Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The use of psychotropic drugs has been associated with the syndrome of inappropriate antidiuretic hormone secretion (SIADH) in a number of case reports. SIADH is characterised by the sustained release of antidiuretic hormone (ADH) from the posterior pituitary. The patients have a reduced ability to excrete diluted urine, ingested fluid is retained, and the extracellular fluid expands and becomes hypo-osmolar. The cardinal signs are hyponatraemia, serum hypoosmolality and a less than maximally diluted urine. Common symptoms include weakness, lethargy, headache, anorexia and weight gain. These symptoms may be followed by confusion, convulsions, coma and death. The early symptoms are vague and nonspecific, and they may even mimic the symptoms of the psychiatric disorder itself. For antidepressants, the risk of SIADH seems to be highest during the first weeks of treatment. For antipsychotics, the risk seems to be more spread out in time. The causative role of the drug may sometimes be difficult to estimate, as even drug-free psychiatric patients, mostly those with schizophrenia, develop SIADH on the basis of psychogenic polydipsia. Smoking is another factor associated with the development of SIADH, and the risk may also increase with age. The acute treatment of SIADH induced by a psychotropic drug includes discontinuation of the drug as well as restriction of fluid intake. In cases with significant clinical symptoms, infusion of sodium chloride is recommended. After the acute management, it is useful to evaluate the causative role of the drug by performing a water loading test and/or drug rechallenge. If continued treatment with an antidepressant or antipsychotic is indicated, a drug with a different pharmacological profile should be chosen, and the serum sodium levels should be monitored closely. If treatment with the drug that caused SIADH must be continued, concomitant treatment with demeclocycline may reduce the tendency of hyponatraemia.
 ...
PMID:Hyponatraemia and the syndrome of inappropriate antidiuretic hormone secretion (SIADH) induced by psychotropic drugs. 761 32

Recent epidemiologic studies (11) have shown a frequency of 3-5% of hyponatremia in chronic psychiatric patients, characterized by headaches, blurry vision, weakness, cramps, vomiting and sometimes seizures or coma leading to death. The etiopathology of this electrolytic syndrome is still debated and intriguing. Six to 17% of hospitalized patients in psychiatry present primary polydipsia, among which 25-50% develop hyponatremia. Another cause is the syndrome of inappropriate secretion of anti-diuretic hormone, SIADH, which may be due to a number of psychotropic drugs as carbamazepine, thioridazine, amitriptyline, desipramine, haloperidol, chlorpromazine and fluoxetine (1, 2, 7, 9, 15, 18, 24). These medications can be associated with primary polydipsia but not necessarily, and the hyponatremia is reversible after discontinuiting the treatment. We describe a case of hyponatremia possibly related to clomipramine which has been rarely reported in the literature and discuss the relations between hyponatremia, psychosis, and SIADH.
 ...
PMID:[Hyponatremia of therapeutic origin. Apropos of a case]. 782 16

An association between primary mediastinal germ cell tumors and hematologic malignancies has been recognized since 1985. We present a patient with a suprasellar germ cell tumor and an associated leukemia. A 20-year-old black female presented in December 1987 with a 6-month history of headaches and weight loss, confusion, polyuria, and polydipsia. Evaluation revealed hypernatremia, normal neurologic examination except poor recall, and an enhancing inhomogeneous suprasellar mass on cranial computed tomography. Biopsy of the mass diagnosed a dysgerminoma, which was treated with craniospinal radiation. In February 1988, the patient developed pancytopenia, which resolved with discontinuation of cimetidine and phenytoin. She did well until June 1988 when she presented with skin lesions over the trunk and extremities. Skin biopsy revealed a leukemic infiltration. She was admitted with a WBC 1,500/microliter (without blasts), Hb 11.6 g/dl, PLT 210,000 microliter. Bone marrow biopsy revealed hypercellularity with 50% blasts, demonstrating mixed-lineage acute myeloblastic leukemia (myelomonocytic-M4; megakaryoblastic-M7). The patient was induced with a standard Ara-C/daunorubicin regimen. Two weeks postinduction, she became septic and expired. An autopsy demonstrated leukemic involvement of the spleen, liver, bone marrow, and skin, without residual dysgerminoma. This represents the first reported case of suprasellar dysgerminoma associated with a mixed-lineage leukemia not related to chemotherapy.
 ...
PMID:Mixed-lineage acute myeloid leukemia associated with a suprasellar dysgerminoma. 784 66

A case of sinus thrombosis occurring during combination chemotherapy with CDDP and VP-16 (PE) for a suprasellar germ-cell tumor is presented. A 5-year-old girl developed polyuria, polydipsia and headache in April, 1991 and became unconscious on May 10, 1991, when MRI and CT demonstrated a suprasellar tumor and marked hydrocephalus. After a ventriculo-peritoneal shunt operation, radiotherapy and two courses of PE therapy were carried out. During the second course of PE therapy, diabetes insipidus became quite difficult to control and severe hypovolemic hypernatremia developed. While it was being treated, the patient developed a clonic convulsion of her left extremities and visual disturbance. CT scan demonstrated a right parietal hemorrhagic infarction and IV-DSA suggested thrombosis of the superior sagittal sinus. Laboratory data disclosed DIC. The main cause of sinus thrombosis in this patient was considered severe dehydration. It is also possible that cisplatin and steroid played a role. In addition to these, dysfunction of hypothalamus, which is one of the regulatory centers of the plasma concentration of factor VIII, may have contributed to the acceleration of blood coagulation. This case re-emphasized the importance of preventing dehydration and monitoring the blood coagulation fibrinolytic system during PE therapy in patients with a suprasellar germ-cell tumor accompanied with diabetes insipidus.
 ...
PMID:[Sinus thrombosis during CDDP and VP-16 (PE) therapy for suprasellar germ-cell tumor: case report]. 825 77

The frequency and severity of physical and emotional menstrual symptoms were investigated with a cross-sectional study of 502 women not seeking treatment for menstrual symptoms. The most frequent symptoms were abdominal bloating, backache, headache, constipation, low abdominal pain, fatigue and symptoms related to depression. Some symptoms increased during the late luteal phase, and others were related to the women's life-style. Lack of schooling and living in rural areas were associated with headache, backache, sadness, insecurity, restlessness and weakness. Women from urban areas with more schooling had more breast tenderness, abdominal pain, irritability, depression, aggressiveness and increased sexual desire. Younger women had increased appetite, lack of concentration, insecurity, desire to be alone, weakness and dissatisfaction with their looks. Heavier women had more leg cramps, swollen feet, lack of coordination and polydipsia. Menstrual symptoms seem to be determined by the interplay of the menstrual cycle with biologic factors and life-style.
 ...
PMID:Association of physical and emotional symptoms with the menstrual cycle and life-style. 833 24

The majority of cases of central diabetes insipidus are still pathogenetically unclear (idiopathic). Atherosclerotic cholesterol emboli might be partly responsible for some of these idiopathic cases. A 54-year-old woman with known aortic valve stenosis and a history of a transitory ischemic attack presented with sudden-onset polyuria and polydipsia of up to eight l/d, which had started acutely with headaches. She had been treated with lithium for 3 years because of cyclothymic depression. Plasma sodium was in the upper normal range (142-148 mmol/l). Hypertonic saline infusion during lithium therapy revealed a normal threshold of thirst and resetting of vasopressin secretion (osmotic threshold > 300 mosmol/l), whereas vasopressin reserve was normal. Lithium withdrawal led to an even greater delay of vasopressin release upon hypertonic saline infusion (> 310 mosmol/l). Pituitary function tests revealed a normal anterior pituitary function. MR imaging of the hypothalamo-hypophyseal region showed a normal hypothalamic region and a highly intensive neurohypophyseal signal in the T1-weighted image. The patient responded well to desmopressin. We suggest that in this rare case clinical symptoms as well as biochemical findings like impairment of AVP release might be related to a minor structural hypothalamic damage by a vascular lesion, caused, for example, by an atheromatous (cholesterol) embolism in the hypothalamic region responsible for integration of osmoreceptor function and AVP-secretion. The patient's atherosclerosis and aortic stenosis might be responsible for this event.
 ...
PMID:Atherosclerosis, aortic stenosis and sudden onset central diabetes insipidus. 928 11

A case of superficial siderosis that appeared in a case of suprasellar embryonal carcinoma is reported. A 24-year-old man presented polydipsia and vertigo. MRI revealed a suprasellar tumor. The tumor contained high intense spots on T1-weighted images, suggesting intratumoral hemorrhage. He underwent a surgery, which proved it as embryonal carcinoma pathologically. Cerebrospinal fluid was xanthochromic at surgery, suggesting terminal hemorrhage. After surgery, he received a total dose of 56 Gy of irradiation. Tumor decreased in size and symptoms improved. However, he presented occipital headache 7 months after surgery. MRI showed disseminated tumors in the subarachnoid spaces. He received irradiation for the whole spine and adjuvant chemotherapy. During treatment, MRI demonstrated low signals on the surface of the brain stem, suggesting the superficial siderosis. The lesions spread to the surface of the cerebellum and tentorium cerebelli. Superficial siderosis is characterized by the deposition of hemosiderin in the leptomeninges, cranial nerves and spinal cord. The etiology of the hemosiderin deposition is thought to be chronic or recurrent bleeding into subarachnoid space. Experimentally, similar lesions have been produced in the animals following intrathecal injection of blood or hemolysed red cells. In the literature, MRI demonstrated a rim of marked hypo-intensity on T2-weighted images, consistent with hemosiderin deposits, on the surface of cerebellum and brain stem. Gradient-echo sequences have been more sensitive than T2-weighted images of spin echo sequences. In the present case, the superficial siderosis seems to be due to chronic tumoral hemorrhage. This phenomenon could be related to chemotherapy using CDDP and etoposide.
 ...
PMID:[Superficial siderosis appeared in a case of suprasellar embryonal carcinoma]. 984 53

During the past 11 years 69 patients underwent transsphenoidal surgery for symptomatic intra- and suprasellar non-neoplastic cysts in our department. Eighteen of them harbored intra- and suprasellar colloid cysts. The most frequent presenting symptoms were oligomenorrhea, galactorrhea, and headaches. One patient presented with polydipsia. One male patient complained about mild hypogonadism and oligospermia. Two male patients presented with symptoms of panhypopituitarism. Endocrine assessment revealed hyperprolactinaemia in 72% of the female patients. Hypogonadism was found in 72%. Panhypopituitarism was found in two cases. During transsphenoidal surgery, a circumscribed collection of colloid material was removed in each case. Additional tumorous tissue was encountered in three cases that harbored a concomitant pituitary adenoma. Biopsies confirmed the surrounding tissue to be normal pituitary tissue. Postoperatively, regular menstrual cycles were found in 82% of the female patients with oligomenorrhea and headaches improved in 80%. Serum prolactin levels were restored in 92%, galactorrhea ceased in 89%. Only in one case deterioration of pituitary function occurred (diabetes insipidus). Symptomatic SIADH occurred in another one. There were no other post-operative complications. We conclude, that transsphenoidal surgery is a safe therapy for treating symptomatic intra- and suprasellar colloid cysts. Surgery is mainly indicated for female patients in childbearing age to restore fertility and to prevent further deterioration of pituitary function. The differential diagnosis is often unclear preoperatively, but a non-enhancing mass on MRI between anterior and posterior lobe may suggest the presence of an intra- and suprasellar colloid cyst.
 ...
PMID:Intra- and suprasellar colloid cysts. 1108 Nov 62

We studied the clinical presentation by age of 36 children with craniopharyngioma, and outcome by height and body mass index (BMI). Presenting symptoms included headache (51.4%), vomiting (31%), visual disturbances (22.9%), polyuria and/or polydipsia (17.1%), delayed puberty (19.4%), short stature (13.8%), and precocious puberty (2.7%). Growth deceleration was overlooked, as was diabetes insipidus (actual rate, 52% for both). Delayed puberty was observed in all patients of appropriate age. Mean height standard deviation score (SDS) at admission was significantly lower than mean target height SDS (p = 0.004), while mean final height SDS was similar (p = 0.14). BMI SDS at last follow-up was similar to mean parental BMI SDS. We conclude that although endocrinopathies are present in most patients with craniopharyngioma, they are rarely the reason for referral. While affected prepubertal children have non-endocrine complaints, most adolescents are referred because of delayed puberty. Diabetes insipidus may be more prevalent in craniopharyngioma than previously reported. When patients with hypothalamic obesity are excluded, mean BMI SDS remains within normal range and is influenced mostly by parental BMI SDS.
 ...
PMID:Craniopharyngioma: presentation and endocrine sequelae in 36 children. 1288 Jan 19

Four patients who had ingested large amounts of phenacetin-salicylate medications were studied during a 12-month period. Renal failure had progressed slowly over a number of years. All patients took the drug because of psychogenic headache. Considerable skill was required to elicit the history of drug habituation. The major features of the nephropathy were multiple episodes of metabolic acidosis, minimal proteinuria, pyuria but no bacteriuria, and polyuria and polydipsia early in the course of drug ingestion. Papillary necrosis was not a prominent clinical feature of this series. Discontinuation of drug ingestion by one patient was associated with recovery of a considerable degree of renal function. Preliminary experimental evidence obtained in the dog suggests that salicylate impaired the efficiency of the counter-current multiplier by decreasing sodium transport in the ascending limb of Henle, and decreased the permeability to water of the distal convoluted and collecting tubule; phenacetin had no such effect.
 ...
PMID:PHENACETIN NEPHROPATHY. 1422 36


<< Previous 1 2 3 4 5 6 7 8 Next >>