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)

Four patients with systemic mastocytosis, two men and two women, are presented. Three of them (patients 1, 2, and 4) developed portal hypertension and ascites without histological evidence of cirrhosis in liver biopsy. The remaining patient (patient 3) had severe bone lesions with multiple vertebral fractures. None of the patients had skin or lymph node involvement. Two patients (patients 1 and 2) died 12 and 9 months after diagnosis with acute nonlymphocytic leukemia and overt mastocytic leukemia, respectively, while the other two (patients 3 and 4) are alive 58 and 14 months after diagnosis. Treatment with hydroxyurea or cytosine arabinoside had not any beneficial effect in two patients, while a substantial amelioration of back pain had been obtained by local irradiation and recombinant human interferon-alpha-2b administration in one patient (patient 3). All patients had laboratory findings compatible with autoimmune cholangitis. We concluded that systemic mastocytosis is a rare cause of noncirrhotic portal hypertension often simulating autoimmune cholangitis and leading to the erroneous diagnosis of liver cirrhosis. Diagnosis is based on the presence of mast cells in Giemsa-stained liver histological sections, and it may be confirmed by immunohistochemical detection of tryptase in the cytoplasm of these abnormally proliferating cells.
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PMID:Systemic mastocytosis: a rare cause of noncirrhotic portal hypertension simulating autoimmune cholangitis--report of four cases. 944 86

The frequency and severity of neurologic symptoms in children with systemic cancer is unknown. The authors reviewed the records of children with systemic cancer for whom a neurologic consultation was requested between 1993 and 1996. The 157 patients had 161 malignancies and 205 consultations. Leukemia (59) and lymphoma (34) were the most common malignancies. The 68 solid tumors included neuroblastoma (13), Ewing's sarcoma, and rhabdomyosarcoma (10 each). In contrast to adults, in whom back pain and altered mental status are the most common reasons for neurologic consultation, headache (33) and seizures (29) were the most common symptoms in children. Structural lesions were present in 84% of patients with headache and focal deficit and in 14% of patients with isolated headache. Structural disease was identified in 37% of children with seizures. Neurologic signs were caused by complications of cancer therapy in 70 instances and to direct tumor invasion of the nervous system in 60. In 71 consultations, neurologic symptoms could not be attributed to cancer or its treatment. The spectrum of neurologic symptoms in children with cancer differs from adults and requires the consulting neurologist to have a thorough knowledge of childhood cancer and its effects on the nervous system.
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PMID:Neurologic consultations in children with systemic cancer. 1008 40

Vertebral body collapse and back pain are an unusual presentation for childhood leukemia. This report is intended to promote greater awareness that acute lymphocytic leukemia can cause significant back pain in children without other systemic symptoms. We describe four cases in which patients with acute lymphocytic leukemia presented with back pain and vertebral compression fractures. All of the patients were initially misdiagnosed. No patient had neurologic compromise, despite extensive vertebral body collapse. The back pain was relieved after chemotherapy.
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PMID:Childhood leukemia presenting with back pain and vertebral compression fractures. 1022 99

Acute lymphatic leukemia presenting with bone pain and spine involvement is a recognized clinicopathologic complex that can mimic a wide range of orthopaedic conditions. Bone pain as the presenting complaint is common, with a reported incidence of 27% to 50%. Radiologic abnormalities associated with leukemia in children has been described previously. In the literature, the incidence of spinal involvement is controversial, but there is agreement that the spine is less commonly involved than are the long bones. At the onset of the disease, only 10% of children have normal peripheral blood counts. If the patient has spinal involvement and a normal leukocyte count, the diagnosis is often unclear. Only three of these patients have been described in the literature; this article adds one more patient with acute lymphatic leukemia with back pain as the main symptom, vertebral collapse, and a normal peripheral blood cell count at the time of initial presentation. It illustrates that delay in diagnosis frequently occurs, with the classic features of the disease being uniformly absent.
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PMID:Vertebral collapse and normal peripheral blood cell count at the onset of acute lymphatic leukemia in childhood. 1064 13

A 73-year-old man was admitted because of back pain and paralysis of the lower extremities. Magnetic resonance imaging of the spine at the Th4-6 level, obtained after gadolinium injection, demonstrated abnormal signal intensity within the Th5-6 vertebral bodies and an extradural soft-tissue mass on the right posterior side of the spinal canal, compressing the thecal sac. The patient underwent prompt decompression with laminectomy, but this was unsuccessful. A biopsy sample of the mass revealed the histological features of granulocytic sarcoma, including diffuse infiltration of numerous cells containing cytoplasmic granules and immunohistochemical positivity for myeloperoxidase. Two months later, a subcutaneous soft-tissue mass appeared at the anterior chest wall, and this was confirmed to be granulocytic sarcoma by microscopic examination. Both of these tumors were radiosensitive, but the patient died of septic shock. Granulocytic sarcoma usually occurs in association with leukemia or other myeloproliferative disorders. However, it is rarely found before leukemia becomes evident in the peripheral blood or bone marrow; only eight such instances have been reported previously.
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PMID:[Granulocytic sarcoma presenting as an epidural mass with spinal cord compression]. 1102 Sep 93

We report a case of transverse myelopathy in a 31 year old white man with acute lymphoblastic leukemia, subtype L3 (ALL-L3). This is a severe form of leukemia that affects children more often than adults. Less than 1% of leukemic patients develop neurologic complication in the spinal cord. The symptomatology in the present case started with back pain, flaccid paraplegia, and loss of sensibility and vegetative functions below the lesion. The etiologic diagnostic was obtained through peripheral blood study, bone marrow cytology, cerebrospinal fluid analysis and magnetic resonance image of the dorsal cord. The antileukemic treatment with specific drugs had no influence on the fatal outcome of the disease.
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PMID:[Transverse myelopathy in an adult with acute lymphoblastic leukemia: case report]. 1140 42

In her twenty-fifth week of pregnancy, A.C., a 27-year-old married woman diagnosed with leukemia, complained of shortness of breath and back pain. Her physicians discovered a tumor in her lung and concluded that passive treatment was appropriate because the mother was terminal and the fetus was very unlikely to survive. A D.C. trial court appointed counsel for both the mother, who was heavily sedated and declining quickly, and the fetus. Despite disagreement over whether A.C. would have chosen to have a cesarean section at such an early stage of her pregnancy, the trial court ordered the procedure based on its determination that the fetus was viable. The D.C. Court of Appeals refused to set aside the trial court decision on the grounds that under the 9th and 14th Amendments, the state's interest in the medical profession's integrity and in preservation of life of innocent third parties outweighed an individual's privacy right to be free from bodily invasion.
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PMID:In re A.C. 1164 74

Three children, aged 7-10 years, with acute lymphoblastic leukaemia presented with back pain, along with a mild kyphosis. Collapse of the vertebral bodies at multiple levels was shown on imaging. Chemotherapy resulted in pain resolution and spontaneous remodelling of the vertebrae.
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PMID:Vertebral compression fractures in acute lymphoblastic leukaemia and remodelling after treatment. 1171 37

We retrospectively reviewed 16 patients who presented to hospitals with orthopaedic complaints. Twelve patients experienced initial symptoms in the extremities and four patients had back pain. The leukocyte count was elevated in one patient, decreased in two patients, and normal in 13 patients. On radiographic examination, osteopenia was observed in 10 patients, osteolytic lesions were observed in five, and pathologic fractures were observed in five. Because the initial presentation of patients with leukemia often involves the musculoskeletal system, orthopaedists need to recognize the symptoms of this disease to avoid misdiagnosis and to expedite the initiation of appropriate potentially lifesaving treatment.
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PMID:Musculoskeletal conditions of acute leukemia and malignant lymphoma in children. 1581 84

We report 6 children, aged 4.5- 16 years, with acute lymphoblastic leukaemia with back pain, exacerbated by walking as the first symptom of disease. Collapse of the vertebral bodies at multiple levels was shown on imaging. The presented group had good prognosis. In densitometric examination of BMD (bone mineral density) was observed loss in the thoracic and lumbar vertebrae in 5 out of 6 children. Chemotherapy resulted in decrease of pain and spontaneous remodelling of the vertebrae.
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PMID:[Vertebral compression fractures--the first manifestations of acute lymphoblastic leukemia of childhood]. 1595


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