Author/Editor		Marn-Pernat, Andreja; Accetto, Rok; Pirc-Čerček, Olga
Title		Malignant hypertension - report of four cases
Type		članek
Source		In: Buturović-Ponikvar J, Bren AF, editors. Zbornik 2. slovenski nefrološki kongres z mednarodno udeležbo ob 30. letnici dialize in transplantacije ledvic v Sloveniji; 2000 sep 27-30; Brdo pri Kranju. Ljubljana: Klinični center, Klinični oddelek za nefrologijo,
Publication year		2000
Volume		str. 69-73
Language		eng
Abstract		We report clinical course, response to treatment and outcome of four patients presenting with malignant hypertension. An appropriate evaluation for etiological causes of the hypertension was performed and potential role of humoral immune system was tested. In all four patients, malignant hypertension manifested with markedly elevated blood pressure, bilateral retinal exudates and hemorrhages with or without papilloedema, hypertensive encephalopathy, renal insufficiency and hypertensive heart disease. Treatment included a normal salt diet and oral medications with ACE inhibitor, dihydropyridine calcium antagonist and alpha and/or beta adrenergic blockers in all four patients. In addition to that, 2 patients received angiotensin II receptor antagonist (losartan) and 3 of them central alpha agonist. None of the patients was given diuretic. The blood pressure has been reduced gradualy and clinical status of the patients improved within 3 weeks. Despite effective antihypertensive therapy, in three of four patients decreased renal function persists. Discontinuation of antihypertensive treatment was the main couse of deterioration of primary hypertension to the malignant phase. Primary immunologic disturbance is less likely to be involved in progression to malignant hypertension. All patients survived and returned to normal life.
Descriptors		HYPERTENSION, MALIGNANT TREATMENT OUTCOME