Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0392680 (shortness of breath)
 5,217 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This paper reviews 72 cases of death caused by myocarditis between the years 1996 and 2004, autopsied at the Office of the Wayne County Medical Examiner in Michigan. Myocarditis as a cause of sudden and unexpected death represented 1.3% of all natural deaths in Wayne County during said period. The year 1999 contained the highest number of deaths of this cause (18), where the average number of myocarditis deaths was 8 per year for this 9-year span. In this study, each case was reviewed based on information gathered from investigative, autopsy, and toxicology reports. Significantly, 58% of these cases were male, and 63.4% were African American. Myocarditis caused death in every age group between 7 months and 67 years, but adults between the ages of 19 and 67 were most significantly affected (75%). Flu and/or cold were the most common symptoms experienced in the days directly proceeding death (28%), followed by shortness of breath (17%) and sudden collapse (15%). Sixty-nine percent of these 72 cases were pronounced dead after ACLS (advanced cardiac life support) protocol by emergency medical services or hospital attendants. Cardiomegaly was observed in 24 cases of adults aged 19 or older (54%), and flabby/soft myocardial tissue was observed grossly in 16% of all 72 cases.
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PMID:Death caused by myocarditis in Wayne County, Michigan: a 9-year retrospective study. 1713 24

BACKGROUND Rituximab is a genetically engineered chimeric (murine-human) monoclonal antibody (mAb) directed against CD20 antigen on the surface of B cells. Commonly reported adverse effects are chills and fevers, which are usually associated with the first infusion. Recent studies have shown an association between rituximab use and low immunoglobulin (Ig) level due to a reduction in plasma cell precursors, which leads to an increased risk of infections with the use of rituximab. CASE REPORT We present a case of hypogammaglobulinemia associated with rituximab use in a patient with Granulomatosis with Polyangiitis (GPA). A 59-year-old woman presented with shortness of breath. After an extensive workup, she was diagnosed with GPA. She received rituximab for the induction of remission. Laboratory workup, which was done five days after she received the second rituximab dose, showed IgG and IgM levels below the level of normal. One month after her second dose of rituximab, she presented to the Medical Intensive Care Unit as a transfer from an outside facility intubated and sedated due to acute respiratory failure secondary to septic shock with E. coli bacteremia. The patient died on admission despite aggressive management, including the ACLS protocol. CONCLUSIONS Rituximab is an effective medication in the management of ANCA-associated vasculitis. Obtaining an immunoglobulin level at baseline and before each rituximab cycle is of great clinical importance and helps guide physicians in prescribing B cell-targeted therapy.
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PMID:Rituximab Use and Hypogammaglobulinemia. 3226 10