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 69-year-old Japanese man suffered from bronchial asthma, atrial fibrillation, general fatigue, high fever, and weight loss of about 5 kg within a month. He also had intermittent claudication, a tingling feeling in his fingers and toes, and an ulcer on his toe. His laboratory data revealed leukocytosis with absolute eosinophilia. The patient was treated with predonisolone 30 mg daily. Although the ulcers healed once, the lesions recurred with tapering predonisolone. The patient visited us because of the ulcer on his toe. Physical examination showed a 2 cm ulcer surrounded by slight erythema on his right fourth toe. Magnetic resonance angiography detected tapering stenosis of the medium-sized arteries in both legs. A biopsy from his myocardium showed the infiltration of eosinophils into the myocardium. The neuron conduction rate of his lower leg was slower than that of the normal control, demonstrating mononeuritis. From these findings, we diagnosed this patient as Churg-Strauss syndrome.
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PMID:Churg-Strauss syndrome involving medium-sized arteries. 1134 69

Despite advances in the therapy of chronic hepatitis C for some hepatitis C virus (HCV) genotypes interferon and ribavirin combination therapy is effective in less than 50% of patients. Abnobaviscum Quercus (AQ) is a mistletoe preparation containing defined amounts of mistletoe lectins (ML). It has shown immunomodulatory properties in vitro and in vivo. In small clinical trials AQ resulted, within an anthroposophical treatment concept, in a biochemical or virological response in up to 40% of patients with chronic hepatitis C. In order to evaluate the effect of this preparation we conducted an individually controlled cohort study. 25 patients with chronic hepatitis C (mean duration 147 +/- 80 months) and elevated alanine aminotransferase (ALT) levels were included in the study. As control they were observed for 6 months pre-treatment. This pre-treatment period was followed by 6 months of active treatment in which the mistletoe preparation was subcutaneously injected three times a week. Main outcome parameters were normalization of ALT and viral load. Hepatitis C associated signs and symptoms like tiredness, fullness in the right upper abdomen and musculoskeletal pain were assessed monthly in a standardized questionnaire. All 25 patients completed the study and most of the patients wanted to continue treatment. Mean duration of treatment was 9.1 months. None of the patients had complete or partial normalization of ALT or HCV RNA levels during pre-treatment or treatment period. Mean ALT did not change during the study. Tiredness, fullness in the right upper abdomen and musculoskeletal pain were present in 18, 8 and 4 patients respectively. They significantly improved within two months of treatment. A significant eosinophilia (p=0.0001) occurred between month 2 and 6 during treatment. 9 month treatment with a ML containing mistletoe preparation has no effect on viral load or ALT as markers of activity in patients with chronic hepatitis C. However, frequency and intensity of clinical signs and symptoms in our patients decreased significantly, similar to reports of improved quality of life in tumour patients treated with such preparations. A significant eosinophilia suggests that ML containing mistletoe preparations induce a T-helper 2 immune response.
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PMID:Effects of a mistletoe preparation with defined lectin content on chronic hepatitis C: an individually controlled cohort study. 1166 85

Omeprazole is a proton pump inhibitor that is used commonly in the treatment of acid-peptic disorders. Although omeprazole is generally well tolerated, serious adverse effects such as renal failure have been reported. Thus far, 17 cases of acute interstitial nephritis (AIN) secondary to omeprazole have been described. Another case of AIN is described in a 36-yr-old woman presenting with nausea, vomiting, weight loss, and a rising serum creatinine concentration. Omeprazole therapy had ceased 2 wk before admission. AIN was diagnosed by renal biopsy and corticosteroid therapy was initiated. After 4 wk of therapy the serum creatinine concentration had normalized. Among the reported cases in the literature, AIN was diagnosed after an average of 2.7 months of therapy with 20-40 mg of omeprazole daily. Recurrence was universal on rechallenge. Common symptoms included fatigue, fever, anorexia, and nausea. The classic triad of fever, rash, and eosinophilia was uncommon. Typical laboratory features included hematuria, proteinuria, pyuria, eosinophilia, and anemia. Management consisted of withdrawal of omeprazole and corticosteroid therapy in some patients. All but one patient recovered normal renal function. Corticosteroid therapy was well tolerated and may have been beneficial.
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PMID:Acute interstitial nephritis due to omeprazole. 1177 62

A 50-year-old man had been well until three months earlier, when he felt general fatigue, and cutaneous rash with itching. Thereafter a general muscular weakness developed and the patient could not walk for a month. Four weeks before referral to our hospital, he had high fever and could not role over in the bed. On admission, the patient was able to walk. He had no skin rash. Neurologically, he showed mild weakness in proximal muscles. Hematologic examination showed mild eosinophilia and serum creatine kinase was mildly elevated. Needle electromyogram revealed a diffuse myogenic pattern in extremities. Eosinophilic myositis was diagnosed by a biopsy of the left calf muscle showing mild infiltration of eosinophilis which was identified using antibodies against eosinophilic granule protein.
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PMID:[A case of eosinophilic myositis proven by immunohistochemistry using antibodies against eosinophilic granule protein]. 1180 47

Autologous hematopoietic stem cell transplantation (HSCT) is currently being evaluated as a therapy for patients with progressive multiple sclerosis (MS) at risk of debilitating neurological impairment. While preliminary results from a few studies have been reported, little is known about toxicities or outcome of HSCT for MS. We report a relatively frequent triad of non-infectious fever, rash and fatigue or lassitude that may also be associated with pruritus, pulmonary symptoms, and eosinophilia and frequently occurs around engraftment. This syndrome occurred in 26% of our series of patients (5/19) undergoing HSCT for multiple sclerosis. The engraftment syndrome is usually self-limited but may require intervention with systemic corticosteroids.
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PMID:Engraftment syndrome: a common cause for rash and fever following autologous hematopoietic stem cell transplantation for multiple sclerosis. 1184 Jan 50

A 63-year-old Taiwan aboriginal male was admitted with exertional dyspnea, appetite loss and general fatigue. Echocardiography revealed moderate pericardial effusion and histological examination of the pericardiocentesis sample revealed an eosinophil-dominated bloody exudate. The larvae of Strongyloides stercoralis were detected in the pericardial specimen. After treatment with anti-nematodal agents, the eosinophilia decreased from 26% to 1% and the patient's symptoms improved. This is a rare case of Strongyloides-induced bloody pericardial effusion in a non-immunosuppressed patient.
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PMID:Strongyloides stercoralis infection with bloody pericardial effusion in a non-immunosuppressed patient. 1207 84

A 30-y-old farmhand was admitted to our clinic in September 2000 with a 6-week history of increasing fatigue and polydipsia/polyuria after an initial short spell of gastroenteritis. No evidence of disease was discovered. During follow-up he developed leucocytosis with prominent eosinophilia, leading to the discovery of multiple liver abscesses and subsequently to the diagnosis of human fascioliasis of domestic origin. Although not uncommon in Europe, the infestation has hitherto not been reported from Scandinavia. The patient was successfully treated with praziquantel.
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PMID:A Scandinavian case of domestically acquired human fascioliasis. 1219 89

The patient was a 29-year-old woman. When she consulted a local physician with chief complaints of fever and fatigue of the extremities, cerebral infarction was detected on MRI, in addition to abnormalities found on ECG. Ultrasonic cardiography revealed the presence of a tumor in the left ventricle. Therefore, tumorectomy and endocardectomy were performed under extracorporeal circulation based on a diagnosis of cardiac tumor. Inflammatory cell infiltration into the ventricular wall was pathologically confirmed, and eosinophilia was observed preoperatively. Therefore, the patient was diagnosed as having endomyocardial fibrosis, which is rarely observed in Japan. The postoperative course of this patient was satisfactory, and the eosinophil count was normalized postoperatively. At present, this patient is being followed at the outpatient clinic.
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PMID:A case of left ventricular endomyocardial fibrosis. 1247 77

Unclear pulmonary infiltrates with eosinophilia, a problem of differential diagnosis. HISTORY AND ADMISSION FINDINGS: A 60-year-old woman was admitted for the diagnosis of pulmonary infiltrates. A year before she had been exposed to tuberculosis when working as a doctor in Manila, the Philippines. Ten days before admission she had spent 10 days in Sao Paulo, Brazil. On admission she complained of fatigue, dry cough and nocturnal sweating. Her body temperature was 37.8; C. At auscultation of the chest fine rales were heard with diminished percussion sounds over both lungs. INVESTIGATIONS: The chest radiogram showed bilateral apical infiltrates. Blood count indicated normal white and red cells, but platelets were raised to 606 x 10 9/l. The differential blood count revealed an eosinophilia of 30%, ESR was raised at 91 mm/h and C-reactive protein increased to 103 mg/l. Angiotensin-converting enzyme, IgG, IgA, IgM, IgE, C3 and C4, paraproteins, antinuclear antibodies and double-strand DNA antibodies were all within normal limits. There was no direct or indirect evidence of tuberculosis and no parasites were found in sputum, stool, urine and blood. DIAGNOSIS, TREATMENT AND COURSE: After bronchoscopy with bronchial biopsy had failed to establish a diagnosis, an open lung biopsy with partial lung resection was performed. This revealed histologically an eosinophilic pneumonia with intra-alveolar protein precipitation and multinucleated giant cells, as well as interstitial fibroblast proliferation without demonstrable mincroorganisms. Under cortisone administration there was striking improvement of symptoms within a few days, and C-reactive proteins fell to 3 mg/l, ESR to 25 mm/h and the eosino-philia to 2%. CONCLUSION: Eosinophilic pneumonia should be included in the differential diagnosis of unclear pulmonary infiltrations with eosinophilia, once parasitological and malignant diseases, tuberculosis and allergic pulmonary aspergillosis have been excluded.
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PMID:[Unclear pulmonary infiltrates with eosinophilia, a problem of differential diagnosis] 1275 Oct 17

A 45-year-old man from the Netherlands who travelled a lot and who had visited Cameroon, amongst other places, presented a few months after his trip with transient unilateral swellings (so-called Calabar swellings), located on his forearms, hands, fingers and feet, and which were accompanied by pruritus, pain, signs of scratching, arthralgia, general fatigue and evident eosinophilia. The differential diagnosis included strongyloidiasis, schistosomiasis, filariasis (in particular loiasis) and hypereosinophilia syndrome. Loiasis was diagnosed by means of positive IgG4 serology against Loa loa. The patient was treated with albendazole and remained free of swellings after treatment.
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PMID:[A patient with loiasis following a trip to Central Africa]. 1286 63


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