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)

We reviewed the Tumor Registry for 1981 at the Children's Hospital of Philadelphia to identify all the children with newly diagnosed cancer who were seen initially in the emergency department (ED). Of the 220 new patients listed, 16 (7.3%) sought initial care in the ED (1 per 4,500 ED visits). Seven had leukemia, five had non-CNS solid tumors (2 lymphoreticular, 1 Wilms', 1 neuroblastoma, and 1 ovarian), and four had CNS tumors. Among the children with leukemia, pallor (6) and decreased activity (4) were the most common complaints. Duration of symptoms ranged from 4 days to 3 weeks. Physical examination showed pallor (5), splenomegaly (4), fever (3), hepatomegaly (3), lymphadenopathy (3), and ecchymoses or petechiae (2). The complete blood count and peripheral smears were all abnormal. The five patients with non-CNS solid tumors had symptoms related to the location of their neoplasms. The patients with Wilms' tumor, neuroblastoma, and ovarian dysgerminoma had abdominal masses; the patient with lymphoma had a large, painful inguinal node; and the patient with histiocytosis X had an infiltrative rash, gingivitis, and pneumonitis. Of the four children with CNS tumors, three had headache, and one had an incidentally detected scotoma following head trauma. All four eventually had abnormal neurologic exams and computer tomographic scans, but two were discharged initially with psychiatric diagnoses. We conclude that cancer, although rare in children, occurs with greater relative frequency in the referral hospital ED than that predicted by published cancer rates from the referring hospital's ED.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Detection of cancer in the pediatric emergency department. 384 22

Visceral leishmaniasis (kala-azar) is an important cause of morbidity and mortality in widely scattered areas of the world. To better characterize the South American form of the disease, the clinical and laboratory manifestations of 29 patients admitted to hospital (18 male and 11 female patients, mean age 4.9 years), were assessed in an endemic area in northeastern Brazil. Fever, weight loss, pronounced splenomegaly, hepatomegaly, anemia, thrombocytopenia, relative neutropenia, hypoalbuminemia and hypergammaglobulinemia were found in the majority of patients. Symptoms were often present for two or more months before diagnosis. Secondary infections complicated many cases; there were ten cases of pneumonia and half of the patients had one or more intestinal parasites. The average length of hospital stay was 27 days; all patients were treated with meglumine antimoniate (Glucantime). The mortality rate was 3%. American visceral leishmaniasis remains an important disease among children living in endemic areas.
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PMID:American visceral leishmaniasis (kala-azar). 402 31

With the advent of effective antiviral treatment for disseminated herpes infection it has become important to be able to make a firm clinical diagnosis of this condition. We undertook a retrospective analysis of 20 patients with disseminated herpes simplex infection diagnosed at necropsy to derive useful clinical pointers to this severe form of the disease. The most useful clinical criteria were malnutrition, post measles state, and local herpes infection in addition to encephalopathy, enlarging hepatomegaly, and deteriorating pneumonia. The liver showed characteristic histological changes in 18 of 19 patients. These clinical criteria combined with liver biopsy were applied in a prospective pilot study of five patients at risk for disseminated herpes infection and the results were encouraging.
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PMID:Usefulness of clinical features and liver biopsy in diagnosis of disseminated herpes simplex infection. 648 59

From Oct 1, 1982, to Oct 1, 1983, the Centers for Disease Control (CDC) received reports of 35 children whose illness met the CDC definition of acquired immune deficiency syndrome (AIDS). All of the children had serious opportunistic infections without a known underlying illness to explain susceptibility to the infections. The 35 children were residents of ten different states; cases clustered in five major metropolitan areas. Three of the children had a parent with AIDS, and one child who had been previously reported had received a blood transfusion from a person in whom AIDS later developed. Most of the children had at least one parent in a population group in which adult AIDS cases have occurred. Many of the children had histories of prodromal symptoms, including pneumonitis, lymphadenopathy, hepatomegaly, and oral thrush. The mean age at onset of illness was 5 months, and the mean age at diagnosis was 12 months. To determine whether opportunistic infection in children without underlying immunodeficiency was truly a new phenomenon, a review of requests to the CDC for the drug pentamidine isethionate was undertaken. This revealed an apparent increase from 1979 to 1983 in Pneumocystis carinii pneumonia in children without known underlying immunodeficiency.
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PMID:Unexplained immunodeficiency in children. A surveillance report. 661 Jul 74

An outbreak of louse-borne relapsing fever, caused by the return to their original recruitment areas of soldiers at the end of 30 years of fighting in northern Ethiopia, was reported in the Arsi region. We studied 103 infants and children with louse-borne relapsing fever who were admitted to Asella Hospital between 1 May 1991 and 30 April 1992. Twenty-one per cent of the patients had a clear history of contact with sick ex-soldiers; 42% were students admitted to the hospital following the re-opening of schools after the summer vacation. The common clinical features of the disease were fever in 100%, headache in 84.5%, chills in 74%, abdominal pain in 51%, epistaxis in 20%, hepatomegaly in 26%, splenomegaly in 14%, petechial rash in 34% and jaundice in 10%. Differences in symptoms and signs according to age are described. Observed complications were pneumonia in 14% and central nervous system involvement in 10%. Four children went into deep coma, and two of them died. Severe disease was associated with a high density of spirochaetes in blood smears. Patients were treated with two low doses of penicillin or one dose of penicillin followed by, according to age, chloramphenicol or tetracycline, and with intravenous fluids. The case fatality rate was 1.9%. Jarisch-Herxheimer reactions occurred in 61% of patients. There were relapses in 2.9% of treated patients.
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PMID:Louse-borne relapsing fever in Ethiopian children: a clinical study. 768 13

Only few published autopsy studies exist on AIDS in Indians and they concentrate upon AIDS in adults. The authors report findings from the first autopsy study of a child with AIDS in India: a 2-year old female who presented with failure to thrive and pneumonia, and ultimately died in the hospital. The patient was stunted, emaciated, apathetic, and tested seropositive for antibodies to HIV. Investigators found precocious involution of the thymus, splenic atrophy, lymphoid interstitial pneumonia (LIP), and cryptosporidiosis of the colon in the body. No evidence was found of mycobacterial, fungal, or cytomegalovirus infection, and the heart, kidneys, endocrine organs, and brain were all normal. The lymph nodes were of normal size and showed unremarkable histological appearances, without apparent lymphocyte depletion. An enlarged liver revealed fatty change and mild portal lymphocytic infiltration. The presence of profound growth retardation and the finding of LIP suggest that HIV infection was acquired perinatally. The authors suggest in closing that all infants presenting with unexplained failure to thrive, growth retardation, and signs of pulmonary disease be screened for HIV infection.
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PMID:Paediatric AIDS: first autopsy report from India. 768 18

During a 16-month period children presenting to a pediatric outpatient facility from an area with a high tuberculosis incidence (> 400/100,000) and suspected of having respiratory tuberculosis (TB) were evaluated for close contact with adult pulmonary tuberculosis, weight loss, symptom duration, respiratory signs, lymphadenopathy and hepatosplenomegaly and by chest radiography and tuberculin testing (Mantoux or tine). Probable tuberculosis was diagnosed in 258 children and was confirmed in 109 (42%) patients with a mean age of 31 months by culture of Mycobacterium tuberculosis from gastric aspirate or another source. Eleven children with confirmed TB had a normal chest radiograph. After review of special investigations, clinical course and follow-up of the remaining 149 children, 86 children (58%) with a mean age of 32.4 months were considered to have probable TB and 63 (42%) with a mean age of 27 months not to have TB. Significantly fewer children in the "not TB" group than in the confirmed and probable TB groups had a close adult pulmonary tuberculosis contact (13 (21%) and 95 (49%), respectively; P < 0.01). There was no difference between the "not TB" group and the confirmed and probable TB groups in the proportion presenting with weight loss, cough or other respiratory symptoms, a symptom duration > 2 weeks, the presence of bronchial breathing, wheeze, hepatomegaly or splenomegaly or peripheral lymphadenopathy. Final diagnoses in the "not TB" group included bacterial or viral pneumonia or bronchopneumonia in 37, asthma often accompanied by segmental collapse in 9 and cavitating pneumonia in 3 children.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Respiratory tuberculosis in childhood: the diagnostic value of clinical features and special investigations. 776 Nov 83

ARI is the most common cause of illness and death in children under 5 years of age. Pneumonia is the leading cause of death. This prospective study was part of an ARIC project conducted to identify risk factors associated with mortality and morbidity of community acquired pneumonia in Thai children younger than 5 years of age. Study subjects were 267 moderately severe pneumonia who were admitted to hospital. Fifteen percent required a ventilator and were categorized as severe cases. Nine patients (3.4%) died and were categorized in the fatal group. From univariate analysis only, risk factors of fatal pneumonia were lower body weight (p = 0.04), paternal age less than 35 year (OR = 6.1, p = 0.01), underlying heart disease (OR = 12.1, p = 0.0000) and protein energy malnutrition (OR = 7.9, p = 0.0087). Predictors on admission to predict fatal outcome were rapid respiratory rate > 50/minute (OR = 4.1, p = 0.03), gallop rhythm (OR = 11, p = 0.04), enlarged liver (OR = 13.2, p = 0.001), and cyanosis (OR = 12, p = 0.0006). Significant factors associated with severe pneumonia after multiple logistic regression were underlying heart disease (OR = 4.04, 95% CI 1-15.4), enlarged liver (OR = 4.31, 95% CI 1.2-15.2) and cyanosis (OR = 5, 95% CI 0.8-28.7). This information should create awareness in physicians who are responsible for young children with pneumonia. Early recognition and intervention may prevent deaths and complications.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Risk factors associated with morbidity and mortality of pneumonia in Thai children under 5 years. 782 27

Laboratory personnel at Taif Children's Hospital in Saudi Arabia used indirect hemagglutination tests (IHAT) to analyze blood samples from 78 Saudi Arabian premature infants suffering from neonatal jaundice (21 infants), lymphadenopathy (18), fever (20), chorioretinitis (15), hepatomegaly (3), or pneumonia (1). Laboratory personnel in Egypt used ELISA assays to examine the second set of blood samples. The researchers wanted to measure antibodies to Toxoplasma gondii in the infants exhibiting symptoms of congenital toxoplasmosis. 32.1% of the infants tested positive for Toxoplasma antibodies based on the IHAT. The most common symptoms among these positive congenital toxoplasmosis cases were jaundice (57.1%) and lymphadenopathy (38.9%). The ELISA test for IgG found Toxoplasma antibodies in 46.2% of the premature infants. The ELISA test for IgM found Toxoplasma antibodies in 23.1%. The leading symptoms for IgG included jaundice (66.7%), chorioretinitis (53.3%), and lymphadenopathy (50%). The leading symptoms for IgM were jaundice (42.9%) and lymphadenopathy (22.2%). None of the premature infants with hepatomegaly or pneumonia tested positive for Toxoplasma antibodies. Pregnant women can avoid toxoplasmosis by cooking the meat they eat, and not eating it raw or frozen; not touching cats; and washing hands after handling raw meat, cats, or contaminated soil. Women should be routinely tested for Toxoplasma antibodies before pregnancy.
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PMID:Congenital toxoplasmosis among premature infants with different clinical pictures in Saudi Arabia. 784 30

A case of glycogen storage disease associated with multiple hepatic adenomas and Niemann-Pick disease is reported. Type IA glycogen disease was diagnosed soon after birth in a female patient, and she was treated at our clinic. At the age of 12 yr, the patient was found to have a hepatic tumor, which was surgically extirpated. Histological examination showed that the tumor was a hepatocellular adenoma. Increasing hepatomegaly and jaundice were noted when the patient was 18 yr of age. She died of pneumonia and cardiac tamponade at the age of 19. The liver weighed 3310 g, and showed severe jaundice and many nodules measuring up to 8 cm in diameter. These nodules were composed of mature hepatocytes without atypia and were diagnosed as hepatocellular adenomas. In addition, many adenomatous lesions were found at the microscopical level. The spleen weighed 1310 g, and showed two small infarctions at the upper part. A histological examination showed a diffuse infiltration of large foamy cells in the splenic red pulp. These cells were 20 to 100 microns in diameter and weakly positive for periodic acid-Schiff (PAS) staining, positive for lipid staining with Sudan black B, and positive for Pearce's phospholipid staining. Electron microscopy showed many lamellar bodies in the cytoplasm that were characteristic of Niemann-Pick disease. These foamy cells were also found in liver, bone marrow, lymph nodes, kidneys, and lungs.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Glycogen storage disease associated with Niemann-Pick disease: histochemical, enzymatic, and lipid analyses. 805 18


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