Primary reninism. Hypertension, hyperreninemia, and secondary aldosteronism due to renin-producing juxtaglomerular cell tumors

Conn, Jerome W.; Cohen, Edwin L.; Lucas, Charles; McDonald, Walter J.; G, Mayor; Blough, W. M.; Eveland, Warren C.; Bookstein, Joseph J.; Lapides, Jack

doi:10.1001/archinte.130.5.682

Cited by 96 publications

(48 citation statements)

References 25 publications

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“…Selective renal vein sampling (RVS) has been the traditional method of isolating and localising the tumour [1,10]. However, in a series of 8 cases of reninoma among 30 000 hypertensive patients, RVS was positive in only 64%.…”

Section: Discussionmentioning

confidence: 99%

“…A reninoma is a very rare tumour of the juxtaglomerular cells of the renal cortex [1]. It was first described by Robertson et al in 1967 [2], and independently by Kihara et al [3] in 1968.…”

mentioning

confidence: 99%

“…The clinical manifestations are the result of an increased secretion of renin from cells that are not in their normal position in relation to the proximal renal tubule. The renin secretion does not respond to normal physiological control mechanisms [1]. The condition is characterised by severe hypertension in young people, with increased plasma renin levels [1,6].…”

mentioning

confidence: 99%

“…The condition is characterised by severe hypertension in young people, with increased plasma renin levels [1,6]. Hypokalaemia may present late, as a response to secondary hyperaldosteronism [1,[7][8][9]. This condition represents an important surgically correctable cause of hypertension.…”

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confidence: 99%

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The anaesthetic management of a patient with a reninoma

Nicholson¹,

Rayman

Donaldson³

et al. 2003

Anaesthesia

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We report on the anaesthetic management of a 28-year-old woman presenting for excision of a reninoma. This is a very rare tumour of the juxtaglomerular cells of the kidney, which can be cured immediately by surgery. Previous reports have failed to record the presence or absence of perioperative cardiovascular lability. We have shown that blood pressure, cardiac index (CI) and systemic vascular resistance (SVRI) were remarkably stable in our patient throughout surgery, even during manipulation of the tumour. Isolation of the tumour was associated with a 23% reduction in SVRI, and a similar decrease in blood pressure. The cardiovascular lability associated with the removal of catecholamine-secreting tumours was not seen in this case.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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The anaesthetic management of a patient with a reninoma

Nicholson¹,

Rayman

Donaldson³

et al. 2003

Anaesthesia

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“…1). In a patient with renin producing juxtaglomerular cell tumors, hyperreninism responded to postural change but not to changes in sodium intake [34]. Corvol et al argued that renin secreting tumors of a juxtaglomerular origin responded to normal modulators of renin [1].…”

Section: Discussionmentioning

confidence: 99%

A Case of Renin Producing Leiomyosarcoma Originating in the Lung.

Kawai¹,

Fukamizu

Kawakami³

et al. 1991

Endocrinol Japon

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Abstract. A 54-year-old woman was referred to our hospital for the treatment of a tumor of the right chest wall. Clinical examination revealed hypertension, hypokalemia, metabolic alkalosis, hyperaldosteronism and hyperreninemia. Computed tomography and an abdominal echogram indicated a tumor in the right phrenic area and two tumors in the retroperitoneum near the pancreas head. After the surgical resection of these tumors, the primary reninism was diminished. The pathological diagnosis of these tumors was leiomyosarcoma. Plasma active and inactive (trypsin-activated) renin activities (PRA) were 85.7 and 38.9 ng angiotensin I/ml/h, respectively. These PRA did not respond to either postural stimulation or suppression by the volume expansion. Active and inactive renin activities in a right phrenic area tumor were 208 and 32 ng angiotensin I/mg protein /h, respectively. Those of an abdominal tumor were 196 and 30 ng angiotensin I/mg protein/h, respectively. Renin mRNA identical in molecular size to that of the human kidney was identified by northern blot analysis. This is the first case report of renin producing leiomyosarcoma derived from the lung, which is characterized by relatively lower plasma prorenin concentrations.

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Versatility of Adrenal Photoscanning

Conn¹,

Cohen²

1973

Arch Intern Med

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Sel ecti ve adrenal phlebography is useful in detecting small adrenal tumors.1-4 However, there are several disadvantages inherent in this technique. First, about 5% of patients are sensitive to contrast media\p=m-\a factor precluding the use of this method. Second, even in the most experienced hands, it is frequently impossible to direct the catheter into one of the adrenal veins, particularly the right one. Third, the technique requires the availability of a radiologist with great expertise in the manipulation of a catheter. The fourth and major disadvantage is the occasional occurrence of rupture of intra-adrenal capillaries in the course of the procedure, with extravasation of contrast material and hemorrhage into the gland.5 This complication may result in destruction of all glandular tissue within the capsule.4,6,7 There have been recent8-11 reports on the advantages of a new technique, adrenal photoscanning, for the diagnosis of adrenal abnormalities. In the course of studies with both techniques, we have made an inter¬ esting observation that prompts this report. It is now possible, by the tech¬ nique of adrenal photoscanning, to recognize chronic unilateral adrenal failure. Such a situation has not been clinically recognizable heretofore, since it is not accompanied by clinical or laboratory evidence of adrenal in¬ sufficiency, a compensatory increase in the function of the contralateral gland having occurred. The capability of recognizing unilateral adrenal fail¬ ure could provide, in a number of situ¬ ations, important clinical information that would otherwise not be attain¬ able. Patient Summary A 55-year-old white man was admitted to University of Michigan Hospital on May 7, 1970. Hypertension had been discovered ten years previously. Under treatment, blood pressure remained at about 160/110

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Primary reninism. Hypertension, hyperreninemia, and secondary aldosteronism due to renin-producing juxtaglomerular cell tumors

Cited by 96 publications

References 25 publications

The anaesthetic management of a patient with a reninoma

The anaesthetic management of a patient with a reninoma

A Case of Renin Producing Leiomyosarcoma Originating in the Lung.

Versatility of Adrenal Photoscanning

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