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)

To know the clinical characteristics and the prognostic factors of hyperleukocytic acute leukemia, we reviewed 244 patients with acute leukemia associated with hyperleukocytosis. Restrospective analysis and control study were used. Hyperleukocytosis occured in 8.5% of patients with acute leukemia. Hyperleukocytosis in ALL was more common than that in AML. Among AML with hyperleukocytosis, M5 subtype was the most. Hepatomegaly, splenomegaly, lymphadenopathy, DIC and CNSL were more frequent in hyperleukocytosis group. The complete remission rate was 41.4% for patients with hyperleukocytosis versus 54.2% for patients with non-hyperleukocytosis. The early mortality rate was significantly increased in hyperleukocytic patients (23.8%) as compared to the nonhyperleukocytic group (11.1%). Intracranial hemorrhage was the main cause of early death. The high risk factors of early death were: hemoglobin < or = 40 g/L, blood platelet < or = 30 x 10(9)/L, DIC, infection, CNSL at presentation. Acute leukemia with hyperleukocytosis has poor prognosis. Especially, acute myeloid leukemia with hyperleukocytosis must be taken seriously because of high early mortality rate.
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PMID:[244 patients with hyperleukocytic acute leukemia. Shanghai Leukemia Cooperation Group]. 1043 59

An 11-year-old boy was diagnosed as having acute lymphoblastic leukemia (ALL, L1) in 1987 and underwent treatment with an ALL high-risk protocol (prednisolone, vincristine (VCR), daunorubicin, 1-asparaginase), which resulted in complete remission. In 1990 he developed chronic hepatitis C and received interferon therapy. In December 1994, ALL recurred, and the patient was treated with VCR. He subsequently developed severe hemolysis (Hb 12.5 g/dl-->6.8 g/dl) with increases of indirect bilirubin, AST, and LDH. Furthermore, symptoms resembling a syndrome of inappropriate secretion of ADH (SIADH) and DIC developed. Upon incubation of the patient's red blood cells with VCR in vitro, extreme deformity of the cells was observed. These findings suggested that splenomegaly, due to liver cirrhosis which had developed rapidly from chronic hepatitis C while the patient was in an immunosuppressed state induced by anticancer drugs, had trapped the deformed red blood cells and resulted in severe hemolysis. The patient died on the 165th day after admission due to liver failure.
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PMID:[Severe hemolysis and SIADH-like symptoms induced by vincristine in an ALL patient with liver cirrhosis]. 1119 45

Clinical observations of Babesia canis infection in 63 dogs during a 1-year period are summarised, demonstrating the pathogenicity of the Babesia strain endemic in Hungary. Most patients had babesiosis in the spring and autumn, correlating with the seasonal activity of ticks. Male animals appeared in higher numbers, probably due to an overrepresentation of outdoor dogs. Uncomplicated babesiosis was diagnosed in 32 cases. The disease affected dogs of any age in this study. Symptoms were similar to those published from other parts of the world: lethargy, fever, splenomegaly, pallor, icterus, haemoglobinuria and presence of ticks were the most common observations. Thrombocytopenia, lymphopenia and neutropenia were frequent haemogram changes. Imidocarb appeared to be highly effective in eliminating the Babesia infection. Thirty-one animals demonstrated babesiosis with complications. Most Rottweilers (7/9) developed complicated disease. Old age was a risk factor for multiple complications. Multiple organ manifestations had poor prognosis. Hepatopathy (44%), pancreatitis (33%), acute renal failure (ARF; 31%) and disseminated intravascular coagulation (DIC; 24%) were frequent complications, while immune-mediated haemolytic anaemia (IMHA; 10%), acute respiratory distress syndrome (ARDS; 6%) and cerebral babesiosis (3%) were rarely observed. There was a significant difference between the mean age of dogs having uncomplicated disease, babesiosis with a single complication and babesiosis with multiple complications (3.4, 4.8 and 8.6 years, respectively, p < 0.001). The recovery rate (78, 68 and 25%, respectively, p = 0.005) and mortality rate (3, 21 and 67%, respectively, p < 0.001) also tended to differ significantly in these groups. Systemic inflammatory response syndrome (SIRS) and DIC are two possible pathways leading to multiple organ dysfunction syndrome (MODS) in babesiosis. DIC was found to predict MODS more sensitively in this study than SIRS: there were 6 animals developing MODS out of 11 identified with DIC, while only 5 dogs developed MODS out of 22 having SIRS.
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PMID:Clinical manifestations of canine babesiosis in Hungary (63 cases). 1702 Jan 40

Thrombocytopenia is frequently observed in vivax malaria but the exact mechanism has not been elucidated. We studied 27 cases of acute vivax malaria out of which 24 cases had thrombocytopenia. This was the most common hematological finding. None had bleeding from any site. Anaemia and splenomegaly were not present in any of the cases. Platelet counts reverted to normal on treatment. Other causes of thrombocytopenia were ruled out by complete history and physical examination, dengue serology and blood culture. DIC was ruled out by peripheral smear examination and measurement of FDP levels. Our study stresses the importance of thrombocytopenia as an early indicator for acute malaria; a finding that is frequent and present even before anemia and splenomegaly set in. The possible mechanisms leading to thrombocytopenia in malaria have been discussed which include immune mechanisms, oxidative stress, alterations in splenic functions and a direct interaction between plasmodium and platelets.
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PMID:Thrombocytopenia--an indicator of acute vivax malaria. 1718 38

Case. A 34-year-old African-American female with a history of adult-onset Still's disease presented to an outside hospital with oligoarthritis. She experienced a generalized tonic-clonic seizure en route via ambulance, was intubated upon arrival, and transferred to the intensive care unit for treatment of suspected pneumonia and sepsis. She subsequently developed generalized cutaneous desquamation that progressed despite the cessation of antibiotics and other potential offending drugs which required transfer to our hospital's burn unit. She was suspected to have reactive hemophagocytic syndrome based on her clinical presentation of fever, rash, polyarthritis, elevated liver enzymes, coagulopathy, splenomegaly, normocytic anemia, thrombocytopenia, hypertriglyceridemia, hyperferritinemia, and hemophagocytosis visualized in bone marrow biopsy specimen. Magnetic resonance imaging demonstrated necrotic demyelination of the deep white matter and corona radiata. The patient developed multiorgan dysfunction and DIC without any other attributable etiology. Despite aggressive broad spectrum therapy and high dose of steroids she progressively deteriorated and eventually expired. Conclusion. Previous publications have highlighted the prevalence of necrotic leukoencephalopathy in children with familial hemophagocytic syndrome. Our patient demonstrated some uncommon features complicating her HLH including DIC and necrotic leukoencephalopathy, which are very rare entities in AOSD.
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PMID:An Unusual Case of Adult-Onset Still's Disease with Hemophagocytic Syndrome, Necrotic Leukoencephalopathy and Disseminated Intravascular Coagulation. 2470 28


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