BIOMAT Database Logo BIOMAT Database Logo

Effects of losartan on blood pressure and humoral factors in a patient who suffered from anaphylactoid reactions when treated with ACE inhibitors during LDL apheresis. 2001

S Kojima, and M Shida, and H Takano, and S Inami, and K Yodogawa, and H Yokoyama, and M Kuramochi
Department of Clinical Research, Tohsei National Hospital, Shizuoka, Japan. skojima@jun.ncvc.go.jp

In a patient who was taking an angiotensin-converting-enzyme inhibitor, low-density lipoprotein (LDL) apheresis with dextran-sulfate cellulose provoked hypotension accompanied by lacrimation and blurred vision. Hypotension was eliminated by changing the anticoagulant from heparin to a protease inhibitor, nafamostat mesilate. A study was undertaken to clarify whether an antagonist of angiotensin type 1-receptor, losartan, could be safely used in the same patient during LDL apheresis treatment. Blood pressure and humoral factors were compared between the apheresis sessions with losartan and those without. Although angiotensin II and bradykinin plasma levels during LDL apheresis were significantly greater with losartan than without, blood pressure reduction by losartan was mild and unpleasant symptoms were not induced. Losartan was thus safely used for this patient during treatment by LDL apheresis. The greater rise in bradykinin levels during apheresis with losartan might be ascribable to angiotensin type 2-receptor stimulation.

UI MeSH Term Description Entries
D007022 Hypotension Abnormally low BLOOD PRESSURE that can result in inadequate blood flow to the brain and other vital organs. Common symptom is DIZZINESS but greater negative impacts on the body occur when there is prolonged depravation of oxygen and nutrients. Blood Pressure, Low,Hypotension, Vascular,Low Blood Pressure,Vascular Hypotension
D008078 Cholesterol, LDL Cholesterol which is contained in or bound to low density lipoproteins (LDL), including CHOLESTEROL ESTERS and free cholesterol. LDL Cholesterol,Cholesteryl Linoleate, LDL,LDL Cholesteryl Linoleate,Low Density Lipoprotein Cholesterol,beta-Lipoprotein Cholesterol,Cholesterol, beta-Lipoprotein,beta Lipoprotein Cholesterol
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009842 Oligopeptides Peptides composed of between two and twelve amino acids. Oligopeptide
D012083 Renin A highly specific (Leu-Leu) endopeptidase that generates ANGIOTENSIN I from its precursor ANGIOTENSINOGEN, leading to a cascade of reactions which elevate BLOOD PRESSURE and increase sodium retention by the kidney in the RENIN-ANGIOTENSIN SYSTEM. The enzyme was formerly listed as EC 3.4.99.19. Angiotensin-Forming Enzyme,Angiotensinogenase,Big Renin,Cryorenin,Inactive Renin,Pre-Prorenin,Preprorenin,Prorenin,Angiotensin Forming Enzyme,Pre Prorenin,Renin, Big,Renin, Inactive
D001781 Blood Component Removal Any procedure in which blood is withdrawn from a donor, a portion is separated and retained, at the same time the remainder is returned to the donor. Apheresis,Pheresis,Aphereses,Blood Component Removals,Phereses,Removal, Blood Component
D001794 Blood Pressure PRESSURE of the BLOOD on the ARTERIES and other BLOOD VESSELS. Systolic Pressure,Diastolic Pressure,Pulse Pressure,Pressure, Blood,Pressure, Diastolic,Pressure, Pulse,Pressure, Systolic,Pressures, Systolic
D001920 Bradykinin A nonapeptide messenger that is enzymatically produced from KALLIDIN in the blood where it is a potent but short-lived agent of arteriolar dilation and increased capillary permeability. Bradykinin is also released from MAST CELLS during asthma attacks, from gut walls as a gastrointestinal vasodilator, from damaged tissues as a pain signal, and may be a neurotransmitter. Arg-Pro-Pro-Gly-Phe-Ser-Pro-Phe-Arg,Bradykinin Acetate, (9-D-Arg)-Isomer,Bradykinin Diacetate,Bradykinin Hydrochloride,Bradykinin Triacetate,Bradykinin, (1-D-Arg)-Isomer,Bradykinin, (2-D-Pro)-Isomer,Bradykinin, (2-D-Pro-3-D-Pro-7-D-Pro)-Isomer,Bradykinin, (2-D-Pro-7-D-Pro)-Isomer,Bradykinin, (3-D-Pro)-Isomer,Bradykinin, (3-D-Pro-7-D-Pro)-Isomer,Bradykinin, (5-D-Phe)-Isomer,Bradykinin, (5-D-Phe-8-D-Phe)-Isomer,Bradykinin, (6-D-Ser)-Isomer,Bradykinin, (7-D-Pro)-Isomer,Bradykinin, (8-D-Phe)-Isomer,Bradykinin, (9-D-Arg)-Isomer,Arg Pro Pro Gly Phe Ser Pro Phe Arg
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

Related Publications

S Kojima, and M Shida, and H Takano, and S Inami, and K Yodogawa, and H Yokoyama, and M Kuramochi
Anaphylactoid reactions, LDL apheresis with dextran sulphate, and ACE inhibitors.
October 1992, Lancet (London, England),
S Kojima, and M Shida, and H Takano, and S Inami, and K Yodogawa, and H Yokoyama, and M Kuramochi
LDL-apheresis with dextran sulphate and anaphylactoid reactions to ACE inhibitors.
January 1993, Lancet (London, England),
S Kojima, and M Shida, and H Takano, and S Inami, and K Yodogawa, and H Yokoyama, and M Kuramochi
Prevention with icatibant of anaphylactoid reactions to ACE inhibitor during LDL apheresis.
June 1994, Lancet (London, England),
S Kojima, and M Shida, and H Takano, and S Inami, and K Yodogawa, and H Yokoyama, and M Kuramochi
Anaphylactoid reactions and bradykinin generation in patients treated with LDL-apheresis and an ACE inhibitor.
January 1993, ASAIO journal (American Society for Artificial Internal Organs : 1992),
S Kojima, and M Shida, and H Takano, and S Inami, and K Yodogawa, and H Yokoyama, and M Kuramochi
ACE inhibitors and anaphylactoid reactions during venom immunotherapy.
October 1992, Lancet (London, England),
S Kojima, and M Shida, and H Takano, and S Inami, and K Yodogawa, and H Yokoyama, and M Kuramochi
ACE inhibitors and LDL-apheresis with dextran sulphate adsorption.
December 1992, Lancet (London, England),
S Kojima, and M Shida, and H Takano, and S Inami, and K Yodogawa, and H Yokoyama, and M Kuramochi
Anaphylactoid reactions during hemodialysis on AN69 membranes in patients receiving ACE inhibitors.
November 1990, Kidney international,
S Kojima, and M Shida, and H Takano, and S Inami, and K Yodogawa, and H Yokoyama, and M Kuramochi
Hypotension during sham apheresis in a patient taking ACE inhibitors.
February 1995, JAMA,
S Kojima, and M Shida, and H Takano, and S Inami, and K Yodogawa, and H Yokoyama, and M Kuramochi
Anaphylactoid reactions during dextran apheresis may occur even in the absence of ACE-inhibitor administration.
May 1997, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association,
S Kojima, and M Shida, and H Takano, and S Inami, and K Yodogawa, and H Yokoyama, and M Kuramochi
Anaphylactoid reactions during hemodialysis on AN69 membranes: role of ACE inhibitors and back-filtration.
January 1992, Nephron,
Copied contents to your clipboard!