Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019158 (hepatitis)
 30,205 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Ranitidine was first marketed in 1981; since then many patients have been treated such that much experience has been accumulated on the safety of this histamine H2-receptor antagonist in the treatment of gastroduodenal disease. A wide array of ranitidine-associated side effects has been described, but infrequently. As so much information is now available, the aim of this review is to assess the weight of evidence for a causal link between ranitidine and the reported side effects. Overall, ranitidine is well tolerated. The incidence of general side effects at less than 2% is very similar to placebo. Headaches, tiredness, dizziness and mild gastrointestinal disturbance (e.g. diarrhoea, constipation and nausea) are among the most frequent complaints, but have very seldom resulted in stopping treatment. Cardiovascular side effects are extremely rare and unpredictable with the usual doses of oral ranitidine (at most 1 in 1 million patients). They mostly comprise sinusal bradycardia and atrioventricular blockade, especially after rapid intravenous administration, receding after cessation of the drug. Clinical studies, however, have not shown a significant pharmacological effect of ranitidine on the cardiovascular system via H2-receptors, even though individual sensitivities cannot be ruled out in a few isolated reports. Ranitidine is unlikely to be directly hepatotoxic: a transient change in liver function tests has been noted in only 1 in 100 to 1 in 1000 patients. Several cases of mixed hepatitis have been reported, but very few were fully documented. The incidence of ranitidine-associated acute hepatitis has been estimated to be less than 1 in 100,000 patients. Neuropsychiatric complications may be less common and clinically quite similar to those reported with cimetidine, i.e. confusion, disorientation, hallucinations, delirium. These side effects have occurred especially in critically ill and multiple-therapy patients, or patients with chronic renal or hepatic failure, so that the direct causal link with ranitidine treatment was often difficult to ascertain. Even though an H2-receptor-mediated effect is an attractive hypothesis (since similar complications were noted with other H2-receptor antagonists), other mechanisms have been suggested to play a role, e.g. cholinergic or histaminic effects. The overall incidence of neuropsychiatric complications is probably markedly less than 1%. White cell injury (i.e. agranulocytosis) appears to be the most frequent haematological complication, even though case reports are very few and poorly documented.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Side effects of ranitidine. 204 87

Three members of a family of nine persons contracted psittacosis with severe pneumonia, respiratory failure, delirium, hepatitis and renal involvement. A newly purchased cockatiel was probably the primary source of infection but person-to-person transmission is likely to have taken place between twin brothers who shared a bedroom, one of whom had no direct contact with birds. Type-specific chlamydial serological tests identified the infecting agent as Chlamydia psittaci. The highest titres in the initial samples of serum from the patients, however, were to C. psittaci TWAR (Taiwan Acute Respiratory) and serological cross-reactivity among chlamydial strains was demonstrated. This study of a clearly defined outbreak of psittacosis provides useful information for those undertaking larger population surveys of chlamydial disease and emphasises the need for detailed serological investigation of cases.
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PMID:Serological cross-reactivity among chlamydial strains in a family outbreak of psittacosis. 267 92

Ten (17%) of 58 patients with chronic viral hepatitis treated with a four- to 12-month course of recombinant human interferon alfa developed psychiatric side effects. The psychiatric side effects fell into three categories: an organic personality syndrome characterized by irritability and short temper; an organic affective syndrome marked by extreme emotional lability, depression, and tearfulness; and a delirium marked by clouding of consciousness, agitation, paranoia, and suicidal potential. These psychiatric side effects appeared after one to three months of therapy, usually improved within three to four days of decreasing the dose of interferon alfa, and invariably resolved once therapy was stopped. The organic personality and affective syndromes tended to occur in patients who received the highest dose of interferon alfa, who had relatively mild hepatitis, and who lost weight during interferon treatment. Delirium tended to occur in patients with severe hepatitis who had previous evidence of organic brain injury or dysfunction or previous drug and alcohol abuse. Failure to recognize these side effects quickly and to treat them with supportive therapy and modification of the dose of interferon alfa could result in limitation of therapy and serious personal and interpersonal consequences.
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PMID:Psychiatric complications of long-term interferon alfa therapy. 330 72

Ejaculates from 30 patients with alcohol toxic delirium have been tested. We found a decreased number of hypospermia (n = 8) and a reduced sperm density of 18 mill.spermatozoa/ml. Judging sperm density, morphology and motility, 29 sperm-counts are severe pathological. The disturbance of spermiogeneses is most pronounced (2 = 0.01), when increased FSH-values (n = 10) and acute alcohol toxical hepatitis (n = 4) were found, but is less dependent on the drinking habits according to Jellinek or on increased oestradiol values (n = 6) or increased CK-values. The sperm parameters in chronic alcoholics show no better values when fertility has been proved before (n = 10).
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PMID:[Sperm count in male patients after alcoholic delirium]. 641 Sep 34

General anesthesia offers greater comfort for both the abortion patient and the operator. The combination of diazepam and ketamine which is rapidly reversible and offers a moderately deep anesthesia was used in 127 voluntary abortions and 3 therapeutic abortions. Patients ranged in age from 14-40 years and averaged 26, with 58% under 26. Patient weights ranged from 40-82 kg and averaged 56 kg. 43% were primaparas and average parity was 2.5. The average duration of the prenancy was 8.1 weeks. 10 patients were obese, 1 was asthmatic, 1 was a controlled hypertensive, 3 had cardiopathies, and 4 each had hepatitis and meningitis. 1 had treated epilepsy and 2 had serious depressive syndromes. 3 women had previously had voluntary abortions, 9 had had miscarriages, and 1 had had an extrauterine pregnancy. 17% had no fear or anxiety before the procedure, 56% had moderate levels, 28% had significant levels, and 19% had very high levels. 94% of the procedures were done by aspiration and in most cases a preliminary insertion of laminaria was done. The average duration of the procedure was 5 minutes, with extremes of 2 and 25 minutes. Patients were premedicated 1 hour before the procedure with intramuscular injections of 10 mg diazepam and 1/4 mg of atropine. For the induction, a butterfly needle with an antireturn system was used to inject 10 mg of diazepam and 1/4 mg of atropine diluted in 20 ml of distilled water. The patient was placed in the gynecological position and, if necessary, 5 mg of diazepam were added. Between .5-1 mg/kg of ketamine were injected in 10-15 seconds. The same dose was reinjected if the anesthesia was insufficient or the procedure was prolonged. A mixture of 40% oxygen and 60% nitrous oxide was administered if necessary. Patients remained in bed for 6 hours after awakening. 85% of patients received total doses of ketamine of .70mg/kg or less. Average duration of anesthesia was 9.2 minutes, with durations of less than 15 minutes in 94% of cases. On awakening 5% of patients had nausea and vomiting. 16% had minor psychic disturbances or disorientation, 8% had moderate problems with vocalization, and 2% had hallucinatory delirium with agitation. Overall, 20% of patients experienced headaches, 11% nausea, and 9% dizziness. It was concluded that the combination of diazepam .2 mg/kg and ketamine .5-.7 mg/kg provides well tolerated light anesthesia utilizable for outpatient abortions.
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PMID:[Diazepam and ketamine for voluntary interruptions of pregnancy]. 692 72

We present the case of a worker who was accidentally exposed (inhalational and dermal routes) to the chemicals dimethylacetamide and ethylenediamine for 90 minutes in a confined space. Clinical effects included delirium, hallucinations, skin burns, cellulitis, bilateral conjunctivitis, hepatitis, secondary coagulopathy, rhabdomyolysis, and a grade 2 esophagitis. Urinary monomethylacetamide levels 6 days after the exposure were 61 ppm.
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PMID:Toxicity associated with severe inhalational and dermal exposure to dimethylacetamide and 1,2-ethanediamine. 807 26

We experienced a case of anorexia nervosa (AN) associated with refeeding syndrome (RS). The patient was a 24-year-old woman who was taken to the hospital emergency room in a hypoglycemic coma as a result of aggravated emaciation due to AN. On the admission day, she had severe emaciation (BW, 27kg; BMI, 11.4), malnutritional hepatitis, bradycardia, hypotension, hypothermia and hypophosphatemia. After she was intravenously administered glucose, her level of consciousness rapidly improved. On the 7th day, we started intravenous hyperalimentation (IVH). On the 13th day, she developed delirium. Because the delirium appeared after administration of IVH, we diagnosed her with RS. An EEG study disclosed frequent high-amplitude generalized slow waves. SPECT (99mTc ethyl cysteinate dimer) showed a bilateral decrease in the average blood flow. Regional blood flow was decreased bilaterally in the frontal and temporal lobes, and in the thalamus. After she recovered from the delirium and her state of nutrition improved, follow-up EEG and SPECT studies showed a decreased frequency of generalized slow waves and improved blood flow, respectively. Her serum values of P, K, and Mg had been within the normal ranges in the course of the delirium. Thus, before giving more calories to a severely malnourished patient, a physician should consider the possibility that RS will occur, even when serum electrolytes are within the normal ranges.
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PMID:[A case of anorexia nervosa associated with delirium because of refeeding syndrome]. 1570 May 34

Psychotic conditions of iatrogenic nature form a non-negligible portion of psychiatric practice. In this paper we present a case of a 62-year-old patient with the primary diagnosis of autoimmune hepatitis-induced cirrhosis who following the orthotopic liver transplantation developed an episode of depressive psychosis. The appearance of symptoms and signs directly correlated with the administration of the maximal dose of cyclosporine. The dose was upwardly titrated because the laboratory results (an increase in transaminase level) had indicated the transplant rejection. Because psychiatric and neurological examinations prior to the episode showed no abnormalities, other plausible causative factors such as the level of cholesterol and magnesium and the concomitant therapy were also analysed. In contrast to the more frequent cyclosporine-induced delirium, cyclosporine-induced depressive psychosis has been rarely reported in the literature.
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PMID:[Cyclosporine-induced depressive psychosis in a liver transplant patient: a case report]. 1755 48

Hepatitis-C virus (HCV) has infected an estimated 130 million people worldwide, most of whom are chronically infected. Infection is marked by both treatment- and non-treatment-related psychiatric symptoms. Symptoms associated with antiretroviral therapy, interferon-alpha (IFN-alpha), include acute confusional states, delirium, depression, irritability, and even mania. These psychiatric symptoms are further complicated by the high rate of substance abuse and comorbid HIV infection inherent to this population. Even in the absence of IFN-alpha therapy, comorbid depression, cognitive decline, and especially fatigue are common in patients suffering HCV. These comorbidities have significant effects on both treatments and outcomes, and thus are reviewed herein.
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PMID:Psychiatric implications of hepatitis-C infection. 1940 58

Anti-ribosomal phosphoprotein autoantibodies (anti-RP Abs) are highly specific for SLE, especially for neuropsychiatric manifestations including psychosis, mood disorders, anxiety, cognitive dysfunction and delirium. In addition to the neuropsychiatric involvement, anti-RP antibodies are believed to be correlated with nephritis, hepatitis and dermal diseases in SLE. Several studies indicate the association between increased titers of anti-RP Abs in the patient's sera and active SLE disease. The reported prevalence of anti-RP Abs among SLE patients is 10%-40%. Recently, a connection between the presence of anti-RP Abs in the serum and class V lupus nephritis has been demonstrated. Anti-RP Abs binds 3 ribosomal proteins identified as P0, P1 and P2 (38, 19 and 17-kDa, respectively) by recognizing a certain epitope found in those 3 proteins. This specific epitope contains 22 amino acids at the C terminal end (C-22) of the protein. There are studies in the literature relating to the involvement of anti-RP Abs in the pathogenesis of organ damage. The main pathways described are cross-reaction with anti-dsDNA antibodies, a cytotoxic effect on mesangium cell proliferation, invasion into living cells and onset of apoptosis, a defect in the synthesis of apolipoprotein B resulting in accumulation of lipids inside the cell, and downregulation of the total protein synthesis. The authors provide an updated review concerning the multisystem involvement of anti-RP Abs in SLE, particularly in the brain, kidney and liver. Moreover, this article includes a summary of the most relevant studies regarding the cellular involvement of anti-RP Abs.
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PMID:[The clinical importance of anti-ribosomal-P antibodies]. 2191 4


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