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)

Six sporadic cases of Legionnaires' disease seen over 13 months in the region of Lake Zurich (Switzerland) are reported. The disease was severe in all cases; 2 patients died while on artificial respiration; 5 patients were heavy smokers; 3 had probably acquired the infection in France. These 6 patients showed the following typical symptoms and signs: fever above 39 degrees C (6 patients), nonproductive cough (4), gastrointestinal symptoms (4), encephalopathy (4), renal insufficiency (5), hepatic involvement (4), bilateral pneumonia (4), and pO2 below 60 mm Hg (4). The disease was diagnosed serologically in all cases and by staining and culturing Legionella pneumophila from lung tissue in one case. The authors propose to treat unusual cases of pneumonia with erythromycin from the outset.
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PMID:[Legionnaires' disease in the Lake Zurich area. Report on 6 sporadic cases]. 720 63

A 52-year old female patient with rheumatoid arthritis (RA) had mistakenly taken 112.5 mg methotrexate (MTX) over a period of five days. As a result, extensive erosions along with necrotic changes occurred in the oral cavity, the groins and vulva mucous membrane. Haemorrhages in the gastrointestinal tract, dermal xanthochromia, interstitial pneumonia and progressive renal insufficiency, as well as hair loss, also followed. Laboratory examination showed peripheral blood agranulocytosis, a decrease in the overall number of blood platelets, anaemia, an increase in the level of transaminases and bilirubin, along with megakaryocyte deficiency. Cultivated dermal specimens initially developed bacteria, then Candida albicans. The patient died on the 22nd day after the overdose from pneumonia and extensive mycosis.
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PMID:[Overdose of methotrexate with a fatal outcome in a patient with rheumatoid arthritis]. 747 60

FK506 has been proven effective for prevention and treatment of liver allograft rejection. Herein, we compare FK506-based immunosuppression with an effective quadruple immunosuppressive regimen, including cyclosporine and antithymocyte globulin. The results of a single center participating in the European multicenter FK506 study are reported, including immunosuppressive efficacy as well as toxicity. One-year patient and graft survival was 96.7% and 90.0% for the CsA group and 90.2% and 88.5% for the FK506 group, which is not statistically different. The incidence and severity of acute rejection episodes during the first postoperative year was similar in both treatment groups with 34.4% and 33.3% for the FK506 and CsA treatment group, respectively. Immunosuppressive potency was better for the FK506 group compared with the CsA group according to the incidence of chronic rejection. Furthermore, 5 patients (8.3%) required conversion to FK506 for immunological reasons, i.e., refractory acute or chronic rejection. The incidence of moderate and severe neurotoxicity during the early postoperative period was higher in the FK506 group (21.3%) compared with the CsA group (11.7%), while the incidence of renal insufficiency and acute renal failure was similar (18.0% and 18.3% for the FK506 and CsA treatment groups, respectively). The incidence of CMV infection was significantly higher under treatment with CsA (25.0%) than with FK506 (6.6%) (P < or = 0.05), while the incidence of pneumonia (13.1% and 13.3%), cholangitis (29.5% and 26.7%), and urinary tract infection (39.3% and 28.3% for the FK506 and CsA treatment groups, respectively) was similar in both treatment groups. However, infection was more serious in some cases treated with FK506, and evolved as the main cause of death in the FK506 treatment group. Therefore, caution should be paid to over immunosuppression and toxicity in FK506-treated patients. Regarding the monitoring of FK506, FK506 plasma level failed to be a reliable indicator, and therefore we recommend measurement of whole blood FK506 levels. Our data indicate that immunosuppressive potency of FK506 is greater than that of CsA, especially concerning the incidence of chronic rejection.
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PMID:Comparison of FK506- and cyclosporine-based immunosuppression in primary orthotopic liver transplantation. A single center experience. 753 Aug 68

We evaluated retrospectively the presenting clinical features, response to treatment and clinical course of 19 patients with LCDD, 11 of whom had multiple myeloma. At presentation, renal insufficiency was present in 18 patients and proteinuria in 16. Renal biopsy revealed typical LCDD in 16 patients, while in the remaining three LCDD was associated with other abnormal tissue deposits. Extrarenal signs were observed in 12 patients (63%), with the liver, heart and peripheral nerves being the most frequently involved organs. After diagnosis, 18 patients underwent therapy: 2 received steroids alone and 16 were treated with steroids and cytotoxic drugs; 7 patients also underwent plasma exchange. At the end of the first month of treatment renal function improved in 5 patients, worsened in 5 and remained unchanged in 8. All but 3 of the patients continued treatment beyond the first month: 7 patients developed end-stage renal disease, 5 an improvement and 4 a worsening in renal function. No effect on proteinuria was observed. Extrarenal symptoms developed in 4 previously unaffected patients and in 3 others they extended to more organs. Sixteen patients died: 12 during the first year of the follow-up, and 4 at 21st, 34th, 37th and 82nd month of observation. Five patients died from neoplastic cachexia, 4 from hypokinetic cardiopathy, 3 from hemorrhagic complications, 2 from pneumonia and one from unknown cause. Mean patient survival after presentation was 18.1 +/- 20.7 months.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Renal disease and patient survival in light chain deposition disease. 763 43

We report a rare case of a female newborn presenting with muscular hypotonia, pneumonia, and cardiovascular and renal insufficiency. Adrenal insufficiency was diagnosed clinically and proven by extremely low cortisone (0.4-0.8 microgram/dl) and high ACTH plasma levels. Myopathy was diagnosed clinically, as well as by muscular biopsy. DNA analysis of both X chromosomes showed no abnormality in the region of the genes for adrenal hypoplasia and Duchenne muscular dystrophy. After 4 weeks of intensive care therapy the patient died of multiorgan failure. At autopsy she had only microscopically visible fetal adrenal cells and multiple porencephalic lesions.
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PMID:[Congenital adrenal gland insufficiency and myopathy]. 770 32

A 26 year old female patient was admitted to our hospital because of septic temperatures and chills. In the patient's history renal insufficiency has been known for several years due to agenesia of the right and pyelonephritic renal congestion of the left kidney. Long lasting anorexia nervosa had been treated by psychotherapeutical interventions for years and when failing it necessitated repeated intravenous nutrition by central venous lines. The prominent symptom of the intravenously treated young woman was fever up to 39.7 degrees C and pneumonia, which was considered by the first treating clinic to be caused directly by diminished immunoreactivity in malnutrition and preuremia. The chest X-ray confirmed pneumonia and revealed multiple abscesses in both lungs (Figure 1). After being transferred to our intensive care unit the pathophysiological context became obvious. From inspection (positive jugular pulsation), from auscultation (holosystolic murmur at the left parasternal border) tricuspid incompetence due to infective endocarditis was suspected. This was confirmed immediately by TM and two-dimensional transthoracic echocardiography, which showed a large vegetation on the anterior tricuspid valve leaflet (Figures 2a and 2b). Tricuspid regurgitation was also ascertained by color flow echocardiography (Figure 2c). Several blood cultures were positive for staphylococcus aureus. Clinical and laboratory recovery was achieved by antibiotic therapy with vancomycin and cephtazidim for 3 months.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Fever and lung abscesses in anorexia nervosa after infusion therapy]. 792 23

Renal cell carcinoma invades the vena cava in 4-10% of cases. Another 10% of patients present with invasion of the renal vein. The surgical approach, complications and long-term outcome of 95 patients were investigated. Intraoperative complications occurred in 1 of 73 patients with involvement of the renal vein and 5 of 22 patients with vena cava thrombus. One patient in each group died due to pulmonary emboli in the perioperative period. Minor renal insufficiency occurred in 39 (54.2%) and 11 (50%) of the patients respectively. The rates of minor complications such as wound infections, haematoma and pneumonia were similar in the two groups. The mean intra-operative blood loss of 780 ml in patients undergoing tumour nephrectomy was significantly lower than the blood loss of 1485 ml in patients with tumour thrombus extension into the vena cava. The 5-year survival rate of patients with V1 tumours (71%) is comparable to that of patients without venous involvement. Tumour extension into the vena cava (V2) influences the 5-year survival rate significantly, decreasing it to 56.7%. In conclusion, long-term survival can be achieved for patients with renal cell carcinoma and venous involvement, though for patients with lymph node metastases or distant metastases only short-term palliation can be achieved. However, the potential benefits should be carefully weighed against the possible complications, the surgical morbidity and the resources expended in vena cava resection.
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PMID:[Venous tumor invasion by renal cell carcinoma. Surgical technique, complications and survival rate]. 797 34

A 78-year-old man with a history of hypertension was admitted for a fall with back pain. The blood pressure was at 110/50 mmHg and the pulse at 115 b.min-1. A pulsatile abdominal mass was palpated. No signs of respiratory insufficiency or congestive heart failure were found. The diagnosis of abdominal aortic aneurysm was promptly confirmed by echography. Before laparotomy, a pulmonary artery catheter was inserted for haemodynamic monitoring which showed a high cardiac output, low systemic vascular resistances, increased pulmonary artery wedge pressure and a high SvO2 (93%). This was not consistent with a hypovolaemic shock but rather an aortocaval fistula. After incision and aortic clamping, surgical procedure consisted of transaortic closure of the fistula and restoration of arterial continuity with a prosthetic graft. Initial control of venous bleeding was obtained by passing a Foley's catheter distally and by clamping the vena cava. The postoperative course was initially satisfactory. The patient was extubated, but remained with a major renal insufficiency. After a stay of 15 days in the intensive care unit, he died from nosocomial pneumonia. Aortocaval fistulas are either traumatic or spontaneous. Spontaneous fistulas are more common, and in about 90% of the cases result from a rupture of an atherosclerotic aortic aneurysm. Clinical findings include signs of high cardiac output symptoms of venous hypertension and regional arterial insufficiency. Haemodynamic changes can be of value for the recognition of an aortocaval fistula. Most authors emphasize the importance of preoperative diagnosis, allowing the use of appropriate operative techniques and a prompt control of the fistula. This could decrease haemodynamic instability and transfusion requirements.
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PMID:[Hemodynamic diagnosis of aortocaval fistula complicating abdominal aortic aneurysm]. 799 47

In two male patients the deficiency of G-6-PD in erythrocytes became manifested in 27th year of age with severe hemolytic crisis. In the first case hemolysis appeared after three days of heavy alcohol drinking. There was no evident relation between alcohol and hemolysis. In the second patient (an Iraqi Student) suffering from diabetes since adolescence, hemolysis was provoked by respiratory tract infection, antiinflammatory drugs and concomitant ketosis. Pneumonia, renal insufficiency and acute pancreatitis complicated the course of illness. The patient required a consecutive erythrocyte concentrate transfusions. Aplastic crisis was treated with folic acid.
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PMID:[Glucose-6-phosphate dehydrogenase deficiency in erythrocytes observed in two cases]. 823 7

An 83-year-old woman with histologically confirmed Hunner's cystitis presented with persistent fever, progressive dyspnea, and pulmonary patchy infiltrates. A transbronchial biopsy specimen revealed bronchiolitis obliterans organizing pneumonia. She progressively had development of renal insufficiency, due to systemic lupus erythematosus, proved by renal biopsy specimen. She recovered under corticosteroid treatment, but irreversible renal failure made long-term hemodialysis necessary.
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PMID:The association of bronchiolitis obliterans organizing pneumonia, systemic lupus erythematosus, and Hunner's cystitis. 833 71


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