Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0018801 (heart failure)
 72,216 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 24-year-old woman presented a severe HUS followed 3 months later by a cardiac failure diagnosed echographically as a dilated cardiomyopathy. The patient was hemodialysed and successfully transplanted. Later course of dilated cardiomyopathy was favourable. Review of literature confirms the rare and severe nature of cardiac lesions occurring in the course of HUS. We suggest a related pathophysiology concerning these two entities.
 ...
PMID:[Dilated cardiomyopathy during post-partum hemolytic and uremic syndrome (HUS)]. 176 31

The mitomycins are antitumor antibiotics that are under investigation now for more than 30 years. Mitomycin C (MMC) is the best investigated subtype. It serves as a prototype for drugs with bioreductive alkylation, which is a unique feature of this class. MMC is mainly active under anaerobic circumstances. The pharmacokinetics are linear in a two-compartment model. The main toxicities of MMC are thrombocytopenia and leucocytopenia. Rare but severe side effects are a hemolytic uremic syndrome, pneumonitis and cardiac failure. MMC has a wide clinical antitumor spectrum with efficacy in various tumor types such as gastric cancer, pancreatic cancer, breast cancer, non-small cell lung cancer, cervical cancer, prostate cancer and bladder cancer. Still, the above mentioned side effects prevent a more widespread use. The most important features of the drug will be reviewed.
 ...
PMID:Mitomycin C: mechanism of action, usefulness and limitations. 213 Oct 38

Six new cases of mitomycin C (MMC)-induced hemolytic uremic syndrome are reported and the literature on renal-, pulmonary- and cardiotoxicity of the drug is reviewed. The number of reports concerning these side effects is still increasing. The incidence of all three side effects will be below 10%, while there appears to be a dose-dependency, with toxicity mainly occurring at cumulative doses of 20-30 mg/m2 or more. Toxicity often develops very sudden and the mortality rate especially of HUS is very high despite supportive care. The pathogenesis of toxicity is still unknown, although for HUS there are indications for a role of circulating immune complexes. The pulmonary toxicity can often be treated by corticosteroids, while the left ventricular cardiac failure can be treated with diuretics. The possible role of oxygen radicals in the development of MMC side effects is mentioned.
 ...
PMID:Mitomycin C-induced hemolytic uremic syndrome. Six case reports and review of the literature on renal, pulmonary and cardiac side effects of the drug. 310 Nov 42

Ten patients with hemolytic uremic syndrome (HUS) were admitted to our ICU during the last 7 years. The mean age at entry was 26 month old. Only one child was more than 2 years of age. A greater incidence of this illness was noted during the summer season. Almost all cases (90%), were severe with arterial hypertension and requiring peritoneal dialysis. HUS is a multisystemic disorder with early renal involvement, but the possibility of other sites being affected must be kept in mind. Half of the patients presented extrarenal manifestations of disease, including: seizures (30%), colonic ischemia requiring intestinal resection, and heart failure with lung edema due to severe hypertension. The two parameters that were helpful in determining the prognosis were the interval of renal insufficiency (greater than 14 days) and neurologic impairment, with the later being of most importance.
 ...
PMID:[Hemolytic uremic syndrome. Evaluation of clinical and prognostic factors]. 828 50

A 27-year-old male with acute lymphoblastic leukemia (L2) received allogeneic bone marrow transplantation on June, 7 1990. He was conditioned with cyclophosphamide, Ara-C and total body irradiation. GVHD prophylaxis consisted of cyclosporin and short term methotrexate. He was diagnosed as having hemolytic uremic syndrome (HUS) on the basis of microangiopathic hemolytic anemia, thrombocytopenia and renal dysfunction on day 224. Cyclosporin was discontinued and FFP was transfused and plasma exchange was performed. He died of heart failure and sepsis on day 582. Autopsy confirmed the findings of HUS.
 ...
PMID:[An autopsy case report of hemolytic uremic syndrome after allogeneic bone marrow transplantation]. 849 23

The hemolytic uremic syndrome (HUS) is the end result of a variety of etiologic agents that can induce endothelial cell injury and thrombotic microangiopathy (TMA) mostly within the kidney. The typical, post-diarrheal verocytotoxin associated HUS (D + HUS) is the major cause of acute renal failure in children worldwide. In the course of HUS treatment, fluid overload is usually the result of overhydration in the context of oliguria or anuria which cause edema, hypertension, worsening of neurologic signs and cardiac failure. Appropriate and timely use of dialysis has dramatically reduced complications of renal failure and extra-renal complications are now the main causes of mortality and morbidity in D + HUS. The reasons for treatment by infusion of fresh frozen plasma and/or plasmapheresis for D + HUS are theoretical and their therapeutic effects are inconclusive. We believe that plasma administration for regular D + HUS has no value and is potentially harmful. Until new strategies become available in clinical practice, the general consensus for the moment is that careful supportive management with patience is still the most appropriate form of D + HUS therapy.
 ...
PMID:[Advances in the treatment of hemolytic uremic syndrome (HUS)]. 908 86

Clinical presentation, laboratory findings, renal biopsy findings and subsequent clinical course were studied retrospectively in 90 children with acute renal failure to intrinsic renal damage. The mean age at presentation was 8.1 years. Diagnosis and number of patients were as follows: Hemolytic uremic syndrome (HUS) in 32 patients, tubulo-interstitial nephritis in 19, idiopathic nephrotic syndrome in 10, IgA nephropathy on 9, membranoproliferative glomerulonephritis in 8, lupus in 5, poststreptococcal glomerulonephritis in 4, cortical necrosis in 1, Henoch Schoenlein purpura nephritis in 1 and anti-neutrophil cytoplasmic antibody associated glomerulonephritis in 1. Thirty-nine patients needed dialysis, but 36 of these were able to stop dialysis, 3 patients with HUS without gastrointestinal symptoms needed chronic dialysis. The mean follow-up period was 7.3 years from onset, and the the latest follow-up 82 patients had normal renal function, 3 showed chronic renal failure, 2 had regular dialysis, 2 had successful renal transplantation, an 1 had died due to heart failure. A poor outcome was associated with diffuse crescents and the presence of severe vascular changes. The early biopsy findings were very useful for the management of children with acute renal failure.
 ...
PMID:[A clinicopathological study of 90 children with acute renal failure]. 928 14

Hemolytic uremic syndrome (HUS) is a leading cause of acute renal failure (ARF) in children, and one for which treatment with peritoneal dialysis (PD) is often necessary. Between January 1982 and December 1996, 176 children received PD for ARF at St. Christopher's Hospital for Children; 34 (19%) of whom had HUS. Of these 34, 7 (20%) developed pleural effusions (PE) while receiving PD, whereas none of the remaining 142 children with other causes of ARF did so. The mean age of the 7 affected children was 5.2 (range 0.4-17) years; none had heart failure or nephrotic syndrome, nor had any of them undergone thoracic surgery. PE were diagnosed by chest radiograph at an interval of 2 (range 1-3) days after starting PD. Thereafter, 4 (57%) patients were successfully maintained on a modified PD prescription; 2 others were converted to hemodialysis and 1 to continuous venovenous hemodiafiltration. Although PE are a known complication of PD, none of the patients so treated for non-HUS related ARF developed them. Whether they represent a purely mechanical complication of PD, or are in some way attributable to HUS itself, is not entirely clear. Regardless, when children with HUS require PD, physicians should monitor for the development of this potential complication to minimize the risk of serious respiratory compromise.
 ...
PMID:Pleural effusion complicating acute peritoneal dialysis in hemolytic uremic syndrome. 987 25

Extrarenal involvement manifesting in the cardiovascular system is a rare but potentially fatal complication of hemolytic uremic syndrome (HUS). Current treatment is aimed at cardiovascular supportive measures while awaiting organ recovery. However, there are cases in which this recovery never occurs, and patients succumb secondary to heart failure. We report two cases of severe cardiac failure in children in the acute phase of HUS and the use of extracorporeal membrane oxygenation (ECMO) to support one patient to cardiac recovery. Clinicians should be aware of this potentially life-threatening cardiac involvement and should consider the use of ECMO for potentially salvageable children with HUS.
 ...
PMID:Cardiac failure in hemolytic uremic syndrome and rescue with extracorporeal life support. 1513 1

The aim of the study was to analyze the etiology, the factors for progression of chronic renal failure to end-stage-renal disease (ESRD), and the influence of ESRD on the survival rate among a cohort of 59 heart transplant patients (HTP) referred for the management of chronic renal failure (CRF). At the time of the first nephrology consultation (6 +/- 4.25 years after cardiac transplantation) the mean creatininemia was 261.5 +/- 99 micromol/L and mean creatinine clearance (Cockcroft formula) was 32 +/- 15 mL/min. The cause of CRF were calcineurin inhibitor toxicity in 38.9% of patients, vascular events in 15.2%, hemolytic uremic syndrome in 5%, membranous glomerulopathy in 3.3%, diabetes in two patients, focal/segmental glomerulosclerosis in 3.3%, renal hypoplasia in 1.7%, and unknown in 27%. Evolution to ESRD occurred in 38.9% of patients: 17 patients started hemodialysis, three peritoneal dialysis, and two received a preemptive kidney transplantation. Creatininemia (micromol/L) at the time of nephrology referral was 229.2 +/- 72.6 versus 315.8 +/- 113.4 (P < .001) and creatinine clearance (mL/min) was 34.9 +/- 15.1 versus 27.3 +/- 13.7 (P = .049) for patients with CRF versus ESRD, respectively. Both proteinuria (g/24 hours) of 1 +/- 2.2 versus 2.3 +/- 1.8 (P = .02) and tobacco use in 35.1% versus 54.4% (P = .045) were significantly associated with progression of CRF, while age at the time of heart transplantation, cause of cardiac failure and renal failure, high blood pressure, type 2 diabetes, dyslipidemia, alcoholism, cirrhosis, and cerebral vascular accident were not. Death occurred in 18 HTP: 50% of patients with ESRD and 18.5% of patients with CRF-a 2.6 relative risk of of death in HTP patients with ESRD compared with HTP with CRF only (P < .01).
 ...
PMID:Chronic renal failure and end-stage renal disease are associated with a high rate of mortality after heart transplantation. 1584 18


1 2 Next >>