An NIDDM Patient with Repeated Postprandial Hypotension Successfully Treated with Amezinium Methylsulfate.

DOI 1 Citations 25 References
  • Kanda Tsutomu
    Division of Gastroenterology and Metabolism, Department of Internal Medicine, Osaka Prefectural General Hospital
  • Imano Eiichi
    Division of Gastroenterology and Metabolism, Department of Internal Medicine, Osaka Prefectural General Hospital
  • Matsushima Hiroyuki
    Division of Gastroenterology and Metabolism, Department of Internal Medicine, Osaka Prefectural General Hospital
  • Wada Masahiko
    Division of Gastroenterology and Metabolism, Department of Internal Medicine, Osaka Prefectural General Hospital
  • Hayaishi Rieko
    Division of Gastroenterology and Metabolism, Department of Internal Medicine, Osaka Prefectural General Hospital
  • Kimura Takashi
    Division of Nurology, Department of Internal Medicine, Osaka Prefectural General Hospital

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  • 反復する食事性低血圧にメチル硫酸アメジニウムが奏効したＮＩＤＤＭの１例

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We encountered an NIDDM patients with the complication of postprandial hypotension (PPH) who repeatedly experienced syncope after meals. The patient was successfully treated with amezenium methylsulfate which increased endogenous norepinephrine levels and blood pressure.<BR>The patient, a 66-year-old woman, was diagnosed with NIDDM in 1971 and treated with oral hypoglycemic agents. Thereafter, she maintained poor glycemic control. Since she repeatedly experienced post prandial syncope with palpitation which lasted up to ten minutes and occurred once or twice amonth beginning in February 1993, she was hospitalized in August 1993. We noted that she had a history of syncope after meals, and performed 24-hour ambulatory blood pressure monitoring (AMBP) and 2-hour AMBP during a 75g oral glucose tolerance test (OGTT). She was diagnosed with NIDDM complicated by PPH based on complaints of general fatigue as well as a systemic blood pressure (SBP) decrease of 25mmHg. The concentrations of plasma norepinephrine (NE) were 338pg/ml before OGTT and 268pg/ml after OGTT. When she was given 10mg of amezinium methylsulfate (AM) per os 2hours before OGTT, the decrease in SBP was only 12 mmHg. The patient had no further complaints and plasma NE concentrations increased from 290 pg/ml before OGTT to 348pg/ml after OGTT.<BR>These results indicate that PPH in this case was caused by the intake of meals including glucose. PPH improved rapidly with AM administration which increased plasma NE.

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