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)

Infectious mononucleosis is a clinical manifestation of primary EBV infection in adolescents, characterized by a triad of clinical, laboratory, and serologic features. The classic signs and symptoms are not seen in every patient; rather, the presentations tend to fit into one of three clinical forms (pharyngeal, glandular, or febrile). Recognizing these syndromes provides a useful framework for anticipating the clinical course, complications, and differential diagnosis. Nonclassic presentations of IM include a wide variety of neurologic abnormalities, thrombocytopenic purpura, and splenic rupture. The laboratory features of IM include absolute lymphocytosis with a large percentage of atypical lymphocytes, and abnormal liver chemistries in 90% of patients. The diagnosis of IM is confirmed serologically, usually with the demonstration of heterophile antibodies; the test can conveniently be performed in office laboratories. If the heterophile antibody test is negative, EBV-specific serologic tests can identify whether the illness is due to primary EBV infection. Once the diagnosis of IM is made, appropriate guidelines for resumption of activity should be provided to patients, especially to those with evidence of splenomegaly. Medical management includes supportive therapy with adequate analgesia. Corticosteroids are indicated for patients with upper airway obstruction; they may be helpful in patients with neurologic, hematologic, or cardiac complications. Acyclovir may prove to be useful, but further studies are needed before its use can be recommended.
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PMID:Infectious mononucleosis in adolescents. 164 97

Acyclovir (ACV) has an ED50 of 0.3 microM against EBV replication in vitro. Based on these and other data we carried out a pilot, double-blind, placebo-controlled trial of ACV for treatment of infectious mononucleosis. Only patients with relatively severe illness requiring hospital management were enrolled. Ten subjects with proven infectious mononucleosis received placebo and 10 ACV. The drug was administered intravenously at 8-hourly intervals in a total daily dosage of 1500 mg/m2 for 5 days. Preliminary analyses of the results indicate that the drug interrupted virus excretion in the oropharynx transiently but had no effect on ability to generate lymphocytic lines from peripheral blood. Symptoms and signs unaffected by ACV were splenomegaly, lymphadenopathy, lethargy, fever and pharyngitis. There was significantly more rapid regain of weight in the ACV-treated group. On the basis of these results we have instituted an out-patient trial of orally administered ACV in patients with less severe illness earlier in its course. We have also begun in-vitro tests of other drugs that might prove to be effective against Epstein-Barr virus infection, and have shown that 9-1 (1,3-dihydroxy-2-propoxymethyl)guanine (BW759) has an ED50 of 0.05 microM.
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PMID:Acyclovir and Epstein-Barr virus infection. 631 91