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)

A 55-year-old woman had progressive weakness, weight loss, night sweats, fever, right-sided facial weakness, and hepatomegaly. Reticulonodular infiltrates were seen on chest x-ray film and a central filling defect was noted on liver scan. Study of the peripheral blood was noted on liver scan. Study of the peripheral blood revealed pancytopenia and myeloblasts. The bone marrow was not markedly hypercellular but contained noncaseating granulomas and myeloblasts. The patient's condition deteriorated and she died on the 22nd hospital day. Autopsy disclosed disseminated sarcoidosis but no evidence of leukemic infiltrates. Although concomitant "smoldering" acute leukemia cannot be ruled out, the findings in this patient can be best explained on the basis of a myeloblastic leukemoid reaction accompanying sarcoidosis.
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PMID:Probable myeloblastic leukemoid reaction with disseminated sarcoidosis. 27 Feb 28

Brucellosis has always been an unusual disease in children and, concomitant with the control of the disease in domestic animals, reports have become sparse. The pediatrician, therefore, may not be aware of the protean clinical manifestations of childhood brucellosis. In 1973, nine cases occurred during a three-month period in El Paso, Texas. All cases were marked by spiking fevers and lethargy of four days to four weeks in duration. Tender hepatomegaly or splenomegaly was striking in seven patients. Other characteristics included epistaxis, arthralgia, myalgia, and weight loss. Leukopenia and leukemoid reaction were found in five patients. All of the patients tested had elevated liver enzymes. Febrile agglutinins were invaluable in screening for an early clue to diagnosis. When Brucella abortus antigen agglutinated serum from patients with a positive screen in dilutions greater than 1:320, a presumptive diagnosis of brucellosis was made. Brucella was isolated from the blood or bone marrow in seven patients and the time of incubation proved crucial for successful recovery. Bacterial blood cultures are usually discarded at ten days of age, as were cultures from the only two patients from whom the organism was not recovered. All of the cultures incubated for 12 to 15 days grew B. melitensis, an unusual causative species in the United States. However, several patients admitted eating cheese from the State of Chihuahua, Mexico, made from unpasteurized goat's milk, the presumed source of the infection. Within one to three days, all patients responded dramatically to antibiotics; tetracycline was given orally for 21 days and streptomycin intramuscularly for 14 days. Pediatricians caring for patients in areas where consumption of unpasteurized milk products is likely would do well to consider brucellosis in a child with obscure fever or toxic hepatosplenomegaly.
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PMID:Brucellosis in childhood. 80 83

A case of severe sulfasalazine-induced hepatotoxicity is reported in a 14-year-old girl with Crohn's disease. Fourteen days after beginning sulfasalazine, she developed a systemic reaction characterized by high fever, maculopapular rash, lymphadenopathy, abdominal pain, and malaise, with tender hepatomegaly and elevated liver functions, leukemoid reaction, with eosinophilia, and immune complexes. She responded promptly to high-dose intravenous steroids with complete recovery. This case was compared to the three similar pediatric cases in the literature. The latent period was 11-19 days between sulfasalazine therapy and the onset of high fever, generalized lymphadenopathy, and pruritic maculopapular rash that spared palms and soles and resolved with desquamation. All children had hepatotoxicity indicated by tender hepatomegaly, elevated liver enzymes, and histologic inflammation on liver biopsy. The similarity between these features and those of other sulfa-induced hepatotoxic reactions suggests that the sulfapyridine moiety is the etiologic agent in these hypersensitivity reactions. Those children with circulating immune complexes responded well to steroids. Proper therapy for this rare but severe idiosyncratic reaction includes prompt recognition and discontinuation of sulfasalazine, and high-dose corticosteroid therapy.
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PMID:Sulfasalazine-induced hepatotoxicity in children with inflammatory bowel disease. 256 69

Chronic neutrophilic leukaemia (CNL) is a rare myeloproliferative disorder of elderly patients characterised by sustained neutrophilia. The diagnosis of CNL requires the exclusion of BCR/ABL positive chronic myelogenous leukaemia and leukemoid reaction. We present here a case of a 61-year-old Egyptian man with CNL and 21 months of follow-up. The main symptom of our patient was purpura. Splenomegaly, hepatomegaly and lymph node enlargement were not detected at presentation or throughout the patient's course. Thrombocytopenia was a considerable problem in our patient, causing recurrent bleeding and affecting the hydroxyurea dose adjustment. While hydroxyurea decreased the total leucocytic count, it could not affect the fatal course of the disease. The survival course of our patient extended to 21 months after presentation. The cause of death was attributed to disease progression.
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PMID:Chronic neutrophilic leukaemia: an Egyptian case. 2170 72