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 young man with dermatitis herpetiformis developed fatigue and neurologic complaints 4 years after he began oral dapsone therapy. Neurologic examination and nerve conduction studies confirmed the presence of a combined motor and sensory peripheral neuropathy. The symptomatic improvement reported by the patient was supported by improvement in the nerve conduction studies after cessation of dapsone therapy. Substitution of sulfapyridine did not adversely affect the resolution of his neuropathy.
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PMID:Dapsone-induced peripheral neuropathy. 301 89

Computed tomographic (CT) findings of cerebral and cerebellar calcification are described in three American adults with raised serum lead levels and known exposure to lead for 30 or more years. Calcification patterns were punctiform, curvilinear, speck-like, and diffuse and were found in the subcortical area, basal ganglia, vermis, and cerebellum. Admission serum lead levels ranged from 54 to 72 micrograms/dl (normal, 0-30 micrograms/dl). Nonspecific neurologic manifestations consisted of dementia, diminished visual acuity, peripheral neuropathy, syncope, dizziness, nystagmus, easy fatigue, and back pain. Two patients developed chronic renal disease and hypertension; in both cases, serum parathormone was elevated. Blood, calcium, and phosphorus were normal in all three. No other structural abnormalities were observed with CT. Although the pathophysiologic mechanism of these findings remains poorly understood, it is suggested that chronic lead exposure should be included in the differential diagnosis of unexplained intracranial calcifications in adults.
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PMID:Intracranial calcification in adults with chronic lead exposure. 348 74

We describe the clinical courses of 5 patients with Lyme disease who developed significant late complications, despite receiving tetracycline early in the course of their illness. All 5 patients had been treated for erythema chronicum migrans with a course of tetracycline that met or exceeded current recommendations. The late manifestations of Lyme disease included arthritis, cranial nerve palsy, peripheral neuropathy, chronic fatigue, and changes in mental function. Our findings suggest that the use of tetracycline at a dosage of 250 mg, 4 times a day for 10 days, as a treatment for early Lyme disease should be reconsidered. To determine optimal therapy for early Lyme disease, a study that compares an increased dosage of tetracycline with alternative treatments is indicated.
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PMID:Failure of tetracycline therapy in early Lyme disease. 358 12

Primary biliary cirrhosis (PBC) is a chronic nonsuppurative, destructive cholangitis, whose etiology is unknown. Morbidity arises early from pruritus and later from hypercholesterolemia with xanthoma formation. Therapy is supportive and directed at the complications of cholestasis. Plasmapheresis has been reported to benefit patients with hyperlipidemia and PBC; thus a pilot study of plasmapheresis utilizing the Haemonetics Model 30 with replacement by albumin and saline was conducted. Five patients (four female and one male) with a mean age of 43 (range 29-58) and a mean duration of illness of 9.5 years (range 6-21) with marked jaundice, xanthomas, xanthelasma, hepatomegaly, fatigability, anorexia, and pruritus, as well as mild nausea were studied. Peripheral neuropathy was present in two patients. Two patients had splenomegaly. Two patients had an associated Sjogren syndrome. All patients had high serum bilirubin, alkaline phosphatase, and cholesterol levels and mild elevations in aspartate amino transferase and alanine amino transferase activities. Immune complexes measured in four patients were present. Antimitochondrial antibody titers were significant in all patients. Patients underwent a mean of 63 plasmapheresis procedures over a mean of 112 weeks removing a mean of 94.7 liters of plasma. No serious toxicity was seen. All patients showed a reduction in pruritus, xanthomas, xanthelasmas, and serum cholesterol values. The two patients who had evidence of Sjogren syndrome noted subjective improvement. All patients who had fatigue, anorexia and nausea also noted moderate improvement. There was no change in hepatomegaly or splenomegaly in patients demonstrating such organomegaly. Liver function did not change significantly. Overall, four patients had improvement in their condition and one patient achieved stability.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The clinical effectiveness and safety of chronic plasmapheresis in patients with primary biliary cirrhosis. 403 Jul 9

There is deep concern about the long term health effects of exposure to phenoxy herbicides and the contaminant TCDD; however, there is considerable scientific and medical uncertainty regarding the health effects from exposure to these chemicals. There are at least ten ongoing studies on reproduction, morbidity and mortality as well as studies of tissue concentrations of TCDD that are attempting to determine the health effects of these chemicals (see Table 2). Appropriate efforts should be made to prevent human and environmental exposure and to decontaminate the environment while awaiting the results of these investigations. Animal toxicity studies show such wide variations that extrapolations from a different species to humans are tenuous. Human studies on exposed workers and nonoccupational exposures are difficult to interpret because the exposure has not been quantified and because workers were exposed to mixtures of chemicals. Chloracne appears to be an important specific clinical marker of TCDD exposure, however, it can be caused by structurally similar compounds. Many of the past studies on human health effects of 2,4,5-T and TCDD are controversial. Since the scientific data are not firm, no specific statements can be made regarding the long term health effects at this time. Any individual who has had a significant exposure to TCDD should see his/her physician and have appropriate consultation. Long term follow up will be required. Physicians should be instructed regarding the possible manifestations of TCDD exposure to look for chloracne, soft tissue masses, muscle pain, fatigue, peripheral neuropathy, tender hepatic enlargement, enlargement, elevated liver enzymes, elevated lipids, prolonged prothrombin time, hemorrhagic cystitis and hirsutism.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Commentary on 2,3,7,8-tetrachlorodibenzo-para-dioxin (TCDD). 406 May 65

Fifty-two patients with metastatic or recurrent non-small-cell lung cancer (NSCLC) were treated, during a phase II trial, with methylglyoxal-bis-(guanylhydrazone) (MGBG). Of the 44 patients who had adequate trials, 4 had partial responses (PR), for an overall 9% PR rate. Response durations ranged from 3 to 5+ months. Prior treatment with chemotherapy may have adversely affected response rate; 15% of previously untreated patients responded, compared to only 4% of previously treated patients. A syndrome of weakness and fatigue was the most serious side effect. Anorexia and weight loss, stomatitis, nausea and vomiting, diarrhea, and peripheral neuropathy were the other toxic effects. We conclude that MGBG has activity in NSCLC, especially in previously untreated patients, and further studies are indicated in that population.
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PMID:Phase II trial of methylglyoxal-bis-(guanylhydrazone) in non-small-cell lung cancer. 627 32

Since their initial description in 1957, the interferons (IFNs) have been increasingly used to treat a wide array of diseases. Acute adverse effects, i.e. 'flu-like' syndromes, hypo- or hypertension, tachycardia, headache, myalgias and gastrointestinal disorders, occur within the first hour or day after starting treatment. They are seldom treatment-limiting and are easily manageable. Sub-acute and chronic effects develop after several days, usually within 2 and 4 weeks of therapy. The most typical is neurological toxicity, including fatigue/asthenia, and behavioural and cognitive changes. Such symptoms may seriously impair quality of life and result in treatment discontinuation. Seizures have seldom been described. Other infrequent central nervous system adverse effects include vertigo, cramp and oculomotor nerve paralysis. Distal paraesthesias and peripheral neuropathy have been reported. IFN-associated autoimmunity is quite rare but a matter of concern. Biological or clinical manifestations usually require several months to become apparent. Autoantibodies have been shown to develop in most patients but have been inconsistently associated with clinical symptoms of systemic lupus erythematosus, rheumatoid-like arthritis and thyroiditis. Both hypo- and hyperthyroidism have been described but are usually reversible. Other infrequent autoimmune reactions include diabetes, pemphigus and worsening of multiple sclerosis. Although several patients present with a pre-existing autoimmune disorder, no predisposing factor has been clearly established. While hypotension and tachycardia are the most frequent acute cardiovascular complications, a few additional cases of cardiac arrhythmias and myocardial ischaemia have been reported after a short course or several weeks of treatment. These latter complications do not appear to be dose-dependent or age-related. Isolated cases of congestive heart failure have also been described. Mild proteinuria has been observed in 15 to 25% of patients, but acute renal toxicity is uncommon. A transient rise in serum aminotransferase levels is frequently noted during the first stage of therapy, especially in patients receiving the highest dosages. Direct hepatotoxicity is extremely rare. Autoimmune hepatitis, which is ill-diagnosed as chronic viral hepatitis, and de novo induction of autoimmune hepatitis, account for the majority of liver diseases. Haematotoxicity is relatively common but mild to moderate, and develops gradually during the first weeks of treatment. Neutropenia is the most common haematological toxicity, but is usually not dose-limiting and resolves rapidly upon drug discontinuation. Myelosuppression, autoimmune and immune allergic haemolytic anaemias and thrombocytopenias have seldom been described. Cutaneous adverse effects comprised nonspecific erythema and hair loss and, less frequently, vasculitis, local ulcerations at the site of injection and exacerbation of psoriasis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Clinical toxicity of the interferons. 751 63

A 44-year-old man with a documented 12-year history of progressive sensorineural hearing loss developed a generalized tonic-clonic seizure followed by a visual field deficit and apraxia. Six months later he developed a peripheral neuropathy and muscle fatigue followed by a slowly progressive aphasia and cortical blindness as well as increased seizure activity. A computed tomography scan showed bilateral basal ganglion calcification. The serum lactate level was elevated at 3.4 mEq/dL. A muscle biopsy enabled the diagnosis of mitochondrial myopathy. This disorder is presented as an unusual cause of progressive sensorineural hearing loss in adults.
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PMID:Mitochondrial encephalomyopathy: a rare genetic cause of sensorineural hearing loss. 757 56

To explore the potential therapeutic differences between 3- and 96-hour infusions of paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) in patients with refractory malignant diseases, we conducted a phase II study in which patients were treated first with paclitaxel 135 mg/m2 by 3-hour infusion. If patients did not respond or relapsed after response, they were then treated by 96-hour infusion of paclitaxel at the same dose. Patients with metastatic or incurable breast, ovarian, lung, head/neck carcinomas, and lymphoma were eligible. They were required to have an Eastern Cooperative Oncology Group performance status of 2 or better and adequate hematologic, hepatic, and renal functions. In 22 patients entered thus far, we have observed one partial response in 10 lung cancer patients treated by 3-hour paclitaxel and one partial response in six patients treated by 96-hour infusion. Four partial responses were observed with 3-hour paclitaxel alone in nine breast cancer patients, while three partial responses occurred in five patients with 96-hour infusion after the 3-hour infusion failed. Nonhematologic toxicities such as fatigue, peripheral neuropathy, and mucositis occurred more commonly in the 96-hour infusion group. Our preliminary results suggest (1) that 3-hour infusion of paclitaxel is active against refractory breast cancer, (2) that 96-hour infusion of paclitaxel can induce partial response in breast cancer that was refractory to 3-hour treatment of paclitaxel, and (3) that more studies are needed to define the optimal treatment schedule of paclitaxel.
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PMID:Paclitaxel by 3-hour infusion followed by 96-hour infusion on failure in patients with refractory malignant disease. 759 29

The results from experiments in various modalities of evoked potentials are described in a subject with a complete large peripheral neuropathy below the neck. He has no tactile or position sensitivity below that level, but has retained fatigue, pain, and temperature sensation. Percutaneous electrical stimulation of peripheral nerves led to scalp recorded evoked potentials with thresholds and propagation velocities compatible with conduction along A-delta peripheral pathways. CO2 laser evoked potentials were similar to those seen in controls, further support for intact A-delta peripheral fibres. Movement-related cortical potentials (MRCPs) were recorded associated with active and passive movement of the middle finger. The former were normal, evidence that the termination of the MRCP is not dependent on peripheral feedback. By comparing passive MRCPs between controls and the subject it was possible to establish which parts of the potentials are visual and which are proprioceptive and to gain evidence of central reorganisation in the subject. Magnetic brain stimulation was used to show that the subject did not perceive induced movement, had a normal centrally originating silent period, and could focus his attention during real and imagined movement of the finger more successfully than could normal controls.
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PMID:Evoked potentials in a subject with a large-fibre sensory neuropathy below the neck. 762 62


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