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)

A 48-year-old woman was admitted because of spiking high fever, sore throat, and jaundice. A diagnosis was made of adult-onset Still disease (AOSD) presenting with acute hepatitis and very high serum ferritin levels (32,240 ng/mL), and she was treated with 2 courses of pulse therapy of methylprednisolone (2 g/day for 3 days) followed by 40 mg/day prednisolone. Subsequently, the serum level of ferritin decreased, but serum total bilirubin increased to 17.3 mg/dL. Therefore, cyclosporin was administered orally. Within the next 3 months, results of liver function tests, as well as serum levels of ferritin, soluble interleukin-2 receptor, interferon-gamma, interleukin-6, and tumor necrosis factor-alpha gradually returned to within normal limits, and cyclosporin administration was subsequently reduced gradually. The clinical presentation suggests that AOSD should be considered when liver dysfunction is accompanied with high fever and extreme hyperferritinemia, and that treatment with cyclosporin or other immunosuppressive drugs that selectively suppress cytokine production by helper T cells is a valuable option in the treatment of AOSD with very high serum ferritin levels.
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PMID:Successful treatment with cyclosporin in adult-onset Still disease manifesting as acute hepatitis with marked hyperferritinemia. 1450 Dec 32

After influenza vaccination an 83-year-old woman was referred to us because of fever and sore throat with no response to antibiotics. Chest computed tomography showed thickened bronchovascular bundles, multiple nodules with feeding vessels, and consolidation. Laboratory tests showed a high level of serum myeloperoxidase anti-neutrophil cytoplasmic antibody (MPO-ANCA) and soluble interleukin-2 receptor (sIL-2R), as well as abnormal renal function and urinary sediment. Transbronchial lung biopsy revealed organizing pneumonia. We made a diagnosis of microscopic polyangiitis after influenza vaccination. Corticosteroids and cyclophosphamide were effective. Careful attention should be paid to severe adverse effects such as systemic vasculitides after influenza vaccination.
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PMID:Microscopic polyangiitis after influenza vaccination. 1615 95

Ehrlichiosis, caused by transmission of Ehrlichia chaffeensis to humans through the bite of an infected lone star tick, can lead to secondary hemophagocytic lymphohistiocytosis (HLH), a life-threatening condition caused by uncontrolled activation of the cellular immune system. We describe a child with HLH secondary to ehrlichiosis who developed multiorgan failure and was successfully managed with extracorporeal membrane oxygenation (ECMO). A 9-year-old boy developed headaches, fever, and sore throat after suspected tick exposure. He presented with pancytopenia, elevated ferritin, and soluble interleukin-2 receptor levels, all consistent with HLH. Bone marrow biopsy revealed hemophagocytosis. Polymerase chain reaction was positive for E chaffeensis He developed acute kidney injury, coagulation failure, hepatic insufficiency, and progressive respiratory failure requiring intubation. Due to refractory hypoxemia, he was cannulated for veno-venous ECMO. Continuous veno-venous hemofiltration was used to manage acute kidney injury and fluid overload. He received doxycycline and dexamethasone/etoposide for treatment of ehrlichiosis and HLH, respectively. Plasma exchange was used for thrombocytopenia-associated multiple organ failure. The patient was decannulated after 140 hours of ECMO and subsequently transferred for inpatient rehabilitation after extubation. Review of the Extracorporeal Life Support Organization Registry database identified 6 patients with tickborne diseases who received ECMO for organ support (survival in 3 of 6); ehrlichiosis was not reported in any of these cases. ECMO likely allowed a platform for stabilization and additional therapeutic interventions in this patient.
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PMID:Use of Extracorporeal Support in Hemophagocytic Lymphohistiocytosis Secondary to Ehrlichiosis. 2763 21

A 28-year-old Hispanic woman was admitted to the hospital with fever, sore throat, arthralgia, and a generalized rash of 2 weeks' duration. Her medical history was significant for various food and medication allergies. Multiple antibiotics were given for suspected infection, and she subsequently developed a new skin rash, acute liver injury, eosinophilia, and pancytopenia. Additional studies showed hypertriglyceridemia; elevated interleukin-2 receptor levels; absent natural killer cell activity; and hemophagocytosis in skin, liver, and bone marrow biopsy specimens. Treatment with intravenous immunoglobulin and steroids resulted in complete remission.
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PMID:A 28-year-old woman with fever, rash, and pancytopenia. 2866 13