More than 80% of patients with Cushings syndrome develop hypertension., which is accompanied by distinct symptoms of the syndrome, such as central obesity, lipodystrophy, moon face, sweating, hirsutism and anxiety.Neuroendocrine tumors are also a well known cause of secondary hypertension. Pheochromocytoma (most often located in the adrenal medulla) increases secretion of catecholamines such as epinephrine and norepinephrine, causing excessive stimulation of adrenergic receptors, which results in peripheral vasoconstriction and cardiac stimulation. This diagnosis is confirmed by demonstrating increased urinary excretion of epinephrine and norepinephrine and/or their metabolites (vanillylmandelic acid). Other secondary hypertension
Hormonal contraceptives
Neurologic disorders
Obstructive sleep apnea
Liquorice (when consumed in excessive amounts)
Scleroderma
Neurofibromatosis
Pregnancy: unclear cause. Cancers: tumours in the kidney can operate in the same way as kidney disease. More commonly, however, tumors cause inessential hypertension by ectopic secretion of hormones involved in normal physiological control of blood pressure. Drugs: In particular, alcohol, nasal decongestants with adrenergic effects, NSAIDs, MAOIs, adrenoceptor stimulants, and combined methods of hormonal contraception (those containing ethinylestradiol) can cause hypertension while in use. Heavy alcohol use
Steroid use
Nicotine use. Malformed aorta, slow pulse, ischemia: these cause reduced blood flow to the renal arteries, with physiological responses as already outlined. Coarctation of the aorta
Atherosclerosis
Anemia: unclear cause. Fever: unclear cause. White coat hypertension, that is, elevated blood pressure in a clinical setting but not in other settings, probably due to the anxiety some people experience during a clinic visit. Perioperative hypertension is development of hypertension just before, during or after surgery. It may occur before surgery during the induction of anesthesia; intraoperatively e.g.
Neonatal hepatitis refers to many forms of liver dysfunction that affects fetuses and neonates. It is most often caused by viruses or metabolic diseases, and many cases are of an unknown cause. Signs and symptoms
The infant with neonatal hepatitis usually has jaundice that appears at one to two months of age, is not gaining weight and growing normally, and has an enlarged liver and spleen. Infants with this condition are usually jaundiced. Jaundice that is caused by neonatal hepatitis is not the same as physiologic neonatal jaundice. In contrast with physiologic neonatal jaundice, infants with neonatal hepatitis present with dark urine. Infants may also present with delayed growth. Causes
The causes of neonatal hepatitis are many. Viruses that have been identified include cytomegalovirus, rubella virus, hepatitis A and B viruses, herpes simplex viruses, coxsackievirus, echovirus, and paramyxovirus. Metabolic and immune disorders can also cause neonatal hepatitis. Giant cell transformation throughout the parenchyma is common. Diagnosis
Differential diagnosis
Conditions that can present similarly include galactosaemia, hereditary fructose intolerance, cystic fibrosis, and biliary atresia. See also
Neonatal jaundice

References


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