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Query: UMLS:C0038002 (splenomegaly)
 9,873 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A description of the clinical and haematological features of splenomegalic idiopathic myelofibrosis is followed by the presentation of two personal cases, one with a classic picture of the advanced stage and marked, progressive anaemia, leukopenia, frank splenomegaly and renal alterations, the second in the initial stage, with liver and spleen enlargement, very marked thrombocytosis and high white and red cell counts. The clinical diagnosis was confirmed by bone biopsy in each case. A description of the clinical findings precedes an explanation of the anatomical and histological pictures observed at biopsy. These are fundamental importance for the purposes of diagnosis.
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PMID:[Idiopathic splenomegalic myelofibrosis. Report of 2 clinical cases]. 668 5

A patient with splenomegaly, severe granulocytopenia and a strongly positive rheumatoid factor test initially had no clinical evidence of rheumatoid arthritis. Leukopenia responded to splenectomy and did not recur during one year of follow up. Symmetrical metacarpophalangeal joint swelling developed after nine months. This case emphasizes that arthritis may occasionally be a late and minor manifestation of Felty's syndrome.
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PMID:Felty's syndrome presenting without arthritis. 668 Nov 43

Two groups of three German shepherd dogs each were inoculated with Leishmania chagasi or Leishmania donovani amastigotes and the infection was followed for 82 days. The dogs developed a persistent infection, became thin, and developed splenomegaly and lymphadenomegaly by 55 days after inoculation. All dogs developed a normocytic, normochromic anemia of increasing severity. Thrombocytopenia and leukopenia occasionally occurred. Blood tryptophan levels were decreased significantly in infected dogs. Increased total serum protein, with hypergammaglobulinemia and hypoalbuminemia, was present in all dogs to various degrees. There was a marked increase in gamma globulins, with smaller increases in alpha and beta globulins. Many of the clinicopathologic changes observed in these dogs were similar to the disease as it occurs in man. The German shepherd dog may be a useful laboratory model for the study of visceral leishmaniasis.
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PMID:Visceral leishmaniasis in the German shepherd dog. I. Infection, clinical disease, and clinical pathology. 671 Aug 16

223 cases with chronic lymphoid leukemia (CLL) were subjected to a prospective study on the presence of adeno- and splenomegaly at diagnosis and their subsequent variation. Subjects with no initial organ involvement were usually female (76%) and of old age (mean 69.2 years). Adenopathy or combined lymph node and spleen enlargement were inversely proportional to the mean age at diagnosis. Subsequent organ enlargement was noted in 11.7% of patients with no initial organomegaly, splenomegaly in 15% of patients with adenopathy only and adenopathy in 15% of patients with splenomegaly only. Except in the few cases with leukopenia, particularly high leuklocyte levels were noted in patients with splenomegaly (with or without adenopathy). Anemia at diagnosis was not related to the degree of organ enlargement. It is suggested that qualitative and also quantitative differences in organomegaly in CLL merit further study to establish their underlying mechanisms. CLL must be seen as something more complex than the simple mechanical expression of progressive lymphocyte accumulation.
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PMID:Chronic lymphoid leukemia. Clinical observations about its natural progression. 676 4

A 15-year-old woman with thyrotoxicosis controlled by propylthiouracil presented with chills, fever, splenomegaly, anemia, thrombocytopenia, leukopenia, hypergammaglobulinemia, immune complexes, a positive anti-nuclear antibody test, and a cellular marrow with normal maturation. Anti-neutrophil antibody was detected by cytotoxicity testing. The activity was restricted to the IgM fraction and was absorbed optimally at 4 degrees C. The antibody activity was recovered in both heat and ether eluates made from granulocytes. Lymphocytes, platelets, and red blood cells failed to absorb reactivity. The antibody did not inhibit superoxide production or bacterial killing. Propylthiouracil was discontinued and all signs and symptoms resolved.
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PMID:An anti-neutrophil antibody associated with a propylthiouracil-induced lupus-like syndrome. 683 92

A man aged 31 with remittent fever, leukopenia, polyuria, and splenomegaly in addition to chronic and recurrent episodes of neurologic abnormalities was examined pathologically. A chronic type of perivenous encephalomyelitis was found in the CNS, and chronic inflammatory lesions were noticed in the infundibulo-hypophyseal system and also in the peripheral nerves. Moreover, hemophagocytic lymphohistiocytosis predominated in the reticuloendothelial system. This seemed to be the first adult case of demyelinating disease with hemophagocytic lymphohistiocytosis.
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PMID:Chronic recurrent demyelinating encephalomyelitis associated with hemophagocytic lymphohistiocytosis. 683 66

A patient had cutaneous vasculitis, leukopenia, and splenomegaly caused by the antithyroid drug, propylthiouracil. Histopathologic changes of acute vasculitis of the superficial and deep dermal blood vessels accompanied by fibrin thrombi formation were found in biopsy specimens of the cutaneous lesions. Direct immunofluorescence studies demonstrated IgM and C3 of the vessel walls suggesting immune complex deposition. The literature disclosed five cases with similar features associated with propylthiouracil therapy. Characteristic cutaneous findings include a recurrent, self-limited, symmetrical purpuric eruption that can involve the face or earlobes. Clinicians should recognize these changes as a cutaneous sign of a vasculitis associated with propylthiouracil therapy.
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PMID:Propylthiouracil-induced cutaneous vasculitis. Case presentation and review of the literature. 689 30

Clinicopathological features of three male cases with malignant histiocytosis (MH) are described. Case 1, aged 27, had had an indurated swelling of the left mandibular region, histologically being chronic lymphocytic inflammation, with ebb and flow for 4 years prior to the onset of MH, with low grade fever, lymphadenopathy and pulmonary infiltration. Histology of the lymph node was compatible with MH, and only a temporary improvement was obtained by COP therapy. Case 2, aged 32, showed acute febrile onset with severe anemia and splenomegaly. Diagnosis of MH was determined by bone marrow histology. COP therapy appeared effective, but caused severe leukopenia and thrombocytopenia resulting in fatal gastrointestinal bleeding. Case 3, aged 16, had high fever and cutaneous mass of the left chest wall, histology of which suggested MH. Bone marrow biopsy was also diagnostic. Severe pancytopenia allowed only a limited therapy. Morphology of the histiocytes was variable in each case. Diffuse infiltration of neoplastic histiocytes in many organs and erythrophagocytosis in the bone marrow were commonly found in all the cases. The present cases suggested a diagnostic value of bone marrow biopsy and possible effect of antineoplastic combination therapy on earlier stage of MH.
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PMID:Malignant histiocytosis: a clinico-pathological study of three autopsied cases. 698 20

Leukopenia, thrombocytopenia, and hemolytic anemia occur commonly in advanced cirrhosis. Some investigators have reported that portacaval anastomosis (PCA) abolished hypersplenism while others have not found PCA to be uniformly beneficial. We compared the frequency of hypersplenism before and after admission to a controlled investigation of the effects of PCA in 52 unoperated control subjects and 38 patients with patent PCA. The two groups were followed for an average period of 5 1/2 years. On admission to the study leukopenia was present in about 2% of patients, thrombocytopenia in 6%, and hemolytic anemia in 4%. Splenomegaly was present in 48% and hypersplenism in 11%. After randomization splenomegaly disappeared more frequently in the shunted group. In addition, fewer patients with PCA developed splenomegaly for the first time after inclusion into the study than did unoperated control subjects. Leukopenia, thrombocytopenia, and hemolytic anemia, when present at inclusion into the study, disappeared with equal frequency in the shunted and unshunted patients, and appeared with equal frequency in both groups after randomization in previously unaffected patients. In no instance was hypersplenism clinically significant nor was splenectomy considered or carried out in any of these 90 patients. In additional uncontrolled studies we observed that therapeutic PCA did not affect hypersplenism differently from prophylactic PCA. We conclude that PCA has neither clinically nor statistically significant effects on hypersplenism.
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PMID:Effect of portacaval anastomosis on hypersplenism. 700 9

In a 41-year-old woman who had suffered from hypofibrinogenemia, thrombocytopenia, leukopenia and splenomegaly for several years a causative hamartoma of the spleen (splenoma) was removed surgically. The results of a preoperative therapeutic trial with heparin, the marked accumulation of 125I-activity in the splenoma following intravenous injection of radioiodinated fibrinogen, the immunohistochemical demonstration of extensive fibrinogen deposits in the splenoma, and normalization of fibrinogen levels and blood cell counts after surgery point to the pathogenetic role of this rare splenic tumor. The salient clinical and pathological features of 41 splenoma cases in the literature are briefly reviewed. Hematologic signs were observed in only 9 splenoma patients.
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PMID:[Chronic defibrination syndrome and thrombocytopenia in splenic hamartoma (splenoma)]. 711 62


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