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Article
July 1986

Episodic Dopamine Discharge in Paroxysmal Hypertension: Page's Syndrome Revisited

Author Affiliations

From the Clinical Research Institute of Montreal (Drs Kuchel, Buu, Larochelle, and Hamet), Hôtel-Dieu Hospital (Drs Kuchel, Larochelle, and Hamet), Royal Victoria Hospital (Dr Genest), University of Montreal, and McGill University, Montreal.

Arch Intern Med. 1986;146(7):1315-1320. doi:10.1001/archinte.1986.00360190079011
Abstract

• Dopamine concentration, a marker of the sympathetic discharge additional to norepinephrine and epinephrine levels, was determined in 31 patients. These patients, mostly women, had essential hypertension and hypertensive episodes that mimicked pheochromocytoma, except that the patients were rather plethoric (instead of pale) and often had associated nausea, epigastric discomfort, and polyuria. During and after hypertensive paroxysms, plasma free norepinephrine and epinephrine levels did not increase, but we found a mean eightfold and 16-fold increase of free and sulfated plasma dopamine levels, respectively, and similar although less marked dopamine level increases in the urine collected following the paroxysm. The hypertensive paroxysms, spontaneous or precipitated by stimulation of the autonomic nervous system, were similar to those described by Page as simulating diencephalic stimulation. Dopamine level may be a marker of the sympathetic discharge, undetected by measurements of free norepinephrine level, and may explain some clinical features of Page's syndrome.

(Arch Intern Med 1986;146:1315-1320)

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