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)

Two cases of atypical Kawasaki disease are reported. Case 1 was a five-month-old male infant admitted to this hospital with a 10-day's history of high fever. On examination, he appeared ill-looking and only hepatomegaly was noted. Laboratory studies showed leukocytosis, thrombocytosis, elevated ESR and pleocytosis in CSF. He was treated as sepsis with meningitis. Sudden death occurred on the eighth day of admission, and left coronary artery aneurysm with thrombosis was noted at autopsy. Case 2 was a four-month-old male infant referred to our hospital with fever and cervical lymphadenopathy of 11 day's duration, and unresponsive to antibiotics. Skin rash had developed after oxacillin injection. Echocardiogram, performed on the third day of admission, disclosed a 5-8 mm aneurysm of the left coronary artery and a 4 mm aneurysm of the right coronary artery. Before a specific diagnostic test for Kawasaki disease becomes available, we suggest that a possible diagnosis of Kawasaki disease and echocardiographic evaluation should be considered in case of (1) presence of partial criteria of Kawasaki disease with thrombocytosis; and/or (2) young infants with prolonged unexplained fever.
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PMID:Atypical Kawasaki disease: report of two cases. 151 14

A 3-year-old boy, who developed the signs and symptoms characteristic of Kawasaki disease, is described. The child also had an 8 cm tender hepatomegaly. Hydrops of the gallbladder could not be shown. Liver biopsy showed marked infiltration of inflammatory cells, including neutrophil and eosinophil leucocytes in the portal tracts involving the periphery of the portal arteries and veins, and acute inflammation of the bile ducts with neutrophil and eosinophil infiltration of the walls. Overt cholangitis has been described only once before in Kawasaki disease, when a viral agent was suggested as being important in the pathogenesis. Although the clinical and laboratory findings in cases of Kawasaki disease clearly suggest an acute infection--as they did in this case--no aetiological agent has yet been incriminated. The possibility of a drug-induced auto-allergic or hypersensitivity state is considered. Evidence for such a state includes a history of drug administration, pathological findings similar to peri-arteritis nodosa--a condition often associated with a hypersensitivity state--the presence of eosinophils in the lesions and a response to treatment with aspirin, a drug known to ameliorate hypersensitivity states.
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PMID:Kawasaki disease manifesting with acute cholangitis. A case report. 172 32

Pathologic studies of the liver were performed on 30 autopsied cases of Kawasaki disease. The cases were classified into four groups (stages I-IV), and stage IV was further divided into two subgroups according to the duration of the illness at the time of death. Liver weights were markedly increased in stage II (12-25 days) and in stage III (28-36 days) but returned to normal in stage IVb (7 months to 6 years). Likewise, spleen weights were also markedly increased in stages II and III. Stage I (0-9 days) and stage II were characterized by acute inflammation in portal area, and degree of inflammatory changes decreased gradually. There was significant correlation between hepatomegaly and the degree of inflammation in portal areas, but not with definite heart failure or the use of drugs. These data suggest that the pathogenesis of hepatomegaly in acute-stage Kawasaki disease involves the inflammation in portal areas and/or latent heart failure.
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PMID:Hepatomegaly and splenomegaly in Kawasaki disease. 383 50

Yersinia pseudotuberculosis infection was diagnosed in 12 children on the basis of recovery of the organism from stool cultures and a 4-fold or greater titer change in agglutinating antibody. Eight of the 12 Yersinia isolates were recovered from stool cultures only after cold enrichment. Clinical findings in 50% or more of patients were fever, rash, diarrhea, desquamation, strawberry tongue, vomiting, red and cracked lips, abdominal pain, arthralgias, hepatomegaly and conjunctivitis. The patients' clinical manifestations and courses of illness resembled those of Izumi fever, an illness that occurs epidemically in Japan. Additionally the finding in two children fulfilled the strict criteria for Kawasaki syndrome, and signs in the other 10 children were consistent with that diagnosis.
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PMID:Yersinia pseudotuberculosis infection in children, resembling Izumi fever and Kawasaki syndrome. 634 44

The diagnosis of an acute hydrops of the gallbladder was done by ultrasonography during a mucocutaneous lymph node syndrome, with jaundice and hepatomegaly. Surgery was avoided when ultrasonographic follow-up showed the spontaneous resolution of the hydrops.
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PMID:[Ultrasonography in mucocutaneous lymph node syndrome with jaundice and acute gallbladder distension]. 712 17

Two children with Kawasaki disease (KD), a girl 3 yrs. and a boy 2.5 yrs., were described. The children met all criteria for the diagnosis of KD (fever, conjunctivitis, oral changes, extremity changes, rash, lymphadenopathy), and other diseases were excluded. In both children or one of them other clinical and laboratory findings occasionally detected in KD were observed: arthralgia, hepatomegaly and splenomegaly, slight elevation of transaminases and bilirubin level, slight elevation of CSF pleocytosis, sterile pyuria and hematuria. Electrocardiograms revealed sinus tachycardia and transient disturbances of heart repolarization. In both children changes in blood morphology and biochemical disturbances typical for inflammatory processes were noted. Thrombocytosis was seen in the 2nd week of the illness in the child in whom platelet counts were controlled. The child in whom diagnosis of KD was established in the first week of symptoms was treated with acetylsalicylic acid along with an oral penicillin. A child with retrospectively diagnosed KD was treated with antibiotics and corticosteroids. Clinical and laboratory findings of KD resolved in both children within 4-6 weeks without complications from coronary blood vessels.
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PMID:[Mucocutaneous lymph node syndrome (Kawasaki disease) in 2 children]. 892 38

The authors present a case of an adult with Kawasaki syndrome, who, due to jaundice, enlarged liver and abnormal liver function tests, was admitted the hospital with the suspicion of liver disease. The symptoms of Kawasaki syndrome appeared during the first nine days of the hospital stay. The authors emphasise, that liver function tests are frequently abnormal in adults presenting with this clinical entity, therefore Kawasaki syndrome should be taken into consideration in the differential diagnosis of liver diseases.
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PMID:[Adult-onset Kawasaki syndrome in the differential diagnosis of liver disease]. 1148 9

Ten children (4.6%) among a cohort of 219 with Kawasaki disease (KD) had their onset with severe abdominal complaints. Incomplete KD presentation at the time of acute abdomen was present in nine of 10 patients. Acute abdominal pain and distension, vomiting, hepatomegaly, and jaundice were the most common symptoms at onset. Hematemesis was present in one; toxic shock syndrome requiring care in the intensive care unit occurred in four. Five patients had laparotomy, three had percutaneous transhepatic biliary drainage, and one had a gastrointestinal endoscopy. Postoperative diagnosis was gallbladder hydrops with cholestasis in five, paralytic ileus in three, appendicular vasculitis in one, and hemorrhagic duodenitis in one. All patients completely recovered, but 50% developed coronary aneurysms despite early intravenous gammaglobulin treatment. Acute surgical abdomen can be the presenting manifestation of KD. In older children with fever, rash, and acute abdominal pain or hematemesis, KD should be considered in the differential diagnosis.
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PMID:Acute surgical abdomen as presenting manifestation of Kawasaki disease. 1283 7

Kawasaki disease predominantly affects children younger than 5 years. Coronary artery aneurysms were found in around 20% of untreated patients. We report on a case of a 10-year-old boy who had atypical presentation of Kawasaki disease with significant hepatobiliary dysfunction, including hepatomegaly and jaundice, and persistent fever. He did not have conjunctivitis until the 8th day of fever, and periungual desquamation and strawberry tongue until the 13th day of fever when Kawasaki disease was diagnosed. Echocardiography revealed multiple coronary artery aneurysms. Such atypical clinical pictures of Kawasaki disease may cause delay in the treatment, and the fatality rate can be increased. So, a persistent fever with jaundice should evoke the differential diagnosis of Kawasaki disease.
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PMID:Kawasaki disease presenting with hepatitis and prolonged fever: report of one case. 1452 Oct 27

Aspirin is commonly used as an anti-inflammatory therapy for Kawasaki syndrome. Early initiation with high dose aspirin (80 to > 100 mg/kg per day), followed by low-dose therapy at the afebrile stage, has been often used to reduce morbidity and mortality in coronary complications. We report a 10-month-old infant who was diagnosed with Kawasaki syndrome. Sudden onset of poor activity, poor appetite, lethargy, tachycardia, tachypnea, hepatomegaly, increased AST/ALT, coagulopathy and hyperammonemia developed 3 days after the high-dose aspirin therapy. His histopathological and ultrastructural findings from the liver biopsy were compatible with Reye's syndrome. He recovered completely, and there was no recurrence.
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PMID:Reye's syndrome developing in an infant on treatment of Kawasaki syndrome. 1595 35


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