Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0010200 (cough)
23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Idiopathic pulmonary haemosiderosis (IPH) is a rare disease characterized by recurrent episodes of intrapulmonary bleeding, chronic iron deficiency anaemia and pulmonary fibrosis. IPH is a diagnosis made by exclusion of other causes. It occurs in both adults and children. Other conditions than IPH can cause pulmonary haemosiderosis. The etiology is unknown, but might be an immunological mechanism causing a defect in the basement membrane of the pulmonary capillary. IPH should be suspected in patients with recurrent episodes of coughing, haemoptysis, dyspnoea and anaemia. Chest X-ray shows pulmonary infiltrates during an acute attack. Examination of sputum or lung biopsy discloses large numbers of haemosiderin-laden pulmonary macrophages. The mortality-rate is high, but the prognosis is difficult to evaluate because many patients survive for a long time either with a course of recurrent attacks or with chronic symptoms, such as dyspnoea and persistent anaemia. Steroids may improve the condition of the patient during a bleeding episode.
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PMID:[Idiopathic pulmonary hemosiderosis]. 863 26

The idiopathic hypereosinophilic syndrome (HES) is an infrequent entity defined by an eosinophil count > 1.5 x 10(9)/l and the specific infiltration of different organs not attributable to another disease. Its prognosis is marked by the complications derived from visceral, particularly cardiac, infiltration determining a median survival of less than one year if treatment is not administered. Although a notable prolongation in survival may be achieved in these patients with the administration of glucocorticoids and cytolytic drugs, mainly hydroxiurea, there remains a group of patients who do not respond to these therapeutic measures, thus leading to alpha interferon trials with promising results. A favourable experience with the use of alpha interferon in two patients with IHS resistant to conventional treatment is reported. The first patient presented a picture characterized by diarrhoea, palpitations and effort dyspnea demonstrating heart involvement suggestive of eosinophilic infiltration on echocardiographic study. The second patient presented dyspneic night cough and generalized pruritus in addition to anemia and thrombocytopenia. The administration of alpha interferon (3 x 10(6) U/3 days a week and 3 x 10(6) U/day, respectively) was followed in both cases by the rapid disappearance of the symptomatology, normalization of the hematologic parameters and a reduction of the eosinophilia to values of less than 1 x 10(9)/l. This response has maintained over the two years of control in which the patients have received alpha interferon as a maintenance treatment.
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PMID:[Alpha interferon treatment in idiopathic hypereosinophilic syndrome resistant to conventional therapy]. 866 89

A case of rheumateid arthritis (RA) with pernicious anemia (PA) and wandering multiple patchy densities in bilateral lung fields is reported. A 72-year-old woman was hospitalized in February 1994, because of cough. She had already advanced RA (Class IV, Stage IV). She showed macrocytic and hyperchromic anemia as follows ; red-cell count (RBC), 176 x 10(4)/microliters; hemoglobin (Hb),7.2 g/dl; hematocrit (Ht), 21.0% ; MCV, 119.3 fl; and MCH, 40.9 pg. Chest roentgenogram revealed multiple patchy densities in bilateral lung fields and there was no response to the administration of antibiotic agents. From these clinical pictures bronchiolitis obliterans organizing pneumonia (BOOP) was highly suspected. After steroid injection into the joint space, the abnormal lung shadows disappeared. Anemia had been recovering spontaneously, but recurred in July. The results of blood examination were as follows ; RBC, 162 x 10(4)/microliters; Hb, 6.7ng/dl; Ht, 19.1%; MCV, 117.9 fl; and MCH, 41.4 pg. Anti-intrinsic factor antibody was positive. The level of serum vitamin B12 was low, 76 pg/ml. Sternal bone marrow aspiration showed magaloblastic changes with hypersegmentation of granulocytes. PA was diagnosed and improvement was noted after the intramuscular administration of vitamin B12. Subjective symptoms based on RA did not change during the clinical course. It is suggested that the pathogenesis about the combination of RA, BOOP and PA is related to common immunological abnormalities in our patient. A case of RA with PA and BOOP has not been reported previously, thus this case is considered clinically valuable.
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PMID:[A case of rheumatoid arthritis associated with pernicious anemia and bronchiolitis obliterans organizing pneumonia]. 872 Feb 71

In the period of 1989-1995 seven patients with amebic liver abscess were observed in Clinic of Infectious Diseases of Pomeranian Medical School in Szczecin. The diagnosis has been made on the base of epidemiological data, presence of intrahepatic defect by a scanning procedure of liver (ultrasonography, CT, scintigraphy) and positive serologic test for amebiasis. All patients were male of Polish nationality, 29-57 years old, who became ill after travel to Africa or India. Intestinal amebiasis was present only in two cases. Five patients had acute onset of disease and two chronic. The most common complaints included fever, abdominal pain, anorexia. A cough, chest pain, diarrhea or weight lose were less common. At physical examination paleness of skin, subjaundice, abdominal tenderness, hepatomegaly and sometimes pleural effusion have been observed. Laboratory tests revealed high RBS, leucocytosis and mild anemia. Slightly higher serum level of bilirubin, alkaline phosphatase were transient. Trophozoits of Entamoeba histolytica have been found in stool specimens of one only patient. Amebic antibodies tested with indirect hemagglutination (IHA) were present in all cases. Visual technics have shown abscess of 3 to 9 cm in diameter located at right liver lobe. Six patients have been treated with both chemotherapy (metronidazole or/and dehydroemetine) and "skin needle" aspiration. In two cases recrudescence of abscess has been observed after one and three years respectively. These two patients have been undergone second course of treatment with using not only needle aspiration and metronidazole/dehydroemetine but luminal agents as well.
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PMID:[Amebic liver abscess--personal observations]. 892 39

A 2-year prospective audit on the profile and outcome of malaria cases admitted to a general hospital was performed. Fifty-six cases were seen from January 1991 to December 1992, 52 of which were due to monoinfections with Plasmodium vivax. The main presenting complaints were fever, chills, sweats, myalgia, dry cough and headache. A significant percentage had anaemia (64.3%), thrombocytopaenia (57.1%), hyponatraemia (42.9%), and liver dysfunction (44.7%). Diagnosis rests on the demonstration of parasites in stained peripheral blood smears. None of the patients developed major complications. A high index of suspicion of malaria must be maintained in the medical evaluation of all patients and in particular, of returning travellers.
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PMID:Malaria: an audit of 56 cases admitted to a hospital. 894 52

A 67-year-old male was hospitalized because of nonspecific symptoms and bilateral pleural effusions. He gave no history of cough, dyspnea or thoracic pain. The blood counts showed moderate anemia and high-grade lymphopenia. The tuberculin test and the anergy-panel were both negative. Testing for HIV was negative. Analysis of pleural fluid showed an exudate with 47% lymphocytes and absence of acid-fast bacilli on Ziehl-Neelsen smear. On histologic examination, the pleural tissue showed no evidence of granuloma. However, cultures for mycobacteria of pleural tissue yielded M. tuberculosis. In this case of pleural tuberculosis, leading symptoms were absent and the tuberculin test was negative in the presence of active tuberculosis. In addition, the cells in the pleural effusion were not predominantly lymphocytic. Patients presenting with unclear effusion should undergo extensive investigations, including a tuberculin test, and anergy panel, pleural fluid cultures, and pleural biopsy with cultures for microorganisms, with the object of establishing or ruling out pleural tuberculosis.
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PMID:[An unusual presentation of tuberculosis]. 901 35

A cohort of 12,501 adults aged 15-54 years was randomly selected from 12 rural communities in Mwanza region, Tanzania, in 1991-92 and followed for 2 years to assess the contribution of HIV/AIDS to mortality in the region. HIV seroprevalence in the sample was 4% at baseline. 73 of the 196 deaths recorded over the period occurred among HIV-positive individuals. Mortality rates per 1000 person-years were 6.0 among the HIV-seronegative and 93.5 among the HIV-seropositive. The age-adjusted mortality rate ratio was 15.68 overall. 35% of overall mortality was attributed to HIV infection, 53% among those age 20-29 years. Verbal autopsies administered for each death reported showed that HIV-positive deaths were significantly associated with fever, rash, weight loss, anemia, cough, chest pain, abdominal pain, and headache. The specificity of individual symptoms, however, was low. The World Health Organization clinical case definition of AIDS was satisfied for only 13 deaths, of which seven were HIV-positive at baseline. HIV/AIDS was mentioned during the verbal autopsy interview by only seven respondents as being associated with a given death.
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PMID:HIV-associated adult mortality in a rural Tanzanian population. 914 13

A 55-year-old man with myelofibrosis was treated with natural alpha-interferon with a good hematologic response. Initially, he had anemia, leukocytosis, thrombocytosis and hepatospleomegaly. A bone marrow biopsy showed replacement with fibrosis with an increase in megakaryocytes. Natural alpha-interferon (alpha-IFN) was started at a dose of 3 x 10(6) units/day. The leukocyte and platelet counts gradually normalized, and the liver and spleen decreased in size. However, the patient complained of a dry cough and dyspnea on the 61st treatment day, when the accumulated dose of alpha-IFN treatment had reached 1.8 x 10(8) units. He subsequently developed acute respiratory failure (PaO2 < 60 mm Hg) with bilateral lung infiltrations, suggesting the occurrence of interstitial pneumonitis associated with alpha-interferon therapy. Immediately, the alpha-interferon was discontinued and high-dose methylprednisolone (1.5 g/day) was administered for 3 days. This treatment was followed by oral prednisone therapy. Steroid therapy brought about gradual improvement as suggested by a repeat radiograph. Since high levels of fibrogenic cytokines, such as PDGF and TGF-beta, have been reported in patients with myelofibrosis, it is necessary to pay attention to interstitial pneumonia as a complication in alpha-IFN therapy for myelofibrosis.
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PMID:A case of interstitial pneumonitis associated with natural alpha-interferon therapy for myelofibrosis. 915 65

Here we report an autopsy case with anti-neutrophil antibodies (ANCA) associated vasculitis accompanied by autoimmune hepatitis and hepatocellular carcinoma. A 69-year-old woman was admitted to Tokyo Metropolitan Ohtsuka Hospital in October 1995 because of leg edema. She had presented cough in 1990 and diagnosed as interstitial pneumonia, esophageal varices and liver chirosis. On admission, laboratory data showed mild anemia, hypoproteinemia, and marked gammagloblinemia. IgM-HA antibody, HBs antigen, HBs antibody, HCV antibody and HDV antibody were negative. Anti-nuclear antibody, anticentromere antibody, anti-neutrophil cytoplasmic antibody against myeloperoxidase and cathepsin G (MPO-ANCA and cathepsin G), rheumatoid factor and direct coombs test were positive. Serum level of AFP and CEA were elevated. Ultrasonography and computed tomography of abdomen scowed liver chirosis and tumor in left lobe of liver. The diagnosis of liver chirosis based on autoimmune hepatitis and Interstitial pneumonia was made with clinical course, laboratory findings and radiographic findings although liver biopsy was not performed. She complained of bloody stool due to ulcer of the large intestine, and died of liver failure which progressed rapidly. The autopsy findings detected that pulmonary fibrosis, liver fibrosis with multiple hepatocellular carcinoma, necrotizing crescentic glomerulonephritis, and vasculitis of small artery inn colon. This was the first report of MPO-ANCA associated vasuculitis complicated with autoimmune hepatitis and hepatocellular carcinoma. Clinical significance of ANCA and immunogenetic background of these diseases were discussed.
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PMID:[An autopsy case of anti-neutrophil cytoplasmic antibodies associated vasculitis accompanied by autoimmune hepatitis and hepatocellular carcinoma]. 917 69

This study involved 25 elderly (> 65 years old) patients (pts) with unresectable non small cell lung cancer (NSCLC) who were not eligible for polychemotherapy. The diagnosis of NSCLC was histologically or cytologically documented, and all of them had measurable or evaluable disease. The median age of the patients was 71 (range 65-77); 9 had been pretreated. The pts received 25 mg/m2 of vinorelbine weekly or bi-weekly depending on the results of blood tests. The treatment continued until disease progression or tolerance. No complete response was achieved: 3 pts (12%) had a partial response (RP) (8-12-14 months), 13 (52%) stable disease (SD) with an improvement in symptoms, such as cough and/or pain, and 9 pts (36%) progressed. Compliance with the therapy was acceptable. The main toxicity was hematological: neutropenia was observed in 16 pts, with only 1 case of grade 4 neutropenia without sepsis; grade 1-2 anemia occurred in 8 patients. The other toxicities included grade 1-2 neurotoxicity in 8 pts, chemical phlebitis in 2 pts and grade 3 cardiotoxicity reversible with medical treatment in 1 patient. The median survival time was 10 months (lower quartile 5 months, upper quartile 23 months) (Kaplan and Meyer method). Vinorelbine can be considered a rational choice in elderly pts with advanced NSCLC who are not suitable for aggressive polychemotherapy, with the aim of improving their quality of life in terms of symptoms and outpatient treatment.
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PMID:Vinorelbine chemotherapy in non small cell lung cancer: experience in elderly patients. 926 13


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