Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011168 (dysphagia)
 15,644 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Since its identification in 1989, hepatitis C has been implicated in the pathogenesis of an increasing number of diseases previously believed to be primary or idiopathic. We report 2 rarely seen cases of isolated central nervous system (CNS) vasculitis in patients with hepatitis C infection. Patient 1. A 43-year-old man with 4 day right temporal headache developed a left hemiparesis. Weakness was his only physical finding. Computed tomography (CT) scan demonstrated a large right frontotemporal hemorrhage, and angiography revealed focal dilatations and irregularities of multiple branches of the right middle and anterior cerebral arteries. Cerebral decompression was performed and leptomeningeal biopsies showed granulomatous angiitis. Laboratory results were normal except for elevated liver biochemical tests. Later testing for hepatitis C was positive. His neurological symptoms improved with corticosteroids and cyclophosphamide. Patient 2. A 39 yr old male developed 3 days of left sided weakness, slurred speech and difficulty swallowing fluids. Physical findings were limited to his weakness. Magnetic resonance imaging demonstrated a right superior pontine subacute infarct with a small left internal capsule lacunar infarct. Angiography revealed multiple areas of focal narrowing with no areas of abrupt vessel cut off. Cerebral spinal fluid showed 71 PMN, 29 RBC, normal glucose, elevated protein (64 mg/dl), no oligoclonal bands, and low myelin basic protein. Other laboratory analyses were normal including liver biochemical tests. However, hepatitis C serology was positive and mixed cryoglobulins were detected. CNS vasculitis was diagnosed and nearly full recovery was achieved with corticosteroids, cyclophosphamide and warfarin.
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PMID:Isolated central nervous system vasculitis associated with hepatitis C infection. 1052 55

We reported two cases of silicosis exhibiting MPO-ANCA associated disorder. Case 1 was a 69 year-old man with silicosis and chronic interstitial pneumonia. He was admitted because of fever, dry cough, left chest pain, dyspnea and body weight loss. He was diagnosed as acute exacerbation of interstitial pneumonia, pericarditis and gastrointestinal bleeding. Case 2 was a 67 year-old man with silicosis. He repeated attack of fever, hoarseness, dysphagia and headache. The cell counts of cerebrospinal fluid increased and the thickness of cerebellar tent and left dura mater was observed in the brain MRI. Therefore, he was diagnosed as pachymeningitis and neuropathy of cranial nerves. Both cases were complicated by silicosis and the laboratory findings showed high serum levels of P-ANCA, ANA and rheumatoid factor and inflammatory responses, indicating they were suspected vasculitis. The two cases were treated by steroid and immunosuppressive therapy and had good clinical response. Silicosis may affect multiple organ involvement associated with P-ANCA.
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PMID:[Two cases of silicosis exhibiting MPO-ANCA associated disorder]. 1069 8

A multivariate analysis of the data was conducted to evaluate the effects of age, gender, and performance status on symptom profile. A comprehensive prospective analysis of symptoms was conducted in 1,000 patients on initial referral to the Palliative Medicine Program of the Cleveland Clinic. The median number of symptoms per patient was 11 (range 1-27). The ten most prevalent symptoms were pain, easy fatigue, weakness, anorexia, lack of energy, dry mouth, constipation, early satiety, dyspnea, and greater than 10% weight loss. The prevalence of these 10 symptoms ranged from 50% to 84%. Younger age was associated with 11 symptoms: blackout, vomiting, pain, nausea, headache, sedation, bloating, sleep problems, anxiety, depression, and constipation. Gender was associated with 8 symptoms. Males had more dysphagia, hoarseness, >10% weight loss and sleep problems; females, more early satiety, nausea, vomiting, and anxiety. Performance status was associated with 14 symptoms. Advanced cancer patients are polysymptomatic. Ten symptoms are highly prevalent. Symptom prevalence for 24 individual symptoms differs with age, or gender, or performance status.
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PMID:The symptoms of advanced cancer: relationship to age, gender, and performance status in 1,000 patients. 1078 56

Esophageal cancer in advanced stages grows to occlude the esophageal lumen; presenting symptoms include dysphagia and weight loss. Esophageal cancer rarely grows to occupy a narrow column of the esophagus or manifests neurologic symptoms. We report the case of a 58-year-old man with a history of tobacco and alcohol abuse and chronic obstructive airway disease who presented with headaches, left-sided weakness, unsteady gait, and weight loss. Physical examination showed left-sided weakness. Computed tomographic scan of the brain and chest revealed, respectively, a right frontoparietal mass and a tumor mass in the distal esophagus. The patient's weakness and headaches improved after treatment with dexamethasone and craniotomy with partial enucleation of the brain lesion. An esophagogastroduodenoscopy revealed a large, elongated mass in the esophagus. Pathologic analyses of biopsies of the esophageal mass showed mixed adenosquamous carcinoma. The brain mass histology showed poorly differentiated carcinoma. Several weeks after craniotomy, the patient developed respiratory failure and died. While it appears that the esophageal cancer metastasized to the brain, there is the possibility of other undetected primary tumor with metastasis to the brain. Nonetheless, the endoscopic appearance and clinical presentation of this case are unusual and noteworthy.
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PMID:Esophageal cancer: an unusual endoscopic appearance and presentation. 1082 16

A case of Collet-Sicard Syndrome caused by skull base metastasis of prostate carcinoma is reported. A fifty-five years old man presenting multiple lymph node and bone metastases of prostate carcinoma was treated with LH-RH agonist and Flutamide, which induced transient decrease in serum PSA levels and size of lymph node metastases. After 8 months of the treatment, the patient started complaining headache, dysphagia and dysarthria. Brain CT and MRI demonstrated a soft tissue mass replacing left pyramidal bone and occipital bone around left jugular foramen. The tumor was diagnosed as skull base metastasis of the prostate carcinoma and was treated with 50Gy of radiation. The symptom improved after the radiation but died of the disease in 4 months. The autopsy revealed the skull base metastasis of the prostate carcinoma and the tumor was proved to be poorly differentiated adenocarcinoma, which was positively stained by anti-PSA antibody. The case showed cranial nerve palsy of IX to XII, which is usually called Collet-Sicard syndrome. This is the third case report of Collet-Sicard syndrome caused by the skull base metastasis of prostate carcinoma, and it is the first case in Japan.
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PMID:[A case of Collet-Sicard syndrome caused by skull base metastasis of prostate carcinoma]. 1089 82

We report on a 48-year-old man with idiopathic hypertrophic cranial pachymeningitis (IHCP) manifesting headache, facial pain, and tongue pain with unilateral atrophy, dysarthria, and dysphagia. Although steroid therapy ameliorated these symptoms, they recurred after he developed steroid-induced diabetes mellitus. We treated the patient by lymphocytapheresis (LCP), which resulted in an improvement of his symptoms, a reduction in the CD4 lymphocyte population, a reduction of the CD4/CD8 ratio, and a reduced thickening of the dura mater that lasted for more than 14 months. Results presented here suggest that LCP can be effective in the treatment of IHCP.
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PMID:Long-term improvement of idiopathic hypertrophic cranial pachymeningitis by lymphocytapheresis. 1097 80

Eagle syndrome is an aggregate of symptoms caused by an elongated ossified styloid process, the cause of which remains unclear. This is a rare finding that often goes undetected in the absence of radiographic studies. In this case, we present the diagnostic CT and lateral view plain film radiography findings of a 39-year-old woman with clinical evidence of Eagle syndrome. Eagle syndrome can occur unilaterally or bilaterally and most frequently results in symptoms of dysphagia, headache, pain on rotation of the neck, pain on extension of the tongue, change in voice, and a sensation of hypersalivation (1, 2). We present rare and diagnostic radiographic evidence of this on both plain film radiographs and CT scans. Although well documented in otolaryngology literature and dentistry literature, this syndrome has not been reported in the radiology literature.
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PMID:CT findings associated with Eagle syndrome. 1149 37

We report a case of a 14-year-old girl who presented, following a sudden onset, with bilateral ptosis, gait disturbance, difficulty swallowing and loss of appetite, right hypochondriacal pain, and frontal headache. Protracted neurological and medical examinations were unremarkable; neither was precipitating psychological stresses evident. The condition, which manifest as typical conversion disorder, lasted for one year. "Treatment" involving electrical stimulation of both eyes muscles and legs with positive reassurance resolved the symptom. This case supports the view that conversion disorder, not only involves a strong element of suggestion, but also incorporates socio-cultural sanctioned prescription.
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PMID:A case of bilateral ptosis with unsteady gait: suggestibility and culture in conversion disorder. 1176 Aug 65

A 58-year-old woman developed headaches and increasingly severe dysphagia over two years, which made her dependent on a nasogastric tube. Other symptoms were an unsteady gait and paraesthesias in the face, hands and feet. MR scanning of the craniospinal junction showed cerebellar ectopia with protrusion into the foramen magnum (Chiari I malformation). The patient recovered completely following surgical decompression. Previous reports show that this reversible cause of dysphagia is often not recognised until at a late stage.
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PMID:[Severe reversible dysphagia caused by herniation of the cerebellar ectopia]. 1199 56

Ganglioneuromas are rare benign neurogenous neoplasms. The clinical symptoms of ganglioneuromas of the neck are usually mild and non-specific and definitive diagnosis requires a histological examination. We present the case of a 35-year-old female who complained of retroauricular pain as her first symptom and who was initially diagnosed with migraine. ENT examination revealed a bulging of the left pharyngeal wall. Fine-needle aspiration biopsy was misleading in terms of diagnosis. Histology after extirpation showed a ganglioneuroma. Ganglion cell differentiation was proven using the new intermediate filament class alpha-internexin immunohistochemical staining technique. Headache is an uncharacteristic symptom of ganglioneuroma and an interdisciplinary approach is required to find a possible cause. Periauricular pain without abnormal otoscopic findings should lead the otorhinolaryngologist to consider a retropharyngeal condition, especially if combined with dysphagia. Complete resection of the tumor using modern microsurgical techniques is the best way to extract ganglioneuroma today.
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PMID:Headache as an unusual presenting symptom of retropharyngeal ganglioneuroma. 1220 71


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