Hypertension as a paraneoplastic syndrome in hepatocellular carcinoma.
We report a 66-year-old man with hepatocellular carcinoma who was positive for hepatitis B surface antigen, and was hospitalized because of hypoglycemia and hypertension. His plasma renin activity was normal (2.3 ng/ml per h), but concentrations of angiotensin I (>2500 pg/ml) and II (86 pg/ml) were high. Increased angiotensin I level at sites proximal and distal from the confluence of the hepatic vein and the inferior vena cava indicated that the hypertension was provoked by overproduction of angiotensin I from the hepatocellular carcinoma. Previous reports of patients with hepatocellular carcinoma with hypertension due to abnormality of renin-angiotensin system are reviewed.
Arai
H
H
Department of Internal Medicine, National Sanatorium Nishi-Gunma Hospital, Shibukawa, Japan.
Saitoh
S
S
Matsumoto
T
T
Makita
F
F
Mitsugi
S
S
Yuasa
K
K
Takagi
H
H
Mori
M
M
D000368:Aged; D000803:Angiotensin I / Q000097:blood; D000804:Angiotensin II / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging; D017809:Fatal Outcome; D006801:Humans; D006973:Hypertension / Q000175:diagnosis*; D007003:Hypoglycemia / Q000175:diagnosis; D008113:Liver Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging; D008297:Male; D010257:Paraneoplastic Syndromes / Q000097:blood / Q000175:diagnosis*; D012083:Renin / Q000097:blood; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
D000804:Angiotensin II; D000803:Angiotensin I; D012083:Renin