Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027947 (neutropenia)
 17,527 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Following extensive bowel resection, a young woman experienced severe malnutrition; subsequent administration of parenteral nutrition precipitated the copper deficiency syndrome. This consisted of hypocupremia, subnormal ceruloplasmin levels, anemia, and severe neutropenia. The bone marrow was megaloblastic, vacuolated, and sideroblastic; granulocytic maturation was not observed beyond the myelocyte stage. Copper sulfate therapy was followed by a marked reticulocytosis, increase in hematocrit, and recovery of neutrophils. Additional studies indicated that both serum and urinary erythropoietin values were low; serum activity increased after copper supplementation. Abnormal granulopoiesis was demonstrated using the in vitro granulocyte colony assay. The patient's granulcoytic stem cells were normal on two occasions; however, mixing studies showed that culture of the patient's copper-deficient marrow with her copper-deficient serum yielded significantly reduced numbers of granulocyte colonies. Thus, copper appears to be a necessary element for normal hematopoiesis; lack of this trace element may result in ineffective erythropoiesis and granulopoiesis.
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PMID:Observations on the anemia and neutropenia of human copper deficiency. 30 69

Thirty-four infants (25 Inuit and 9 Caucasians) with protein-energy malnutrition and intractable diarrhea were treated with total parenteral nutrition (TNP) consisting of a casein hydrolysate, a soybean emulsion and dextrose. Initially peripheral veins were used in all the infants, and 22 were treated successfully without resort to a central venous catheter. The mean duration of treatment by the peripheral route was 29 days. Although mean energy intake and protein intake were high, weight gain was poor and growth continued at the prehospitalization percentiles. There were two deaths, both from complications of the use of central lines. Specific diagnoses were established for 7 of the 9 Caucasian infants but only 2 of the 25 Inuit infants. Concentrations of serum glutamic oxaloacetic transaminase (SGOT) were elevated in 80% of the patients at the time of admission, increased further in 82% when TPN was begun, but decreased towards normal before discharge in all patients. Eosinophilia was common during TPN. Liver biopsy in seven patients with elevated SGOT values showed eosinophilia, increased pigment in the Kupffer cells and slight lymphocytosis in the portal tract. Intercurrent infections occurred frequently and were often preceded by a short period of lipid intolerance or neutropenia, or both. Tolerance to lipids returned after the infections resolved. Thus, peripheral TPN is a safe and relatively simple method of providing adequate nutrition during episodes of diarrhea in malnourished infants.
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PMID:Total parenteral nutrition in malnourished infants with intractable diarrhea. 40 99

Myelopoiesis was assessed in 41 untreated patients with widespread cancer without evidence of infection. None of these patients had neutropenia, although leukopenia due to decreased concentrations of blood lymphocytes was observed in two. Sixteen patients (39%) had neutrophilia and 12 patients (29%), 5 of them with neutrophilia, had decreased marrow granulocyte reserve. Neither the blood neutrophil counts nor the marrow granulocyte reserve correlated significantly with the marrow myeloid mitotic indices, myeloid to erythroid ratio or the number of marrow colony-forming cells. There was no difference in the duration of the disease, the extent of systemic metastasis and the degree of malnutrition between patients with or without myelopoietic abnormalities. Our findings suggest that decreased marrow granulocyte reserve and neutrophilia are common in untreated patients with disseminated carcinoma.
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PMID:Myelopoietic abnormalities in patients with metastatic carcinoma. 63 62

Three patients are described with anorexia nervosa in whom malnutrition was present with neutropenia and a granulocyte bactericidal degect. Their peripheral blood granulocytes were found to have a reduced rate of killing of Staphylococcus aureus and E. coli in vitro. The opsonic activity of the patients' sera towards Staphylococcus aureus was normal. One of these patients had recurrent episodes of infection which stopped after she had gained 13 kg in weight. Clinical recovery was associated with a return of granulocyte function to normal. It is concluded that granulocyte bactericidal capacity towards a variety of bacteria may be reduced in patients with anorexia nervosa who have malnutrition. This type of acquired granulocyte bactericidal deficiency appears to be reversible.
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PMID:Reversible granulocyte killing defect in anorexia nervosa. 110 64

Mucormycosis refers to the disease caused by a growing number of members of the Mucorales. Typically an airborne infection, primary disease is initiated in the upper or lower airways and is associated with the clinical development of sinusitis, rhinocerebral mucormycosis, or pulmonary infection. Dissemination of infection to skin, brain, and other sites is less common, but direct extension of the infection to contiguous sites is common if patients do not receive aggressive surgical and medical therapy. Risk factors for the development of mucormycosis include diabetic ketoacidosis; neutropenia; protein-calorie malnutrition; and iron overload, with or without the concomitant use of deferoxamine. This last association has only recently been recognized and has emerged as a major life-threatening complication for patients who are undergoing hemodialysis. Intravenous drug abusers may inject spores of Mucorales with their drugs and may present with space-occupying lesions of the CNS. The underlying immunologic defects that are responsible for predisposing different populations of patients to the development of mucormycosis are not well understood, and there is no unifying theory to explain why most individuals have innate immunity to this group of fungi. Patients with mucormycosis who are managed aggressively (i.e., those who undergo surgical debridement and who receive therapy with iv amphotericin B) may have increased rates of survival. The role of new azole derivatives in the treatment of mucormycosis is unknown.
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PMID:Mucormycosis. 156 84

Malnutrition alone may provoke considerable immune alterations, mainly in the immunocellular function, and in particular in the T lymphocyte and macrophage-monocytic function. This gives rise to an increase in proneness to infections, which in patients subjected to bone marrow transplants, will be increased by the intense neutropenia suffered by them. This study shows the greater incidence of infection among badly nourished patients compared to nourished patients. It was also observed that short bouts of high temperature mainly occurred in a subgroup of patients with an acceptable nutritional level, which in our opinion was the cause for none of them developing the infectious illness. Finally, one of the germs most often found in these patients is Staphylococcus epidermis, and the most common method of entry is through the catheters used in the administration of medicines and artificial nutrition. Emphasis is placed on the role played by nursing in preventing this type of infection.
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PMID:[The effect of nutrition on bone marrow transplantation]. 176 Apr 83

Pulmonary infection due to opportunistic organisms and usually nonpathogenic mycobacteria may occur whenever immune defenses are weakened by external factors. These factors include neutropenia, treatment with corticosteroids or cytotoxic agents, previous antibiotic therapy, and nosocomial hazards (eg, catheters, ventilators). Nutritional deprivation is also often implicated as an important coexistent variable. An infection due to Mycobacterium xenopi (usually a nonpathogenic mycobacterium) in a patient with anorexia nervosa and no other predisposing factor for infection provides a model for discussing the possible effects of malnutrition on pulmonary immunocompetence. Since pulmonary infection in anorexia nervosa is often subtle, early evaluation of depressed cell-mediated immunity is appropriate.
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PMID:Effect of anorexia nervosa on pulmonary immunocompetence. 192 16

With the increased number of immunocompromised patients there has been a concomitant increase in patient morbidity and mortality due to fungi. The etiologic microorganisms vary depending upon the type of immune dysfunction. Patients with malignancies and chemotherapy-induced neutropenia commonly are infected with Candida and Aspergillus. Other ubiquitous fungi such as Rhizopus, Fusarium, and Trichosporon are more frequently implicated as agents of disease in these patients. Patients with cell-mediated immune dysfunction such as acquired immune deficiency syndrome (AIDS) are susceptible to mucocutaneous candidiasis and pulmonary and disseminated cryptococcosis. Histoplasmosis and coccidioidomycosis have been particularly lethal infections in AIDS patients. Contributing factors such as broad-spectrum antibiotic use, intravenous catheterization, malnutrition, hyperalimentation, multiple surgical procedures and/or trauma, and steroids used either singly or in combination may also predispose patients to invasive fungal disease. Definitive diagnosis is often difficult to establish and usually requires invasive biopsy. Delay of culture results due to the time required to process specimens and to allow the fungus to grow also contributes to the poor results of therapy. Biopsy of skin lesions represents a useful technique for making a diagnosis. Recent advances in antifungal therapeutics promise to change the current approach to treatment for several of the mycoses. The availability of new oral azoles with spectra of activity that include aspergillosis and cryptococcosis, which currently require treatment with parenteral amphotericin B, may prove practical for prolonged oral therapy of otherwise lethal mycoses.
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PMID:Fungal infections in the immunocompromised host. 268 23

A patient is described who developed pancytopenia several months after home intravenous nutrition (IVN) was started following a major small bowel resection for volvulus. In the post-operative period his weight fell by about 15 kg to 45 kg. Bone marrow aspiration and leucokinetic studies were carried out which suggested that bone marrow failure was the cause of this patient's haematological abnormalities. Five of the 16 patients at St Mark's Hospital who are receiving home IVN were noted to have had transient neutropenia. In 3 of these patients significant weight loss was also noted in the few months preceding the development of neutropenia. It is suggested that there is an association between relative energy malnutrition and the development of the haematological abnormalities that have been observed. In the patient described here these abnormalities were prolonged.
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PMID:Pancytopenia in a patient receiving home intravenous nutrition. 314 61

The clinical and microbiologic characteristics of 29 episodes of sepsis caused by Acinetobacter calcoaceticus were reviewed in 25 children with underlying malignancies. Of the 29 episodes of sepsis with this organism 28 occurred from 1980 through 1984, compared with 1 episode from 1973 to 1979. Risk of infection was associated with the presence of intravascular cannulae, osteosarcoma and recent administration of antitumor chemotherapy. There was no association with neutropenia, malnutrition or focal infection. Of 28 organisms for which the biotypes were known, 14 (50%) were var. lwoffi and 14 (50%) were var. anitratus; 11 episodes (38%) were part of a polymicrobial bacteremia. All patients responded favorably to antimicrobial therapy.
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PMID:Acinetobacter calcoaceticus sepsis in children with malignancies. 346 39


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