Diagnostische und therapeutische Besonderheiten bei einigen Hochdruckkranken mit Nierenarterienstenosen

Heberer, G.; Engelking, R; Fw, Eigler

doi:10.1055/s-0028-1103685

Cited by 17 publications

(3 citation statements)

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“…It is significant that in five patients 1,4,5,15,17 out of twelvel-5, 15-18 with vascular changes induced by direct tumor compression and in one6 out of 4 patients6, 7, s, 2o with immediately adjacent but non-compressing tumors, the underlying pheochromocytoma was not appreciated pre-operatively despite angiography. It is even more significant that retrospective analysis of the arteriograms in these six cases revealed tumor vasculature about the stenosed segment of the renal artery in three instances.…”

Section: Discussionmentioning

confidence: 91%

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Renal Artery Alterations Associated with Pheochromocytoma

et al. 1972

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Pheochromocytoma may be associated with renal artery stenosis which con. tributes to the production of hypertension.l-11 This paper presents a classification of alterations in the renal artery associated with pheochromocytoma and discusses their significance. CASE REPORTIn 1969 a 22 year old white male presented to Montefiore Hospital with hypertension and ataxia. Historical review disclosed successful resections of large left and right para-adrenal pheochromocytomas in 1959 and 1960. Admission physical examination revealed blood pressure of 210/150, bilateral papilledema, and severe right-sided ataxia. Urinary levels of catecholamines and vanillyl mandelic acid (VMA) were elevated. Lumbar puncture revealed clear spinal fluid with opening pressure of 40 cm of water.Aortography and selective renal arteriography demonstrated a smoothly contoured segmental stenosis of the mid-portion of the right renal artery and a &dquo;tumor stain&dquo; superior to the renal artery indicating recurrent pheochromocytoma (Fig. 1). At surgery the right renal artery was found to be compressed by fibrous adhesions which produced a measured pressure gradient of 15 cm of water. The renal artery was dissected free of adhesions, but, despite extensive search, the tumor was not located. Post-operatively the patient did not resume spontaneous respiration and expired.Postmortem findings were (1) a small round well-encapsulated, extraadrenal pheochromocytoma extending posterior to the right adrenal gland and inferior vena cava; (2) a second two cm tumor nodule immediately adjacent to the right renal artery producing minimal compression; (3) slight residual right renal artery narrowing but otherwise normal kidneys and renal vasculature; (4) a 6 x 7 cm right cerebellar cyst, which contained a 1 cm mural nodule demonstrated microscopically to be a hemangioma; (5) compression of the 4th ventricle with mild hydrocephalus; (6) marked right tonsillar herniation with severe compression of the medulla; (7) normal adrenals, thyroid, parathyroids, liver, lungs and pancreas. COMMENTS This case illustrates the occurrence of renal artery compression by both a contiguous extra-adrenal tumor nodule of pheochromocytoma and by fibrous From the

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Section: Discussionmentioning

confidence: 91%

“…Since the first report by Harrison in 1959,9 numerous authors have documented a variety of mechanisms by which pheochromocytoma may be associated with renal arterial disease1-11, [15][16][17][18][19][20][21][22] (Table 1).…”

Section: Classification Of Pheochromocytoma-related Renal Arterial DImentioning

confidence: 99%

Renal Artery Alterations Associated with Pheochromocytoma

et al. 1972

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“…Wir finden hier also die Verhältnisse vor, die auch bei der renovaskulären Hypertonie angetroffen werden (15,40,57), wobei hier nicht die Nierenarterien durch pathologische Wandprozesse verändert sind, sondern von außen durch einen Tumor komprimiert werden. Diese »phäochromozytom-induzierte« renovaskuläre Hypertonie oder die Kombination von Nierenhilustumoren verschiedener Genese und renovaskulärer Hypertonie wurde schon von mehreren Autoren gefunden (17,22,25,33,34,42) und konnte auch kürzlich von uns bei vier Fällen beschrieben werden (51). Die erhöhte Plasma-Renin-Aktivität im Fall 1 ist höchstwahrscheinlich auf eine derartige Reninstimulation zurückzuführen.…”

Section: Patienten Und Ergebnisseunclassified

Die Plasma-Renin-Aktivität beim Phäochromozytom^*

Werning¹,

Ziegler²,

Baumann³

et al. 1970

Dtsch med Wochenschr

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Scornik und Paladini (36) stellten zum Beispiel nach intravenösen Infusionen von Noradrenalin einen signifikanten Anstieg des Plasma-Angiotensins fest. Wathen und Mitarbeiter (49) fanden bei Tierexperimenten eine Reninstimulation, wenn die Katecholamine direkt in die Nierenarterie gegeben wurden, bei intravenösen Gaben blieb die Stimulation des Renins jedoch aus. Vander (45) sah demgegenüber auch nach intravenöser Verabreichung von Katecholaminen eine deutliche Reninerhöhung bei Hunden.

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Regulation of Erythropoietin Production

Fisher

1992

Comprehensive Physiology

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The sections in this article are: Physicochemical Properties of Erythropoietin Assay and Standardization of Erythropoietin Model for Kidney Production of Erythropoietin Renal Site of Production of Erythropoietin Extrarenal Erythropoietin Production Sites of Action of Erythropoietin Anemia of Renal Insufficiency Erythropoietin and Polycythemia Pharmacological Agents that Influence Erythropoietin Production Pharmacokinetics of Erythropoietin Potential Therapeutic uses of Erythropoietin Summary

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Diagnostische und therapeutische Besonderheiten bei einigen Hochdruckkranken mit Nierenarterienstenosen

Cited by 17 publications

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Renal Artery Alterations Associated with Pheochromocytoma

Renal Artery Alterations Associated with Pheochromocytoma

Die Plasma-Renin-Aktivität beim Phäochromozytom^*

Regulation of Erythropoietin Production

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Diagnostische und therapeutische Besonderheiten bei einigen Hochdruckkranken mit Nierenarterienstenosen

Cited by 17 publications

References 0 publications

Renal Artery Alterations Associated with Pheochromocytoma

Renal Artery Alterations Associated with Pheochromocytoma

Die Plasma-Renin-Aktivität beim Phäochromozytom*

Regulation of Erythropoietin Production

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Die Plasma-Renin-Aktivität beim Phäochromozytom^*