Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019214 (hepatosplenomegaly)
 4,408 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Angio-immunoblastic lymphadenopathy (AIL) is a disease of unknown aetiology and pathogenesis. It has features of hyperimmunity, immune deficiency and can behave like a malignant lymphoma. An underlying abnormality of T-cell regulatory function has been proposed. We report ten patients with AIL followed prospectively and review 200 cases from the literature. As well as showing the typical features described in previous retrospective series namely: constitutional symptoms, generalized lymphadenopathy, hepatosplenomegaly, skin eruptions, hypergammaglobulinaemia and characteristic lymph node histology; four patients had oedema with ascites or pleural effusions associated with hyponatraemia and hypoalbuminaemia. We have also observed low free thyroxine indices in three patients with elevated TSH levels in two, but without clinical features of hypothyroidism. Seven of the patients in this study were treated with prednisone and cyclophosphamide. Three achieved complete remission but only one patient has survived longer than two years. Failure to achieve complete remission has been associated with a 90 per cent mortality within one year of the onset of disease in the reports reviewed. Corticosteroids alone have produced only a 40 per cent rate of remission. The management of poor responders, non-responders and many relapse cases in unsatisfactory. More instensive chemotherapy is very hazardous, increasing the already high risk of severe infections, and is often unsuccessful. Histological features recently reported to represent co-existent immunoblastic lymphoma at diagnosis were recognized in three of our patients, two of which went on to develop definite lymphoma.
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PMID:Angio-immunoblastic lymphadenopathy: report of ten cases and review of the literature. 48 88

Two young females were admitted one by one because of peculiar skin eruptions suggesting mosquito-allergy and severe pancytopenia with normo-hypercellular bone marrow. The outcome of the first case was fatal on account of severe pancytopenia, immune deficiency and marked jaundice 14 months after the initial pancytopenic episode. In the post-mortem examination, HMR (histiocytic medullary reticulosis) was highly suggestive since hepatosplenomegaly with increase of Kupffer cells and large histiocytes including some atypical cells were detected. The second patient was treated with splenectomy because the past treatment were unsatisfactory in the first case and another cases in literatures. After the operation, the patient sustained almost normal blood cell level for 11 months without any treatment. As for the histopathological findings of resected spleen and lymphnodes, some erythrophagocytic mature histiocytes were found, but no atypical cells was detected. The relationship with pancytopenia, mosquito-allergy and HMR was discussed on the two cases and literatures.
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PMID:[Severe pancytopenic episodes in two cases with mosquito-allergy]. 197 33

A 44-yr-old homosexual male with symptomatic human immune deficiency virus (HIV) infection presented with abdominal pain, hepatosplenomegaly, and rising serum alkaline phosphatase. Laparoscopy revealed multiple purplish nodules on the surface of the liver. Histopathology of the lesions was consistent with Kaposi's sarcoma. Six weeks later, cutaneous Kaposi's sarcoma became apparent on the head and neck. This case is unusual because, in all previously published cases, with the exception of one, intrahepatic Kaposi's sarcoma was found on autopsy. Moreover, all patients had evidence of extrahepatic Kaposi's sarcoma prior to the documentation of liver involvement.
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PMID:Hepatic involvement as the primary manifestation of Kaposi's sarcoma in the acquired immune deficiency syndrome. 281 78

The clinical signs and immunological abnormalities in ten babies with lymphadenopathy associated virus infections (LAV) are described. We have made this diagnosis based on the association of specific immunological abnormalities, serological tests or the positive isolation of the virus. In one very severe case, whose mother died of AIDS, the serology and attempts to isolate the virus were both negative. Excluding the two post-transfusion cases, the ethnic and familial history always suggested the diagnosis. The clinical characteristics were very close to those in adults, being hepatosplenomegaly and generalized lymphadenopathy. There was an associated retardation of growth and weight gain. A decrease of the absolute number of OKT4(+) lymphocytes and hypergammaglobulinaemia were the abnormalities most frequently observed. The degree of immunodeficiency, both humoral and cellular was very variable. The existence of LAV infection during the first few months of life suggests a maternal-foetal transmission, but a post-natal infection cannot be eliminated. It is difficult to decide the long-term prognosis; it depends mainly on the degree of the immune deficiency.
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PMID:[LAV virus infections in children]. 300 18

The clinical and immunologic abnormalities of 7 infants with Lymphadenopathy Associated Virus (LAV) infection are reported. Indicative immune changes, positive anti-LAV serologic test and/or virus isolation led to the diagnosis. In a case with a particularly severe form of the disease, whose mother died from AIDS, serologic tests and virus isolation were negative. Beside a case associated with blood transfusion, the familial and ethnic context helped the diagnosis. Clinical and biochemical features were close to those in adult AIDS, including hepatosplenomegaly, polyadenopathy, a decreased absolute number of OKT4(+) lymphocytes and hypergammaglobulinemia. The importance of cellular and sometimes also humoral immune deficiency was highly variable. For 4 patients, the severity of the immune deficiency allowed the diagnosis of AIDS. Occurrence of such an infection in the first months of life suggests a fetomaternal viral transmission; however, a postnatal contamination cannot be ruled out. Long-term prognosis is difficult to assess. It depends, among other factors, on the importance of the immune deficiency.
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PMID:[LAV infections and the acquired immunodeficiency syndrome in infants]. 301 18

Familial hemophagocytic lymphohistiocytosis (FHL) is probably a genetically transmitted disease affecting infants and very young children. Cardinal symptoms are fever, hepatosplenomegaly, and pancytopenia. Frequently meningeal involvement is seen, manifested by neurologic symptoms and a lymphohistiocytic pleocytosis with increased protein levels in the cerebrospinal fluid. Characteristic laboratory findings in FHL are hypertriglyceridemia and hypofibrinogenemia, which are reversible with treatment. The disease has been rapidly fatal in most patients, but recently longterm remissions have been achieved with cytotoxic agents. Pathohistologic examination shows a widespread infiltrate of lymphocytes and mature macrophages with prominent hemophagocytosis affecting especially liver, spleen, lymph nodes and the central nervous system. Atrophy of the lymphatic tissue is a common finding. From the histologic picture FHL has to be grouped among the histiocytoses of reactive origin since the cells involved show no signs of malignancy. The etiology and pathogenesis of FHL are not known at present. Immunologic studies present evidence for a disturbed function of T lymphocytes, but a secondary immune defect seems to be more likely than primary immune deficiency. Among the broad clinical spectrum of histiocytic disorders especially histiocytic reactions due to infection, histiocytosis X and malignant histiocytosis have to be considered in the differential diagnosis of FHL.
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PMID:Familial hemophagocytic lymphohistiocytosis. 635 20

Graft versus host disease (GVHD) is a well recognized entity following bone marrow transplantation. Similar syndromes have been described after blood product transfusions, notably in patients with primary immunodeficiency syndromes and in patients with malignancies associated with immune deficiency or under immunosuppressive treatment. Review of the literature shows that posttransfusion GVHD is characterized by maculopapular skin rash, gastro-intestinal symptoms, liver disease, severe pancytopenia and, in some cases, hepatosplenomegaly and lymphadenopathy. The time to onset and the duration of the disease are short (10 days) and the mortality approaches 90%. The clinical features of this rare disorder are presented in the hope that, with increased awareness of this complication, clinicians will take preventive measures in patients at risk because no satisfactory therapy yet exists.
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PMID:[Clinical characteristics and evaluation of risk in the graft versus host reaction following transfusion]. 663 42

We present a case of a patient with common variable immune deficiency presenting as the Letterer-Siwe syndrome (disseminated Langerhans cell histiocytosis). To our knowledge, this is the only known patient with this association. The clinical presentation was chronic diarrhea, weight loss, recurrent infections, hepatosplenomegaly, and interstitial pneumonitis. Laboratory evaluation revealed evidence of immunodeficiency, with agammaglobulinemia and diminished number and function of T cells. The diagnosis of Langerhans cell histiocytosis was confirmed by electron microscopic examination of the lung biopsy specimen demonstrating Birbeck granules in the cells of the infiltrate. It is known that patients with the combined immunodeficiency syndrome may present as disseminated Langerhans cell histiocytosis, and the case presented demonstrates that patients with common variable immune deficiency may similarly present. It is advisable that patients newly diagnosed with Langerhans cell histiocytosis be evaluated to screen for immunodeficiency. Conversely, patients presenting with combined immunodeficiency or common variable immune deficiency may display features of disseminated Langerhans cell histiocytosis. These associations must be considered in newly diagnosed immunodeficient patients.
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PMID:A 13-month-old child with chronic diarrhea, weight loss, and tachypnea. 821 98

Omenn's syndrome is a fatal, autosomal-recessive combined immune deficiency characterized by several erythematous exfoliative eruptions, lymphadenopathy, hepatosplenomegaly, and elevated eosinophil count. In some of these patients an expansion of CD3+CD4-CD8- double negative (DN) T cell population was observed. We show here that the DN population represents a clonal expansion of T cells which preferentially use V beta 14 in their T cell receptor complex. Using polymerase chain reaction, we show that patient's DN cells express spontaneously high levels of IL-5, thus possibly explaining the abundance of eosinophils in this disorder. The increase of IgE observed in patients with Omenn's syndrome is unlikely to be related to IL-4 production, as IL-4 levels in patient samples were low. However, patient's low expression of interferon-gamma (IFN-gamma), which has been reported to inhibit IgE production, may explain the elevated levels of IgE in this patient. The results thus highlight the importance of the inhibitory effect of IFN-gamma on regulation of IgE production.
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PMID:Expansion of CD3+CD4-CD8- T cell population expressing high levels of IL-5 in Omenn's syndrome. 828 98

An 11-month-old patient with parvovirus infection mimicking juvenile myelomonocytic leukemia (JMML) is presented. The patient's history, presenting physical and laboratory features, was suggestive of JMML and consisted of fever, hepatosplenomegaly, lymphadenopathy, desquamation of the skin, anemia, leukocytosis with monocytosis and trilineage dysplastic findings of the peripheral blood and bone marrow. However, positive IgM titers for parvovirus B19 followed by seroconversion, negative cytogenetics and the benign follow-up of the patient suggested acute parvovirus infection as an etiologic factor for development of dysplastic features in the patient, and thus is recommended for consideration in the differential diagnosis of MDS. Although parvovirus B19 infection mimicking MDS has previously been shown in two patients with spherocytosis and one with subclinical immune deficiency; to our knowledge, the present report is the first describing the association of acute parvovirus B19 infection with dysplastic features mimicking myelodysplasia (MDS) in a child without a demonstrable underlying hematolymphoid disorder.
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PMID:Acute parvovirus B19 infection mimicking juvenile myelomonocytic leukemia. 1107 69


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