Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0392525 (nephrolithiasis)
 2,669 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The case of a 58-year-old employee of an antibiotic-producing factory with occupationally related disorders (asthmatic dyspnea, episodic fever in the evening and malaise) is presented. A change of workplace did not completely relieve the patient. The further course was complicated by nephrolithiasis with urinary infection requiring nephroureterotomy. The extensive allergological investigation resulted in absolutely negative skin tests of the immediate and delayed type with environmental allergens including moulds and antibiotics. The serological examinations showed a high total IgE level and positive specific IgE to benzylpenicilloyl (BPO). The arterial blood gas analyses at rest showed that the patient hyperventilated massively. Consecutive inhalation of lactose, tetracycline, ampicillin and chloramphenicol dust administered by Spinhaler turboinhaler produced a delayed asthmatic reaction with an FEV1 a fall of 42% five hours after provocation, accompanied by general symptoms identified by the patient as here former disorders. Circulating immunocomplexes (C1q-binding test) were now positive, as was anti-BPO-IgG, while anti-BPO-IgE decreased slightly.
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PMID:[Occupation-related bronchial asthma caused by ampicillin. Diagnostic significance of occupation-specific inhalation provocation tests]. 711 77

The files were studied of 300 patients operated for primary hyperparathyroidism for the first time. Their median age was 60 years. The female/male ratio was 3/1, but in the younger patients males and females were about equally present. Preoperatively, one third was considered as asymptomatic with respect to hyperparathyroidism. In this subgroup the hypercalcemia was detected coincidentally and the mean parathyroid hormone level was lower than in the others. Another third of the patients had nephrolithiasis, they were on the average younger and there were more males. Finally one third showed other symptoms as gastrointestinal disease, bone disease or general malaise. Intraoperatively, we found a solitary adenoma in 90% of the cases, a double adenoma in 5% (on each side of the neck in half of the cases) and hyperplasia in 4%. The adenomas had a tendency to occur more often in the upper parathyroid glands, but the difference was not important enough to influence the surgical technique. Hyperplasia patients were, on the average, younger and double adenoma patients older. The female/male ratio was 1/1 for hyperplasia and 15/1 for double adenoma.
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PMID:Pre- and intra-operative findings in primary hyperparathyroidism. 1144 71

Primary hyperparathyroidism (PHPT) is the most common cause of hypercalcemia in the outpatient population. It is diagnosed in most individuals in the Western world at an asymptomatic stage without signs or symptoms of parathyroid hormone (PTH) calcium excess. Nonspecific symptoms include weakness, malaise, fatigue, and possible mood disturbances, which may be present at the time of diagnosis. The diagnosis of PHPT is confirmed in the presence of hypercalcemia and a normal or elevated PTH level in the absence of conditions that mimic PHPT. Indications for surgery have recently been revised based on international consensus, and surgery is advised in the presence of significant hypercalcemia, impaired renal function, and osteoporosis and in individuals younger than 50yr. The classical complications of PHPT are skeletal fragility, nephrolithiasis, and nephrocalcinosis. Surgery is always appropriate in an individual with confirmed PHPT after excluding conditions that can mimic PHPT and in the absence of contraindications. Individuals with asymptomatic PHPT not meeting the guidelines for surgery or those with contraindications for surgery may be followed and considered for medical management. For those at an increased risk of fragility fracture, antiresorptive therapy may be considered with close monitoring of biochemical data and bone densitometry. Targeted therapy with a calcimimetic agent may be of value in lowering serum calcium and PTH. There are currently no fracture data for the medical options available, and prospective randomized controlled trials are required to confirm the effects of medical therapy on fracture risk reduction in those with asymptomatic PHPT.
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PMID:Medical management of primary hyperparathyroidism. 2337 43