[Plasma renin activity in pheochromocytoma]

Partial correction of hypertension by angiotensin II blockade in a patient with phaeochromocytoma

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.

Acute and chronic intrarenal alpha- and beta- adrenergic receptor stimulation of renin release in the conscious dog

The effect of continuous intrarenal infusion of norepinephrine, isoproterenol, and methoxamine on renin release was studied in the uninephrectomized conscious dog. Chronic intrarenal infusion of norepinephrine produced a biphasic curve of plasma renin activity (PRA) and a sustained 25 mm Hg increase in mean arterial pressure (MAP). The initial increase in PRA peaked at 3 hours, after which PRA returned to control levels. Alpha- or beta-adrenergic antagonists did not attenuate the initial rise in PRA. The PRA increased again after 48 hours of chronic intrarenal norepinephrine infusion and remained elevated thereafter. The second rise in PRA was increased by 30% with alpha-adrenergic blockade. Chronic intrarenal isoproterenol administration produced a similar increase in PRA, which peaked at 3-5 hours and then returned to control levels. In contrast to norepinephrine, chronic isoproterenol administration did not result in a second increase in PRA. At the end of the chronic isoproterenol infusion period, beta-adrenergic receptor refractoriness was demonstrated, as PRA did not increase significantly in response to a fourfold increase in the dose of isoproterenol. An increase in PRA was produced by acute intrarenal infusion of methoxamine. This increase in PRA was blocked by phentolamine, suggesting a vascular alpha-adrenergic receptor-mediated release of renin.

A case of secondary aldosteronism induced by pheochromocytoma

A case of secondary aldosteronism caused by a pheochromocytoma containing a large amount of norepinephrine is described. The increased level of angiotensin induced by norepinephrine seems to play an important role in the development of secondary aldosteronism.