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)

The immunoglobulin class and subclass of cytophilic antibodies have been studied using peripheral leucocytes from twenty-two patients with allergic bronchopulmonary aspergillosis, aspergilloma and cryptogenic pulmonary eosinophilia. In patients with allergic bronchopulmonary aspergillosis, significantly increased histamine liberation occurred following challenge of their leucocytes with antisera to IgE, IgG2, IgG3 and IgG4 as well as with Aspergillus fumigatus antigen. The results were considerably modified if the patient was receiving corticosteroids at the time of the test. The presence of IgG2-specific antibody to A. fumigatus in the serum of one patient, capable of sensitizing donor leucocytes, was demonstrated in passive sensitization experiments. In two patients with uncomplicated aspergillomas no evidence of cytophilic antibody to any class was found although large amounts of precipitating IgG antibody was present in the serum. Two patients with aspergilloma and systemic symptoms of weight loss and fatigue (which have been interpreted by others as 'hypersensitivity' responses) had increased amounts of cytophilic antibody similar to those with allergic bronchopulmonary aspergillosis. Six patients with cryptogenic pulmonary eosinophilia were also studied. No evidence of specific antibody to A. fumigatus was found but, as a group, significantly increased histamine liberation using antisera to IgG2 was demonstrated. Individual patients also showed evidence of other classes of cytophilic antibody, one having IgE, three IgG3 and two IgG4. The relationship between heat-stable short-term sensitizing antibody (IgG STS) inducing immediate skin responses and the pattern of cytophilic antibodies found in our patients with bronchopulmonary aspergillosis having dual (immediate and late reactions) is discussed. Clinically these tests are of diagnostic value and they may be helpful in assessing symptomatic patients with aspergillomas for corticosteroid treatment.
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PMID:Cytophilic antibodies in bronchopulmonary aspergilloma and cryptogenic pulmonary eosinophilia. 6 46

We surveyed stool and urine specimens from 245 Saudi Arabian trainees for parasites. Schistosoma mansoni eggs were found in the stool in 66 (26.9%) and S. haematobium eggs were recovered from the urine in 1 (0.4%). Additional parasites were recovered in 167 (68.2%) of the survey group and were not more common in those with schistosomiasis (P greater than .10). Schistosome egg counts ranged from 0--6,320 eggs/g feces (mean 447.9). When patients with high egg counts (over 400 eggs/g) were compared with uninfected controls, abdominal complaints and fatigue were found to be more frequent (P less than .05) in the infected group, as was eosinophilia (P less than .001). Other laboratory and physical examination findings were equally present in both groups. This study reaffirms the value of quantitative examination of stool specimens for schistosome eggs.
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PMID:Schistosomiasis in Saudi Arabian recruits. A morbidity study based on quantitative egg excretion. 71 36

Two patients with nonpitting edema associated with extreme fatigue were found to have hyperimmunoglobulinemia M and eosinophilia. Additional laboratory abnormalities included an elevated ESR and the presence of rheumatoid factor. One patient had the symptom complex continually, and it was controlled with minimal amounts of prednisone. The other patient had intermittent symptoms, with eosinophilia in the asymptomatic state and decreased eosinophil counts while symptomatic. His symptomatic episodes were diminished in duration by methylprednisolone. We believe these cases, which have been evaluated for eight and four years, respectively, constitute a new syndrome that has substantial morbidity, but that is apparently benign and that can be controlled with corticosteroids.
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PMID:Elevated IgM levels, edema, and fatigue syndrome. 99 19

Leponex (clozapine) is an atypical neuroleptic indicated in severe schizophrenia, launched in France in December 1991. The safety and efficacy data pertaining to 1,062 patients treated on a compassionate needs basis between May 1989 and December 1991 constitute the first French experience on the drug. The results of an interim analysis pertaining to 602 patients, i.e. available data on 03-15-1992, generally collected on a retrospective basis, by means of a specific questionnaire are reviewed. The population included patients with severe and long-standing schizophrenia i.e. 15.71 +/- 9.3 years, resistant to usual neuroleptic therapy (90.86% of cases), and rarely with a history of intolerance to this class (2.49%). The indication was in the majority of the cases a paranoid schizophrenia (67.2%). The mean maintenance daily dose was 419 mg/d (+/- 152). Overall, with respect to associated drugs, neuroleptics were recorded in 16.4%, another psychotropic drug in 44.7% and symptomatic treatments for extrapyramidal disorders in 21.3% of patients. Of interest is the fact that, for those patients started on Leponex more recently, the drug is more often prescribed on a single basis. Leponex was stopped in 24.3% for the following reasons: adverse events 10.6%, lack of efficacy 6%, non compliance 3.8%, other reasons 3.8%. The adverse event profile is consistent with the literature data, taking into account the fact that certain adverse events were more commonly described: fatigue of lower limbs 11.8%, leucocytosis 19.8% and eosinophilia 4.3%.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Clozapine (Leponex) in France]. 133 58

We report here the long-term sequelae in 22 patients with L-tryptophan-induced eosinophilia-myalgia syndrome (EMS). The mean follow-up was 23 months (range, 5 to 40 months). Myalgia, rash, pruritus, edema, and respiratory symptoms often improved with the use of corticosteroids, but fatigue and weakness persisted in most cases. Other abnormalities that commonly persisted were arthralgia, muscle-cramping, peripheral neuropathy, and thickened skin. One patient had chronic pulmonary hypertension. These findings indicate that for most patients, EMS is a chronic disorder.
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PMID:Eosinophilia-myalgia syndrome: the aftermath. 152 46

A rare side effect of minocycline is acute eosinophilic pneumonia. In the literature only ten cases have been reported. We report two cases of minocycline which induced (eosinophilic) alveolitis. A high fever, dry cough, dyspnoea and fatigue are the main features of the clinical picture. Peripheral blood eosinophilia and elevated total IgE content were seen in one patient. Bronchoalveolar lavage in this patient revealed eosinophilia. Transbronchial lung biopsies showed infiltration with eosinophilic granulocytes in both patients. Airway macrophages contained brown-black pigment granules. In the acute stage an important decrease in diffusion capacity was observed. The pulmonary and systemic symptoms promptly cleared up after discontinuation of minocycline. Provocation with minocycline was positive, because both patients noticed the same symptoms within one day.
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PMID:[Minocycline as a cause of acute eosinophilic pneumonia]. 153 40

We describe the histopathologic changes of skin, muscle, vessels, and fascia in 11 patients with eosinophilia myalgia syndrome, a newly described entity that has been linked to the ingestion of L-tryptophan. This syndrome is defined clinically by severe incapacitating myalgias and a peripheral eosinophilia. Arthralgias, edema of the extremities, morbilliform rashes, skin induration, weakness, fatigue, and respiratory weakness may be present as well. The earliest apparent histologic changes were observed at the septa between subcutaneous fat lobules and in the deep dermis or fascia. The septa and fascia were infiltrated with a sparse mixture of lymphocytes and histiocytes. In the deep fascia, in addition to inflammatory cells, there were distinctive, reactive mesenchymal cells that showed features of both histiocytes and fibrocytes. Minimal tissue eosinophilia was seen despite the extent of blood eosinophilia. Dermal thickening and homogenization of collagen bundles occurred with replacement of fat and adnexa (changes indistinguishable from scleroderma or morphea). Vessel walls in the dermis and fascia showed thickening and endothelial swelling, but no overt vasculitis was noted. Skeletal muscle biopsies showed a perimysial, epimysial, and/or fascial inflammatory infiltrate of lymphocytes and distinctive reactive mesenchymal cells with some eosinophils. Minimal myofiber atrophy, regeneration, or necrosis was seen despite the clinical history of severe myalgias in almost all patients. This syndrome should help gain insight into the mechanisms of fibrosis in environmental-induced, scleroderma-like syndromes and in idiopathic, scleroderma-like disorders as well.
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PMID:Pathologic manifestations of the eosinophilia myalgia syndrome: analysis of 11 cases. 156 45

Tropical pulmonary eosinophilia is one of the many PIE syndromes [pulmonary infiltrates with eosinophilia (of the peripheral blood)]. It is caused by immunologic hyperresponsiveness to the filarial parasites Wuchereria bancrofti or Brugia malayi. Its clinical presentation includes nocturnal cough, dyspnea, wheezing, fever, weight loss, fatigue, interstitial mottling on chest radiograph, predominantly restrictive but also obstructive lung function abnormalities, and peripheral blood eosinophilia of more than 3000 per microliter. It can be distinguished from other PIE syndromes by the patient's history of residence in the tropics, by the presence of extraordinarily high levels of both serum IgE and antifilarial antibodies, and by the dramatic clinical improvement after treatment with the antifilarial drug diethylcarbamazine. Recent studies indicate that the compromised lung diffusion capacity of patients with acute tropical pulmonary eosinophilia is a function of the degree of the eosinophilic alveolitis present and that, despite a 3-week course of diethylcarbamazine, low-grade alveolitis persists in almost half of such patients; this persistent alveolitis is likely to be the cause of the progressive interstitial fibrosis seen in many untreated or inadequately treated patients with tropical pulmonary eosinophilia.
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PMID:Tropical pulmonary eosinophilia. 158 May 99

The optimal schedule for recombinant interleukin-2 (rIL-2) administration is unclear. Because the clinical and immunological effects of prolonged continuous exposure to rIL-2 are unknown, we have conducted a phase I study to assess the toxicity and feasibility of continuous low dose infusion of rIL-2 (EuroCetus) using central venous access with a portable infusion device on an out-patient basis. Twenty-two patients entered the study, 13 with melanoma and nine with renal cell cancer, age range 26-66 years (median 51), performance status less than or equal to 1. They were treated with one of the following doses per m2 per 24 h: 0.18 x 10(6) IU, 0.6 x 10(6) IU, 1.8 x 10(6) IU, 3 x 10(6) IU, 6 x 10(6) IU and 9 x 10(6) IU. Toxicity was evaluable in 20 patients receiving greater than or equal to 3 weeks treatment duration or in whom treatment was discontinued prematurely because of toxicity. Constitutional symptoms consisting of fatigue, malaise and fever up to 40 degrees C without significant organ dysfunction occurred with doses greater than or equal to 1.8 x 10(6) IU m-2. The maximum tolerated dose was 6 x 10(6) IU m-2 24 h-1. In all patients toxicity reached a peak at 3 weeks and resolved thereafter despite continued rIL-2 treatment. Peripheral blood eosinophilia (up to 66% of white blood cell count) followed the same pattern. An infection of the central venous access occurred in 55% of the patients but this was mostly asymptomatic. Thirteen patients were treated greater than or equal to 6 weeks and were evaluable for tumour response. A partial remission occurred in a patient with melanoma with a dose of 1.8 x 10(6) IU rIL-2 m-2 24 h-1.
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PMID:A phase I study of prolonged continuous infusion of low dose recombinant interleukin-2 in melanoma and renal cell cancer. Part I: Clinical aspects. 158 2

Two of three members (a 29-year-old man [case 1] and a 26-year-old woman [case 2]) of a tourist party to the tropics (Mali) developed a high fever (less than or equal to 40 degrees C), headache, cough, weight loss (less than or equal to 5 kg) and tiredness 3-4 weeks after returning to Germany. In case 1, acute schistosomiasis was tentatively diagnosed as the cause because he reported an attack of dermatitis after exposure to fresh water in an endemic schistosomiasis region and had marked eosinophilia (2118/microliters; 28%) on admission. Serological tests were positive (ELISA with adult antigen, O.D. 0.65 [normal less than 0.15]; with egg antigen O.D. 1.73 [normal less than 0.30], antibody titre in the immunofluorescence test 1:320 [normal less than 1:80]) supported the diagnosis and it was confirmed by demonstrating the parasite, Schistosoma mansoni, in stool but not urine. Findings in case 2 were similar. The third member of the group [case 3], a 58-year-old woman, was symptom-free, but tests revealed schistosomiasis. All three patients were treated with a single dose of Praziquantel (40 mg/kg). A second course of praziquantel (single dose of 40 mg/kg as well as 20 mg/kg three times daily for 3 days) became necessary in case 1, while in case 3 a further single dose of 40 mg/kg was given to ensure a parasite-free state. A follow-up scheme is suggested: clinical examination with white cell and differential counts 1, 3, 6 and 12 months after treatment; three stool and/or urine examinations 3, 6 and 12 months after treatment.
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PMID:[Acute schistosomiasis in travellers to the tropics]. 160 Aug 68


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