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September 1989

Arterial Hypertension as a Paraneoplastic Phenomenon in Hepatocellular Carcinoma

Author Affiliations

From the Departments of Medicine and Pediatrics, Witwatersrand University Medical School and Baragwanath and Johannesburg Hospitals, Johannesburg, South Africa; and MRC Blood Pressure Unit, Western Infirmary, Glasgow, Scotland.

Arch Intern Med. 1989;149(9):2111-2113. doi:10.1001/archinte.1989.00390090135028

• 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.

(Arch Intern Med. 1989;149:2111-2113)

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