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Query: UMLS:C0017160 (gastroenteritis)
 11,398 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A child with severe gastroenteritis developed acute rhabdomyolysis combined with acute renal failure. The pathophysiological mechanisms of this clinical syndrome are not completely understood. Rhabdomyolysis is mainly due to osmotic changes on both sides of the cell membrane. The preventive and therapeutic measures consist of adequate fluid substitution, correction of electrolyte and acid-base imbalances, administration of diuretics and alkalization of the urine. Dialysis treatment may be necessary. In this particular case renal failure resolved but the child died of other organ failure.
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PMID:[Secondary rhabdomyolysis and acute renal failure in gastroenteritis with hypernatremic dehydration]. 841 50

Autopsy kidney specimens from 24 children with kwashiorkor and 21 with other miscellaneous diseases, at the Obafemi Awolowo Teaching Hospital Complex, Ile-Ife, Nigeria, were analyzed for the presence of aflatoxins using high-performance liquid chromatography. Aflatoxins were detected in 14 children who died of kwashiorkor and in 13 of those who died from miscellaneous diseases. Aflatoxicol was detected in 10 specimens, 7 of which had severe gastroenteritis. Seven kidney specimens demonstrated the presence of more than one type of aflatoxin; four of these were kidneys of patients with kwashiorkor and the remaining three died from renal failure. No difference was found between the frequency of detection, type of aflatoxin detected, or mean concentrations of total aflatoxins in the kidney specimens of the kwashiorkor children when compared to the kidney specimens of children who died from miscellaneous diseases. These findings demonstrate that aflatoxins can be detected in the kidneys of children exposed to aflatoxins.
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PMID:Aflatoxins in autopsy kidney specimens from children in Nigeria. 982 55

Mushroom poisoning from the genus Amanita is a medical emergency, with Amanita phalloides being the most common species. The typical symptoms of nausea, vomiting, abdominal pain, and diarrhea are nonspecific and can be mistaken for gastroenteritis. If not adequately treated, hepatic and renal failure may ensue within several days of ingestion. In this case series, patients poisoned with Amanita virosa are described with a spectrum of clinical presentations and outcomes ranging from complete recovery to fulminant hepatic failure. Although there are no controlled clinical trials, a few anecdotal studies provide the basis for regimens recommended to treat Amanita poisoning. Use of i.v. penicillin G is supported by most reports. Silibinin, although preferred over penicillin, is not easily available in the United States. In those with acute liver failure, liver transplantation can be life saving.
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PMID:Mushroom poisoning--from diarrhea to liver transplantation. 1201 50

Gastroenteritis of unknown etiology (GUE) is a significant cause of mortality in the United States. In the present study, the demographic and medical characteristics of people who died of GUE were examined, using the 1995-1997 Multiple Cause of Death files to calculate GUE death rates and proportionate mortality ratios. There were 13,153 GUE deaths during the period, or approximately 4400 deaths per year. Death rates were highest among infants and elderly persons, especially nursing home residents, and increased during the winter months. Compared with all decedents, GUE decedents were more likely to have certain other medical conditions, including bacteremia, volume depletion, renal failure, and human immunodeficiency virus/acquired immunodeficiency syndrome. Fatal GUE often appeared to be infectious in origin, but death certificates provide insufficient information to determine whether the causative agents were unknown or foodborne. The accuracy of GUE reporting on death certificates and the etiology of fatal GUE merit further investigation.
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PMID:Mortality due to gastroenteritis of unknown etiology in the United States. 1255 28

An enzymatic, kinetic method for determining serum lipase activity was evaluated and compared to a standard manual method for use in dogs. The kinetic method was a commercial kit adapted for use on a tandem access clinical chemistry analyzer and utilized a series of coupled enzymatic reactions based on the hydrolysis of 1,2-diglyceride by lipase. The manual method was the Cherry-Crandall technique based on the titration of base against the acid formed by hydrolysis of an olive oil substrate by lipase. The correlation between the two methods was very good (r = 0.94). The reference range for 56 clinically healthy dogs assayed by the kinetic method was 90 to 527 U/L. Diseases associated with a greater than twofold elevation in serum lipase activity as determined by the kinetic method included pancreatitis, gastritis with liver disease, and oliguric renal failure with metabolic acidosis. In some cases, pancreatitis was seen with other clinical problems, such as gastroenteritis, diabetic ketoacidosis, duodenal mass, disseminated intravascular coagulation, and septic peritonitis. Diseases associated with serum lipase activity within the reference range or elevated less than twofold included gastritis, gastric ulcer, cholestasis, phenobarbital-induced hepatopathy, colitis, copper hepatopathy, abdominal hematoma, apocrine gland adenocarcinoma, and thrombocytopenia with pneumonia.
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PMID:Serum lipase determination in the dog: a comparison of a titrimetric method with an automated kinetic method. 1267 88

The major health problems in Africa are AIDS, tuberculosis, malaria, gastroenteritis and hypertension; hypertension affects about 20% of the adult population. Renal disease, especially glomerular disease, is more prevalent in Africa and seems to be of a more severe form than that found in Western countries. The most common mode of presentation is the nephrotic syndrome, with the age of onset at five to eight years. It is estimated that 2 to 3% of medical admissions in tropical countries are due to renal-related complaints, the majority being the glomerulonephritides. There are no reliable statistics for ESRD in all African countries. Statistics of the South African Dialysis and Transplant Registry (SADTR) reflect the patients selected for renal replacement therapy (RRT) and do not accurately reflect the etiology of chronic renal failure (CRF), where public sector state facilities will offer RRT only to patients who are eligible for a transplant. In 1994, glomerulonephritis was recorded as the cause of ESRD in 1771 (52.1%) and hypertension in 1549 (45.6%) of patients by the SADTR. In a six-year study of 3632 patients with ESRD, based on SADTR statistics, hypertension was reported to be the cause of ESRD in 4.3% of whites, 34.6% of blacks, 20.9% mixed race group and 13.8% of Indians. Malignant hypertension is an important cause of morbidity and mortality among urban black South Africans, with hypertension accounting for 16% of all hospital admissions. In a ten-year study of 368 patients with chronic renal failure in Nigeria, the etiology of renal failure was undetermined in 62%. Of the remaining patients whose etiology was ascertained, hypertension accounted for 61%, diabetes mellitus for 11% and chronic glomerulonephritis for 5.9%. Patients with CRF constituted 10% of all medical admissions in this center. Chronic glomerulonephritis and hypertension are principal causes of CRF in tropical Africa and East Africa, together with diabetes mellitus and obstructive uropathy. The availability of dialysis and transplantation is quite variable in Africa: treatment rates in North Africa are 30 to 186.5 per million population (pmp) in countries with more established programs: Algeria 78.5; Egypt 129.3; Libya 30; Morocco 55.6; Tunisia 186.5 pmp. In South Africa, treatment rates of 99 pmp were reported; Dialysis and transplant programs in the rest of Africa are dependent on the availability of funding and donors. Services are still predominantly urban and therefore generally inaccessible to the poorer, less educated rural patient. There is not enough money for healthcare in the developing world, particularly for expensive and chronic treatment such as RRT. The goal should be to have a circumscribed chronic dialysis program, with as short a time on dialysis as possible, and to increase the availability of transplantation (both living donor and cadaver). Efforts should be made to optimize therapy of renal disease and renal failure globally and particularly in developing countries. Strategies should be developed to screen for and manage conditions such as hypertension and diabetes mellitus at the primary healthcare level in an effort to decrease the incidence of chronic renal failure. Increasingly, health is influenced by social and economic circumstances. Any improvements in health thus demand integrated, comprehensive action against all the determinants of ill health.
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PMID:End-stage renal disease in sub-Saharan and South Africa. 1286 89

More precise analysis of causes of death is needed to focus research efforts and improve morbidity and mortality in sickle cell disease. In this study, the morphological evidence of the cause of death was studied in 306 autopsies of sickle cell disease, which were accrued between 1929 and 1996. The most common cause of death for all sickle variants and for all age groups was infection (33-48%). The terminal infection was heralded by upper respiratory tract syndromes in 72.6% and by gastroenteritis in 13.7%. The most frequent portal of entry in children was the respiratory tract but, in adults, a site of severe chronic organ injury. Other causes of death included stroke 9.8%, therapy complications 7.0%, splenic sequestration 6.6%, pulmonary emboli/thrombi 4.9%, renal failure 4.1%, pulmonary hypertension 2.9%, hepatic failure 0.8%, massive haemolysis/red cell aplasia 0.4% and left ventricular failure 0.4%. Death was frequently sudden and unexpected (40.8%) or occurred within 24 h after presentation (28.4%), and was usually associated with acute events (63.3%). This study shows that the first 24 h after presentation for medical care is an especially perilous time for patients with sickle cell disease and an acute event. Close monitoring and prompt aggressive treatment are warranted.
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PMID:Causes of death in sickle cell disease: an autopsy study. 1453 21

Adenoviral infections of immunocompetent patients usually present as self-limiting pharyngitis, gastroenteritis, urocystitis, or conjunctivitis. In immunosuppressed patients, development of the illness can be severe, even life-threatening or fatal, and therapeutical intervention is difficult. Previous case reports of adenoviral infections after kidney transplantation have described a symptomatology of hemorrhagic cystitis, fever, renal dysfunction, and rarely fatal systemic dissemination. Here we report on a 46-year-old female renal transplant recipient suffering from adenoviral serotype 35 nephritis of the donor organ 29 days after transplantation. In this case, the main symptoms of the adenoviral infection were high fever and progressive renal failure of the transplanted organ. At the peak of the clinical symptoms, owing to histological and immunohistochemical evaluations of a kidney biopsy, we were able to establish the diagnosis in time so that adequate therapy could be employed. Immunosuppression was reduced and modified, and a self-limiting course of the infection was observed, followed by significant improvement of graft function. Subsequent to histological diagnosis, adenoviral particles were isolated from urine and identified as adenovirus serotype 35. Adenoviral nephritis of the transplanted organ should be considered in the differential diagnosis of persistent anuria after kidney transplantation. Our case highlights the importance of applying all possible diagnostic techniques, including histological evaluation of renal biopsies.
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PMID:Acute adenoviral infection of a graft by serotype 35 following renal transplantation. 1453 42

The case of fatal course of rotaviral gastroenteritis at eight months old boy has been described. Two days history of frequent watery stools in home care, hyperosmolar dehydration grading to hypovolemic shock, cardiopulmonary resuscitation in regional hospital, transported comatose with vital functions support. In spite of temporary stabilization of the patient, there was retrogression to multiorgan failure (ischemic myocardial infliction, circulatory failure, ARDS, renal failure, DIC, enteritis, post ischemic hepatopathy). Four day later patient exits. Rotaviruses have been proved from stools specimen post mortem.
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PMID:[Lethal course of rotavirus gastroenteritis - a case history.]. 1592 23

Hemolytic uremic syndrome is caused primarily by Shiga toxin-producing Escherichia coli O157:H7. The most common cause of acute renal failure in children, hemolytic uremic syndrome also can occur in adults. Characteristic features of the syndrome are microangiopathic anemia, thrombotic thrombocytopenia, and renal failure. Although the presentation of this syndrome is diverse, the classic prodromal illness is bloody diarrhea following ingestion of hamburger meat contaminated with E. coli O157:H7, the most common mode of infection in the United States. Children with hemolytic uremic syndrome generally present with gastroenteritis complaints (e.g., abdominal pain or tenderness, nausea or vomiting, fever, anemia); affected adults may be asymptomatic. Complications from hemolytic uremic syndrome can include intussusception, chronic renal failure, and seizures in severe cases. Because an incubation period of approximately one week occurs between the start of diarrhea and the onset of hemolytic uremic syndrome, physicians should maintain a high index of suspicion; early laboratory testing is important to diagnose and manage this syndrome. Obtaining a complete blood count and stool culture and performing Shiga toxin testing are the first of a series of tests that may help diagnose hemolytic uremic syndrome.
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PMID:Hemolytic uremic syndrome: an emerging health risk. 1700 34


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