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)

We report a case of gliomatosis cerebri in a 46-year-old woman with five-year history of seizures and psychiatric disturbance. There were also two episodes of lethargy, disorientation, and headache which cleared promptly with Mannitol. A 3rd episode terminated in her death. Remarkably, between the episodes of presumed increased intracranial pressure, the neurologic examination was normal except for the patient's denial of her illness. Postmortem examination revealed the entire right cerebral hemisphere to be enlarged and infiltrated by cells resembling astrocytes. The clinical signs, symptoms, and controversial histopathologic features of this rare entity are discussed.
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PMID:Gliomatosis cerebri: a case report. 176 54

To better assess the role of hyperammonemia versus hypoosmolarity versus hyponatremia in the TUR syndrome, we developed a rat model. Sprague-Dawley female rats received an intraperitoneal injection (250 cc/kg body weight) of either 1.5% glycine, 2.0% glycine, 2.0% glycine plus 1.5% mannitol, 3.0% mannitol, 5.0% mannitol, or 2.0% glycine plus 0.25% saline. Arterial blood samples were obtained prior to injection, at 2, 8, 16, and 24 hr and analyzed for osmolarity, sodium, and ammonia. Those animals receiving 2.0% glycine, 2.0% glycine plus 1.5% mannitol, and 5.0% mannitol all died within 24 hr with lethargy, convulsions, and coma. Hyponatremia developed in all animals; death, however, occurred only when the sodium concentration declined to 90-95 meq/dl. Mannitol maintained serum osmolarity but did not prevent coma and death. Including 0.25% saline in the initial injection, or an iv injection of 5.0% saline delayed 8 hr achieved 100% survival. Ammonia concentrations increased 15-fold by 8 hr in groups receiving 2.0% glycine; it rapidly decreased to near normal by 24 hr. Decreasing the rise in ammonia by 50% with iv arginine had no effect on survival. Our results suggest that hyponatremia rather than hyperammonemia or hypoosmolarity accounts for the major morbidity and mortality secondary to the TUR syndrome.
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PMID:The physiologic basis of the TUR syndrome. 291 15

Mannitol is an osmotic diuretic widely used in the diagnosis and prevention of acute oliguric renal failure, acute cerebral edema and acute glaucoma. Mannitol, though ordinarily a benign substance, may accumulate in renal failure with potentially deleterious consequences. Mannitol intoxication is ordinarily characterized by confusion, lethargy, stupor, and if severe enough, coma. The use of mannitol in renal failure has rarely been associated with a worsening of the preexistent renal dysfunction. We report a case of acute oliguric renal failure solely attributable to mannitol administered in the course of therapy for acute glaucoma.
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PMID:Mannitol-induced acute renal failure. 310 45

Mannitol is an osmotic diuretic used in acute oliguric renal failure, acute cerebral edema, and acute glaucoma. It is metabolically inert and is excreted through the kidneys. So once renal function is impaired, mannitol accumulates and the movement of water into the intravascular space with resultant cellular dehydration. Two patients suffered reversible acute oliguric renal failure following mannitol infusion given as treatment for intracranial hypertension. Both patients experienced nausea and vomiting and became increasingly lethargic with edema of general body. Congestive heart failure occurred. Laboratory data showed severe dilutional hyponatremia with hyperosmolality. We successfully treated them with extracorporeal ultrafiltration method (ECUM) and hemodialysis (HD). Some discussions were presented about acute renal failure following mannitol infusion.
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PMID:[Acute renal failure following mannitol infusion]. 837 73