losartan-potassium and Cushing-Syndrome

Cushing's syndrome of glucocorticoid excess is named after the eminent Boston neurosurgeon Harvey W. Cushing (1869-1939). The recognition that glucocorticoid excess produces hypertension led to examination of the role of cortisol in essential hypertension, but it is only over the last decade that evidence has emerged to support the concept. Despite the widespread assumption that cortisol raises blood pressure as a consequence of renal sodium retention, there are few data consistent with the notion. Although it has a plethora of actions on brain, heart and blood vessels, kidney, and body fluid compartments, precisely how cortisol elevates blood pressure is unclear. Candidate mechanisms currently being examined include inhibition of the vasodilator nitric oxide system and increases in vasoconstrictor erythropoietin concentration.

Topics: Cardiovascular Diseases; Cushing Syndrome; Disease Models, Animal; Erythropoietin; Glucocorticoids; Humans; Hydrocortisone; Hypertension; Infant, Newborn; Nitric Oxide; Vasoconstriction; Vasodilation

Topics: Adrenocorticotropic Hormone; Chorionic Gonadotropin; Cushing Syndrome; Erythropoietin; Gastrointestinal Hormones; Hormones, Ectopic; Hypercalcemia; Hypoglycemia; Hyponatremia; Melanocyte-Stimulating Hormones; Neurologic Manifestations; Paraneoplastic Endocrine Syndromes; Parathyroid Hormone; Polycythemia; Prostaglandins E; Somatomedins; Vasopressins

Topics: Adenocarcinoma; Adrenocorticotropic Hormone; Arginine; Biliary Tract Diseases; Bronchial Neoplasms; Carcinoma; Chorionic Gonadotropin; Colonic Neoplasms; Cushing Syndrome; Erythropoietin; Female; Follicle Stimulating Hormone; Growth Hormone; Gynecomastia; Hormones, Ectopic; Humans; Hypercalcemia; Lactation Disorders; Lung Neoplasms; Luteinizing Hormone; Models, Biological; Neoplasms; Paraganglioma; Paraneoplastic Endocrine Syndromes; Polycythemia; Pregnancy; Prolactin; Thyroid Neoplasms; Vasopressins

Topics: Adolescent; Adrenocorticotropic Hormone; Adult; Brain Neoplasms; Carcinoma; Carcinoma, Bronchogenic; Carcinoma, Hepatocellular; Carcinoma, Squamous Cell; Cerebellar Neoplasms; Child; Child, Preschool; Choriocarcinoma; Cushing Syndrome; Diagnosis, Differential; Erythropoietin; Female; Gonadotropins; Hemangiosarcoma; Hormones, Ectopic; Humans; Hypercalcemia; Hypoglycemia; Infant; Infant, Newborn; Insulin; Insulin Secretion; Kidney Neoplasms; Liver Neoplasms; Lung Neoplasms; Male; Neoplasms; Parathyroid Hormone; Pheochromocytoma; Polycythemia; Pregnancy; Teratoma; Testicular Neoplasms; Thymus Neoplasms

Topics: Adrenocorticotropic Hormone; Cushing Syndrome; Erythropoietin; Gonadotropins; Hormones, Ectopic; Humans; Hypercalcemia; Hypoglycemia; Hyponatremia; Insulin; Melanocyte-Stimulating Hormones; Paraneoplastic Endocrine Syndromes; Parathyroid Hormone; Pigmentation Disorders; Vasopressins

Among the malignant tumors of nonendocrine origin that are capable of producing polypeptide hormones and of manifesting as different endocrine syndromes discussed here are ectopic ACTH syndrome, SIADH, and ectopic gonadotropin-producing tumors.

Topics: Adrenocorticotropic Hormone; Carcinoma, Hepatocellular; Carcinoma, Small Cell; Chorionic Gonadotropin; Cushing Syndrome; Diagnosis, Differential; Erythropoietin; Follicle Stimulating Hormone; Gynecomastia; Hormones, Ectopic; Humans; Hyperthyroidism; Hypoglycemia; Hyponatremia; Liver Neoplasms; Lung Neoplasms; Luteinizing Hormone; Male; Paraneoplastic Endocrine Syndromes; Polycythemia; Puberty, Precocious; Thyrotropin; Vasopressins; Water Intoxication

The exact prevalence of the humoral syndromes associated with neoplasm is not known but it seems clear that they exist more commonly than is realized. Hormonal syndromes are very often seen in patients with carcinoma of the lung. Awareness of the large number of ectopic hormonal syndromes in patients with tumors can lead to early diagnosis, treatment, and herald recurrence. They may be responsible for new signs and symptoms which can be life-shortening. Hormonal causes of clinical deterioration must be considered before concluding that symptoms are due to metastases in patients with neoplastic disease. Tumors are chemically active and the important concept which has had great impact on the diagnosis, treatment, and basic understanding of mechanisms, which are important to endocrinologists and oncologists has been stated by Liddle: "Certain tumors of nonendocrine tissue can produce hormones that are similar to normal hormones except that their production is not appropriately controlled by normal physiologic mechanisms." Survival and quality of life can be reduced in patients with the metabolic complications of these humors. The list of humoral substances released by tumors is growing as technologic advances lead to their detection. Other chemical substances produced by neoplastic tissue may have biologic activity which impacts on the patient's clinical condition and which we cannot recognize, at this time, because the techniques to detect them have not been developed. If there are signs or symptoms of overproduction of a hormone, search for a tumor; if a patient has a tumor, search for biologically active substances.

Topics: Cushing Syndrome; Erythropoietin; Hormones; Hormones, Ectopic; Humans; Hypercalcemia; Hypoglycemia; Neoplasms; Paraneoplastic Endocrine Syndromes; Vasopressins