Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0042963 (vomiting)
 31,883 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A case of hepatitis is reported in a 38-year-old alcoholic woman taking disulfiram to aid in maintaining sobriety. She presented with anorexia, vomiting, fatigue, right upper-quadrant pain, pruritus, darkened urine, and jaundice after about two weeks of disulfiram 500 mg/d. The patient also had been taking enalapril 10 mg/d for one year. Hepatocellular enzymes, total bilirubin, and eosinophils were significantly elevated. Hepatitis B core antibody, hepatitis A antibody, hepatitis B surface antibody, and antinuclear antibody were negative. After discontinuation of disulfiram, the clinical and biochemical manifestations of hepatitis began to resolve and the patient was discharged in a much improved condition. Seventeen previous cases of disulfiram-induced hepatitis are reviewed. It has been suggested that the mechanism of hepatotoxicity is an allergic or hypersensitivity reaction. The findings in this case are consistent with the earlier descriptions of hypersensitivity hepatitis, and lend further support to the possibility that disulfiram may cause hepatitis.
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PMID:Disulfiram-induced hepatitis: case report and review of the literature. 268 28

We studied an outbreak of hepatitis A in a day-care center in a rural community where less than 7 per cent of the population possessed anti-HAV. Serotesting for IgM specific antibody to hepatitis A virus identified 78 cases in center attendees, staff, and families. Thirty-five per cent of the center children were seropositive. In children under age three anicteric infection was at least 17 times more frequent than icteric infection, but in older children and adults icterus was a predominant manifestation of the disease. Clinical suspicion should be high in any day-care child with nausea, emesis, diarrhea, or arthralgia. The low incidence of icterus in infected children suggested that outbreak reports reaching public health departments are likely to be incomplete and poorly indicative of outbreak magnitude. The high frequency of intrafamilial transmission and anicteric infection appeared to justify administration of immune serum globulin to household contacts of center children under age three when a day-care outbreak is detected.
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PMID:Serologic investigation of an outbreak of hepatitis A in a rural day-care center. 661 73

Hepatitis A occurred in five registered nurses, a licensed practical nurse, and a recently discharged patient at a community hospital; one of these seven was asymptomatic. All had been exposed to a woman with confirmed hepatitis A who had undergone elective cholecystectomy and who had had vomiting, diarrhea, and fecal incontinence during the eight days before onset of jaundice. Of the 107 hospital workers identified as having at least some exposure to the source patient, 58 (54.2 percent) had no pre-existing antibody to hepatitis A virus (anti-HAV) and were considered susceptible. Six persons, including the five clinically ill registered nurses, had IgM-specific anti-HAV. The infection attack rate was 5.6 percent for all exposed hospital workers but 10.3 percent for the 58 who were serosusceptible. Risk of infection was highest for persons with documented or probable contact with the source patient and for registered nurses. Among hospital personnel, the prevalence of anti-HAV increased with age but varied inversely with socioeconomic status. Hospital personnel and patients may be at risk for hepatitis A infection when exposed to patients who are in the prodromal stage of hepatitis A. Vomiting, diarrhea, and fecal incontinence may increase the risk of transmission.
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PMID:Nosocomial hepatitis A transmission by an adult patient with diarrhea. 711 79

A 27-yr-old Jamaican male presented with a 2-month history of jaundice, pruritus, intermittent diarrhea, and right upper quadrant abdominal pain. Over the next month, his abdominal pain and diarrhea improved, but his jaundice and pruritus worsened. He was afebrile and profoundly jaundice, with a benign abdominal examination. Medical workup included a normal abdominal ultrasound, iron studies, ceruloplasm, and serum electrophoresis. Negative viral (Epstein-Barr virus, cytomegalovirus, mononucleosis, hepatitis A, B, C) studies, ANA, AMA, ASMA, RPR were noted. He denied any alcohol, drug, or toxin exposure. Liver tests revealed total bilirubin of 25.6 mg/dl, direct bilirubin of 13.9 mg/dl, alkaline phosphatase 278 IU/L, AST 45 IU/L, and ALT 71 IU/L. Liver biopsy demonstrated centrilobular zonal necrosis and cholestasis most consistent with a toxic reaction. The patient was again interviewed regarding potential toxins, and he admitted to the ingestion of ackee fruit, a native Jamaican fruit that is illegal in the United States. Shortly after he had ceased intake of the fruit, his symptoms resolved and his liver function tests returned to normal. We present a case of chronic ackee fruit ingestion that led to cholestatic jaundice, vomiting, and abdominal pain.
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PMID:Cholestatic jaundice due to ackee fruit poisoning. 807 44

To evaluate the frequency, pattern, and severity of liver function test abnormalities in patients with Lyme disease associated with erythema migrans (EM), 115 individuals with no other identifiable cause for liver function test abnormalities who presented with EM between July 1990 and September 1993 were prospectively evaluated. For individuals with abnormal liver function tests, common causes of hepatitis, including hepatitis A, B, and C, were excluded. A local control group was used for comparison. Forty-six (40%) patients had at least one liver test abnormality, and 31 (27%) had more than 1 abnormality compared with 19 (19%) and 4 (4%) of controls, respectively (P < .01 for each comparison). gamma-Glutamyl transpeptidase (28%) and alanine transaminase (ALT) (27%) were the most frequently elevated liver function tests among Lyme disease patients. Anorexia, nausea, or vomiting was reported by 30% of patients, but did not occur more frequently in patients with elevated liver function tests compared with those with normal values. Patients with early disseminated Lyme disease were more likely to have elevated liver function studies (66%) compared with patients with localized disease (34%) (P = .002). After antibiotic treatment, elevated liver function tests improved or resolved in most patients. Liver function test abnormalities are common in patients with EM but were mild, most often not associated with symptoms, and improved or resolved by 3 weeks after the onset of antibiotic therapy in most patients.
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PMID:Liver function in early Lyme disease. 867 58

Most cases of acute hepatitis are caused by hepatitis viruses A, B or C. Diagnosis rests on the risk factor history and serological tests. In seronegative cases, consider other agents, such as Epstein-Barr virus and cytomegalovirus, drug reactions and autoimmune hepatitis. Hepatitis A and B can be prevented by appropriate use of highly effective, safe vaccines. Acute liver failure is an uncommon, devastating complication of acute viral hepatitis; continued vomiting, prolongation of prothrombin time and clouding of consciousness are indications for urgent transfer to a liver transplant unit. Hepatitis A is a simple, enterically transmitted illness that does not cause chronic hepatitis. 95% of adults recover from acute hepatitis B, whereas infection with hepatitis B virus acquired in childhood usually becomes chronic.
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PMID:Acute viral hepatitis. 964 Mar 8

50 children under the age of 15 years were studied who had been hospitalized in two hospitals in the Dominican Republic with HIV diagnosed by the presence of biphasic hyperbilirubinemia and elevation of glutamic-pyruvic and glutamic-oxalacetic transaminases. The sera of the patients were examined for the presence of leptospirotic immunoglobulin M (IgM) antibodies by means of the enzymatic immunoassay method (UREASA-ELISA). The Leptospira-positive sera were also investigated for the presence of hepatitis B surface antigen (HBsAg) and for the IgM antibody (ab) of the hepatitis A virus (ab-HAV) by ELISA. 5 cases were positive for IgM Leptospira antibodies (10%), not finding in this percentage the presence of HBsAg; 3 of the 5 Leptospira-positive samples demonstrated the presence of ab-HVA-IgM. Only 2 cases (4%) presented IgM Leptospira antibodies. Out of the 5 cases with IgM antibodies, males predominated (3/5). When compared to negative cases, however, there were more rural elements among them than in negative cases: regarding origins (10% vs. 16%), agricultural workers (40% vs. 20%), contact with cattle and fresh water (80% vs. 40%), and daily contact with humid soil in living quarters (60% vs. 48%). The clinical picture of the 5 positive cases featured myalgia (p = 0.05) and abdominal pain (p = 0.05). The stiffness of neck was relatively more frequent in positive cases (20%) than in negative cases (7%); also, fever (100% vs. 80%), vomiting (60% vs. 22%), headache (80% vs. 56%), constipation (20% vs. 9%), and hepatomegaly (100% vs. 71%). There was clear evidence that leptospirotic infection must be watched and also its association with acute infectious hepatitis.
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PMID:[IgM Leptospira antibodies in acute infectious hepatitis cases in children]. 1229 May 51

A 37-year-old woman presented with increasing abdominal pain and jaundice. Six weeks before admission, she developed persistent diarrhea and jaundice of the skin. She also bruised easily, and her gums bled. In the subsequent weeks, her appetite decreased, she was fatigued, and she had nausea, vomiting, and abdominal distension. She had a history of drinking 1 quart of vodka every day for 20 years, with brief periods of abstinence; she stopped consuming alcohol 11 days before admission because it no longer provided symptomatic relief. Her past medical history was also notable for depression, including a suicide attempt 4 years earlier. She did not smoke, use illicit drugs, or have unprotected sexual intercourse. She had received no blood transfusions and had not traveled recently. She took no medications, except for occasional ibuprofen. On physical examination, she was thin and deeply jaundiced, and she trembled and responded slowly to questions. She was afebrile but tachypneic, and she had orthostatic hypotension. Her HEENT examination was notable for scleral and sublingual icterus, as well as crusted blood on her gums and teeth. The jugular veins were flat. The cardiac examination revealed tachycardia (heart rate, 103 beats per minute) without murmurs, rubs, or gallops. The abdomen was nontender and protuberant, with hypoactive bowel sounds; the spleen was not palpable, and there was no fluid wave or caput medusae. The liver percussed to 18 cm, with a smooth edge extending 10 cm below the costal margin. She had cutaneous telangiectases on her chest and bilateral palmar erythema. There was no peripheral edema. The neurologic examination was notable for asterixis. Her stool was guaiac positive. Laboratory studies revealed the following values: hematocrit, 21.2%; white blood cells, 17,310/mm(3); ammonia, 42 micromol/L; serum creatinine, 3.9 mg/dL; serum urea nitrogen, 70 mg/dL; albumin, 2.1 g/dL; total bilirubin, 26.8 mg/dL; alanine aminotransferase, 14 U/L; aspartate aminotransferase, 77 U/L; alkaline phosphatase, 138 U/L; prothrombin time, 103 seconds (international normalized ratio, 10.6); and urinary sodium, <5 mg/dL. Urinalysis revealed an elevated specific gravity and numerous muddy granular casts. Hepatitis A, B, and C serologies were negative. On abdominal ultrasound examination, there was no ascites, and the liver was echogenic. The portal and hepatic veins were patent, and the hepatic arteries were normal. The spleen measured 14 cm. What is the diagnosis?
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PMID:Cases from the Osler Medical Service at Johns Hopkins University. 1258 38

A party of 57 people dined together in a restaurant in Hamamatsu City on December 11, 2001. The next day, 22 of them developed symptoms of acute gastroenteritis, such as diarrhea, vomiting, and fever. Examination of 4 fecal specimens from these patients by ELISA for Norovirus (Norwalk-like virus, NV) detected both genogroup I (GI) and genogroup II (GII) NV in all the 4 specimens. In addition, RT-PCR and real-time PCR methods for NV detected the NV gene. Approximately one month after the outbreak of the food poisoning (acute gastroenteritis) by NV, 4 individuals in the same party developed type A hepatitis. Both RT-PCR and real-time PCR methods for hepatitis A virus (HAV) detected the HAV gene in their fecal specimens. The party of these patients ate purple Washington clam (Saxidomus purpuratus, imported from China) steamed with red pepper. Since this food appeared to have caused the viral infections, the one with the same lot number was subjected to viral examinations, which successfully detected the NV GI, NV GII, and HAV genes. These results led to the conclusion that the clam contaminated with NV and HAV had caused the food poisoning. The DNA sequences of the NV detected in the patients and the clam had 74 to 99% homology, indicating strains of various genotypes. All the strains of HAV that were derived from the patients and the clam were genotype 1A, and these sequences had over 95% homology, but were not completely identical. This outbreak led to the demonstration of imported fishery products as a cause of type A hepatitis, and indicated the need for guiding and enlightening people on the importance of adequate cooking of bivalves.
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PMID:[A food poisoning outbreak caused by purple Washington clam contaminated with norovirus (Norwalk-like virus) and hepatitis A virus]. 1266 Oct 84

The successful cultivation of the virus of infectious hepatitis in chick embryo tissue culture and in the amniotic cavity of the embryonated hen's egg is supported by a comparison of the disease induced in volunteers by the cultivated virus with hepatitis without jaundice resulting from experimental infection with natural infectious hepatitis virus. Both types of viral preparations produced illnesses in comparable percentages of volunteers (83 and 75 per cent, respectively) after similar average periods of incubation (24.4 and 23.4 days, respectively) and of similar average duration (28.3 and 27.6 days, respectively). The disease could be divided in both groups of patients into a primary stage, followed after a short interval of relative well being by the secondary stage. The illnesses in both instances were characterized by anorexia, nausea, vomiting, enlarged, tender livers and abnormal liver function tests, and frequently temperature elevations. They differed in that jaundice was observed in 31 per cent of the cases resulting from infection with natural virus but not in any patients infected with the cultivated virus.
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PMID:Studies on the agent of infectious hepatitis; the disease produced in human volunteers by the agent cultivated in tissue culture or embryonated hen's eggs. 1543 37


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