Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0013911 (emaciation)
 1,059 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 44-year-old man suffered from repeated impairment of consciousness associated with flapping tremor, myoclonus and generalized convulsions, and died in coma 6 months after admission. He had had a psychosomatically underdeveloped childhood, with a propensity for legumes without a family history of the same or a record of consanguinity. On admission, he had disturbed consciousness and emaciation without other physical abnormalities. The EEG revealed diffuse slow waves with occasional appearance of triphasic waves. A high level of serum citrulline (534.7 nmol/ml) was recognized and the assay of urea cycle enzymes in the liver demonstrated decreased argininosuccinate synthetase (ASS) activity (0.062 U/g liver, 7.4% of that in normal liver), although no kinetic abnormality was found. Accordingly he was diagnosed as having type II citrullinemia. In addition, this case could be classified as cluster type of localization of the ASS in the liver by immunohistochemical study. There were characteristic findings concerning his clinical picture and laboratory data, such as a significant correlation between the grade of disturbed consciousness and arterial blood gas pH (r = 0.61, p less than 0.01). However, the blood ammonia level did not always correlate with the severity of disturbed consciousness. Oral treatment with sodium citrate and sodium benzoate was very effective, though transiently, for disturbed consciousness in this case. Pathological findings of the autopsied liver were fatty change and fibrosis. Neuropathologically, characteristic findings were brain edema with cerebellar tonsilar herniation, laminar necrosis with spongy formation in cerebral cortex, and Alzheimer type II glia. The relationship between citrullinemia and other hepatic encephalopathy was also discussed.
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PMID:[An autopsied case of type II citrullinemia--transient effectiveness with either citrate or benzoate to the consciousness disturbance]. 269 30

Since 1984, a significant number of privately owned and feral horses on Easter Island have died of a syndrome consisting of progressive anorexia, weight loss, obtundation, and other central nervous system abnormalities. A single horse experiencing clinical signs of the reported syndrome was identified, examined and necropsied. Clinical signs included inappetence, emaciation, ataxia and icterus. Gross necropsy findings included hepatic enlargement and mottling, ascites and gastric impaction. Histopathological lesions included hepatic hemorrhage and necrosis, periportal megalocytosis, portal fibrosis, bile duct hyperplasia and multinucleate hepatocytes. Crotalaria grahamiana and C pallida, were identified in the pasture of the presenting horse, and found to be widespread on the island. Alkaloid fingerprinting identified grahamine, monocrotalin, and a grahamine analog in C grahamiana. A retrorsine analog and a senecionine analog were identified in C pallida. The highly characteristic lesions and the identification of pyrrolizidine alkaloids in the 2 plants strongly suggest that ingestion of 1 or both of the Crotalaria species led to chronic liver damage and hepatic encephalopathy in the presenting horse. Widespread distribution of C grahamiana on the island and reported temporal and seasonal trends in incidence among horses and cattle suggest that C grahamiana may be responsible for extensive morbidity and mortality among horses and cattle on Easter Island.
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PMID:Hepatotoxicity associated with pyrrolizidine alkaloid (Crotalaria spp) ingestion in a horse on Easter Island. 1019 40