Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0038002 (splenomegaly)
 9,873 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Two patients admitted to the hospital because of severe bacterial infection were diagnosed as having visceral leishmaniasis. The types of bacterial infection were perianal abscess and pneumonia; Escherichia coli and Streptococcus pneumoniae were isolated from exudates and blood cultures, respectively. A third patient admitted because of acute necrotizing infection of the pharynx and visceral leishmaniasis is also discussed. Cultures from this patient failed to yield pathogens. Anemia, leukopenia, or thrombocytopenia was present in all patients, and bone marrow aspirate revealed the presence of Leishmania in macrophages. We conclude that in areas where leishmaniasis is endemic, early bone marrow aspirate should, in most instances, be performed in patients with bacterial infection associated with anemia, leukopenia, or thrombocytopenia if hepatomegaly and/or splenomegaly is present.
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PMID:Bacterial infection as a presenting manifestation of visceral leishmaniasis. 219 55

Neonatal septicemia was assessed by blood cultures in 115 newborns (NB) during a two years study in a pediatric hospital of reference in Mexico City. The studied patients were divided in two groups of gestational age, and the differences of etiologic agents, clinical signs, laboratory findings and clinical outcome were compared at term and preterm neonates. We observed Staphylococcus epidermidis became the first cause of septicemia in at term NB (P less than 0.001), while Escherichia coli and Klebsiella pneumoniae (P less than 0.01) were more frequent in the preterm neonates. The clinical manifestations of fever (P less than 0.001), hepatomegaly (P less than 0.01), splenomegaly (P less than 0.05), and rejection to feeding (P less than 0.05) were more common in at term NB. On the other hand, apneas (P less than 0.01), hypothermia (P less than 0.02), and abdominal distension (P less than 0.05) were more frequent in the preterm NB. The altered white blood cell counts were more commonly observed in the preterm group, as leukopenia (P less than 0.05), neutropenia (P less than 0.01), and high I/T ratio (P less than 0.05). There were not significant differences in complications or sequels between the two groups; however, the mortality ratio was higher in the preterm NB group (P less than 0.02). Changing etiology of neonatal septicemia is discussed, and we propose these kind of data are very useful for purpose of detection, diagnostic and treatment of septic neonates.
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PMID:[Neonatal septicemia: differences in full-term and pre-term newborn infants]. 234 9

A patient who developed mutilans-type arthropathy, splenomegaly, leukopenia, leg ulcer and massive hydroxyapatite accumulation during the course of progressive systemic sclerosis (PSS) was reported. A 56-years-old female had suffered Raynaud's phenomenon since the beginning of her third decade. She developed multiple symmetrical arthritis and morning stiffness at the age of 29, and was treated with NSAIDs and low dose corticosteroids under the diagnosis of rheumatoid arthritis (RA) Because of dysphagia and diarrhea, she was admitted in Niigata-Kenritsu Senami Hospital in September, 1987. Physical and roentgenographic examinations revealed diffuse scleroderma, mutilans-type arthropathy, lung fibrosis, splenomegaly and right leg ulcer. Laboratory examinations showed leukopenia, high titer of anti-DNA antibody, positive anti-Scl-70 antibody and mild hypocomplementemia. These findings suggested that she had PSS and Felty's syndrome. Furthermore, massive subcutaneous and intraarticular hydroxyapatite accumulation were noticed. The leg ulcer and laboratory data gradually improved with the combination therapy of corticosteroids, D-penicillamine and plasmapheresis. Although it has been well recognized that PSS patients reveal frequently the articular lesions similar to these of RA, severe mutilans-type arthropathy seen in this case is extremely rare. The joint contracture might be induced by hydroxyapatite accumulation, of which the early diagnosis seems to be very important in long-standing PSS patients.
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PMID:[A case of progressive systemic sclerosis associated with mutilans-type arthropathy and suspected Felty's syndrome]. 237 41

Black children with homozygous sickle-cell disease usually have anatomic asplenia by 6-8 years of age. In the Eastern Province of Saudi Arabia, sickle-cell disease runs a benign course. Here we report six sicklers with hypersplenism as manifested by 1: splenomegaly (6/6); 2: persistent thrombocytopenia (6/6); 3: increasing severity of anaemia with the need for repeated blood transfusion (5/6); 4: leukopenia (1/6); 5: high reticulocyte count (6/6); 6: circulating nucleated red blood cells (5/6). All improved after splenectomy, with resolution of the thrombocytopenia and leukopenia, improvement in the degree of anaemia, decrease in the reticulocytes and disappearance of circulating nucleated red blood cells.
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PMID:Hypersplenism in homozygous sickle-cell disease in Saudi Arabia. 241 52

Bone marrow involvement was seen in 11 percent of patients with Hodgkin's Disease which was determined from pre-treatment biopsy specimens using established histopathologic criteria. Analysis of 32 evaluable patients with marrow involvement showed male preponderance with a peak in fourth decade of life. Twenty four cases (75%) had B-symptoms and 15 (46%) presented within six months of onset of symptoms. On categorizing for clinical staging, 21 (65%) belonged to stage III and IV. Hepatomegaly (greater than or equal to 2 cms) was present in seven cases (21%) and splenomegaly in 13 cases (40%). Mixed cellularity and lymphocytic depletion histopathologic subtypes showed the highest frequency of involvement (21 cases; 65%). Out of 28 cases ESR was raised in 27 cases (96%). Eighteen cases (56%) showed elevated serum alkaline phosphatase levels. Serum copper levels were determined in 14 cases, out of which 12 (85%) showed elevated levels. These parameters along with anemia (hemoglobin of 12 g/dl or less) in 26 cases (81%), correlated well with the disease activity. Only four cases had leukopenia at presentation pointing to no hindrance for aggressive chemotherapy. All cases received minimum of six courses of standard combination chemotherapy with or without local radiotherapy. Sixteen cases (50%) relapsed subsequently and were managed accordingly. A five year follow-up revealed a minimal 31 percent overall survival, and 18 percent of patients were disease free and well since the time of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Hodgkin's disease with bone marrow involvement. 259 99

In 24 cases of thrombopenic purpura associated with human immunodeficiency virus infection the clinical, immunological and therapeutic features were evaluated. Thrombopenia resulted in clinical manifestations in 20 patients. Splenomegaly was found in only one fourth of patients. Antiplatelet antibodies were found in 9 patients, and thrombopenia was associated with anemia in 37% of cases and with leukopenia in 21%. Bone marrow examination showed megakaryocyte hyperplasia in two thirds of the patients. The major immunological abnormalities were an inverted helper/suppressor T lymphocytes ratio, a reduction in the number of helper T lymphocytes, polyclonal hypergammaglobulinemia, and increased serum concentrations of circulating immunocomplexes. The different therapeutic modalities, steroids, vincristine, danatrol and plasma exchange, resulted in short responses; only two patients had normal platelet counts. The median follow-up was 14 months; during this time three patients fulfilled the criteria of acquired immunodeficiency syndrome.
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PMID:[Thrombopenic purpura associated with human immunodeficiency virus infection. Analysis of 24 cases]. 274 29

The patient is a 44-year-old female case of RA having a history of 10 years after onset, being admitted due to fever accompanied by granulocytopenia. By laboratory findings, WBC was 1,900/mm3, CRP 5+, RA 2+, RAHA 80 times, LE cells positive, antinuclear antibody strongly positive, granulocyte-specific antinuclear antibodies positive, and granulocyte specific cytotoxicity test strongly positive. Examination of bone marrow smears revealed, the cell numbers tended to decrease in the neutrophil maturity phase. The case was diagnosed as Felty's syndrome because of the obvious splenomegaly and leukopenia. Administration of 30 mg/day of prednisolone was not sufficient in effect, and plasmapheresis was conducted concomitantly. As a result, the granulocyte count increased and the granulocyte cytotoxicity titer was lowered. It is hence suggested that the antigranulocyte antibodies are responsible for the mechanism of granulocytopenia in this case, and the possibility of promotion of destruction in the periphery was inferred, and it is accordingly considered useful to combine administration of small dose of adrenocortical steroid preparation with plasmapheresis for the treatment of this disease.
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PMID:[A case of antigranulocyte antibody positive Felty's syndrome and its efficacy of plasmapheresis]. 278 58

A case of chronic myelogenous leukemia (CML) of 10-year survival in described. A 44-year old male was admitted to our hospital because of general malaise, abdominal fullness and fever in February, 1977. On physical examination, giant splenomegaly and hepatomegaly were detected. Peripheral blood examination revealed leukocytosis without hiatus leukemia , normochromic macrocytic anemia and thrombocytosis. NAP rate and score were 16% and 22. Cytogenetic analysis of PB without stimulator revealed 46, XY, Ph1. Then he was diagnosed as having a typical type of Ph1-positive CML. He had been successfully treated over 9 years by intermittent administration of busulfan. However, anemia suddenly progressed in February, 1986 followed by leukopenia and thrombocytopenia. Hemorrhage was not detected by the examination. Though he had been received blood transfusion, the anemia progressed rapidly. He was died of cachexia on 4th of August, 1987. The postmortem examination revealed bone marrow aplasia with no signs of blast crisis nor myelofibrosis. Secondary hemochromatosis was seen in the liver, spleen, pancreas and some other organs.
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PMID:[Bone marrow aplasia without blast crisis in a case of CML of 10-year survival]. 279 87

To establish the indications for splenectomy in patients with human immunodeficiency virus (HIV) infection we retrospectively analyzed 12 patients who underwent splenectomy. Patients with HIV infection who had immune thrombocytopenic purpura (ITP) were excluded as they had no splenomegaly and a definite indication for splenectomy exists in some of these patients. All 12 patients were anemic; 6 were thrombocytopenic and 6 leukopenic. All patients had splenomegaly and all were febrile. At surgery 3 patients were found to have Mycobacterium avium intracellulare (MAI) infection; 2 had splenic abscess due to Salmonella group D; 1 each had cytomegalovirus (CMV) splenitis and localized Kaposi's sarcoma (KS) of the spleen. No definite histopathologic diagnosis could be made in five patients, all of whom had evidence of extramedullary hematopoiesis. The degree of splenic enlargement did not correlate with the outcome. Both clinical and hematologic improvements were achieved in patients with splenic abscess and in patients who had splenomegaly, anemia, and thrombocytopenia. The presence of either of these findings constitutes an indication for splenectomy. Anemia and/or leukopenia without thrombocytopenia failed to improve; the presence of MAI and active CMV infection also resulted in failure. The presence of either of these conditions may be considered a contraindication to splenectomy.
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PMID:Splenectomy in patients with AIDS. 281 11

We report two cases of a T cell lymphoproliferative disease not previously described, with cytologic and clinical features similar to those associated with Galton's "prolymphocytic" leukemia (PL). Our patients, like those with Galton's PL, had massive splenomegaly and minimal or absent hepatomegaly and lymphadenopathy. In contrast, however, our patients had leukopenia, as well as low percentages of leukemic cells in the peripheral blood and in the bone marrow. In splenic imprints, the nuclear chromatin pattern of most of the leukemic cells was intermediate between those of mature lymphocytes and those of lymphoblasts, and the nuclei contained single, centrally located, conspicuous nucleoli. In sections of the spleen, the leukemic cells diffusely infiltrated the red pulp in a pattern strikingly similar to that of hairy cell leukemia; however, when the leukemic cells were studied cytochemically, the cytoplasmic acid phosphatase positivity was punctate and tartrate-sensitive. The leukemic cells were sheep erythrocyte rosette-positive and expressed T cell-associated antigens. Initially, both patients responded well to therapeutic splenectomy. One patient received combination chemotherapy after splenectomy and is alive and well 24 months after diagnosis. The other patient was in complete clinical remission for one year after splenectomy and received chemotherapy at relapse. He died, however, 23 months after splenectomy, with disseminated disease. IgG antibody titers against human T lymphotropic virus type I (HTLV-I) were detected in one patient and against HTLV-II in the other. The leukemia in these patients represents a distinct clinicopathologic entity within the spectrum of peripheral T cell lymphoproliferative diseases that includes Galton's PL of T cell derivation, T cell chronic lymphocytic leukemia, T cell hairy cell leukemia, and adult T cell leukemia/lymphoma.
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PMID:Leukopenic chronic T cell leukemia mimicking hairy cell leukemia: association with human retroviruses. 300 37


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