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)

Hypercalcemia and severe osteolytic lesions are rare complications of acute lymphoblastic leukemia (ALL) in childhood. We report a case of a 3 years old boy who presented with prolonged fever, nausea, vomiting and increasing lower limbs pain. Skeletal X-rays and CT scan showed severe osteolytic lesions of the skull and extremities. Her physical examination showed multiple cervical lymph nodes. In laboratory tests, he had severe hypercalcemia. Parathyroid hormone (PTH) was not elevated. Despite the absence of circulating blasts, bone marrow biopsy revealed B-precursor (ALL). Hypercalcemia was initially treated with intravenous isotonic sodium chloride solution and diuretics but the serum calcium level normalized only after the beginning of corticosteroids and chemotherapy. The child responded initially to chemotherapy and eventually relapsed and died of septic shock. Acute leukemia must be considered in differential diagnosis in patients with hypercalcemia. A detailed examination even when there no circulating blasts in their peripheral blood smear, and if in doubt bone marrow aspiration should must be taken into consideration.
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PMID:Osteolytic bone lesions, severe hypercalcemia without circulating blasts: unusual presentation of childhood acute lymphoblastic leukemia. 2869 Jul 58

A 3-year-old boy with high-risk precursor-B ALL presented with abdominal pain, vomiting, and hypoalbuminemia just before his second scheduled course of high-dose methotrexate in interim maintenance. Examination was significant for epigastric tenderness and periorbital edema. Abdominal imaging revealed a circumferential thickening of the stomach with an increased mucosal enhancement and a mild circumferential thickening of segments of small bowel loops. Cytomegalovirus (CMV) of the patient, determined by PCR, in blood was positive with a low titer and was subsequently negative. Upper endoscopy revealed hypertrophic rugae and folds in the stomach and duodenum, and biopsy showed giant gastric folds and foveolar hyperplasia but was negative for CMV. He received supportive care and a 2-week course of ganciclovir and Cytogam with clinical improvement. We report a case of Menetrier's disease (Protein-losing gastropathy), which was diagnosed in a child with acute leukemia. Menetrier's disease should be considered in any patient with symptoms referable to the gastrointestinal tract and thickened stomach and bowel loops detected by radiologic imaging.
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PMID:Menetrier's disease (protein-losing gastropathy) in a child with acute lymphoblastic leukemia. 3308 10

Burkitt lymphoma (BL) is a highly aggressive B cell lymphoma, presenting in extranodal sites or as an acute leukemia. Three clinical variants of BL are recognized: endemic BL, sporadic BL and immunodeficiency associated BL. Sporadic BL is seen worldwide, mainly in children and young adults involving the abdominal organs mostly the ileocaecal area. Pancreatic involvement is rare. The authors report a unique case of abdominal Burkitt lymphoma, initially diagnosed and treated as acute pancreatitis. Clinically, the patient presented severe abdominal pain and vomiting. Imaging findings were suggestive of inflammatory involvement of the pancreas, heading treatment towards this hypothesis. Unfortunately, the patient died during the diagnostic work up, and the autopsy findings demonstrated advanced Burkitt lymphoma with extensive involvement of pancreatic parenchyma and other organs within the abdominal cavity. Once Burkitt lymphoma is a potentially curable disease, early diagnosis is crucial for better outcomes.
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PMID:Burkitt lymphoma mimicking acute pancreatitis. 3152 74

Acute myelogenous leukemia (AML) is the most prevalent acute leukemia and is defined by the presence of myeloid blasts in the blood or bone marrow. Rarely, AML can be present in the gastrointestinal tract. We present a patient with AML undergoing treatment with decitabine who presented with hematemesis. He underwent endoscopy which revealed two 5 mm duodenal ulcers that were biopsied, and pathology was consistent with AML. Endoscopy should be considered in patients with leukemia who present with nausea, vomiting, or signs of bleeding to evaluate for gastrointestinal involvement. Patients diagnosed with AML are treated with chemotherapy.
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PMID:Acute Myelogenous Leukemia as a Rare Cause of Duodenal Ulcers. 3162 May 43


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