Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030305 (pancreatitis)
 16,014 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Clinical observations on two cases of staphylodermia superficialis circinata are reported. This rare variation of superificial staphylococcal skin infection is identical with the "erythema necroticans migrans". As this cutaneous manifestation is highly associated with malignant internal diseases it must be regarded as a "cutaneous paraneoplasia". Out of 14 cases of erythema necroticans migrans, so far published this dermatosis occured in 13 patients suffering from pancreatic cancer. Association with pancreatitis was demonstrated in one case. In both cases herein reported the cutaneous manifestations were associated with a carcinoma of the pancreas and with cervix cancer. Extreme loss of weight, atrophic glossitis, therapy-resistant anemia and a slight diabetes are extra-cutaneous symptoms of this paraneoplastic syndrom.
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PMID:[Staphylodermia superficialis circinata. The 5th obligatory cutaneous paraneoplasia]. 19 72

Ten episodes of massive transaminase increase with hepatic necrosis were observed in 7 patients after infusion of megluminioglycamide (Biligram). The patients were 3 men and 4 women aged 49 to 65 years with biliary tract disease (n = 1), recurrent pancreatitis (n = 1), hyperlipidaemia and minimal toxic liver damage (n = 1), pyelonephritis (n = 1), , arteriitis (n = 1), and pseudo-LE (n = 1). In 6 patients there was an increase of the alkaline phosphatase without icterus before the investigation and a slight increase of transaminases in 3 patients. After infusion of 100 ml of Biligram in 5 patients and of 200 ml in 2 patients there was an abrupt increase of GPT (98-2202 U/l) with a lesser increase of GOT. The alkaline phosphatase activity remained unchanged. Three patients showed symptoms such as upper abdominal pain, fever erythema, or conjunctivitis. Histologically all patients showed centrolobular necroses. Transaminases should be checked 2 days after intravenous cholangiograms. In patients with a definite increase reexposure should be avoided.
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PMID:[Hepatic necroses after infusion cholangiography (author's transl)]. 63 57

Patients with abdominal pain resulting from pancreatitis are often misdiagnosed initially. There are no pathognomonic physical signs to implicate the pancreas as a source of chronic abdominal discomfort. Four patients seen consecutively (and one studied retrospectively) illustrate that erythema ab igne of the abdomen or low back may be a sign of pancreatitis. These patients had used heat on their abdomens or backs in attempts to relieve the pain. Using heat in this manner is common among patients with undiagnosed pancreatitis; the heat enhances the appearance of the erythema ab igne. The presence of pigmentation is a sign of organicity which should lead the physician to investigate the pancreas as a source of the patient's pain.
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PMID:Erythema ab igne, a sign of pancreatic disease. 85 Nov 10

Interleukin-2 (IL-2) is increasingly used to treat patients with cancers refractory to conventional treatment. Flu-like syndromes are extremely frequent but usually mild. A variety of skin complications (mostly erythema and mucositis) have been reported. Life-threatening skin reactions have also been described. Acute reactivation of psoriasis can also occur. Immediate hypersensitivity reactions have so far not been described, but IL-2 treatment has been shown to predispose to acute hypersensitivity reactions to iodine-containing contrast media. Hypothyroidism is the major endocrine complication and antithyroid antibodies have been detected in approximately 50% of patients. Neurological and psychiatric disturbances with moderate or severe mental status changes are common and sometimes treatment-limiting. The occurrence of peritumoural oedema in patients with brain metastases can also be a major practical problem. Musculoskeletal disorders are transient and resolve spontaneously. The vascular leak syndrome is the most frequent and severe complication of IL-2 of which weight gain, generalised oedema, hypotension and impaired renal function are the main features. Even though a damaging effect on vascular endothelium cells by various cytokines released by activated lymphoid cells or mediated by non-lymphocyte-dependent factors has been proposed to be involved, the mechanism remains unclear. Other cardiovascular injuries, possibly life-threatening, including myocarditis, angina pectoris and myocardial infarction, can occur during the first days of treatment. Supraventricular arrhythmias are the most common rhythmic disorder. Decreases in myocardial contractility and haemodynamic pattern similar to those of septic shock have been encountered in most cases. Acute renal dysfunction is common but resolves with symptomatic management. Intrahepatic cholestasis with hyperbilirubinaemia is observed in most patients but permanent liver damage has not been described. Several cases of pancreatitis have been reported. Anaemia, thrombocytopenia, lymphocytopenia and eosinophilia are frequent and occur in most if not all patients. Some data suggest a high incidence of infectious complications, particularly in patients with surgically tunnelled catheters, but marked flu-like syndromes may be confounding. Finally, death directly related to IL-2 treatment has been noted in less than 1% of all patients. Investigations are under way to minimise IL-2 toxicity with varying dose regimens and combined treatments.
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PMID:Clinical toxicity of interleukin-2. 141 98

We report a case of sero-negative tsutsugamushi disease diagnosed by polymerase chain reaction (PCR). A 54-year-old man who worked in Nagano prefecture presented with flu-like symptoms that did not respond to cephalosporin therapy. On admission to another hospital, chest roentgenography revealed abnormal shadows; liver dysfunction was also present. Despite therapy, the patient's condition gradually worsened and he was transferred to our intensive care unit. Erythema on all extremities and scabs on the right medial femoral region and the dorsum of the left foot suggested a diagnosis of tsutsugamushi disease. We administered minocycline and gave percutaneous cardiopulmonary support for adult respiratory distress syndrome. Despite all efforts, the patient died. Although serologic tests were not positive, Karp strains of R. tsutsugamuschi were identified on PCR amplification. Autopsy revealed evidence of acute hemorrhagic pancreatitis, which has not been reported previously in tsutsugamushi disease. We conclude that PCR techniques may be useful in confirming a diagnosis of early tsutsugamushi disease.
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PMID:[Sero-negative tsutsugamushi disease (scrub typhus) diagnosed by polymerase chain reaction]. 956 83

Necrolytic migratory erythema is characterized by waves of irregular erythema in which a central bulla develops, and subsequently erodes and becomes crusted. It usually occurs in patients with an alpha-islet cell tumor of the pancreas. However, necrolytic migratory erythema has also been observed in patients without an associated glucagonoma. We describe a woman with iatrogenic necrolytic migratory erythema. She received intravenous glucagon for hypoglycemia associated with an insulin-like growth factor II-secreting hemangiopericytoma. After chemotherapy, she developed necrolytic migratory erythema. The characteristics of the previously reported patients with nonglucagonoma-associated necrolytic migratory erythema are reviewed. In patients with nonglucagonoma-associated necrolytic migratory erythema, the dermatosis-related conditions most commonly observed were celiac disease or malabsorption, cirrhosis, malignancy, and pancreatitis; less common conditions included hepatitis, inflammatory bowel disease, heroin abuse, and odontogenic abscess. Although the pathogenesis of necrolytic migratory erythema remains unknown, hyperglucagonemia appears to have had a causative role in the development of this dermatosis in our patient. Patients who develop necrolytic migratory erythema should be evaluated for the presence of a glucagonoma; if a glucagonoma is ruled out, evaluation for other conditions known to occur with necrolytic migratory erythema, such as liver disease, malabsorptive disorders, and nonislet-cell tumors is warranted.
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PMID:Iatrogenic necrolytic migratory erythema: a case report and review of nonglucagonoma-associated necrolytic migratory erythema. 959 6

Relapse after transplant for malignant lymphomas remains the main cause of treatment failure. Most conditioning regimens contain total body irradiation (TBI). We investigated the toxicity and efficacy of an intensified chemotherapy conditioning regimen without TBI in patients with relapsed or high-risk malignant lymphoma who had received prior radiation therapy and were therefore not eligible for TBI. Twenty patients with a median age of 38 (18-56) and relapsed or high-risk malignant non-Hodgkin's lymphoma (NHL, n = 16) or Hodgkin's disease (HD, n = 4) underwent high-dose chemotherapy consisting of busulfan (16 mg/kg), cyclophosphamide (120 mg/kg) and etoposide 30 mg/kg (n = 8) or 45 mg/kg (n = 12) followed by peripheral stem cell support (n = 14), autologous bone marrow (n = 3), allogeneic (n = 2) or syngeneic (n = 1) transplantation. All but two had chemosensitive disease before high-dose chemotherapy. The main toxicity -- according to the Bearman score -- was mucositis II in 18 (90%) patients; five patients (25%) suffered a grade I hepatic toxicity. GI toxicity I occurred in three (15%) and renal toxicity I in two patients (10%). Sixty percent of the patients developed transient dermatitis with erythema and three of them (15%) had skin desquamation; one patient experienced asymptomatic pancreatitis. Toxicity was slightly higher in patients treated with 45 mg/kg etoposide. One patient (5%) died of treatment-related venoocclusive disease. After a median follow-up of 50 months (24-84) the disease-free and overall survival were 50% and 55%. One of the nine relapsing patients developed secondary AML 18 months after transplant. High-dose busulfan, cyclophosphamide and etoposide is an effective regimen resulting in long-term disease-free survival in 50% of patients with relapsed malignant lymphoma and prior radiation therapy. The toxicity is moderate with a low treatment-related mortality (5%).
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PMID:Busulfan, cyclophosphamide and etoposide as high-dose conditioning therapy in patients with malignant lymphoma and prior dose-limiting radiation therapy. 967 47

For good performance in clinical and forensic toxicology, it is important to be aware of the signs and symptoms related to xenobiotic exposure since they will assist clinicians to reach a useful and rapid diagnosis. This manuscript highlights and critically analyses clinical and forensic imaging related to ethanol abuse. Here, signs that may lead to suspected ethanol abuse, but that are not necessarily related to liver disease are thoroughly discussed regarding its underlying mechanisms. This includes flushing and disulfiram reactions, urticaria, palmar erythema, spider telangiectasias, porphyria cutanea tarda, "paper money skin", psoriasis, rhinophyma, Dupuytren's contracture, multiple symmetrical lipomatosis (lipomatosis Lanois-Bensaude, Madelung's disease), pancreatitis-related signs, black hairy tongue, gout, nail changes, fetal alcohol syndrome, seborrheic dermatitis, sialosis and cancer.
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PMID:Clinical and forensic signs related to ethanol abuse: a mechanistic approach. 2427 40

Kawasaki disease is a multisystem inflammatory disease of small- and medium-sized blood vessels with acute and self limiting course. It occurs most frequently in children under five years of age and is characterized by high fever lasting more than five days, conjunctivitis, stomatitis, edema of hands or feet erythema of the palms and soles, epidermic desquamation of the fingers and toes, polymorphic rush and cervical lymphadenopathy. Such symptoms from other organs as cholestatic jaundice, inflammation and hydrops of the gallbladder, pancreatitis, hepatitis and traits of acute abdomen can also be present. The most serious complications of Kawasaki disease are coronary aneurysms. The principal treatment of the disease is intravenous infusion of immunoglobulin and aspirin. Prompt diagnosis with echocardiogram and the treatment with immunoglobulins before 10th day after the first symptoms improve prognosis and diminish life threatening complication such as coronary arteries aneurysms.
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PMID:[Kawasaki disease in children: epidemiology, clinical symptoms, diagnostics and treatment]. 2449 Apr 69

Dear Editor,Eosinophilic annular erythema (EAE) is a rare figurate dermatitis of unknown etiology with prominent tissue eosinophilia. A 59-year-old male patient presented with a one-month history of itchy, polycyclic, annular, and partially serpiginous lesions involving the back, the gluteal region, and the extremities (Figure 1, a, b). There was no medical history of drug intake. High potency local steroids and antihistamines were prescribed, but without adequate therapeutic results. Extensive laboratory work-up including serological infectious disease testing was performed and was within normal ranges. Histopathological examination of a biopsy taken from a lesion on the gluteus showed perivascular lymphocytic infiltrate around superficial and deep vascular plexus with admixture of eosinophils that was found interstitially (Figure 2, a,b) and within the lobules of subcutaneous fat. The overlying epidermis was unremarkable. There were no signs of flame figures and granulomatous inflammation. Based on the clinical and histopathological findings, a diagnosis of EAE was established. The patient was given 40 mg of prednisone orally which resulted in partial improvement, but the lesions relapsed soon after the dose was tapered down to 20 mg. Chloroquine was started at a dose of 4 mg/kg daily for 10 days, then 250 mg daily for next the 10 weeks, resulting in complete clearance of all the lesions, which was sustained for over 2 years of follow-up. It is still matter of debate whether EAE is a clinical subtype of Wells syndrome (WS) presenting with an annular or figurate pattern or is a distinct entity. In recently published paper, El-Khalawany et al. argued that EAE is a peculiar clinical variant of WS, because flames figures, blood and tissue eosinophilia, and granulomatous infiltrate can be observed in well-developed and long-standing lesions (1). The etiology of EAE is still unknown, although it has been suggested that it occurs as a result of a hypersensitivity reaction to an unidentified allergen (2). EAE has been associated with Helicobacter pylori, Borrelia burgdorferi, and hepatitis C virus infection, diabetes mellitus, chronic kidney disease, thymoma, autoimmune pancreatitis, autoimmune hypothyroidism, and internal malignances (clear cell renal carcinoma, metastatic prostate adenocarcinoma) (3,4). Clinically, EAE is characterized by asymptomatic or mildly pruritic urticarial papules and plaques in annular configuration, mainly on the trunk and proximal extremities (5). Histologically, as in our patient, EAE is characterized by the appearance of a superficial and deep perivascular inflammatory infiltrate composed of lymphocytes and abundant eosinophils and absence of epidermal change (5). There is no standard treatment for EAE. Systemic steroids and antimalarials are the usual first-line options (5). Other treatment options include dapsone, indomethacin, cyclosporine, and UVB therapy (1,3,5). Response to antimalarials is usually observed within the first 2-4 weeks (2). However, as in our case, it may take several weeks for patients to respond to antimalarial treatment, and complete regression may even take longer (3). We believe that EAE should be treated with antimalarials over a longer time period in order to avoid frequent relapses.
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PMID:Prolonged Treatment of Eosinophilic Erythema Annulare with Chloroquine. 3039 Jul 30


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