SEARCH · PubMed Health

Results for “DROPSY”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 19 recordsLinked to original sources

PubMed2002

Ippolito Albertini and Michael Albertus: disparate old and innovative theories on dropsy and edema.

The concept of edema and dropsy as a part of heart and renal failure developed in the 17th and 18th centuries with the observations of Albertini, who realized that two clinical entities were derived from the blood rather than the tissues. Albertus, who lived in the same period, was the last physician to interpret fluid accumulation according to the old, scholastic and dogmatic procedures of medicine. The fundamental concepts of Albertus held little in addition to the classification and categories of the physicians of the Middle Ages. Bloody congestions were distinguished from stagnation: the former have the purpose of reducing superfluites of blood and occurred in plethoric patients. Plethora in turn is caused by the ancient villain, inculpated since Hippocrates and Galen: suppressed hemorrhoids, suppressed menstrual evacuation and cutaneous eruption driven inward. Because of its suppression, transfer of blood occurs toward the chest, which impedes thoracic expansion and contraction, then asthma and dyspnea occur. On the contrary, Albertini with his clinical and autoptic observations and pronouncements filled in the anatomical and clinical picture of fluid accumulation and created the rudiments of diagnostic criteria. Edema, dropsy, asthma, dyspnea were, according to Albertini, the signs and symptoms of heart and renal failure. Albertini was the first to point out that dyspnea is apt to arise with special rapidity when a lesion occurs in the left atrial chamber and ventricle and by implication the mitral valve. In modern physiopathological terms, he discovered the picture of pulmonary edema. To this important discovery, he added a number of extremely important comments: changes in the respiratory organs are secondary to changes in the cardiovascular system; edema that is accompanied by dyspnea also affects the viscera, most especially the lungs, and finally dropsy of the lungs must be differentiated anatomically and clinically from dropsy of the chest (hydrothorax). In other words, he depicted the anatomical and clinical picture of congestive heart failure in modern terms.

Edema↗

PubMed1988

Pathogenesis of epidemic dropsy glaucoma.

Thirty-one cases of epidemic dropsy with raised intraocular pressure were studied. Glaucoma was bilateral in all, with open angles and no signs of anterior segment inflammation. The outflow facility was unimpaired (C value, 0.24 +/- 0.09 microL/min/mm Hg). Aqueous bioassays revealed significantly elevated prostaglandin E2 level (23.33 +/- 4.32 ng/mL) and histamine activity (13.0 +/- 2.76 ng/mL) in all samples from patients with epidemic dropsy glaucoma as compared with negligible levels in control samples from patients with open angle glaucoma. Aqueous biochemical analysis revealed increased total protein level (1.03 +/- 0.10 g/L) with a normal globulin pattern as compared with controls (0.26 +/- 0.08 g/L). On histopathologic and histochemical testing, a normal trabecular meshwork was found in 11 of the 12 trabeculectomy specimens. It is concluded that dropsy glaucoma is hypersecretory in nature; prostaglandin and histamine release may have significant roles in its pathogenesis.

Alkaloids↗

PubMed2000

Evaluation of oxidative stress in some cases of argimone oil poisoning during a recent outbreak of epidemic dropsy in India.

The study was designed to evaluate the oxidative stress and modulation of anti-oxidant enzymes in 10 accidental argimone oil poisoning cases admitted in a hospital in Delhi, India during a recent outbreak of epidemic dropsy in 1998. Serum malondialdehyde (MDA) level, oxygen free-radical scavenging enzymes such as superoxide dismutase (SOD) and catalase (CAT), and glutathione (GSH) and related enzymes, e.g. glutathione reductase (GR), glutathione peroxidase (GPx), gamma glutamyl transpeptidase (GGT) and glutathione-S-transferase (GST) in erythrocytes were assayed. The sanguinarine level in serum was measured by high-performance liquid chromatography. The serum MDA level was higher and the GSH level in erythrocytes was lower in argimone oil poisoning cases than those in controls. There was a significant decrease in SOD and GPx activities in erythrocytes of epidemic dropsy cases but no changes were observed in CAT, GR and GST assay. The depletion of GSH in erythrocytes, serum MDA level and clinical severity were dependent on serum sanguinarine level. The results indicate that sanguinarine (argimone oil) poisoning creates an oxidative stress in humans. The oxidative stress and differential modulation of anti-oxidant enzymes by sanguinarine might play a pathogenic role in epidemic dropsy, which suggests the incorporation of anti-oxidant drugs in the treatment protocol of the disease.

Chromatography, High Pressure Liquid↗

PubMed2004

Pattern of intraocular pressure in epidemic dropsy in India.

This study was conducted to report on the intraocular pressure (IOP) pattern in patients with epidemic dropsy. Two hundred and thirty proven cases of epidemic dropsy were sent for ocular examination. We measured IOP by applanation tonometry at different intervals. Patients were followed up until 24 weeks. Intraocular pressure of more than 22 mm of Hg was detected in 10.86% patients at the start of the study. However, at 12 weeks only 0.43% patients needed medication for control of IOP. None required medication for IOP control after 20 weeks. The rise of IOP in this case series of epidemic dropsy appeared to be a transient phenomenon and drugs needed to be titrated on a weekly basis.

Adult↗

PubMed1985

Epidemic dropsy following transcutaneous absorption of Argemone mexicana oil.

Four cases manifesting features characteristic of epidemic dropsy following body massage with contaminated mustard oil are reported. A transcutaneous route of absorption for the toxin (sanguinarine) resulting in epidemic dropsy has not been documented previously in man. Oil used for body massage was found to be adulterated with Argemone mexicana oil, while hydrogenated vegetable fat used for cooking did not reveal any contamination. Diagnosis of the disease was confirmed by establishing the presence of sanguinarine in the urine and serum of all four cases.

Adult↗

PubMed1975

Epidemic dropsy in New Delhi.

Forty-five cases of epidemic dropsy were studied from an epidemic in New Delhi. Argemone oil contamination was found in the mustard oil used for cooking. Sanguinarine was detected in the eight urine samples collected within 2-3 weeks of onset of dropsy and its concentration ranged from 0.4 to 3.6 mug/100 ml. Three of the 18 sera were positive for sanguinarine, the concentration being 1.2, 1.6 and 3.6 mug/100 ml. The clinical manifestations and epidemiological factors were studied. Edema of the legs was the most consistent clinical finding, and was present in all the patients. In contrast to the earlier epidemics, three striking features were pigmentation in 33%, hair loss in 77.7% and nontender hepatomegaly in 24.4% of cases. A follow-up of 10 months showed almost complete recovery in all.

Adolescent↗

PubMed1999

Epidemic dropsy in the eastern region of Nepal.

Twenty-six persons from five families comprising 34 members residing in different areas of Saptari district of the eastern region of Nepal developed symptoms of epidemic dropsy over 6-8 weeks. Seventeen patients were studied during July-August 1996. The age of affected individuals varied from 3 to 75 years. Members who had not consumed food cooked in mustard oil or who were not residing with the family were spared. Mustard oil, which was used for cooking, was found to be contaminated with oil of Argemone mexicana seeds. Sanguinarine was detected in all mustard oil samples collected from the homes of affected families. Gastrointestinal symptoms were present in 82 per cent of cases a week or so prior to the onset of pedal oedema. Pitting oedema of the lower limbs, fever, and darkening of the skin were the most consistent features, found in all cases. Other prominent features such as local erythema (82 per cent) and tenderness (88 per cent) of the lower limbs were present in most cases. Two striking features not previously noted were perianal itching (100 per cent) and severe carditis (35 per cent) with congestive cardiac failure (29 per cent). Other unique features noted were 'sarcoid' skin changes (18 per cent), bilateral pleural effusion, and Roth's spots and subhyloid haemorrhages in the fundus in one patient. Other important findings were anaemia (88 per cent), hepatomegaly (41 per cent), pneumonia (35 per cent) and ascites (12 per cent). There were no deaths due to epidemic dropsy. In the majority of cases, oedema, cutaneous changes, and carditis showed a marked improvement in 2-3 weeks and patients were well after 6-8 weeks of follow-up.

Adolescent↗

PubMed1997

Unravelling dropsy: from Marcello Malpighi's discovery of the capillaries (1661) to Stephen Hales' production of oedema in an experimental model (1733).

A modern understanding of oedema formation traditionally begins with Starling's description in 1898 of hydrostatic and oncotic forces acting on the capillary membrane. Clearly, hypotheses of oedema formation predating the knowledge of the existence of capillaries must have been incomplete. Marcello Malpighi first described capillaries in 1661, but although he displayed a good grasp of the principles of the Harveian circulation and believed that oedema fluid (the clinical entity dropsy) was derived from the blood rather than the tissues, we have found no evidence that he realised the central role played by his discovery. However, only 60 years later, Stephen Hales' Haemastaticks reveals the creation of an experimental model for dropsy which led him towards an understanding of oedema formation not far behind Starling.

Anatomy↗

PubMed2002

Epidemic dropsy: observations on pathophysiology and clinical features during the Delhi epidemic of 1998.

Epidemic dropsy results from the consumption of edible oils adulterated with Argemone mexicana oil by unscrupulous traders. Twenty consecutive 'in-door' patients of dropsy were intensively studied during the recent Delhi epidemic. Samples of edible oil used by them, their urine and their serum samples tested positive for sanguinarine on thin layer chromatography. The illness starts as a gastro-enteric illness followed by oliguria and pedal oedema. The following are often observed: cutaneous erythema with blanching and tenderness on pressure; violacious pigmentation of the skin; shortness of breath with orthopnoea; right-sided heart failure with normal left ventricle (LV) functions; as well as severe anaemia and hypoalbuminaemia. Renal function tests showed: bland urinary sediments; decreased glomerular filtration rate (GFR); mild to moderate azotaemia; acute tubular necrosis; patchy pneumonitis; moderate hypoxia with respiratory alkalosis; and restrictive ventilatory defects on blood gas analysis; and spirometry suggestive of interstitial pulmonary oedema of non-cardiogenic origin. 99mTc colloid sulphur liver scans showed colloid shift. There was marked dilatation and proliferation of dermal capillaries in the absence of significant inflammation in the biopsy specimens. Toxic alkaloids of Argemone mexicana oil induce widespread capillary dilatation and permeability causing leakage of protein rich plasma into the interstitial tissues of various organs. A hypovolaemic state is thus induced producing renal hypoperfusion which may progress to acute tubular necrosis. Interstitial fluid in alveoli causes restrictive ventilatory dysfunction with hypertension and right-sided failure with well-preserved LV function. The hepatic venous congestion induces Kupffer's cell dysfunction, which results in colloid shift on a radionuclide liver scan.

Adolescent↗

PubMed1999

Acute renal failure in epidemic dropsy.

Acute renal failure (ARF) complicating epidemic dropsy is reported in three patients. In this study, ARF resolved in two patients over a period of 4-6 weeks with conservative and dialytic support. One patient died of refractory heart failure. To the best of our knowledge ARF in association with epidemic dropsy has not been reported before in the literature from India.

Acute Kidney Injury↗

PubMed2000

Neurologic complications of dropsy: from possibility to reality.

Epidemic dropsy, which results from the accidental ingestion of mustard oil adulterated with argemone oil, has been associated with certain neurologic symptoms. The occurrence of objective neurologic involvement has, however, precluded this illness. We report two cases, who were victims of epidemic dropsy in the recent outbreak in India and showed objective neurologic deficit in the form of brachial neuritis.

Adult↗

PubMed2000

Epidemic dropsy--a clinical study of the Delhi outbreak.

BACKGROUND: A major outbreak of epidemic dropsy occurred in Delhi, India, in August-September 1998, due to the consumption of contaminated mustard oil. METHODS: The clinical data of 212 adult patients of epidemic dropsy who presented to our hospital is analysed. RESULTS: Pitting pedal oedema (100%), skin erythema (75%), limb tenderness (63%), diarrhea (51%) and hepatomegaly (34%) were the prominent clinical manifestations observed in the patients. Superficial retinal haemorrhages and retinal venous dilatation was observed on fundus examination and 9% of patients developed an open angle glaucoma over a three month follow up period. Cardiac failure was present in 14% of patients. Most patients had mild disease which responded to cessation of mustard oil consumption, bed rest, diuretics and antioxidants. There were six deaths, all of whom had intractable cardiac failure. A unique feature of this outbreak was the documentation of acute renal failure in three patients, a phenomenon never described previously. CONCLUSIONS: Strict law enforcement to prevent the contamination of edible oils is essential to avoid the occurrence of future similar outbreaks.

Adolescent↗

PubMedDate not supplied

Pulmonary functions in patients with epidemic dropsy.

Pulmonary functions were performed in thirteen patients with epidemic dropsy. The epidemic occurred in Delhi in 1998 during which 102 patients with epidemic dropsy reported to our medical unit. Other investigations included chest radiograph, ECG, liver and renal function tests. There was a restrictive ventilatory defect with diminution of diffusion capacity for carbon monoxide in these patients. Echocardiogram was done in seven of these patients and was normal. The cause of breathlessness and restrictive ventilatory defect is likely to be non-cardiogenic pulmonary oedema.

Adolescent↗

PubMed1992

An out-break of epidemic dropsy in the Barabanki District of Uttar Pradesh, India: a limited trial for the scope of antioxidants in the management of symptoms.

An attempt was made to explore the scope of the bio-antioxidants in the management of symptoms of epidemic dropsy caused by argemone alkaloids, sanguinarine and dihydrosanguinarine. The study was performed on 24 randomly selected epidemic dropsy cases who consumed argemone contaminated mustard oil. On examination the cases revealed characteristic pitting edema over limbs (95.8%) accompanied by tenderness (79.2%) and diffuse erythema (95.8%). Tachycardia was present in 1/3 of the examined cases while elevated jugular venous pressure was seen in over 40% of the cases. In two of the cases, reddish-purplish blotches over lower limbs, not raised and which blanched on pressure, was an unusual feature. Chest X-ray revealed pulmonary congestion in 5 cases. ECG performed in 3 cases with severe breathlessness, showed non-specific ST-T changes most marked in L2,L3, avF and V2-V6 which reversed on recovery. Treatment with a combination of antioxidants, riboflavin and tocopherol showed improvement in pain in lower limbs (75%), edema (83.3%) and erythema (66.6%).

Adolescent↗

PubMed1989

Electrophysiological studies of the eye, peripheral nerves and muscles in epidemic dropsy.

The involvement of the neurological system in epidemic dropsy is controversial. During two outbreaks of epidemic dropsy, detailed neurological and ocular examinations and electrophysiological studies of peripheral nerves and muscles (motor nerve conduction velocities, sensory nerve latencies and electromyography) and eye (electroretinogram and visually evoked cortical responses) were therefore undertaken. Amongst the 239 subjects examined, burning sensation and tingling paraesthesias of feet were reported by 42.3 and 35.6%, respectively; but none had any objective evidence of central or peripheral nervous system involvement. Electrophysiological studies of peripheral nerves and muscles (10 cases with subjective manifestations) and eyes (24 eyes of 12 patients hospitalized for control of glaucoma) were essentially normal. It is concluded that Argemone mexicana or its toxins do not have any significant effect on the nervous system.

Adolescent↗

PubMed1987

Optic disc vasculitis in epidemic dropsy.

During an outbreak of epidemic dropsy in Delhi, 233 patients were studied. Retinal changes including venous dilatation and tortuosity, haemorrhages and disc oedema were observed. A clinical picture compatible with type I optic disc vasculitis was seen in 13 eyes and that of type II in 3 eyes. Fluorescein angiography was carried out in 23 randomly selected cases. Relevant angiographic findings included dilated and tortuous retinal veins, prominent vascular staining, blocked fluorescence, microaneurysms, disc oedema and peripapillary dye spillage. Presence of positive angiographic findings correlated well with the severity of the systemic disease, glaucoma, however, revealed no correlation. Papillophlebitis, a new ocular manifestation of Argemone mexicana oil toxicity, as also the fluorescein angiographic picture in epidemic dropsy is being reported for the first time in the literature.

Disease Outbreaks↗

PubMed2001

A two-centre collaborative study on clinico-epidemiological profile of a recent outbreak of epidemic dropsy in New Delhi (India) with special emphasis on its cardiac manifestations in pediatric patients.

A hundred and six clinically diagnosed cases of epidemic dropsy, admitted in June to August 1998 to the P-III unit of RML Hospital and the Department of Pediatrics, Safdarjang Hospital, were studied. All of them consumed mustard oil contaminated with Argemona mexicana, confirmed by ferric chloride and nitric acid tests. No specific sex predilection was seen. No child was affected below the age of 3 years. Pedal edema and reddish hyperpigmentation were the most consistent findings (100 per cent). Frank cardiac failure was seen in only 24 (22.64 per cent), yet persistent tachycardia was alarmingly high (104/106, i.e. 98.4 per cent). Notably ECG showed prolonged Q-T interval in 24 children (22.64 per cent), unrelated to serum Ca2+ level in patients with congestive cardiac failure (CCF). Color Doppler echocardiography showed biventricular dilatation in all the 24 patients with CCF. Wide pulse pressure was recorded in two patients only. Mortality occurred in only two patients (1.89 per cent). Eye involvement was a late finding. All those who survived (i.e. 104/106) recovered completely, except two patients who were left with sarcoid-like changes of skin telangiectasia.

Disease Outbreaks↗

PubMed1999

Epidemic dropsy in India.

Epidemic dropsy is a clinical state resulting from use of edible oils adulterated with Argemone mexicana oil. Sanguinarine and dehydrosanguinarine are two major toxic alkaloids of Argemone oil, which cause widespread capillary dilatation, proliferation and increased capillary permeability. Leakage of the protein-rich plasma component into the extracellular compartment leads to the formation of oedema. The haemodynamic consequences of this vascular dilatation and permeability lead to a state of relative hypovolemia with a constant stimulus for fluid and salt conservation by the kidneys. Illness begins with gastroenteric symptoms followed by cutaneous erythema and pigmentation. Respiratory symptoms such as cough, shortness of breath and orthopnoea progressing to frank right-sided congestive cardiac failure are seen. Mild to moderate anaemia, hypoproteinaemia, mild to moderate renal azotemia, retinal haemorrhages, and glaucoma are common manifestations. There is no specific therapy. Removal of the adulterated oil and symptomatic treatment of congestive cardiac failure and respiratory symptoms, along with administration of antioxidants and multivitamins, remain the mainstay of treatment. Selective cultivation of yellow mustard, strict enforcement of the Indian Food Adulteration Act, and exemplary punishment to unscrupulous traders are the main preventive measures.

Adolescent↗