Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0151825 (bone pain)
 3,118 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Sixty-eight patients with plasmacytic neoplasia and osteosclerotic lesions were analyzed. Men predominated in this series. Mean age was 55.3 years and 26 patients were younger than 51 years at diagnosis. Early onset of disease was statistically different from multiple myeloma in general. Thirty patients had peripheral polyneuropathy and often neurological manifestations preceded other symptoms. Skeletal pain was less common, whereas hepatomegaly, splenomegaly, and lymphadenopathy were more common than in myeloma in general. Incidence of azotemia, hypercalcemia, high ESR, and anemia was lower than in myeloma. In one fourth of the patients, the number of skeletal lesions did not exceed three. Mean survival was less than 20 months from first symptom and 12 months from diagnosis. Mortality was related sometimes to polyneuropathy. Thus, in several aspects, plasmacytic neoplasia with osteosclerotic lesions is different from the classical multiple myeloma.
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PMID:Plasma cell neoplasia with osteosclerotic lesions. A study of five cases and a review of the literature. 22 10

Peripheral polyneuropathy (PPN) is a rare complication of plasma cell neoplasia (PCN), occurring in less than one percent of the patients. Fifty-four such patients (including our 5) were reviewed. There were 42 men (78%) and 12 women (22%) aged 28 to 72 years. Forty-nine percent of patients were younger than 51 years at the time of diagnosis. The initial complaints were different from those observed in multiple myeloma in general, and were related to polyneuropathy in 80% of the patients. PPN was usually of a mixed sensory-motor type and most often involved all four extremities. Skeletal pain was less common than in myeloma in general, occurring initially in 15% and at diagnosis in 45% of the patients. In 21 patients, reversibility of neuropathy was observed. These patients were compared to those with irreversible neuropathy and found to be relatively younger and more aggressively treated with irradiation and modern chemotherapy. Elevated sedimentation rate was uncommon. Less than half of the patients had anemia, and six patients, all with osteosclerotic lesions, had polycythemia. Azotemia was detected in 44% of the cases. No hypercalcemia was observed in 21 examined patients. M components were usually of IgG class, and when the light chains of M components were examined they were invariably of lambda type. Often the level of M component was below 2.0 g/dl. In all patients the bone marrow was infiltrated with immature, abnormal-looking plasma cells, but the infiltrate was often limited to one or a few foci. Solitary plasmacytoma was observed in 14 patients. No anemia, hypercalcemia or azotemia was recorded in this group. Eight patients had serum M components. Bone marrow aspirate was usually normal. In seven patients definite reversibility of PPN was observed after irradiation of plasmacytoma. Twelve patients presented with osteosclerotic lesions (22%), 18 with both osteosclerotic and osteolytic lesions (33%) and 13 with osteolytic lesions. Forty-two percent of the patients had less than three visible lesions in the skeleton. Eleven patients had either osteoporosis or radiologically normal skeleton. The mean survival from the first symptom was about 28 months and from the diagnosis 20 months. The five-year survival was 21% and 20%, respectively. These observations highlight the differences between PCN with PPN and multiple myeloma without PPN.
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PMID:Plasma cell neoplasia with peripheral polyneuropathy. A study of five cases and a review of the literature. 624 19

Two acromegalic patients with severe headache were treated with the somatostatin analogue, octreotide (Sandostatin). A double-blind study of octreotide versus placebo in which pain intensity was measured using a visual analogue scale (VAS) was performed initially with these patients. A rapid (within 4-15 min) pain relief occurred lasting 2-8.5 h after injection of 100 micrograms of octreotide, an effect that was not reversed by intravenous (i.v.) naloxone. These 2 acromegalic patients then received treatment for 71 and 82 months, respectively, with doses starting at 500 micrograms/day and 1500 micrograms/day, respectively, without evidence of either tolerance or dependence, although the effect of octreotide on headache appears to be selective. No unwanted sedative effect has been observed. A screening procedure with injection of 50 micrograms of subcutaneous (s.c.) octreotide was performed in 11 other patients with chronic severe pain associated with various conditions. Only 3 patients (2 with diabetic polyneuropathy and 1 with bone pain associated with myelodysplastic syndrome) reported more than 50% pain relief. In the insulin-dependent diabetic patients the double-blind check was not performed due to the risk of octreotide-induced hypoglycemia. In the patient with bone pain the same double-blind check as in the acromegalic patients could not confirm the analgesic effect. It may thus be concluded that octreotide appears to be useful for the treatment of both chronic and acute severe painful conditions in acromegalic patients. However, since its analgesic effect in our patients was confined to headaches only, further controlled studies must be carried out in order to determine appropriate target groups.
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PMID:Analgesic effect of the somatostatin analogue octreotide in two acromegalic patients: a double-blind study with long-term follow-up. 833 92

Bone pain after transplantation is a frequent complication that can be caused by several diseases. Treatment strategies depend on the correct diagnosis of the pain. Nine patients with severe pain in their feet, which was registered after transplantation, were investigated. Bone scans showed an increased tracer uptake of the foot bones. Magnetic resonance imaging demonstrated bone marrow oedema in the painful bones. Pain was not explained by other diseases causing foot pain, like reflex sympathetic dystrophy, polyneuropathy, Morton's neuralgia, gout, osteoporosis, avascular necrosis, intermittent claudication, orthopaedic foot deformities, stress fractures, and hyperparathyroidism. The reduction of cyclosporine- or tacrolimus trough levels and the administration of calcium channel blockers led to relief of pain. The Calcineurin-inhibitor Induced Pain Syndrome (CIPS) is a rare but severe side effect of cyclosporine or tacrolimus and is accurately diagnosed by its typical presentation, magnetic resonance imaging and bone scans. Incorrect diagnosis of the syndrome will lead to a significant reduction of life quality in patients suffering from CIPS.
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PMID:Calcineurin-inhibitor induced pain syndrome (CIPS): a severe disabling complication after organ transplantation. 1126 51

We report a case of an adult with dengue hemorrhagic fever who developed acute idiopathic scrotal edema and glove-and-stocking polyneuropathy. A 54-year-old man who had fever, chills, bone pain, and skin rash for 4 days was admitted. We diagnosed dengue hemorrhagic fever because of fever, gum bleeding, thrombocytopenia, and hemoconcentration, and confirmed the diagnosis by serology. The patient had scrotal and penile edema and distal limb numbness with a glove-and-stocking distribution. After supportive care, the scrotal edema and other symptoms subsided. Patients with dengue hemorrhagic fever may develop scrotal edema caused by plasma leakage.
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PMID:Dengue hemorrhagic fever complicated with acute idiopathic scrotal edema and polyneuropathy. 1818 76