saralasin and Pheochromocytoma

Topics: Adenoma; Adrenal Gland Neoplasms; Adrenocortical Hyperfunction; Catecholamines; Contraceptives, Oral, Hormonal; Estrogens; Female; Humans; Hyperaldosteronism; Hypertension; Hypertension, Renal; Hypertension, Renovascular; Male; Pheochromocytoma; Renin; Saralasin; Sodium

Topics: Adrenergic beta-Antagonists; Angiotensin II; Blood Pressure; Diagnosis, Differential; Diuretics; Ferricyanides; Furosemide; Humans; Hyperaldosteronism; Hypertension; Hypertension, Renal; Nitroprusside; Oligopeptides; Pheochromocytoma; Propranolol; Renal Veins; Renin; Saralasin; Stimulation, Chemical; Teprotide

Topics: Adrenal Cortex Hormones; Adrenal Gland Neoplasms; Adrenocorticotropic Hormone; Aldosterone; Catecholamines; Cushing Syndrome; Diagnosis, Differential; Humans; Hyperaldosteronism; Hypertension; Pheochromocytoma; Renin; Saralasin

Topics: Adrenal Gland Neoplasms; Humans; Hypertension; Male; Middle Aged; Pheochromocytoma; Saralasin

4 patients with hypertensive crisis (glomerulonephritis [n = 2], phaeochromocytoma [n = 1], reno-vascular hypertension [n = 1] combined with encephalopathy, showed a normalisation of blood-pressure up to 18 days during angiotensin-II-blockade with saralasin. Prior, blood pressure was treated insufficiently by intravenous diazoxide and Na-nitroprusside. Increased plasma-renin-activity and plasma levels of catecholamines pointed to an activation of the renin-angiotensin- and sympathico-adrenergic system. A trial of therapy with saralasin--especially, if blood-pressure response to diazoxide and sodium-nitroprusside is insufficient--could be indicated. Side-effects like pressor-reactions are excluded by very low priming doses (0,1 microgram/kg/min); rebound-hypertension at the end of the therapy is avoided by an overlapping therapy with renin suppressing drugs (beta-receptor blockers, clonidine, guanfacinum).

Topics: Adrenergic beta-Antagonists; Adult; Aged; Angiotensin II; Clonidine; Female; Furosemide; Glomerulonephritis; Humans; Hypertension; Hypertension, Renovascular; Male; Pheochromocytoma; Renin; Saralasin

Topics: Abdominal Neoplasms; Angiotensin II; Blood Pressure; Child; Humans; Hypertension, Renal; Hypertension, Renovascular; Male; Nephrectomy; Pheochromocytoma; Saralasin; Vasopressins

Topics: Adult; Catecholamines; Diazepam; Dihydralazine; Female; Furosemide; Humans; Hypertension, Malignant; Male; Metoprolol; Pheochromocytoma; Saralasin; Sympathetic Nervous System; Vanilmandelic Acid

This case report describes a patient with malignant hypertension and phaeochromocytoma in whom blockade of angiotensin II receptors by the competitive antagonist 1-sar-8-ala-angiotensin II (Saralasin) resulted in a partial correction of the elevated BP. Plasma renin activity was high and rose further during the blockade. Competitive inhibition of angiotensin II by Saralasin does not abolish the pressor effect of catecholamines. It was therefore interesting to observe that in this patient with phaeochromocytoma, independently, both alpha-adrenergic receptor blockade and angiotensin II receptor blockade were effective in lowering BP.

Topics: Adrenal Gland Neoplasms; Adrenergic alpha-Antagonists; Angiotensin II; Humans; Hypertension, Malignant; Male; Middle Aged; Pheochromocytoma; Receptors, Angiotensin; Receptors, Cell Surface; Renin; Saralasin

Topics: Adrenal Gland Neoplasms; Angiotensin II; Blood Pressure; Depression, Chemical; Humans; Hypertension; Pheochromocytoma; Saralasin

Topics: Adrenal Gland Neoplasms; Angiotensin II; Blood Pressure; Catecholamines; Humans; Male; Middle Aged; Neurofibromatosis 1; Pheochromocytoma; Plasma Volume; Renin; Saralasin; Stimulation, Chemical