Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0012833 (dizziness)
 9,689 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Autoimmune hemolytic anemia often develops in patients with chronic lymphocytic leukemia, particularly elderly women. It is heralded by a drop in the hematocrit, elevation of reticulocytes, development of jaundice, or a rise in the indirect fraction of serum bilirubin. Evidence of hemolysis supports the diagnosis, and a positive result of the Coombs test confirms it. Survival time is considerably shorter in patients who have both diseases than in those with chronic lymphocytic leukemia alone. Presenting symptoms in patients with the two diseases may include weakness, dizziness, fever, or hemorrhagic phenomena. If the anemia is severe, palpitations, otic pulsations, and cardiac decompensation are common. Physical examination may show enlargement of reticuloendothelial structures. On the other hand, some patients may be essentially asymptomatic. The hemolytic process must be treated as a separate entity, as even vigorous treatment of the leukemia often does not control it. Corticosteroid therapy is preferred, with splenectomy as a second line of defense. If the patient is not a good surgical risk, chemotherapy should be considered. Transfusions are usually incompatible but should be risked if progressive congestive failure, neurologic disturbance, angina, or signs of an impending infarct are present.
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PMID:When autoimmune hemolytic anemia complicates chronic lymphocytic leukemia. 63 66

The first reported case of a patient with chronic lymphocytic leukemia, who 14 years after diagnosis developed bilateral symmetrical ear lobe swelling secondary to lymphocytic infiltrates and its management, is presented. The various otologic and specific skin manifestations of leukemia are discussed and the literature reviewed. The temporal bone findings take the form of leukemic infiltrations, inflammation, and hemorrhage. These may present as a red or thickened tympanic membrane, hemotympanum, exudates in the middle ear, acute otitis media, mastoiditis, conductive or sensori-neural hearing loss, dizziness, vertigo or facial paralysis. The specific skin manifestations take the form of nodules, papules, infiltrations, plaques, ulcerations and exfoliative erythroderma. These may present as skin lesions most commonly in the head and neck area, rarely presenting in the auricle and ear canal.
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PMID:Unusual otologic manifestation of chronic lymphocytic leukemia. 79 97

Thirty-eight workers from a factory producing nickel-cadmium and other types of batteries came to us for medical evaluation. They included 21 women and 17 men (seniority 2-20 years, age range 31-63 years), and represented a self-selected subset of 700-900 ever-employed and 200+ recently or currently employed workers in the factory. Thirty-four worked on the nickel-cadmium assembly line. Symptoms and signs included: headache in 34; weakness, fatigue and lassitude in 26; dizziness in 16; pruritus and skin eruptions in 37; gingivitis, teeth loss and caries in 34; nasal congestion, nosebleeds and anosmia in 30; cough, phlegm production, wheezing and shortness of breath in 26; "asthma" in 14; bone pain in 18; urinary frequency, beta 2 microglobulinuria and kidney stones in 17; and sterility or multiple abortions (33) in 8 of 21 women. One additional patient had died from an "amyotrophic lateral sclerosis-like syndrome", while CT scans in six workers revealed brain atrophy. One other worker had leukemia, and two had died from cancer (lung and pancreas). Those who had worked for more than 10 years had more symptoms and signs than shorter-term employees, especially neurological illness, bone pain and urinary tract problems, including beta 2 microglobulinuria. Past blood and urinary cadmium levels were in the range of 1.6-8.7 micrograms/dl and 8-306 micrograms/l, respectively. Our findings indicated that: a) health risks for workers were not confined to the nickel-cadmium assembly line or to older workers, b) hazardous exposures still existed and illness appeared in new workers after a clean-up and intervention program, and c) exposures involved increased risks for renal disease and cancers. Finally, there is a need to control exposures and determine health risks in the full cohort of those ever employed, in the workers' children, and in the surrounding environment (air, ground, water) due to the dumping of waste from the plant.
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PMID:Medical findings in nickel-cadmium battery workers. 142 13

The occurrence of hypoplastic acute leukemia is widely recognized as an atypical leukemia, and is defined as hypocellular marrow with more than 30% blasts and none or few blasts in the circulating blood. The pathogenesis of hypoplastic acute leukemia is still unknown. Clinically, it usually follows a less progressive course and has a high prevalence rate among the elderly. The treatment and prognosis remains unclear. We present a case of hypoplastic acute leukemia, which responded well to low dose Ara-C. The 67 year-old female patient had symptoms of bruising easily and dizziness for about 3 years. Initial investigation revealed pancytopenia in the circulating blood and hypocellularity (10%) with blast cells (60%) in the bone marrow. Besides supportive treatment with blood transfusions and antibiotics, chemotherapy of low dose Ara-C 10 mg/m2 was administrated for 14 days by subcutaneous injection. Bone marrow examination revealed an increase of cellularity and a decrease of blast cells following chemotherapy. Anemia and thrombocytopenia also simultaneously improved. Such results may suggest induction of differentiation effect of low dose Ara-C in hypoplastic leukemia.
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PMID:Remission of hypoplastic acute leukemia by low dose Ara-C: one case report. 181 Oct 73

Central nervous system (CNS) leukemia is a pathologic condition whereby leukemic cells enter the cerebrospinal fluid (CSF) causing meningeal irritation syndrome. Temporal bone findings in the case of a 32-year-old man who died of CNS leukemia are presented. He complained of fullness of the ear 4 months prior to death and of dizziness 1 month prior to death. Leukemic cells were seen to have infiltrated the scala tympani of the basal turn in the cochlea, the saccule, and posterior semicircular canal along the vestibulocochlear nerve.
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PMID:Temporal bone findings in central nervous system leukemia. 181 74

An 80-year-old male was admitted because of dizziness and palpitation. Laboratory investigation revealed pancytopenia. A bone marrow aspirate showed a markedly hypocellular marrow with 41.6% blast cells. Peroxidase activity was negative and PAS reaction was block positive in the blast cells. Surface markers of these cells were positive for HLA-DR antigen and partially positive for CD13 (MY7). Other markers, such as T, B or myeloid antigens were all negative. These blast cells were classified as L1 according to the FAB system but suggested essentially unclassifiable in cell differentiation. The patient was treated successfully with vincristine and prednisolone and induced into complete remission although repeated marrow examination findings revealed hypocellular. As for the classification of hypoplastic leukemia, lymphoid or primitive "stem cell" leukemia also should be considered as other categories of acute leukemias and be treated according to each case.
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PMID:[An unclassifiable case of hypoplastic leukemia in old age treated successfully with vincristine and prednisolone]. 281 Jul 88

Patient 1; A 78-year-old woman was admitted to our hospital because of general malaise. Her peripheral blood count showed bicytopenia of 900/microliter with 2% blasts, 7.0 g/dl hemoglobin, and 199,000/microliter platelets. Examination of bone marrow revealed hypocellular marrow with peroxidase-negative blasts (89%). Surface marker analysis of blast cells revealed CD13 agents. Electron-microscopically, myeloperoxidase staining was positive. The diagnosis was hypoplastic leukemia in which blasts had a feature of minimally differentiated acute myeloid leukemia (AML-MO). Patient 2; A 78-year-old man was admitted to our emergency unit because of dizziness and dyspnea on exertion. Examination of peripheral blood showed pancytopenia but no blast cells. Examination of bone marrow showed a markedly hypocellular marrow with 38% blast cells. These blast cells were negative for myeloperoxidase and they had CD13 antigen on their surfaces. The diagnosis was minimally differentiated hypoplastic leukemia. At the time of this writing these two patients had been receiving only red cell transfusions for about six months, and the disease had not progressed.
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PMID:[Minimally differentiated hypoplastic leukemia in two elderly patients]. 907 9

Treatment of healthy donors with recombinant human granulocyte colony-stimulating factor (rhG-CSF) allows the mobilization and peripheralization into circulating blood of an adequate number of CD34+ cells that can then be collected by leukapheresis (PBSC). This procedure avoids the invasiveness of bone marrow harvest and the risks related to general anesthesia. The main adverse effects of rhG-CSF are: bone pain, 84%, headache, 54%, fatigue, 31%, and nausea, 13%, which are usually scored by the donors as moderate to severe, resolving within 2-3 days after discontinuation of the cytokine. Analgesics, mainly acetaminophen, are sufficient to control the pain. Less than 5% of the donors experience non-cardiac chest pain, a local reaction at the injection site, insomnia, dizziness or a low-grade fever. Discontinuation of the PBSC procedure because of adverse effects of rhG-CSF or leukapheresis is rarely necessary (0.5%) but this good tolerability can be hampered by the need, in 5-20% of cases, for an adequate venous access that requires insertion of a central or venous catheter. There are no absolute contraindications to the stimulation of healthy donors with rhG-CSF but the description of cases of non-traumatic splenic rupture, iritis, cardiac ischemia, and gouty arthritis suggests that further precautionary restrictions are advisable when deciding eligibility for PBSC collection. The main advantages for patients receiving an allogeneic PBSC transplant are the faster hematologic and immunologic recovery and the potential for a greater efficacy in advanced disease by lowering the transplant-related mortality. One of the major concerns regarding the use of rhG-CSF in unrelated healthy donors is the uncertainty about its possible role in triggering malignancy, in particular myelodysplastic syndrome and acute myeloid leukemia. There are no studies with an adequate sample size and follow-up that can answer this question but two recent retrospective studies reported that in the medium term rhG-CSF is not associated with an excess of lymphoproliferative disorders. Currently, caution on the long-term safety of the use of rhG-CSF in healthy donor is still warranted but the data so far accumulated on allogeneic PBSC transplants are encouraging both as far as concerns the good short-medium tolerability profile of G-CSF-stimulation of the donor and the potential major efficacy in leukemia patients.
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PMID:The use of cytokine-stimulated healthy donors in allogeneic stem cell transplantation. 1241 88

Thalidomide, an antiemetic administered in 60th of the 20th century to pregnant women, has become notorious for a range of adverse effects which led to its taking off market. In recent years, its antimyeloma effect was discovered. The aim of the work was to evaluate the incidence of adverse reactions to thalidomide. Its therapeutic effect has not been assessed because of a short period of monitoring and diversity of a sample. The assessed sample consisted of 17 patients with diagnosis of multiple myeloma (10 men and 7 women). An average age of patients was 62.9 +/- 9.4. An average time elapsed from making the diagnosis to starting the treatment with thalidomide was 51.0 +/- 23.7 months. An average length of therapy was 20.1 +/- 9.6 weeks. An average daily maximum therapeutic dose was 138.3 +/- 83.2 mg. Data were collected from outpatient physicians reports, regular laboratory tests, and direct interviews with patients. To classify severity of adverse drug effects (grades 0-4) we used WHO criteria, Cancer and Leukemia Group B criteria, and in cases where certain adverse effects were not included in the above mentioned criteria, we defined our own criteria. The most frequent adverse effects included: leucopenia or neutropenia in 12 (70.6%) patients, altered state of consciousness in 11 (64.7%) patients, obstipation in 10 (58.8%) patients, skin alterations in 9 (52.9%) patients, dizziness in 8 (47.1%) patients, peripheral neuropathy in 7 (41.2%) patients, spasms and spasmodic convulsions in 7 (41.2%) patients, and altered liver tests in 6 (35.3%) patients. From the perspective of necessity to interrupt treatment or reduce the dose the most severe disorders included: peripheral neuropathy in 2 patients (inability to control lower extremities), altered consciousness in 1 patient (protracted somnolence during a day), skin alteration in 1 patient (generalized toxoalergic reaction), leucopenia or neutropenia in 1 patient (1.0 resp < 0.5 x 10(9)/l), altered vision in 1 patient (blurred vision), hypothyroidism in 1 patient, and altered mood in 1 patient (subjective feeling of depression). This work proved thalidomide to be beneficial for the patients with multiple myeloma but it also shoved necessity to intensively monitor its adverse effects and to adjust its doses.
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PMID:[Desirable and undesirable effects of thalidomide in patients with multiple myeloma]. 1468 82

PTK787/ZK 222584 (PTK/ZK) is an oral angiogenesis inhibitor targeting vascular endothelial growth factor (VEGF) receptor tyrosine kinases, including VEGFR-1/Flt-1, VEGFR-2/KDR, VEGFR-3/Flt-4, the platelet-derived growth factor receptor tyrosine kinase and the c-kit protein tyrosine kinase. The objective of this Phase I study was to evaluate the safety, tolerability, biologic activity and pharmacologic profile of PTK/ZK administered orally, twice daily, on a continuous dosing schedule in patients with primary refractory or relapsed acute myeloid leukemia (AML), secondary AML, poor-prognosis de novo AML or advanced myelodysplastic syndrome (MDS). Acute myeloid leukemia patients for whom PTK/ZK monotherapy was ineffective could receive PTK/ZK combined with standard induction chemotherapy. Sixty-three patients received PTK/ZK at doses of 500-1000 mg orally b.i.d. Safety and pharmacokinetic data were collected. Responses were evaluated according to standard bone marrow and peripheral blood criteria. At 1000 mg b.i.d., dose-limiting toxicities of lethargy, hypertension, nausea, emesis and anorexia were observed. Other adverse events related to PTK/ZK were dizziness, weakness, fatigue, diarrhea and pruritus; these were generally mild and reversible. Pharmacokinetic data showed that steady state was reached by day 14, there was no accumulation with repeat dosing and there was no significant increase in exposure at steady state beyond the maximum tolerated dose (MTD). Complete remission was observed in five of 17 AML patients treated with PTK/ZK combined with chemotherapy. In conclusion, the MTD of PTK/ZK is 750 mg orally b.i.d. The drug is generally well tolerated and can be given in combination with chemotherapy for patients with MDS and AML.
Leukemia 2006 Jun
PMID:Phase 1 study of PTK787/ZK 222584, a small molecule tyrosine kinase receptor inhibitor, for the treatment of acute myeloid leukemia and myelodysplastic syndrome. 1661 23


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