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Query: UMLS:C0019209 (
hepatomegaly
)
5,798
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Sarcoidosis is being increasingly recognized in India. Over the last 7 years we studied 40 patients. Older males out numbered young females. Thoracic (98%), constitutional (50%) and ocular (40%) involvement dominated the clinical profile. In addition, erythema nodosum (20%), facial palsy (13%), parotid enlargement (8%), lymphadenopathy (42%),
hepatomegaly
(37%) and splenomegaly (17%) were also observed. Radiologically, 53%, 30% and 15% of patients were in Stage I, II and III respectively at presentation. Kveim test was positive in 45% of those tested. The diagnosis was histologically confirmed in 80% of patients. The remaining eight patients (20%) were relatively asymptomatic, all had bilateral hilar lymphadenopathy and either erythema nodosum or uveitis or both. 88% were tuberculin negative. Systemic steroids were used in 60% and topical steroid eye drops in a further 20%. Response to therapy was excellent except in Stage III disease where radiological and spirometric deterioration was observed in three patients. There were no fatalities. The overall clinical behaviour of north Indian patients with sarcoidosis was quite similar to that of patients in England but different from previously reported Indian patients.
Sarcoidosis 1987
Sep
PMID:Sarcoidosis in north India: the clinical profile of 40 patients. 365 20
A case of phenytoin-induced hepatitis with mononucleosis is reported, and syndromes associated with phenytoin hypersensitivity reactions are discussed. A 23-year-old black woman with a two-month history of seizure disorder was admitted to a hospital with nausea, vomiting, fever, lymphadenopathy, diffuse maculopapular rash, left-upper-quadrant tenderness, and
hepatomegaly
. She was receiving phenytoin sodium 300 mg/day; carbamazepine 200 mg four times daily had been discontinued four days before admission because of leukopenia. Phenytoin was discontinued after admission; however, phenytoin 1 g i.v. was given for a tonic-clonic seizure two days after admission, after which swelling of the face and legs and pruritus developed. Over the next few days, signs and symptoms of hepatotoxicity progressed, and she became comatose. Seizures were treated with diazepam. She began to recover after 10 days of supportive therapy and was discharged several weeks later on primidone therapy. Serious phenytoin hypersensitivity reactions may appear as dermatologic, lymphoid, or hepatic syndromes. Fever, rash, and lymphadenopathy often accompany hepatic injury. Encephalopathy and death may occur. Proposed mechanisms for phenytoin hypersensitivity include antigen-antibody reactions, alteration of lymphocyte function, and an enzyme abnormality causing the production of toxic metabolites. Treatment is supportive; phenobarbital and carbamazepine may be used with caution as alternate anticonvulsant therapy. The possibility of phenytoin hypersensitivity reactions should be considered when patients receiving phenytoin have unusual symptoms, particularly fever, rash, and lymphadenopathy.
Clin Pharm 1987
Sep
PMID:Phenytoin-induced hypersensitivity reactions. 367 71
An 8-year-old male ferret had icterus,
hepatomegaly
and an enlarged gallbladder. Microscopically, the gallbladder had numerous mucinous cysts and papillary hyperplasia of the mucosa, consistent with a diagnosis of cystic mucinous hyperplasia. No previous published reports of this condition in ferrets were found.
J Comp Pathol 1987
Sep
PMID:Cystic mucinous hyperplasia in the gallbladder of a ferret. 368 Jun 48
Four of 44 patients who had undergone the Fontan operation had persistent low cardiac output necessitating takedown of the shunt 6 to 65 hours (average 23 hours) postoperatively. All four were in a group of 22 patients with complex lesions other than tricuspid atresia with ventriculoarterial concordance. The development of postoperative right atrial hypertension (average 24 torr),
hepatomegaly
, marked ascites, and decreasing lung compliance led to severe systemic hypotension with systolic arterial pressure ranging from 55 to 82 torr (average 68 torr), persistent metabolic acidosis, and oliguria despite massive colloid and crystalloid infusions (11,000 ml/m2/24 hr) and inotropic support. At reoperation the atriopulmonary anastomosis, which was found to be wide open, was taken down and an atrial septal defect was created in all patients. Three patients were left with a Glenn shunt and an aortopulmonary shunt to the left lung. One patient had bilateral aortopulmonary shunts. Two patients who survived reoperation had immediate postoperative improvement in systolic arterial and mean right atrial pressure (average 100 torr and 11.5 torr, respectively). Both are well 5 months and 4 years later. Repeat Fontan operation remains a possibility with acceptable risks because of the presence of the Glenn shunt in both patients. We believe that takedown should be considered in patients with persistent low cardiac output after the Fontan operation.
J Thorac Cardiovasc Surg 1986
Sep
PMID:Persistent low cardiac output after the Fontan operation. Should takedown be considered? 374 71
A 46-year-old man experienced weakness, lassitude, and vague, aching abdominal pain in the right upper quadrant. Physical examination was notable for
hepatomegaly
and slight hyperpigmentation of the hands. Elevated levels were revealed on liver function tests, and massive iron deposition was shown on liver biopsy. The patient was started on a therapeutic regimen of 400-ml phlebotomies. Hereditary hemochromatosis is an iron-storage disease in which total body iron stores can reach incredibly high levels, leading to damage of the liver, heart, pancreas, and pituitary gland. The most specific screening test is measurement of the serum concentration of ferritin, and a transferrin saturation determination is also helpful in diagnosis. Phlebotomy is still the treatment of choice, although new ways of administering chelating agents are being investigated.
Postgrad Med 1986
Sep
01
PMID:Hereditary hemochromatosis in a 46-year-old man. 374 25
Necropsy findings of hepatobiliary system from 78 patients with end-stage renal disease maintained on hemodialysis are reported. Ninety percent of the patients exhibited some abnormalities. Multiple abnormalities often coexisted in each patient.
Hepatomegaly
was found in 50% of the patients and could be attributed to a discernible cause in all but two of the affected patients who had isolated
hepatomegaly
. Hepatic congestion was also prevalent and was complicated by fibrosis, cardiac cirrhosis, and centrilobular necrosis and hemorrhage in some patients. This was associated with chronic fluid overload, hypertension, and/or cardiovascular disease in the affected patients indicating the importance of adequate control of these factors. Mild periportal hepatic fibrosis, fatty metamorphosis, triaditis, hemosiderosis, and cystic changes were also seen with some frequency--the latter were associated with polycystic kidney disease and were complicated by massive intracystic hemorrhage and abscess formation, each in one patient. Chronic active hepatitis was found in three patients and was associated with chronic HBs antigenemia in one patient and presumed non-A, non-B infection in two. Nearly 22% of the patients showed either cholelithiasis at autopsy or before cholecystectomy due to complications. Significant negative findings included lack of acute viral hepatitis, silicone hepatosis, and recently described focal anoxic lesions associated with erythrocyte sludging. In conclusion, the present study has demonstrated the spectrum of hepatobiliary pathology in a large group of patients with end-stage renal disease maintained on hemodialysis.
Am J Gastroenterol 1986
Sep
PMID:Hepatobiliary pathology in hemodialysis patients: an autopsy study of 78 cases. 375 41
The case of a 29-year-old man with Niemann-Pick disease and hepatic failure is presented. Massive
hepatomegaly
with hepatic calcification were noted in association with a course of persistent hepatitis B serum antigenemia with rapid hepatic decompensation, ascites, encephalopathy and renal failure. The possible relationship of the clinical course to the underlying disease process is discussed, and a review of Niemann-Pick disease is presented.
Am J Med Sci 1986
Sep
PMID:Hepatic failure in adult Niemann-Pick disease. 375 63
The purpose of this study was to elucidate the clinical features of right ventricular (RV) dysplasia, a recently described clinical entity characterized by RV myopathic changes and ventricular tachycardia of left bundle branch block morphology. Five cases were reported, in which the diagnosis was established according to the criteria of Marcus. Case 1, a 33-year-old man, was referred to us for evaluation of his paroxysmal ventricular tachycardia of five years duration. Case 2, a 38-year-old man, was admitted because of shock caused by ventricular tachycardia. In both cases, the QRS configurations during ventricular tachycardia were those of the left bundle branch block pattern, and electrocardiograms during sinus rhythm showed T wave inversions in the right precordial leads and late ventricular potentials. Two-dimensional echocardiography, radionuclide angiography and contrast angiography disclosed RV dilatation and dysfunction with normal left ventricular (LV) function. The biopsied myocardium from the right and left ventricles in Case 2 revealed myocytolysis, a paucity of myofibrils and proliferation of collagen fibers. Case 3, a 73-year-old woman began to experience exertional dyspnea since 16 years of age. Her treatment consisted of bed rest, diuretics and digitalis. In December 1983, her New York Heart Association functional class was III, and physical examinations disclosed a Levine III/VI systolic murmur suggestive of tricuspid regurgitation, jugular vein dilatation,
hepatomegaly
, and pretibial edema. Electrocardiogram showed atrial fibrillation, incomplete right bundle branch block and T wave inversions in the precordial leads. Chest radiograph revealed marked cardiomegaly (cardiothoracic ratio of 92%). Echocardiography, radionuclide angiography and contrast angiography revealed marked RV dilatation, depressed ejection fraction (RV end-diastolic volume index of 342 ml/m2, and RV ejection fraction of 28%). Case 4, a 20-year-old man, was admitted with a chief complaint of palpitation. Case 5, a 19-year-old man, was referred to us for the evaluation of asymptomatic cardiomegaly, and his cardiothoracic ratio was 54%. A 12-lead electrocardiogram showed right bundle branch block and T wave inversions in the right precordial leads. Ambulatory electrocardiography revealed frequent premature ventricular complexes of the left bundle branch block pattern. Echocardiography, radionuclide angiography, and contrast angiography disclosed RV dilatation and dysfunction in both cases, and mild LV dilatation and dysfunction (LV end-diastolic volume index of 149 ml/m2, LV ejection fraction of 48%) in Case 4.(ABSTRACT TRUNCATED AT 400 WORDS)
J Cardiogr 1985
Sep
PMID:[Right ventricular dysplasia: clinical characteristics of five patients]. 383 64
One hundred twenty-eight records of patients with multiple myeloma were reviewed to assess the incidence and manifestations of liver involvement. Histologic study of the liver was available in 21 patients. Diffuse infiltration of the liver by plasma cells was observed in 10 patients, myeloid metaplasia in four, amyloidosis in two, toxic hepatitis in two, and extrahepatic cholestasis secondary to infiltration of the peripancreatic tissue by plasma cells in one. The clinical signs of plasma cell infiltration of the liver consisted of
hepatomegaly
in seven patients, mild elevation of liver enzymes in five, and portal hypertension in two. Jaundice was only observed in patients with hepatitis or extrahepatic cholestasis. Liver infiltration by plasma cells did not appear to have a major prognostic significance.
Am J Hematol 1985
Sep
PMID:Liver involvement in multiple myeloma. 402 19
The hypolipidaemic drug nafenopin (NAF) has been shown to enhance the hepatocarcinogenic effect of N-nitrosodimethylamine (NDMA) and N-nitrosodiethylamine in rats. We have investigated whether the NAF-induced peroxisome proliferation in hepatocytes interferes with NDMA's metabolism and interaction with DNA. Adult male Wistar rats received a single i.p. injection of [14C]NDMA (2 mg/kg) and were killed 4 h later. DNA was isolated from liver and kidney, hydrolysed in 0.1 N HCl and analysed by Sephasorb chromatography. In rats pre-treated with NAF (0.2% in the diet over a period of 3 weeks), the concentration of N7-methylguanine in hepatic DNA (mumol/mol guanine) was 46% below control values. This is probably due to the greater amount of target DNA, as NAF caused a marked
hepatomegaly
with a 50% increase in total liver DNA content. Concentrations of N7-methylguanine in kidney DNA were twice as high in NAF-pre-treated animals when compared to control rats. This is unlikely to result from a shift in the metabolism of NDMA from liver to other rat tissues since the time course and extent of the conversion of [14C]NDMA to 14CO2 and 14C-labelled urinary metabolites were identical in NAF-treated and control animals. There was no indication that NAF inhibits the activity of the hepatic O6-alkylguanine-DNA alkyltransferase.
Carcinogenesis 1985
Sep
PMID:Nafenopin-induced rat liver peroxisome proliferation reduces DNA methylation by N-nitrosodimethylamine in vivo. 402 30
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