Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0023418 (leukemia)
 93,477 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Advances in medicine are allowing patients with hematologic disease to live longer and healthier lives than ever before. As these patients age, however, manifestations of their disease processes may develop as complications in other organ systems. We discussed the major genitourinary complications of sickle cell anemia, leukemia, and thromboembolic disease. These range from the benign inability to concentrate urine that is seen in sickle cell disease to renal infarction that results from nephrotic syndrome. Our ability to treat and prevent these complications will improve as our understanding of these disease processes and their pathophysiology grows. Additionally, it is important for urologists to understand the underlying pathophysiology of hematologic disease to best serve the patients. For example, it may be the urologist who makes the diagnosis of ovarian vein thrombosis in a pregnant woman with right lower quadrant pain and fever. This diagnosis, with the proper treatment of antibiotics and anticoagulation, could prevent the potential development of septic thrombophlebitis. Urologists will increasingly be called upon to deal with the manifestations of these complex diseases as these patients are living longer. It is our duty to educate ourselves about these disease processes so that we can make the best clinical decisions for our patients.
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PMID:Urologic manifestations of hematologic disease sickle cell, leukemia, and thromboembolic disease. 1258 May 57

OBJECTIVE: To present, in practical form and updated terms, the clinical aspects of the varicella and its prevention using either vaccination or isolation precautions. METHOD: Review of the literature using MEDLINE and LILACS referring to the last 10 years; presentation of the most recent aspects in the literature as well as reference to the author's professional experience in the area. RESULTS: Current aspects of the clinic and treatment of this disease are analyzed. The vaccine is examined in relation to the soroconversion and safety. The technique of application of the vaccine is presented, considering its indication for healthy children, adults, seniors and high risk patients. Among these, we consider those with leukemia, solid tumors, nephrotic syndrome, AIDS, and those transplanted. The application of the vaccine is analyzed in relation to contacts, personal in the health area and people in closed communities. Precautions, contraindication, production and types of vaccines are analyzed. The association and combination of vaccines, as well as their current indications are carefully discussed. As a nosocomial infection, varicella requires much attention due to its very easy dissemination. Recommended procedures are indicated for both hospitalized and contact cases of varicella or zoster. CONCLUSIONS: The appropriate knowledge of the clinic, treatment and preventive procedures in cases of varicella is mostly important for the pediatrician, especially with the introduction of its vaccine in our country.
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PMID:[Varicella: clinical aspects and prevention] 1468 90

A 5-year-old African-American male was diagnosed with nephrotic syndrome (NS). Because of concomitant leukopenia, bone marrow aspiration was performed, which did not demonstrate a hematological malignancy. The patient received standard daily steroid therapy for treatment of NS. Steroid resistance at 5 weeks of therapy led to a renal biopsy, which documented focal segmental glomerulosclerosis (FSGS). He was begun on cyclosporin A (CsA) and later switched to tacrolimus because of side-effects of CsA. Seven months after the initial diagnosis of NS, the patient was diagnosed with acute lymphoblastic leukemia (ALL). The patient is in complete remission of ALL and partial remission of NS with continued nephrotic-range proteinuria. Review of the literature shows four other cases of pediatric ALL after NS. No particular immunosuppressive agent seemed to be causative in the evolution of ALL. Although the exact mechanism for development of ALL after NS is unknown, the incidence of leukemia may be increased after immunosuppressive therapy when used in this context.
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PMID:Acute lymphoblastic leukemia in a child with nephrotic syndrome. 1537 24

Nephrotic syndrome occurs rarely after bone marrow transplantation. We describe three patients with myeloid malignancy who developed nephrotic syndrome from 5, 22 and 25 months after allogeneic stem cell transplantation (SCT), confirmed by electron microscopy as membranous glomerulonephritis in two and minimal change glomerulonephritis in one. Proteinuria was initially severe in all and clinically distinct from prior graft-vs.-host disease in two patients. While all responded initially to prednisolone and cyclosporine therapy, two recipients with high-risk leukemia developed late solid organ and bone marrow relapse of their disease, which ultimately proved fatal. The third patient remains alive and disease-free with minimal proteinuria off immunosuppressive therapy. Hence, the onset of de novo high-grade proteinuria after allogeneic SCT should prompt renal histological confirmation, and a trial of immunosuppressive therapy after other causes of nephritic syndrome have been excluded.
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PMID:Nephrotic syndrome after stem cell transplantation. 1565 48

The simultaneous presentation of B-cell chronic lymphocytic leukaemia and nephrotic syndrome is described. The leukaemia responded to cytotoxic therapy but prednisolone was required to achieve remission of the nephrotic syndrome. The nephrotic syndrome relapsed when the leukaemia again became active and the white cell count rose above 20x10(9)/l, and it remitted again with treatment. The relationship between the two diseases is discussed.
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PMID:Nephrotic syndrome associated with chronic lymphocytic leukaemia. 1576 80

Previous studies have demonstrated that the genetic variations of glucocorticoid receptor gene (NR3C1) are associated with both familial steroid resistance and acquired steroid resistance in some diseases, such as Cushing's disease, leukemia, lupus nephritis, and female pseudohermaphroditism. In this study, we examined the genetic variations of NR3C1 in 35 children with sporadic steroid-resistant nephrotic syndrome (SRNS), and in 83 cases with sporadic steroid-sensitive NS (SSNS) using polymerase chain reaction, denaturing high-performance liquid chromatography and DNA sequencing, and analyzed possible associations between NR3C1 variants and steroid resistance in sporadic NS. No causative mutations were found; however, six previously identified and six novel polymorphisms, 1206C > T, 1374A > G, 2382C > T, 2193T > G, IVS7-68_-63delAAAAAA, and IVS8-9C > G, were detected. Two novel haplotypes, [1374A > G; IVS7-68_-63delAAAAAA; IVS8-9C > G; 2382C > T] and [1896C > T; 2166C > T; 2430T > C], of NR3C1 were also identified in sporadic NS and controls. The odds ratios (95% Confidence Interval) for the two novel NR3C1 haplotypes in the sporadic nephrotic children at risk of steroid resistance were 4.970 (0.889-27.788) and 2.194 (0.764-6.306), respectively, but the association between NR3C1 haplotypes and steroid resistance was not significant. Further studies on the possible association between the two novel NR3C1 haplotypes and steroid resistance in sporadic NS in larger cohorts are required.
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PMID:Genetic variations of the NR3C1 gene in children with sporadic nephrotic syndrome. 1689 Feb 4

Glucocorticoids (GCs) are among the most commonly used drugs. They have been employed to treat almost every known disease, from urticaria to leukemia. GCs are so termed because of their action to increase plasma glucose as a result of enhanced hepatic gluconeogenesis, but they play, also, key regulatory roles in a wide variety of physiologic processes. They are essential for survival under stress. GC effect is mediated through receptors localised in cytosol. Receptor-GC complexes bind to hormone response elements in nuclear DNA, affect transcription of genes, either stimulating or inhibiting mRNAs. Proteins so produced (enzymes, hormones) are responsible for the steroid response. There is one type of GC receptor and all GCs will affect all tissues in the same way. At present rational use of GCs falls into two categories: replacement therapy (in Addison's diseasse and in congenital adrenal hyperplasia) and pharmacotherapy, mostly for their anti-inflammatory and immunosuppressive properties, but also to lyse leukemic lymphocytes or to reduce brain edema. GC therapy does not cure the primary disease--it only ameliorates its manifestations and provides time for the body natural defenses to work. After the withdrawal of steroid therapy manifestations of primary process usually return. So, as a result, there is no positive effect on long-term prognosis. Most common indications for prologned high-dose GC therapy are in organ transplantation, tumour chemotherapy, collagen vascular syndromes, ulcerative colitis, nephrotic syndrome and regional enteritis. Asthma, allergic diseases, inflammatory eye diseases and blood dyscrasias are also often treated with GCs. Used in pharmacological doses GCs have a number of adverse side effects. The use of alternate 0 day therapy can decrease most GC side effects (less suppression of hypothalamic-pituitary-adrenal axis, growth inhibition, cushingoid features, infections and myopathy). Discontinuation of long-term therapy is potentially difficult ("steroid withdrawal syndrome"). It is necessary to reduce the total dose gradually, in small weekly decrements. Recent use of GCs in prenatal treatment of congenital adrenal hyperplasia is described.
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PMID:[Glucocorticoids in pediatrics]. 1819 4

Kidney disease frequently complicates malignancy and its treatment. Although many solid and hematologic cancers may involve the renal parenchyma, clinical sequelae are usually not prominent. Published reports cite membranous nephropathy as the most common malignancy-associated glomerulopathy, occurring with many carcinomas and occasionally with leukemia and lymphoma followed by minimal change disease. Rarely membranoproliferative glomerulonephritis (MPGN) has been reported in patients with malignancy. The mechanism by which malignancy induces disease remains unproved, but may involve deposition of tumor antigen in the subepithelial space with in situ immune complex formation and subsequent complement activation. Treatment of the underlying malignancy may lead to resolution of nephrotic syndrome, lending indirect support to this theory. We report a rare autopsy case of a patient with metastatic carcinoma (with unknown primary) associated with MPGN. The association between MPGN and metastatic carcinoma with unknown primary is uncommon and has not been previously reported in the literature.
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PMID:Membranoproliferative glomerulonephritis in a carcinoma with unknown primary: an autopsy study. 1860 90

A 56-year-old man presented with peripheral monocytosis and massive nephrotic syndrome. He was diagnosed as having chronic myelomonocytic leukemia and membranous glomerulonephritis. He received prednisone, chlorambucil and hydroxyurea, but the nephrotic syndrome persisted. Seven months after diagnosis, he was started on cyclosporin A; 1 month later he developed acute renal failure due to radiolucent bilateral renoureteral stones. His kidney function recovered after placing ureteral catheters and urine alkalization. Afterward, he was given mycophenolate mofetil, and proteinuria decreased to subnephrotic levels (1 g/24 hours). This case highlights 2 severe renal complications in this type of leukemia. To the best of our knowledge, there are only 2 previous cases of glomerulonephritis, histologically proven, associated with chronic myelomonocytic leukemia. On the other hand, reversible acute renal failure due to radiolucent bilateral renoureteral stones has never been reported. Also, as far as we know, mycophenolate mofetil was successfully used here for the first time for treating glomerulonephritis-related chronic myelomonocytic leukemia.
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PMID:Severe renal complications in chronic myelomonocytic leukemia. 1865 53

We report a patient with AH amyloidosis associated with lymphoplasmacytic leukemia that has remained in a stable state with a nephrotic syndrome for 17 months since the commencement of cyclic rituximab therapy aimed at suppression of pathogenetic gamma heavy chains. Free light chains in serum and CD20-positive cells in peripheral blood were useful as hematological markers in the patient. Rituximab might be a potent therapeutic option for AH amyloidosis associated with a B-cell lymphoproliferative disorder.
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PMID:Rituximab therapy in nephrotic syndrome due to AH amyloidosis. 1959 Sep 93


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