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)

An allergic disease may develop in any organ or system. The respective etiological factors include foreign proteins, infectious agents such as various microbes, viruses, moulds, parasites, chemical compounds often in the form of drugs usually designated as haptens, polysaccharides, benign and malignant neoplasms. Of the factors operating in the causal pathogenesis of such diseases the most important one is an exaggerated formation of antibodies, which appears to be uncontrolled and occurring irrespective of the demands of the organism. The essential morphological features in allergic inflammation are rather variegated, their diagnostic value differing in a wide range but being never absolute. The above features include eosinophilic leucocytes, allergic arteritis and phlebitis, fibrinoid necrotic glomerulonephritis, histiocytic granulomatous inflammation or histiocytic granuloma. Granulomatous capsulitis and trabeculitis affecting the spleen and lymph nodes are believed to be of major diagnostic significance. The immunofluorescent and immunoperoxidase methods and electron microscopy are important diagnostic tools. It has been generally acknowledged that many drugs operate as antigens. They may cause death of the respective patient, but allergic manifestations may subside after withdrawal of such drugs. On occasion they operate as a trigger mechanism with the allergy progressing even after treatment had been interrupted. Therefore they have been receiving extreme attention. Our collection of cases a case of giant-cell myocarditis following sulfamethoxypyridazine, anaphylactic shock has been reported to occur after intravenous administration of novocaine, and generalized cutaneous vasculitis developed in the same patient during the subsequent phase. A similar cutaneous finding was reported to have developed after penicillin injection, granulomatous inflammation developed owing to sulfonamide treatment. Allergic tumour-like lymphadenitis developed after administration of anti-anthracic serum; an anticonvulsive syndrome developed after hydantoinate administration. The latter consisted of generalized exanthema, hepatomegaly, splenomegaly and generalized lymphadenopathy. The lymph nodes showed tumour-like lymphadenitis mimicking lymphogranuloma or reticulosis. Allergic diseases appear as either isolated organ lesions or systemic diseases. Thus, isolated and systemic polyarteritis nodosa, isolated nasal, pulmonary or systemic Wegener's granulomatosis have been recognized. Temporal arteritis has been recognized as a localized form of systemic giant-cell arteritis. The haemolytic-uraemic syndrome appears to be a milder variety of thrombotic thrombocytopenic purpura. Allergic diseases or manifestations occasionally affect two or more organs or systems.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Pathology of allergic diseases. 248 27

The authors present the clinical history of the first case of benign hemophagocytic syndrome diagnosed in Panama. The patient, a 4 year old girl, presented with fever, anemia, cervical lymphadenitis, hepatomegaly, lymphocytosis and histophagocytosis of red cells, lymphocytes, neutrophils and platelets. Spontaneous remission of the fever occurred sixty days after the onset of the disease. Although it was not possible to demonstrate serologically that the syndrome was due to acute toxoplasmosis, she was treated with sulfadiazine and pyrimethamine for fifteen days, on the 37th hospital day, and with clindamycin for ten days, consecutively. Remission occurred seventy days after the onset of fever. A second serological examination for toxoplasmosis (immunofluorescent antibodies) was positive in a titer of 1:2048 again, nine months after the first serology.
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PMID:[Benign hemophagocytic syndrome. First confirmed case in Panama]. 272 29

Among 137 members of 30 families, 6% (and 8% of those aged under 15 years) were seropositive for toxocara antibodies. In these seropositive subjects and in 84 patients known to have raised toxocara titres the commonest clinical features were abdominal pain, hepatomegaly, anorexia, nausea, vomiting, lethargy, sleep and behaviour disturbances, pneumonia, cough, wheeze, pharyngitis, cervical adenitis, headache, limb pains, and fever. 61% of patients with raised toxocara titres had recurrent abdominal pain. Eosinophilia was in many cases associated with a raised toxocara titre, but 27% of patients with high titres had normal eosinophil counts. Toxocariasis is common, especially in children, and is associated with clinical features that are generally regarded as non-specific but together form a recognisable symptom complex. Toxocariasis should be considered in the differential diagnosis of such symptoms and especially in recurrent abdominal pain, which might otherwise be labelled as idiopathic. The absence of eosinophilia does not exclude toxocariasis.
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PMID:The expanded spectrum of toxocaral disease. 289 21

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

Clinicomorphological characteristics are given of primary reaction at the site of tick (Rhipicephalus pumilio) bite in new rickettsiosis spreading in Astrakhan Province--Astrakhan fever. The disease presented with long-term fever (body temperature 39-40 degrees C), intoxication, conjunctivitis, hepatomegaly, regional lymphadenitis, disseminated roseolous papular-hemorrhagic rash, arterial hypotension.
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PMID:[The primary effect and characteristics of the course of a new tick-borne rickettsiosis--Astrakhan fever]. 932 3

Although tuberculosis is common and well recognised in many countries, unusual presentations of the disease sometimes raise difficulties in differential diagnosis. We report a young patient who presented with weight loss, shortness of breath and easy fatiguability. Extensive lymphadenopathy involving the cervical, axillary and inguinal regions were found on physical examination. Chest X-ray and computed tomography revealed generalized lymphadenopathy of cervical, mediastinal and para-aortic chains, bilateral pulmonary miliary reticulonodular infiltrates, pleural effusion, hepatomegaly with low density, macronodular hypodense areas in spleen, ascites, peritoneal irregularity and thickening of bowel walls. Mantoux test was negative. Peritoneal fluid was exudative, but pleural fluid was transudative, probably due to mediastinal lymphatic obstruction. The initial clinical diagnosis was malignant lymphoma; however, positive sputum smears for mycobacteria and excisional cervical lymph node biopsy revealing caseating granulomatous lymphadenitis were consistent with tuberculosis. The patient responded well to appropriate therapy with regression of radiological abnormalities.
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PMID:Unusual miliary tuberculosis presenting with generalized lymphadenopathy and abdominal involvement. 944 Nov 4

Mycobacterium avium-intracellulare (MAI) is a ubiquitous organism with limited virulence in the immunocompetent host. Disseminated disease is associated with a high mortality rate. Except for localized cervical adenitis, MAI disease is rare in immunocompetent children. We report a child with antibody deficiency (dysgammaglobulinemia) and disseminated MAI infection, in whom complete, long-term remission was attained with multiple antimycobacterial therapy. The patient presented with progressive cervical lymphadenopathy and hepatomegaly at 7 years of age. A lymph node biopsy showed acid-fast bacilli and granulomas. Despite a transient response to conventional antituberculous therapy, including isoniazid and rifampin, his symptoms progressed. Cultures from blood, bone marrow, spleen, and cervical lymph node tissues revealed an MAI organism. Subsequent treatment using a combination of clarithromycin, amikacin, and ethambutol for 16 months resolved clinical symptoms, and subsequent blood culture results became negative. By the time of this report, the patient has been disease-free for 4 years. Multiple-drug therapy is promising for the treatment of MAI in children with antibody deficiency; however, the selection of antiinfective drugs should include a member of the newer macrolide family. acquired immunodeficiency syndrome, clarithromycin, dysgammaglobulinemia, Mycobacterium avium-intracellulare, treatment.
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PMID:Long-term remission for disseminated Mycobacterium avium-intracellulare complex associated with antibody deficiency. 991 93

One hundred and thirteen children suffering from tubercular lymphadenitis proven histopathologically, were studied for clinical and laboratory features. Age distribution was equal in all age groups except during infancy when it was rare. Sex ratio indicates a male preponderance with male to female in the ratio of 1.5:1 (67:46). Family history of contact with known tuberculous patient was positive in 19 (17%) children, 44 (40%) had received BCG, and 98 (88%) were either normal nourished or had mild malnutrition. Cervical, axillary and inguinal nodes were found in 90 (80%), 14 (12%), and 8 (7%) children respectively. Epitrochlear node was found in only 1 child. 11 (10%) children had discharging sinus, all being in cervical group. The consistency of nodes was firm in 98 (87%), fluctuation was present in 15 (13%). In 87 (77%) lymph nodes were matted. Hepatomegaly of more than 2 cm was present in 13 (11%) and spleen was enlarged (> 2 cm) in 4 (4%) only: Mantoux test was positive in 96 (85%) children and chest X-ray was abnormal in 25 (22%) cases. Findings suggest that tubercular adenitis occurs in all age groups with equal frequency. It can occur in vaccinated children also. It may be a sole manifestation of tubercular infection. The cervical nodes are predominantly involved. There is no typical location of nodes in individual groups but multiplicity and matting of nodes are characteristic features of tubercular adenitis in children.
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PMID:Tubercular lymphadenitis: clinical manifestations. 1082 23

Kikuchi-Fujimoto disease is a rare disease first described in 1972 by Kikuchi and Fujimoto et al. (1,2). Clinically the disease presents with lymphadenitis usually in the cervical region. Most reported cases of Kikuchi-Fujimoto disease have been of Asian origin. The cause is unknown and the condition is self-limiting. Some kind of viral or postviral etiology has been implicated. Bacterial and protozoal organisms as well as various other antigens, chemical, physical and neoplastic, have also been postulated. An association with systemic lupus erythematosus has also been shown. Lymphadenitis, hepatomegaly and splenomegaly as well as leukopenia, elevated erythrocyte sedimentation rate and hepatic abnormalities are common findings. Fever, malaise, fatigue, headache, night sweats, nausea, vomiting, weight loss, cutaneous manifestations, and even neurological symptoms are other complaints. Histologically the lymph nodes show partial involvement with patchy irregular areas of necrosis in the paracortical area with absence of neutrophils. We describe four cases of Kikuchi-Fujimoto disease observed in Greece. Their characteristics are discussed, whilst a review of the literature is attempted.
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PMID:Kikuchi-Fujimoto disease in Greece. A study of four cases and review of the literature. 1249 69

Kikuchi-Fujimoto disease (KFD), also know as histiocytic necrotizing lymphadenitis, is a benign disorder characterized histologically by necrotic foci surrounded by histiocytic aggregates, and with the absence of neutrophils. KFD was recognized in Japan, where it was first described in 1972. The disease is most commonly affecting young women. The cause of the disease is unknown, and its exact pathogenesis has not yet been clarified. Many investigators have postulated viral etiology of KFD, connecting it with Epstein Barr virus, human herpes simplex virus 6 parvo B 19, but also with toxoplasmic infection. Kikuchi-Fujimoto disease is usually manifested with lymphadenopathy and high fever, and is associated with lymphopenia, splenomegaly, and hepatomegaly with abnormal liver function tests, arthralgia, and weight loss. The disease has the tendency of spontaneous remission, with mean duration of three months. Single recurrent episodes of KFD have been reported with many years' pauses between the episodes. Kikuchi-Fujimoto disease may reflect systemic lupus erythematosus (SLE), and self-limited SLE-like conditions. Final diagnosis could only be established on the basis of typical morphological changes in the lymph node, and lymph node biopsy is needed for establishing the diagnosis. Lymphadenopathy in a patient with fever of the unknown origin could provide a clue to the diagnosis of lymphoma, tuberculosis, metastatic carcinoma, toxoplasmosis and infectious mononucleosis. As KFD does not have any classical clinical features and laboratory characteristics, it may lead to diagnostic confusion and erroneous treatment. We described a case of KFD, and suggested that this disease should be considered as a possible cause of fever of the unknown origin with lymphadenopathy.
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PMID:[Kikuchi-Fujimoto disease]. 1460 43


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