HDCN--Hypertension with Elevated Urinary Dopamine Levels

HDCN Ask the Professor:

Hypertension with elevated urinary dopamine levels

Question:
I have had two patients with hypertension who have normal urinary catecholamines and elevated urinary dopamine. I recall reading something about this in the literature in the recent past, but I can't locate the reference. If someone knows the source of such a paper, or if anyone has personal experience with this condition, please let me know.

Vincent R. Pateras, M.D. (Evanston, IL)

The expert consulted in this question was:
William J. Elliott, M.D., Ph.D.
Rush University Hypertension Center, Chicago, IL

It is possible that the syndrome you recall is Page's Syndrome which has been investigated most thoroughly by Otto Kuchel of the Montreal Heart Institute. Drl Kuchel believes that many female patients (especially those who are young) with episodic hypertension (and perhaps mitral valve prolapse) have a distinctive syndrome which includes elevated urinary dopamine levels (perhaps related to a defect he and his coworkers have described in the sulfation of free dopamine). Such patients have episodic hypertension, symptoms reminiscent of pheochromocytoma, and normal free catecholamines, VMAs and metanephrines, but increased urinary dopamine levels.

The most recent summary of this in the easily-accessible medical literature was:
Kuchel O, Buu NT, Larochelle P, Hamet P, Genest J: Episodic dopamine discharge in paroxysmal hypertension: Page's Syndrome revisited. Arch Intern Med., 1986;146:1315-20.

(May, 1996)