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)

Twelve patients with liver disease related to methyldopa were seen between 1967 and 1977. Illness occurred within 1--9 weeks of commencement of therapy in 9 patients, the remaining 3 patients having received the drug for 13 months, 15 months and 7 years before experiencing symptoms. Jaundice with tender hepatomegaly, usually preceded by symptoms of malaise, anorexia, nausea and vomiting, and associated with upper abdominal pain, was an invariable finding in all patients. Biochemical liver function tests indicated hepatocellular necrosis and correlated with histopathological evidence of hepatic injury, the spectrum of which ranged from fatty change and focal hepatocellular necrosis to massive hepatic necrosis. Most patients showed moderate to severe acute hepatitis or chronic active hepatitis with associated cholestasis. The drug was withdrawn on presentation to hospital in 11 patients, with rapid clinical improvement in 9. One patient died, having presented in hepatic failure, and another, who had been taking methyldopa for 7 years, showed slower clinical and biochemical resolution over a period of several months. The remaining patient in the series developed fulminant hepatitis when the drug was accidentally recommenced 1 year after a prior episode of methyldopa-induced hepatitis. In this latter patient, and in 2 others, the causal relationship between methyldopa and hepatic dysfunction was proved with the recurrence of hepatitis within 2 weeks of re-exposure to the drug.
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PMID:Patterns of hepatic injury induced by methyldopa. 42 37

Four cases of malignant histiocytosis of the intestine (MHI) are described in detail, with emphasis on the clinical features and laboratory findings that may lead to a diagnosis. MHI is a rapidly progressive, usually fatal condition, which may occur in a setting of adult celiac disease or apparently spontaneously; all patients, however, have villous atrophy and crypt hyperplasia of the jejunum. Characteristic symptoms are malaise, weight loss, abdominal pain, and diarrhea followed, after a period of weeks or months, by acute small intestinal obstruction, perforation, or bleeding. Because of the high mortality associated with MHI, suggestive symptomatology and investigations should, in the absence of a definitive diagnosis, lead to an urgent laparotomy with a view to chemotherapy if the diagnosis is made.
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PMID:Malignant histiocytosis of the intestine. 46 14

Naturally acquired Brucella canis infection is believed to be uncommon, but is not readily diagnosed. A 55-year-old woman developed fever, abdominal pain, malaise, weakness, and anorexia eight weeks after her dog delivered stillborn pups. Blood cultures yielded B canis. Specific B canis agglutinins were negative initially and remained negative during convalescence. Therapy with tetracycline and streptomycin was successful but was associated with a probable Jarisch-Herxheimer reaction.
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PMID:Case report. Brucella canis bacteremia: a case with negative B canis agglutinins. 72 14

Men under 20 and over 50 years of age used a free walk-in clinic of the Navy more than women of the same age. Women 20-50 years old used it more than men in this age group. This appears to be a result of the distribution of Navy health care facilities in the study area. Teenagers used the clinic as much as patients over 50. Sore throat, skin rash, abdominal pain, earache, and backache were the five most common complaints (302 per 1,000 patients.) These complaints and 19 other problems were responsible for 822 patient visits per 1,000 in a study of 2,272 consecutive new patient visits. Eighteen percent of all visits were return visits for a specific complaint. An analysis of complaints by body system showed that 21.9 percent were otolaryngological, 18.8 percent musculoskeletal, 12.5 per cent gastrointestinal, 9.7 percent dermatological, 8.7 percent cardiopulmonary, 7.8 percent genitourinary, 9.0 percent general (fatigue, nervousness, malaise, or weakness), and 11.6 percent other system (neurological, hematological, and miscellaneous). These data indicate that a physician's time might be used more efficiently in a walk-in setting and that training for such a clinic must be different from traditional training for such fields as internal medicine.
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PMID:Chief complaints in a free walk-in clinic: a study of 3,009 consecutive patient visits. 84 87

A urinoma is a mass formed by encapsulated extravasated urine. It may follow closed renal injury, surgical operation or arise spontaneously in the presence of obstruction. The essential factors are continued renal function, rupture of the collecting system and distal obstruction. The extravasating urine is localised within the perirenal fascia and stimulates an intense fibrous reaction which forms a thick wall. Early diagnosis is important for successful treatment. The clinical features include malaise, vague abdominal pain, weight loss and a palpable mass. Plain films usually reveal a mass with loss of the retroperitoneal landmarks. High-dose excretion urography usually shows renal displacement, hydronephrosis and extravasation of contrast medium into the urinoma. Should renal function be inadequate for diagnosis, renal puncture, preceded by ultrasound examination, is the investigation of choice.
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PMID:Urinoma. 86 27

The clinical findings in 56 patients with hepatic amebiasis are reviewed. This illness was most frequent in male black patients, 20-39 years old. The clinical picture is dominated by upper right quadrant abdominal pain, general malaise, pain on percussion of the right hypochondrium and tender hepatomegaly. Jaundice is not rare and appears to have no prognostic significance. The importance of early diagnosis is emphasized.
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PMID:Hepatic amebiasis, analysis of 56 cases. I. Clinical findings. 92 Jul 12

On three occasions, a 63 year old housewife with hyperthyroidism developed a reaction which included fever, pruritus, malaise, and, on one occasion, jaundice one to 17 days after taking carbimazole. Challenge with carbimazole was followed within 12 hours by abdominal pain, pruritus, and increased serum transaminase levels. Light microscopy of a liver biopsy showed increase of portal zone cellularity over the control and the electron microscopy revealed fine structural changes compatible with drug-related liver injury.
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PMID:Jaundice due to carbimazole. 119 20

A 15-year old Black teenager came to a clinic at the University of Alabama's School of Medicine in Tuscaloosa requesting oral contraceptives (OCs). The physical examination indicated that she was in good health and the physician prescribed an OC (1 mg norethindrone and .035 mg ethinyl estradiol). 21 months later she returned complaining of yellow eyes for 3 weeks. The oral mucosa was also jaundiced. She had considerably high levels of bilirubin and alkaline phosphatase. She had no hepatitis virus antibodies. 5 months later she returned for the physical examination required to renew the OC prescription. She did not have jaundice at this time. 10 months later she complained of malaise and muscular pain. Her alkaline phosphatase level was high, but her bilirubin level was normal. She had mild hepatosplenomegaly without focal defects. After reviewing her medical records, the physician diagnosed intrahepatic cholestasis and discontinued her OC prescription. Liver function tests were normal within 3 months. 14 months later, she returned complaining of malaise and reported taking OCs obtained at another clinic 3 months earlier. The physician advised her about the complications of OCs and about other contraceptive methods. The same physician also examined a 32-year-old Black woman who had intermittent epigastric and right-upper quadrant abdominal pain for 2 weeks. Eating worsened the pain, which lasted for up to 15 minutes. She had used an OC for 12 years. Ultrasound revealed a 4.2 cm hypoechoic mass in the left upper lobe of the liver. The physician discontinued the OCs. The tumor regressed over 12 months. Active liver disease is a contraindication to OC use. Women who had cholestatic jaundice while pregnant or have first degree relatives with cholestatic jaundice of pregnancy should not use OCs. Physicians may introduce OCs to closely monitored women with a history of liver disease whose liver function tests are normal. Women with a family history of biliary excretion defects should not use OCs.
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PMID:Hepatobiliary complications of oral contraceptives. 133 97

Between May 29 and September 13, 1991, 4 patients developed acute intravascular hemolysis during hemodialysis with Monitral-S delivery systems and Hospal BSM A77 blood lines. All had malaise, nausea and headache; 3 had severe abdominal pain and 2 became very ill. Plasma hemoglobins were 3-21 g/l and LDH 542-3,300 IU in the 4 patients. Hepatoglobin became unmeasurable in 3 and was 0.09 g/l in the 4th patient. Soon afterwards, we found the arterial blood line tightly kinked at the dialyzer inlet port in the 4th patient and released it; he developed abdominal pain, hemolysis was present. We then found these lines had an extra long pump segment, and the rest was short and fitted poorly. When put in the first tubing organizer, severe kinking could occur just after the pump segment, causing back pressure but no alarm. We produced early visible hemolysis in a 1-liter circulating closed loop blood system with the blood line kinked either at the dialyzer inlet or just below the first arterial line tubing organizer with 40 g/l free plasma hemoglobin by 30 min. We excluded reported causes of intravascular hemolysis during hemodialysis. No hemolysis occurred before or during the 9 months after we discarded BSM A77 lines. The evidence indicates that kinked blood lines caused the hemolysis.
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PMID:Hemodialysis intravascular hemolysis and kinked blood lines. 143 36

Cytomegalovirus (CMV) pancreatitis was diagnosed in eight out of 124 pancreatic transplant recipients. Five of the eight patients developed intrapancreatic abscesses and four of the grafts were lost, but one is still functioning. In the three additional cases of pancreatitis, antiviral treatment with foscarnet or ganciclovir was given as soon as signs of CMV pancreatitis were detected. No such grafts were lost during the acute phase. CMV infection was diagnosed in cells from pancreatic juice, by virus isolation, detection of CMV antigen in cells from pancreatic juice or by CMV serology. The signs and symptoms of CMV pancreatitis included fever, general malaise, abdominal pain, diarrhoea, localized peritonitis, hyperamylasaemia, leukopenia and hyperglycaemia. It is recommended that rapid diagnostic procedures for CMV should be carried out when early signs of pancreatitis develop in pancreatic graft recipients. Antiviral treatment should be given when CMV pancreatitis is suspected or diagnosed in order to prevent the development of intrapancreatic abscesses and graft loss.
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PMID:Development of intrapancreatic abscess--a consequence of CMV pancreatitis? 165 18


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