Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019829 (Hodgkin's disease)
 30,247 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Here 145 reported post-splenectomy infections in 115 patients with Hodgkin's disease are reviewed. Such infections can occur at any age (median age 19.8 years) and the interval from splenectomy to the infection is quite variable (median 21.9 months). Most infections are present clinically as pneumonia, septicemia, meningitis, or a combination thereof, with the most common offending organism being pneumococcus. The infection can be fulminant and even fatal. It is recommended that the spleen should only be removed when essential. A staging laparotomy and splenectomy seem justifiable only in cases of Hodgkin's disease where a change of staging would lead to a change of planned therapy. Prophylactic penicillin should be administered at least for 3 years and possibly indefinitely since post-splenectomy infections can occur many years later. Pneumococcal vaccine should also be given before any chemotherapy or radiotherapy is initiated. Prompt and aggressive treatment should be given when post-splenectomy infection is diagnosed.
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PMID:Late infections following splenectomy in Hodgkin's disease. 666

Sixty-eight untreated patients with Hodgkin's disease (HD), stages I-III, presenting with a large mediastinal mass were treated as follows: patients with "good-risk HD" (lymphocyte predominant or nodular sclerosis and no "B" symptoms) stages I and II were treated by randomization with involved field radiotherapy (IF RT) or IF RT plus six cycles of combination chemotherapy (CT). Those with "poor-risk HD" (presence of B symptoms or with other histologic types) stages I and II and all patients with stage III were treated by randomization with total nodal radiation (TNR) or TNR + CT. Complete remission (CR) was achieved in 66/68 patients (97%) with the initial RT. A significantly longer duration of remission (p = 0.001), but not of survival (p = 0.08) was observed in patients treated with RT + CT compared to RT alone. Significantly longer duration of remission (p = 0.01), but not of survival, was observed in patients with good-risk stages I-II treated with RT + CT. In this category, remission and survival was better with RT + CT than with RT alone in stage III, but these differences were not statistically significant. In poor-risk patients stages I-II, a trend for longer remission and survival (not significant) was observed in patients treated with RT + CT; in stage III, both treatment modalities gave similar poor results. Both treatment modalities were well tolerated by most patients. One patients died with radiation pneumonitis shortly after completion of TNR. One patient developed a malignant schwannoma after treatment with IF RT, and another one developed acute nonlymphocytic leukemia after TNR + CT. Decrease in the transverse diameter of the heart without overt manifestations of cardiac disease was observed in 59% of the patients evaluated for this parameter.
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PMID:Large mediastinal mass in Hodgkin's disease. Results of two treatment modalities. 669 53

Between 1956 and 1981, 306 splenectomies for hematologic diseases were performed at the UCLA Medical Center. Of these operations, more than 75% were performed for therapeutic reasons to control anemia, thrombocytopenia, neutropenia, or painful symptoms of splenomegaly. Of the 65 patients who had idiopathic thrombocytopenic purpura, 77% showed an excellent response, and of the 39 patients who had hereditary spherocytosis, 90% responded. Other diseases with predictably good response rates were autoimmune hemolytic anemias, Felty's syndrome, and hairy cell leukemia. Forty patients with Hodgkin's disease had splenectomies for diagnostic purposes the last 10 years. The overall morbidity and mortality were 24% and 6%, respectively, the most common complications being pneumonia, wound infections, and local postoperative bleeding, and the most common cause of death being sepsis. The review supports the thesis that in carefully selected patients, therapeutic splenectomy can have desirable palliative effects and that diagnostic splenectomy has a sufficiently low risk to warrant its consideration in patients with Hodgkin's disease.
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PMID:Splenectomy for hematologic disease. The UCLA experience with 306 patients. 673 25

M. pneumoniae is a common cause of pneumonia. The diagnosis is suspected when the patient presents with symptoms suggesting primary atypical pneumonia including cough, fever, chills, headache, and malaise in association with a segmental or subsegmental pulmonary infiltrate(s), the white blood cell count is normal or only slightly elevated, and the Gram stain of the sputum (if any can be obtained) reveals polymorphonuclear leukocytes and few bacteria. The diagnosis is more difficult when the patient presents with symptoms not suggestive of pneumonia including lethargy, dyspnea, and a 1- to 4-week history of shortness of breath without cough or fever in association with diffuse reticulonodular or interstitial pulmonary infiltrates. The disease in the previously healthy host is usually benign and self-limiting. However, the course is shortened by the administration of tetracycline derivatives or erythromycin. M. pneumoniae pneumonia can occur in association with other diseases including sickle cell anemia, sarcoidosis, systemic lupus erythematosus, Hodgkin's disease, and various other immunodeficiency states. In these patients mycoplasma pneumonia can be very serious. Although there is no pathognomonic clinical or radiographic presentation, careful consideration of epidemiologic, clinical, laboratory, and radiographic data are usually sufficient to suggest the diagnosis in most patients.
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PMID:Mycoplasma pneumonia. 676 79

X-ray radiographs of the thorax of 119 patients suffering from Morbus Hodgkin (period of therapy VI/1974-III/1979) which have been taken during radiotherapy and at routine follow up examinations have been analysed with regard to temporal progress and extent of the pulmonary radioreaction after standardised mantle-field irradiation with a 4-MeV linear accelerator, extended-field satellite technique and tumor doses of 40-46 Gy. After a characteristic latency period without radio-morphological reaction the patients on average showed 12 weeks after beginning of irradiation signs of a beginning pneumonitis (phase I), after 15 weeks a florid pneumonitis (phase IIa), and after 20 weeks a florid pneumonitis with beginning shrinkage (phase IIb). After 5-9 months (average level 34 weeks) the pulmonary radioreaction was complete after having reached a steady paramediastinal lung fibrosis (phase IV). Classifying the radioreaction into 3 degrees of gravity a light pneumonitis was found in 44%, a medium one in 29%, and a severe pneumonitis in 16% of the cases. For clinical use it is important to know that after beginning shrinkage new expansion of mediastinum and/or of peripheral parenchymal shadows cannot be radioreactions. Primarily these new changes have to be interpreted as recurrence.
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PMID:[Pulmonary radioreaction demonstrated by x-ray pictures (author's transl)]. 680 92

A fatal case of Streptococcus equisimilis pneumonia and septicemia is described in a young man with Hodgkin's disease. The disease course consisted of exudative pharyngitis, macular rash, septic shock, disseminated intravascular coagulation, deep vein thrombosis, and pulmonary embolization. S. equisimilis was isolated from blood, throat, and sputum cultures antemortem and from lung cultures at autopsy.
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PMID:Streptococcus equisimilis Pneumonia in a compromised host. 683 89

To determine the incidence and types of infections in Hodgkin's disease, particularly those related to the overwhelming pneumococcal sepsis syndrome, 210 consecutive patients with previously untreated Hodgkin's disease who underwent staging laparotomy with splenectomy from March 1968 to October 1979 were reviewed. For 178 patients (85 percent) alive at the end of the study, the mean follow-up time was 68.1 months. Eighty-two serious infections occurred among 59 (28 percent) of the patients; 47 (57 percent) serious infections were microbiologically documented and 35 (43 percent) were clinically documented. Forty-seven microbiologically documented serious infections occurred in 34 patients and consisted of 23 episodes of pneumonia, 10 cases of bacteremia, seven wound infections, two cases of disseminated herpes zoster, one subphrenic abscess, and four miscellaneous infections. Microbiologically documented serious infections occurring during initial treatment or remission had lower incidences of leukopenia (29 versus 58 percent) (p = 0.09) and death (11 versus 53 percent) (p = 0.005) than those occurring after relapse of Hodgkin's disease. Of the microbiologically documented serious infections, 76 percent were associated with a predisposing factor(s) (leukopenia, postoperative state, steroids, peripheral neuropathy, leukemia), of which 34 percent were fatal. Microbiologically documented serious infections unassociated with a predisposing factor were never fatal, including the only episode of pneumococcal sepsis in the series. In contrast to microbiologically documented serious infections, only 14 percent of clinically documented serious infections (versus 38 percent) were fatal. The overwhelming pneumococcal sepsis syndrome and other infections thought to be associated with the asplenic state are uncommon problems in patients with Hodgkin's disease after splenectomy.
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PMID:Infection among 210 patients with surgically staged Hodgkin's disease. 685 90

A patient with Hodgkin's disease developed acute radiation pneumonia four months after completion of mantle radiotherapy and during cyclical adjuvant chemotherapy. Respiratory function tests were useful in the diagnosis of the interstitial abnormality and in monitoring response to prednisone. Serial respiratory function tests in patients receiving bimodal therapy may facilitate early diagnosis of this potentially serious complication.
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PMID:Radiation pneumonia complicating adjuvant cytotoxic chemotherapy. 693 Feb 14

161 children followed up postoperatively following splenectomy, 29% had spherocytosis, 14% Hodgkin's disease, 12% traumatic rupture of the spleen, 11% portal hypertension and 7% idiopathic thrombocytopenia. Postoperatively a slight wound infection occurred in 5% of the children, while complications were seen in 2% which could be interpreted as directly caused by the operation; in 23 patients, however, (i.e. 15%), severely infections occurred such as pneumonia, meningitis and sepsis. The lethality rate of the infected children was 31.8%. Postoperatively we determined the leucocyte count, thrombocytes and erythrocyte count, the immunoglobulins IgG, IgA, IgM and IgE, the serum concentrations of the complement components C3, C4 and the serum proteins alpha 1-antitrypsin and transferrin. The data obtained were compared with the corresponding data reported in the literature.
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PMID:[Complications of splenectomy in childhood (author's transl)]. 704 92

Pericardial involvement with legionnaires' disease is rare. Pericarditis with legionnaires' pneumonia developed in a patient with previous mediastinal irradiation for Hodgkin's disease. Subsequently, the patient had progressive symptoms of pericardial constriction that required pericardiectomy. Acute infection with agents such as legionnaires' bacillus may precipitate the late appearance of pericardial disease in patients with previous mediastinal irradiation.
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PMID:Pericarditis in a patient with Legionnaires' disease. 709 33


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