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)

Background: As the role of PET-FDG imaging is being established in the staging and monitoring of response to therapy in children with lymphoma, we encountered a case of an infection common in adolescence that may present with lymphoma-like signs and symptoms.Methods: A 13-year-old previously healthy male presented with a left neck mass associated with weakness, fatigue, intermittent fevers and weight loss. He was then referred to the hematology/oncology department with a working diagnosis of lymphoma. The total wbc count was 5920/cu mm with 75% lymphocytosis without atypical lymphocytes. ESR was 20 mm. Serologic analysis for EBV, CMV, toxoplasmosis and hepatitis was also performed. The chest x-ray was normal. CT scan demonstrated multiple enlarged lymph nodes in both right and left jugulodigastric and spinal accessory chains; the largest mass within the left spinal accessory chain had focal necrosis within it. There were no enlarged mediastinal or axillary nodes. The spleen was massively enlarged and the splenic index was 924 (normal for age = 744).Results: FDG imaging showed intense uptake in both cervical regions, the mediastinum and in the enlarged spleen. The results of the Monospot test and the EBV panel which were both positive, were available 3 & 5 days later. Based on these serologic results, the history, physical findings and the negative chest x-ray, the final diagnosis was infectious mononucleosis.Conclusion: Despite availability, ease of performance and sensitivity of FDG imaging, this case illustrates the importance of clinical, hematologic and serologic assessment of disease prior to FDG imaging.
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PMID:22. FDG Uptake in Infectious Mononucleosis. 1115 Jul 79

The aim of this study was to assess, by positron emission tomography (PET), the effect on cerebral functional activity of a new lorazepam-gamma-aminobutyric acid (GABA) conjugate [3-(4-acetamido)-butyrril lorazepam (DDS2700)]. Ten healthy volunteers were studied by PET and [18F]fluoro-deoxy-D-glucose ([18F]FDG) under baseline conditions and following the administration of DDS2700. Regional cerebral blood flow (rCBF) was measured by PET and 15O-water in three additional participants while they performed attentive tasks, before and after drug administration. DDS2700 induced a decrease in the regional cerebral metabolic rate of glucose (rCMRglu) in the thalamus (-17%), cerebellum (-11%) and caudate nucleus (-8%). The observed effects on glucose metabolism were probably related to the subjective sedation and tiredness reported by the participants. During the attentive tasks, rCBF increased in frontal and temporal regions associated with attentional processing of auditory material. These circuits were no longer active after DDS2700 administration, while rCBF increased in cingulate cortex, occipitoparietal regions, pons and cerebellum. These drug-induced activations might be directly related to intervening sleepiness and to the consequent effort in keeping attention focused on the tasks. The effects of DDS2700 on glucose metabolism at rest, and on rCBF during activation conditions, indicate a drug action on cerebral networks involved in alertness, vigilance and attention maintenance. PET assessment by [18F]FDG and water may provide complementary information in pharmacodynamic studies.
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PMID:Acute effect of 3-(4-acetamido)-butyrril-lorazepam (DDS2700) on brain function assessed by PET at rest and during attentive tasks. 1133 50

Positron emission tomography (PET) has emerged as a powerful tool in clinical oncology which allows to detect pathological changes in the metabolic characteristics of different tissues. In recent years the PET with the radiopharmakon 18F-2-fluoro-2-deoxyglucose has proved to be valuable for the diagnostic approach in inflammatory diseases. We report the case of a 69 year old female patient who was admitted for the diagnostic evaluation of a single pulmonary nodule in the right upper lobe which was suspicious for malignancy in the CT scanning. In the last three month the patient lost 13 kg weight, and was complaining about weakness, fatigue, enhanced body temperature up to 101 degrees F and night sweets. In the laboratory findings a microcytic anemia (80 g/L, 74,4 fL), an enhanced C-reactive protein (133 mg/L) and an accelerated ESR of 100 mm Hg/h was remarkable. The pulmonary nodule located in the second segment of the right upper lobe was not accessible in the bronchoscopic examination. Abdominal and cerebral CT scannings showed no pathological findings. In the positron emission tomography an enhanced accumulation of 18F-2-fluoro-2-deoxyglucose could be detected in the complete aorta and the large-sized arteries of the aortic arch consistent with the diagnosis of a giant-cell arteritis. The suspicious pulmonary nodule of the CT scanning showed no metabolic activity as provable with the PET. The 18F-FDG PET which is used in the initial staging of newly diagnosed lung cancer and known to be superior to CT in the evaluation of lymph node and distant metastases, is applicable in the diagnostic assessment of chronic inflammatory diseases. As the diagnostic approach in patients presenting with clinical symptoms as fatigue, weight loss, night sweets and fever is often arduous and time-consuming, the PET might become a more central role in the future.
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PMID:[PET-imaging proves giant-cell arteritis as the cause of FUO in a patient with a pulmonary nodule of unknown malignancy]. 1286 94

We reviewed our initial institutional experience with the use of stereotactic hypofractionated radiation therapy (SFRT) in patients with stage I non-small cell lung cancer (NSCLC). Thirty patients with inoperable stage I non-small cell lung cancer due to a severe chronic obstructive pulmonary disease (COPD) and/or chronic heart disease (Eastern Cooperative Oncology Group (ECOG) performance status of 0-2) were treated between December 2000 and October 2003 with SFRT in curative intent. Infiltration of locoregional lymph nodes and distant metastases were ruled out by computerized tomography (CT) scan of the brain, thorax, and abdomen, and by whole body FDG-positron emission tomography scan in all patients. Total RT doses ranged from 24.0 to 37.5 Gy, given in 3-5 fractions to the 60% isodose encompassing the planning target volume. Immobilization was carried out by a vacuum couch and a low-pressure foil. The clinical target volume was the tumor as it appeared in lung windowing on lung CT scan. Organ movements (caused by breathing; range, 6-22 mm) and reproducibility of patient positioning in the couch (range, 3-12 mm) were calculated by sequential CT and orthogonal films. The individual values were taken into account as a safety margin for the definition of the planning target volume (PTV). The median follow-up of living patients is 18 months (range, 6-38 months). As maximum response, there were 10 (33%) complete responses (CRs) and 14 (47%) partial responses (PRs), resulting in a total response rate of 80%. Stable disease was observed in 6 (20%) patients, while no patient experienced progressive disease. During follow-up, 2 (7%) local recurrences were observed (after 17 and 18 months, respectively). Of 5 (17%) patients who developed distant metastasis, 1 patient developed it in liver (3 months), another one in brain (6 months), and another one in the lung (36 months), while 2 patients developed it in mediastinal lymph nodes (after 8, and 11 months, respectively) only. Of 9 (30%) patients who have died, only 3 (10%) died of cancer, while 6 (20%) died of cancer-unrelated or unknown causes. Acute side effects were mild and affected 9 (33%) patients during the RT course (fatigue being the most frequent one in 6 patients). There were 22 acute events occurring in 19 (63%) patients during the first 3 months post-SFRT, the most frequent one being pneumonitis observed in 14 (46%) patients. However, there was only one (3%) grade 3 acute toxicity and no patient experienced greater than grade 3 toxicity during this study. One (3%) patient experienced rib fracture as the late event. SFRT is a feasible and safe treatment method in inoperable patients with stage I NSCLC having reduced lung capacity. Longer follow-up is necessary to get robust data on late toxicity as well as survival.
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PMID:Stereotactic hypofractionated radiation therapy for stage I non-small cell lung cancer. 1577 77

October 2004. A 49-year-old right-handed man developed progressive cognitive difficulties over a 4-month period. There was impairment in recent memory, calculations and language. He also developed fatigue, weight loss, gait imbalance and urinary incontinence. Past history included transfusion-associated Hepatitis C. Neurologic exam showed mild dysarthria, dysnomia, left sided neglect, bilateral Babinski signs, and a prominent grasp reflex. Laboratory testing provided no positive etiologic data. An EEG showed generalized intermittent slowing suggestive of a diffuse encephalopathy and decreased background in the right hemisphere, suggestive of a structural lesion. MRI showed multiple areas of high signal on FLAIR imaging and patchy enhancement. FDG-PET showed multi-focal areas of increased uptake, correlating with the abnormal areas on MRI, on a background of decreased uptake. A 4-vessel cerebral angiogram showed no abnormalities. A brain biopsy showed diffuse infiltrates of large malignant cells that were immunoreactive with antibodies to CD20, diagnostic of diffuse large B cell lymphoma. In summary, the clinical presentation suggested bilateral hemispheric involvement, which was supported by physical examination, EEG, MRI, and PET scans. The differential diagnosis for this presentation is limited to demyelinating disease such as multiple sclerosis, vascular dementia, and infiltrating neoplasm such as glioblastoma multiforme or lymphoma. Diagnosis was made by morphologic and immunohistochemical analysis of brain tissue.
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PMID:October 2004: a 49-year-old man with progressive dementia. 1591 74

We report a case where acute varicella infection, chickenpox, mimics the findings of recurrent Hodgkin disease on F-18 FDG PET/CT. A 28-year-old man with a history of Hodgkin disease in remission had fatigue, pyrexia, and a raised ESR. His F-18 FDG PET/CT, performed to exclude lymphoma recurrence, demonstrated FDG-avid lymphadenopathy and increased FDG uptake in his spleen. A day later he developed the generalized rash of acute varicella infection. This was managed with valacyclovir. Repeat F-18 FDG PET/CT done 1 month later showed no evidence of FDG-avid disease. In this patient the stimulation of an immune response by the acute viral infection mimics recurrent lymphoma.
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PMID:Acute varicella infection mimics recurrent Hodgkin's disease on F-18 FDG PET/CT. 1788 70

FDG PET-CT imaging is increasingly accepted as a modality for evaluation of many malignancies, but FDG also can be accumulated intensely by inflammatory lesions. We present a case of a 60-year-old woman with intermittent fever, chills, fatigue, and dyschezia. CT scans indicated colon carcinoma with thoracic and retroperitoneal lymph node metastases. Whole body FDG PET-CT was performed to confirm and stage the malignant disease and showed intense FDG uptake in those lesions. However, histopathology confirmed tuberculosis. The literature describing FDG accumulation in constitutional tuberculous lesions is sparse, and one must be aware of patterns of FDG accumulation in tuberculosis in the diagnosing malignancies.
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PMID:Systemic disseminated tuberculosis mimicking malignancy on F-18 FDG PET-CT. 1809 61

A 71-year-old woman with type 2 diabetes mellitus complained of generalized fatigue. A 36-mm tumor in the pancreatic tail was detected with ultrasonography. The tumor was found to have marked hypervascularity with contrast-enhanced computed tomography (CT) and magnetic resonance. Combined (18)F-fluorodeoxyglucose positron emission tomography and CT ((18)F-FDG PET/CT) showed (18)F-FDG by the tumor with a maximal standardized uptake value of 2.98 at 50 min and 3.29 at 100 min following injection of (18)F-FDG. (18)F-FDG PET/CT suggested no extrapancreatic spread of the tumor. The patient had no pancreatic hormone-associated symptoms. Distal pancreatectomy was performed, and a well-differentiated endocrine tumor was diagnosed. The resected specimen showed neither infiltration of adjacent structures nor metastasis to regional lymph nodes. The present case suggests that (18)F-FDG PET/CT is a reliable modality for staging endocrine pancreatic tumors.
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PMID:Nonfunctioning endocrine pancreatic tumor examined with 18F-FDG PET/CT. 1831 38

Vasculitis is a disorder characterized by inflammation of blood vessels. Its clinical manifestations are diverse and depend on the size of the involved vessels and the organs affected by ischemia. In some cases the disease is manifested only with symptoms and signs of systemic inflammation (e.g. fever, night sweats, fatigue). Results of laboratory tests usually indicate only the inflammatory process. It is known that radiolabeled glucose analogue 18F-fluoro-deoxyglucose ([18F] FDG) used in positron emission tomography (PET) accumulates in both malignant and inflammatory tissue (Zhuang et al. in Radiol Clin North Am 43:121-134, 2005). We report a case of a patient with FDG-PET/CT findings of large-vessel vasculitis with follow-up results that convinced us to change the treatment.
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PMID:FDG-PET/CT in large-vessel vasculitis: its diagnostic and follow-up role. 1958 44

Takayasu's arteritis (TA) is characterized by a chronic inflammatory arteriopathy with unknown etiology affecting large vessels. As TA occurs mostly in young females, elderly males with this disease may be under-diagnosed. A 65-year-old Chinese male with a 6-week history of fever, fatigue, low appetite, night sweats, and a 5-kg weight loss did not experience symptoms of jaw claudication, localized headache, sudden visual change, upper or lower extremity claudication, arthralgia, and rashes. On physical examination and laboratory findings, there was no evidence of infectious disease or malignancy. (18)F-Fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) was performed which suggested TA. The patient was treated with methylprednisolone and clopidogrel. His symptoms subsided gradually and hematological examination showed decreases of erythrocyte sedimentation rate and high-sensitivity C-reactive protein. We reported here a patient who presented with fever of unknown origin and was diagnosed with TA using PET/CT. Although elderly males are beyond the predominant population of TA, TA should be considered when there is no evidence of infectious disease and malignancy.
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PMID:Diagnosis of a 65-year-old male patient with Takayasu's arteritis by 18F-FDG PET/CT. 1982 33


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