Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0002871 (anemia)
 52,094 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Penicillium marneffei has emerged as an important opportunistic pathogen in HIV-infected patients in Southeast Asia. We report the first 5 cases of P. marneffei diagnosed in Singapore. All the patients were HIV-infected and were either Thai nationals or had frequently travelled to Thailand. Fever, weight loss, anaemia and papular skin lesions were common clinical manifestations in our patients, all of whom had the organism isolated from blood. Skin biopsy specimens showed histological evidence of P. marneffei in 2 patients. In 1 patient each, the organism grew in cultures of specimens from bone marrow and respiratory secretions. Amphotericin B therapy followed by itraconazole were used in 3 of our 5 patients and was associated with good clinical response and outcome.
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PMID:Disseminated Penicillium marneffei infection: a report of five cases in Singapore. 1056 84

Penicillium marneffei (PM) is a fungal pathogen that has become a common cause of opportunistic infection in HIV-infected patients in Southeast Asia and Southern China. Clinical features usually present as disseminated infection, reminiscent of disseminated infection with other endemic mycoses or of disseminated mycobacterial infection. Common symptoms involve fever, anemia, and weight loss. Clinical features of children with PM in HIV infection are identical to those seen in adults. Amphotericin B has become standard therapy followed by itraconazole once clinical resolution has been achieved.
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PMID:Penicilliosis. 1136 35

Amphotericin B is generally considered to be the standard treatment against candidiasis, cryptococcal meningitis, and aspergillosis. The potential side effects of kidney toxicity and anemia, however, limit its use. Amphotericin B has therefore been incorporated into a lipid complex and clinical results thus far suggest that this ensemble may significantly reduce the risk of toxicity while maintaining or increasing drug efficacy. This modified version of amphotericin B (ABLC) is available on a compassionate use basis in the US and Europe for patients with life-threatening systemic fungal infections for whom currently marketed drugs are ineffective or too toxic. 250 patients have thus far been treated with ABLC under the compassionate use program; several hundred more have received it in controlled clinical trials; and additional large US phase 3 trials are being planned. The Liposome Company, Inc., of Princeton, New Jersey, has initiated named patient distribution of ABLC in the Republic of South Africa. 2 patients with cryptococcal meningitis have thus far received it. Cryptococcal meningitis is a type of fungal infection occurring in up to 10% of patients with AIDS; 20% of patients die within 30 days of diagnosis. The chairman and CEO of Liposome argues that getting the drug to AIDS patients in South Africa will help the company accumulate data quickly on the drug's efficacy and safety. The company is also working upon an application to get ABLC approved for use in Europe.
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PMID:Amphotericin B lipid complex available for AIDS related cryptococcal meningitis. South Africa. 1234 10

Kala-azar is an intracellular parasitic infection that infects and multiplies in the macrophages of the liver, the spleen, and the bone marrow. It is characterized by intermittent fever, hepatosplenomegaly, pancytopenia, and hypergammaglobulinemia. Although anemia is a usual finding, Coombs-positive autoimmune hemolytic anemia (AIHA) has rarely been reported with this disease. Pentavalent antimonial compounds remain the mainstay of treatment worldwide. Liposomal amphotericin B (L-AmB) is currently preferred in the treatment of kala-azar because of the resistance to pentavalent antimonals. The authors diagnosed kala-azar associated with Coombs-positive AIHA in 3 patients and treated them with L-AmB (1-5 mg/kg/day) for 30-36 days. Now, all of these patients are healthy following up at the outpatient base for 18-34 months. Kala-azar must be considered in patients with Coombs-positive AIHA and living in and coming from the endemic region for this disease, and it can be successfully treated with L-AmB.
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PMID:Kala-azar associated with coombs-positive autoimmune hemolytic anemia in the patients coming from the endemic area of this disease and successful treatment of these patients with liposomal amphotericin B. 1672 66

Amphotericin B (AmB) is widely used for treating severe systemic fungal infections. However, long-term AmB treatment is invariably associated with adverse effects such as anemia. The erythropoietin (EPO) suppression by AmB has been proposed to contribute to the development of anemia. However, the mechanism whereby EPO is suppressed remains obscure. In this study, we investigated the possibility that AmB inhibits the transcription of the EPO gene by inactivating HIF-1, which is a known key transcription factor and regulator of EPO expression. EPO mRNA levels were markedly attenuated by AmB treatment both in rat kidneys and in Hep3B cells. AmB inactivated the transcriptional activity of HIF-1alpha, but did not affect the expression or localization of HIF-1 subunits. Moreover, AmB was found to specifically repress the C-terminal transactivation domain (CAD) of HIF-1alpha, and this repression by AmB required Asn803, a target site of the factor-inhibiting HIF-1 (FIH); moreover, this repressive effect was reversed by FIH inhibitors. Furthermore, AmB stimulated CAD-FIH interaction and inhibited the p300 recruitment by CAD. We propose that this mechanism underlies the unexplained anemia associated with AmB therapy.
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PMID:Amphotericin B blunts erythropoietin response to hypoxia by reinforcing FIH-mediated repression of HIF-1. 1618 67

Visceral leishmaniasis (VL) is caused by the protozoan parasite Leishmania donovani and transmitted by the bite of infected sandfly Phlebotomus argentipes. Nearly half of the VL cases occur in children (childhood or paediatric VL). The clinical manifestations of childhood VL are more or less same as in the adults. Prolonged fever with anorexia and loss of appetite are the major presenting features. Marked enlargement of the spleen and liver (spleen larger than liver) with moderate to severe anaemia and changes in hair take place. Bacterial infection is a common coinfection and intestinal parasitic infestations are very common in children with VL. Liver function tests, blood, urine and stool may show abnormalities. Confirmation of diagnosis is made by demonstration of parasite by microscopic examination and culture of materials obtained by bone marrow aspiration or splenic puncture. Sodium antimony gluconate (stibogluconate) has been the drug of choice for over past 50 yr. Pentamidine isothionate, though effective is relatively toxic. Amphotericin B is the most effective drug for the treatment of VL. Miltefosine is the first-ever oral drug, is highly effective. Post kala-azar dermal leishmaniasis (PKDL) in children poses a therapeutic challenge. In the absence of an ideal vaccine for VL, control measures would essentially include prevention of transmission through vector control and community awareness.
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PMID:Childhood visceral leishmaniasis. 1677 16

Kala-azar is a chronic infection of reticuloendothelial system caused by flagellated protozoan, leishmania donovani injected into human host by the bite of the sand fly (phlebotomous) previously infected by biting and sucking the blood of a patient of leishmaniasis. It is characterized by irregular fever of long duration, large spleen and liver, anaemia, leucopenia and progressive emaciation. This article reports a case of a 10 year old girl from Khotang, a nonendemic zone for Kala-azar, who presented with long history of abdominal distension for 11 months, fever for 9 months, cough for a week and weight loss. Clinical examination revealed pallor, enlarged liver and huge splenomegaly. Investigations confirmed the diagnosis of kala-azar by the presence of L.D bodies in bone marrow smear. The patient is being treated with i.v Amphotericin B in Infectious Disease Hospital, Teku.
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PMID:Kala-azar (visceral Leishmaniasis) from Khotang. 1860 4

One hundred and one children with visceral leishmaniasis (VL) who admitted to Akdeniz University Hospital during a 20-year period were analyzed. Median age of the patients was 3 years (range: 5.5 months-13 years). The most common symptoms at presentation were fever, pallor and abdominal distension. Splenomegaly was found in all of the patients while hepatomegaly was present in 98%. Anemia (96%), leukopenia (74%) and thrombocytopenia (56%) were the main laboratory abnormalities. Thirty-three (33%) of the patients were pancytopenic on admission. Bone marrow smear was positive for leishmania in 91% of the patients. Seventy-four patients were treated with antimony +/- pentamidine and 27 with amphotericin B. Three of our patients died because of secondary infections and hemorrhage. Relapse was observed in two patients. No patient showed post kala-azar dermal leishmaniasis findings. We conclude that VL should be considered in patients with prolonged fever, hepatosplenomegaly and cytopenia who live in an endemic region. Amphotericin B is a therapeutic agent as effective as pentavalent antimony compounds and could be preferred.
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PMID:Visceral childhood leishmaniasis in southern Turkey: experience of twenty years. 1937 83

Amphotericin B is widely used as antifungal drug. Side effects include anemia. A variety of drugs and diseases associated with anemia has recently been shown to trigger suicidal erythrocyte death or eryptosis, i.e. cell membrane scrambling and cell shrinkage. Eryptosis may be triggered by increased cytosolic Ca2+ activity and by lack of ATP. The present study explored whether amphotericin B stimulates eryptosis. Cell membrane scrambling was estimated from annexin V-binding to phosphatidylserine exposed at the cell surface, cell shrinkage from forward scatter in FACS analysis, cytosolic Ca2+ activity from Fluo3 fluorescence and the cytosolic ATP concentration from a luciferase-based assay. Exposure to amphotericin B (0.1-1 microg/ml) within 48 hours significantly increased annexin V-binding, decreased forward scatter, increased cytosolic Ca2+ activity and decreased cytosolic ATP content. In conclusion, amphotericin B stimulates suicidal cell death of erythrocytes, which may in turn contribute to the clearance of circulating erythrocytes and thus to anemia.
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PMID:Triggering of suicidal erythrocyte death by amphotericin B. 1971 May 41

Existing standard treatment options for visceral leishmaniasis are less than optimal. We report here the use of oral miltefosine in the treatment of two paediatric cases of visceral leishmaniasis at a tertiary care hospital in Karachi, Pakistan. One patient came from Balochistan while the second patient was from Northern Pakistan. Both presented with a prolonged history of fever, massive hepatosplenomegaly, anaemia and thrombocytopenia. Visceral leishmaniasis was diagnosed with bone marrow studies. Amphotericin B was first started in the first patient; however severe hypokalaemia and allergic reaction occurred. Oral miltefosine was then administered. The child showed clinical improvement with regards to signs of leishmania infection but succumbed to a nosocomial infection during the hospital stay. In the second patient, miltefosine was started in the first instance. He showed remarkable clinical improvement. At 2 months follow-up, the child showed adequate weight gain along with successful resolution of hepatosplenomegaly and fever. Miltefosine has the potential to be considered a first line therapy for visceral leishmaniasis in developing countries; however larger studies are warranted to validate the trends observed in this small case series.
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PMID:Use of miltefosine in the treatment of visceral leishmaniasis in children at a tertiary care hospital of Karachi. 2052 51


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