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Query: UMLS:C0019209 (hepatomegaly)
 5,798 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

An etiologic study was made of 107 cases of granulomatous hepatitis which were observed in a Department of Internal Medicine between January, 1971 and December, 1977 (excluding the hepatobiliary diseases). The most common etiology was tuberculosis (30 cases, 28 percent) followed by sarcoidosis (19 cases, 17.7 percent), Mediterranean exanthematous fever (13 cases, 12.1 percent), brucellosis (8 cases, 7.4 percent) typhoid fever (7 cases, 6.5 percent) and the idiopathic forms (8 cases, 7.4 percent). A lower rate of incidence was among Hodgkin's disease, toxoplasmosis, adenocarcinomas, leprosy, and those of unknown etiology, classified in this way because the study and follow-up of the patients could not be completed. There were, moreover, individual cases caused by mononucleosis, BCG reaction, hypogammaglobulinemia, celiac disease, and temporal arteritis. From a clinical point of view 50 percent of the patients had hepatomegaly and moderate disturbance of the liver enzymes. The most important enzymatic increases were detected in the cases caused by brucellosis; in the cases which were secondary to sarcoidosis the liver enzymes were normal. A comparison is established between the etiologic incidence of the present series and of others published in the literature. The causes and diagnostic problems of this type of lesion are discussed.
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PMID:[Granulomatous hepatitis. Etiologic study of 107 cases (author's transl)]. 45 94

In this series, the commonest aetiology was tuberculosis (30 cases, 28%), followed by sarcoidosis (18 cases, 17,7%), mediterranean fever (Olmer's disease) (13 cases, 12,1%), brucellosis (8 cases, 7,4%), typhoid fever (7 cases, 6,6%) and idiopathic forms (8 cases, 7,4%). These were followed by Hodgkin's disease, toxoplasmosis, adenosarcoma, and leprosy. Finally, there were single cases due to infectious mononucleosis, B.C.G. reaction, hypogammaglobulinaemia, coeliac disease and temporal arteritis. Half of the patients had hepatomegaly and an increase, in general moderate, in hepatic enzymes (transaminases, alkaline phosphatase). The highest enzyme levels were seen in cases of brucellosis, hepatic enzymes being normal in patients with sarcoidosis.
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PMID:[Granulomatous hepatitis: aetiological study of 107 cases (author's transl)]. 73 1

Toxoplasmosis was diagnosed in a 3-week-old red lory (Eos bornea). Grossly, there was hepatomegaly and pulmonary consolidation. The salient microscopic lesions were multifocal necrotizing mycocarditis, interstitial pneumonia with multifocal necrosis and vasculitis, and multifocal necrotizing hepatitis with periacinar hepatocellular necrosis. Toxoplasma gondii-like organisms were observed in lung, heart, and liver by light and electron microscopy. The organisms in tissues stained with anti-T. gondii serum using an immunohistochemical method.
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PMID:Fatal toxoplasmosis in a red lory (Eos bornea). 195 90

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

Toxoplasmosis is a special prenatal infection because it is susceptible to medication. Serologic screening and early diagnosis of a new infection is a prerequisite for successful treatment, which protects the fetus from infection. A case of a twenty-two year old gravida-II shows, that infection is possible despite negative initial screening. A new infection was diagnosed because of seroconversion at a routine screening at the end of the second trimester. An ultrasound scan showed severe hydrocephalus, hepatomegaly, and ascites. Labor was induced in the 33rd gestational week. Conatal toxoplasmosis was confirmed by histologic and microbiologic studies of the placenta and membranes. We discuss the difficulties resulting from negative primary serology.
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PMID:[Severe fetopathy--toxoplasma despite serologic screening. A case report]. 273 44

Infection with the human immunodeficiency virus (HIV) is characteristically associated with hypergammaglobulinemia in both adult and pediatric cases. We report herein four infants who had an HIV infection in association with severe hypogammaglobulinemia and did not exhibit antibodies against HIV. HIV was isolated antemortem or postmortem in all four infants from either peripheral blood, cerebrospinal fluid, or body tissues. HIV infection could be presumed to be acquired transplacentally in two infants and by way of infected blood transfusions during the neonatal period in the other two. Each infant became symptomatic within the first year of life and developed rapidly progressive manifestations of the disease. Features that were common to all four infants include premature birth, failure to thrive, hepatomegaly, and progressive neurological abnormalities that were associated with intracranial calcifications. We concluded that, when infection occurs early in development either by transplacental exposure to the virus or from blood transfusion in small premature infants, hypogammaglobulinemia and deficiency of antibody production leading to the absence of antibody responses on which diagnosis is usually based can occur. Furthermore, progressive central nervous system disease may be a frequent finding in such infants, and this may lead to cerebral calcifications that must be attributed to the HIV infection itself and not to complicating infections--e.g., toxoplasmosis. It is suggested that patients with hypogammaglobulinemia, antibody deficiency syndrome, and central nervous system disease have an extremely bad prognosis.
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PMID:Prematurity, hypogammaglobulinemia, and neuropathology with human immunodeficiency virus (HIV) infection. 347 85

The original TORCH complex described clinically similar congenital infections caused by Toxoplasma gondii, rubella virus, cytomegalovirus, and herpes simplex virus, types 1 and 2. Cutaneous manifestations, including petechiae, purpura, jaundice, and dermal erythropoiesis, are commonly seen in toxoplasmosis, rubella, and cytomegalovirus infections. In herpes simplex virus infections, 80% of symptomatic infants show single or grouped cutaneous vesicles, oral ulcers, or conjunctivitis. Extracutaneous signs and symptoms are variable and can be severe. Significant clinical signs in congenital toxoplasmosis include diffuse intracerebral calcification, chorioretinitis, and microcephaly; congenital rubella can result in deafness, congenital heart disease, retinopathy, and brain calcification. Cytomegalic inclusion disease can include hepatomegaly, splenomegaly, paraventricular calcification, and intrauterine growth retardation. Localized or disseminated congenital herpes virus infection often involves the central nervous system and the eye. Diagnosis is confirmed by culture and identification of species-specific immunoglobulin M within the first 2 weeks of life. Histological examination contributes to the diagnosis in herpes simplex virus infection. Treatment for toxoplasmosis includes pyrimethamine with sulfadiazine or trisulfapyrimidine; congenital herpes simplex virus infection is treated with acyclovir. No specific therapy for congenital rubella or cytomegalovirus infections has been established, and so treatment is primarily supportive.
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PMID:TORCH syndrome. 764 Feb

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

Three hundred children with hepatomegaly were selected. They were subjected to full clinical and laboratory examinations. Also serum samples were examined to detect IgG using ELISA against SEA, chromatography purified hydatid cyst antigen, commercially available Toxoplasma antigen, partially purified adult Fasciola antigen and second-stage larvae Toxocara canis antigen. IFAT was used to detect IgG against Toxoplasma and T. canis. A commercially available IHAT kit for leishmaniasis was used. Based on immunological assays, 125 cases were suffering from various parasitic infections. Thirty cases with schistosomiasis (10%), 26 cases fascioliasis (8.7%), 18 toxocariasis (6%), 35 toxoplasmosis (11.7%), 3 cases hydatidosis (1%) and 13 cases mixed parasitic infections. No parasitic causes could be found in 175 cases (58.3%). Moderate or marked hepatomegaly favours the presence of schistosomiasis. Whereas, most cases with other parasites and those with non-parasitic infections fall in the category of mild hepatic enlargement. There was no associated splenomegaly in cases with Fasciola, Toxocara, hydatid disease and/or the non-parasitic group. Most of hepatomegalic cases with non-parasitic causes were found to be associated with fever (88.5%). Fever was found in nearly 50% of cases with either Toxoplasma or Toxocara infections. Mild eosinophilia was found in all cases with parasitic causes. Only 24 cases of non-parasitic group (13.7%) had easinophilia. Moderate and high eosinophilia were found in cases with fascioliasis and toxocariasis. Cases with fascioliasis had a statistically significant increase in enzymes activities specially alkaline phosphatase. It was concluded that parasitic infections should be considered as an important cause of liver enlargement in children. Serological methods using purified antigenic fractions are an important tool for diagnosis.
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PMID:Parasitic causes of hepatomegaly in children. 872 Dec 39

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


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