Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020639 (hypoproteinemia)
 1,134 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A detail of an unsuccessful trial of transoral transclival operation for an aneurysm arising from the left vertebral artery was reported. The patient was 66 years old male who had bronchial asthma and difficulty in phonation and swallowing. The angiograms showed that the aneurysm, 1.5X1.5X2.0 cm in size, was situated in the midline at the level of caudal one-third of the clivus. A transoral transclival operation was performed following preoperative tracheostomy and gastrostomy to improve his pulmonary and nutritional condition. A midline incision on the palate was followed by the removal of the posterior half of palatal bone. The upper part of incision on the retropharyngeal mucosa was placed approximately 1 cm off the midline to facilitate closure afterwords. A caudal 1/3 of the clivus, anterior arch of the atlas and a part of the odontoid process were removed. The aneurysm, fusiform in shape, was then collapsed by needle puncture after the left vertebral artery was trapped between the posterior inferior cerebellar artery and the vertebro-basilar junction. Closure of the dura with a fascial patch was incomplete due to an extensive incision and coagulation of the dura. Closure of the retropharyngeal mucosa around the orifice of the Eustachian tube was also incomplete in spite of the paramedian incision described above. Postoperative course was complicated by an frequent occurrence of the attack of bronchial asthma causing loss of gastic juice from the gastrostomy and resultant hypoproteinemia, although the recovery of lower cranial nerve palsy was good. There was no signs of infection until the 21st postoperative day when meningitis developed. The patient died in the 28th postoperative day. The importance of complete closure of the dura and retropharyngeal mucosa to prevent meningial infection was discussed. Since the mucosa around the orifice of Eustachian tube was extremely friable and the closure was almost impossible, the risk of meningial infection was considered to be high, especially when the intradural procedure was necessary through transoral high clivotomy.
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PMID:[A midline vertebral artery aneurysm operated via transoral transclival approach (author's transl)]. 94 25

Primary peritonitis among children with the nephrotic syndrome is increasing following a decline when antibiotics and steroids were introduced. Meningitis has not been reported in such patients. Six nephrotic children with primary peritonitis and two with pneumococcal meningitis are reported. Peritonitis occurred in relapsing long standing cases while meningitis occurred in recently diagnosed cases. Steroid therapy was not found to be a contributing factor in the causation of the septic episodes. Long standing ascites was not a precursor to the development of peritonitis. All cases had hypoproteinemia and all those tested had low plasma IgG. The pneumococcus was grown from ascitic fluid and blood in three of the peritonitis cases and streptococcus pyogenes from the throat of one. All responded to penicillin therapy.
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PMID:Primary peritonitis and meningitis in nephrotic syndrome in Riyadh. 710 18

We present a case of tuberculous meningitis (TBM), wherein pleural effusion developed as a manifestation of paradoxical reaction during anti-tuberculosis therapy. An 87-year-old diabetic man was referred to our clinic for fever and impaired consciousness. He did not obey vocal commands. No ocular motor deficit, facial palsy, or limb weakness was observed. He had hyponatremia due to inappropriate antidiuresis. Examination of the cerebrospinal fluid revealed lymphocytosis and high adenosine deaminase (ADA) activity, suggestive of TBM. He was treated with isoniazid, rifampicin, and pyrazinamide, after which his symptoms quickly resolved. Lymphocyte count, ADA activity, and protein concentration in the cerebrospinal fluid decreased. However, approximately 30 days after the initiation of therapy, he developed mild hypoxemia. A chest CT scan revealed pleural effusion. The pleural fluid was exudate with elevated ADA activity, which was consistent with tuberculous pleural effusion. Shortly after the use of a herbal medicine, Goreisan extract, hyponatremia and hypoproteinemia improved, and the pleural effusion was reduced. Approximately one-third of patients with TBM are reported to develop a paradoxical reaction, such as tuberculoma, hydrocephalus, and optochiasmatic and spinal arachnoiditis. The present case suggests that extra-central nervous system manifestations, including pleural effusion, should be considered when treating TBM.
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PMID:[A case of tuberculous meningitis with pleural effusion as a manifestation of a paradoxical reaction during anti-tuberculosis therapy]. 3134 Nov 31