Persistent Hypotension Associated with Hypermedullipinemia: A New Syndrome |
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Authors: | E. Eric Muirhead David H. P. Streeten Bennie Brooks Edward T. Schroeder Lawrence W. Byers |
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Affiliation: | a Departments of Pathology and Medicine, University of Tennessee, Memphis and Baptist Memorial Hospital, Memphis, TNb Departments of Medicine and Section of Nephrology, State University of New York Health Science Center, Syracuse, NY, USA |
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Abstract: | A new syndrome is described in a patient with advanced renal insufficiency. This consists of severe and persistent hypotension causing weakness but associated with a clear mental status. Also present is evidence for decreased vascular reactivity. The hypotension was not orthostatic. The hypotension was associated with a circulating vasodepressor substance having the characteristics of medullipin I. The medullipin appears to have been derived from the remaining right kidney. Hypotension existed despite the presence of major prohypertensive mechanisms, including an endstage kidney, hyperreninemia and hyperaldosteronemia. It is likely that hypotension due to hypermedullipinemia is an entity occurring in the human being. |
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Keywords: | medullipin renomedullary interstitial cells hypotension hypermedullipinemia SKF525A Tween 20 SHR |
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