Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0033687 (proteinuria)
 24,015 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We describe a patient with positive antinuclear and anti-Smith antibodies, proteinuria, and thrombocytopenia suggesting systemic lupus erythematosus (SLE). During hospitalization, the patient developed labile hypertension, tachycardia, and intermittent fever. A computer tomography scan of the abdomen showed an extraadrenal mass, which was confirmed as a pheochromocytoma. After removal of the pheochromocytoma, the patient's symptoms resolved and her serology normalized. Previous case reports describe SLE patients with adrenal pheochromocytomas that presented many years after the diagnosis of lupus. This is a novel case of pheochromocytoma discovered at the onset of SLE, with resolution of SLE manifestations shortly after its removal.
 ...
PMID:New onset systemic lupus erythematosus with pheochromocytoma. 1206 56

With the objective to assess the prognostic value of office values as compared with ambulatory monitoring in pregnancy, we analyzed 2430 blood pressure series systematically sampled from 403 untreated pregnant women for 48 consecutive hours every 4 weeks from the first visit to the hospital until delivery. Women were divided into 5 groups: "detected" gestational hypertension, women with office blood pressures >140/90 mm Hg after 20 weeks of gestation and hyperbaric index (area of blood pressure excess above the upper limit of a time-specified tolerance interval) consistently above the threshold for diagnosing hypertension in pregnancy; "undetected" gestational hypertension, office values <140/90 mm Hg but hyperbaric index above the threshold for diagnosis; normotension, both office values and hyperbaric index below the thresholds for diagnosis; white coat hypertension, women with recorded diagnosis of gestational hypertension but hyperbaric index consistently below the threshold for diagnosis; and preeclampsia, defined as gestational hypertension and proteinuria. Results indicate small and nonsignificant differences in 24-hour mean of ambulatory pressures between "detected" and "undetected" gestational hypertension at all stages of pregnancy, in contrast with highly significant differences between these two groups and normotensive pregnancies. Average office blood pressure values were similar for preeclampsia, "detected," and "undetected" gestational hypertension. The hyperbaric index was, however, significantly higher for women with preeclampsia after 20 weeks of gestation as compared with all other groups and higher for women with either "detected" or "undetected" gestational hypertension as compared with normotensive pregnant women. The incidence of preterm delivery and intrauterine growth retardation were similar for "detected" and "undetected" gestational hypertension but significantly lower for normotensive women. In pregnancy, the hyperbaric index derived from ambulatory monitoring is markedly superior to office measurements for diagnosis of what should be truly considered gestational hypertension, as well as for prediction of the outcome of pregnancy.
 ...
PMID:Prognostic value of office and ambulatory blood pressure measurements in pregnancy. 1221 70

Patients with essential arterial hypertension either have or do not have compelling reasons for specific drug classes. Patients lacking a compelling reason for a specific drug class are those without target organ damage (e.g. left ventricular hypertrophy, microalbuminuria, proteinuria, atherosclerosis) and without comorbidities. In these patients antihypertensive treatment can be initiated with Diuretics and perhaps Betablockers. Calciumantagonists, ACE-Inhibitors and Angiotensin II-Receptorenblockers (Sartans) are unlikely to be superior. However, adverse effects, patient preferences and antihypertensive efficacy of a drug in the particular individual ultimately determine the "choice" of the medication. In patients with a compelling reason for an individual drug class, i.e., in patients with target organ damage (e.g. left ventricular hypertrophy, microalbuminuria, proteinuria) or very high cardiovascular risk (e.g. Diabetes) Angiotensin II-Receptorblockers or ACE-Inhibitors should be used initially. In many hypertensives blood pressure will normalize in response to a combination therapy only. Usually, addition of a low dose thiazide to another drug class is the most beneficial combination. In most patients resistant to therapy, a 24-h-ambulatory blood pressure measurement to exclude white coat hypertension or a white coat component, evaluation of medication compliance, non-pharmacological measures and the tailored use of diuretics and other optimizations of therapy will lead to success.
 ...
PMID:[Modern therapy of hypertension]. 1470 54

We compared the risk of preeclampsia (PE) among women with normal blood pressure (BP), high-normal BP, high BP, temporary hypertension (THT), white coat hypertension (WCH), and chronic hypertension (CH) in the first trimester. This was a retrospective cohort study involving 2858 pregnant women, who received regular maternal checkups at <12 weeks. BP levels were evaluated using the average of the second and third BP readings. When patients showed HT in the first trimester that later normalized during 14-19 weeks, we called this condition THT. BP levels were classified as normal BP, high-normal BP, high BP, THT, WCH, and CH. PE was defined as a new onset of HT after 20 weeks accompanied by either proteinuria or other organ dysfunctions. Gestational hypertension (GH) was defined as the new onset of HT after 20 weeks. The proportion of WCH in women with newly diagnosed HT was 47%. PE occurred in 1.3, 4.3, 8.1, 8.2, 14.3, and 25.0% of women with normal BP, high-normal BP, high BP, THT, WCH, and CH, respectively. GH occurred in 0.3, 1.8, 9.9, 2.0, and 28.6% of women with normal BP, high-normal BP, high BP, THT, and WCH, respectively. After adjusting for possible confounding variables, high-normal BP, high BP, THT, WCH, and CH were independent risk factors for PE vs. normal BP; in addition, high-normal BP, high BP/THT, and WCH were independent risk factors for GH vs. normal BP. In conclusion, THT and WCH in the first trimester were risk factors for PE, and WCH was a risk factor for GH.
 ...
PMID:Temporary hypertension and white coat hypertension in the first trimester as risk factors for preeclampsia. 3139 9