Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019209 (hepatomegaly)
 5,798 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We describe retrospectively the experience with 44 cases of AIDS from January 1987 to October 1991 at the Instituto Nacional de Pediatria, a tertiary care children hospital in Mexico City. All patients with 2 ELISA and a positive Western Blot test were included. Thirty three patients were infected perinatally (75%) and 11 through blood transfusion (25%). Fourty one patients belonged to the P2 classification of the Centers for Disease Control. Chronic diarrhea (77%), lymphadenopathy (75%), hepatomegaly/splenomegaly (70%) and oral candidiasis (61%) were the most common clinical findings. Twenty patients died (45.4%). No statistical relation were found between survival rate and the way of transmission and age at onset. Autopsy was performed in 14 patients and revealed a sharp decrease of lymphoid tissue at all levels with severe thymic atrophy.
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PMID:[AIDS in children. Experience at the National Institute of Pediatrics]. 138 80

HIV is efficiently transmitted through transfusion with HIV-infected blood. Accordingly, 203 multitransfused children with thalassemia attending the thalassemia clinic of the Charak Palika Hospital in New Delhi were screened for antibodies to HIV using ELISA and Western blot tests. 8.37% of the sample tested HIV-seropositive (HIV+). These 17 children were joined by 3 others referred from a neighboring state to constitute a group to be matched against 20 HIV-children for the purpose of comparing psychosocial aspects. The control group was matched for age, sex, educational level, and socioeconomic status with mean age 10.8 years ranging over 1-16 years. 4 members of the HIV+ sample were diagnoses as having clinical AIDS according to WHO criteria. The remaining 14 boys and 2 girls were HIV+, but asymptomatic. 25% were of lower class, 63.5% middle class, and 12.5% upper class. Of those with AIDS, 50% were diagnosed in their first year of life and 82% were diagnosed by year 3. Symptoms generally developed after 4-6 months of life. Lymphadenopathy and hepatomegaly tend to be visible at birth, while chronic diarrhea, prolonged fever, oral thrush, recurrent bacterial infections, and hepatosplenomegaly may also be presented. 7.1% of cases aged 2-3 years exhibited rocking and head banging problems worse than did control subjects. Furthermore, 28.5% had temper tantrums and 21.5% ground teeth. These children may have delayed developmental milestones as well as behavioral problems. The small sample size, however, precludes concluding that psychosocial differences exist between those with HIV/AIDS and those with thalassemia major. In fact, behavioral problems in these children were due to child illness and not of HIV-positivity, for children tend to be unaware of HIV/AIDS infections and its consequences. The author recommends that HIV+ children continue to attend school unless they can not control bodily secretions, have uncoverable oozing lesions, have unacceptable behaviors, or if there is extreme possibility of contracting infectious diseases at school. The author also stresses parents' and families' need for long-term medical and psychological care.
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PMID:Psycho-social aspects of HIV infection and AIDS in multiple transfused thalassemic children. 145 60

This review describes the transmission, clinical picture and immunological abnormalities of HIV infection in children in general, and the special problems of AIDS in African children. The review begins with a thorough introduction to the epidemiology of AIDS. Transmission to children generally involves vertical transmission by placental transfer or transmission of HIV via transfusion of blood and blood products, or by contaminated needles. Casual transfer is unknown, and only a few cases of transmission via breast milk are known. The clinical picture of HIV infection in infants and children differs from that in adults in 3 important aspects: earlier onset, different clinical presentation and existence of AIDS embryopathy. The average onset was 5 months of age. The most common symptoms in young children are chronic interstitial pneumonitis without demonstrable etiology, hepatomegaly, failure to thrive, adenopathy, diarrhea, oral or perineal thrush, eczema and thrombocytopenia. The common opportunistic infections are pneumocystis carinii pneumonia, cytomegalovirus, Epstein-Barr virus, Cryptosporidium diarrhea, pyogenic infections of the middle ear and gram-negative septicemia. Several infections seen in adult AIDS cases are rare in children: mycobacterium avium-intracellulare, toxoplasma gondii, hepatitis B, as well as Kaposi's sarcoma, malignant lymphoma and cardiac abnormalities. The AIDS embryopathy or HIV dysmorphic syndrome is characterized by immunological abnormalities, growth failure, and craniofacial dysmorphism, particularly microcephaly, prominent box-like forehead, hypertelorism, flattened nasal bridge, obliquity of the eyes, blue sclerae and patulous lips. AIDS in African children is extremely difficult to diagnose because of similarities between the presenting symptoms and those commonly seen in sick children there, many of whom are also immune compromised. Where serotesting is available, the picture is complicated by cross reaction between the test agents and some factor found in sera from malaria patients. Seropositivity in some areas is high, increased by the prevalence of transfusion and injection treatments. Diagnosis is made more difficult by lack of laboratory facilities and difficulties in follow-up for pediatric patients. The CDC definitions of AIDS and ARC, and the WHO/CDC definitions of AIDS are appended.
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PMID:Human immunodeficiency virus infection in childhood. 245 15

HIV infection was present in 18 out of 40 (45%) consecutive malnourished children aged 2 to 29 months in pediatric wards of Bujumbura, Burundi. No difference was observed within and between the seropositive and seronegative groups for sex and anthropometric measures. HIV seropositive cases could be explained by a HIV seropositive mother (83%) or by a transfusion history (17%). The onset of marasmus was earlier in the HIV seropositive group (5 cases observed less than 6 months old compared to none of the other group, Fischer's exact test: P = 0.026). A more complex clinical picture was seen in the HIV seropositive cases (12/18 compared to 4/22, Fischer's exact test: P = 0.004) with the presence of hepatomegaly, adenopathy, thrush, dyspnoea and skin disorders. No difference was observed concerning fever and diarrhoea. HIV seropositive group tended to show a higher hospitalisation frequency and did not well respond to high protein-energy diet: 7 were discharged without gain weight compared to none of the other group (Fischer's exact test: P = 0.011). These results suggest a high rate of vertical transmission mother-child for HIV infection and a frequent association of malnutrition and HIV infection in hospitalized children in Burundi. Marasmic children less than 6 months old should be highly suspected of HIV infection.
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PMID:[Malnutrition and HIV infection in children in a hospital milieu in Burundi]. 313 33

We report here nine children with AIDS. The risk factors of these patients were hemophilia in one, blood transfusions in four, maternal intravenous drug use in three and paternal AIDS in one. One baby was also of Haitian parentage. The major clinical symptoms included failure to thrive, hepatomegaly, lymphadenopathy, interstitial pneumonia, recurrent bacterial and viral infections and persistent oral thrush. Three infants had chronic recurrent parotitis. Five infants developed opportunistic infections primarily Pneumocystis carinii pneumonia and all five died of bacterial sepsis. None of the infants were lymphopenic but all had reversed T4/T8 ratios and poor in vitro lymphocyte responses to pokeweed mitogens. Although many of the clinical and laboratory features of pediatric and adult AIDS are similar, there are some unique features for pediatric AIDS such as the absence of lymphopenia and the high prevalence of recurrent bacterial infections and sepsis.
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PMID:Acquired immunodeficiency syndrome (AIDS) in infants and children: report of nine cases. 383 Feb 64

From Oct 1, 1982, to Oct 1, 1983, the Centers for Disease Control (CDC) received reports of 35 children whose illness met the CDC definition of acquired immune deficiency syndrome (AIDS). All of the children had serious opportunistic infections without a known underlying illness to explain susceptibility to the infections. The 35 children were residents of ten different states; cases clustered in five major metropolitan areas. Three of the children had a parent with AIDS, and one child who had been previously reported had received a blood transfusion from a person in whom AIDS later developed. Most of the children had at least one parent in a population group in which adult AIDS cases have occurred. Many of the children had histories of prodromal symptoms, including pneumonitis, lymphadenopathy, hepatomegaly, and oral thrush. The mean age at onset of illness was 5 months, and the mean age at diagnosis was 12 months. To determine whether opportunistic infection in children without underlying immunodeficiency was truly a new phenomenon, a review of requests to the CDC for the drug pentamidine isethionate was undertaken. This revealed an apparent increase from 1979 to 1983 in Pneumocystis carinii pneumonia in children without known underlying immunodeficiency.
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PMID:Unexplained immunodeficiency in children. A surveillance report. 661 Jul 74

Clinically, malnutrition appears as the last stage in pediatric AIDS. It is, however, difficult to determine the causes of malnutrition without diagnostic facilities and in the absence of differentiating clinical criteria. The authors therefore set out to determine the prevalence of HIV in children, to assess the various modes of infection in children, and to define a clinical profile indicative of HIV infection in malnourished children. They found that among children exhibiting severe malnutrition, HIV-seropositive children are distinguished by a high horizontal transmission rate, a high specific clinical profile, and a very poor prognosis. The study population consisted of 433 severely malnourished children of average age 19 months, in the range 4-48 months, admitted to the Sanou Souro National Hospital in Burkina Faso. 63% presented with marasmus, 13%% with kwashiorkor, and 24% with both forms of malnutrition. 13.8% of children older than 12 months were infected with HIV; HIV-1 in 95.8% of these cases. Mother-to-child transmission was proved in 77% of cases; in 10% of the observed pediatric AIDS cases, transmission may have occurred through multi-injections with contaminated equipment. Marasmus was the form of malnutrition most frequently associated with HIV, with its severity exacerbated by HIV infection. Adenopathy, oral candidiasis, skin disorders, and hepatomegaly appeared to be significantly related to HIV infection. Discriminant analysis, however, revealed that the presence of adenopathies was the strongest indicator symptom of HIV infection. Multivariate analysis defined a clinical profile of marasmus, adenopathies, and oral candidiasis as indicative of HIV infection in the population. The short-term clinical prognosis for the infants was poor and usually led to the death of the child when seropositive.
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PMID:HIV infection and severe malnutrition: a clinical and epidemiological study in Burkina Faso. 844 99

The clinical and epidemiologic characteristics of the acquired immunodeficiency syndrome (AIDS) were studied in a tropical area of Brazil. During an 18-month period (July 1989-January 1991), 111 consecutive AIDS patients (102 men and nine women) were evaluated. Patients reported homosexual/bisexual activities (60%), intravenous drug use (19%), or both (6%), heterosexual activities (11%), blood transfusions (2%), and 2% belonged to an undetermined category. Weight loss, fever, oral thrush, and diarrhea were present in > or = 70% of the patients at presentation. An unexpected high frequency of hepatomegaly (49%) was detected, and found to be significantly associated with tuberculosis (P < 0.0001). Although the epidemiologic features of human immunodeficiency virus transmission were comparable to the United States/European pattern, the clinical spectrum of opportunistic infections more closely resembled that reported in Africa and Haiti, with a greater frequency of fungal and mycobacterial infections than Pneumocystis carinii pneumonia and viral infections.
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PMID:Characteristics of the acquired immunodeficiency syndrome in Brazil. 851 87

A cross-sectional study of a cohort of 49 male human immunodeficiency virus (HIV)-infected intravenous drug users attending the Infectious Diseases Unit of the National University of Malaysia during 1991-94 yielded a clinical profile of these patients. The mean age of respondents was 33.2 years and the mean duration of intravenous drug use was 12.7 years. On average, these men had known of their HIV-positivity for 53.2 weeks. Intravenous drug use was the only reported HIV risk factor in 34 men (69%). Clinical symptoms at intake included fatigue (49%), weight loss (47%), night sweats (31%), fever (14%), and diarrhea (6%), while clinical findings included hepatomegaly (57%), lymphadenopathy (35%), and oral thrush (29%). Anemia (82%), leucocytosis (53%), hypoalbuminemia (43%), hyperglobulinemia (88%), elevated liver enzymes and hyponatremia (57%) were frequent laboratory findings. The prevalences of hepatitis B virus, cytomegalovirus, and toxoplasma infection were 12.1%, 72.7%, and 59%, respectively. A total of 91 diagnoses were made in these 49 patients: most common were pneumonia, tuberculosis, bacteremia, infective endocardiditis, mycotic aneurysm, and psychiatric disorders. The mean duration of known progression to acquired immunodeficiency syndrome (AIDS) in the 7 patients at this stage was 391 days. Pneumocystis carinii pneumonia was the most common AIDS-defining illness. Three months into the study, 19 men (57%) had defaulted, reflecting the difficulties of involving drug addicts in research and intervention projects. Moreover, 16 patients (33%) were first confirmed HIV-positive at presentation to the hospital, suggesting that many drug users' HIV status remains unknown until they develop symptoms requiring hospital care.
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PMID:A study of Malaysian drug addicts with human immunodeficiency virus infection. 906 11

HIV is a very common infection in Thailand, affecting about one million of the population already, with 99,555 persons with full blown AIDS at the end of 1999. The first case of AIDS was reported in Thailand in 1984. Gastrointestinal involvement is very common, the commonest presentations are diarrhea, esophageal symptoms, hepatobiliary symptoms, and weight loss. When the CD4+ T cell count falls below 200, the body becomes highly susceptible to opportunistic infections and neoplasms. Almost all AIDS patients will have GI symptoms at sometime during the course of their illness. This is because the GI tract contains an abundant quantity of lymphoid tissue and is likely to function as a reservoir of HIV infection. In chronic diarrhea cases, apart from other investigations, small bowel biopsy and aspiration may help to find the cause. If oral candidiasis is present, one should keep HIV in mind and look for oral hairy leucoplakia, dysphagia and odynophagia as one-third of patients with AIDS will develop dysphagia or odynophagia in the course of their disease. Those with esophageal candidiasis will usually have oral candidiasis and odynophagia while 18 per cent of the patients will not have oral thrush. CMV esophagitis and HIV ulcer (or idiopathic oesophageal ulcer) are also common. Upper gastrointestinal endoscopy and biopsy are helpful in finding the exact cause of the oesophageal symptoms. Hepatobiliary manifestations are present with jaundice, hepatomegaly, and pain. ERCP is very helpful in diagnosing and classifying these conditions. Papillary stenosis and dominant biliary stricture can be treated by endoscopy but long term results are still poor due to late manifestation of these conditions.
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PMID:Endoscopy in HIV infected patients. 1152 42


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