Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 24-year-old woman hospitalized with fever, general fatigue, and upper abdominal pain was found to have liver dysfunction and an increase in atypical lymphocytes in peripheral blood. Serum immunological studies showed positive Epstein-Barr virus (EBV) VCA IgM antibody and human herpesvirus 6 (HHV-6) IgM and IgG antibodies, and negative EBV VCA IgG and EBNA antibodies on admission. Liver function was back within normal limits 8 weeks after onset, EBV VCA IgM and IgG antibodies were positive, EBNA and HHV-6 IgM antibodies were negative, and the HHV-6 IgG antibody titer was 8 times higher than that on admission. This case was diagnosed as infectious mononucleosis due to EBV with suspected reactivation of HHV-6.
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PMID:[A case of infectious mononucleosis due to Epstein-Barr virus with suspected reactivation of human herpesvirus 6]. 1830 80

An 11-year-old boy with irreversible intestinal failure secondary to chronic intestinal pseudo-obstruction (CIPO) and intestinal failure-associated liver disease (IFALD) underwent a combined en bloc reduced liver and small bowel transplantation. He was discharged home after 9 weeks on full oral intake without requiring intravenous nutritional or fluid supplementation. The first episode of mild acute rejection, which occurred 18 months after transplantation, was successfully treated with steroids. An episode of rotavirus gastroenteritis led to severe exfoliative rejection of the bowel graft, which was resistant to steroid and Infliximab treatment but responded to OKT3. There was associated Epstein-Barr virus viremia with no evidence of posttransplant lymphoproliferative disease. Another episode of moderate to severe acute liver rejection occurred 5 months later. At the same time, multiple biliary strictures were diagnosed and treated. Persistent clinical symptoms of abdominal pain and increased stomal output as well as atrophy of the ileal mucosa on several biopsies, suggested the possibility of chronic rejection (CR). A second combined whole liver and small bowel transplant was performed. The diagnosis of CR was confirmed on histology of the explanted graft. The postoperative course was severely complicated and 71 days after the retransplantation, the boy died because of respiratory failure and multiorgan failure. In summary, intestinal transplantation can be successfully performed in children with CIPO, giving them the opportunity to be free from total parenteral nutrition. As survival following intestinal transplantation continues to improve, the problem of CR has become increasingly important and the only treatment available is retransplantation, which is associated with poor outcomes.
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PMID:Chronic rejection after combined liver and small bowel transplantation in a child with chronic intestinal pseudo-obstruction: a case report. 1858 90

Lymphoepitelioma is a particular form of undifferentiated carcinoma, characterized by a prominent lymphoid stroma, originally described in the nasopharynx. Lymphoid stroma-rich carcinomas arising in other organs have been termed lymphoepithelioma-like carcinoma (LELC). In the liver, primary LELCs are very rare, and the majority has been identified as cholangiocarcinomas. Here a rare case of lymphoepithelioma-like hepatocellular carcinoma (HCC) is described. A 47-year old woman presented with abdominal pain. Ultrasonography revealed a liver nodule, 2.2 cm in diameter, localized in the right lobe, adjacent to the gallbladder. Viral markers for hepatic B virus (HBV), hepatic C virus (HCV) and Epstein-Barr virus (EBV) were negative. The nodule was hypoechogenic. The patient underwent surgery, with resection of the nodule. Histology showed hepatocellular carcinoma, characterized by a prominent lymphoid infiltrate. At immunocytochemistry, tumor cells were reactive for Hep Par1 and glypican 3. Immunophenotyping of tumor infiltrating lymphocytes evidenced the predominance of CD8+ cytotoxic suppressor T cells. The postoperative clinical outcome was favorable and the patient was recurrence-free 15 mo after resection. This case, to the best of our knowledge, is the first reported non EBV and non cirrhosis-associated lymphoepithelioma-like hepatocellular carcinoma. The association between the lack of EBV infection, the absence of cirrhosis, a "cytotoxic profile" of the inflammatory infiltrate and a good prognosis could identify a variant of lymphoepithelioma-like HCC with a favorable clinical outcome.
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PMID:Lymphoepitelioma-like hepatocellular carcinoma: a case report and a review of the literature. 1869 86

Choledochal cyst is a relatively uncommon entity in Western countries. No reports of choledochal cyst in heart transplant patients have been reported to date. We report two cases of choledochal cyst in pediatric heart transplant recipients, one with post-transplant lymphoproliferative disorder (PTLD) within the cyst. The first patient had abdominal pain, increased liver enzymes and was seropositve for Epstein-Barr virus. A choledochal cyst with PTLD was removed 4 years after heart transplantation. The second patient presented 14 years after heart transplantation with a choledochal cyst that was excised for severe abdominal pain. This previously unreported association between choledochal cysts in conjunction with PTLD and heart transplantation is interesting and a possible common pathogenesis is proposed. The management and alternative treatments were briefly noted. We recommend an aggressive treatment for patients with suspected choledochal cyst after heart transplantation because of the increased potential for malignant transformation.
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PMID:Choledochal cyst in two pediatric heart transplant patients. 1899 56

Gastric carcinoma with osteoclast-like giant cells (OGCs) is an extremely rare tumor. So far, only six cases have been reported in the literature. Here we report an additional case of this tumor in a Chinese 78-year-old man presented with abdominal pain, vomiting, and hematemesis. Physical examination and gastroscopy revealed a tumor in the gastric antrum. The biopsy and pathological findings indicated a gastric adenocarcinoma with OGCs, which were present in both the tumor and the metastatic lymph nodes. Further immunohistochemical staining indicated that OGCs were reactive with CD68, CD45, and vimentin protein, but not with pancytokeratin, carcinoembryonic antigen, or epithelial membrane antigen, suggesting the monocytic/histiocytic derivation of these OGCs. In situ hybridization for Epstein-Barr virus showed no nuclear positivity in either adenocarcinoma or OGCs. Postoperative follow-up showed that the patient had survived for at least 6 months without recurrence. Further investigation is warranted to clearly define the prognostic significance of OGCs in gastric carcinoma.
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PMID:Gastric carcinoma with osteoclast-like giant cells: a case report and review of the literature. 1928 80

Sevoflurane, a halogenated anesthetic, is associated with mild aminotransferase elevations but does not tend to cause clinically significant hepatotoxicity. We report a rare case of severe hepatic necrosis following exposure to sevoflurane during surgery. A 37-year-old man presented with nausea,vomiting, abdominal pain, and jaundice on the third postoperative day after an abdominal wall mass resection. Laboratory tests showed markedly elevated aminotransferase levels, hyperbilirubinemia, and coagulopathy. His viral hepatitis and human immunodeficiency virus (HIV) serologies were negative for acute infection, and his Epstein-Barr virus (EBV) and cytomegalovirus (CMV) serologies were suggestive of recent EBV infection and remote CMV infection. Antinuclear antibody and anti-smooth muscle antibody screens were negative. Ceruloplasmin and serum copper values were in the normal range. The histopathological findings included an acute centrilobular cholestatic hepatocellular injury compatible with the clinical history of acute drug-induced hepatotoxicity. The patient improved with conservative management. Unlike other halogenated anesthetics, proposed mechanisms of sevoflurane hepatotoxicity include production of compound A, increased cytosolic free Ca(2+), and activation of free radical metabolizing enzymes. The patient was likely susceptible to toxicity due to an underlying EBV infection and a probable history of exposure to halogenated anesthetics. Sevoflurane is generally considered to be relatively safe for subjects with mild liver dysfunction, in comparison with other halogenated anesthetics. However, this case suggests that sevoflurane can lead to severe life-threatening hepatic necrosis in at-risk individuals.
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PMID:Sevoflurane hepatotoxicity: a case report of sevoflurane hepatic necrosis and review of the literature. 1945 19

We report two rare examples of Epstein-Barr virus (EBV)-associated inflammatory pseudotumor of the spleen. One patient presented with night sweats, abdominal pain, and weight loss and was found to have a splenic mass on CT scan suspected of lymphoma. The splenic mass in second patient was found incidentally at the time of work up for kidney stones. The pathologic examination of these splenectomy specimens showed similar histologic features. However, the spindle cells were composed of EBV-infected follicular dendritic cells in one case whereas the second case lacked significant follicular dendritic cell proliferation and showed only focal EBV-infected cells suggesting that these proliferations are heterogenous in nature.
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PMID:Epstein-Barr virus-associated inflammatory pseudotumor of the spleen: report of two cases and review of the literature. 1966 95

A 69-year-old man underwent right hemicolectomy for colon cancer in the transverse colon in 2005. Two years after surgery, he was admitted with abdominal pain. Colonoscopy revealed a submucosal tumor of approximately 4 cm in size at the ileocolonic anastomosis site. In the biopsied samples from the anastomosis site, there was diffuse proliferation of large lymphoid cells, which were immunohistochemically positive for CD3 and CD4, but negative for CD8 and CD20. Clonality analysis of T-cell receptor-beta gene rearrangement revealed a single band, indicating monoclonal proliferation of the T- lymphocytes. Epstein-Barr virus in situ hybridization did not reveal any positive signals in any of the tumor cells. Anti-human T-lymphotropic virus-I was negative. Based on these findings, the recurrent tumor was diagnosed as peripheral T-cell lymphoma-unspecified (PTCL-u).
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PMID:Peripheral T-cell lymphoma developing at ileocolonic anastomosis site after colectomy for adenocarcinoma. 1983 49

We report the case of a 17-year-old girl who presented with a several month history of fevers and abdominal pain. After cytomegalovirus (CMV) and Epstein-Barr virus (EBV) titers returned normal, FDG-PET/CT was obtained due to concern for lymphoma. FDG-PET/CT revealed a pattern of hypermetabolic activity in the adenoids, bilateral cervical lymph nodes, abdominal lymph nodes, and spleen, highly concerning for lymphoma. However, subsequent biopsy of a cervical lymph node revealed lymphadenitis consistent with EBV. This case highlights infection as the most well-known false-positive cause on FDG-PET, and how biopsy is essential to definitively distinguish malignancy from infection.
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PMID:Epstein-Barr virus mimicking lymphoma on FDG-PET/CT. 2013 24

Autoimmune hepatitis (AIH) is thought to be a primary liver disease, occurring in the absence of any known etiology. We present three unusual cases of new-onset AIH in young female patients with longstanding preexisting liver disease (Alagille's syndrome, cystic fibrosis liver disease and sickle cell hepatopathy). All patients developed an insidious onset of abdominal pain, fatigue, jaundice and hepatitis after many years of their primary diagnosis and had negative serology for hepatitis A, B, C, cytomegalovirus and Epstein-Barr virus. The occurrence of AIH in these patients may be due to a complex interaction between the underlying liver disease, chronic medication use and genetic predisposition resulting in altered immunoregulatory mechanisms.
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PMID:New-onset autoimmune hepatitis in young patients with preexisting liver disease. 2022 31


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