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)

Bleeding and thrombosis are major causes of morbidity and mortality in patients with chronic myeloproliferative disorders. We retrospectively evaluated 101 consecutive patients affected by primary thrombocytosis (46 male, 55 female, aged 18-84 years; mean +/- SD 61 +/- 15) followed for a period ranging from 6 months up to 10 years (median 5 years) at our hematological unit. At the time of diagnosis 48 patients were asymptomatic; 26 had clinical evidence of atherothrombosis (cerebral ischemic attacks, ischemic heart disease, peripheral occlusive arterial disease), ten had venous thrombosis, four experienced major hemorrhages, 23 presented microvascular ischemic manifestations namely erythromelalgia, paresthesias, acrocyanosis and dizziness. At presentation 51.2% of the patients had elevated serum lactic dehydrogenase, 34.5% hyperuricemia, and 23.4% serum creatinine > 1.2 mg/dL. Color Doppler ultrasound provided evidence of vascular stenosis or medium-intimal hyperplasia of epiaortic vessels in 48.9% of patients studied, and similar alterations of lower limb arteries in 23.8% of cases. Therapy modality included an antiplatelet agent (picotamide 300 mg/bid); a cytoreductive agent (busulphan, hydroxyurea, pipobroman or melphalan) was used when platelet count was > 800000/microL. Symptoms due to microvascular ischemia promptly regressed after picotamide and cytoreductive therapy. During follow-up. nine patients suffered from atherothrombotic events (transient ischemic attacks, ischemic stroke, unstable angina pectoris) and five developed deep vein thrombosis or superficial thrombophlebitis. Five patients experienced major hemorrhages (two melena, two hematuria, one perioperative bleeding); the two gastrointestinal hemorrhages occurred in patients self-medicated with non steroidal anti-inflammatory drugs, and the two episodes of hematuria occurred on oral anticoagulant therapy and aspirin respectively. No major bleeding occurred in patients on continuative therapy with picotamide, even in the presence of upper digestive tract disorders. Seven patients died: mortality resulted from one sudden coronary death, three solid neoplasia, one blast crisis, one anile, and one massive hemorrhage due to abdominal aortic prosthesis tearing. Our study suggests that a long-term antithrombotic prophylaxis with picotamide may be of benefit in patients affected by primary thrombocytosis; a controlled clinical trial is warranted to assess whether picotamide can ameliorate the natural history of the disease.
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PMID:Thrombotic and hemorrhagic complications in chronic myeloproliferative disorders. 895 59

Vascular involvement is not infrequent in Behcet's disease (BD). It is generally seen in the form of superficial thrombophlebitis or occlusion of major veins. In rare instances, arterial occlusion and aneurysm formation may be seen in BD. We reported a young male with BD, diagnosed at the age of twenty for relapsing and remitting oral ulceration, skin rash, arthralgia and ocular painful redness for three years. At the age of 21, he had recurrent abdominal aortic aneurysm and inconspicuous neurological manifestations including dizziness, tinnitus and transients of blurred vision. The carotid angiography disclosed the occlusion of bilateral common carotid arteries (CCA). A carotid endarterectomy was subsequently performed to reduce the risk of stroke. The pathological examination of the occluded segment of CCA revealed chronic inflammation, which was attributable to BD. There was no atherosclerotic change. To the best of our knowledge, this is the first case report of concurrent bilateral CCA occlusion and relapsing abdominal aortic aneurysm. Even in the absence of specific neurological symptoms, we suggest that cerebrovascular investigation need to take into consideration in BD patients with unexplained cranial symptoms.
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PMID:Behcet's disease with involvement of major arteries: a case report. 1928 Aug 70