Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 26-year-old female with Bartter's syndrome associated with Graves' disease is reported. This patient had a history of Graves' disease from the age of 22 and anti-thyroid drug (Methimazole) had been administered for 2 years. Thyroid function returned to normal but general fatigue and polyuria continued. Hypokalemia was diagnosed at 25 years of age and she was referred to our hospital for evaluation. Blood pressure was normal and laboratory data revealed normal thyroid function, hypokalemic alkalosis, high plasma renin activity and high plasma aldosterone concentration. She showed normal pressor sensitivity to norepinephrine infusion, grossly diminished pressor sensitivity to exogenous angiotensin II infusion compared with the normal. A renal biopsy specimen showed juxtaglomerular cell hyperplasia. Electron microscopy confirmed lacis cell (agranular cell) proliferation.
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PMID:Bartter's syndrome--case report. 15 51

The first autopsy of a case of multiple sclerosis from the District of Hokuriku was reported. The patient, a 50-year-old house-wife, born in Toyama Prefecture, had noticed a paresthesia of her face, fatigue, numbness and weakness in the right limbs, dimness of vision and gait disturbance at ave 44. Furthermore, in the course of the disease, she had suffered from visual disorder, tetraplegia, hyperreflexia, pyramidal signs and cerebellar syndroms such as dysarthria, nystagmus, intention tremor and ataxia. She also showed symptoms of euphoria and dementia. After a course of six years she died of bronchopneumonia. Remissions and exacerbations were noted four times during her clinical history. Histopathologically, there were many recent and old demyelinating lesions of varying sizes and shapes in all parts of the central nervous system, namely the cerebrum, brainstem, spinal cord and optic nerve. In contrast to the clinical symptoms, the cerebellum itself revealed less plaques than the other areas of the brain. According to the observed distributions of the lesions, our case can be classified as belonging to the optico-cerebro-spinal type in the Ikuta and Zimmerman classification. The demyelinated lesions were characterized by a perivenular distribution of the plaques, lack of tissue necrosis, paucity of inflammatory reaction and marked fibrous gliosis of varying degrees.
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PMID:First autopsy report of a multiple sclerosis case in Hokuriku District of Japan. 53 38

A 27 year old woman was hospitalized for progressive dyspnea, fatigue and retrosternal chest pain. She had progressive cardiac enlargement with clinical and laboratory confirmation of a dilated cardiomyopathy. Transvenous percutaneous right ventricular endomyocardial biopsy yielded a specimen showing a noncaseating granuloma. The patient's dyspnea responded dramatically to steroid therapy with corresponding improvement in radiographic and echographic measures of ventricular performance. This case illustrates the problem of diagnosing cardiac sarcoidosis when there is no apparent evidence of other organ involvement.
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PMID:Cardiac sarcoidosis. Diagnosis with endomyocardial biopsy and treatment with corticosteroids. 67 30

Panic attacks occur more often in females than males with onset usually in the late 20s. A 27-year old woman who experienced a panic attach (heart palpitations, fatigue, bodily shaking, labored breathing, and feelings of terror and being out of control) after she stopped taking a combined oral contraceptive (COC) (.5 norgestrel and .05 mg ethinyl estradiol) was admitted to Osaka Medical College in Takatsuki, Japan. She experienced depression at 18 and took limited amounts of antidepressants for only 1 year. When she started taking the COC at 27, she experienced feelings of unreality and fear, hyperventilation, and heart palpitations. Laboratory results showed lower than normal levels of plasma luteinizing hormone (LH) and follicle stimulating hormone (FSH) and a low estradiol level. Yet the plasma cortisol level was much high than normal (22.5 mcg/d1 vs. 3-15.2 mcg/d1). Administration of 200 mg sulpiride/day and 1.2 mg alprazolam/day alleviated almost all symptoms. She did experience mild phobic avoidance and anxiety, however. After successful treatment in the hospital, she discharged herself. Because she was concerned that the panic attacks would recur, she was provided with information on her disorder. She agreed to continue the medication. 1 possible explanation for this case is rapid endocrinological change induced by the ingestion and stopping of the COC which in turn induced a sympatho-adrenal response (her high cortisol levels) to several simple physiological stimuli. Another possible explanation is the COC induced rapid endocrinological changes that may have brought on an anxiotropic effect in someone who had earlier experienced depression.
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PMID:A case of panic disorder induced by oral contraceptive. 131 8

An autopsy case of pulmonary metastasis of cholangiocellular carcinoma is presented. A 44-year-old woman was admitted to our hospital because of dyspnea, general fatigue and a sense of abdominal fullness on February 5, 1990. In November 1986, at an other hospital, she had been diagnosed as having diffuse metastatic lung tumor and multiple bone metastases, by transbronchial lung biopsy and other examinations. During the clinical course, she was not received chest irradiation and chemotherapy which induced fibrotic change of lungs. Chest X-ray film on December 21, 1986 showed diffuse nodular shadows in both lung fields. Chest X-ray film on February 4, 1990 showed diffuse reticular shadows with marked shrinkage of lung fields. She died two months after admission. The primary site of the carcinoma was not determined clinically, but was revealed by autopsy to be cholangiocellular carcinoma of the liver, with generalized metastasis. Microscopic findings of the autopsied lung showed markedly increased connective tissue around bronchi and blood vessels, in areas where microtubular adenocarcinoma was scattered. This is a very rare case of pulmonary metastasis of cholangiocellular carcinoma, associated with marked fibrotic change of the lungs during about 3.5 years. To our knowledge, this is the first reported case.
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PMID:[An autopsy case of pulmonary metastasis of cholangiocellular carcinoma associated with marked fibrotic change of the lungs]. 133 23

This case report describes multiple phantom feet in a child after amputation of a leg. The subject is a 16-year-old girl who was born with a right leg 10 cm shorter than the left and who at the age of 6 was amputated below the right knee so that she could wear a prosthesis that would give her normal mobility. The girl reports that she subsequently experienced 2 phantom feet and 3 sets of phantom toes which have persisted to the present time. Each phantom has a distinct size, length and position in relation to the others and each is also the site of vivid sensations such as heat, tickle, and fatigue as well as voluntary and involuntary movement. She also describes sensations that resemble sensations experienced before the amputation: one of her phantom feet feels flat and locked into a forward position which corresponds with the actual shape and position of her congenitally deformed amputated foot. The implications of multiple phantoms are discussed with reference to recent concepts of phantom limbs.
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PMID:Multiple phantom limbs in a child. 139 50

A 44-year-old female with 16-year history of rheumatoid arthritis visited Akiru Hospital with complaints of a thirst, a dry mouth and a general fatigue. One week prior to admission, the patient manifested excessive thirsty feeling, a body weight loss and a sleepless by the polyuria. She has been given 5-10 mg of prednisolone and 240 mg of lobenzarit disodium (CCA) in a day for 11 months. A hematologic examination showed no abnormality, and the examination of her serum showed the following values: BUN, 9.3 mg/dl; creatinine, 0.9 mg/dl; sodium, 139 mEq/l; chloride, 102 mEq/l; potassium, 3.9 mEq/l; osmolality, 290 mOsm/l. Plasma antidiuretic hormone (ADH) level increased slightly (6.0 pg/ml). Examination of her urine revealed specific gravity, 1.005; no trace of glucose, protein, blood and ketones; normal sediment; and osmolality, 209 mOsm/l. The patient was given exogenous ADH (10 units of vasopressin tannate in oil, intramuscularly) to obtain a diagnosis, and she was found to be unable to concentrate her urine more than 1.008 in the specific gravity. A water restriction, as a test for diabetes insipidus, also failed to concentrate her urine in the specific gravity and in the osmolality. Together with these findings, the patient was diagnosed to be a diabetes insipidus, and CCA was seemed to account for the disease. This unfavorable effect of CCA appeared to be reversible, since the patient recovered her urinary concentrating ability after the medication of CCA was discontinued.
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PMID:[Lobenzarit disodium (CCA)--induced diabetes insipidus in a patient with rheumatoid arthritis]. 141 95

This is a case report of a 69-year-old woman with sarcomatoid hepatocellular carcinoma (HCC), which was diagnosed clinically as hemangioma. She was first admitted to our university hospital, complaining of general fatigue in December, 1988, and cholelithiasis and liver cirrhosis with hepatic tumor in Segment 8 were diagnosed. The serum AFP level was within normal range, and the tumor was diagnosed as hemangioma radiologically. She underwent only cholecystectomy and was well without any therapy for the liver tumor up until March in 1991 when she was readmitted to our university hospital due to rapidly progressive liver dysfunction. The size of the liver tumor was unchanged. Despite intensive care, she died of hepatic failure due to cirrhosis in a decompensation state. At autopsy, a well defined yellowish white tumor of 3 cm in maximum diameter was seen in the cirrhotic liver. Although the largest part of the tumor revealed necrosis and hyalinization, a sarcomatoid part composed of spindle-shaped cells was noted in the peripheral portion. In addition, some necrotic ghost cells, probably hepatocellular carcinoma, were also noted. Low molecular cytokeratin, which is always found in HCCs, was seen in spindle-shaped sarcomatoid cells. The liver tumor was diagnosed as sarcomatoid HCC from these pathological findings. We report this histologically unusual HCC with an immunohistochemical study.
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PMID:[Sarcomatoid liver carcinoma diagnosed clinically as hemangioma]. 147 Jul 79

A sixty nine-year-old woman was admitted to the hospital because of further examination of hypercalcemia. On July 1990, she complained of general fatigue and loss of appetite. She was pointed out to have hypercalcemia (15.1mg/dl), urolithiasis, and renal insufficiency. CT films of the chest showed swelling of the mediastinal lymphnodes and CT of the abdomen nephrocalcinosis. Ga-scintigraphy demonstrated an abnormal accumulation of gallium in the mediastinum. Levels of the parathyroid hormone was normal. Levels of the serum calcium (13.7mg/dl), angiotensin converting enzyme (30.4IU/L) and 1.25 (OH)2D (87PG/ml) were elevated. Giant cells were found in the biopsy specimen of the lung. A significant relationship between the serum calcium and creatinine were observed (r = 0.76, p < 0.02). Proximal fractional reabsorption of sodium showed to be suppressed (47.7%), and distal fractional reabsorption of sodium showed to be normal (88.4%). From these findings hypercalcemia and urolithiasis was suggested to result from sarcoidosis. The hypercalcemia and renal insufficiency improved with corticosteroid therapy.
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PMID:[A case of sarcoidosis with hypercalcemia, urolithiasis, nephrocalcinosis and renal insufficiency]. 148 16

A 74-year-old woman was admitted to our hospital with the complaint of general fatigue. Chest X-ray revealed multiple thin-walled cavities in both lung fields. Cystadenocarcinoma in the liver and secondary lung cancer were diagnosed on the basis of chest X-ray, abdominal CT, and lung biopsy. She died of respiratory failure, in spite of treatment with chemotherapy for 8 months. At autopsy, the liver mass was diagnosed as cystadenocarcinoma, which had developed from a benign cystadenoma with the capacity to produce mucinous material. Thin-walled cavities in the lungs showed the same histological findings. Therefore, the mechanism of cavity formation in this case was speculated to have been metastasis of mucin-producing cystadenocarcinoma, with entry of air secondary to communication with the terminal bronchiole.
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PMID:[A case of secondary lung cancer of cystadenocarcinoma showing multiple thin-walled cavities]. 148 38


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