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)

We report on a tourist returning from Thailand, who presented with classical dengue fever. While in Thailand a 36-year-old Swiss female laboratory assistant suddenly developed fever, devastating headache, retro-ocular pain, myalgia and arthralgia, photophobia, nausea and diarrhea. In addition she suffered from epistaxis, urogenital and skin bleeding, and a morbilliform exanthema. After her return to Switzerland we noted lymphadenopathy and splenomegaly, enanthema and laboratory findings of mild hepatitis, thrombocytopenia and leukopenia. The diagnosis of dengue virus infection was verified serologically. Apart from a long lasting convalescent asthenia we observed restitutio ad integrum within days under symptomatic therapy. Epidemiological clinical and diagnostic aspects of dengue virus infection are discussed.
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PMID:[Imported dengue fever following a stay in the tropics]. 842 57

Forty-seven patients who underwent splenectomy for splenomegaly > or = 1000 g were studied retrospectively. There were 29 men and 18 women of mean age 56 (range 19-87) years. Haematological malignancy was the most common disorder (42 patients). The main indications for splenectomy were cytopenia (20 patients), diagnosis (14), initial treatment of leukaemia (eight), pain (four) and spontaneous rupture (one). Thirteen patients underwent an associated surgical procedure. One patient died (mortality rate 2 per cent) and 12 (26 per cent) had postoperative complications. The advantages of splenectomy included histopathological diagnosis in 13 of 14 patients with splenomegaly of unknown origin, effective initial treatment in prolymphocytic and hairy cell leukaemia, definitive relief of pain in all affected patients, and long-term improvement of cytopenia in most.
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PMID:Splenectomy for splenomegaly exceeding 1000 grams: analysis of 47 patients. 847 44

A 58-year-old man admitted to hospital as an emergency with pain in the left hypochondrium. The initial physical examination revealed hypotension, giant splenomegaly and ascites but no lymphadenopathy was found. Laboratory findings at admission included hemoglobin level of 9.2g/dl, leucocyte count of 22, 100/microliters with 2% of lymphoma cell and platelets count of 66,000/microliters. A presumptive diagnosis of ruptured spleen was made. Splenectomy was performed after 7 hours from admission. The spleen was infiltrated by malignant lymphoma. Three weeks after surgery, left neck and abdominal lymphoadenopathy were recognized, therefore systemic chemotherapy was started. The leukemic change was one of important factors for the mechanisms of spontaneous splenic rupture in malignant lymphoma.
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PMID:[Spontaneous splenic rupture in a case of non-Hodgkin's lymphoma]. 849 17

A 74-year-old man was admitted because of swelling, pain and ecchymosis in the night lower extremity. A blood analysis revealed that Hb was 11.8g/dl, WBC 37,600/microliters, and platelet count 137.1 x 10(4)/microliters. The NAP value was high. Bone marrow examination disclosed marked megakaryocytic hyperplasia. Chromosomal analysis revealed 47, XY, +9. Hemostatic data were within normal ranges, but the 2nd aggregation of platelet by ADP was diminished. The serum beta-TG was 159, PF-4 56ng/ml, B12 1,100, UB12 BC 1,800pg/ml. Gastric fiberoscopy revealed gastric cancer and CT scan disclosed marked splenomegaly. Essential thrombocythemia (ET) coexisting with gastric cancer was diagnosed based on these examinations. He was treated with anti-platelet agents, busulfan and tegafur uracil, however thromboembolic symptoms suggesting central nervous system and peripheral vascular ischemia and gastrointestinal bleeding occurred. Among diagnostic criteria for ET established by the polycythemia vera study group, there is a category "No known cause for reactive thrombocytosis." The case reported here had gastric cancer which may have contributed to the elevated platelet count, however this case could be diagnosed as ET coexisting with gastric cancer because of the above various clinical signs and laboratory results. Although then are few reports of the coexistence of other malignancies in ET, there may be many more similar cases because of the age preponderance in ET. In order to diagnose ET more precisely, more strict diagnostic criteria are needed.
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PMID:[Coexistence of essential thrombocythemia and gastric cancer]. 849 22

Much of the morbidity associated with sickle cell anemia (SCA) is due to ongoing infarction resulting in organ dysfunction. Because the spleen is often the first organ damaged in this illness, there is a significant impairment of the immune system in these patients. Hydroxyurea (HU) has been shown to increase fetal hemoglobin (HbF) and decrease painful episodes in patients with this disease. It is unclear whether HU can prevent organ damage. We treated two SCA patients with HU for several years and found evidence of reversal of previously documented splenic dysfunction. Patient no. 1 was treated for 30 months with an increase in HbF to 30%. HU was stopped because of cytopenia. She developed left upper quadrant pain. A splenectomy was performed due to the possibility of splenic abscesses. A pathologic review found no evidence of infection and an enlarged spleen that showed active germinal centers. Patient no. 2 was treated for 24 months with HU before developing splenomegaly. His HbF levels were 25% to 30%, his pit counts averaged 2%, and his liver spleen scans showed uptake. These two cases show that chronic HU therapy may reverse splenic dysfunction in certain patients and suggest that this drug may have efficacy beyond the elimination of pain in SCA.
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PMID:First report of reversal of organ dysfunction in sickle cell anemia by the use of hydroxyurea: splenic regeneration. 882 12

Spontaneous rupture of the spleen is a rare and life-threatening complication of bacterial pneumonia, only six properly documented cases having been reported to date. A case of spontaneous splenic rupture associated with pneumonia caused by Legionella pneumophila is presented, together with a review of the literature. Most of the patients were aged over 50, but none had predisposing conditions. Left lung involvement predominated. Legionellosis and Q fever were the most frequent etiologic diagnoses. Empiric antibiotic therapy was adequate in all but two patients. One patient died; he had not undergone laparotomy. Spontaneous rupture of the spleen is an extremely rare complication of bacterial pneumonia that endangers the patient's life if surgery is not performed immediately. This complication should be borne in mind in patients with atypical pneumonia who have left quadrant pain and a falling hematocrit, even in the absence of prior splenomegaly.
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PMID:Spontaneous rupture of the spleen associated with pneumonia. 892 73

The objective of this retrospective study was to determine the indications for splenectomy in hematological disorders and to analyze the results depending on the indication leading to surgery. Fifty-six patients with various hematological disorders were splenectomized between 1990 and 1994. The main indication was noted. Operative success was defined as: return to normal platelet counts without further medication in thrombocytopenia, relief of pain and local compression syndrome in painful splenomegaly, hemoglobin levels > 10 g/dl without the need for further transfusions in hemolytic anemia, response to chemotherapy after splenectomy for prior resistance because of massive splenic infiltration, and relief of infection in splenic infection. Morbidity and mortality were noted. Five major indications for splenectomy were found: thrombocytopenia (n = 36, success 78%), painful splenomegaly (n = 8, success 100%), hemolytic anemia (n = 5, success 60%), resistance to chemotherapy because of massive splenic infiltration (n = 5, success 100%). One patient with thrombocytopenia died (mortality 2%). Seven patients had major complications (13%). In hematological diseases, thrombocytopenia, painful splenomegaly and splenic infection are likely to be improved by splenectomy. In hemolytic anemia it can be a helpful approach, while in resistance to chemotherapy because of massive splenic infiltration success is less likely.
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PMID:Indications for and results of splenectomy in different hematological disorders. 912 72

Benign, non-parasitic splenic cysts are an uncommon cause of splenomegaly in children. Potentially they may enlarge, causing pain, rupture, or haemorrhage, or become infected. Traditional management has been total splenectomy. We report two cases of true epithelial-lined splenic cysts successfully treated by partial splenectomy using an oxidised cellulose gauze 'sandwich' technique.
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PMID:Conservative surgery for benign non-parasitic splenic cysts. 988 Jul 31

Splenic infarction is a rare disorder. The typical clinical presentation is sudden pain in the left upper quadrant of the abdomen, and awareness to this possibility is the major clue for diagnosis. We describe a 49-year-old man with chronic atrial fibrillation and splenomegaly who was treated with anticoagulants. Because of hematuria, the regular dose of anticoagulant therapy was reduced. The hematuria stopped but he complained of sudden onset of pain in the left upper quadrant. Computerized tomography and isotope scan of the spleen confirmed the clinical suspicion of splenic infarction. Treatment with anticoagulants and analgesics was followed by clinical improvement.
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PMID:[Embolic splenic infarction: a rare complication of atrial fibrillation]. 926 89

Nine thousand four hundred evaluable patients with breast complaints were consecutively studied from 1984 to 1994. Their ages ranged between 15-65 years with a median of 33 years. Five thousand, six hundred and seventy-five of these presented on account of pain and a mass was the cause of pain in 74%. Gross fibrocystic disease of the breast was the commonest tumour encountered in this group. Seven hundred and thirty eight patients were found to have 'referred' pain, and splenomegaly was the commonest cause of this 'referred' pain. At present, a simple breast biopsy remains the cheapest and most effective method of investigating this organ in most developing countries.
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PMID:How confounding are breast pain confounders? 944 93


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