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Query: UMLS:C0019209 (hepatomegaly)
 5,798 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A case of toxocariasis in a 2(6)/12 years old boy is described. The visceral larva migrans syndrome usually is seen in preschool children. Clinical symptoms were characterised by eosinophilia of more than 30%, leukocytosis, hepatomegaly, pulmonary infiltrations, and hypergammaglobulinaemia. There may be myocardial, ocular or central nervous system involvement, and a few affected children have died. The disease is caused by invasion of the body tissues by Toxocara canis or cati larvae, often ingested by contaminated dirt. The developmental cycle and the migration of the Toxocara larvae in the human host is discussed. Diagnosis can usually be made by clinical and serological investigations. The microprecipitation test on living larvae of Toxocara canis is highly specific for the diagnosis. There is no effective specific therapy for toxocariasis, however, treatment with thiabendazole and diethylcarbamazine may be helpful. Primary prevention of visceral larva migrans syndrome can be achieved by reduction of the children exposure to infected animals and contaminated environments, or by elimination of infections in dogs, puppies, and cats.
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PMID:[Toxocariasis in childhood. Visceral larva migrans syndrome (author's transl)]. 706 27

Forty-one Egyptian schoolchildren (36 boys and five girls; age, 12-16 years) who were heavily infected with Schistosoma mansoni were studied. Symptomatic subjects had swimmer's itch and hematochezia. Hepatomegaly was found in 39 and splenomegaly in 31 children. All subjects had eosinophilia, 13 had anemia, 31 had elevated levels of serum globulins, and nine had elevated levels of alkaline phosphatase. All but one subject had antibody to hepatitis A virus, and 26 had antibody to hepatitis B core antigen, antibody to hepatitis B surface antigen, or both. Oxamniquine was given in single daily doses of 20 mg/kg of body weight for either two or three days and cured 50% and 85%, respectively, of subjects treated; ova excretion was reduced by 86%-93% for up to 12 months. Morbidity was associated with heavy S. mansoni infection. Therapy with oxamniquine was safe and efficacious.
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PMID:Clinical characteristics and response to therapy in Egyptian children heavily infected with Schistosoma mansoni. 708 3

Visceral Larva Migrans (Toxocara canis) is usually a relatively benign disease which is caused by infective second-stage larvae of the common cosmopolitan ascarid of dogs, characterized chiefly by sustained eosinophilia, pulmonary symptoms and hepatomegaly. Its severity varies with the number of larvae in the tissue and the immune or allergic state of the infected individual. The most important aspect of the neurotropic larvae perhaps is its potential as a facilitating agent, for instance, for Virus or Toxoplasma gondii invasion of the central nervous system by destroying the blood-brain barrier. Ocular invasion characteristically occurs after primary infestation, seldom bilaterally. Larvae may present three different ocular lesions: a granulomatosis at the posterior pole (solitary granuloma), a chronic endophthalmitis or peripheral retinal lesions with proliferation. Prognosis regarding visual acuity depends on early diagnosis and larval localization. The author reports on successful therapy with a combination of antibiotics, sulfonamides, prednisolone and vermifuge. The microprecipitation test on living larvae is considered to be superior all serological tests at present but a negative result (at first) does not exclude T. canis invasion (compare case report). LMV syndrome should be ruled out if the patient suffers from cerebral spasms whose cause is unclear.
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PMID:[Toxocara canis (larva migrans visceralis) from an ophthalmological point of view (author's transl)]. 725 11

The hypereosinophilic syndrome is a heterogeneous group of clinical disorders comprising a spectrum of pathologic conditions. We have described a patient with chronic eosinophilia for eight years. His course of progressive organ dysfunction and tissue infiltration by eosinophils, with myelofibrosis, lytic bone lesions, hepatomegaly, and generalized adenopathy are most compatible with a chronic myeloproliferative syndrome.
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PMID:Unusual manifestations of hypereosinophilia. 730 42

Cases of human infestation by Fasciola hepatica are not uncommon in Spain and other European countries. We report our experience with 20 patients diagnosed from 1982 to 1991 and present a critical review of published cases from western countries. Because F. hepatica has a special tropism for the liver, abdominal pain, hepatomegaly, and constitutional symptoms are among the most common manifestations of acute-stage fascioliasis. However, in the chronic stage, biliary colic and cholangitis are the predominant manifestations. The clinical spectrum of fascioliasis is variable, and patients may present with extrahepatic abnormalities, such as pulmonary infiltrates, pleuropericarditis, meningitis, or lymphadenopathy. Therefore, a high index of suspicion is required to establish a correct diagnosis. Eosinophilia is the most frequent laboratory abnormality. The CT scan has become a useful technique in the diagnostic work-up. A definitive diagnosis may be established by the observation of parasite ova in the feces, but most cases may be diagnosed by serologic methods. Triclabendazole and bithionol are the most effective drugs against F. hepatica. The efficacy of praziquantel is controversial.
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PMID:Fascioliasis in developed countries: a review of classic and aberrant forms of the disease. 783 67

A series of 20 patients with granular lymphocyte proliferative disorders (GLPD) is reported. The criterion of inclusion was presence of persistent (> or = 6 months) granular lymphocytosis in the absence of any causative illness. Diagnoses made upon analytical control in half the patients of splenomegaly (25%) and hepatomegaly (25%) were infrequent. Clinical course was nonprogressive in 17/20 patients, but two developed high-grade NHL several years later and one showed progressive disease. Actuarial probability of survival at 5 years was 85%. Granular lymphocyte morphology was relatively homogeneous, and peripheral blood counts were preserved in the most patients. Bone marrow lymphocytic infiltration was low, as assessed by bone marrow aspiration and/or biopsy. Eosinophilia was an outstanding feature in eight cases. Ultrastructurally, all cases showed parallel tubular arrays; cytoplasmic granules and numerous short microvilli were noticed. The lymphoid phenotype was heterogeneous, the most common being CD2+CD3+CD4-CD8+, but six patients (30%) were CD4+ with variable expression of natural killer-associated antigens. Chromosomal analysis was abnormal in 4/10 patients [trisomy 19, t(5;6); inv(14) and inv(10)]. The study of beta-chain of the T-cell receptor revealed clonal rearrangements in 14 (78%), restricted to CD3+ patients (92%). In vitro culture of myeloid precursors showed decreased CFU-GM in 5/6 patients. Virological studies for HTLV-I and II were negative. In conclusion, the presence of a clonal proliferation was not correlated with the clinical course or an associated disease.
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PMID:Granular lymphocyte proliferative disorders: a multicenter study of 20 cases. 791 27

We report a case of massive hepatic infection by Capillaria hepatica in a 14-month-old girl who presented with the symptom triad of persistent fever, hepatomegaly, and leukocytosis with eosinophilia. Twenty-five cases of human infection with this parasite, mostly in children, have been reported in the literature. This is the first case of hepatic capillariasis reported in the Republic of Korea. The diagnosis was made by needle biopsy of the liver. Scanning electron microscopic examination of the biopsy specimen was also performed. Thiabendazole therapy was initiated and the patient developed liver disease-related IgA nephropathy during the therapy. The literature dealing with proven cases of infection with C. hepatica is briefly reviewed.
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PMID:Hepatic capillariasis: first case report in the Republic of Korea. 851 80

Three hundred children with hepatomegaly were selected. They were subjected to full clinical and laboratory examinations. Also serum samples were examined to detect IgG using ELISA against SEA, chromatography purified hydatid cyst antigen, commercially available Toxoplasma antigen, partially purified adult Fasciola antigen and second-stage larvae Toxocara canis antigen. IFAT was used to detect IgG against Toxoplasma and T. canis. A commercially available IHAT kit for leishmaniasis was used. Based on immunological assays, 125 cases were suffering from various parasitic infections. Thirty cases with schistosomiasis (10%), 26 cases fascioliasis (8.7%), 18 toxocariasis (6%), 35 toxoplasmosis (11.7%), 3 cases hydatidosis (1%) and 13 cases mixed parasitic infections. No parasitic causes could be found in 175 cases (58.3%). Moderate or marked hepatomegaly favours the presence of schistosomiasis. Whereas, most cases with other parasites and those with non-parasitic infections fall in the category of mild hepatic enlargement. There was no associated splenomegaly in cases with Fasciola, Toxocara, hydatid disease and/or the non-parasitic group. Most of hepatomegalic cases with non-parasitic causes were found to be associated with fever (88.5%). Fever was found in nearly 50% of cases with either Toxoplasma or Toxocara infections. Mild eosinophilia was found in all cases with parasitic causes. Only 24 cases of non-parasitic group (13.7%) had easinophilia. Moderate and high eosinophilia were found in cases with fascioliasis and toxocariasis. Cases with fascioliasis had a statistically significant increase in enzymes activities specially alkaline phosphatase. It was concluded that parasitic infections should be considered as an important cause of liver enlargement in children. Serological methods using purified antigenic fractions are an important tool for diagnosis.
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PMID:Parasitic causes of hepatomegaly in children. 872 Dec 39

Over two successive years, out of 187 cases of fevers of undetermined origin (FUO) admitted to Abbassia and Embaba Fever Hospitals, 30 (16%) cases proved to be of parasitic origin. Ten within normal subjects were taken as controls. Complete blood picture, repeated stool examination, rectal snip by transparency technique, ELISA for specific IgM antibodies for S. mansoni, indirect haemagglutination test for S. mansoni, Fasciola, hydatid, amoebic liver abscess and toxoplasmosis, indirect fluorescent antibody test for toxoplasmosis and abdominal ultrasonography were performed whenever indicated. Cases comprised 8 (26%) acute S. mansoni, 7 (24%) acute fascioliasis, 3 (10%) hydatid cyst, 8 (26%) amoebic liver abscess, 2 (7%) toxoplasmoisis and 2 (7%) malaria cases. The clinical picture of acute S. mansoni and acute fascioliasis were similar in the form of prolonged fever, diarrhea, hepatomegaly and leucocytosis with high eosinophilia. Serology (ELISA and IHAT) was essential in differentiating them. Abdominal ultrasonography is an easy, sensitive, cheap, non-invasive technique aiding in the diagnosis of amoebic liver abscess, liver hydatid cysts and fascioliasis but again serology was essential in differenting them. Toxoplasmic lymphadenitis mimic the clinical picture of infectious mononucleosis. Serology (monospot test, IHAT, IFAT) clinched the diagnosis. Malaria cases presented atypically by gastrointestinal manifestations and hepatic affection. Diagnosis was by positive blood smears.
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PMID:Parasitic infections presenting as prolonged fevers. 875 58

In order to determine the frequency and characteristics of patients with liver abnormalities as the presenting manifestation of Hodgkin's disease (HD), 421 consecutive HD patients were studied. Six patients in the series (1.4%) presented with liver abnormalities that led to of a liver biopsy and the subsequent diagnosis of HD. All had fever prior to HD diagnosis, four frank jaundice, and one hepatic failure. No patient had pruritus. Moderate hepatomegaly was present in four patients. Cholestasis was observed in all cases; in most patients a moderate increase in the transaminase activity was also seen. Two patients had a mild rise in the serum LDH, four had leukopenia, and one eosinophilia. At liver histologic study, Reed-Sternberg cells were demonstrated in four patients; in the remaining two, the presence of atypical histiocytes, lymphocytes, and eosinophils was highly suggestive of HD, the latter diagnosis being confirmed by subsequent study of bone marrow and/or retroperitoneal lymphadenopathies. In three of the six patients, HD was not demonstrated in sites other than the liver. Three patients older than 60 years died shortly after HD diagnosis. By contrast, three patients younger than 40 years showed a dramatic response to chemotherapy: two of them had a further relapse, and one is considered cured after 14 years of continuous remission. Liver disease constitutes an infrequent form of HD presentation which must be included in the differential diagnosis of any patient with fever of unknown origin.
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PMID:Hodgkin's disease presenting as a cholestatic febrile illness: incidence and main characteristics in a series of 421 patients. 876 4


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