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)

Adult wild-trapped opossums were infected with Leishmania donovani (Khartoum strain, WR 378) and evaluated as an animal model of visceral leishmaniasis. All infected opossums died within 32 days. Loss of body fat, hepatomegaly, and petechiae of skin and abdominal musculature were seen at necropsy. Microscopically, numerous amastigote-laden macrophages were seen in histologic sections of liver, spleen, and lymph nodes; fewer parasite-laden macrophages were in the bronchial-associated lymphoid tissues and renal glomeruli. Hematological findings included thrombocytopenia (terminal), neutropenia, and lymphopenia. Blood lymphocyte blastogenesis in response to concanavalin A and phytohemagglutinin was decreased markedly at day 24 post-infection (PI). Serum antibodies (1:40 dilution) to promastigotes of L. donovani were detected in five of eight infected opossums tested on days 10 and 24 PI. Total bilirubin concentrations and alanine aminotransferase and aspartate aminotransferase activities were increased after day 25 PI. Activated partial thromboplastin times and one-stage prothrombin times were prolonged before death. Concurrently, factors V, VIII, and XII activities were decreased.
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PMID:Experimental visceral leishmaniasis in the opossum. 276 21

In this prospective study of 240 black patients with liver enlargement admitted to the medical wards of King Edward VIII Hospital, Durban, a cause for the hepatomegaly was found in 92.5% of cases (63.8% without recourse to biopsy, 28.7% after liver biopsy). The commonest cause was congestive heart failure (36.7%), followed by amoebic liver abscess (7.1%), hepatocellular carcinoma (5.8%) and cirrhosis (5.4%). Liver biopsy provided the diagnosis in 90.8% of patients with initial unexplained hepatomegaly. The diagnostic yield of liver biopsy was increased by submitting 3 biopsy specimens for histological examination. The 3 specimens are obtained using a single intercostal entry site and redirecting the biopsy needle, without increasing the risk of complications. Hepatic tuberculosis was present in 9.2% of patients who underwent biopsy. There were no consistent clinical findings in these patients. Therefore, in communities in which tuberculosis is endemic, all patients with unexplained hepatomegaly require liver biopsy since it provides the only means of making this diagnosis.
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PMID:Causes of hepatomegaly at King Edward VIII Hospital, Durban. A prospective study of 240 black patients. 300 36

Two patients with epithelioid haemangioendotheliomata of the liver are described. Both presented with abdominal pain and malaise, with hepatomegaly and a variable degree of hepatocellular dysfunction. Diagnosis was delayed in both cases, each patient undergoing a protracted series of investigations including repeated liver biopsies. The major obstacles to early diagnosis were a lack of clinical awareness of the condition and difficulties in interpretation of the liver histology: the widespread sclerosis in the tumour tissue is easily mistaken for a post-necrotic or cirrhotic process. The key to the diagnosis is the demonstration of cells containing Factor-VIII-related antigen confirming the endothelial origin of the tumour. One patient died within three months of presentation and the other after 18 months. The tumour may, therefore, be more aggressive than earlier reports seem to suggest. It seems likely that the tumour is being under-diagnosed and although no specific therapy has been shown to be of value, a greater awareness of the condition, resulting in a more prompt diagnosis, should save patients from undergoing unnecessary investigation.
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PMID:Hepatic epithelioid haemangioendothelioma: difficult name, difficult diagnosis? 317 23

A retrospective study was designed to analyse the mode of presentation, clinical signs, haematological, biochemical and histological features in 46 Indian patients admitted with cirrhosis to R. K. Khan and King Edward VIII Hospitals, Durban, between 1977-1981. The commonest presenting feature was swelling of the body followed by pain in the right upper quadrant, most patients had hepatomegaly, jaundice and ascites, and splenomegaly was detected in one-third of cases. Biochemical investigations indicated that most patients had a high globulin and low albumin concentration. Liver function tests revealed raised bilirubin and gamma-glutamyltransferase values in most cases. On histological examination, micronodular cirrhosis predominated (95%) with a high incidence of fat and iron deposition. Changes consistent with alcoholic hepatitis were superimposed in one-third of cases while immunological and viral markers were absent. This study suggests that alcohol is the predominant cause of cirrhosis in Natal Indians.
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PMID:Patterns of cirrhosis in Natal Indians. 320 19

Progressive disseminated histoplasmosis (PDH), a recognized defining illness of AIDS, is an opportunistic fungal infection caused by Histoplasma capsulatum. The authors report a case of PDH in a HIV-infected African child from a Histoplasma capsulatum non-endemic area. An 8-year-old girl from Kwazulu/Natal, South Africa, was admitted to King Edward VIII hospital with pyrexia and respiratory distress. Pale with generalized lymphadenopathy, she had been sick with general malaise and fever for 3 weeks. A punched-out painless ulcer was present on the child's lower left leg and she had ulcerative lesions on the tip of her tongue and the angle of her mouth. There was a tender hepatomegaly and clinical signs of pneumonia, while a chest roentgenogram showed right upper lobe consolidation with early cavitation. The purified protein derivative tuberculin skin test was negative and no acid-fast bacilli were detected on three sputum samples taken on different days. A Western blot test conducted for antibodies to HIV was positive. Additional laboratory tests were conducted. The patient was treated with parenteral acyclovir for herpesvirus infection, ceftriaxone for severe community-acquired pneumonia, and trimethoprim-sulfamethoxazole because Pneumocystis carinii infection was part of the clinical differential diagnosis. Bone marrow aspirate and trephine biopsy revealed yeast forms of H. capsulatum. The girl died on the second day of hospital admission, before antifungal therapy could be commenced.
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PMID:Disseminated histoplasmosis in a human immunodeficiency virus-infected African child. 910 50

In an attempt to evaluate various clinical and laboratory features available within 24 h of admission, prior to the Widal test and bacteriological culture results as potential diagnostic aids in typhoid fever, we undertook a retrospective unit-based case control study in 90 febrile adult and paediatric patients admitted to King Edward VIII Hospital, Durban, South Africa with an initial diagnosis of typhoid fever. A total of 30 blood culture-proven typhoid fever patients (cases) were matched to 60 patients confirmed as not having typhoid fever (controls) by age, sex, race and severity of illness on admission. Features significantly associated with a final diagnosis of typhoid fever were: a pre-admission duration of fever > or = 7 days (odds ratio (OR) 6.9); hepatomegaly (OR 3.2); a normal leucocyte count (OR 10.8); a leucocyte count of < 10.0 x 10(3)/mm3 (OR 30.2); and leucopenia due to absolute neutropenia with a relative lymphocytosis (OR 11.8). Although the sensitivity, specificity and predictive values of any of these features cannot be used reliably to distinguish typhoid fever from other non-typhoidal febrile illness, it is concluded that leucopenia due to absolute neutropenia with relative lymphocytosis, when present, is highly suggestive of typhoid fever. A leucocyte count of > 10.0 x 10(3)/mm3 (OR 0.03) provides strong presumptive evidence against such a diagnosis.
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PMID:The early diagnosis of typhoid fever prior to the Widal test and bacteriological culture results. 958 36