Multi-organ

Explain the pathophysiology of cystic fibrosis (CF) and its multi-organ system involvement. 

The intensity of the daily chronic maintenance regimen varies based on patient age, baseline lung function, other organ system involvement, and social factors such as time available for therapy and patient-selected care choices. Generally, with more severe lung disease and multi-organ system involvement, therapies become more complicated and time intensive. Additionally, therapy is intensified when pulmonary symptoms are increased with acute exacerbations or even mild viral upper respiratory illness such as the common cold. The approach to treatment is best described by the organ system affected. 

Patients at greatest risk for mortality from acute pancreatitis are those who have multi-organ failure (e.g., hypotension, respiratory failure, or renal failure), pancreatic necrosis, obesity, volume depletion, greater than 70 years of age, and an elevated APACHE II score.3,4 The Acute Physiology, Age, and Chronic Health Evaluation (APACHE) II score is a rating scale of disease severity in critically ill patients. 

Krause, D.S., Theise, N.D., Collector, M.I., et al (2001) Multi organ, multi lineage engraftment by a single bone marrow-derived stem cell. Cell 105, 369 377. 

Multi-organ failure syndrome Patients recovering from dehydration myeloma... 

Fero, M., Rivkin, M., Tasch, M., Porter, P., Carow, C., Fiipo, E., Tsai, L., Broudy, V., Perlmutter, R., Kaushansky, K., and Roberts, J. (1996). A syndrome of multi-organ hyperplasia with features of gigantism, tumorigenesis and female sterility in p27 -deficient mice. Cell 85,733-744. 

Organ failure Fatalities associated with multi-organ failure and various degrees of hepatic failure have been reported. Most cases occurred in association with other serious events (eg, status epilepticus, overwhelming sepsis), making it impossible to identify the initiating cause. 

Hypersensitivity reactions Serious and sometimes fatal hypersensitivity reactions have been associated with abacavir therapy. Hypersensitivity to abacavir is a multi-organ clinical syndrome usually characterized by a sign or symptom in 2 or more of the following groups ... 

This includes patients with Banff grade II acute rejection or vascular rejection prior to cyclosporine withdrawal, those who are dialysis-dependent, or with serum creatinine greater than 4.5 mg/dL, black patients, retransplants, multi-organ transplants, or patients with high panel of reactive antibodies. 

The spectrum of gastrointestinal tract infections (GTI) cover a wide spectrum from asymptomatic Helicobacter pylori gastritis to self-limiting viral gastroenteritis to food poisoning to bacterial enterocolitis to antibiotic-associated Clostridium difficile colitis to typhoid fever with sepsis and multi-organ failure. 

Complications included acute respiratory distress syndrome, renal failure, and multi-organ failure. Evidence that the clinical spectrum of human H5N1 infections is not restricted to pulmonary symptoms was provided by a reported case of possible central nervous system involvement in a Vietnamese boy who presented with diarrhea, followed by coma and death. Influenza H5N1 virus was isolated from throat, rectal, blood, and cerebrospinal fluid specimens, suggesting widely disseminated viral replication. 

V.V. Nikonov et al, proposed use of massive doses of Enterosgel combined with Eortrans laxative and various eubiotics as the means for prophylaxis of endotox-emia, oxidative stress and bacterial translocation during preparation for surgery associated with the risk of massive blood loss, and in critical state patients with multi-organ insufficiency, severe bums, sepsis, and polytrauma [56]. This scheme may be used for therapy of different pathologies such as chronic hepatitis, allergy and exacerbation of bronchial asthma. 

Efficacy of Modified Hemosorbents Used for Treatment of Patients with Multi-Organ Insufficiency... 

Keywords Hemosorption Multi-organ failure Activated carbon... 

Although IEF of serum transferrin is relatively easy to perform, it is assumed that many CDG patients are still missed. Due to the complex clinical presentation of CDG, all patients suffering from unclear multi-organ diseases, especially in combination with mental and psychomotor retardation, strabismus, cerebellar atrophy and blood-clotting problems, should be investigated for CDG. 

LPS can provoke a multi-organ failure, due to the secretion of acute-phase reactants such as platelet-activating factor (PAF), TNF-a, and LBP. Multi-organ failure is also due to the secretion of prostaglandin E2 (PGE2) and inflammatory cytokines such as TNF-a, IL-ip, IL-6, whose production may increase the secretion of the acute-phase reactant, LBP [63], thus constituting an amplifying loop. The presence of a tumor may modify this host response as will be discussed below. 

Thus, cadmium causes multi-organ toxicity, and at least some of the toxic effects are due to it being a divalent metal similar to zinc and able to bind to sulfydryl groups. 

Lead is a toxic metal to which there is wide exposure. Exposure is via inhalation (main source, leaded petrol) and ingestion (water, old paint). Multi-organ toxicity occurs with the kidneys, central and peripheral nervous system, testes, red cells, bones, and gastrointestinal tract all damaged. After initial distribution into red blood cells, it is eventually deposited in bone. The main biochemical effect is interference with heme synthesis at several points. Kidney toxicity may be due to lead-protein complexes and inhibition of mitochondrial function. Damage to nerves leads to peripheral neuropathy. 

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