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)

Sixty infants in whom clinical symptoms suspected of cytomegalovirus (CMV) infection were studied. CMV infection was found in 50% of the subjects. The diagnosis was based on studies of specific antibodies and isolation of the virus from urine and/or throat swabs. In most of the children the examinations were repeated several times, and clinical observations continued for 1 to 42 months (avg. 18 months). IgM-class antibodies were detected in 26 children and in 18 the virus was isolated. In 3 infants, isolation of CMV virus was the only evidence of active infection. Persisting viruria (avg. 11 months) and long-term presence of Ig G antibodies, even to 44th month of life were also observed. Congenital infection was diagnosed in 4 infants; the remaining ones acquired the infection during the perinatal period or later. In 7 cases transfused blood cannot be excluded as the source of infection. The clinical symptoms manifested in infected and non-infected children were similar. There was a statistically significant increase in the occurrence of hepatomegaly, splenomegaly, hyperbiliru-binemia and diarrhoea in infected children. Congenital abnormalities were found in 10 infected children, including 4 cases of congenital cytomegaly.
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PMID:[Congenital and acquired cytomegalovirus infection in infants confirmed by virologic studies]. 852 3

At the end of 1984, there were about 1.5 million children worldwide infected with HIV-1. 75% of these children lived in sub-Saharan Africa and Latin America. The rate of mother-to-child transmission of HIV-1 is estimated to range from 13% to 42%. It is twice as high in Africa as it is in Europe. By the year 2000, 6 million pregnant women and 5-10 million children will be infected with HIV-1. It appears that clearance of HIV-1 infection occurs in 2.7% to 6.4% of infected infants. Possible intervention strategies to reduce perinatal HIV-1 transmission include antiretroviral therapy with zidovudine, recommending breast feeding only in areas where it is clearly necessary, cesarean section, passive immunotherapy with anti-HIV immunoglobulins, and viral envelope subunit vaccines. An accurate diagnosis of HIV-1 infection can occur in non-breast fed infants born to seropositive mothers by the age of 3 months. Most children (80-90%) with HIV-1 infection develop features of HIV-1 infection within the first year of life. Common manifestations in the first year are lymphadenopathy, splenomegaly, and/or hepatomegaly. Young infants, especially those 3-6 months old, are more likely to be diagnosed with Pneumocystis carinii pneumonia (PCP) than older HIV-1 infected children. HIV-1 infected children are more likely to develop PCP, serious bacterial infections, cytomegalovirus infection, lymphoid interstitial pneumonitis, and encephalopathy than adults. They are, however, less likely to develop other opportunistic infections (e.g., toxoplasmosis, tuberculosis, cryptococcoses, and histoplasmosis). Possible underlying mechanisms of disease progression in HIV-1 infected children include presence of rapidly replicating syncytium-inducing HIV-1, high virus burden, persistent neutralizing antibody response, antibody-dependent cellular cytotoxicity against HIV-1, and transplacental passage of maternal neutralizing antibodies.
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PMID:Paediatric HIV infection. 894 23

We studied 14 adult patients presenting with fever and cytopenia of the peripheral blood and histiocytic hyperplasia with hemophagocytosis (HHH) in the bone marrow regarding an association of cytomegalovirus (CMV) and Epstein-Barr virus (EBV) by using in situ hybridization (ISH) and also evaluated the clinical and laboratory findings according to the encountered organisms. ISH using a CMV RNA probe demonstrated infected cells in 6 out of 14 cases (43%), and ISH using an EBV EBER RNA probe demonstrated infected nuclei in 5 out of the same 14 cases (36%) of HHH. No cases showed a positive reaction with both probes. Three cases showed a negative reaction with both probes. The mean age of all patients was 29 years; and that of the CMV-positive patients was 27 years and that of the EBV-positive patients was 36 years. Organomegaly was found in 3 out of 6 CMV-positive patients (1 hepatomegaly, 1 splenomegaly, 1 hepatosplenomegaly), and 4 out of 5 EBV-positive patients (lymphadenopathy in all 4 cases, hepatosplenomegaly in 2 cases). One of the CMV-positive case had acute myeloblastic leukemia, and 2 EBV-positive cases had underlying malignancy (1 Hodgkin's disease, 1 non-Hodgkin's lymphoma). Seven out of the 14 HHH cases (50%) died within several months after diagnosis. Nucleic acid hybridization methods can be used for the routine examination of the association of CMV or EBV.
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PMID:In situ hybridization studies of cytomegalovirus and Epstein-Barr virus in reactive histiocytic hyperplasia with hemophagocytosis. 887 10

Liver biopsies were studied in 47 cases representing various histiocytosis syndromes. These included 32 cases of hemophagocytic syndrome, 11 cases of Langerhans cell histiocysis (LCH), and 4 cases of other histiocytic disorders. All cases of hemophagocytic syndrome, except one with cytomegalovirus infection, displayed portal lymphohistiocytic infiltrates dominated by T lymphocytes. Activation of the hepatic mononuclear phagocytic system (MPS), evidenced by enlarged von Kupffer cells, some of which were hemophagocytic, was seen in 28 cases of hemophagocytic syndrome. Endothelial enlargement, minor degrees of hepatocellular degeneration, and steatosis were also noted. Ten of the 11 cases of LCH also showed activation of the MPS. It was the only lesion in two biopsies. Seven cases demonstrated nonspecific "triaditis." In three this was associated with cholangiocentric and random acinar histiocytic lesions. Evidence of activation of the MPS was also observed in both cases of Rosai-Dorfman disease and was accompanied by acinar histiocytic lesions in one and triaditis in the other. Likewise, both cases of juvenile xanthogranuloma showed activation of the MPS and focal granulomatous lesions. It is concluded that activation of the MPS is a common feature of liver disease in histiocytosis syndromes and that hepatic enlargement may be the result of this process instead of, or in addition to, the liver lesions known to be featured in these disorders. Hepatic lesions of the various histiocytosis syndromes resemble typical lesions in other sites and, in some instances, are accompanied by nonspecific changes. These nonspecific changes may occur in the absence of lesions that are diagnostic or typical of the particular histiocytosis syndrome. The location and character of hepatic lesions are important factors in the significance of liver involvement.
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PMID:Histopathology of the liver in histiocytosis syndromes. 902 43

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

To study prevalence of cytomegalovirus (CMV) infection in patients with viral hepatitis and its clinical characteristics, serum anti-CMV-IgM was detected in 6411 hospitalized hepatitis cases, and clinical symptoms, signs and liver function in 115 cases with CMV infection were compared with 192 cases of non-CMV infection. Results showed a CMV infection rate of 1.79% in them with an average age of 33.6 years, a sex ratio of 2.13, and dual superinfection with CMV and hepatitis accounting for 44.74%, and triple and quadruple superinfection for 47.37% and 7.89%, respectively. Proportion of those with fever, digestive symptoms, hepatomegaly, changes of gallbladder in ultra sound scan, rising activities of serum alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gamma-glutamyltransferase (gamma-GT) were more, and duration of hospitalization longer in the cases with CMV infection. It suggests that CMV can be found in the cases with viral hepatitis, most in a form of dual or multiple infection, and it can aggravate hepatitis.
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PMID:[An analysis of CMV infection in 115 cases with viral hepatitis]. 920 27

We report a 2-month-old boy without any immuno-compromised diseases, who suffered from the severe cytomegalovirus (CMV) infection after the subclavian flap aortoplasty and pulmonary artery banding for coarctation complex. He underwent the operation at 2 months old and received 2 units of irradiated packed red blood cells before and after the surgery. His postoperative course was uneventful but the interstitial pneumonitis, until he developed watery diarrhea 10 days after the surgery following hepatitis with the marked hepatomegaly 3 weeks after. Since CMV infection was confirmed as the cause of the pneumonitis, enterocolitis and hepatitis, he was initially treated by gamma-globulin with the high CMV titer at a dose of 200 mg/kg/day for 2 days and ganciclovir at a dose of 10 mg/kg/day for 14 days. Because of the persistent CMV infection, he needed two more treatments of ganciclovir at the same dosage and gamma-globulin once a week for 2 months. He finally recovered from severe CMV infection 5 months after the above treatments. In conclusion, the severe CMV infection can occur by blood transfusion even in the surgical case with normal immune system. If one finds pneumonitis, hepatitis or enterocolitis after any type of surgery with history of blood transfusion, CMV infection should be suspected as the cause of these diseases.
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PMID:[A case of severe cytomegalovirus infection after the repair of coarctation of aorta]. 974 11

We present a rare case of adult T cell leukemia (ATL) in which leukemic T cells simultaneously expressed CD4 and CD8 surface antigens and refractory cytomegalovirus (CMV)-induced gastroenterocolitis preceded its clinical onset. A 40-year-old male was admitted to our hospital with abdominal pain and bloody stool. Biopsy specimens of the gastric and rectal mucosa indicated CMV-induced gastroenterocolitis. The patient also proved to be seropositive for human T lymphotropic virus type I (HTLV-I). While being administered gancyclovir for CMV infection, he presented hepatomegaly and systemic lymphadenopathy. Monoclonal expansion of lymphoid cells integrated with HTLV-I genome was observed. He underwent a LSG15 regimen and hepatomegaly and lymphadenopathy improved markedly. Gastroenterocolitis also improved, but the symptoms did not disappear completely. CMV-induced diseases are prevalent among immunosuppressed patients. Although there was no evidence that this patient had ATL on admission, it is likely that he was severely immunodeficient. CMV can easily infect damaged mucosa. ATL cells often infiltrate gastrointestinal mucosa and may have triggered CMV gastroenterocolitis in this case.
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PMID:CD4/CD8 double-positive adult T cell leukemia with preceding cytomegaloviral gastroenterocolitis. 1007 57

Nine infants suffering from congenital cytomegalovirus infection were studied for clinical features with special reference to hematological manifestations. The mean age of appearance of first clinical symptom of disease was 14 days and mean age at presentation was 58 days. Significant pallor, thrombocytopenia and evidence of hemolysis were present in 8 (89%), 4 (44%) and 4 (44%) patients respectively out of three bone marrow examination performed, paucity of erythroid and megakaryocytic cells were seen in two. The other clinical features included hepatomegaly in a (100%) splenomegaly in 6 (66%) each, petachial rash in 5 (55%), Hepatitis in 4 (44%) optic atrophy and corneal opacities in one patient each. Two patients died. Remaining patients showed symptomatic improvement without specific therapy.
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PMID:Hematological manifestations of congenital cytomegalovirus infection. 1082 8

The principal viruses implicated in pericarditis are enteroviruses. Cytomegalovirus pericarditis is quite rare and has been reported in immunocompromised patients with acquired immunodeficiency syndrome, malignant neoplasm or organ transplantation. We report a three-month-old male infant who suffered from cough and rhinorrhea for two weeks. He developed shortness of breath for three days, and fever for one day, prior to admission. Physical examination revealed tachycardia, tachypnea, pale conjunctiva, hepatomegaly, and a muffled heart sound without significant murmur. Chest radiography showed marked enlargement of the cardiac silhouette. Echocardiography demonstrated a large amount of pericardial effusion with impaired diastolic ventricular function. After pericardial drainage and supportive treatment, the fluid gradually disappeared. Viral culture of the pericardial fluid and serologic data confirmed a cytomegalovirus infection. Cytomegalovirus pericarditis should be included in the differential diagnosis of pericardial effusion in a young infant.
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PMID:Cytomegalovirus pericarditis with cardiac tamponade in a young infant. 1086 55


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