Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0021051 (immunodeficiency)
 71,517 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A twenty-six year old, previously healthy nurse presented with new onset of seizures and was given a clinical diagnosis of herpes simplex encephalitis. After treatment with acyclovir there was incomplete resolution of the lesions by MRI scans and within a few months the patient's neurologic symptoms worsened, prompting a stereotactic biopsy. A diagnosis of progressive multifocal leukoencephalopathy (PML) was made using electron microscopy, and in situ hybridization studies. Subsequent to this biopsy, she was shown to be infected with human immunodeficiency virus (HIV) and had a CD4 T-cell count of 63. She had no known risk factors for HIV infections and had been tested as recently as eighteen months previously during her pregnancy. Neither the husband nor the child were positive for HIV. PML as a presenting sign of HIV infection is rare.
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PMID:Case of the month: September 1997--a 26 year old woman with new onset seizures. 945 83

In this short review, the Author evaluates the most important diagnostic problems about tuberculous meningoencephalitis. Any inadequate therapy can alternate the clinical picture and the results of the cerebrospinal fluid examination, and the clinical evaluation may become very difficult. The neuroradiological findings (CT and MRI), even when correlated to the typical neuropathological features of the disease, could be very sensitive but not specific. An accurate evaluation of the clinical context and, above all, of the clinical history, is the best way to avoid a tardive diagnosis and inappropriate therapies, and to choose which diagnostic procedures must be performed. In the latest years, the immunodeficiency status related to HIV infection, and the mobility of many persons from geographic areas endemic for TBC stressed the importance of this diagnosis. The extreme variability of the clinical picture is discussed, and the author describes the common manifestations as well as the rare syndromes associated with this disorder. The review indicates also the diseases with which the neurologist must challenge for a differential diagnosis. Some practical suggestions indicate how to minimize a diagnostic and therapeutic delay, for a disorder that in many cases is still lethal or leading to serious neurological complications or sequelae.
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PMID:[Clinical evaluation in the early diagnosis of tuberculous meningoencephalitis]. 952 6

A patient is reported on with a common variable immunodeficiency syndrome (CVID), in whom chronic gastritis with antibodies against parietal cells and a cytomegalovirus associated enteritis led to vitamin B12 deficiency with consecutive subacute combined degeneration of the spinal cord. The resulting medullary changes, most probably representing demyelination, were visualised with MRI. The effects of treatment were also monitored over three years by MRI and clinical examination. The resolution of the MRI changes correlated with clinical improvement of the patient's signs. In the medical literature only five cases of vitamin B12 related spinal cord changes have been identified by MRI; none was caused by a CVID syndrome.
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PMID:Common variable immunodeficiency leading to spinal subacute combined degeneration monitored by MRI. 959 86

The incidence of gastrointestinal bleeding has been reported as 10-30% of the patients with neoplastic diseases of the hematopoietic organ. The pathogenesis of gastrointestinal bleeding is multifactorial; direct leukemic cell infiltrations mucosal changes ensuing from bone marrow suppression or immunodeficiency states, infections due to various organisms, and preceding peptic ulcers. Once the diagnosis of hematopoietic neoplasm has been established, complete gastrointestinal work-up by endoscopy, CT-scanning or MRI should be mandatory. Early examination of the gastrointestinal tract has advantages of recognition of preceding peptic ulcers and their treatment, as well as providing prophylactic steps to the gastrointestinal mucosa vulnerable to hemorrhage. The prognosis of gastrointestinal bleeding complicated with hematopoietic malignancies seems to be poor due to the fact that DIC, multiorgan failures or fatal infections are seriously involved in their terminal stages.
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PMID:[Complicated gastrointestinal bleeding of neoplastic diseases of the hematopoietic system]. 978 Jul 29

Neurological complications occur in 40% of "human immunodeficiency virus type 1" (HIV-1)-infected patients. Aim of the study was to evaluate the diagnostic yield of stereotactic brain biopsy and non invasive diagnostic procedures (CT, antitoxoplasma antibodies) and to calculate the benefit of the brain biopsy for the patient and the costs of both methods. From October 1989 through September 1995 we biopsied 44 of 2749 (2%) HIV-1-infected patients after non invasive diagnostic procedures had been performed. In 93% of the patients an unambiguous diagnosis was possible based on the biopsy and lead in 73% of the patients to a change of therapy. No complications occurred after biopsy. 40 CTs and 15 MRIs were done. The radiological appearance of toxoplasmosis and non Hodgkin lymphoma (NHL) differed from that of progressive multifocal leucencephalopathy (PML) in respect to enhancement (PML). CT showed a sensitivity of 55% (toxoplasmosis, NHL) and 78% (PML) and a specificity of 83% (PML), 84% (NHL) and 96% (toxoplasmosis), respectively. Antitoxoplasma antibodies showed a sensitivity of 45%, only. The stereotactic brain biopsy was more expensive (20.166,- ATS) than CT, MRI and antitoxoplasma antibodies (4109,- ATS up to 6959,- ATS). We conclude that stereotactic brain biopsy is an efficient and safe and for the patients important diagnostic procedure. In selected patients even expensive investigations should be undertaken considering specific therapy and cost effective homecare.
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PMID:[Stereotactic brain biopsy in AIDS patients: a necessary patient-oriented and cost-effective diagnostic measure?]. 981 1

We describe the radiological findings at presentation and follow up in 24 adult patients with Burkitt's and Burkitt-like lymphoma, age range 17-67 years. This is an older age group than previously described in North American series, but the clinical and imaging characteristics appear similar. Disease confined to the abdomen was seen in 12 (50%) at presentation, of whom 11 had bowel or mesenteric tumours. Of those with bowel involvement, five patients had disease that had arisen in the ileocaecal region. Intra-abdominal disease was large volume (greater than 5 cm) in the majority of patients. Four patients (17%) had small isolated masses in the head and neck region, two (8%) had isolated unilateral axillary lymphadenopathy. Six (25%) patients presented with disseminated disease, all with hepatic and/or splenic involvement, intra-abdominal and peripheral lymphadenopathy. Three of these patients with disseminated disease were human immunodeficiency virus (HIV) positive. Neurological symptoms were present in a total of five patients at presentation or relapse but positive imaging findings were present in only two patients who had MRI. Computed tomography (CT) head scans performed in four patients were normal. Disease recurrence most commonly occurred within the abdomen.
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PMID:The imaging of Burkitt's and Burkitt-like lymphoma. 983 88

Disinfectant MRI-1 was prepared by dissolution of non-ionic and ionic detergent in ethanol. The disinfectant inactivated extracellular and intracellular enveloped and non-enveloped viruses including herpes viruses, influenza A and human immunodeficiency disease virus in suspension or on surfaces by pre-exposure or post-exposure to the disinfectant; in addition, cells were disabled as potential hosts for viral infection using concentrations of MRI-1 which were 50-fold less than the operative concentration for disinfection. There was no evidence of in vitro mutagenicity using Salmonella typhimurium or sensitization or other adverse effect in a guinea pig model or in human subjects.
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PMID:Antiviral efficacy of disinfectant solution MRI-1. 1032 33

We review the MRI findings of human immunodeficiency virus (HIV)-positive patients with "spinal" symptoms and review the literature. In 23 consecutive HIV-positive patients presenting with acute neurologic complaints thought to be referable to the spine, we reviewed spinal MRI, medical charts, and laboratory, pathologic, and autopsy data. In the early stages of HIV infection, the common causes of spinal complaints (i. e., degenerative spine and disc disease) predominated. However, pathology may be missed without contrast-enhanced MRI of the spine. In more advanced cases, the differential diagnosis includes one or more neoplastic and/or infectious causes which require contrast-enhanced MRI for detection. In these cases, normal cerebrospinal fluid findings should not preclude contrast-enhanced MRI of the spine. Imaging of the brain may also be indicated in cases when the spinal study is negative.
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PMID:Spinal disease in neurologically symptomatic HIV-positive patients. 1037 96

The authors report a series of five cases of non tuberculous cervical spinal epidural abscesses. There were neither patients suffering from immunodeficiency syndromes nor drug addicts; all the patients were in their seventh decade; two patients were affected by diabetes mellitus refractory to medical treatment. Retropharyngeal abscess was the main etiological risk factor (two cases); Staphylococcus aureus was cultured in two cases. Gadolinium MRI was necessary for a preoperative diagnosis, planning surgical approach and postoperative prognosis. Surgical debridement was performed via an anterior approach in those cases where the collection was located lower than C4 and did not span more than three vertebral segments; posterior approach, via a laminectomy, was performed in a case of C1-C2 location of the lesion and in a case of involvement of the whole cervical spine. Surgical results were poor in those patients affected by diabetes mellitus, a lesion involving the high cervical segments (higher than C4) or a lesion spanning more than three levels. Medical treatment with MRI follow-up was not undertaken in any of the patients and we opted for surgical drainage in all the cases due to the possibility of a sudden neurological deterioration, caused both by spinal cord mechanical compression and vascular compromission.
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PMID:Cervical spinal epidural abscesses. A report on five cases. 1049 68

We present the results paragraph signof MRI examinations in ten patients with documented Nijmegen paragraph signbreakage syndrome (NBS), aged 1.75-19 years. T1-, Proton-Density- and T2-weighted spin-echo sequences were performed in three planes. All patients showed microcephaly with decreased size of the frontal lobes and narrow frontal horns. In four patients agenesis of the posterior part of the corpus callosum was found, with colpocephaly and temporal horns dilatation. In one patient callosal hypoplasia was accompanied by abnormal cerebrospinal fluid spaces and wide cerebral cortex, suspicious of pachygyria. Sinusitis was present in all ten patients, as a result of primary immunodeficiency. As in ataxia teleangiectasia and other breakage syndromes, patients with NBS show an inherited susceptibility to malignancy and hypersensitivity to X- and gamma-radiation. CT is therefore contraindicated in these patients and MRI should be the method of choice for diagnostic imaging.
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PMID:Cranial MRI in the Nijmegen breakage syndrome. 1066 71


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