Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0023380 (lethargy)
 5,697 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Twenty-two patients with non-Hodgkin's lymphoma (NHL) were treated with a combined regimen of interferon alfa-2b (Intron A; Schering-Plough) and chlorambucil to evaluate the response and efficacy in pre-treated or relapsed patients. Ten patients were classified as having follicular lymphoma and 12 diffuse lymphoma. The treatment schedule consisted of interferon alfa-2b 3 X 10(6) IU/m2 thrice-weekly and chlorambucil 10 mg daily for three weeks, with a week's rest between each cycle. Treatment continued for upto six cycles. We obtained two complete remissions (CR), 12 good partial remissions (GPR), seven no remissions (NR) and one stable disease. On histologic examination we observed a response in 8 of 10 patients with follicular lymphoma (2 CR and 6 GPR); three of five patients with diffuse mixed lymphoma, and three of seven patients with diffuse lymphoma showed GPR. The major toxicity consisted of fever and nausea and, in one case, lethargy. In one patient the treatment was stopped at the second cycle because of poor compliance. Hematologic toxicity was generally mild and occurred between the third and fourth cycle. We observed hepatic toxicity i.e. a transient increase of transaminase levels, in three patients. We consider this regimen to be effective in the treatment of relapsed or resistant NHL and no more toxic than single agent therapy. A randomized study to verify this therapeutic approach versus conventional therapy with chlorambucil alone in first-line treatment is recommended.
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PMID:Interferon alfa-2b and chlorambucil in the treatment of non-Hodgkin's lymphoma. 329 32

Meningitis should be suspected in a patient who presents with fever, meningism, or severe headache. A careful physical examination should be performed of perimeningeal foci, with emphasis on the sinuses, ears, throat, neck, and lungs. A history of exposure to tuberculosis, viral disease, rodents, or suspicious dairy products or farm animals may give clues to the source of the meningitis. Immunosuppression through the use of corticosteroids or chemotherapy for such conditions as Hodgkin's disease, lymphoma, leukemia, malnutrition, or acquired immunodeficiency syndrome (AIDS) should also be noted and alert the clinician to the possible presence of an unusual pathogen. Meningitis associated with leukemia or most of the non-T-cell lymphomas is likely to be from a common bacterial agent (often Listeria), unless the patient is being treated with a steroid or is receiving other chemotherapy. Patients with Hodgkin's disease or AIDS or who have been treated with a steroid are more likely to have cryptococcal or tuberculous meningitis. Neonates and the very elderly may present with only irritability or lethargy and fever, without any of the other common symptoms. In neonates up to one week of age, group B streptococcal infection should be suspected. Gram-negative organisms should be suspected in elderly patients and those who have had neurosurgery. In patients with CSF shunts, infection with coagulase-negative Staphylococcus should be assumed and these patients are treated empirically until results of cultures are received. Several noninfectious conditions may mimic infectious meningitis, as may some unusual causes of infectious meningitis (eg, syphilis and schistosomiasis), which have not been discussed in this article.
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PMID:The many causes of meningitis. 361 11

Peripheral lymph node enlargement was found in 14 of a series of 132 feline lymph node biopsy specimens. Six of nine cats tested had antibodies for feline leukemia virus (FeLV). Half of the cats were clinically normal while the remainder had fever, lethargy, anorexia, and hepatosplenomegaly. There was severe distortion of lymph nodal architecture with variable loss of discernible follicles and sinuses. Histiocytes, lymphocytes, immunoblasts, and plasma cells were present in expanded paracortical regions which encroached on, and occasionally effaced, lymphoid follicles. Postcapillary venules were numerous and prominent throughout the paracortex. The lymphadenopathy was most commonly transient (86% of cases) with subsequent development of lymphoma in one cat. Lymph nodes from seven kittens with experimental FeLV infection were compared with spontaneously enlarged lymph nodes; four of seven had B and T lymphocyte hyperplasia with normal nodal architecture. Three had partial loss of nodal architecture as a result of expanded paracortical regions populated largely by histiocytes and lymphocytes. Proliferation of postcapillary venules was not prominent in nodes from FeLV-infected cats. The cause of spontaneous lymph node hyperplasia of young cats was not determined. However, the similarity of lesions to those of kittens with experimental FeLV infection and the association with FeLV by serologic tests in six of nine cats suggest that this retrovirus may be involved in the pathogenesis of the lesion.
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PMID:Distinctive peripheral lymph node hyperplasia of young cats. 375 Jul 32

To study the biologic behavior and natural history of this rare but challenging tumor faced by oncologists, a clinicopathologic study of 42 patients with histologically proven adrenal cortical carcinoma from Roswell Park Memorial Institute (1929--1977) was done. These constituted .04% of all cancer cases and 0.2% of all autopsy cases. Age range was 3--74 years with median of 53 years; female to male ratio was 1.5 to 1. Clinical manifestations were: abdominal mass (36%), metastatic disease (30%), hormonal excess (17%) and weakness with lethargy (17%). Nine of ten functioning tumors were seen in female patients. Tumors arose in left adrenal in 26 patients, right adrenal in 12, and in four the site could not be determined because of bilateral presence of cancer. Median duration of symptoms was six months. At diagnosis, 52% had distant metastases, 41% had locally advanced tumor and 7% had tumor confined to adrenal. Sixteen patients underwent "curative" resection. Tumor diameter ranged from 1--30 cm with median of 10 cm. Of 28 patients who received different chemotherapeutic regimens, three (11%) had objective response; four of ten patients had objective response to radiation therapy. Overall median and five-year survival rates were 14 months and 24%. Prolonged survival (P less than .05) was noted in women, patients who had "curative" resection, a disease-free interval of more than 12 months, and tumor size greater than 10 cm diameter. Patients with functional tumors had longer median survival than those with non-functional ones (28 vs. 12), but P value was greater than .05. A second primary cancer was noted in 22.4% of cases, breast and lymphoma being the most common. At autopsy in 31 patients, the most common metastatic sites were retroperitoneal lymph nodes 68%, lung 71%, liver 42%, and bone 26%. To improve survival, an aggressive surgical approach is recommended to extirpate the tumor with involved organs and retroperitoneal lymph nodes. Adrenal carcinoma should be suspected in patients with metastatic cancer with an occult primary.
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PMID:Natural history of adrenal cortical carcinoma: a clinicopathologic study of 42 patients. 722 9

Spirogermanium is a new azaspirane antitumor agent, with the metal germanium substituted for a one-carbon moiety in the ring structure. This drug inhibits DNA and RNA synthesis in HeLa cells, is cytotoxic in vitro, and has curative in vivo antitumor activity against the ascitic Walker 256 carcinosarcoma in rats. No hematologic toxicity was recorded during the preclinical toxicologic evaluation. The principal clinical toxic effects observed in this phase I trial were neurologic, manifested as lethargy, dizziness, and ataxia, while a grand mal seizure was produced after an accidental overdose. There was no evidence of hematologic, renal, or hepatic toxicity. A partial response was achieved in a patient with a well-differentiated lymphocytic lymphoma. We recommend that phase II trials be conducted with a twice or thrice weekly dose of 50-80 mg/m2, administered in a 30-minute iv infusion.
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PMID:Phase I clinical trial of spirogermanium. 745 90

A cranial mediastinal mass was observed radiographically in two 5-year-old adult male ferrets (Mustela putorius furo), both with histories of chronic episodic vomiting, dyspnea, and lethargy. Malignant lymphoma, a common neoplasm observed in ferrets, was considered the most likely diagnosis. Cardiomegaly and splenomegaly were also present. Histologically both mediastinal masses were composed of thymic epithelial cells and small lymphocytes, establishing a diagnosis of thymoma. Thymoma should now be included in the differential diagnosis of a cranial mediastinal mass in ferrets.
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PMID:Thymoma in two ferrets. 747 72

Three male Shar-pei dogs and one female spayed Boxer dog ranging in age from 4 years, 4 months to 7 years, 8 months had 4-7-week histories of diarrhea, progressive anorexia, weight loss, and vomiting. The dogs were depressed, lethargic, and hypoalbuminemic, with losses of 23-39% of body weight. Endoscopic examination revealed gastric ulceration with areas of mucosal hyperemia and pallor. Small nodules with occasional central depressions were present in three dogs. Gastric and proximal duodenal mucosal biopsies showed neoplastic lymphocytes infiltrating the lamina propria, with invasion of the superficial and glandular epithelial basement membrane. Immunohistochemical evaluation of two dogs was negative for anti-canine IgG and positive for anti-CD3. Necropsy of the Boxer and two Shar-peis confirmed epitheliotropic gastric and small intestinal lymphoma in all three dogs, with mesenteric lymph node and hepatic involvement in two and one dog, respectively.
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PMID:Primary gastrointestinal lymphosarcoma with epitheliotropism in three Shar-pei and one boxer dog. 748 19

A 45 year old man is described with Whipple's disease who presented with weight loss, lethargy, and ascites. He subsequently developed fever and a mass in the neck, but died despite antibiotic treatment and nutritional support. Necropsy showed extraintestinal lymphoma.
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PMID:Extraintestinal lymphoma in association with Whipple's disease. 769 90

Simian T-cell leukemia virus type 1 (STLV-1), a type C retrovirus associated with leukemia/lymphoma in Old World monkeys, is closely related to human T-cell leukemia virus type 1, the etiologic agent of adult T-cell leukemia/lymphoma in humans. In a colony of 3200 baboons, the prevalence of antibodies to STLV-1 is more than 40%. Seropositivity is more frequent in female baboons than in males and increases with age. Of 27 STLV-1 antibody-positive baboons with non-Hodgkin's lymphoma, 20 were females and 7 were males, ranging in age from 3 to 21 years (mean, 13 years). Non-Hodgkin's lymphoma was not found in STLV-1 antibody-negative baboons. Clinical signs and laboratory findings were variable but generally included lethargy, low body weights, anemia, dyspnea, lymphadenopathy, hepatosplenomegaly, pneumonia, nodular skin lesions, and leukemia with or without multilobulated lymphocytes in peripheral blood. Radiography revealed pulmonary infiltrates consistent with pneumonia in 17 of the baboons. Serum chemical values were normal except for hypercalcemia in one baboon. Lymphocytosis was found in 18 of the baboons, with leukemia diagnosed in 11. At necropsy, variable enlargement of lymph nodes and other lymphopoietic tissue was usually found. Pale tan to white space-occupying foci typical of proliferative lymphoid tissue were often found in various organs, including lungs, spleens, livers, skin, and hearts. The lungs in 14 baboons had thickened pleuras, congestion,edema, and large tan to brown areas of consolidation.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Spontaneously generated non-Hodgkin's lymphoma in twenty-seven simian T-cell leukemia virus type 1 antibody-positive baboons (Papio species). 790 50

This case report details of the presentation of a young woman in the first trimester of her pregnancy with lethargy, weakness, vomiting, pyrexia and lymphadenopathy. Extensive investigation revealed an advanced T cell lymphoma and only the second reported case in pregnancy to our knowledge. We discuss her management and subsequent chemotherapy in the context of a short review of the literature spanning the last decade.
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PMID:T cell non-Hodgkin's lymphoma presenting in the first trimester of pregnancy. 801 12


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