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

To determine the clinical presentation and manifestations of Paget's disease of the bone in patients older than 60 years, we reviewed the cases of 56 patients attending a bone clinic. Pain was the presenting symptom in 34 cases. It was attributed to the disease process in 21 cases, to osteoarthritis in 11, to trigeminal neuralgia in 1, and to osteosarcoma in 1. Other clinical manifestations included deformities (15 cases), diminished mobility and unsteady gait (9), hearing impairment (7), lethargy (4), diminished vision (3), cognitive deficit (3), sense of warmth in limbs (2), ill-fitting dentures (1), and fracture (1). We concluded that in patients older than 60 years, Paget's disease of the bone may present itself in a variety of ways, some of which may be mistakenly attributed to the "aging process" or some other disease. Furthermore, in this age group, osteoarthritis is responsible for the pain experienced by about one third of symptomatic patients.
 ...
PMID:Clinical presentation of Paget's disease of the bone in older patients. 821 23

Two adult guinea pigs were examined because they were lethargic and reluctant to walk. Additionally, I guinea pig had otitis media, and the other had dental malocclusion. Both guinea pigs had been fed a commercially available diet of cereals and pellets enriched with vitamin C and formulated for this species. Radiographically, the guinea pigs had coarse trabecular bone patterns, skeletal deformations, pathologic fractures, and polyarthritic degenerative joint disease. A double cortical line was also evident on several long bones, the pelvis, and the vertebrae. A diagnosis of osteopenia was confirmed by use of dual-energy x-ray absorptiometry. Analysis of a food sample fed to 1 guinea pig revealed calcium and phosphorus contents of 0.524 and 0.425%, respectively (Ca:P ratio, 1.23:1). Microscopic examination of bone tissue from both guinea pigs revealed severe fibrous osteodystrophy. Nutritional secondary hyperparathyroidism caused by calcium-phosphorus imbalance was considered to be the underlying cause of osteodystrophia fibrosa in both guinea pigs.
 ...
PMID:Osteodystrophia fibrosa in two guinea pigs. 1143 72

Polyarticular septic arthritis is an underappreciated clinical entity. Pre-existing joint diseases such as osteoarthritis and rheumatoid arthritis have been shown to be risk factors for septic arthritis. However, there is a paucity of data in the literature regarding the risk of septic arthritis in those patients with enteropathic arthritis. Here, we describe the case of a 47-year-old female with a background history of ulcerative colitis who presented with difficulty mobilizing and pain in the hips associated with lethargy, fever, and a significant inflammatory response. After an investigative process, she was newly diagnosed with enteropathic arthritis, complicated at presentation, by bilateral septic arthritis of the hips, based on progressive radiological destruction and a joint aspirate that grew staphylococcus aureus. After treatment with antibiotics and steroids, her pain and mobility significantly improved, and she was discharged with a plan for an elective hip replacement and to commence disease modifying therapy with sulfasalazine. This case reminds us that we must have a high index of suspicion to diagnose septic arthritis in those who present feverish and unwell with joint pain, even in those who present with multiple joint involvement. Furthermore, it describes a rare occurrence of bilateral septic arthritis of the hips occurring in a patient with enteropathic arthritis, which unlike osteoarthritis and rheumatoid arthritis, is not well described in the literature as a risk factor for septic arthritis.
 ...
PMID:A case of enteropathic arthritis complicated by superimposed bilateral septic arthritis of the hips. 3323 4