Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0917798 (cerebral ischemia)
 17,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Echocardiographic studies have demonstrated a high prevalence of valvular disease in patients with primary antiphospholipid syndrome (PAPS). However, there are no studies assessing changes over time in valvular abnormalities. We conducted a study to determine whether there are changes over time in valvular lesions as detected by serial transesophageal echocardiography (TEE). Twelve patients with a first TEE had a second evaluation after a mean period of 13.5 months. There were 10 women and two men with a mean age of 38 years. Two patients had normal TEE on both initial and follow-up studies. Ten patients (83%) had valvular abnormalities, predominantly of the mitral and aortic valves in both studies. Abnormalities consisted of thickening, nodules, regurgitation, regurgitation and stenosis, and calcification. The type and frequency of lesions changed over time. As an example, one mitral valve nodule disappeared on follow up but three new aortic nodules developed even though all patients were receiving anticoagulant therapy. Two patients with mitral and aortic nodules presented cerebral ischemia. Mitral valvuloplasty was performed in one case. These results show that valvular abnormalities in patients with PAPS resolve, appear, or persist irrespective of anticoagulant therapy. Regurgitation is often mild or moderate, but stenosis may appear.
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PMID:[Valvulopathy in primary antiphospholipid syndrome. Prospective echocardiography study]. 1072 93

A 64-year-old man was presented to another hospital with bleeding from the upper jaw with a platelet count of 0.1 x 10(4)/microl one year ago, and idiopathic thrombocytopenic purpura complicated with aortic stenosis and regurgitation was diagnosed. Corticosteroid administration was initiated and the patient was admitted to our hospital for surgery two months after confirmation of symptoms associated with cerebral ischemia. Corticosteroid was administered for one year until the day of surgery, and aortic valve replacement was performed with a platelet count of 8.4 x 10(4)/microl. During surgery, bleeding tendency with decreased platelets was confirmed, which was corrected with intraoperative platelet transfusion, postoperative gamma-globulin administration, and postoperative oral corticosteroid administration. Caution must be exercised against perioperative bleeding tendency in open heart surgery, even when platelet count is maintained using small amounts of preoperative corticosteroid.
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PMID:A surgical case of aortic valve replacement in patient with chronic idiopathic thrombocytopenic purpura. 1553 88