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

In three cases of pulmonary tuberculosis associated with the adult respiratory distress syndrome the clinical features, which were similar to those of patients with miliary tuberculosis and adult respiratory distress syndrome, included a history of cough, fever, and dyspnoea on effort, and the physical signs of fever, tachypnoea, pulmonary adventitious sounds, tachycardia, and hepatomegaly. In these cases the radiological features, though suggestive of diffuse pulmonary oedema, were more prominent on the side in which the cavitatory lesion appeared. The diagnosis of tuberculosis was made easily from direct examination of sputum. Despite early ventilatory support and antituberculous therapy, two of the three patients died. Postmortem examination of the lungs in these cases showed evidence of acute alveolar damage (loss of type 1 pneumocytes and the presence of hyaline membranes within alveolar ducts) and of chronic alveolar damage (interstitial and alveolar fibrosis).
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PMID:The adult respiratory distress syndrome bronchogenic pulmonary tuberculosis. 674 May 41

The authors report a case of Fanconi's disease equilibrated for a period of 8 years by androgen therapy. The patient died after interruption of treatment; the clinical picture comprised hepatomegaly, jaundice, pancytopenia. The autopsy showed hepato-splenic peliosis and acute tuberculosis. The subject of peliosis is brought up to date by a thorough review of current literature and the relationships between steroid treatment and hepatic complications are discussed.
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PMID:[Fanconi's disease associated with hepato-splenic peliosis (author's transl)]. 722 98

Twenty children with constrictive pericarditis are reported on. Tuberculous etiology was established in five, could not be excluded in 7, while the etiology could not be identified in 8 cases. The main symptoms were venous congestion involving the pulmonary and systemic circulation (hepatomegaly, pulmonary congestion), pericardial click at the apex, abnormalities of repolarization in the ECG. X-ray evidence of pericardial calcification and a "quiet heart" were occasionally found. Hypoproteinaemia, hypalbuminaemia and ascites, signs of an associated protein losing enteropathy may occur in constrictive pericarditis, but are not invariably present. Pericardiectomy is the most adequate form of treatment. Sixteen of the 17 cases in whom the operation was performed recovered completely; one child died.
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PMID:Chronic constrictive pericarditis in children - etiology, clinical picture and treatment. A report of 20 cases. 723 57

In a survey of 15,272 canine necropsies, natural infection with Mycobacterium tuberculosis was found to have been diagnosed in eight dogs (0.05%). Clinical findings were anorexia, loss of body weight, lethargy, vomiting, and leukocytosis; radiography revealed pleural and pericardial effusion, ascites, and hepatomegaly. Granulomatous lesions with acid-fast bacilli were consistently found. Mycobacterium tuberculosis was isolated from lesions in the lungs, liver, or lymph nodes of five dogs. All eight dogs had a history of contact with human patients with tuberculosis.
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PMID:Canine tuberculosis. 742 50

Sixty-two cases of disseminated tuberculosis seen over a 6-year period in a large teaching hospital are reviewed. The commonest symptoms were cough, loss of weight and appetite, fever and general malaise. Headache, when present, was highly specific for meningeal involvement. Pyrexia, hepatomegaly, evidence of weight loss and adventitious chest sounds were the commonest physical signs. Hyponatraemia, hypo-albuminaemia and abnormal liver function were common. Severe haematological abnormalities were not present in any of the patients. The best diagnostic sources were sputum, bronchial brushings and biopsies of liver and bone marrow. Forty patients (64%) died, 31 deaths being directly attributable to disseminated tuberculosis. Twenty-five patients had associated diseases. More female patients and Black patients died than did males, Whites or Coloureds (mixed race). The duration of symptoms prior to admission was, in general, long in comparison with the interval between admission and death. We should like to re-emphasize the need to consider disseminated tuberculosis early in the differential diagnosis of a wasting pyrexial illness with chest symptoms and signs, even in the absence of a miliary or miliary-like chest radiograph.
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PMID:Disseminated tuberculosis. A study of 62 cases. 744 85

The recent pattern of immigration from Indochina and Latin America to the United States suggests that tuberculosis will remain a significant public health problem. Two infants recently seen with probable congenital tuberculosis prompted critical evaluation of the 24 cases of congenital tuberculosis reported in the English literature since the introduction of isoniazid in 1952. Failure to thrive, jaundice, and central nervous system involvement, all reported in previous reviews and textbooks to be very common, were unusual presenting manifestations. In contrast, hepatomegaly, a finding not mentioned in the recent literature, was common. Diagnostic procedures previously underutilized but found in this review to be useful included liver biopsy, biopsy of skin lesions when present, and cultures of gastric aspirates. Factors which enable differentiation of congenital from early postnatally acquired tuberculosis include (1) the presence of known maternal tuberculosis at delivery, (2) whether infant and mother were separated from birth until the onset of illness, and (3) whether other tuberculous exposure of the infant can be determined. Insufficient data prevent recommendation of a preferred regimen of drugs in addition to isoniazid for the treatment of congenital tuberculosis. However, the responses of our patients suggest that streptomycin can be omitted without hazard. Information regarding the long-term prognosis of survivors is lacking, but early diagnosis and institution of appropriate therapy has markedly decreased the mortality of this previously fatal disorder.
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PMID:Congenital tuberculosis: critical reappraisal of clinical findings and diagnostic procedures. 745 91

The clinical characteristics of hepatic tuberculosis in 52 cases diagnosed pathologically were analyzed. Fever, abdominal pain and hepatomegaly were the major clinical manifestations; they were present in 96.2%, 42.3% and 88.5% of the patients respectively. The fever had no consistent pattern and the abdominal pain was usually localized to the right hypochondrium and not related to overwork. Hypergrammaglobulinaemia, elevated alkaline phosphatase level and increased ESR were noted in most of the patients (76.9%, 75.0%, 76.5% respectively). 62.5% of the 52 patients was diagnosed by percutaneous liver biopsy. Since there is no consistent clinical pattern in patients with hepatic tuberculosis, the diagnosis should be considered in patients with unexplained fever associated especially with hepatomegaly or hepatosplenomegaly, elevated alkaline phosphatase level, hypergrammaglobulinaemia and increased ESR, Liver biopsy is the most valuable method to confirm the diagnosis of hepatic tuberculosis.
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PMID:[Clinical characteristics of hepatic tuberculosis]. 760 Aug 75

The clinical and pathological features of 22 patients, 11 males and 11 females 17-70 years of age (48.0 +/- 16.0 years), with hepatic tuberculosis were reviewed. Five patients had no evidence of extrahepatic tuberculosis (local form), and 17 had the miliary form. The clinical features of the miliary and local forms were similar with pyrexia, abdominal pain, hepatomegaly and body weight loss as the main manifestations. The biochemical findings were also quite similar in reversed albumin and globulin (A/G) ratio (2.9/3.5 vs. 3.2/3.4 g/dl) and disproportionate elevation of alkaline phosphatase (ALP) in comparison with bilirubin values but lower levels of alanine aminotransferase (ALT) (40.4 +/- 51.0 vs. 170.8 +/- 209.4 U/l; p < 0.05) and ALP (208.5 +/- 138.9 vs. 389.5 +/- 271.1 U/l; p < 0.05) in the miliary form. Patients with the local form had higher albumin (3.2 +/- 0.8 vs. 2.9 +/- 0.7 g/dl), aspartate aminotransferase (AST) (160.4 +/- 221.7 vs. 65.9 +/- 69.7 U/l), and gamma glutamyl-transpeptidase (gamma GT) (217.0 +/- 144.0 vs. 136.0 +/- 92.1 U/l), although the differences were not significant. The histopathological features of the miliary form were also similar to the local form with granuloma, caseation, acid-fast bacilli, fatty change and portal fibrosis as the main findings. The local form revealed more severe signs of hepatocytic damage while the miliary form was more wasting. The results suggest that the miliary and local forms of hepatic tuberculosis had quite similar clinical presentations and pathological features. The biochemical tests suggesting hepatic tuberculosis were reversed A/G ratio and disproportionate elevation of ALP.
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PMID:Hepatic tuberculosis: comparison of miliary and local form. 774 92

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

A 54 year old Asian woman developed fulminant hepatic failure followed by renal failure. Because of a past history of possible tuberculosis, she was given antituberculous drugs. The chest x ray was normal. A transjugular liver biopsy showed caseating necrosis, granulomas, and acid fast bacilli indicative of miliary tuberculosis. Despite full supportive therapy, her condition deteriorated and she died. Postmortem examination showed widespread miliary tuberculosis; culture confirmed the presence of Mycobacterium tuberculosis. Tuberculosis causes fulminant hepatic failure rarely and only three cases have been described. In this, as with the other cases, hyponatraemia and hepatomegaly were features at presentation. This is the first report of treatment being given before death.
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PMID:Fulminant hepatic failure caused by tuberculosis. 779 33


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