Idiopathic orthostatic hypotension from failure of noradrenaline release in a patient with vasomotor innervation
| Autor: | R N Nanda, R H Johnson, F. C. Boyle, J S Gillespie, H J Keogh |
|---|---|
| Rok vydání: | 1977 |
| Předmět: |
Adult
Male Sympathetic nervous system medicine.medical_specialty Sympathetic Nervous System Valsalva Maneuver Adrenergic Pressoreceptors Sweating Norepinephrine (medication) Hypotension Orthostatic Norepinephrine Orthostatic vital signs Erectile Dysfunction Heart Rate Internal medicine medicine Humans Sympathomimetics Phenylephrine Sympathomimetic drug Gastric Juice Autonomic nerve business.industry Muscles Respiration Peripheral Nervous System Diseases Pupil Vasomotor System Psychiatry and Mental health medicine.anatomical_structure Endocrinology Blood pressure Surgery Neurology (clinical) business Research Article medicine.drug |
| Zdroj: | Journal of Neurology, Neurosurgery & Psychiatry. 40:11-19 |
| ISSN: | 0022-3050 |
| DOI: | 10.1136/jnnp.40.1.11 |
| Popis: | A 26 year old man is described with life-long orthostatic hypotension unrelated to autonomic nerve degeneration and apparently due to failure of peripheral noradrenaline realese. Tests of parasympathetic and sympathetic cholinergic nerve function were normal, but sympathetic adrenergic activity was defective. Thus blood pressure regulation was abnoraml. There was no pressor response to tyramine, an indirect sympathomimetic drug, but a marked pressor response to the directly acting sympathomimetic drugs phenylephrine and noradrenaline. On standing there was a progressive fall rather than a rise in circulating noradrenaline concentrations, although adrenaline levels rose normally. The pupils showed diminished responses to ephedrine and cocaine, and a normal response to phenylephrine. Fluorescence microscopy of blood bessels showed that they were innervated with adrenergic nerves. His orthostatic hypotenstion responded well to oral phenylephrine (50 mg five times daily) but not to other forms of therapy. It is suggested that this patient's symptoms were due to failure of noradrenaline release even though sympathetic adrenergic nerves were present. We therfore wish to draw attention to a further cause of orthostatic hypotension, failure of peripheral noradrenaline release without autonomic neuropathy. |
| Databáze: | OpenAIRE |
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