Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0032463 (polycythemia vera)
 3,374 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Erythropoietin is a glycoprotein hormone that plays a vital role in erythropoiesis. It is mainly produced in the fetal liver till the third trimester of pregnancy. At that point, the kidney interstitium takes over this function and becomes the main source of erythropoietin. Hypoxia stimulates erythropoietin production by a mechanism that may require a heme protein as a second messenger. Erythropoietin stimulates the maturation of erythroid precursors (colony-forming unit-erythroid and burst-forming unit-erythroid) via at least two types of cell surface receptors. The higher-affinity receptors appear to be more important in modulating the effects of erythropoietin in vivo. Changes in intracellular calcium may ultimately mediate the action of erythropoietin on erythroid precursors. A specific and sensitive radioimmunoassay is now available for accurately measuring erythropoietin levels. All forms of erythrocytosis except polycythemia vera are associated with elevated erythropoietin levels. Levels are also high in cord blood obtained following fetal asphyxia. Reduced levels are seen in patients with anemia due to renal diseases. The response of erythropoietin to the degree of anemia appears to be attenuated in patients with cancer, chronic diseases, and human immunodeficiency virus (HIV) infection. Erythropoietin has been successfully used for treating patients with anemia due to renal failure. Its use has also been approved for the treatment of anemia patients receiving zidovudine for HIV infection. Encouraging results have been observed when erythropoietin was used to treat anemia due to rheumatoid arthritis, hematological malignancies, and prematurity. It has also been used to increase the yield of autologous blood collected prior to an elective surgical procedure. However, it has not proved to be useful in sickle cell anemia and myelodysplastic syndromes.
 ...
PMID:Erythropoietin. Biology and clinical applications. 178 66

The purpose of the present study was to determine the risk of neonatal morbidity in infants of diabetic mothers in relation to birth weight percentiles, maternal White classification and metabolic control during pregnancy. The subjects consisted of 51 infants of gestational and Type II diabetic women and 148 infants of insulin-dependent diabetic women. The following neonatal symptoms commonly associated with maternal diabetes were analyzed: macrosomia, hypoglycemia, erythremia, hyperbilirubinemia, hypocalcemia, prematurity and hyaline membrane disease. The incidence of the symptoms was as follows: hypoglycemia in the first hour of life 34.3% macrosomia 24.6%, hyperbilirubinemia 23.7%, prematurity 18.1%, hypoglycemia after the first hour of life 16.6%, hypocalcemia 11.1%, erythremia 7.6%, and hyaline membrane disease 2.0%. There were statistically significant differences in the symptoms "hypoglycemia after the first hour of life" and "erythremia" between the birth weight percentile groups, i.e. the incidence of these symptoms increased with higher birth weights. The risk of neonatal morbidity among infants of insulin-treated gestational diabetics was higher than that of infants of diet-controlled gestational diabetic women. The incidence of macrosomia and hypocalcemia was significantly higher in the first group. Newborns of insulin-dependent diabetic women with proliferative retinopathy and/or nephropathy (White class FR) had an increased risk of neonatal morbidity in comparison to infants of White classes B, C, and D, especially with regard to prematurity and associated problems. Neonatal morbidity varies with the quality of metabolic control in women with insulin-dependent diabetes. Infants of poorly-controlled mothers were more often macrosomic and premature than infants of well-controlled mothers.
 ...
PMID:[Neonatal morbidity of children of diabetic mothers]. 234 9

Polycythemia vera is a myeloproliferative syndrome. This clonal disorder involves a pluripotent stem cell capable of differentiating into red blood cells, granulocytes, and platelets. Polycythemia vera is characterized by the overproduction of mature red blood cells in the bone marrow. Myeloid and megakaryocytic elements are also often increased. Polycythemia vera (PV) is rarely associated with pregnancy. About 20 cases have been reported. Prognosis of PV is not influenced by pregnancy. Conversely, pregnancy outcome is poor, due to the occurrence of gestational hypertension, stillbirth and induced prematurity. During pregnancy, clinical management needs to be close including a collaborative approach between obstetricians, hematologists and anesthesists. The risk of poor outcome may be reduced by the association of antiaggregant and anticoagulant therapy. Phlebotomy can be provided in order to maintain hemoglobin level under 42%.
 ...
PMID:[Polycythemia vera and pregnancy: difficulties for diagnosis and treatment]. 1587 88