Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0242429 (sore throat)
 2,760 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Four adults with an illness similar to the systemic variant of juvenile rheumatoid arthritis seen in children (Still's disease) are described. All four had fever, an erythematous maculopapular rash, splenomegaly and arthritis. The arthritis was asymmetric and involved only a few joints simultaneously. Erosive arthritis developed in one patient. Three patients had a sore throat, two had pleurisy and pericarditis, and one had transient abnormalities of liver function. The laboratory features included anemia, leukocytosis and high leukocyte counts in the synovial fluid. High titres of rubella hemagglutination-inhibiting antibody were detected in two patients, one of whom was found to have rubella virus in the urine. Only one patient responded well to therapy with acetylsalicylic acid; the other three were given prednisone therapy, and two continue to require it.
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PMID:Adult-onset Still's disease. 45 6

A 40-year-old male had periods of fever, sore throat and anemia for 14 months before acute myeloblastic leukemia could be diagnosed from hematological findings. During the preleukemic state, impaired bactericidal capacity of the granulocytes was repeatedly demonstrated and multiple hepatosplenic and skin granulomas occurred. Results of granulocyte function studies may prove to be of significant aid in the diagnosis of the preleukemic state of acute myeloblastic leukemia.
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PMID:Neutrophil dysfunction and granulomatosis in the preleukemic state. 106 40

Adult onset Still's disease seems to be the adult form of Still's disease in children. The key symptoms of the disease are high spiking fever, arthritis and a macular or maculopapular, salmon-pink evanescent rash, almost always accompanied by neutrophilic leukocytosis and frequently by sore throat, intense myalgias, lymphadenopathy, splenomegaly and signs of serositis. Tests for IgM rheumatoid factor and antinuclear antibody are characteristically negative. With respect to haematologic abnormalities, the disease may give rise to several problems. First, there is a neutrophilic leukocytosis, which currently is unexplained, and often a normocytic normochromic anaemia, that may be profound. The anaemia has the characteristics of anaemia of chronic inflammatory disease. Both abnormalities disappear after effective treatment of the disease or at spontaneous remission. Secondly, there might be a problem to differentiate AOSD from malignant haematological disorders, including malignant lymphoma and leukaemia, especially when the picture is dominated by lymphadenopathy, splenomegaly, fever and leukocytosis. Although in rare cases the differential diagnosis is extremely difficult, diagnosis can mostly be made or excluded by peripheral blood smear staining, bone marrow biopsies and occasionally lymph node biopsy. Finally, like the juvenile counterpart, AOSD is occasionally complicated by sometimes life-threatening diffuse intravascular coagulation. Factors that might be important in the development of this complication include severe disease activity, liver abnormalities and particular drugs including salicylates, other NSAIDs and some slow-acting antirheumatic drugs. Prompt therapy, including withdrawal of the drug, corticosteroids and sometimes anticoagulant therapy have been successfully applied to most patients.
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PMID:Adult-onset Still's disease. 175 84

We reported a case of adult Still's disease accompanied by pericarditis, pleuritis and extensive pneumonitis with respiratory failure. A 59-year-old woman was admitted to our hospital because of high grade fever and sore throat. She had a spiking fever between 38 degrees C and 40 degrees C. Surface lymph nodes were palpable in the neck and inguinal lesions and hepatosplenomegaly was recognized. Laboratory data showed a marked increase in peripheral leukocytes, erythrocyte sedimentation rate, liver dysfunction and anemia. Serologic tests were negative for various autoantibodies and rheumatoid factor. She received various antibiotics, but there was no improvement. Later, a rheumatoid rash which suggested adult Still's disease developed. The diagnosis of adult Still's disease was made by skin biopsy and clinical course. Although pericarditis, pleuritis and extensive pneumonitis were accompanied with severe respiratory failure, her symptoms improved with steroid pulse-therapy. A transbronchial lung biopsy revealed moderate fibrosis and cell infiltration in alveoli.
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PMID:[A case of adult Still's disease with severe pulmonary complications]. 258 6

A 57-year-old woman who suffered from acute myeloblastic leukemia during the course of chronic thyroiditis, is described. The patient was diagnosed as having chronic thyroiditis in 1984 when she was 53 year-old, and was treated with L-T4.Na. She admitted in July 1988 because of general fatigue, fever, cough and sore throat. On admission, hematological examination in the peripheral blood showed marked anemia and increased leukocytes with 20.5% leukemic cells positive for peroxidase staining. Bone marrow aspiration showed 38.8% leukemic cells. She was diagnosed acute myeloblastic leukemia. She reached complete remission after combination chemotherapy. The case of acute myeloblastic leukemia associated with chronic thyroiditis is rarely reported. We reviewed the literature and discussed acute myeloblastic leukemia associated with chronic thyroiditis including this case.
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PMID:[Acute myeloblastic leukemia associated with chronic thyroiditis]. 269 19

Adult Still's Disease (SD) has evolved into a well-characterized nosologic entity. This categorization allows physicians to place a unifying label on the rare, puzzling patient who presents with a systemic illness characterized by high spiking fever of unknown cause associated with intense arthralgias or arthritis, an evanescent erythematous macular or maculopapular rash, and other less constant features of systemic illness including lymphadenopathy, hepatosplenomegaly, sore throat, leukocytosis, anemia and elevated concentration of hepatic enzymes. The diagnosis of Adult SD is syndromic, based solely on compatible clinical findings; serologic or other diagnostic tests do not aid in diagnosis. The diagnostic problem presented by these patients with such severe systemic illness and the insecurities inherent in diagnosis based solely on clinical features make the availability of the diagnosis, Adult SD, useful in patient care. The cause of Adult SD is unknown. Some have speculated that the disease has features of non-necrotizing immune complex vasculitis. Rubella infection has been reported to be associated with Adult SD, but no clear-cut etiologic relationship has been established. Neither rubella infection nor any other potential antigen has been identified consistently in association with the disease. Management of patients with the disease depends on the correct diagnosis. Diagnosis should include recognition of the syndrome as well as exclude other possible diseases. Control of systemic manifestations may require unusually high doses of aspirin, indomethacin or other non-steroidal anti-inflammatory drugs, prednisone or combinations of these drugs. Some adults appear to require both high-dose prednisone and indomethacin to control disease manifestations. Fortunately, systemic attacks are usually episodic; steroid toxicity can be minimized by use of alternate day doses and attempts to discontinue steroids between episodes. The current series and other reports of long-term follow-up indicate that Adult SD may be more disabling than was originally reported. At least three patterns of recurrences occur: 1) systemic attacks with or without arthritis, 2) pauciarticular disease, and 3) disabling deforming chronic arthritis, which may require surgery and long-term anti-inflammatory, gold, or cytotoxic therapy.
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PMID:Adult Still's disease. Evolution of a clinical syndrome and diagnosis, treatment, and follow-up of 17 patients. 670 Apr 35

Acute febrile juvenile rheumatoid arthritis (JRA) of adult onset is often diagnosed by ruling out other problems. The classification of JRA is primarily based on the distinct type of onset, of which there are usually three: (1) acute febrile or Still's type, (2) polyarticular, and (3) monoarticular pauciarticular arthritis. Fever of unknown cause is frequently the initial symptom. This type of arthritis may be characterized by any or all of the following: unexplained high fever, rash, weight loss, lymphadenopathy, splenomegaly, pericarditis, pleurisy, pneumonitis, abdominal pain, myalgias, arthralgias, arthritis, sore throat, leukocytosis, anemia, circulating immune complexes, liver test abnormalities, and carpal-metacarpal and tarsal-metatarsal fusion. Patients often respond dramatically to anti-inflammatory agents. Corticosteroids, gold salts, penicillamine, and cytotoxic drugs have been effective for certain patients. The prognosis of the disease has been generally favorable. Although symptoms may recur, remission can be prolonged.
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PMID:Acute febrile juvenile rheumatoid arthritis in adults: cause of polyarthritis and fever. 737 68

Between January 1990 and February 1991 we evaluated the cases of 20 patients for a symptom complex consisting of Sore throat, elevated Temperature, migratory Arthritis, and a pruritic urticarial Rash (STAR). The patients ranged in age from 3 1/2 to 48 years; most were from central Texas. Duration of illness varied from 2 weeks to longer than 1 year. Results of laboratory studies included the following abnormal findings: elevated erythrocyte sedimentation rate, leukocytosis, anemia, and thrombocytosis. Eleven of 18 (61%) patients had low antinuclear antibody titers. HLA-A2 was noted in 8 of 10 (80%) of those tested. Test results were positive in eight cases for IgM antibodies to parvovirus and in six cases for IgM antibodies to rubella, suggesting that these entities may represent an underdiagnosed cause of STAR complex. In six cases no specific cause of disease was found; these cases may be attributable to other infectious agent(s) yet to be identified. Here we present a description of the cases, a discussion of the differential diagnosis, and an evaluation of STAR complex.
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PMID:STAR complexes: febrile illnesses associated with sore throat, arthritis, and rash. 848 98

A 67-year-old male was admitted with consciousness disturbance (JCS, III-200) after completing a 12-day tour to east Africa without malaria chemoprophylaxis. When he visited the hospital one day prior to the admission complaining of fever and a slightly sore throat, he did not mention the travel history. Soon after his travel history was revealed, blood films were prepared which showed abundant ring forms accompanied with a small number of trophozoites and schizonts of Plasmodium falciparum, with the parasitemia of 26%. Despite intravenous quinine infusion, first that of loading dose, his consciousness state (JCS, III-300), renal and hepatic functions and anemia (Hb, 5.8 g/dL) deteriorated progressively. Moreover, metabolic acidosis worsened with pH of 6.954, HCO3- of 3.4 mEq/L, BE of--27.0 mEq/L, PCO2 15.5 mmHg by arterial blood gas analysis, although he received a large volume of sodium bicarbonate solution. The patient died on the 4th day of his illness. According to the literature, it is suggested that the treatment of metabolic acidosis in severe faciparum malaria with sodium bicarbonate is sometimes harmful, since it can result in sodium overloading, which may then precipitate pulmonary edema/ARDS. However, alternative treatment regimens have not yet been established. Future investigation on the etiology and the proper treatment of metabolic acidosis associated with severe falciparum malaria is highly needed.
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PMID:[A rapidly fatal case of severe falciparum malaria complicated with high-level metabolic acidosis]. 1086 Mar 64

Giant cell arteritis (GCA) is a common vasculitis of unknown cause that affects persons in middle age and older. Its incidence rises with increasing age. The inflammatory lesions involve larger arteries that contain an abundance of elastic tissue. Although cranial symptoms such as headache, tender scalp, jaw claudication and visual symptoms are common, the disease presents in many different fashions, often with symptoms not directly related to the arteries. These latter presentations include fever, severe malaise, polymyalgia rheumatica, high erythrocyte sedimentation rate and anemia, thrombocytosis, sore throat, and hepatic dysfunction. GCA appears to have a self-limited course, but is also characterized by relapses and recurrences. Visual loss due to occlusion of the optic arteries is the most important early manifestation and aortic aneurysm is the most important late complication. Patients respond promptly to varying doses of glucocorticoids but drug side effects are common.
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PMID:Clinical features of GCA/PMR. 1094 48


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