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Query: UMLS:C0019158 (
hepatitis
)
30,205
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Lyme disease, caused by a tick-transmitted spirochete, typically begins with a unique skin lesion, erythema chronicum migrans. Of 314 patients with this skin lesion, almost half developed multiple annular secondary lesions; some patients had evanescent red blotches or circles, malar or urticarial rash, conjunctivitis, periorbital edema, or diffuse erythema. Skin manifestations were often accompanied by malaise and fatigue, headache, fever and chills, generalized achiness, and regional lymphadenopathy. In addition, patients sometimes had evidence of meningeal irritation, mild encephalopathy, migratory musculoskeletal pain,
hepatitis
, generalized lymphadenopathy and
splenomegaly
, sore throat, nonproductive cough, or testicular swelling. These signs and symptoms were typically intermittent and changing during a period of several weeks. The commonest nonspecific laboratory abnormalities were a high sedimentation rate, an elevated serum IgM level, or an increased aspartate transaminase level. Early Lyme disease can be diagnosed by its dermatologic manifestations, rapidly changing system involvement, and if necessary, by serologic testing.
...
PMID:The early clinical manifestations of Lyme disease. 685 26
A patient with leukemic reticuloendotheliosis had
splenomegaly
, neutropenia, and a severe underproduction anemia. During a three-year period, the hematocrit was never in the normal range, and periodic transfusions were required. However, after an episode of
hepatitis
that was positive for B surface antigen, the spleen became smaller, the number of neutrophils increased, the transfusion requirement disappeared, and the hematocrit rose to normal. Several mechanisms for this observation are proposed.
...
PMID:Beneficial effect of hepatitis in leukemic reticuloendotheliosis. 724 95
The diagnosis and management of childhood visceral leishmaniasis were studied in 51 parasitologically proven cases from Abha, Saudi Arabia. Bone marrow aspiration was positive in 40 of 47 cases (85%). Splenic aspiration, though rarely used because of perceived dangers, was not associated with complications and revealed the parasite in all 12 cases in which it was used. There was prompt response to sodium stibogluconate, with defervescence in 93% and decrease of hepatosplenomegaly in 67% of patients within 1 week of commencing chemotherapy. A dose of 20 mg/kg/day for at least 3 weeks was generally safe and effective in achieving cure and preventing relapse. Two children with persistent massive
splenomegaly
after the first course responded to prolonged chemotherapy. Bronchopneumonia and severe cytopenia were common complications. Disseminated intravascular coagulation and
hepatitis
were associated with a poor outcome. The four patients who died had a progressive course with multiple complications. Early detection and appropriate management of complications may help to reduce morbidity and mortality in childhood visceral leishmaniasis.
...
PMID:Diagnostic and management problems in childhood visceral leishmaniasis in south-western Saudi Arabia. 751 38
The clinical presentation and outcome of 32 children with primary sclerosing cholangitis (PSC) are reviewed, the largest North American series. The majority of patients were diagnosed in their second decade (median age: 13 years). Four children presented before the age of 2 years, but none in the neonatal period. Seventeen patients had inflammatory bowel disease (IBD), all with colitis, 14 ulcerative colitis, and 3 Crohn's disease. Eight patients presented with chronic liver disease before clinical onset of IBD. Only 8 of 32 patients were jaundiced at presentation. Fifteen of 32 had a normal serum alkaline phosphatase (ALP) level at presentation. Nine children presented with features similar to those of autoimmune
hepatitis
. Cholangiography was performed in all cases and classified by a scoring system specifically developed for pediatric patients. Intrahepatic disease predominated; in only three cases a common bile duct stricture was identified requiring stenting. Findings on the initial liver biopsy were classified according to Ludwig's criteria for staging PSC: there were 15 biopsies in stages 1 to 2 and 17 biopsies stages 3 to 4. HLA class I and II antigens were determined in 27 patients. An increased incidence of HLA B8 and DR2(15) but not DRw52a (DRB3*0101) was found. Anti-neutrophil cytoplasmic antibody (ANCA) was positive in 10 of 24 patients tested. Survival analysis indicated that a later age at presentation,
splenomegaly
, and prolonged prothrombin time (PT) at presentation were significant contributors to the prediction of poor outcome (i.e., death or listing for transplantation). Liver transplantation was successfully performed in seven children. Physicians must maintain a high index of suspicion of PSC in any child or young adult presenting with chronic liver disease, especially in the presence of IBD, even with a normal serum alkaline phosphatase level.
...
PMID:Primary sclerosing cholangitis in 32 children: clinical, laboratory, and radiographic features, with survival analysis. 759 Jun 57
The records of 52 children with Niemann-Pick disease type C were reviewed to establish whether the disease process and outcome varied with the initial clinical pattern; 34 children (65%) had cholestatic liver disease and hepatosplenomegaly in infancy; 18 were seen at a mean age of 4 years with
splenomegaly
or neurologic disease or both. Of the 34 children with early cholestatic liver disease, three died in the neonatal period; cholestasis and hepatomegaly subsided in the remaining 31 children, although
splenomegaly
persisted. Of these 31 children, 15 had persistent liver disease with elevated aminotransferase values. Serial liver biopsy specimens showed that 3 of the 15 children had normal architecture and 12 had hepatic fibrosis, with progression to cirrhosis in 5. No other significant morbidity or additional deaths were associated with the liver disease. The clinical importance of persistent liver disease was overshadowed by the subsequent development of severe neurologic disease. There was no difference in the age at onset of the disease (mean, 4.5 years) or in the pattern of neurologic disease, including supranuclear ophthalmoplegia, whether or not the child had early liver disease. Overt neurologic disease has not yet developed in seven surviving children with liver disease at onset. Sixty-seven percent of children died during the study; the main cause of death was bronchopneumonia. We conclude that the diagnosis of Niemann-Pick disease type C should be considered in patients with unexplained neonatal
hepatitis
, especially if
splenomegaly
is a persistent feature. Because liver biopsy specimens may not demonstrate storage cells, bone marrow aspiration to detect the characteristic storage cells is recommended in such patients.
...
PMID:Niemann-Pick disease type C: diagnosis and outcome in children, with particular reference to liver disease. 815 88
In addition to classic organ system involvement, Lyme disease may be characterized by myositis, liver and spleen involvement, and atypical cutaneous manifestations. Myositis is characteristically localized near an involved joint or localized neuropathy. Nuclear imaging with gallium-67 may be useful for detection. Myositis responds to treatment with intravenous or oral antibiotics. Patients with erythema migrans have been observed to have liver function test abnormalities in the absence of symptomatic
hepatitis
.
Splenomegaly
has been noted infrequently in patients with Lyme disease. Chronic cutaneous manifestations of Lyme disease--including erythema migrans, acrodermatitis chronica atrophicans, and lymphadenosis benigna cutis--have been observed more frequently in Europe than in the United States. It appears that they are caused primarily by the Borrelia afzelii genomic group of Borrelia burgdorferi, which has been found exclusively in Europe.
...
PMID:Muscle, reticuloendothelial, and late skin manifestations of Lyme disease. 772 94
A multicenter longitudinal study was performed to assess the survival of hepatitis B surface antigen positive compensated cirrhosis, primarily in relation to hepatitis B virus replication and
hepatitis
delta virus infection, and to construct a prognostic index based on entry characteristics. This cohort study involved nine university medical centers in Europe. Three hundred and sixty-six Caucasian HBsAg positive patients with cirrhosis who had never had clinical manifestations of hepatic decompensation were enrolled and followed for a mean period of 72 months (6 to 202 months). Inclusion criteria were biopsy-proven cirrhosis, information on serum hepatitis B e antigen and antibody to hepatitis D virus at the time of diagnosis and absence of complications of cirrhosis. At entry 35% of the patients were HBeAg positive, 48% of the patients tested were HBV-DNA positive and 20% anti-HDV positive. Death occurred in 84 (23%) patients, mainly due to liver failure (45 cases) or hepatocellular carcinoma (23 cases). The cumulative probability of survival was 84% and 68% at 5 and 10 years, respectively. Cox's regression analysis identified six variables that independently correlated with survival: age, albumin, platelets,
splenomegaly
, bilirubin and HBeAg positivity at time of diagnosis. According to the contribution of each of these factors to the final model, a prognostic index was constructed that allows calculation of the estimated survival probability. No difference in survival of hepatitis D virus infected and uninfected patients was observed. Termination of hepatitis B virus replication and/or biochemical remission during follow up correlated with a highly significant better survival. These data show that in compensated cirrhosis B, hepatitis B virus replication, age and indirect indicators of poor hepatic reserve and established portal hypertension significantly worsen the clinical course of the disease, whereas hepatitis D virus infection does not influence the prognosis. The highly significant improvement in life expectancy following cessation of hepatitis B virus replication and biochemical remission favors antiviral therapy in those patients with a guarded prognosis, as estimated by a prognostic index.
...
PMID:Survival and prognostic factors in 366 patients with compensated cirrhosis type B: a multicenter study. The Investigators of the European Concerted Action on Viral Hepatitis (EUROHEP). 781 13
An easy, inexpensive and rapid indirect immunoperoxidase assay for serodiagnosis of Kala-azar (VL) has been tried using whole promastigotes of L. donovani in dried smear form as antigen. A total of 138 sera were tested including sera from parasite positive cases of VL (32), normal controls from endemic (20) and non-endemic (20) areas, cases of tuberculosis (10), leprosy (10), amoebic
hepatitis
(10), malaria (10) and tropical
splenomegaly
(26). All the positive control sera were positive in very high dilutions of serum ranging from 1/500 to 1/64,000. None of the sera with other diseases were positive by this method except 3 cases with tropical
splenomegaly
were positive in low titres. No other cause could be established in these cases for
splenomegaly
. Sensitivity and specificity of the test were found to be 100 and 95.3% respectively. Predictive values of the negative and positive tests were 100 and 86.5% respectively.
...
PMID:An indirect immunoperoxidase assay for rapid serodiagnosis of visceral leishmaniasis. 789 12
Niemann-Pick disease type C (NPC) presents in about half of the cases in the newborn period with jaundice, hepato-
splenomegaly
, and a clinical pattern similar to neonatal
hepatitis
. The definitive diagnosis can in most instances be made by the appropriate biochemical testing of lipoprotein stimulated cholesteryl ester synthesis and cholesterol accumulation in cultured patient fibroblasts. We report two infants who by liver biopsy had classical findings of NPC and a cholesteryl ester synthesis level about 50% of the normal lower limit. On the other hand neither of these patients' fibroblasts showed any evidence of low density lipoprotein-induced cholesterol accumulation, precluding the possibility of a definitive diagnosis. These cases demonstrate the importance of the appropriate biochemical testing before final counseling is carried out. The possibility of our patients representing allelic or non-allelic variants of NPC are discussed.
...
PMID:Niemann-Pick-like liver disease and reduced cholesterol esterification in fibroblasts of two male infants. 803 25
Disseminated infection with Mycobacterium avium complex is described in 3 adult Siamese cats. All cats were the result of father-daughter matings. Clinical signs included anorexia, weight loss, and lethargy. Physical examination revealed pale mucous membranes, lymphadenopathy,
splenomegaly
, and pyrexia. Nonregenerative anemia was detected in all 3 cats, and macrocytosis was observed in 2. An antemortem diagnosis of mycobacterial infection was made on the basis of identification of acid-fast bacilli in tissue aspirates. The cats died or were euthanatized owing to clinical deterioration, despite antibiotic treatment. Necropsy findings included granulomatous lymphadenitis, enterocolitis, pneumonia, cellulitis, myelitis, and
hepatitis
. Organisms from the Mycobacterium avium complex were identified in bacteriologic cultures of tissue samples.
...
PMID:Disseminated Mycobacterium avium complex infection in three Siamese cats. 812 27
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