Katecholaminverhalten, Adrenorezeptorendichte an intakten Zellen und Katecholaminempfindlichkeit bei einer Patientin mit orthostatischer Hypotonie

We evaluated sympathetic nervous system function in a patient with primary orthostatic hypotension. Plasma catecholamine levels — ecept for dopamine levels — and urinary catecholamine excretion were decreased, alpha-adrenoreceptor responsiveness to noradrenaline and beta-adrenoreceptor responsiveness to isoproterenol were increased according to increased beta-2-adrenoreceptor density on intact polymorphonuclear leukocytes. Alpha-2-adrenoreceptor density on intact platelets and adrenaline-induced platelet aggregation in vitro, however, were unchanged. We evolved a therapeutic regimen with fludrocortisone, propranolol, and dihydroergotamine that allowed the patient to resume nearly a regular degree of mobility.