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)

Eighty-five patients with chronic splenomegaly and proven oesophageal varices were studied at Kenyatta National Hospital, Nairobi. The major defined groups were hepatosplenic schistosomiasis (24%), cirrhosis (20%) and portal vein occlusion (11%). Hyper-reactive malarial splenomegaly (tropical splenomegaly syndrome) was considered as the cause of oesophageal varices in only one patient. In 26% of cases liver biopsy was non-diagnostic and the extrahepatic portal vein was demonstrated radiologically to be patent. Such patients were thought to be suffering from idiopathic portal hypertension, not previously described elsewhere in Africa. Hepatitis B surface antigen was detected in 12% of controls and in 58% of patients with cirrhosis (p less than 0.001). Some serological marker of previous hepatitis B virus infection was present in 92% of patients with cirrhosis and in 79% of controls. Kamba patients from Machakos and Kitui Districts were significantly more prevalent than expected among these 85 cases of portal hypertension.
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PMID:Chronic splenomegaly in Nairobi, Kenya. II. Portal hypertension. 312 51

Chronic splenomegaly in 131 Kenyan patients was investigated at Kenyatta National Hospital, Nairobi. Patients were allocated to diagnostic groups on the basis of clinical, haematological, parasitological, histological, radiological and endoscopic data. The major diagnostic groups were hyper-reactive malarial splenomegaly, our preferred name for tropical splenomegaly syndrome, (31%), hepatosplenic schistosomiasis (18%), visceral leishmaniasis (5%) and "indeterminate splenomegaly", where no diagnosis could be reached (12%). Another 20% of patients were suffering from various non-schistosomal forms of portal hypertension. A number of specific and rarer causes accounted for the rest of the cases. The tribal and geographical distribution of patients with chronic splenomegaly was compared with the pattern of general medical admissions. Splenomegaly was more frequent than expected in Kamba and Luo patients. Hyper-reactive malarial splenomegaly and hepatosplenic schistosomiasis were common in both groups, whereas visceral leishmaniasis was almost restricted to the Kamba and indeterminate splenomegaly was especially prevalent in the Luo. Malarial antibody and immunoglobulin levels differed significantly between the various diagnostic categories of patients and controls. Malarial serology can be diagnostically useful for chronic splenomegaly, provided results are interpreted in their geographical context.
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PMID:Chronic splenomegaly in Nairobi, Kenya. I. Epidemiology, malarial antibody and immunoglobulin levels. 344 95

Children with sickle cell disease in Nairobi come from tribes living in malarial regions of Kenya. The clinical presentation and complications of this disease are described. The symptoms at onset are nonspecific but the typical features that follow are easy to recognize. Cardiac murmurs and persistently enlarged spleen in older children pose diagnostic challenges. Poor appetite and failure to thrive are common; so are school absenteeism due to crises and infection. The use of white blood cell counts to determine the presence of infection during crises is described.
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PMID:Clinical aspects of sickle cell disease in Nairobi children. 695 42

Sixty-eight patients with proven esophageal varices wer studied at Kenyatta National Hospital, Nairobi, Kenya. Of these patients, 29.4% had schistosomal portal hypertension, 22.1% cirrhosis and only 8.8% extrahepatic portal vein occlusion. One quarter of the patients had a normal liver biopsy and extrahepatic portal vein that was demonstrated to be patent. Problems relating to liver biopsy sampling resulting in underdiagnosis of specific causes of esophageal varices such as schistosomiasis are discussed. We argue that many of these patients were likely to be suffering from idiopathic portal hypertension, a condition apparently not previously recognized in Africa. Of this last group, 70.6% had suffered gastrointestinal bleeding, as had 50% of the patients with schistosomiasis. Together these two groups accounted for three-quarters of all patients who had bled. The detection of eggs of Schistosoma mansoni in stool and/or rectal snip correlated well with liver biopsy findings in both a positive and negative sense. Only 18% of patients with negative stools and snips had evidence of schistosomiasis in the liver, and positive stools or snips were found in only 14.6% of patients without schistosomal liver involvement. Of the patients in the study, 50% were of the Kamba tribe, although only 12.9% of all medical admissions to the hospital were Kamba (P less than 0.01). Luo patients were significantly more frequent within the group with schistosomiasis (P less than 0.02). Esophageal varices were attributed to tropical splenomegaly syndrome in only one patient. The implications of our results are discussed and our findings are compared with previous work from East Africa.
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PMID:Esophageal varices in Nairobi, Kenya: a study of 68 cases. 697 64

A retrospective analysis of all malaria cases admitted to the Nairobi Hospital was performed by reviewing patient records. Six hundred and three cases were recorded between the period of January 1987 and July 1990 (43 months). The mean age of the patients was 32.5 years and 57.5% were male. Although 81.4% were permanent residents of Kenya, only 18.2% could be said to have lived in a malarial zone. One-quarter of the patients (25.6%) admitted having had a previous episode of malaria, and 57.7% were taking regular chemoprophylaxis. The most common presenting symptoms were fever, headache, vomiting and myarthralgia; the most commonly recorded accompanying signs were jaundice and splenomegaly. Sixty patients met the criteria for severe malaria. During their hospital stay, six patients (1%) died; five of whom were severely ill from the time of for the USA and UK, especially as it represents a selected population of the more serious malarial cases admitted to the hospital. Therefore, it may indeed represent clear evidence to support the hypothesis that a high index of suspicion combined with early diagnosis and treatment will result in improved outcome. Comparative features illustrating these points are presented. As the malaria parasite, P. falciparum, has dynamic antimalarial sensitivity and as more travelers are under threat from this disease, it is vital that ignorance of this danger should not be allowed to put individuals at risk for death. Continuing education of both the traveling public and the medical profession is the only way that both parties will shoulder their respective responsibilities.
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PMID:Nairobi Hospital, Kenya: the management of nonimmune P. falciparum malaria abroad. 825 8