Document Detail


Periodic fluctuation of blood pressure and its management in a patient with pheochromocytoma. Case report and review of the literature.
MedLine Citation:
PMID:  3050197     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The case of a 69 year old man with a right adrenal pheochromocytoma who manifested cyclic fluctuations of blood pressure with a cycle length of 9 to 13 min is reported. We collected and reviewed 14 similar cases previously reported in the literature. In these cases, right adrenal pheochromocytoma was most common, while 1 case involved the left adrenal and 2 cases were of extra-adrenal origin. The incidence in males was twice that in females and the median age was 45.3 years. Although a good correlation between the blood pressure and plasma norepinephrine concentrations was observed in our patient, the exact mechanism for the cyclic fluctuations of blood pressure is not known. In our patient, both YM-09538 and bunazosin were effective in controlling severe hypertension preoperatively. YM-09538 induced significant increases in urinary norepinephrine concentrations (1327 +/- 238 micrograms/day), while bunazosin induced a significant decrement in urinary norepinephrine concentrations (475 +/- 188 micrograms/day) compared with pretreatment levels (900 +/- 42 micrograms/day) (p less than 0.01). These observations indicated that bunazosin as a postsynaptic alpha-adrenergic receptor blocker interfered with release of norepinephrine from the tumor and thus might be beneficial in the management of elevated blood pressure in patients with pheochromocytoma.
Authors:
S Oishi; M Sasaki; M Ohno; T Umeda; T Sato
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Japanese heart journal     Volume:  29     ISSN:  0021-4868     ISO Abbreviation:  Jpn Heart J     Publication Date:  1988 May 
Date Detail:
Created Date:  1988-11-10     Completed Date:  1988-11-10     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0401175     Medline TA:  Jpn Heart J     Country:  JAPAN    
Other Details:
Languages:  eng     Pagination:  389-99     Citation Subset:  IM    
Affiliation:
Third Department of Internal Medicine, Faculty of Medicine, University of Kumamoto, Japan.
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MeSH Terms
Descriptor/Qualifier:
Adrenal Gland Neoplasms / physiopathology*
Antihypertensive Agents / therapeutic use*
Blood Pressure*
Catecholamines / urine
Ethanolamines / therapeutic use*
Humans
Hypertension / drug therapy,  etiology*
Male
Middle Aged
Periodicity*
Pheochromocytoma / physiopathology*
Quinazolines / therapeutic use*
Chemical
Reg. No./Substance:
0/Antihypertensive Agents; 0/Catecholamines; 0/Ethanolamines; 0/Quinazolines; 70958-86-0/amosulalol; 80755-51-7/bunazosin

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