Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0016382 (flushing)
 6,387 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 60-year-old man, known for stable coronary artery disease, was admitted for suspected unstable angina. In the previous month, the patient presented with progressive dyspnea on light exertion. In the preceding four months, he had experience occasional episodes of flushing and diarrhea, and had inexplicably lost 22.7 kg. Night sweats and fever were absent. ST segment elevation in the inferior leads and ST segment depression in the precordial leads were documented during an episode of chest pain. The coronary angiogram showed diffuse disease with 70% stenosis of the left anterior descending coronary artery and 50% stenosis on the second diagonal (D(2)). An echocardiogram showed a patent foramen ovale. Balloon angioplasty and stenting were performed on the two lesions. Two days later, prolonged chest pain recurred. Cardiac catheterization was repeated and showed occlusive thrombus within the stent on the D(2). Angioplasty was repeated. Symptoms recurred 36 h later, with the electrocardiogram showing ST segment elevation. The first angiogram was reviewed and vasospasm was suspected on a branch of the D(2), on the second marginal and in the distal circumflex artery. The diagnosis of vasospastic angina was retained. Beta-blockers were replaced by high doses of a calcium channel blocker with an excellent clinical response. The case described is of a patient with an acute coronary syndrome, vasospastic angina, in-stent thrombosis and carcinoid disease. Coronary vasospasm was attributed to serotonin, which was secreted by the carcinoid tumour that reached an atherosclerotic coronary vasculature through a patent foramen ovale, thereby avoiding pulmonary inactivation.
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PMID:A most unusual acute coronary syndrome. 1663 80

A 21-year-old man, who had suddenly developed dyspnea with sneeze, cough and nasal congestion following supper, was admitted to our hospital because of hypoxemia and hypercapnia. Physical examination revealed wheezing in all lung fields and skin flushing. He took home-made Okonomi-yaki made from flour, which had been opened few months ago, and then had been remained uncooked at room temperature. Skin prick tests showed positive for problem flour and mite, but negative for just opened control flour. Collectively, we gave his diagnosis of anaphylaxis caused by mite-contaminated Okonomi-yaki.
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PMID:[A case of anaphlaxis caused by mite-contaminated Okonomi-yaki]. 1688 95

The reported incidence of hypersensitivity reactions (HSRs) associated with oxaliplatin in patients with colorectal cancer (CRC) is approximately 12%, with 1 - 2% of patients developing grade 3 or 4 in severity. However, the recent rising incidence of HSR to oxaliplatin observed is the result of increasing clinical use. HSR to oxaliplatin may manifest as facial flushing, rash/hives, tachycardia, dyspnoea, erythema, pruritus, fever, tongue swelling, headache, chills, weakness, vomiting, burning sensations, dizziness and oedema. Anaphylactic shock is rare but serious, and must be considered in the event of hypotension. No definitive approaches to prevent and treat HSR associated with oxaliplatin are available; however, few successful strategies have been reported. Such strategies include: slowing the infusion rate, use of steroids and antagonists of type 1 and 2 histamine receptors, and desensitisation. Successful implementation of oxaliplatin desensitisation protocols based on other platinum-containing compounds have been reported, which could enable a small number of patients who experience severe HSR to further receive an effective therapy for CRC. However, reintroductions have only been reported as single case studies or small cohorts. Large-scale validation on desensitisation strategies are still missing. Recently, subcutaneous adrenaline has also been utilised as an alternative approach to manage HSR to oxaliplatin. Knowledge of this rare but real toxicity of oxaliplatin is paramount because the use of this drug continues to increase not only for the treatment of patients with stage II-IV CRC, but also other solid malignancies. In this article, the author discusses the incidence, clinical presentation, pathogenesis, risk factors and current strategies of management of HSR associated with oxaliplatin.
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PMID:Hypersensitivity reactions associated with oxaliplatin. 1690 58

Hypothalamic GHRH is secreted into the portal system, binds to specific surface receptors of the somatotroph cell and elicits intracellular signals that modulate pituitary GH synthesis and/or secretion. Moreover, GHRH is synthesized and expressed in multiple extrapituitary tissues. Excessive peripheral production of GHRH by a tumor source would therefore be expected to cause somatotroph cell hyperstimulation, increased GH secretion and eventually pituitary acromegaly. Immunoreactive GHRH is present in several tumors, including carcinoid tumors, pancreatic cell tumors, small cell lung cancers, endometrial tumors, adrenal adenomas, and pheochromocytomas which have been reported to secrete GHRH. Acromegaly in these patients, however, is uncommon. The distinction of pituitary vs. extrapituitary acromegaly is extremely important in planning effective management. Regardless of the cause, GH and IGF-1 are invariably elevated and GH levels fail to suppress (<1 microg/l) after an oral glucose load in all forms of acromegaly. Dynamic pituitary tests are not helpful in distinguishing acromegalic patients with pituitary tumors from those harbouring extrapituitary tumors. Plasma GHRH levels are usually elevated in patients with peripheral GHRH-secreting tumors, and are normal or low in patients with pituitary acromegaly. Unique and unexpected clinical features in an acromegalic patient, including respiratory wheezing or dyspnea, facial flushing, peptic ulcers, or renal stones sometimes are helpful in alerting the physician to diagnosing non pituitary endocrine tumors. If no facility to measure plasma GHRH is available, and in the absence of MRI evidence of pituitary adenoma, a CT scan of the thorax and abdominal ultrasound could be performed to exclude with good approximation the possibility of an ectopic GHRH syndrome. Surgical resection of the tumor secreting ectopic GHRH should be the logical approach to a patient with ectopic GHRH syndrome. Standard chemotherapy directed at GHRH-producing carcinoid tumors is generally unsuccessful in controlling the activated GH axis. Somatostatin analogs provide an effective option for medical management of carcinoid patients, especially those with recurrent disease. In fact, long-acting somatostatin analogs may be able to control not only the ectopic hormonal secretion syndrome, but also, in some instances, tumor growth. Therefore, although cytotoxic chemotherapy, pituitary surgery, or irradiation still remain available therapeutic options, long-acting somatostatin analogs are now preferred as a second-line therapy in patients with carcinoid tumors and ectopic GHRH-syndrome.
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PMID:Neuroendocrine tumors secreting growth hormone-releasing hormone: Pathophysiological and clinical aspects. 1703 95

Carboplatin is used widely to treat cancers such as lung, breast, and ovarian. Hypersensitivity reactions (HSRs) to carboplatin can occur, often after numerous doses. The reactions can range from mild to life threatening. Oncology nurses witness the reactions and are instrumental in providing interventions to assist patients. Symptoms include flushing, rashes, itchy palms, nausea, difficulty breathing, back pain, hypotension, and tachycardia. Interventions include support of patients with oxygen and IV hydration along with administration of certain medications to diffuse HSRs. Predictive measures may include skin testing on patients who have received more than seven total doses of carboplatin, Desensitization protocols may be useful for patients with positive skin tests. Ultimately, with the potential for life-threatening reactions, patients and physicians need to consider the risk-to-benefit ratio of using the drug.
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PMID:Carboplatin hypersensitivity reactions. 1706 13

Disulfiram (Antabuse) is used for aversive treatment of alcohol dependence with good effects. Through inhibition of aldehyde dehydrogenase, disulfiram heightens serum aldehyde concentration after alcohol ingestion and causes aversive disulfiram-ethanol reaction. Typical symptoms of this reaction include flushing, nausea, dyspnea, tremor, and confusion, which are usually self-limiting. However, severe life-threatening arterial hypotension sometimes develops. We report here a patient with generalized flushing, tremor, and refractive hypotension after ingestion of alcohol 18 hours after disulfiram treatment. Initial volume resuscitation and dopamine infusion failed to restore the blood pressure. Noradrenaline was given and the blood pressure returned to normal range. This case illustrates the intensity of disulfiram-ethanol reaction and underscores the advantageous use of noradrenaline in patients in such a critical condition.
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PMID:Refractive hypotension in a patient with disulfiram-ethanol reaction. 1722 Jun 94

The symptoms that result from compression of the superior vena cava are known as superior vena cava syndrome. The syndrome was originally described as secondary to infection such as tuberculosis or syphilitic aortic aneurysm. Currently, the origin is generally cancer or thrombotic events. Adenocarcinoma of the lung is the most common cause. Thrombotic causes are increasing because of the rise in use of pacemakers and central venous catheters for access or treatment purposes. Symptoms may include a feeling of fullness in the head, dyspnea, and cough. Clinical findings may include facial and neck swelling; dilated venous channels over the trunk, upper extremities, and neck; facial flushing; cyanosis; respiratory stridor and distress; and neurologic signs. Primary symptoms are in the neck and head. Treatment of superior vena cava syndrome will depend on the cause of the compression. If thrombosis is found, thrombolysis and anticoagulation may be indicated. With carcinoma or infection, specific drugs or radiation may be used. In cases of compression, dilation and stenting of the superior vena cava may be performed. In some cases a bypass of the superior vena cava may be indicated.
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PMID:Superior vena cava syndrome. 1732 62

A high incidence of cardiac complications was observed in an outbreak of dengue fever at General Hospital, Peradeniya, Sri Lanka, in 2005. This report describes 120 serologically confirmed dengue fever patients who presented during the outbreak. Seventy-five (62.5%) of these patients had electrocardiogram changes (T inversion, ST depression, bundle branch blocks) and were assigned to the 'cardiac group' (50 females, 25 males; median age 34 years, range 13-76). These patients were more susceptible to fatigue, dyspnoea, low peripheral oxygen saturation in room air (P=0.001), chest pain (P=0.001) and flushing of skin (P=0.05) than 45 (37.5%) patients who had normal electrocardiograms and made up the 'non-cardiac group'. In the cardiac group there were 31 primary and 44 secondary dengue patients. In the cardiac group, 17 (23%) patients had hypotension and 58 (77%) developed tachycardia and bradycardia (P<0.001) compared to four (9%) in the non-cardiac group, suggestive of significant cardiac dysfunction. There was no correlation between pulse rate and body temperature: cardiac group (r=0.05; P=0.63); non-cardiac group (r=0.11, P=0.46). RT-PCR detected DEN-3 in three cardiac patients.
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PMID:Cardiac complications of a dengue fever outbreak in Sri Lanka, 2005. 1918 46

Adenosine, a ubiquitous metabolic intermediate in the body, is involved in nearly every aspect of cell function, including neuromodulation and neurotransmission. Adenosine A(1) and A(2) receptors are widely distributed in the brain and spinal cord, and are a novel, non-opiate target for pain management. The potential of adenosine as a non-narcotic analgesic in anesthetized patients has been explored in clinical trials, including double-blind studies versus placebo and remifentanil infusion. These studies suggest that, compared to placebo or remifentanil, an intraoperative adenosine infusion stabilizes core hemodynamics and reduces the requirement for anesthesia during surgery. Further, adenosine improves postoperative recovery, as indicated by lower pain scores and less opioid consumption. The safety profile of adenosine has been well characterized based on use of currently approved adenosine products. The most common adverse events associated with its use include flushing, chest discomfort, dyspnea, headache, gastrointestinal discomfort, and lightheadedness. These effects are generally well tolerated and transient. Further studies are warranted to investigate the full potential of adenosine as a non-opioid analgesic in the perioperative setting.
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PMID:Adenosine as a non-opioid analgesic in the perioperative setting. 1764 10

A 60-year-old man suffered from inoperable recurrent undifferentiated thyroid cancer and was scheduled to undergo chemotherapy. He had no known allergy to medications. In the first regimen, he was given IV granisetron and betamethasone before IV 120 mg paclitaxel was administered. Five minutes after the paclitaxel infusion, he developed anaphylactic shock of hypotension, dyspnea, and flushing. He was treated by steroid and recovered. In the second regimen one week later, he was scheduled to be treated by other antineoplastic medication instead of paclitaxel for fear of anaphylaxis. Prechemotherapy the same as the first regimen, granisetron and betamethasone, were given,but he developed the same anaphylaxis before the antineoplastic medication was given. He was thus thought to develop anaphylaxis due to the granisetron itself. Anaphylaxis caused by granisetron has not yet been reported, and this experience prompted us to report this case.
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PMID:[A case of anaphylactic shock caused by granisetron]. 1787 60


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