Multiple organ systems

MULTIPLE CHEMICAL SENSITIVITY An acquired disorder characterized by recurrent symptoms, referable to multiple organ systems, occurring in response to many chemically-unrelated compounds at doses far below those established in the general population to cause harmful effects. No single widely accepted test of physiologic function can be shown to coiTelate with symptoms. 

Sickle cell disease involves multiple organ systems. 

SCD involves multiple organ systems, and its clinical manifestations vary greatly between and among genotypes (see Table 65-1). 

Purines such as ATP and adenosine play a central role in the energy metabolism of all life forms. This fact probably delayed recognition of other roles for purines as autocrine and paracrine substances and neurotransmitters. Today it is recognized that purines are released from neurons and other cells and that they produce widespread effects on multiple organ systems by binding to purinergic receptors located on the cell surface. The principal ligands for... 

Conditions caused by mutations in mitochondrial DNA often involve multiple organ systems. The effects of these conditions are most pronounced in organs and tissues that require a lot of energy (such as the heart, brain, and muscles). Although the health consequences of inherited mitochondrial DNA mutations vary widely, frequently observed features include muscle weakness and wasting, problems with movement, diabetes, kidney failure, heart disease, loss of intellectual functions (dementia), hearing loss, and abnormalities involving the eyes and vision. 

Tissue injury with multiple organ system failure Fever... 

Ultimately, the macrophages die, releasing the enormous built-up stores of TNF and cytokines, triggering a septic shock-like collapse of multiple organ systems. 

Dibromoethane is a potent carcinogen in rats and mice, causing malignant and benign neoplasms of epithelial and mesenchymal origin in multiple organ systems when administered by inhalation, oral, or dermal routes. Cancer was also induced at initial point of contact with... 

Wong et al. 1982). These studies have found cancer in multiple organ systems in two species of rodents. Thus, the carcinogenic effects of 1,2-dibromoethane appear to be well characterized, and additional studies are not necessary. Because the use of 1,2-dibromoethane has diminished considerably since its registration was canceled in 1984, the potential for additional long-term exposure is lower. 

Pleiotropy exists when a single disease-causing mutation affects multiple organ systems. Pleiotropy is a common feature of genetic diseases. 

Abrupt discontinuation of intrathecal baclofen, regardless of the cause, has resulted in sequelae that include high fever, altered mental status, exaggerated rebound spasticity, and muscle rigidity, which in rare cases has advanced to rhabdomyolysis, multiple organ-system failure, and death. 

Like most anticonvulsants, CBZ may cause adverse side effects involving multiple organ systems, and include the following ... 

Hypersensitivity reactions, occasionally fatal, have been reported in 2-5% of patients receiving abacavir. Symptoms, which generally occur within the first 6 weeks of therapy, involve multiple organ systems and include fever, malaise, and gastrointestinal complaints. Skin rash may or may not be present. Laboratory abnormalities such as mildly elevated serum aminotransferase or creatine kinase levels are not specific for this reaction. Although the syndrome tends to resolve quickly with discontinuation of medication, rechallenge with abacavir following discontinuation results in return... 

The most commonly accepted definition of MCS was written by Mark Cullen, M.D., a professor of medicine and epidemiology at Yale University. In Workers With Multiple Chemical Sensitivities, Occupational Medicine 2 (1987) 655-626, he writes, Multiple chemical sensitivities is an acquired disorder characterized by recurrent symptoms, referable to multiple organ systems, occurring in response to demonstrable exposure to many chemically unrelated compounds at doses far below those established in the general population to cause harmful elfects. No single widely accepted test of physiologic function can be shown to correlate with symptoms. ... 

In the first phase there is exposure (repeated low doses or a single high dose) to toxic substances such as solvents or pesticides. As a result some people develop a loss of their natural tolerance. In the second phase, which in some cases manifests at a much later stage, exposures to very small doses of the same substance and different substances can result in responses at the level of multiple organ systems. 

Two other clinical syndromes involving anomalies of multiple organ systems in fetuses of cocaine-abusing women have been described. 

While zinc deficiency syndromes have been known for many years, and their prevalance noted in diverse groups of people world wide, only recently have any identifiable patterns of some of these syndromes been formulated and the underlying mechanisms stated, however tentatively. These syndromes can be complex, present both in children and adults of both sexes and include single or multiple organ systems. These complexities can cause difficulty for both patients and physicians seeking an understanding of these processes. 

A 40-year-old woman travelling to a malaria-infested region took her homeopath s advice and was immunized with homeopathic remedies Ledum palustre 5CH and Malaria officinalis 4CH) instead of taking conventional protection. She contracted malaria and had to be treated for 2 months in intensive care for multiple organ system failure due to Plasmodium falciparum. 

A review has suggested that fluoroquinolone-associated peripheral nervous system events are mild and short-term (30). Among 60 courses of quinolones in 45 patients (levofloxacin 33 courses, ciprofloxacin 11 courses, ofloxacin 6 courses, lomefloxacin 1 course, trovafloxacin 1 course in eight cases the same antibiotic was prescribed twice) there were 36 severe events that typically involved multiple organ systems. The symptoms lasted more than 3 months in 71% of cases and more than 1 year in 58%. The onset of the adverse events in the 45 patients was usually rapid 15 events began within 24 hours of the start of treatment, 26 within 72 hours, and 38 within 1 week. 

Centers for Disease Control and Prevention (CDC). Fever, jaundice, and multiple organ system failure associated with 17D-derived yellow fever vaccination, 1996-2001. MMWR Morb Mortal Wkly Rep 2001 50(30) 643-5. 

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