the prevailing pathologic findings. In children, associated lesions are especially frequent: coarctation of the abdominal aorta, stenosis, occlusion, aneurysms of the splanchnic arteries, pheochromocytoma. Postoperative prognosis of renovascular hypertension in children is good since atheroma and visceral or renal lesions are usually lacking.
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PMID:[Surgical treatment of renal artery stenosis in children]. 263 Jan 12

Non invasive 24 hours ambulatory blood pressure monitoring was performed in 81 patients with secondary hypertension (renoparenchymatous nephropathy n = 15, diabetic nephropathy n = 10, Conn's disease n = 4, renal artery stenosis n = 15, pheochromocytoma n = 2, hemodialysis patients n = 15 and patients after kidney transplantation n = 20). The results were compared to 201 patients with essential hypertension. The results showed that 98.5% of patients with essential hypertension have a nightly decline in blood pressure of at least 15 mmHg (systolic + diastolic), whereas 69% of patients with secondary hypertension showed either an attenuated circadian rhythm or no circadian rhythm. Patients with pheochromocytoma who had a night time increase in blood pressure demonstrated the greatest difference to the essential hypertension collective followed by patients with diabetic nephropathy, Conn's disease and the group of patients after kidney transplantation. After successful treatment of the condition leading to hypertension circadian periodicity returned in some patients. In summary these results suggest that the absence of a night time decline in blood pressure during 24-hour-ambulatory monitoring is an indication of secondary hypertension.
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PMID:[Absence of nocturnal decrease in blood pressure in 24-hour blood pressure monitoring: an indication of secondary hypertension]. 266 27

A retrospective study of 24 pheochromocytomas observed between 1974 and 1987 is reported. Hypertension is the most frequent sign. In 19 cases diagnosis of pheochromocytoma was confirmed by surgery. In 3 cases, preoperative diagnosis was "silent" adrenal tumor. Two had exploratory surgery for renal artery stenosis and renal tumor. Diagnostic strategy and its evolution with high sensitivity biochemical examinations and computed tomography was analysed.
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PMID:[Pheochromocytomas]. 267 49

The mosaic of essential hypertension seems to be gaining new tiles at an accelerating rate. Of the many pathophysiological factors and markers for the factors that can be considered as possible elements of a profiling algorithm, there are relatively few with solid data to support their use. Use of plasma renin activity for prospective profiling does not appear to be valid for individual patients. It remains useful for diagnosis of renal artery stenosis and primary aldosteronism. The black race does have some well-documented pathophysiological differences from the white race regarding hypertension, and there are some useful data bits for selecting specific therapy. The elderly, obese patients, and young patients with hyperdynamic circulation appear to have enough group characteristics to enable selection of drugs more targeted to their needs. Anxious patients who often display symptoms that mimic pheochromocytoma symptoms comprise a unique group. One of the largest groups is patients with hypertension plus one or more concomitant diseases. Finally, drug selection decisions must also consider the effect of drugs on serum lipoproteins, left ventricular hypertrophy and vascular compliance, sexual function and other quality of life issues, and cost.
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PMID:Newer principles of patient profiling for antihypertensive therapy. 268 80


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