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Query: UMLS:C0030305 (pancreatitis)
 16,014 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Thalidomide has one of the most notorious drug histories because of its teratogenicity. Its widespread use in the 1960s led to a worldwide epidemic of phocomelia in inborns; this in turn led to its complete ban in most of the world. However, it has now been licensed for selected indications including graft-versus-host-disease (GVHD) after bone marrow transplantation, wasting associated with tuberculosis and human immunodeficiency virus infection, and leprosy. Little is known, however, about its use in children in these settings. Therefore, we report our experience and review the literature on thalidomide in children for GVHD after bone marrow transplantation. We studied 6 patients, 2 with chronic GVHD, 2 with acute GVHD, and 2 with acute GVHD progressing into chronic disease. One patient with chronic GVHD had a complete response, whereas the other had a partial response. Side effects consisted primarily of sedation and constipation, which are reported previously and well known side effects. None had neuropathy. One patient had rash, eosinophilia, and early pancreatitis that began shortly after initiation of thalidomide, persisted, and resolved only after discontinuation of thalidomide. Eosinophilia and pancreatitis are both previously unreported side effects or associated findings of thalidomide treatment. Review of the literature reveals three major studies of thalidomide in GVHD; of these two included children and adults together, and one in which age range of patients was not mentioned. In addition, four series of children receiving only thalidomide are reported. These series contained 1 to 14 patients each. Results show efficacy in at least 50% of children with chronic GVHD and little or no efficacy in children with exclusively acute GVHD. Side effects are similar to those reported in adults and consisted mostly of sedation and constipation, both of which subsided over time and resolved after discontinuing the drug. We speculate on the reasons for which thalidomide is more effective in chronic, compared with acute, GVHD in children, and make recommendations for future study.
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PMID:Thalidomide in children undergoing bone marrow transplantation: series at a single institution and review of the literature. 1010 36

A 34-year-old man from Nigeria who had resided permanently in the Netherlands for five years had experienced fever, upper abdominal pain and weight loss for several months. He did not give the impression of being ill. A CT scan gave cause to suspect pancreatitis. An HIV test gave a positive result. Puncture of the accumulated fluid around the pancreas led to the diagnosis 'tuberculosis' (infection by Mycobacterium tuberculosis). Once the patient had made a good recovery with antituberculosis therapy, antiretroviral therapy was initiated, whereupon the number of CD4+ cells in the blood increased. Extrapulmonal tuberculosis is not unusual in HIV seropositive patients from countries with a high prevalence of tuberculosis. However, in such patients isolated tuberculosis of the pancreas is unusual and has not previously been described in the Netherlands. The diagnosis can be established following a CT guided puncture; tuberculosis is instantly suspected if the Ziehl-Neelsen stains are positive and the diagnosis can then be confirmed by a polymerase chain reaction (PCR) analysis and by culturing. Anti-retroviral therapy is withheld until response to anti-tuberculosis treatment is satisfactory.
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PMID:[Tuberculosis of the pancreas in a HIV-seropositive patient]. 1143 66

Tuberculosis, in its extrapulmonary form, though emerging as a common clinical problem, rarely affects the pancreas. Its indolent course, vague symptomatology along with its non-specific laboratory and radiographic findings call for greater vigilance. We report a case of pancreatic tuberculosis, previously managed as recurrent alcohol related pancreatitis which showed symptomatic improvement following commencement of antituberculosis drugs. The diagnosis of pancreatic tuberculosis in this case was based on the abdominal CT scan findings, response to anti-tubeculous chemotherapy and overall laboratory and radiological work-up.
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PMID:Pancreatic tuberculosis presenting with recurrent acute pancreatitis. 1150 5

Tuberculosis of the pancreas is a clinical entity rarely described in the literature. The pancreas is biologically protected from infection by Mycobacterium tuberculosis, probably because of the presence of pancreatic enzymes that interfere with the seeding of M. tuberculosis. However, when pathogens are able to overcome the resistance, they can have diverse presentations, such as pancreatic masses that can mimic carcinoma, obstructive jaundice, pancreatitis, and gastrointestinal bleeding. Herein we describe 2 cases of pancreatic tuberculosis that presented as multicystic masses, and we review the literature to describe the diverse clinical manifestations of this condition.
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PMID:Tuberculosis of the pancreas: report of two cases and review of the literature. 1181 44

This paper discusses the introduction of antiretroviral (ARV) therapy to HIV-infected patients. ARV therapy is treatment with drugs that fight the HIV virus and keep the HIV-infected patient healthy. Treatment may involve only one ARV (monotherapy) or a combination of two or more ARVs (combination therapy). The increasing availability of ARVs in many countries has caused dangerous side effects to develop quickly in patients due to the improper use of drug combinations. Some life-threatening side effects of ARV misuse include vomiting, diarrhea, fever, diabetes, and pancreatitis. People who experience these symptoms need to change their drug combination; a drug must be taken with strict instructions to prevent unpleasant side effects and its reaction with other drugs (protease inhibitors, for example, react with the tuberculosis drug rifampicin). An ARV should also be closely monitored to ensure its continuous effectiveness using CD4 and viral load counts at least every 3-6 months. A change in drug combination is required when CD4 count is dropping or the viral load is not reduced or maintained.
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PMID:Introducing antiretroviral therapy. 1234 94

Tuberculosis infrequently involves pancreas. The clinical features in patients with pancreatic tuberculosis are usually non-specific. The radiological features mimic pancreatic malignancy or pancreatitis. Ultrasound or CT scan guided fine needle aspiration cytology or biopsy may show caseating granulomatous inflammation. The present report includes two cases of pancreatic tuberculosis and review of relevant literature. One of our patients was diagnosed at laparotomy and the other with a CT scan guided fine needle aspiration cytology. Both patients responded well to anti tubercular chemotherapy and are now asymptomatic.
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PMID:Pancreatic tuberculosis. 1269 59

Tuberculosis, specially disseminated tuberculosis, involves the liver frequently. Focal hepatic tuberculosis with local hemorrhage has been reported. We report on a twenty-one year female with disseminated tuberculosis presenting with initially non-localisable massive upper gastrointestinal bleeding, subsequently found to have pancreatitis, right sided pleural effusion and hemobilia which was treated successfully.
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PMID:Disseminated tuberculosis presenting as hemobilia, successfully treated by arterial embolization. 1272 78

Drug-induced acute pancreatitis should be in the differential diagnosis of acute abdomen occurring soon after initiation of tuberculosis treatment and chemoprophylaxis. Isoniazid-induced pancreatitis is potentially reversible; early recognition and drug withdrawal are warranted in the appropriate clinical setting. We present a case of reversible acute pancreatitis after isoniazid treatment of genitourinary tuberculosis, followed by recurrence of pancreatitis 12 years later when the patient received isoniazid again for pulmonary tuberculosis. Isoniazid-induced pancreatitis, if highly suspicious or confirmed with re-challenge test, mandates permanent avoidance of the drug.
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PMID:Recurrent acute pancreatitis after isoniazid. 1536 3

Gastric tuberculosis (TB) is very rare compared with other sites in the gastrointestinal (GI) tract, and upper GI bleeding is an extremely rare manifestation of gastric TB. Also, a pseudoaneurysm is an uncommon cause of GI bleeding and is often encountered with pancreatitis. To our knowledge, no case of GI bleeding due to a pseudoaneurysm of the splenic artery secondary to gastric TB has been reported previously. We report a patient who presented with hematemesis due to a pseudoaneurysm of the splenic artery secondary to gastric TB.
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PMID:Hematemesis due to a pseudoaneurysm of the splenic artery secondary to gastric tuberculosis. 1598 58

Pancreatic tuberculosis is very rare, especially in immunocompetent patients, and represents a diagnostic challenge. The clinical features in patients with pancreatic tuberculosis are usually non-specific. The radiological features mimic pancreatic malignancy or pancreatitis. We describe a case of pancreatic tuberculosis mimicking carcinoma on Computed tomography scan. Ultrasound guided fine needle aspiration cytology (FNAC) showed caseating granulomatous inflammation. The diagnosis of pancreatic tuberculosis was made and the patient was put on anti-tubercular therapy. Five months later, a repeat CT scan of the abdomen revealed resolution of the pancreatic lesion. We emphasize that tuberculosis should now be included in the differential diagnosis of a pancreatic mass. Diagnostic indicators include the association of a pancreatic mass with fever, the presence of abdominal pain and a cystic pancreatic mass in a younger patient coming from a region where tuberculosis is endemic.
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PMID:Isolated tuberculosis of the pancreas diagnosed with needle aspiration: a case report and review of the literature. 1651 65


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