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)

Cytauxzoonosis is a rapidly and highly fatal disease in cats that is caused by the protozoan Cytauxzoon felis, which may be transmitted by Ixodid ticks (Dermacentor variabilis) from parasitemic bobcats (Lynx rufus). During an 8-year period, cytauxzoonosis was diagnosed in 8 cats, 7 cats within 14 months. Risk factors for these cats were warm weather, access to a wooded environment, and exposure to ticks. The most consistent clinical signs were acute lethargy, anorexia, decreased response to external stimuli (depression), icterus, dehydration, and capillary refill time > 2 seconds. Pertinent clinicopathologic findings were normocytic normochromic anemia, leukopenia, and thrombocytopenia; high serum concentrations of total bilirubin and glucose, low serum concentrations of albumin and potassium, high serum alanine transaminase activity; and, bilirubinuria. Confirmation of cytauxzoonosis was made by cytologic or histologic identification of the C felis organism. Splenic, lymph node, and bone marrow aspirates can provide an antemortem diagnosis when the number of parasitized erythrocytes is low on blood smears. Supportive treatment of 6 cats was temporarily palliative in some, but all 8 cats either died (3) or were euthanatized (5) when they became moribund. Survival time from observed onset of illness to death was < 5 days. Necropsy of 4 cats revealed predominately pulmonary involvement with venous congestion. Histologic examination revealed venous occlusion by parasitized mononuclear phagocytes in all tissue specimens, but only minimal inflammatory infiltrates.
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PMID:Cytauxzoonosis in cats: eight cases (1985-1992). 796 Oct 73

We studied 57 infants < or = 14 days of age referred for possible enterovirus (EV) infection to assess the accuracy of that clinical diagnosis and describe the natural history of neonatal EV infection. Twenty-nine neonates proved to have EV infection, 23 had illnesses compatible with (but not proven to be) EV infection, and 5 had alternative diagnoses: bacterial infections (2); herpes simplex virus infection (1); and metabolic disorders (2). Neonates with proved EV infection were generally full term and had uncomplicated immediate postnatal periods but high percentages of ill contacts. Neonatal symptoms and signs included fever, irritability, anorexia, lethargy, hypoperfusion, rash, jaundice and respiratory findings. Laboratory abnormalities included cerebrospinal fluid (CSF) pleocytosis, chest radiograph infiltrates, abnormal urinalyses and elevated transaminases. EVs were most commonly isolated from CSF and rectum/stool but also frequently from serum and urine. Five EV-infected patients had severe multisystem disease (pneumonitis, hepatitis, thrombocytopenia, bleeding and meningitis), requiring supportive care and lengthy hospitalizations. All survived, 2 with residual hepatic dysfunction. Markers of severe disease included: early age of illness onset (especially Day 1 of life); maternal viral symptoms at delivery; absence of fever and irritability; tachypnea; lethargy; abdominal distension; hepatomegaly; and positive serum viral culture. These data support conservative management of ill infants < or = 2 weeks of age and suggest that antiviral therapy for neonatal EV infection would be optimally targeted at infants with early onset illness, multisystem disease and/or viremia.
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PMID:Profile of enterovirus disease in the first two weeks of life. 828 18

Fifty-one patients with histologically confirmed epithelial stage III or IV ovarian cancer were entered into a study in which gemcitabine 800 mg/m2 was given as a 30 min intravenous infusion in a cycle once a week for 3 weeks followed by a week of rest. Patients were aged 58 years (range 23-70 years) with WHO performance status 0-2, and had received up to two different chemotherapy regimens. Thirty-eight patients had received only one prior platinum-containing chemotherapy regimen whereas 9 had received a first-line regimen on more than one occasion. A further 3 patients had received two different regimens. Of 42 patients evaluable for response, 8 (19%; 95% CI: 9%-34%) were partial responders. Seven of the 8 responders were resistant to first-line platinum-based therapy. Median duration of response was 8.1 months (range 4.4-12.5 months). Median progression-free survival was 2.8 months (range 0.2-12.5 months). Haematological toxicity with gemcitabine was modest, with grade 3 leukopenia (11 patients) and grades 3 and 4 thrombocytopenia (6 patients). Grade 3 non-haematological toxicity included nausea/vomiting (6 patients) and elevated AST/ALT (1 patient), while dose-limiting non-haematologic toxicity consisted of flu-like symptoms (2 patients), peripheral oedema (1 patient) and lethargy (1 patient). The activity and modest haematological and non-haematological toxicity seen with gemcitabine suggest that this agent should be further evaluated in the treatment of patients with ovarian cancer and in combination chemotherapy regimens, primarily in combination with platinum.
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PMID:Phase II study of gemcitabine in previously platinum-treated ovarian cancer patients. 871 27

Ilmofosine, an ether lipid derivative of lysophosphatidylcholine has antineoplastic activity in vitro and in vivo. Maximum efficacy in preclinical models is associated with prolonged exposure to the drug. In a Phase I trial of a weekly 2 hour infusion schedule of ilmofosine, a syndrome of lethargy, diminished performance status, and mild hepatotoxicity was dose-limiting at 550 mg/m2. To avoid the higher drug concentrations associated with a brief infusion, a Phase I study of a weekly 24 hour infusional schedule was undertaken in an attempt to maximize dose-intensity. Doses were escalated from 550 to 800 mg/m2. Toxicities included nausea, anorexia, fatigue, and minor elevations of liver function tests. The dose limiting toxicity at 800 mg/m2 was a syndrome of severe abdominal pain. No neutropenia or thrombocytopenia was observed except in one patient who was found to have a myelodysplastic syndrome, thought not to be related to drug therapy. The more prolonged infusion schedule of ilmofosine did not result in a substantial increase in the tolerable dose.
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PMID:Phase I trial of ilmofosine as a 24 hour infusion weekly. 872 47

Seventeen Minnesota and Wisconsin dogs with granulocytic ehrlichosis were studied. The diagnoses were made by finding ehrlichia morulae in peripheral blood neutrophils. Eight dogs were studied retrospectively, and nine dogs were studied prospectively. The medical records of all dogs were reviewed. Eighty-eight percent of the dogs were purebred and 76% were spayed females. The median age was 8 years. Sixty-five percent of the cases were diagnosed in October and November. Fever and lethargy were the most common clinical signs. The most frequent laboratory findings were lymphopenia, thrombocytopenia, elevated activities of serum alkaline phosphatase and amylase, and hypoalbuminemia. No dogs seroreacted to Ehrlichia canis or Ehrlichia chaffeensis antigens, which are cross-reactive. Seventy-five percent of the dogs tested during the acute phase of disease and 100% of the dogs tested during convalescence were seropositive for E. equi antigens. Granulocytic ehrlichial 16S rRNA gene DNAs from six dogs were amplified by PCR. Sequence analysis of a 919-bp sequence of the ehrlichial 16S rRNA gene amplified by PCR from the blood of two dogs revealed the agent to be identical to the agent of human granulocytic ehrlichiosis in Minnesota and Wisconsin and to be very similar to E. equi and Ehrlichia phagocytophila and less similar to E. canis, Ehrlichia ewingii, and E. chaffeensis. The geographic, clinical, serologic, and molecular evidence indicates that granulocytic ehrlichiosis in Minnesota and Wisconsin dogs is not caused by E. ewingii, but suggests that it is a zoonotic disease caused by an agent closely related to E. equi and that dogs likely contribute to the enzootic cycle and human infection.
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PMID:Geographic, clinical, serologic, and molecular evidence of granulocytic ehrlichiosis, a likely zoonotic disease, in Minnesota and Wisconsin dogs. 874 70

Fatal (Panthera tigris) cytauxzoonosis was diagnosed in a 7-year-old female white tiger. The tiger presented with a 2-day history of anorexia and lethargy. She was mildly dehydrated, with a temperature of 105.2 F and a hematocrit of 26%. Over the next day, icterus developed, and her physical condition progressed to recumbency, coma, and death. Hematologic findings obtained shortly before death included icteric plasma, severe thrombocytopenia, mild anemia, hematuria, and parasites consistent with Cytauxzoon felis in circulating erythrocytes. Gross necropsy findings included generalized icterus, generalized petechiae and ecchymoses, splenomegaly, and peribronchial edema. Histologic changes included large numbers of intravascular macrophages containing developmental stages of Cytauxzoon felis that partially or completely occluded blood vessels in the lung, spleen, liver, and bone marrow. Except for an experimental infection of a bobcat, fatal cytauxzoonosis has not previously been diagnosed in felids other than domestic cats. These findings raise questions regarding the pathogenicity of this organism in felids and may impact husbandry and interstate transfer of captive large cats.
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PMID:Fatal cytauxzoonosis in a captive-reared white tiger (Panthera tigris). 882 11

A nine-year-old, castrated male golden retriever had lethargy, fever, massive peripheral lymphadenomegaly, hepatosplenomegaly, and pale mucous membranes. There was a marked leukocytosis (456.3 x 10(3) cells/microliter) with 99% blasts; a moderate, nonregenerative anemia; and marked thrombocytopenia. A tentative diagnosis of acute lymphocytic leukemia was made pending results of cytochemical staining. Despite the severity of the laboratory and clinical findings, the dog exhibited a partial response to an induction chemotherapy protocol commonly used for lymphoma. Subsequent cytochemical staining of the original blood and bone-marrow samples resulted in a revised diagnosis of acute myelomonocytic leukemia (AML-M4). Clinicopathological findings, response to treatment, and clinical outcome in this case of canine AML-M4 are discussed.
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PMID:A potentially misleading presentation and course of acute myelomonocytic leukemia in a dog. 897 24

This paper describes five naturally occurring clinical cases of infectious canine cyclic thrombocytopenia that were the first serologically confirmed cases of Ehrlichia platys infection in Israel. In the USA this disease is considered subclinical, but the dogs in this study developed distinct clinical abnormalities. The signs observed by the owners included anorexia, lethargy, depression, weight loss and a mucopurulent nasal discharge. The principal findings on physical examination included lymphadenomegaly, pale mucous membranes, fever and the presence of ticks. The main abnormal haematological and biochemical findings included thrombocytopenia, the presence of giant platelets, low haematocrit, monocytosis and low albumin concentrations. All five dogs were less than two years of age, and four were purebred dogs, suggesting that these two factors may be associated with increased risk to infection and clinical disease. Two of the dogs were seropositive to E canis, a finding which is compatible with other reports, and which confirms that combined infections of E platys and E canis are common; it also suggests that E canis infections may contribute to the pathogenesis of E platys. The distinct clinical manifestation of the disease in these five dogs suggests that there may be a different, more virulent strain of E platys in Israel.
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PMID:Clinical manifestations of infectious canine cyclic thrombocytopenia. 930 49

One hundred cases of monocytic ehrlichiosis diagnosed in Israeli dogs were confirmed by the presence of anti-Ehrlichia canis indirect immunofluorescent antibody titres greater than 1:40. The disease occurred in all age groups and there was no sex predilection. German shepherd dogs were significantly over-represented whereas crossbreed dogs were significantly under-represented (P > 0.0005). The most common clinical signs were depression, lethargy, lymphadenomegaly, fever, anorexia, panting, pale mucous membranes and bleeding, of which epistaxis was most common. Thrombocytopenia, anaemia (mainly normocytic normochromic) and lymphopenia were the predominant haematological findings. Forty-nine of the 100 cases were followed up for a year. Thirty-two dogs survived and 17 died. A Cox proportional hazards regression model was used to examine the effect of host, environmental, and haematological prognostic factors on survival. It was concluded that severe anaemia, severe leucopenia, pancytopenia, a tendency to bleed (especially epistaxis) and being a German shepherd dog were important indicators of poor survival in cases of monocytic ehrlichiosis in dogs.
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PMID:Canine monocytic ehrlichiosis: a retrospective study of 100 cases, and an epidemiological investigation of prognostic indicators for the disease. 935 Nov 83

Tularemia was diagnosed in 2 cats that were examined because of pyrexia and lethargy; both cats had a history of exposure to wild rabbits. One cat was vomiting, and the other was anorectic. Physical examination revealed dehydration, lymphadenopathy, and hepatomegaly. Hematologic and serum biochemical abnormalities included toxic neutrophils, high band neutrophil count, thrombocytopenia, and hyperbilirubinemia. Diagnosis was confirmed by isolating Francisella tularensis subsp tularensis from bone marrow or lymph node aspirates. Evaluation of samples collected during the acute and convalescent phases of the disease revealed an increase in serum F tularensis antibody titer. Both cats responded to treatment with fluids and antibiotics.
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PMID:Tularemia in two cats. 942 84


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