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)

Symptoms consistent with hypothyroidism or adrenal insufficiency, such as lethargy, anorexia, cold intolerance, weakness, hypotension or paraesthesia, are frequently reported in the literature in patients with Human African Trypanosomiasis (HAT), but an endocrine origin for these symptoms has not yet been demonstrated. Thyroid and adrenocortical function were assessed in 60 patients with late-stage HAT and compared to those in 60 age- and gender-matched healthy controls. Clinical assessment and endocrine laboratory examinations were performed on admission, within 2 days after the end of treatment and at follow-up 3 months later. Signs and symptoms of hypothyroidism, such as fatigue, cold sensation, constipation, paraesthesia, peripheral oedema and dry skin, were significantly more frequent in HAT patients than in the controls. However, these signs and symptoms could not be attributed to hypothyroidism due to the lack of supporting laboratory data, and thus empirical replacement therapy for the clinically suspected hypothyroidism was not warranted. Signs and symptoms consistent with adrenal insufficiency, such as weakness, anorexia, weight loss or hypotension, were significantly more frequent in HAT patients than in controls, but they could not be associated with an insufficiency of the adrenocortical axis. Higher basal levels of cortisol were found in HAT patients than in controls, which can be viewed as a stress response to the infection. However, a transitory adrenal insufficiency was suspected in 8% of HAT patients at admission and in 9% at discharge. All values were normal at follow-up 3 months later.
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PMID:Sleeping glands? - The role of endocrine disorders in sleeping sickness (T.b. gambiense Human African Trypanosomiasis). 1776 11

Natural killer cell proliferation is an uncommon haematological disorder that has a number of different clinical manifestations. There have been only two prior reports linking this process with neurological disease, both reports describing peripheral neuropathy. We report the case of a young man presenting with a short history of lethargy, lower limb paraesthesia and marked weight loss who was found to have a natural killer cell lymphocytosis and features of both an autonomic and a peripheral neuropathy. The patient's clinical features responsed to a combination of cytotoxic and immunosuppressive therapy, and the patient is now clinically stable with mild ongoing lymphocytosis, diarrhoea and postural hypotension. We review the possible pathological link between natural killer cells and neurological disease.
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PMID:Natural killer cell lymphoproliferative disease associated with combined peripheral and autonomic neuropathy. 1863 28

Understanding the particular pharmacology of different antidepressant drugs can help explain their adverse effects when they are discontinued. For all antidepressant drugs, abruptly stopping them can sometimes result in "rebound" hypomania or mania. Antidepressant drugs having anticholinergic effects often are associated with a discontinuation syndrome characterized by cholinergic rebound, with symptoms of nausea, vomiting, abdominal cramping, sweating, headache, and muscle spasms. Discontinuation of monoamine oxidase inhibitor drugs sometimes results in flu-like symptoms, dysphoria, restlessness, tachycardia, hypertension, and a delirium-like state. Serotonergic antidepressant drugs are sometimes associated with a distinct discontinuation syndrome characterized by dizziness, weakness, nausea, headache, lethargy, insomnia, anxiety, poor concentration, and paresthesias. Adverse discontinuation effects can occur with all types of antidepressant drugs, but only rarely would they be considered serious. To minimize adverse discontinuation effects and to reduce the risk of relapse or recurrence of the underlying treated condition, tapering antidepressant medication is prudent for all patients.
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PMID:Potential adverse effects of discontinuing psychotropic drugs: part 2: antidepressant drugs. 2060 81

Selenium is a metalloid of considerable interest in the human from both a toxicological and a nutritional perspective, with a very narrow safe range of intake. Acute selenium intoxication is followed by adverse effects on the nervous system with special clinical relevance, while the neurotoxicity of long-term overexposure is less characterized and recognized. We aimed to address this issue from a public health perspective, focusing on both laboratory studies and the few epidemiologic human studies available, with emphasis on their methodological strengths and limitations. The frequently overlooked differences in toxicity and biological activity of selenium compounds are also outlined. In addition to lethargy, dizziness, motor weakness and paresthesias, an excess risk of amyotrophic lateral sclerosis is the effect on the nervous system which has been more consistently associated with chronic low-level selenium overexposure, particularly to its inorganic compounds. Additional research efforts are needed to better elucidate the neurotoxic effects exerted by selenium overexposure.
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PMID:Selenium neurotoxicity in humans: bridging laboratory and epidemiologic studies. 2426 18

Centipede bites are usually characterized by mildly to moderately painful encounters with humans, however, they are relatively infrequent. The vast majority of centipede envenomations do not cause severe symptoms and only in very rare cases more serious symptoms such as myocardial ischemia and infarction, hematuria, hemoglobinuria, rhabdomyolysis, hemorrhage, pruritus, eosinophilic cellulitis, as well as anaphylaxis are observed. More prevalent are symptoms including pain, paresthesia, lethargy, localized necrosis, headache, dizziness and nausea. The numerous symptoms and complications elicited by these envenomations indicate that centipede venom possesses an arsenal of chemical components with functional diversity. Centipede venom is a rich and complex natural source of bioactive proteins, peptides and other small molecules that aid in predation or defense. The venom can induce myotoxic, cardiotoxic, neurotoxic and other toxic effects. The constituents target different cellular processes and pathways which in turn trigger a cascade of physiological reactions in the victim. The venom components are potent and selective on peripheral targets; thus, they are valuable in studying the molecular basis of these envenomation symptoms and complications. This review highlights the clinical importance of centipede envenomation and the recent discoveries on the underlying molecular mechanisms of the resulting symptoms which is crucial in therapy.
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PMID:Centipede envenomation: Clinical importance and the underlying molecular mechanisms. 3027 3


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