Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0032285 (pneumonia)
 54,520 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Hairy cells from eight patients with hairy cell leukemia were evaluated with both light and transmission electron microscopy for their capacity to phagocytose zymosan, latex, staphylococcus aureus, and pseudomonas aeruginosa. In two patients, there was no phagocytosis of any of these substances; cells from three patients phagocytosed only latex; two, all except pseudomonas; and one, all 4 substances. Hairy cells became relatively smooth while in culture with staphylococcus, but no surface changes were noted during incubation with the other substances. Of the eight patients studied, one died of pseudomonas pneumonia and sepsis; pseudomonas was the only substance which her hairy cells did not phagocytose. The one patient whose hairy cells phagocytosed all 4 test substances developed a disseminated Mycobacterium intracellulare infection; culture of his hairy cells with this atypical myocbacterium showed no phagocytosis. Hairy cells have different phagocytic capabilities from patient to patient, and the evaluation of these capabilities in vitro might provide early identification of potential infectious complications.
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PMID:Hairy cell leukemia: differences in phagocytic capacity of cells in vitro. 3 38

Twenty-six patients with hairy cell leukemia (HCL) were treated with 2-chlorodeoxyadenosine (2-CdA), a purine analogue resistant to adenosine deaminase, at 0.1 mg/kg/d for 7 days by continuous intravenous infusion. Fifteen patients were previously untreated, while 11 patients had received prior treatment with splenectomy alone (three patients), interferon alpha alone (four), splenectomy, then interferon alpha (two), or splenectomy, interferon alpha, then 2-deoxycoformycin (2-DCF) (two). Sixteen (80%) of 20 patients evaluable at 3 months achieved complete remission (CR), and four (20%) achieved partial remission (PR) following a single cycle of therapy. All four patients in PR had complete recovery of their peripheral blood counts (except one patient whose platelet count remained 84,000/microL), but had residual HCL in the bone marrow (three patients) or residual splenomegaly (one). Patients with bulky adenopathy, massive splenomegaly, and severe pancytopenia responded as well as those with only modest marrow involvement. The three patients with residual marrow disease received a second cycle of 2-CdA, and two have attained CR. Therefore, 18 of 20 (90%) achieved CR with either one or two cycles of therapy. No patient achieving CR has relapsed at a median follow-up of 12 (+/- 2.1) months. Toxicities included myelosuppression and culture-negative fever. A community-acquired pneumonia was the only infectious complication. Since a single cycle of 2-CdA induces sustained CR in the vast majority of patients with minimal toxicity, this agent is emerging as the treatment of choice for all patients with HCL.
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PMID:A single cycle of 2-chlorodeoxyadenosine results in complete remission in the majority of patients with hairy cell leukemia. 135 62

Endocarditis by Aspergillus species in patients without prior cardiovascular surgery is extremely rare and difficult to diagnose. We report and discuss a 69-year-old patient with hairy cell leukemia who developed severe bilateral pneumonia and metastatic subcutaneous nodules from which A. fumigatus was cultured. He died after 18 days of treatment with an adequate dose (0.7 mg/kg/day) of amphotericin B intravenously. Fungal endocarditis and a myocardial infarction due to a septic thrombotic occlusion of the left coronary artery by A. fumigatus appeared to be the cause of death. A. fumigatus could still be cultured from the aortic valve postmortem despite a total dose of 756 mg amphotericin B. In case of metastatic spread of Aspergillus spp., endocarditis should be suspected.
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PMID:Aspergillus fumigatus, a rare cause of fatal coronary artery occlusion. 156 13

Nine consecutive patients with HCL seen over a period of five years were reviewed. Male: Female ratio was 8:1. Median age at diagnosis was 49 years. Weakness and fatigue (66%) were the commonest presenting symptoms and splenomegaly (66%) was the commonest physical findings. Varying degrees of pancytopenia was the consistent feature in majority of cases. Diagnosis was made on the basis of bone marrow biopsy and characteristic EM picture. Forty-four percent of cases developed serious infection during their clinical course. Gram negative bacilli and fungi were the most frequently isolated organisms. Major sites of infections were pneumonia and septicemia. Splenectomy was carried out in four cases. Rapid recovery of haematological parameters without any significant complication was observed in all these cases. Two patients were treated with alfa-interferon. In both the cases recovery of haematological parameters was slow compared to those under going splenectomy. One patient treated with alfa-interferon died due to infection related complications while the other went into remission.
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PMID:Hairy cell leukaemia. A review of nine cases. 178 82

A case of community-acquired pneumonia caused by Legionella dumoffii in a patient with hairy cell leukemia is described. Diagnosis was confirmed by isolation by culture of sputum and broncho-alveolar lavage specimens, positive direct fluorescent antibody stains, and antibody seroconversion from 1:16 (acute) to 1:4096 (six months). The blue white autofluorescence of the L. dumoffii colonies when viewed under ultraviolet light was particularly useful in preliminary identification. The patient recovered from his pneumonia after administration of erythromycin and rifampin. Legionella have been shown to multiply in monocytes and cell-mediated immunity appears to be the primary mechanism of host defense in man. Hairy cell leukemia is characterized by monocyte dysfunction and such patients have a predilection for infection by microbes that are controlled by cell-mediated defenses. We review other cases of community-acquired L. dumoffii pneumonia as well as other cases of Legionella infection in patients with hairy cell leukemia.
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PMID:Community-acquired pneumonia caused by Legionella dumoffii in a patient with hairy cell leukemia. 207 12

A 63-year-old man was admitted to the respiratory intensive care unit for pneumonia. Fifteen years earlier, hairy cell leukemia had been diagnosed and the patient underwent splenectomy. A clinical suspicion of legionellosis, later confirmed by both serology and isolation of the microorganism, prompted initiation of high dose erythromycin intravenously. The patient steadily deteriorated and passed away eight days later. This is the first reported case of hairy cell leukemia in which the diagnosis of Legionella longbeachae sero-group 1 infection was based on both serology and isolation.
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PMID:Legionella longbeachae pneumonia in a patient splenectomized for hairy-cell leukemia. 231 74

An unusual case of Q fever in a 62-year-old female is described. The patient presented with severe pneumonia and developed renal failure, disseminated intravascular coagulation and pancytopenia which recurred after antibiotics were discontinued. Subsequently hairy cell leukemia was diagnosed and evolved favorably under treatment with doxycycline and alpha-interferon. A review of the literature confirms that renal failure and disseminated intravascular coagulation do not appear to be associated with Coxiella burnetti infections, nor has the association of Q fever and hairy cell leukemia been previously described.
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PMID:[Unusual manifestations of Q fever disclosing hairy cell leukemia]. 292 42

Three patients with hairy cell leukemia, only one splenectomized, were treated with a combination of vinblastine plus bleomycin at low doses. One achieved a complete remission and another achieved a good partial hematologic and bone marrow remission. Neither of them has relapsed after follow-up periods of 34 and 17 months, respectively. The third patient, although achieving a hematologic improvement, died because of a cytomegalovirus pneumonitis after 2 cycles of chemotherapy. Chemotherapy is not usually employed in the initial management of hairy cell leukemia. However, if life-threatening neutropenia and thrombocytopenia occur secondary to severe bone marrow leukemia infiltration and an improvement does not take place using alternative therapeutic strategies, chemotherapy should be taken into consideration. The nonaggressive chemotherapeutic regimen the authors propose induces a cytoreduction without an evident myelosuppression, and can be also employed on an outpatient basis.
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PMID:Chemotherapy in hairy cell leukemia. Preliminary results of a nonaggressive regimen. 620 Dec 57

Autopsy material from 22 patients with hairy cell leukemia was examined. All patients had the expected widespread involvement of the hematopoietic system. Peripheral lymphadenopathy was detected in only three cases, but significantly enlarged mediastinal, retroperitoneal, and abdominal lymph nodes were present in 15. Lymph nodes of two patients showed malignant lymphoma, large-cell type. Evidence of pulmonary infiltration by hairy cells was present in 15 cases; but in 14 of the 15, there was evidence of coexisting pneumonia, and in 13 of the 15 cases the presence of microorganisms was documented. Only one patient demonstrated clinical findings attributable solely to lung involvement by hairy cell leukemia. Liver involvement was present in every case, but the extent of the leukemic infiltration did not always correlate with serum biochemical abnormalities, and there was no correlation with the hairy cell count in the peripheral blood. M kansasii was found in the lymph nodes of three patients and in the lung and liver specimens of one of these. The tissue response in two of the patients with M kansasii consisted of the presence of poorly formed granuloma; the third patient had only focal areas of necrosis, with no polymorphonuclear or macrophage response.
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PMID:Autopsy findings in hairy cell leukemia. 650 4

Clinical and morphologic characteristics of hairy cell leukemia at 11 patients have been analyzed. The frequency of this disorder is 2.5% from all leukemias. This disorder is often retrospectively diagnosed--at 7 cases from our study. the disorder is often retrospectively diagnosed--older age (78%). Splenomegaly is the main clinical manifestation, at all 11 patients. Pancytopenia is frequent finding but at 4 patients the leucocyte count was over 10 X 10(9)/1 in the beginning. Hairy cells, although not always with typical appearance, in 90% of the cases are found in peripheral blood over 10%. Bone marrow biopsy cytological and hystological findings at 9 patients were typical for diagnosis. Fibrosis was present in 6 specimens. At 7 patients diagnosis was confirmed with histological examinations of lymphocyte concentrates from peripheral blood on thin and ultrathin sections, as well as with electron microscopy characteristic appearance of hairy cells. Pneumonia as complication was registered in 24 occasions, gastro-intestinal infections at 9, haemorrhagic syndrome at 4 and skin carcinoma at 2 cases. Treatment was variable--2 patients were observed for more than 50 months, 2 were splenectomised, of which one with complete remission longer than a year, while from 8 treated with COP protocol, complete remission was obtained in 5 (62%) patients, and two treated with CHOP protocol entered complete remission for longer than 12 months. Average survival is 51 months (2--144). Three (28%) patients died.
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PMID:[Hairy cell leukemia. Personal experience with 11 cases]. 668 Mar 1


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