Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The remarkable history of the 1951 pp 66 year old woman with gastric adenocarcinoma is reviewed. After subtotal gastrectomy she survived for 22 years without any metastases. Presumably the artificially induced high titer IgG, anti-P1 proved to be cytotoxic in two stages: (1) binding of anti-P1 to the terminal fifth sugar, galactose, and (2) the action of cellular immunity in the form of killer T derived lymphocytes containing receptors for IgG molecules. An identical mechanism may be operative in inducing abortions in the pp pregnant woman with a P1 fetus. P1 illegitimate glycolipid (GL) red cell antigen and Forssman (Fs) tissue in adenocarcinoma suggest the self-nonself concept because these are genetically foreign to the host. This concept applies also to numerous "autoimmune" diseases such as RA, lupus, glomerulonephritis, Coombs positive hemolytic anemia and other diseases with immune complexes (ICs) of 20--22 Svedberg units deposited as lesions with tissue damage. In the presence of the GL antigens (ABO, P, Fs), the normal serum contains antibodies for the missing antigen(s). The predicted anti-Fs was present in about 80% of normal employees of ages 18--70. In cancer sera the incidence was 35--40%. On testing normal sera by age in terms of decades anti-Fs was present in 93% in the youngest, and only 55% in the oldest group. This may be associated with the gradual loss of protein synthesis with aging and/or the accumulation of soluble ICs which bind the C1q portion of the C added to the test mixture of heat-inactivated serum (1 : 8) g.p. C (1 : 30) and srbc. In "autoimmune" diseases there is an active immune response to viral or bacterial infections or infestations or drugs which attach to rbc and/or tissue cell membranes. This results in the deposition in selected organs of ICs of 20--22 S units with lesions and tissue damage. For therapy plasma (from young donors) exchange has been recommended to compensate for the loss of IgG antibodies and C.
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PMID:The self-nonself concept as a basis for immune complex to replace "autoimmune diseases". 616 23

Obstetrician-gynecologists reviewed patient records of women delivering during January 1986-December 1992 to determine the maternal mortality rate and trends and the causes of maternal deaths in the maternity ward at the National University of Singapore. There were 26,173 deliveries and 9 maternal deaths (a maternal mortality rate of 22.9/100,000). The causes of maternal deaths were pulmonary embolism (underlying condition, systemic lupus erythematosus [SLE]), hemorrhage from multiple sites (thrombotic thrombocytopenia), acute exacerbation of SLE with interstitial pneumonitis, pulmonary fibrosis (systemic sclerosis), fulminant hepatitis (prior hepatitis and liver disease), and cerebral embolism (rheumatic heart disease with mitral valve replacement). There were also three incidental maternal deaths bringing the maternal mortality rate up to 34.4/1000. The incidental causes of death included septicemia from perforated peptic ulcer (uncontrolled thyrotoxicosis), multiple metastases from lung cancer, and suicide (family dispute over adoption of newborn). A cesarean section preceded 4 (44%) of the 9 maternal deaths. Two of these deaths were incidental maternal deaths. Cesarean section was related to two of the remaining six (33%) deaths. These findings show that traditional direct causes of maternal death (hemorrhage, sepsis, embolism, or hypertension) were not responsible for the maternal deaths at this tertiary facility. Instead, the women tended to have medical conditions that placed them at high risk of death regardless of pregnancy status.
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PMID:Maternal mortality: evolving trends. 781 Nov 98

A qualitative impairment of natural killer (NK) function and the presence of circulating DNA have been independently reported in clinical situations such as cancer and lupus. The existence of receptors for chromatin fragments at the leukocyte membrane raised the question of the relation between the presence of chromatin fragments in the extracellular medium and the impairment of NK function. The present study shows that plasmas from patients with metastatic cancer and with pathological DNA concentrations inhibited significantly the NK activity of normal lymphocytes as compared to cancer plasmas with DNA concentrations in the normal range. In vitro, it was demonstrated that chromatin fragments inhibited the NK-mediated cytotoxicity in a dose-dependent manner. Inhibitory concentrations of nucleosomes (2.5-10 micrograms/ml) were lower than those of DNA and histones alone (100 micrograms/ml). Inhibitory effects of nucleosomes, DNA and histones differed also according to the effector population used: nucleosomes were effective whatever the CD56+ cell enrichment of the effector population, while DNA inhibition needed T cells, and histone inhibition probably resulted from a subtoxic effect, prevented by the presence of adherent cells. Finally we found that nucleosomes could inhibit the NK function only when they were present in the extracellular medium. Taken together, these data suggest that the persistence of nucleosomal DNA at sites of cell death or in the blood might be responsible, at least partly, for the NK activity impairment observed in pathological circumstances characterized by a high rate of cell death phenomena such as cancer.
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PMID:In vitro inhibition of natural-killer-mediated lysis by chromatin fragments. 792 49

Neuroendocrine carcinoma of the skin, Merkel cell carcinoma, is an aggressive malignancy with a high incidence of local recurrence and metastasis. We describe a case of neuroendocrine carcinoma of the skin with unusual metastatic spread to the bone marrow in a 55-year-old man with systemic lupus erythematosus. Following resection of a left temporal subcutaneous nodule and complete left parotidectomy and radical lymph node dissection, the patient presented with pancytopenia. Although focal bony metastatic disease was not identified, his bone marrow was diffusely replaced by metastatic carcinoma. High-dose chemotherapy allowed a brief remission; however, the patient subsequently died with central nervous system metastases.
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PMID:Recurrent neuroendocrine (Merkel cell) carcinoma of the skin presenting as marrow failure in a man with systemic lupus erythematosus. 843 81

Although most patients with thymoma present with a mediastinal mass amenable to surgical resection, some patients develop metastatic disease requiring systemic therapy. The majority of thymomas express somatostatin receptors as demonstrated by octreotide scanning, an observation which has prompted the clinical use of octreotide in patients with this disease. Many patients with thymoma exhibit autoimmune paraneoplastic syndromes, most frequently myesthenia gravis. We report here the case of a patient with metastatic thymoma who developed a profound autoimmune polymyositis and lupus-like syndrome that flared following treatment with octreotide and was associated with a clinical response to this agent. No evidence for myesthenia gravis was discovered. The severity of the myopathy necessitated mechanical ventilation for 12 weeks. The natural history of thymoma, treatment options including recent combination chemotherapy regimens, and potential mechanisms for flaring of autoimmune paraneoplastic syndromes triggered by therapy of thymoma are discussed.
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PMID:Polymyositis with respiratory muscle weakness requiring mechanical ventilation in a patient with metastatic thymoma treated with octreotide. 1050 61

In a young woman with clinical evidence of acute cutaneous, musculoskeletal, and neurologic manifestations of systemic lupus erythematosus, computed tomography (CT) showed enlarged, centrally hypoattenuating mesenteric and retroperitoneal lymph nodes. After treatment with steroids, the CT appearance of the lymph nodes returned to normal. The differential diagnosis of lymph nodes with central hypoattenuation includes Mycobacterium tuberculosis infection, metastatic disease (especially squamous cell carcinoma and germ cell tumor), Whipple's disease, and celiac disease in addition to lupus lymphadenitis.
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PMID:Acute mesenteric and retroperitoneal lymphadenitis in systemic lupus erythematosus: case report. 1144 55

A malignant pheochromocytoma with multiple metastases was diagnosed in a 7-year-old male wolfdog that resulted from a cross between an eastern timber wolf (Canis lupus lycaon) and an Alaskan malamute. A yellowish white neoplastic mass approximately 10 cm diameter was found in the right adrenal gland. The neoplasm penetrated through the wall of the caudal vena cava. A diagnosis of pheochromocytoma was established by histopathologic and immunohistochemical procedures. Immunohistochemically, the neoplastic cells expressed chromogranin A, substance P, synaptophysin, Leu-7, protein gene product 9.5, methionine-enkephalin, S100 protein, and galanin. Multiple metastatic tumors were found in the kidneys, spleen, lungs, heart, and liver.
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PMID:Immunohistochemical evaluation of a malignant phecochromocytoma in a wolfdog. 1146 80

Patients with malignancy often present with a variety of coagulation abnormalities which may ultimately lead to recurrent arterial and venous thromboses. Recently the presence of antiphospholipid antibodies in cancer patients has been proposed as one of the potential mechanisms promoting hypercoagulability. Here we report two consecutive patients with localized tumors, one suffering from breast cancer and another presenting with colorectal cancer, who experienced dramatic exacerbation of the antiphospholipid antibody syndrome (APAS) within 4 weeks after surgery. In the first patient who had also received one course of adjuvant chemotherapy, major ischemic stroke and recurrent venous thromboembolism were paralleled by the development of ulcerative livedoid vasculitis and pancytopenia, constituting the diagnosis of systemic lupus erythematosus with secondary APAS. In the second patient, progressive thrombotic occlusion of the superior and inferior vena cava was associated with bilateral pulmonary embolism, acute renal failure, and disabling soft tissue edema. Although not fulfilling the classic criteria of "catastrophic" APAS, the clinical features were life threatening and appeared to be refractory to oral anticoagulation with phenprocoumon. In addition, a diagnosis of Trousseau's syndrome was unlikely due to missing evidence of gross metastatic disease. Besides a suggested treatment strategy comprising high doses of low-molecular-weight heparin, potential pathogenic mechanisms are discussed in consideration of a recently proposed "thrombotic storm," which may cause multiple thromboses after an initial provocation in patients with known hypercoagulability.
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PMID:Exacerbation of antiphospholipid antibody syndrome after treatment of localized cancer: a report of two cases. 1248 70

Intravenous immunoglobulin (IVIG) is an accepted treatment for certain immunodeficiency states, but also for some autoimmune diseases. In other autoimmune conditions (i.e., systemic lupus erythematosus), it is still empirical although very efficacious. Based mainly on animal studies, IVIG has been shown to exert different antitumour mechanisms that result in metastases suppression. This effective therapy is associated with frequent occurrence of either immediate, delayed or late adverse effects, most of which are mild and transient. Efforts are taken in order to minimise these adverse effects both by pharmaceutical companies that attempt to decrease the risk of infectious agents transmission, and by physicians who monitor closely patients and choose the appropriate mode of administration of IVIG with respect to dose, duration of treatment and preparations used. Overall, IVIG is used in severe medical conditions and it is quite safe. Future research would help to further minimise its associated risks.
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PMID:IVIG in autoimmunity and cancer--efficacy versus safety. 1290 49

Primary Pulmonary Artery Sarcoma is a rare entity, which shares some clinical features with Thromboembolic Pulmonary Disease (TEPD), complicating differential diagnosis. The authors report a Clinical Case of a Primary Pulmonary Artery Sarcoma in a 59 years old man, admitted with a history of dyspnoea on exertion, chest pain and general symptoms. Chest X-ray, Computed Tomography Scan, Angiographies and Magnetic Resonance Imaging suggested TEPD. Blood Analysis performed before anticoagulation therapy: Lupus Anticoagulant-and Ig M Anticardiolipin +. Our presumptive initial diagnosis was TEPD in a patient with a hypercoagulable state. Intravenous heparin was started, with some clinical improvement but 2 months later he was readmitted, due to clinical and radiological deterioration. Pulmonary Thromboendarterectomy was considered but a right pneumonectomy was necessary because of bleeding. He died of ARDS in a single lung in the 7th day after surgery. Pathology revealed pulmonary artery sarcoma with pulmonary and pleural metastases.
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PMID:[Pulmonary Artery Sarcoma - diagnostic and treatment difficulties]. 1295 67


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