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)

Obstructive sleep apnoea syndrome (OSAS) appears to be an extremely rare complication of carcinoid syndrome and has not yet been reported in the literature. We describe a 75-year-old patient with a history of bronchial carcinoid who besides typical carcinoid syndrome symptoms developed sleep disturbance and day lethargy caused by massive facial and nasal tissue oedema. Sleep apnoea was confirmed by sleep study. Abdominal ultrasound and computed tomography (CT) scan showed the presence of multiple liver metastases. Because the patient did not respond to octreotide therapy, embolization of the hepatic artery was performed. After this procedure we observed dramatic improvement of the patient's life quality, and rapid disappearance of facial swelling and sleep apnoea symptoms. We conclude that hepatic artery embolization appeared to be an effective method of abolishing obstructive sleep apnoea associated with carcinoid syndrome.
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PMID:Obstructive sleep apnoea syndrome (OSAS) as a complication of carcinoid syndrome treated successfully by hepatic artery embolization. 905 39

Serotonin syndrome (SS) is a potentially fatal complication of the combined use of agents that enhance serotonin activity. Bupropion inhibits noradrenaline and dopamine reuptake with milder effects on serotonergic activity. Although regarded as a potential causative agent for SS, no cases have been reported in the medical literature. A 62-year-old woman treated with therapeutic dosages of bupropion and sertraline for depression for the previous 3 weeks presented with upper extremity myoclonic jerks, clumsiness, and gait difficulties with fluctuating symptoms of confusion, forgetfulness, and the alternation of agitation and lethargy. Symptoms were interpreted as an aggravation of depression and venlafaxine was added. The clinical picture progressed to alteration of consciousness and dysautonomia. After admission, medications were discontinued and she was started on cyproheptadine and clonazepam with gradual improvement and complete resolution of symptoms. This is a rare report of SS related to the association of bupropion and selective serotonin reuptake inhibitors (SSRIs). It also illustrates the potential for misinterpretation of the earliest manifestations of SS as signs of aggravation of the patient's underlying condition. The role of bupropion in SS is possibly related to its well-established specific inhibition of the cytochrome P450 2D6 pathway, increasing blood levels of SSRIs and tricyclic antidepressants.
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PMID:Serotonin syndrome induced by a combination of bupropion and SSRIs. 1560 2