Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0033377 (prolapse)
 11,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Without treatment, about 60% of atrial arrhythmia patients suffer a relapse within 3 months and 70% within one year. Antiarrhythmic treatment intended to reduce this percentage is therefore justified, on condition that it is well tolerated. Several preliminary questions have to be settled before this medical prophylaxis: 1) Justification of antiarrhythmic treatment (sometimes pointless to deal with very occasional episodes); 2) Treatment of the underlying heart disease (valve disease, cardiothyrotoxicosis, etc.) or promoting factors (potassium depletion etc.); 3) Accurate assessment of any associated conduction abnormalities, which may constitute a contraindication to antiarrhythmic treatment (WPW syndrome in the case of verapamil and the digitalis-like drugs) or require additional treatment (pacemaker); 4) Definition of the mechanism (vagal or sympathotonic) inducing arrhythmia; 5) Evaluation of the hemodynamic parameters of the underlying heart disease (size of the atria, ventricular function, coronary or valvular lesions) which may limit the efficacy of the treatment. Once these parameters have been identified, the primary treatment should be type la or lb antiarrhythmics, which have been shown to be effective, despite the fact that they are not without arrhythmic risks (the Ib antiarrhythmics are less effective and have a poor safety profile). The beta-blockers have preferential indications (hypersympatheticotonia, hyperthyroidism, hypertrophic myocardiopathy, mitral prolapse, angina etc.) and can be replaced by verapamil or bepridil if there are non-cardiac contraindications (ulcers, asthma, diabetes). Amiodarone is extremely effective, but its poor extracardiac safety restricts its long-term use. Complementary treatments (digitalis-like, anticoagulants or anti-PAF and cardiostimulant drugs) should be added if necessary. Recurrences (to be confirmed by ECG or Holter) should lead to rigorous confirmation of therapeutic compliance and observance of simple hygienic and dietary measures (no excessive exertion, elimination of stimulants etc.). With strict clinical and ECG monitoring, it would then be possible either to increase the dose levels (accompanied by plasma determinations if possible) or to switch to a treatment with more effective, but more aggressive drugs (amiodarone, flecainide) or to use drug associations (la and lb, la and II etc.). Repeated failure of such attempts should lead to a non-medical approach to treatment.
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PMID:[Preventive drug therapy of recurrence of atrial fibrillation]. 129 92

Twenty-nine patients with paroxysmal supraventricular tachycardias of different origins and clinical pattern were investigated to detect latent thyroid disorders; hyperthyroidism was diagnosed in 2 of those, and hypothyroidism, in 4. Functional thyroid disorders were more common in patients with mitral prolapse and supraventricular tachycardias due to additional conductive pathways (the Wolff-Parkinson-White syndrome) and paroxysmal nodal reciprocal tachycardia, particularly if they were resistant to antiarrhythmic treatment and/or had aggravated thyroid history. It is suggested that thyroid dysfunction is just a triggering factor of arrhythmia since thyrostatic and replacement therapy eliminate paroxysms of tachycardia, while organic pathology of the heart and its conductive network remains unaffected.
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PMID:[Study of thyroid function in patients with paroxysmal supraventricular tachycardia]. 273 16

Eighty-two patients (60 females and 22 males) who were under treatment for hyperthyroidism at the King Saud University affiliated hospitals in Riyadh, Saudi Arabia, were evaluated by M-mode and cross-sectional echocardiography for the presence of mitral valve prolapse. Sixty-seven patients (51 females and 16 males) had diffuse toxic goitre while 15 of them (9 females and 6 males) had nodular toxic goitre. The overall frequency of prolapse was 37.8% (31 of 82) and the frequency was similar for both sexes, being 38.3% in females and 36.3% in males. Prolapse was associated with both diffuse toxic goitre (overall frequency 35.8%) and nodular toxic goitre (overall frequency 46.6%); and the highest frequency was in females with nodular toxic goitre (55.5%). Out of the total of 31 patients with prolapse, early systolic and holosystolic prolapse were each present in 12 patients, while mid-to-late systolic prolapse was found in 7 patients. Cross-sectional echocardiography demonstrated prolapse in 16 cases, the M-mode was positive in 5 cases while the two methods confirmed it in 10 patients. The prevalence of prolapse of the mitral valve in otherwise healthy Saudi subjects has previously been found to be 12-15%. This study has confirmed a high frequency of prolapse in hyperthyroid patients and has demonstrated that sex, ethnic or racial origin and type of hyperthyroidism are not determinants of this association.
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PMID:Prolapse of the mitral valve in hyperthyroid patients in Saudi Arabia. 337 82

The etiological diagnosis of the third nerve palsy frequently imposes a real problem. Therefore, we have attempted to review the different causes by studying 109 personal cases and those described in the literature. Among our 109 cases, 36% were related to an aneurys,, 16% to a tumour, 12% to vascular diseases. Twenty-seven percent of our cases could not be clearly explained and were regarded as "neuritis". In total, sudden and isolated palsy, aneurysm is the first etiology to be considered. However the high incidence of palsies of unknown origin is striking and has been observed by other authors. The various etiological diagnosis of the third nerve palsy are also discussed, as well as the paraclinical investigations to be performed. In addition to the general and neurological examinations, analysis of the CSF, dosage of the PBI and of the glycemia, serologic tests for syphilis, endrophonium (Tensilon) and neostigmine tests, plain skull radiographies as well as frontal and posterior planigraphies of the cranial sinuses, must be kept in mind. Angiography and air encephlography will exclude intracerebral organic lesions. When ptosis and progressive ophtalmplegia are associated, and myasthenia or hyperthyroidism have been excluded, myopathy must be considered and a muscle biopsy may be performed. Finally when symptoms and signs of multineuritis are present and when expansive or vascular lesions of the brain stem has been excluded, examination of the CSF would sometimes help in the diagnosis of encephalitis.
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PMID:[Non-traumatic paralysis of the oculomotor nerve. A review of 109 cases (author's transl)]. 446 65

A 55-year-old woman with a several-decade history of thyroid goiter is presented here as a case of myasthenia gravis complicated with hyperthyroidism and thymoma with serological evidence of systemic lupus erythematous (SLE). She had had right eyelid ptosis since July 1992, with a positive tensilon test. The acetylcholine receptor antibody titer was 4.01 nmol/L. A thyroid function test revealed T3: 162 ngidl, T4: 14.98 micrograms/dl, TSH:0.09 microIU/ml and positive anti-microsomal antibody (1:400). An MRI of the chest showed a thymoma in the left thymus. Other autoantibody screenings include ANA (1:320, speckled pattern) and anti-ds DNA (+) suggesting a serological association with SLE. After three courses of plasmapheresis, she received an extended maximal thymomectomy and a subtotal thyroidectomy. She was then treated with prednisolone, Mestinon, Eltroxin and discharged without complications. The coexistence of myasthenia gravis, hyperthyroidism, thymoma and a serological evidence of SLE have not previously been documented in the literature.
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PMID:Myasthenia gravis complicated with hyperthyroidism, thymoma and serological evidence of systemic lupus erythematosus: a case report. 887 Mar 31

A seven-year-old entire male Irish setter was presented because of a neck mass, prolapse of the third eyelid and apparent drooping of the upper eyelid. Historical findings included increased appetite as well as polyuria and polydipsia for about two weeks. The most remarkable findings on physical examination were right-sided Horner's syndrome, pre-scapular lymphadenopathy and a large, ventral cervical mass. Lateral cervical radiographs showed a large, soft tissue opacity surrounding the trachea and retropharyngeal area which was causing displacement and narrowing of the cervical trachea and oesophagus. Results of thyroid testing suggested hyperthyroidism. At necropsy, a large, invasive tumour was identified in the ventral cervical region and multiple metastases of various sizes were detected in the lungs. Histopathological examination of the tumour revealed follicular thyroid carcinoma and confirmed widespread pulmonary metastasis.
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PMID:Horner's syndrome associated with a functional thyroid carcinoma in a dog. 898 Dec 80

We encountered three cases of thymic hyperplasia associated with hyperthyroidism. Case 1 was in a 35-year-old woman; a chest CT scan showed an anterior mediastinal mass and right-sided pleural effusion, which suggested the presence of a thymoma Case 2 was in a 21-year-old man who complained of palpebral ptosis and also had myasthenia gravis (Osserman type I). Case 3 was in a 47-year-old woman; a chest CT scan showed thymic hyperplasia and mediastinal lymphadenopathy. In all cases, anti-thyroid medication was given first, because of the associations with hyperthyroidism. Moreover, in cases 1 and 2 no tumor was found, and only hyperplasia was detected in the thymus, although both patients underwent extended thymectomy. Furthermore, surgery was not effective against the hyperthyroidism (anti-thyroid medication could not be withdrawn or reduced). In cases 2 and 3, thymic hyperplasia, as seen on chest CT scans, resolved as thyroid function was normalized by anti-thyroid medication. The pretracheal lymphadenopathy seen in case 3 also resolved. Thymic hyperplasia may have been a result, not a cause, of hyperthyroidism. When we encounter patients with thymic masses and hyperthyroidism, we should give anti-thyroid medication and observe the thymus for some time before resorting to surgery.
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PMID:[Three cases of thymic hyperplasia associated with hyperthyroidism]. 936 67

Ninety-six patients with ocular myasthenia gravis (OMG) seen at Siriraj Hospital during 1994 to 2004 were retrospectively reviewed. There were 59 female (61.5%) and 37 (38.5%) male patients with mean ages of 39.5 and 33.8 years, respectively Patients presented with initial symptoms of only ptosis in 46.9%, only diplopia in 13.5% and both ptosis and diplopia in 39.6%. However, diplopia alone is uncommon in childhood OMG. Fifteen percent developed systemic symptoms within two years of diagnosis. Thyroid function test was abnormal in 27.5% of investigated patients. Most abnormalities were hyperthyroidism. Thymoma associated with OMG is a rare condition. Most purely OMG patients can control the disease by pyridostigmine, prednisolone or immunosuppressive drugs.
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PMID:Clinical profiles of Thai patients with ocular myasthenia gravis in Siriraj Hospital. 2197 Feb 2

We report a child presenting with intermittent ophthalmoplegia and fluctuating ptosis and facial weakness whose evaluation revealed no evidence of myasthenia gravis but did reveal hyperthyroidism secondary to Graves disease. Successful treatment of the child's endocrinopathy resulted in complete resolution of his presenting symptoms. Children presenting with ophthalmoplegia and ptosis without proptosis should be evaluated for hyperthyroidism if no evidence of a myopathy or disorder of neuromuscular junction transmission is found.
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PMID:Childhood Graves disease masquerading as myasthenia gravis. 2295 13

Newborns prenatally exposed to methimazole (active metabolite of carbamizole) for maternal hyperthyroidism may present some disorders in common, but the phenotype is not well defined. Choanal atresia is the most frequent, and other anomalies such as esophageal atresia and aplasia cutis were described with this embryopathy. Additionally, patent omphalomesenteric duct or Meckel's diverticulum in similar association was reported in some patients. The predisposed genetic background has to be considered. We report the case of a newborn exposed to carbamizole during the first 4 weeks of pregnancy and define an association related to prenatal methamizole exposure consisting of esophageal atresia, small omphalocele, and ileal prolapse through a patent omphalomesenteric duct.
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PMID:Esophageal atresia, small omphalocele and ileal prolapse through a patent omphalomesenteric duct: a methimazole embryopathy? [Corrected]. 2384 57


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