Arterial hypertension as a paraneoplastic phenomenon in hepatocellular carcinoma.
Three South African blacks with hepatocellular carcinoma and arterial hypertension are described. Plasma angiotensinogen (renin substrate) concentrations were increased eightfold to 10-fold in the two patients in whom these concentrations were measured. One of these two patients also showed a 34-fold rise in plasma inactive, active, and total renin concentrations, and an elevated plasma renin activity (2.73 ng.L-1.s-1 angiotensin l/mL/h). Inactive renin (prorenin) constituted 90% of the total plasma renin concentration. In the third patient only plasma renin activity was measured, and this was considerably raised (6.05 ng.L-1.s-1; angiotensin l/mL/h). Thus, the arterial hypertension that rarely complicates hepatocellular carcinoma may be caused either by a combination of eutopic synthesis of excessive quantities of angiotensinogen and ectopic production and secretion of active renin by malignant hepatocytes, or by eutopic production of angiotensinogen alone.
Kew
M C
MC
Department of Medicine, Witwatersrand University Medical School, Johannesburg, South Africa.
Leckie
B J
BJ
Greeff
M C
MC
D000328:Adult; D000804:Angiotensin II / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000150:complications*; D002648:Child; D006801:Humans; D006973:Hypertension / Q000209:etiology*; D008113:Liver Neoplasms / Q000150:complications*; D008297:Male; D010257:Paraneoplastic Syndromes; D012083:Renin / Q000097:blood
D000804:Angiotensin II; D012083:Renin