Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0034063 (pulmonary edema)
 10,665 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

An 81-year-old woman had chills, fever, nausea, vomiting, and epigastric pain. On day 3 she had hematuria and was treated with trimethoprim-sulfamethoxazole. On day 5 she had a cough, hypotension, anemia, azotemia, and elevated hepatic enzyme levels. Her condition deteriorated with thrombocytopenia, anuria requiring dialysis, edema, and hypoalbuminemia. Treatment with chloramphenicol and doxycycline was started on day 10. By day 11, she was in hypotensive shock; on day 12 she had seizures and died. Murine typhus was diagnosed by demonstration of antibodies to Rickettsia typhi by indirect immunofluorescence. Necropsy revealed interstitial pneumonia, pulmonary edema, hyaline membranes, alveolar hemorrhages, petechiae and vasculitis in the central nervous system, interstitial myocarditis, multifocal interstitial nephritis and hemorrhages, splenomegaly, portal triaditis, and mucosal hemorrhages in urinary tract. Immunofluorescent R. typhi were demonstrated in the lungs, brain, kidneys, liver, and heart. This unusual death occurred in an elderly patient without rash who was treated too late with antirickettsial drugs.
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PMID:Histopathology and immunohistologic demonstration of the distribution of Rickettsia typhi in fatal murine typhus. 249 81

This paper lists the pathological findings and causes of mortality of 93 sea turtles (88 Caretta caretta, 3 Chelonia mydas, and 2 Dermochelys coriacea) stranded on the coasts of the Canary Islands between January 1998 and December 2001. Of these, 25 (26.88%) had died of spontaneous diseases including different types of pneumonia, hepatitis, meningitis, septicemic processes and neoplasm. However, 65 turtles (69.89%) had died from lesions associated with human activities such as boat-strike injuries (23.66%), entanglement in derelict fishing nets (24.73%), ingestion of hooks and monofilament lines (19.35%), and crude oil ingestion (2.15%). Traumatic ulcerative skin lesions were the most common gross lesions, occurring in 39.78% of turtles examined, and being associated with Aeromonas hydrophila, Vibrio alginolyticus and Staphylococcus spp. infections. Pulmonary edema (15.05%), granulomatous pneumonia (12.90%) and exudative bronchopneumonia (7.53%) were the most frequently detected respiratory lesions. Different histological types of nephritis included chronic interstitial nephritis, granulomatous nephritis and perinephric abscesses, affecting 13 turtles (13.98%). Ulcerative and fibrinous esophagitis and traumatic esophageal perforation were the most frequently observed lesions in the esophagus, being associated in the majority of the cases with ingestion of fishing hooks. Larval nematodes of the Anisakidae family caused gastritis in 15 turtles (16.13%). Necrotizing and/or granulomatous hepatitis were the lesions most commonly observed in the liver (27.95%). Traumatic lesions included necrotizing myositis (10.75%) mainly caused by entanglement in fishing nets or boat-strikes, and amputation of 1 or 2 flippers (25.81%) by netting. Traumatic erosions and/or fractures of the carapace/plastron mainly caused by boat-strikes were also observed (26.88%). Eye lesions included heterophilic keratoconjunctivitis, ulcerative keratitis and heterophilic scleritis, affecting 7 turtles (7.53%).
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PMID:Diseases and causes of mortality among sea turtles stranded in the Canary Islands, Spain (1998-2001). 1575 96

Leptospirosis is recognized as a globally re-emerging zoonosis. Interstitial nephritis is the principal feature of the disease. Leptospirosis-induced acute kidney injury typically is nonoliguric and includes hypokalemia. Tubular function alterations precede a decrease in the glomerular filtration rate, which could explain the high frequency of hypokalemia. Studies in human beings and animals have shown increased urinary fractional excretion of potassium and sodium, as well as an increased potassium/sodium ratio, suggesting increased distal potassium secretion caused by increased distal sodium delivery consequent to functional impairment of proximal sodium reabsorption. Confirming these findings, Western blot studies have shown lower renal expression of the sodium/hydrogen exchanger isoform 3 and of aquaporin 2, together with higher renal expression of the Na-K-2Cl cotransporter NKCC2, in infected animals. The severe form (Weil's disease) manifests as diffuse alveolar hemorrhage, pulmonary edema, acute respiratory distress syndrome, or a combination of these features, accompanied by acute kidney injury and can be highly lethal. Antibiotic treatment is efficient in the early and late/severe phases. For critically ill leptospirosis patients, the following are recommended: daily hemodialysis, low daily net fluid intake (because of the risk for pulmonary hemorrhage), and lung-protective strategies (low tidal volumes and high positive end-expiratory pressures after recruitment maneuvers).
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PMID:Leptospiral nephropathy. 1862 Sep 61

Engraftment syndrome (ES) is a complication of hematopoietic stem cell transplantation characterized by fever, rash, and non-cardiogenic pulmonary edema. Acute kidney injury (AKI) has been recognized but is considered a minor criterion in one and excluded another definition of ES. We have noted a high incidence of AKI in patients with immunoglobulin light-chain amyloidosis (AL) undergoing autologous stem cell transplant (ASCT) around the time of leukocyte engraftment. This study was conducted to further investigate the relationship between AKI and ES. Data were collected from 377 AL patients who underwent ASCT from 7/1997 to 10/2009. Patients who experienced an elevation of serum creatinine >0.5 mg/dL within 4 days of leukocyte engraftment and anyone who presented with signs associated with ES regardless of renal manifestations were included. Forty-one patients met criteria. Twelve were excluded for positive cultures (10), acute interstitial nephritis (1), and acute cellular rejection (1). In addition to AKI (93.1%), patients also exhibit fever (82.7%), hypotension (51.7%), rash (48.2%), edema (93.1%), diarrhea (69.0%), conjunctival hemorrhage (31.0%), pulmonary edema (31.0%), pulmonary hemorrhage (13.8%), and transient encephalopathy (17.2%). Patient with pulmonary involvement were more likely to require dialysis but was not statistically significant. AKI was very common during leukocyte engraftment in AL patients. While infectious etiology accounted for some of the AKI, most appeared to be associated with ES. After infection is ruled out, ES should be considered in the differential diagnosis when evaluating AKI in this population.
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PMID:Acute kidney injury during leukocyte engraftment after autologous stem cell transplantation in patients with light-chain amyloidosis. 2207 13

A 30-year-old female was symptomatic with headache, fatigue, and weakness since October 2011 and was told to have anemia. In January 2012, she was admitted outside with pulmonary edema. Investigations revealed advanced azotemia, anemia, and hypercalcemia. Urine showed 2 + proteins and 30-35 red blood cells. There was no history of oral ulcers, rash, Raynaud's phenomenon, or hemoptysis. She was evaluated for causes of rapidly progressive "renal failure." Hemolytic work-up; antinuclear antibody, double-stranded DNA, and anti-neutrophil cytoplasmic antibody were negative. Kidney biopsy was done and interpreted as acute interstitial nephritis with hyaline casts. She was started on hemodialysis and treated with steroids and cyclophosphamide. She came to our institute in January 2012. Investigations showed evidence of paraproteinemia with kappa restriction. Bone marrow showed 15% plasma cells. Kidney biopsy was reviewed and was diagnostic of cast nephropathy. She was treated with 6 monthly cycles of dexamethasone and bortezomib. She achieved complete remission in July 2012. Maintenance doses of bortezomib were continued until May 2014. Autologous bone marrow transplantation was performed on June 06, 2014. Monthly, bortezomib was continued till April 2015. Subsequently, workup for renal transplantation was started with her father as her donor. Test for sensitization was negative. Renal transplantation was done on January 1, 2016, with prednisolone, mycophenolate, and tacrolimus. She achieved a serum creatinine of 0.6 mg% on the 4th postoperative day. Thereafter, she continues to remain stable.
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PMID:Sequential, Autologous Hematopoietic Stem Cell Transplant Followed by Renal Transplant in Multiple Myeloma. 2876 Dec 39

A peracute epizootic disease, strikingly characterized by profuse terminal hemorrhaging from the lungs, caused the deaths of 104 squirrel monkeys and 3 capuchin monkeys over a 22-month period. The case fatality rate was 100%. The pulmonary hemorrhaging was often accompanied by pulmonary edema and congestion, interstitial pneumonia, and hydrothorax. Additional histologic lesions included interstitial nephritis, hepatitis and hepatic necrosis, adrenalitis and adrenal necrosis, myocarditis, splenic atrophy or hypoplasia, pancreatitis and pancreatic necrosis, sialoadenitis, and encephalitis. Macaques maintained under identical conditions were clinically unaffected by the epizootic. There was an incidental relationship with contamination of feed, water, and housing facilities by excrement from feral Norway rats and cockroaches. Due to the association of the disease outbreak with abundant rodent and cockroach populations, and because the histologic features of the disease were suggestive of a viral etiology, encephalomyocarditis virus infection was implicated. However, histopathologic examinations of tissues from 68 monkeys; electron-microscopic studies on five monkeys; bacteriologic culturing; virus isolation attempts from 10 monkeys, rats, and cockroaches; and experimental inoculation studies in mice and squirrel monkeys all failed to reveal the causative agent, to provide a definitive diagnosis, or to reproduce the disease.
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PMID:A fatal epizootic of undetermined etiology in new world monkeys. 3199 87