Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0023467 (acute myeloid leukemia)
 35,200 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 20-year-old male developed both coccygeal and leg pain and followed by rectocystic disturbance. Disc herniation between L5 and S was suspected and laminectomy was performed. At surgery, an easily curretable tumor occupied the epidural space from L5 to the end of the sacrum. In part, the tumor spread out of the vertebral canal and invaded the surrounding muscle tissue. This muscle tissue and part of the lamina were checked histologically. Initial blood analysis revealed 5% blast-like cells, but failed to confirm them as leukemic cells. Histologically, the tumor cells had round or oval nuclei with large nucleoli and scanty cytoplasm without granulocytic differentiation. Malignant lymphoma or Ewing's sarcoma was initially suspected, but the definite diagnosis was uncertain. Immunohistochemical staining with the PAP method and enzyme histochemistry revealed that the tumor cells were positive for lysozyme and naphthol ASD chloracetate esterase. Thus, granulocytic sarcoma was finally diagnosed. Electron microscopic findings supported this diagnosis. Subsequent karyotyping of bone marrow cells revealed 8; 21 translocation, thus the final diagnosis of this patient was myelodysplastic syndrome, refractory anemia with excess blast cells in transformation or acute myelogenous leukemia, M2, by the FAB classification.
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PMID:A case of epidural granulocytic sarcoma preceding acute leukemia. 209 94

A 30-year-old man with acute myeloid leukemia who was pancytopenic after undergoing intensive chemotherapy developed pyrexia and severe pain of both lower legs. We immediately started empiric therapy with cefepime, vancomycin, and fluconazole for febrile neutropenia. However, symptoms progressed. After 4 days, Trichosporon was isolated from venous blood cultures. MRI showed hyperintense lesions within both gastrocnemius muscles and demonstrated reactive vasodilatation and interstitial tissue edema, thought to be induced by hyperpermeability of vessel membranes due to the local fungal infection. Amphotericin B was very effective against this organism. Trichosporosis is a rare infectious disease generally occurring in immunocompromized hosts. To the best of our knowledge, this is first reported case of bilateral Trichosporon infection of lower leg muscles. Severe leg pain was one of the most important signs of fungal infection in this patient with hematologic malignancy.
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PMID:The usefulness of magnetic resonance imaging (MRI) for disseminated trichosporosis of the gastrocnemius muscles. 1643 3

We report on the case of a 66-year-old patient who was hospitalized because of intractable low back pain radiating into the right leg. Leg pain was accompanied by a numbness and muscle weakness which was clearly assigned to the L5 dermatome. Concerning the patient's medical history a nucleotomy L4/5 and a osteomyelofibrosis were known. MRI of the lumbar spine revealed a multisegmental stenosis which was pronounced on the level L4/5. One day after admission of the patient to the hospital a typical zoster exanthema involving the L5 dermatome appeared. Varicella-zoster virus (VZV) was detected in the fluid of the vesicular skin lesions by polymerase chain reaction. Intravenous administration of aciclovir lead to rapid decrease of pain and exanthema. A few months later the patient died because of an acute myeloid leukemia as a complication of the known osteomyelofibrosis. This case report shows that a herpes zoster infection can imitate a radicular spine syndrome usually caused by degenerative changes. Especially in immunocompromised patients, a zoster radiculitis should be included in the differential diagnosis of radiculopathy. VZV infection might also occur without skin lesions (zoster sine herpete) so that serological assays for the early detection of virus DNA can be useful.
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PMID:[Rare differential diagnosis of a radicular spine syndrome: herpes zoster radiculitis]. 1718 32

A 46-year-old woman was urgently admitted to our hospital due to acute renal failure, liver dysfunction, disseminated intravascular coagulation, shock status, and impaired consciousness. About 1 day prior to admission, she developed a high-grade fever, bilateral lower leg pain, and multiple small papules. She was diagnosed with streptococcal toxic shock syndrome (STSS) caused by Streptococcus dysgalactiae subsp. equisimilis (SDSE) associated with acute myeloid leukemia. The emm gene type of the isolated SDSE was shown to be stG2078. Her invasive streptococcal infection resolved with immediate administration of meropenem and continuous hemodiafiltration. However, she died of septic shock caused by multidrug-resistant Pseudomonas aeruginosa one month after admission. Recently, epidemiological studies have shown increasing numbers of invasive SDSE infections, including STSS and necrotizing fasciitis, often among immunocompromised patients. This suggests that hematologists as well as primary care doctors need to be aware of the possibility of the invasive infections caused by SDSE. An influenza-like illness consisting of a fever, lower extremity pain, and diarrhea are common initial symptoms in STSS patients. Awareness of these prodromal symptoms could lead to the early diagnosis of the illness and prompt initiation of antibiotic treatment.
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PMID:[Streptococcal toxic shock-like syndrome caused by Streptococcus dysgalactiae subsp. equisimilis in a patient with acute myeloid leukemia at diagnosis]. 2347 Aug 31

We report the case of a 3-year-old girl diagnosed with acute megakaryoblastic leukemia, who presented after >1 year of bilateral leg pain. At times the pain was severe enough to prevent ambulation, prompting visits to her primary care provider. However, it was not until acute respiratory failure occurred with subsequent hospitalization in the pediatric intensive care unit that severe anemia and thrombocytopenia were discovered and the diagnosis of acute myeloid leukemia was made. Bilateral lower extremity swelling was noted on admission and radiographs showed diffusely abnormal appearance of the long bones of her lower extremities with periosteal reaction and echogenic debris in the subperiosteal space, thought to represent leukemic cells. This case highlights the importance of recognizing atypical signs and symptoms of myelodysplastic syndrome progressing to acute leukemia in the context of abnormal bone pain and radiographic changes.
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PMID:Acute Megakaryoblastic Leukemia With Diffuse Periosteal Reaction of Bilateral Lower Extremities. 3030 70