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Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Myasthenia gravis is a rare disease with unique clinical features. These include (1) progressive fatigue on exertion, most evident clinically in the muscles of the head and neck (2) a definite relationship of the disease to the thyroid, parathyroid and thymus glands. A hypothesis is advanced with correlates these facts on the basis of a common embryologic origin of these glands and the branchial arch muscles. A corollary is that the muscles of the head and neck differ from the somatic musculature in some as-yet-unidentified manner, for example, pharmacologically. A plea is made for comparative studies between the two.
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PMID:Myasthenia gravis: An embryologic and phylogenetic perspective. 93 7

Primary malignant schwannoma of the small intestine is an extremely rare disease. We report a primary malignant intestinal schwannoma of the small bowel in a 66-year-old woman, who was admitted to the hospital because of fatigue and anaemia. On clinical examination there was a solid mass at the abdomen. Ultrasound scanning showed an abdominal tumour. Computed tomography showed a mass in the area of the pancreatic tail involving the small intestine. At laparotomy a 10 x 10 cm tumour was found in the proximal jejunum, and 50 cm of the small intestine was resected. The histology of the lesion corresponded to a malignant intestinal schwannoma. The results of previous studies and of our report suggest that the diagnosis of malignant intestinal schwannoma may be difficult, and to exclude malignant conditions laparotomy and surgical excision of the tumour are adequate in the management of this type of lesion.
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PMID:Primary malignant schwannoma of the small bowel. 145 11

A case of congenital, isolated tricuspid regurgitation is reported. A 48 year old woman has been admitted because of shortness of breath and progressive fatigue. Although the heart murmur had been heard in her childhood, the first symptoms appeared when she was 25. One year later she underwent a plastic surgery of tricuspid valve. During the following 20 years she remained asymptomatic, until dyspnea and fatigue developed again. On admission she was cyanotic and positive, systolic jugular venous pulse was seen. Atrial flutter was present and no systolic cardiac murmur was heart. The liver was enlarged without peripheral oedema. Echo-Doppler examination and cardiac catheterisation revealed huge right cardiac chambers and significant tricuspid regurgitation. During reoperation a valve consisting of only two cusps was found with extremely dilated valvular anulus. A Bex valvuloplasty was successfully performed. One month later a control echo-Doppler showed the diminution of right ventricle and right atrium with hardly visible regurgitant jet. The pathogenesis and the course of this extremely rare disease have been also discussed in the paper.
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PMID:[Isolated congenital tricuspid valve insufficiency--case report]. 147 73

Primary hyperparathyroidism was thought 30 years ago to be a rare disease, and the diagnosis was most often made in patients presenting with either bone disease or kidney stones. Today the minority of patients with hyperparathyroidism present with such symptoms, a fact accounted for by the introduction into general medical practice three decades ago of laboratory technology for efficiently determining the serum concentrations of various blood minerals, including calcium. Hypercalcemia was detected more frequently, and it was realized that most patients with hyperparathyroidism either had minor symptoms, such as constipation, polyuria, tiredness, and muscle weakness, or they were "asymptomatic" and indistinguishable from normal subjects. It was thought that primary hyperparathyroidism was a progressive disease and that sooner or later all patients would become symptomatic and require parathyroidectomy. Since this operation was curative in a high percentage of cases, it was recommended for virtually all patients once the diagnosis was established. In this contribution the long-term benefits of parathyroidectomy in patients with and without symptoms from primary hyperparathyroidism are reviewed. It is concluded that a multicenter prospective randomized trial is needed to resolve the indications for operative and nonoperative management of patients with this disease.
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PMID:Surgical therapy of patients with primary hyperparathyroidism: long-term benefits. 176 66

Allergic alveolitis due to mold dust inhalation in farmers is a severe but rare disease in Scandinavia. In this report 38 cases of the disease are presented. There were 31 men and 7 women, with mean ages of 46 and 38 years respectively. Strict diagnostic criteria were used, resulting in 21 definite, 12 probable and 5 possible cases. None of the patients were current smokers, but 10 of the men were ex-smokers. The great majority of the patients fell ill between October and April. The symptoms were dyspnea, cough, fatigue, episodes of fever, and in some cases loss of weight. The average duration of the disease was 6 months. The moldy material most commonly associated with the disease was straw, followed by hay, grain, and wood chips. For those tested serum lactate dehydrogenase was raised in 80% and the mean value for PaO2 was 7.8 kPa. Precipitating antibodies to mold antigens were positive in 68%. In general, pulmonary function tests showed a restrictive pattern. Over half of the patients still had dyspnea on exercise after recovery. Three fourths of the patients were treated with antibiotics and thus clearly had been misjudged as having an infection.
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PMID:Allergic alveolitis in Swedish farmers. 260 70

Primary cardiac tumor is an extremely rare disease entity. Only three cases of primary malignant cardiac schwannoma, the subject of this report, have been recorded in Japan. Recently, we encountered a case of malignant schwannoma in which retention of pericardial effusion was the first clinical finding. This case was a 30-year-old female, who had dyspnea at work, general fatigue, and fever. Striking cardiac expansion was seen, with a cardiothoracic ratio (CTR) of 69% on chest x-ray. Two-dimensional echocardiograms showed a large volume of pericardial effusion between the side wall of the left ventricle and the epicardium, and the presence of a parenchymatous tumor. An increase in tumor size was detected on chest computer tomography (CT) scan. Using a pump oxygenator, median sternotomy was performed to reach the epicardium. A pale yellow, soft tumor was seen in the left atrium near the left ventricle. Histologically, the patient was diagnosed as having a malignant schwannoma. We have reported a case of primary malignant schwannoma which was surmised to have arisen from the boundary between the atrium and the ventricle.
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PMID:Malignant schwannoma of the heart. 334 6

Unilateral adrenal tuberculosis is a very rare disease. A 66-year-old woman presented with epigastric discomfort and general fatigue. Abdominal CT scan revealed a homogeneous mass shadow in the right adrenal region. Findings of physical examination were normal except that the patient was obese. Hormonal data were in normal range. Adrenal scintiscanning demonstrated no RI uptake in the right adrenal gland. Right adrenalectomy was performed under the diagnosis of nonfunctioning tumor of the right adrenal gland. Histopathological examination, however, revealed typical tuberculosis with Langhans' type of giant cells and infiltrated lymphocytes. Of 322, 148 autopsies performed during the twelve years between 1970 and 1981 in Japan, 228 cases of adrenal tuberculosis were recognized. Furthermore, only 18 cases had tuberculous regions in the adrenal gland alone.
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PMID:[Tuberculosis of the contralateral adrenal gland: a case report]. 402 81

We report on a 44-year-old male with primary cardiac angiosarcoma who died 11 months after onset of nonspecific symptoms (thoracic pain and general fatigue) of intracerebral metastases. A right atrial tumor mass and a pericardial effusion could be demonstrated by transthoracic and transesophageal echocardiography. Cardiac angiography showed a right atrial hemangioma, fed by the right coronary artery. In a review of 108 cases of primary cardiac angiosarcoma we summarize clinical features, diagnostic means, therapeutic approaches and life expectancy of this rare disease.
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PMID:Primary angiosarcoma of the heart. Report of a case and review of the literature. 830 53

Virus-associated hemophagocytic syndrome (VAHS) is associated with a systemic viral infection and is mainly observed in immunosuppressed adult patients. This rare disease is characterized by symptoms which include a high fever, pancytopenia, and splenomegaly and sometimes results in a fatal outcome. However, thus far, little has been reported on VAHS in general surgical patients. We herein report this rare complication which occurred in a patient with hepatocellular carcinoma, as well as chronic hepatitis C, after a hepatic resection. A 66-year-old man with chronic hepatitis C and recurrent hepatocellular carcinoma underwent a repeat hepatic resection without any blood transfusions. In the early postoperative period, he recovered uneventfully. However, he suddenly began to suffer from a high fever (38.4 degrees C) and severe pancytopenia 8 days after surgery. Activated macrophages, which phagocytosed erythrocytes, were identified by a cytological study of the bone marrow. The patient was therefore treated with methylprednisolone pulse therapy 13 days after surgery. On the day following the initial administration of methylprednisolone, his clinical condition drastically improved. Fortunately, with methylprednisolone therapy, our patient recovered from acute, severe pancytopenia. In general surgery, it is often difficult for surgeons to use steroids due to their negative side effects. However, when symptoms such as fever, general fatigue and pancytopenia are observed, even in posthepatectomy patients with hepatocellular carcinoma and hepatitis, a bone marrow aspiration should be performed as soon as possible, and when VAHS is suspected, steroid pulse therapy should be the first treatment of choice. This rare but sometimes fatal complication should thus be taken into consideration in the postoperative management of hepatectomized patients with chronic hepatitis C.
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PMID:Virus-associated hemophagocytic syndrome after hepatic resection: a case report. 949 16

Vasculitis confined to the central nervous system (CNS) is a rare disease usually characterized by headache and focal neurologic symptoms. Patients with primary vasculitis of the CNS may have symptoms and laboratory findings of systemic disease such as fatigue and elevated erythrocyte sedimentation rate, but by definition, focal inflammation should not be present outside the CNS. We describe 3 patients with uveitis in association with this diagnosis. The recognition of this association adds to the complex differential diagnosis of uveitis in association with CNS disease, and indicates that "isolated" angiitis of the CNS may display clinical features outside the brain and spinal cord.
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PMID:Uveitis and central nervous system vasculitis. 951 87


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