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)

Thrombotic microangiopathy (TMA) is a recognized complication of malignant hypertension (HTN). Such patients have blood pressures > or = 200/140 mmHg but the condition is defined by the presence of papilledema and is frequently complicated by acute renal failure. Here we report two patients with severe HTN (systolic > or = 180 mmHg or diastolic > or = 120 mmHg), TMA, thrombocytopenia, renal failure, and, in one case, neurological changes (4 of 5 manifestations of the TTP pentad). A 50-year-old male with HTN presented with blurred vision, dizziness, headache, confusion, renal failure, and a TMA (PLT = 39 x 10(9)/L and LD = 2,781 normal <600 U/L). On presentation, BP was 214/133 mmHg and an ophthalmic exam demonstrated no papilledema. With HTN control over 7 days, his platelet count rebounded (220 x 10(9)/L), LD declined (1,730 U/L), and mental status improved. A 60-year-old female with diabetes, HTN, Lupus erythematosus, mild chronic anemia, and thrombocytopenia presented with abdominal pain, shortness of breath, renal failure, and a TMA (PLT = 83 x 10(9)/L and LD = 2,929 U/L). Blood pressures were 180-210/89-111 mmHg and ophthalmic exam demonstrated no papilledema. With HTN control over 8 days, her platelet count rebounded (147 x 10(9)/L), and LD declined (1,624 U/L). Although in both cases a diagnosis of TTP was considered because of overlap with the classic diagnostic pentad, neither received plasmapheresis. TTP is a diagnosis of exclusion, where there is no other likely diagnosis to explain the TMA. In cases of severe HTN (with or without papilledema), the diagnosis of TTP should be held in abeyance until the effect of HTN control can be assessed.
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PMID:Differentiating thrombotic microangiopathies induced by severe hypertension from anemia and thrombocytopenia seen in thrombotic thrombocytopenia purpura. 1549 50

Dedifferentiated leiomyosarcoma of the primary mesentery is extremely rare. We report a case of dedifferentiated leiomyosarcoma (LMS) of the primary mesentery mimicking ovarian cancer. A 62-year-old woman presented with progressive low abdominal pain. Pelvic magnetic resonance imaging (MRI) revealed a large adnexal mass with carcinomatosis peritonei. Laboratory examination revealed an elevated serum level WBC 46,520/uL (Ref. 4,000~11,000/uL), PLT 687,000/uL (Ref. 140,000~400,000/uL), CA-125 69.1 U/mL (Ref. 0~35 U/mL), and beta-hCG 43.1 mIU/mL (Ref. 0~5 mIU/mL) level. The patient underwent exploratory laparotomy under suspicion of ovarian cancer. We observed a 20-25 cm-sized huge pedunculated subserosal mass arising from the mesentery, and other masses with sizes of 15-20 cm were adherent to peritoneum and ileocecal region. There was a multiple seeding metastasis in the omentum and bowel mesentery. A frozen section revealed malignancy originating from the mesentery, and thus, total abdominal hysterectomy, bilateral salpingo-oophorectomy, omentectomy, pelvic and para-aortic lymph node dissection, and mass excision were performed. Subsequent histopathologic examination resulted in a final diagnosis of dedifferentiated leiomyosarcoma of the mesentery. The patient was transferred to a department of hemato-oncologist for additional managements. Doxorubicin was used for adjuvant chemotherapy.
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PMID:An unusual case of dedifferentiated leiomyosarcoma of the primary mesentery mimicking ovarian cancer. 3193 13