Red cell membrane sodium transport: possible genetic role and use in identifying patients at risk of essential hypertension
Article Abstract:
Essential or primary hypertension (high blood pressure), which is not secondary to other disease, is a significant cause of illness and death among adults. The cause of hypertension is unknown, but may originate in childhood and many mechanisms for it have been postulated. Control of sodium movement into and out of cells has been suggested as a cause. A previous study has suggested that children with essential hypertension have higher intracellular sodium levels, a lower rate of sodium outflow from cells, and decreased levels of sodium-potassium pumps (the proteins which pump sodium out of the cell) compared with healthy children and children with secondary hypertension. However, it is unclear whether these factors are related to the development of hypertension or whether they are coincidentally associated with a true causative factor. To clarify this issue, sodium levels and pumps in red blood cells were characterized in 28 children with hypertension; some of the subjects had strong family histories of hypertension. Whether blood pressure was normal or high, children with a family history of hypertension had significantly higher intracellular sodium levels, lower levels of sodium outflow, and lower levels of sodium pumps, compared with children from families without a history of hypertension. This indicates that changes in sodium handling did not occur subsequent to hypertension. Also, these abnormalities are not absolutely associated with increased blood pressure. Whether altered sodium handling precedes hypertension or is a marker for other factors remains to be determined by further research. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Archives of Disease in Childhood
Subject: Health
ISSN: 0003-9888
Year: 1990
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Phaeochromocytoma - investigation and management of 10 cases
Article Abstract:
Pheochromocytoma, or paraganglioma, is a usually benign lesion occurring in the adrenal medulla, and is characterized by the secretion of catecholamines (substances that have a marked effect on the nervous and cardiovascular systems; e.g. vanillylmandelic acid, norepinephrine, dopa) resulting in hypertension and attacks of palpitation, headache, nausea, dyspnea, anxiety, pallor and profuse sweating. These lesions are a rare but treatable cause of pediatric hypertension. Since 1960, 10 of these cases were diagnosed in a children's hospital in London. The children ranged in age from 3.5 months to 16 years, and all had high blood pressure (hypertension) and headaches. Diagnoses were confirmed by detection of elevated levels of vanillylmandelic acid and noradrenaline in the blood. Others had elevated renin activity and some had evidence of excess calcitonin in the blood. A variety of medications were administered to each of the children to treat and manage the hypertension. The authors report that urinary levels of catecholamines were misleading and that the use of blood levels of catecholamines were more valid indicators of disease or lesions. Arteriography (X-ray of the arteries) and venous catecholamine sampling were found more helpful in localizing tumors than the newer techniques such as ultrasound, computed tomography (CT), or most recently, meta-iodo-benzyl-guanidine (MIBG) scanning. Preoperative control of hypertension was necessary for successful definitive surgery. All children were successfully treated by surgical excision of the lesions. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Archives of Disease in Childhood
Subject: Health
ISSN: 0003-9888
Year: 1990
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Indomethacin responsive hypercalcemia associated with a renal sarcoma
Article Abstract:
Frequently, adult patients with cancer develop hypercalcemia, elevated blood levels of calcium. Usually this is due to the effects of hormones made of proteins, but prostaglandins, much smaller hormones made from special fats, may be involved in some cases. Humoral, or hormone-related, hypercalcemia is infrequent in children with cancer, occurring mostly with unusual malignancies. A case is reported of a six-month-old boy with a kidney tumor who developed hypercalcemia that was associated with elevated prostaglandin levels. The infant had a one-month history of irritability and poor appetite, and had developed abdominal swelling one week before examination. Tests showed a kidney mass which had not metastasized to other organs. Initial treatments did not lower calcium levels, so indomethacin, an inhibitor of prostaglandin synthesis, was administered and successfully lowered blood calcium to normal levels. Levels of prostaglandin E2, one type of prostaglandin, dropped by half after indomethacin treatment. Kidney levels of prostaglandin E2 were over 50-fold higher than those in healthy kidneys, and further tests provided more evidence to indicate increased calcium movement from bone into blood. Treatment included surgical removal of the kidney and nine months of combination chemotherapy; one year after therapy completion, the patient was considered well. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Archives of Disease in Childhood
Subject: Health
ISSN: 0003-9888
Year: 1990
User Contributions:
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