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

In this case report, it is emphasized that duration of exposure to an oral contraceptive is not of prime importance. The patient was a 30-year-old woman complaining of sudden onset of severe epigastric pain which radiated to the right upper abdomen and the right shoulder. She had been using anovulatory pills for 18 months. A mass was felt in the right upper abdomen. The white cell count was 21,000/cu mm. Acute cholecystitis was the original diagnosis. In the next 4 days the bilirubin rose to 2.9 mg% and the alkaline phosphatase to 23.1 KA units. At laparotomy the gallbladder was found to be normal. Hepatomegaly was noted. A liver biopsy was taken. Subsequently a liver scan showed a large defect in the right lobe of the liver. Selective angiography of the right hepatic artery showed a large vascular mass. The diagnosis was changed to hepatic adenoma with secondary hemorrhage. Before further surgery the patient suffered a cardiorespiratory arrest and died. At autopsy a hepatic adenoma was found in the right lobe. A large embolus was found blocking the pulmonary arteries. The embolus was considered the cause of the sudden death.
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PMID:Fatal outcome of an hepatic adenoma following short term oral contraceptive use. 92 51

A retrospective analysis of the clinical and haematological characteristics of patients diagnosed as having juvenile chronic granulocytic leukaemia between 1971 and 1986 was carried out. Thirty-three children were identified who were between the ages of 18 weeks and 8.8 years at diagnosis. The disease was more frequent in boys than girls (23:10). The most common presenting symptoms were skin rash (58%) and bleeding manifestations (45%). All patients had some degree of splenomegaly and in 88% this was more than 3 centimetres below the costal margin. Hepatomegaly and lymphadenopathy were also frequent findings. Anaemia was common and leucocytosis an invariable finding with a white cell count above 50 x 10(9) 1-1 in 42%. Monocytosis was found in 78%. Haemoglobin F measurements were available in 31 children and above 10% in 22 (67%). No child had the Philadelphia chromosome or monosomy 7. Thirty children were treated with chemotherapy, with a variable degree of symptomatic improvement. Twenty-nine patients had died with a median survival time of 5 months. The commonest cause of death was complications of bone marrow failure and no child developed acute leukaemia. Presenting characteristics associated with a longer survival period were age less than 6 months (P = 0.02), female sex (P = 0.02), HbF less than 10% (P = 0.0004) and the absence of bleeding manifestations (P = 0.03). We conclude that the prognosis for children aged over 6 months, with a raised HbF level is very poor, and that, in the absence of possible bone marrow transplantation, consideration should be given to novel treatment approaches for these patients.
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PMID:Prognostic factors in juvenile chronic granulocytic leukaemia. 138 Feb 83

The immunophenotype of leukemicblasts from 111 patients with T-ALL or T-NHL were further examined by using a panel of standardized McAbs of CD nomenclature to human leukocyte differentiation antigens. Four major subsets of T-ALL were defined: pre T-ALL, immature T-ALL (I), common T-ALL (II) and mature T-ALL (III), with the percentages 20.7%, 20.7%, 20.7% and 37.0% respectively. In addition there was a case with M-T acute hybrid leukemia. Some of the clinical features of the patients with T-ALL and T-NHL were compared. It was found that male predominance, older age, higher leukocyte count, lower platelet level, relative higher hemoglobin level and increased incidence of extramedullary involvement, including hepatomegaly, splenomegaly and lymphadenopathy were alike for all subsets of T-ALL cases. However, the average white cell level and incidence of lymphadenopathy in the pre T-ALL subset significantly differed from those in other subsets. The correlation of immunophenotype with morphologic characterization was also discussed in this paper.
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PMID:[Correlation of immunophenotype with clinical features in T-cell acute lymphoblastic leukemia]. 203 95

An autopsy case of ATL with acute hepatic failure is reported. A 39-year-old man born in Miyazaki Prefecture was admitted because of jaundice and general malaise of about 10 days' duration. Palpation of the abdomen revealed moderate hepatomegaly: the patient had clear consciousness. The white cell count was 62,500/mm3, with 34% abnormal lymphocytes having lobulated or convoluted nuclei. Marked liver dysfunction (TB 30.5 mg/dl; GOT 2,740 U; GPT 1,031 U; LDH 3,833 U) was noted. He developed hepatic coma and died of acute hepatic failure on the third hospital day. At autopsy, the enlarged liver weighed 2,000 g and was diffusely infiltrated by ATL cells.
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PMID:[An autopsy case of adult T-cell leukemia with acute hepatic failure]. 301 18

This retrospective review of 136 children with idiopathic thrombocytopenia assesses the prognostic significance of various presenting parameters and the effect of therapy. Initial haemoglobin, white cell count, actual platelet count, splenomegaly, hepatomegaly and lymphadenopathy had no significant effect upon the final outcome. Cases of acute I.T.P. were associated with a higher incidence of preceding infection, a shorter history of bleeding and a preponderance of males. The presence of greater than 20 per cent lymphocytes in the bone marrow was associated with a longer time to achieve a normal platelet count (p = 0.05). Steroid therapy shortened the time for acute cases of I.T.P. to obtain a normal platelet count (p = 0.05), but had no effect on long-term prognosis. Chronicity occurred in 25 children (18%) and nine of these had spontaneous remissions. Immunosuppressive therapy was ineffective, but nine out of 12 children were cured by splenectomy. Mortality was 0.7 per cent (one death) and general morbidity was low.
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PMID:Idiopathic thrombocytopenia in childhood. Edinburgh experience 1962-82. 379 80

Three patients with respiratory failure resulting from miliary tuberculosis had a characteristic clinical presentation that included a long history of a prominent cough, dyspnea, weight loss, tachycardia, tachypnea, pulmonary adventitious sounds, and hepatomegaly. Hematologic investigation showed a normal white cell count with marked left shift in the morphology of white cells in all three patients, and evidence of disseminated intravascular coagulation in one patient. In only one patient was the initial sputum positive for acid-fast bacilli; in the others, invasive diagnostic procedures including lumbar puncture, bone marrow trephine, and open-lung biopsy were necessary for diagnosis. Miliary tuberculosis should be suspected in patients with adult respiratory distress syndrome of unknown etiology. Simple diagnostic procedures such as sputum, bronchial brushings, and urine examination should be followed by bone marrow trephine, liver biopsy, transbronchial lung biopsy, and lumbar puncture if physical signs of meningitis are present.
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PMID:Adult respiratory distress syndrome associated with miliary tuberculosis. 396 42

Six infants with disseminated HSV had no mucocutaneous lesions at any time during the course of the illness. These infants presented with lethargy, poor feeding, apnea, acidosis, and hepatomegaly. The diagnosis of HSV was made by culturing the infant's oropharynx and blood, and the maternal cervix. Eight infants with HSV encephalitis had no skin, eye, or mucous membrane lesions. These infants presented with lethargy and low-grade fever, followed within 24 hours by the onset of focal partial motor seizures. The seizures were refractory to anticonvulsant therapy. The mean CSF white cell count was 131 cells/mm3;the glucose and protein concentrations were in the normal range. Brain biopsy was required for the early diagnosis of HSV encephalitis. These 14 cases presented 70% (14/20) of all infants with neonatal HSV diagnosed during the study period. HSV infection should be considered in infants with no mucocutaneous lesions who have signs usually associated with bacterial sepsis or who develop focal seizures during the first three weeks of life.
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PMID:Neonatal herpes simplex infection in the absence of mucocutaneous lesions. 706 32

Fifty cases of visceral leishmaniasis were admitted in Children's Hospital, Islamabad. Common clinical features were fever (100%), splenomegaly (100%), hepatomegaly (100%), anaemia (96%), abdominal distension (40%), bronchopneumonia (26%) and bleeding diathesis (22%). Hb was below 7.0 G/dl in 80%, white cell count below 4 x 10(9)/cmm in 88% and platelet count below 100 x 10(9)/c4mm in 86%. All the patients showed leishmania donovani bodies in the marrow smears. Fourteen patients were treated with aminosidine (15 mg/kg), intramuscularly daily for 4 weeks. All responded dramatically and none of them went into relapse in a year's follow-up. No side-effects were observed. Aminosidine can therefore, be recommended as a treatment of choice for visceral leishmaniasis in children.
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PMID:A new breakthrough in treatment of visceral leishmaniasis in children. 747 90

Plasmodium falciparum malaria is endemic in the northern KwaZulu areas of South Africa. The clinical morbidity produced by this parasite has not been studied since the institution of the present malaria control programme. Fifty-nine patients were prospectively studied at a peripheral clinic during the peak malaria season; symptoms and signs of the infection, parasite loads, haemoglobin values and leucocyte counts were recorded in all patients. Haemoglobin and leucocyte counts were also measured in 37 control subjects without malaria. The commonest symptoms were persistent headache (100%), rigors (98%) and myalgia (93%). None of the patients presented with coma, pulmonary oedema, hypoglycaemia or algid malaria. Splenomegaly was found in 49%, hepatomegaly in 20% and mental confusion in 5% of patients. Mean parasite load was 1.71% and 57% of patients had parasite loads of < 1%. Anaemia of < 10 g/dl was significantly more frequent (P < 0.0001) in the patient group than in the control group. Leucopenia (white cell count < 4.0 x 10(9)/l) was present in 12 of 50 patients in whom it was measured compared with 2 controls (P = 0.0175). The results show a wide range of morbidity, without severe complications as presenting manifestations. Symptomatic infection in the presence of low parasite loads suggests that there may be little or no immunity in this population.
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PMID:Morbidity from falciparum malaria in Natal/KwaZulu. 845 85

The records of all 96 children below the age of 15 years diagnosed with acute lymphoblastic leukaemia at Tygerberg Hospital in the Republic of South Africa between 1983 and 1995 were reviewed to determine risk factors which may predict poor outcome. Age < 2 and > 8 years, and white cell count > 20 x 10(9)/l at diagnosis were significant predictors of poor outcome. Sex, FAB classification, immunophenotype, hepatomegaly, splenomegaly, BFM risk score, and the presence of mediastinal glands did not predict outcome. The presence of the established risk factors could not adequately explain the difference in 5-year event-free survival in the three ethnic groups which was 67 per cent in white, 17 per cent in black, and 38 per cent in children of mixed ethnic origin. In an attempt to improve survival in black children, our stratification of risk groups will in future be based on factors that include ethnicity, age and WCC > or = 20 x 10(9)/l at diagnosis. Pediatric oncology services in developing countries should adapt therapy to the risk factors of their local populations.
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PMID:An analysis of prognostic variables in acute lymphocytic leukaemia in a heterogenous South African population. 923 36


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