Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019079 (hemoptysis)
 6,129 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The surgical management of patients with nontuberculous Mycobacteriosis caused by Mycobacterium avium complex (MAC) was studied regarding the following cases: (1) We investigated whether there had been an appropriate time for surgical management of patients with MAC who had not responded to medication and who died after their conditions became worse retrospectively. During the past 10 years, 49 patients diagnosed with MAC died at the Toneyama national hospital. 26 patients of them died of respiratory failure, apparently due to the worsening of MAC. Excluding 2 patients who were extremely elderly, we investigated whether surgical management could have been applied in the remaining 24 patients. We found that surgical management would have been possible in only one patient, and that at the time of diagnosis of MAC in 23 patients, surgical management was already not possible. (2) There are patients with MAC who do not respond to medication and who continue to excrete bacilli, chest X-ray findings gradually become worse for several years. In 1989 we retrospectively studied chest X-ray findings from MAC patients and found that 36 out of 103 patients (35%) showed worsening chest X-ray findings. The strains were identified in 44 of the 103 patients by the DNA probes method. However, of 37 patients with M.avium (41%), 15 had worsening of chest X-ray findings, while none out of 7 patients with M. intracellulare had worsening of chest X-ray findings. We then observed the clinical course of 37 patients who showed continuous excretion of bacilli and whose serotypes had been identified (20 with serovars 4, 1 with serovars 6, 6 with serovars 8, 2 with serovars 12, 4 with serovars 14 and 5 with serovars 16) by using the fast-atom bombardment mass spectrometry (FAB/MS). Chest X-ray findings later worsened in 14 (70%) of 20 patients with serovars 4. Nine of these patients have since died; excluding one patient who had liver cancer, eight died of respiratory failure due to worsening of MAC. In 17 patients with serotypes except serovars 4, 4 (24%) patients had worsening of chest X-ray findings, but none of the 5 deaths in this group were due to respiratory failure owing to worsening of MAC. These results suggest that it is difficult to establish the indication of surgical management in MAC patients, except for patients with repeated hemoptysis at present. The prognosis and surgical management of pulmonary disease caused by M. avium complex should be considered.
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PMID:[The indication of surgical management in patients with pulmonary disease caused by Mycobacterium avium-intracellulare complex]. 903 17

Although hematologic dysplasia is common in HIV disease, evolution to AML is unusual. We report a case of AML in a patient with stage-C3 AIDS who had been previously treated with granulocyte colony-stimulating factor (G-CSF). This 41-year-old black man presented with pancytopenia (Hg 8.6 g/dl, Hct 24.3%, platelets 16,000/mm3, WBC 0.6 x 10(3)/mm3) and hemoptysis. His peripheral smear manifested 19% blasts. His bone marrow biopsy was hypocellular (20%) with greater than 90% blasts, which were positive for myeloperoxidase and Sudan black B. The blasts were negative for nonspecific esterase. Immunophenotypic analysis by flow cytometry showed the majority of cells to be of myeloid lineage, expressing CD13, and CD45 at low intensity. In addition, there was aberrant expression of CD2 and no expression of CD14 or CD4. The diagnosis of AML-FAB-M1 was made. The patient refused chemotherapy. Of the rare cases of AML in HIV patients previously reported in the literature, the majority were of the monocytic or myelomonocytic subtype. This case is of special interest because of prior G-CSF therapy. In this setting, the relationship between HIV, G-CSF, and subsequent AML is controversial.
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PMID:Acute myelogenous leukemia (FAB AML-M1) in the setting of HIV infection and G-CSF therapy: a case report and review of the literature. 976 Jan 57

A 16-year-old girl was hospitalized because of anemia and thrombocytopenia in April 1998, and was diagnosed as having AML (FAB:M2). After failure of initial remission induction therapy, she was successfully treated with the MEC regimen as a second-line chemotherapy. On June 22, the first consolidation therapy was started. One week later, the patient developed a high fever with backache. Chest computed tomography (CT) on July 8 showed a 3cm mass lesion adjacent to the thoracic descending aorta in the left upper lobe. She was given fluconazole and antibiotics, and remained in remission. On July 24, the mass lesion changed to a cavitary lesion on chest CT, suggesting a fungal infection, probably aspergillosis. With recovery from neutropenia, the patient became asymptomatic, and fluconazole was changed to itraconazole. On July 27, she suffered sudden, massive hemoptysis and died. Autopsy revealed a localized adhesion between the cavitary lesion and the thoracic descending aorta, and the aortic wall was ruptured at this site. Microscopic examination revealed invasion of mucormycotic hyphae into the wall of the aorta with infiltration of inflammatory cells. The vasa vasorum were occluded by thrombi, in which mucormycotic hyphae were detected.
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PMID:[An autopsy case of pulmonary mucormycosis with fatal hemoptysis from a rupture of the thoracic descending aorta during remission from acute myelocytic leukemia]. 1119 40