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)

The clinical profile of one hundred and six biopsy proved patients with sarcoidosis is reported from New Delhi. The disease occurred more frequently in males (68 of the 106; 64%) in their fifth decade. Dry cough (83%), exertional dyspnoea (61%), fever (56%) and joint pains (44%) were frequent symptoms. Hepatomegaly (45%), peripheral lymphadenopathy (45%), cutaneous involvement (42%), presence of crepitations (36%) were frequent signs. In addition, ocular symptoms (18%), parotid gland enlargement (12%), facial nerve palsy (8%) were observed. Audible wheeze was present in nine patients. Radiologically, 25 (24%), 67 (63%) and 14 (13%) of patients belonged to stage I, II and III respectively at presentation. More than one sibling was involved in six families. Pulmonary functions revealed mixed obstructive and restrictive ventilatory defect. However, obstructive ventilatory defect was predominant. Systemic steroids were used in 81 patients who regularly followed up. Frequent relapses occurred on tapering off or stopping the corticosteroids in 21 patients. History of malaise (p < 0.05), presence of crepitations (p < 0.05), wheezing (p < 0.05), peripheral blood eosinophilia (p < 0.05) and FEV1/FVC (%) < 65% of the predicted value (p < 0.05), were independent predictors of relapse. Hyperuricaemia, hitherto unreported in patients with sarcoidosis was observed in 41% of patients for whom values were available. Two patients died; one from cardiomyopathy and another from stroke. In summary, constitutional symptoms such as fever, weight loss and pulmonary infiltrates, were more frequently encountered in Indian patients with sarcoidosis as compared to western studies. A high index of clinical suspicion and histopathological confirmation early in the illness are required to ascertain the diagnosis lest these patients will get treated as tuberculosis with potentially hepatotoxic drugs.
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PMID:Clinical characteristics, pulmonary function abnormalities and outcome of prednisolone treatment in 106 patients with sarcoidosis. 1157 54

Human fascioliasis is increasing in the Nile Delta particularly in Dakahlia Governorate, where it reached 7.47%. In this study, the tetrad of fascioliasis was established as high eosinophilia (100%), fever (85.6%), painful hepatomegaly (81.93%) and anaemia (100%). The laboratory results showed ESR accelerated in 87%, ALT elevated in 21.5%, AST elevated in 21.9%, S. bilirubin elevated in 16.5%, gamma GT elevated in 80.6%, and SAP elevated in 76.4%. Abdominal ultrasonography showed variable findings, as hepatomegaly, splenomegaly, periportal fibrosis, thickened wall of gall bladder, dilated common bile duct, dilated biliary radicals (partial), dilated common bile duct and biliary radicals (total), Fasciola worms in gall bladder, Fasciola worms in common bile duct, stones in gall bladder, stones in bile duct, cystic lesions in the liver, local lesions in the liver and ascitis. The highest was hepatomegaly in 81.93% of fascioliasis patients and the lowest was biliary dilated radicles (partial) in 0.26%.
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PMID:Clinico-epidemiological study of human fascioliasis in an endemic focus in Dakahlia Governorate, Egypt. 1177 99

Migration of Ascaris lumbricoides into the gallbladder is rare, unlike ascariasis of the bile duct, and, when it does occur, treatment is generally by endoscopic or surgical extraction. We describe a case of the successful treatment of gallbladder ascariasis with conservative therapy. A 44-year-old Korean man was admitted because of nausea and right upper quadrant pain that did not respond to medical control and had worsened 1 day before admission. Abdominal ultrasonography showed a long, linear, moving echogenic structure in the distended lumen of the gallbladder, but no abnormal dilation of the bile duct. Computerized tomography showed a linear soft-tissue density in the dependent portion of the gallbladder. The patient presented with eosinophilia, and abnormal liver function results, but no fever or hepatomegaly. Based on these findings, and presuming a diagnosis of gallbladder ascariasis, we administered antiparasitic medication (albendazole 400 mg/day for 1 day). Seven days later, we obtained one adult female A. lumbricoides from the feces. The symptoms were fully resolved, and no moving structure could be visualized in the gallbladder by ultrasonography. We recommend that initial therapy for gallbladder ascariasis should involve conservative treatment, unless an associated disease is present or a complication arises.
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PMID:Successful elimination of Ascaris lumbricoides from the gallbladder by conservative medical therapy. 1237 53

A two-year-old girl presented with a 3-month history of generalized pruritus. One week before hospitalization she developed a superior vena cava syndrome and obstruction of the upper airways. Clinical and laboratory findings included generalized lymphadenopathy, a mediastinal mass compressing the tracheal lumen to the point of near closure, hepatomegaly and moderate eosinophilia. The diagnosis of an anaplastic large cell lymphoma (ALCL) was made by the histologic examination of a mediastinal lymph node. The history of generalized pruritus without diagnostic skin lesions was as uncommon as age at presentation. In conclusion, this case illustrates that generalized pruritus in a toddler can be an early sign of ALCL.
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PMID:Pruritus in pediatric non-Hodgkin's lymphoma. 1268 50

Chlamydia pneumoniae infection was diagnosed in an elderly patient with prolonged fever and hepatomegaly and no evidence of respiratory tract infection. Laboratory investigation showed hepatitis, eosinophilia, cryoglobulinaemia and the presence of antinuclear antibodies. It was concluded that C. pneumoniae may cause an acute extrarespiratory infection as well as stimulate immunological reactions.
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PMID:Extrarespiratory Chlamydia pneumoniae infection associated with immune disorder, hepatitis and renal disease. 1295 63

This is a retrospective and descriptive review of 277 patients suffering fasciolasis. These patients were seen in Hospital Nacional Cayetano Heredia between 1970-2002; 240 (86.6%) developed the chronic phase and 37 (13.3%) the acute form. Group aged 20-29 years were the most affected (24%). The main places infected were the interandean valleys of Lima, Ancash and Junin. The 277 patients the main symptoms were: abdominal pain in 236, nausea/vomiting in 106 and diarrhea in 100. Hepatomegaly in 56, pallor in 44 and fever in 23 were the main physical findings. 47% (80/169) suffered eosinophilia, 46% (38/82) had an increase of alkaline phosphatase and 31% (52/169) anemia.
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PMID:[Human fasciolasis and gastrointestinal compromise: study of 277 patients in the Cayetano Heredia National Hospital (1970-2002)]. 1524 93

From February, 1981 to May, 2001, 63 children under 15 y old (ages 2 - 15 y, median = 8 y, mean +/- 1 SD = 8 +/- 3 y) presenting 70 episodes of Paracoccidioidomycosis were admitted. The main clinical manifestations and laboratory features observed upon admission were: lymph node enlargement (87.1%), fever (75.7%), weakness (48.6%), pallor (41.4%), hepatomegaly (40%), splenomegaly (35.7%), anemia (90%), hypergammaglobulinemia (88.5%), eosinophilia (75.5%) and hypoalbuminemia (72.5%). Moderate to severe malnutrition was detected in 35.7% of the episodes (Gomez's criterion). Radiographic and technetium studies showed bone lesions in 20 of the episodes, most of them being multiple lytic lesions, involving both long (70%) and plain bones (30%). First line treatment consisted of an association of sulfametoxazole-trimethoprin, which was used, exclusively, in 50 episodes. Follow-up of hemoglobin levels, number of eosinophils in the peripheral blood, albumin and gammaglobulin serum levels revealed significant sequential improvement one and six months after hospital admission, being quite useful to evaluate treatment effectiveness. Six patients died (9.3%) and four developed sequelae (6.3%). In conclusion, the juvenile and disseminated forms can be observed in about 70% of the episodes of PCM occurring in children younger than 15 y old, most of them presenting with a febrile lymphoproliferative syndrome associated to anemia, eosinophilia and hypergammaglobulinemia.
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PMID:Paracoccidioidomycosis in children: clinical presentation, follow-up and outcome. 1528 12

Two types of Fasciola antigens: surface tegumental (ST) and excretory-secretory (ES) products of F. gigantica worms were used for performance of ELISA technique. Results showed that, the circulating anti-Fasciola IgA antibodies were detected in 98% and 94% and the specificity of the test was 93.4% and 89.7% using ST and ES antigens, respectively. As regards ST antigen, a highly significant elevation in the level of the circulating anti-Fasciola IgA antibodies was observed according to the intensity of infection as well as in those with hepatomegaly. There was a significant direct relation between the level of circulating anti-Fasciola IgA antibodies and eosinophilia, anaemia and liver function tests of fascioliasis patients when ST antigen was used.
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PMID:Evaluation of circulating anti-Fasciola IgA antibodies by ELISA technique using two different Fasciola antigens. 1558 3

This study comprised 462 clinically suspected cases of fascioliasis. Stool examination revealed positive 11 cases for Fasciola eggs (2.38%). Serum samples were obtained for serodiagnosis from 133 suspected cases from Cairo governorate (G) and 149 from Giza G. Using IHAT, positive results were reported in 12.03% of suspected cases in Cairo G and 11.41% in Giza G. For ELISA 15.03% and 18.12% respectively were positive. Out of 462 clinically suspected cases, 58 patients were liable to be infected with Fasciola depending on the presence of Fasciola eggs in stool and/or a positive serological result with either IHAT (56.9%) or ELISA (81.03%) or both (48.28%). Serological examination of sera of cases shedding eggs revealed that one case was positive for ELISA, 4 cases were positive for IHAT and ELISA, whereas 5 cases were serologically negative. Serum from one case with Fasciola eggs in stool could not be obtained for serological diagnosis. Clinical picture of infected cases indicated that 82.76% were suffering from abdominal pain, 43.1% palor and digestive disturbances, and 25.86% fever. On physical examination, 46.55% revealed hepatomegaly. Eosino-philia was observed in 70.69% of the patients. Statistically, no significant difference (P. > 0.05) was observed among patients in both governorates regarding age, sex, clinical manifestations, detection of eggs in stool, hepatomegaly, and serological tests. However, eosinophilia was significantly higher (P < 0.05) in cases from Giza G.
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PMID:Human fascioliasis in some areas in Cairo and Giza Governorates, Egypt. 1588 Oct 5

Diaminodiphenyl sulphone (dapsone) is a drug of choice in the treatment of leprosy. It is also useful for the treatment of many neutrophilic and other dermatoses. Dapsone hypersensitivity syndrome is a rare but well recognized serious adverse effect characterized by fever, skin rashes, generalized lymphadenopathy, hepatitis, and hepato-splenomegaly. Twenty-six patients with dapsone hypersensitivity syndrome were studied for clinical profile, outcome, and prognosis. The male:female ratio was 2.2:1, and the mean age was 33.19 years (range 13 to 64 years). The interval between start of dapsone therapy and appearance of symptoms varied from 2-7 weeks (mean 29.82 days). Twenty-four patients received dapsone as a part of multi-drug therapy for leprosy; the other two patients received dapsone for lichen planus and acne vulgaris. Exfoliative dermatitis was the most common cutaneous manifestation followed by erythematous maculo-papular eruption and Stevens-Johnson syndrome-like lesion. The other common systemic manifestations were: fever (26 cases), itching (22 cases), lymphadenopathy (21 cases), jaundice (21 cases), pallor (20 cases), hepatomegaly (19 cases), and pedal edema (14 cases). Investigation profile revealed elevated levels of serum liver enzymes in 100% of patients, elevated erythrocyte sedimentation rate in 92.3%, raised bilirubin in 84.6%, leucocytosis in 69.23%, low hemoglobin (<9 gm/dl) in 46.15% and hypoproteinemia in 42.3%. Eosinophilia, hemolytic anemia, and reticulocytosis count were found in 4 patients each. All the patients had favorable outcomes except three who died due to hepatic failure. Medical personnel must be aware of this potentially fatal syndrome, because it can cause considerable morbidity and mortality.
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PMID:Dapsone hypersensitivity syndrome: a clinico-epidemiological review. 1636 48


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