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)

Colitis due to salmonellae was diagnosed in 9 horses following hospitalization for various reasons at the University of Missouri Veterinary Teaching Hospital, from May, 1971, to April, 1972. Diarrhea, fever, and either a neutrophil count of less than or equal to 3,600/cmm or a rapid decline in neutrophil numbers were specific for salmonellosis. The value of hematologic survelillance in hospitalized Equidae was demonstrated in another group of 9 horses with neutropenia, each of which was promptly treated and did not develop colitis. Bacteriologic culturing of fecal samples from 28 clinically normal horses yielded only 2 salmonella isolations, S manhattan in each case. The serotyped salmonellae isolated from the patients with colitis were all S typhimurium, with similar antibiotic resistance patterns.
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PMID:Neutropenia and salmonellosis in hospitalized horses. 108 99

Of 6,099 children treated for malignancy, 16 (ages 3.5 to 18 years) developed acute appendicitis between 1962 and 1989. Fourteen had leukemia (ALL 10, AML 4). One each had rhabdomyosarcoma and Ewing's sarcoma. Active malignancy at diagnosis was noted in 10, 4 of whom had severe neutropenia (absolute neutrophil count less than 500/mm3). Of all the leukemics (2,794/6,099), abdominal pain during induction was a frequent complaint. The incidence of appendicitis, however, was low (0.5%). Nine of the 16 patients presented classically, facilitating prompt diagnosis and treatment. Six diagnoses were delayed. Three of these patients presented atypically with vague, nonlocalized pain, abdominal distention, lack of abdominal guarding, fever, dehydration, diarrhea, and unusual symptoms such as upper gastrointestinal bleeding. In each of these 6 patients the appendix was ruptured. Delays led to complications and deaths. Three patients required perioperative transfusions to treat excessive bleeding and two patients with ruptured appendicitis developed wound abscesses. Two patients died; in one, ruptured appendix was diagnosed only at autopsy. The other patient died of uncontrolled sepsis. Typhlitis occurring during induction chemotherapy may present similarly and is the main differential diagnosis. Typhlitis will usually improve with medical treatment alone. Nausea and vomiting (13/16), right lower quadrant pain (13/16), guarding (14/16), tachycardia (12/16), fever (10/16), and rebound tenderness (10/16) were the most frequent signs and symptoms of appendicitis. Persistent localized abdominal pain and guarding, lack of improvement with medical treatment, clinical deterioration, and the development of a mass were our indications for laparotomy. Despite major improvements in therapy, there is still a 37.5% error rate in our ability to accurately diagnose appendicitis in pediatric cancer patients.
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PMID:Acute appendicitis in children with leukemia and other malignancies: still a diagnostic dilemma. 152 62

Typhlitis is a neutropenic enterocolitis of varying severity. Its incidence is increasing, particularly in patients with acute myelogenous leukemia undergoing high dose cytosine arabinoside chemotherapy. The onset is heralded by prodromal fever, watery or bloody diarrhea, abdominal distension, and nausea during the phase of severe neutropenia. The symptoms may then localize to the right lower quadrant with an associated increase in systemic toxicity. The diagnosis can be confirmed in these and other less specific cases by serial reexamination and abdominal radiographs, ultrasonography, computerized tomograms, or radionucleotide scans. The mainstay of management is complete bowel rest with nasogastric suction and total parenteral nutrition. Broad-spectrum combination antibiotics are essential, as is the avoidance of laxatives or antidiarrheal agents. Granulocyte support may be helpful. Patients with a history of nonspecific gastrointestinal complaints or of true typhlitis, successfully managed nonoperatively, should have prophylactic bowel rest and total parenteral nutrition instituted at the beginning of further chemotherapy. Patients with ongoing severe systemic sepsis who do not respond to chemotherapy and those with overt perforation, obstruction, massive hemorrhage, or abscess formation require surgical intervention. All necrotic material must be resected, usually by a right hemicolectomy, ileostomy, and mucous fistula. Divided ileostomy for less severe cases may be useful. Failure to remove the necrotic focus in these severely immunocompromised patients is fatal. With adequate recognition of typhlitis and its precipitating factors, the incidence of complications can be reduced through prevention and timely surgical intervention. Although typhlitis developed in a quarter of our acute myeloblastic leukemia patients, use of this combined approach was successful in all cases.
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PMID:Typhlitis: selective surgical management. 345 80

Colitis is a life-threatening complication of aplastic anemia which occurs during periods of profound neutropenia. Four cases of this previously unreported association are described here. A syndrome of fever, watery diarrhea, and generalized abdominal pain and tenderness occurred in close temporal relationship to development of severe neutropenia (less than 50 neutrophils per cu mm). None of the patients had received antibiotics, nor had a history of previous episodes of colitis. Three had cultures positive for colonic organisms during the episodes. In only one instance was the correct diagnosis made without operation. Gross evidence of disease was found in the cecum, the transverse colon, and rectosigmoid in three patients, but the true extent of disease was underestimated. Microscopic examination of the two resected specimens showed extensive mucosal and variable submucosal necrosis with invasion of the colonic wall by bacteria. Acute inflammatory changes were absent. With profound neutropenia, the colon wall lacks resistance to invasion by the resident microflora. The condition is probably best treated without operation. If first recognized at laparotomy, resection should be avoided.
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PMID:Neutropenic colitis and aplastic anemia: a new association. 684 59

Typhlitis is a necrotizing inflammation of the cecum usually found in acute leukemia patients on chemotherapy in the setting of agranulocytosis. We describe five cases of typhlitis, characterized by fever, abdominal pain, abdominal tenderness and watery diarrhea, occurring during periods of neutropenia. In 4 cases, sonography showed thickening of the cecum wall. Ultrasound appears to offer an easy noninvasive method of diagnosing this potential lethal disease. Four patients were treated successfully with broad-spectrum antibiotics and bowel rest. There was 1 death resulting from septic complication.
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PMID:Typhlitis in acute childhood leukemia. 875 77

We report a case where life threatening gram negative sepsis developed in a patient with CLL in association with post chemotherapy neutropenia on three occasions. Bacterial typhlitis or neutropenic enterocolitis, which is a well described entity of bowel necrosis seen in immunosuppressed patients, was demonstrated at colonoscopy and was the probable portal of entry of micro-organisms. After spontaneous resolution of the typhlitis, further chemotherapy has been given without recurrent sepsis. Typhlitis should be considered as a cause of recurrent septicaemia in neutropenic patients.
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PMID:Recurrent septicaemia in a neutropenic patient with typhlitis. 893 93

Protein kinase C (PKC) plays an important role in the cell signal transduction of many physiological processes. In contrast to these physiological responses, increases in PKC activity have also been associated with inflammatory disease states, including ulcerative colitis. The objective of this study was to examine the role of PKC as a causative mediator in initiation of experimentally induced colitis in the rat. Colitis was induced in rats by intrarectal (0.6 ml) instillation of 2,4,6-trinitrobenzenesulfonic acid (TNBS; 75 mg/kg in 50% ethanol) or the PKC activator phorbol 12-myristate 13-acetate (PMA; 1.5-3.0 mg/kg in 20% ethanol). Gross and histological mucosal damage, mucosal neutrophil infiltration, mucosal PKC activity, and PKC protein content for PKC isoforms alpha, beta, delta, and epsilon were assessed 2 h to 14 days after an inflammatory challenge. Both PKC activity and mucosal injury increased significantly within 4 h of TNBS treatment. PKC activity was maximal at 7 days and declined at 14 days, whereas mucosal damage became maximal at 1 day and declined after 7 days. In contrast, neutrophil infiltration as assessed by myeloperoxidase activity only increased 12 h after TNBS treatment, became maximal 1 day after TNBS administration, and declined thereafter. PKCbeta, -delta, and -epsilon were increased in response to TNBS, whereas PKCalpha protein content was decreased. The PKC antagonists staurosporine and GF-109203X (25 ng/kg iv) reduced TNBS-induced changes in mucosal PKC activity and the degree of mucosal damage. In contrast, neutropenia induced by antineutrophil serum treatment did not significantly affect the degree of injury or mucosal PKC activity. Furthermore, activation of mucosal PKC activity with PMA also induced mucosal damage, which was also inhibited by pretreatment with a PKC antagonist. In conclusion, these results suggest that increases in PKC activity play a causative role in TNBS-induced colitis. The PKC-mediated response to TNBS does not appear to involve neutrophil infiltration.
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PMID:Protein kinase C mediates experimental colitis in the rat. 1007 33

Three cases of typhlitis occurring during autologous blood stem cell transplantation (ABSCT) for metastatic breast cancer are described. Typhlitis is a rare complication of neutropenia and has uncommonly been reported in the autologous transplant setting. Although it has been most commonly described in children with leukemia, typhlitis has increasingly been reported in adult leukemias and in association with neutropenia secondary to chemotherapy for a number of solid tumors. Only five previous cases of typhlitis in the setting of ABSCT have been described. Whereas diarrhea and fever are common toxicities associated with high-dose chemotherapy, it is likely that many cases of typhlitis go unrecognized. Bone Marrow Transplantation (2000) 25, 321-326.
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PMID:Typhlitis complicating autologous blood stem cell transplantation for breast cancer. 1067 6

We describe a case of typhlitis with onset before diagnosis of acute myelogenous leukemia or initiation of chemotherapy. Typhlitis is usually seen as a complication of chemotherapy for hematologic malignancies. It is being reported with increasing frequency in association with other disease states that produce profound neutropenia.
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PMID:Typhlitis as a presenting manifestation of acute myelogenous leukemia. 1070 93

Neutropenic enterocolitis, or typhlitis, is an unusual acute complication of chemotherapy-induced neutropenia, characterized by inflammatory process involving colon and/or small bowel that may progress to necrosis, haemorrhage, perforation and septicaemia. Typhlitis is usually seen in the setting of severe chemotherapy-induced neutropenia for acute leukaemia. Nevertheless, it is increasingly recognized as a complication of therapy in solid tumors. We present a case of typhlitis in a patient with advanced non-small cell lung cancer (NSCLC) who received pemetrexed, as second-line chemotherapy treatment.
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PMID:Typhlitis during second-line chemotherapy with pemetrexed in non-small cell lung cancer (NSCLC): A case report. 1934 26


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