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    Caricato da

    Carlos Hernández
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    63

    Caricato da

    Carlos Hernández

    Copyright:

    © All Rights Reserved
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    di 202

    var title_f0_63_1008="Algorithm for hemoptysis in children";

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    " <div id=\"graphicsCopy\">",
    " &copy;2013 UpToDate",
    " <sup>",
    " &reg;",
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    " </div>",
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    " <a class=\"icontxt textLink\" href=\"?imageKey=PEDS
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    " <a class=\"etacLink\" href=\"#\">",
    " <img alt=\"Email graphic(s)\" src=\"./../images/icn_email.myextg\"
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    " <div class=\"graphic\">",
    " <div class=\"figure\" style=\"width: 563px\">",
    " <div class=\"ttl\">",
    " Algorithm for management of hemoptysis in children",
    " </div>",
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    " </div>",
    " <div class=\"lgnd\">",
    " <div class=\"footnotes\">",
    " CT: computerized tomography; BAL: bronchoalveolar lavage.",
    " <br>",
    " * The selection of radiographic and bronchoscopic procedures in the
    hemoptysis workup varies, depending on the severity of the symptoms and suspected
    cause.",
    " </br>",
    " </div>",
    " <div class=\"reference\">",
    " Courtesy of Dr. Diana Quintero.",
    " </div>",
    " </div>",
    " </div>",
    " </div>",
    "</div>"].join("\n");
    var script_f0_63_1008=[""].join("\n");
    var outline_f0_63_1008=null;
    var title_f0_63_1009="SEER surv adeno rectum";
    var content_f0_63_1009=[" <div id=\"graphicsToolbar\">",
    " <div id=\"graphicsCopy\">",
    " &copy;2013 UpToDate",
    " <sup>",
    " &reg;",
    " </sup>",
    " </div>",
    " <div id=\"graphicsLinks\">",
    " <a href=\"?imageKey=ONC
    %2F60598&amp;source=image_view&amp;view=print&amp;elapsedTimeMs=0\" onclick=\"\">",
    " <img alt=\"Print this page\" src=\"./../images/icn_print.myextg\"
    title=\"Print this page\"/>",
    " </a>",
    " <a class=\"icontxt textLink\" href=\"?imageKey=ONC
    %2F60598&amp;source=image_view&amp;view=print&amp;elapsedTimeMs=0\" onclick=\"\"
    title=\"Print this page\">",
    " Print",
    " </a>",
    " <a class=\"etacLink\" href=\"#\">",
    " <img alt=\"Email graphic(s)\" src=\"./../images/icn_email.myextg\"
    title=\"Email graphic(s)\"/>",
    " </a>",
    " <a class=\"icontxt textLink etacLink\" href=\"#\" title=\"Email graphic(s)\">",
    " Email",
    " </a>",
    " </div>",
    " </div>",
    " <div class=\"graphic\">",
    " <div class=\"figure\" style=\"width: 569px\">",
    " <div class=\"ttl\">",
    " Observed survival rates for 9,860 cases with adenocarcinoma of the rectum",
    " </div>",
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    " </div>",
    " <div class=\"lgnd\">",
    " Data from the SEER 1973-2005 Public Use File diagnosed in years 1998-2000.
    Stage I includes 3470; Stage IIA, 2752; Stage IIB, 165; Stage IIC, 268; Stage IIIA,
    595; Stage IIIB, 615; Stage IIIC, 761; and Stage IV, 1234.",
    " <div class=\"footnotes\">",
    " </div>",
    " <div class=\"reference\">",
    " Used with the permission of the American Joint Committee on Cancer (AJCC),
    Chicago, Illinois. The original source for this material is the AJCC Cancer Staging
    Manual, Seventh Edition (2010) published by Springer New York, Inc.",
    " </div>",
    " </div>",
    " </div>",
    " </div>",
    "</div>"].join("\n");
    var script_f0_63_1009=[""].join("\n");
    var outline_f0_63_1009=null;
    var title_f0_63_1010="Simple hepatic cyst series";
    var content_f0_63_1010=[" <div id=\"graphicsToolbar\">",
    " <div id=\"graphicsCopy\">",
    " &copy;2013 UpToDate",
    " <sup>",
    " &reg;",
    " </sup>",
    " </div>",
    " <div id=\"graphicsLinks\">",
    " <a href=\"?imageKey=GAST
    %2F68739&amp;source=image_view&amp;view=print&amp;elapsedTimeMs=2\" onclick=\"\">",
    " <img alt=\"Print this page\" src=\"./../images/icn_print.myextg\"
    title=\"Print this page\"/>",
    " </a>",
    " <a class=\"icontxt textLink\" href=\"?imageKey=GAST
    %2F68739&amp;source=image_view&amp;view=print&amp;elapsedTimeMs=2\" onclick=\"\"
    title=\"Print this page\">",
    " Print",
    " </a>",
    " <a class=\"etacLink\" href=\"#\">",
    " <img alt=\"Email graphic(s)\" src=\"./../images/icn_email.myextg\"
    title=\"Email graphic(s)\"/>",
    " </a>",
    " <a class=\"icontxt textLink etacLink\" href=\"#\" title=\"Email graphic(s)\">",
    " Email",
    " </a>",
    " </div>",
    " </div>",
    " <div class=\"graphic\">",
    " <div class=\"figure\" style=\"width: 470px\">",
    " <div class=\"ttl\">",
    " Images of a simple hepatic cyst",
    " </div>",
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    " </div>",
    " <div class=\"lgnd\">",
    " Panel A: Abdominal CT scan shows a well-defined, low-attenuation lesion in the
    left hepatic lobe. Panel B: Abdominal ultrasound demonstrates an unilocular space
    with internal echoes consistent with bleeding into the cyst cavity. Panel C: T2-
    weighted MRI image, demonstrating a typical high-intensity signal. Panel D:
    Surgical view showing wide unroofing of the cyst.",
    " <div class=\"footnotes\">",
    " </div>",
    " <div class=\"reference\">",
    " Reproduced with permission from: Regev, A, Reddy, KR, Berho, M, et al. Large
    cystic lesions of the liver in adults: A 15-year experience in a tertiary center. J
    Am Coll Surg 2001; 193:36. Copyright &copy; 2001 American College of Surgeons.",
    " </div>",
    " </div>",
    " </div>",
    " </div>",
    "</div>"].join("\n");
    var script_f0_63_1010=[""].join("\n");
    var outline_f0_63_1010=null;
    var title_f0_63_1011="Melanoma subungual amelanotic";
    var content_f0_63_1011=[" <div id=\"graphicsToolbar\">",
    " <div id=\"graphicsCopy\">",
    " &copy;2013 UpToDate",
    " <sup>",
    " &reg;",
    " </sup>",
    " </div>",
    " <div id=\"graphicsLinks\">",
    " <a href=\"?imageKey=DERM
    %2F85672&amp;source=image_view&amp;view=print&amp;elapsedTimeMs=1\" onclick=\"\">",
    " <img alt=\"Print this page\" src=\"./../images/icn_print.myextg\"
    title=\"Print this page\"/>",
    " </a>",
    " <a class=\"icontxt textLink\" href=\"?imageKey=DERM
    %2F85672&amp;source=image_view&amp;view=print&amp;elapsedTimeMs=1\" onclick=\"\"
    title=\"Print this page\">",
    " Print",
    " </a>",
    " <a class=\"etacLink\" href=\"#\">",
    " <img alt=\"Email graphic(s)\" src=\"./../images/icn_email.myextg\"
    title=\"Email graphic(s)\"/>",
    " </a>",
    " <a class=\"icontxt textLink etacLink\" href=\"#\" title=\"Email graphic(s)\">",
    " Email",
    " </a>",
    " </div>",
    " </div>",
    " <div class=\"graphic\">",
    " <div class=\"figure\" style=\"width: 524px\">",
    " <div class=\"ttl\">",
    " Amelanotic subungual melanoma",
    " </div>",
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    " </div>",
    " <div class=\"lgnd\">",
    " <div class=\"footnotes\">",
    " </div>",
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    " Reproduced with permission from: www.visualdx.com. Copyright Logical Images,
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    " </div>",
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    var outline_f0_63_1011=null;
    var title_f0_63_1012="Urinary tract malignancy and atherosclerotic disease in
    patients with chronic analgesic abuse";
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    " <div id=\"topicContent\">",
    " <div id=\"topicTitle\">",
    " Urinary tract malignancy and atherosclerotic disease in patients with chronic
    analgesic abuse",
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    " <div id=\"topicContributors\">",
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    " <a id=\"authors\">",
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    " <a class=\"contributor contributor_credentials contributorType\"
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    " Author",
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    0/63/1012/contributors\">",
    " Marc E De Broe, MD, PhD",
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    " Gary C Curhan, MD, ScD",
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    " Deputy Editor",
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    " Alice M Sheridan, MD",
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    " <div id=\"topicText\">",
    " <p class=\"headingAnchor\" id=\"H1\">",
    " <span class=\"h1\">",
    " INTRODUCTION",
    " </span>",
    " &nbsp;&mdash;&nbsp;In addition to renal impairment, prolonged heavy analgesic
    use can lead to two other major complications: urinary tract malignancy and
    atherosclerotic disease. The development of these conditions in patients with
    chronic analgesic abuse and analgesic nephropathy is discussed here. The effects of
    nonsteroidal antiinflammatory drugs on cardiovascular risk and the association
    between analgesics and risk for hypertension are presented separately. (See",
    " <a class=\"medical medical_review\" href=\"UTD.htm?24/4/24648?
    source=see_link\">",
    " \"Nonselective NSAIDs: Adverse cardiovascular effects\"",
    " </a>",
    " and",
    " <a class=\"medical medical_review\" href=\"UTD.htm?38/27/39351?
    source=see_link\">",
    " \"COX-2 selective inhibitors: Adverse cardiovascular effects\"",
    " </a>",
    " and",
    " <a class=\"medical medical_review\" href=\"UTD.htm?41/43/42674?
    source=see_link\">",
    " \"NSAIDs and acetaminophen: Effects on blood pressure and hypertension\"",
    " </a>",
    " .)",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H2\">",
    " <span class=\"h1\">",
    " URINARY TRACT MALIGNANCY",
    " </span>",
    " &nbsp;&mdash;&nbsp;Transitional cell carcinomas of the renal pelvis, ureter,
    and bladder (which may be multiple and bilateral) all occur with increased
    frequency in this setting [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1012/abstract/1-3\">",
    " 1-3",
    " </a>",
    " ]. The incidence of renal cell carcinoma also may be enhanced but this remains
    controversial [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1012/abstract/4\">",
    " 4",
    " </a>",
    " ].",
    " </p>",
    " <p>",
    " It is estimated that a urinary tract malignancy will develop in as many as 8
    to 10 percent of patients with analgesic nephropathy [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1012/abstract/1-3\">",
    " 1-3",
    " </a>",
    " ], but in well under 1 percent of phenacetin-containing analgesic users
    without kidney disease [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1012/abstract/5\">",
    " 5",
    " </a>",
    " ]. In women under the age of 50, for example, analgesic abuse is the most
    common cause of bladder cancer, an otherwise unusual disorder in young women [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1012/abstract/3\">",
    " 3",
    " </a>",
    " ]. The potential magnitude of this problem has also been illustrated by
    histologic examination of nephrectomy specimens obtained prior to renal
    transplantation; the incidence of urothelial atypia in this setting approaches 50
    percent [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1012/abstract/1\">",
    " 1",
    " </a>",
    " ].",
    " </p>",
    " <p>",
    " The tumors generally become apparent after 15 to 25 years of analgesic abuse
    [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1012/abstract/1\">",
    " 1",
    " </a>",
    " ], usually but not always in patients with clinically evident analgesic
    nephropathy [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1012/abstract/2\">",
    " 2",
    " </a>",
    " ]. Most patients are still taking the drug at the time of diagnosis, but
    clinically evident disease can first become apparent several years after cessation
    of analgesic intake and even after renal transplantation has been performed [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1012/abstract/1\">",
    " 1",
    " </a>",
    " ]. In Australia, for example, the incidence of analgesic nephropathy declined
    progressively in the first 10 years after phenacetin-containing compounds were
    removed from over-the-counter analgesic combinations and 5 years after over-the
    counter sales of analgesic mixtures were banned [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1012/abstract/6\">",
    " 6",
    " </a>",
    " ]. In comparison, the incidence of urinary tract malignancy continued to rise
    (at a greater rate than other malignancies), a possible reflection of late
    phenacetin-induced injury [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1012/abstract/6\">",
    " 6",
    " </a>",
    " ].",
    " </p>",
    " <p>",
    " It is presumed that the induction of malignancy results from the intrarenal
    accumulation of N-hydroxylated phenacetin metabolites that have potent alkylating
    action [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1012/abstract/2\">",
    " 2",
    " </a>",
    " ]. Because of urinary concentration, the highest concentration of these
    metabolites will be in the renal medulla, ureters, and bladder, possibly explaining
    the predisposition to carcinogenesis at these sites.",
    " </p>",
    " <p>",
    " The pathogenetic importance of phenacetin metabolites is suggested indirectly
    from the observation that there appears to be no association with tumor formation
    with the prolonged ingestion of other analgesics that can cause papillary necrosis
    but do not form these metabolites, such as",
    " <a class=\"drug drug_general\" href=\"UTD.htm?15/27/15802?source=see_link\">",
    " acetaminophen",
    " </a>",
    " and the nonsteroidal antiinflammatory drugs [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1012/abstract/7-10\">",
    " 7-10",
    " </a>",
    " ]. (See",
    " <a class=\"medical medical_review\" href=\"UTD.htm?34/32/35335?
    source=see_link\">",
    " \"Risk factors for and pathogenesis of analgesic nephropathy\"",
    " </a>",
    " .)",
    " </p>",
    " <p>",
    " The major presenting symptom of urinary tract malignancy in analgesic
    nephropathy is microscopic or gross hematuria. Thus, continued monitoring is
    essential, and new hematuria should be evaluated with urinary cytology, and, if
    indicated, cystoscopy followed by spiral CT scan, and or magnetic resonance
    imaging. It may also be prudent to obtain yearly urine cytology for the first
    several years if analgesics are discontinued or indefinitely if drug intake
    persists.",
    " </p>",
    " <p>",
    " The incidence of urothelial carcinoma after renal transplantation in patients
    with analgesic nephropathy is comparable to the general incidence of up to 10
    percent of urothelial carcinomas in end-stage renal failure patients with analgesic
    nephropathy. Removal of the native kidneys prior to renal transplantation has also
    been suggested, but the efficacy of this regimen has not been proven [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1012/abstract/1\">",
    " 1",
    " </a>",
    " ]. (See",
    " <a class=\"medical medical_review\" href=\"UTD.htm?19/47/20217?
    source=see_link\">",
    " \"Clinical presentation, diagnosis, and staging of bladder cancer\"",
    " </a>",
    " .)",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H3\">",
    " <span class=\"h1\">",
    " ATHEROSCLEROSIS",
    " </span>",
    " &nbsp;&mdash;&nbsp;Patients with analgesic nephropathy are more likely to
    develop premature aging and graying and atherosclerotic vascular disease (including
    myocardial infarction and thrombotic stroke) [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1012/abstract/5,11\">",
    " 5,11",
    " </a>",
    " ]. As examples, chronic ingestion of phenacetin in women aged 30 to 49 is,
    after 20 years, associated with a twofold increase in risk of myocardial infarction
    and a threefold increase in risk of all cardiovascular diseases [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1012/abstract/5\">",
    " 5",
    " </a>",
    " ]. It is possible that the analgesic microangiopathy that is the earliest sign
    of renal injury [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1012/abstract/12\">",
    " 12",
    " </a>",
    " ] may play an important role in this problem; the incidence of other risk
    factors (such as hypercholesterolemia, smoking, and hypertension) does not appear
    to be enhanced when compared to patients with other forms of chronic kidney
    disease.",
    " </p>",
    " <p>",
    " The effects of nonsteroidal antiinflammatory drugs on cardiovascular risk and
    the association between analgesics and risk for hypertension are presented
    separately. (See",
    " <a class=\"medical medical_review\" href=\"UTD.htm?24/4/24648?
    source=see_link\">",
    " \"Nonselective NSAIDs: Adverse cardiovascular effects\"",
    " </a>",
    " and",
    " <a class=\"medical medical_review\" href=\"UTD.htm?38/27/39351?
    source=see_link\">",
    " \"COX-2 selective inhibitors: Adverse cardiovascular effects\"",
    " </a>",
    " and",
    " <a class=\"medical medical_review\" href=\"UTD.htm?41/43/42674?
    source=see_link\">",
    " \"NSAIDs and acetaminophen: Effects on blood pressure and hypertension\"",
    " </a>",
    " .)",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H16275750\">",
    " <span class=\"h1\">",
    " SUMMARY",
    " </span>",
    " </p>",
    " <p>",
    " <ul class=\"bullet-block\">",
    " <li>",
    " Transitional cell carcinomas of the renal pelvis, ureter, and bladder (which
    may be multiple and bilateral) all occur with increased frequency in patients with
    heavy analgesic use and analgesic nephropathy. (See",
    " <a class=\"local\" href=\"#H2\">",
    " 'Urinary tract malignancy'",
    " </a>",
    " above.)",
    " </li>",
    " <li>",
    " Tumors usually become evident after 15 to 25 years of analgesic abuse and in
    patients with clinically evident analgesic nephropathy. (See",
    " <a class=\"local\" href=\"#H2\">",
    " 'Urinary tract malignancy'",
    " </a>",
    " above.)",
    " </li>",
    " <li>",
    " Intrarenal accumulation of N-hydroxylated phenacetin metabolites, which have
    potent alkylating activity, are concentrated in the renal medulla, possibly
    explaining the predisposition to carcinogenesis in the medulla, and distally in the
    ureters and bladder. (See",
    " <a class=\"local\" href=\"#H2\">",
    " 'Urinary tract malignancy'",
    " </a>",
    " above.)",
    " </li>",
    " <li>",
    " Ingestion of other analgesics that can cause papillary necrosis, such as
    nonsteroidal antiinflammatory drugs, are not associated with urinary tract
    malignancies, supporting the hypothesis that phenacetin metabolites have a
    mechanistic role. (See",
    " <a class=\"local\" href=\"#H2\">",
    " 'Urinary tract malignancy'",
    " </a>",
    " above.)",
    " </li>",
    " <li>",
    " The major presenting symptom of urinary tract malignancy in analgesic
    nephropathy is microscopic or gross hematuria. Thus, patients with analgesic
    nephropathy should undergo routine monitoring with urinalysis. New hematuria should
    be evaluated with urinary cytology, and, if indicated, cystoscopy followed by
    spiral CT scan, and or magnetic resonance imaging.",
    " </li>",
    " <li>",
    " The incidence of urothelial carcinoma in patients with analgesic nephropathy
    is unaltered by renal transplantation. (See",
    " <a class=\"local\" href=\"#H2\">",
    " 'Urinary tract malignancy'",
    " </a>",
    " above.)",
    " </li>",
    " <li>",
    " Patients with analgesic nephropathy are more likely than those in the
    general population to develop premature atherosclerotic cardiovascular disease
    (including myocardial infarction and thrombotic stroke). (See",
    " <a class=\"local\" href=\"#H3\">",
    " 'Atherosclerosis'",
    " </a>",
    " above.)",
    " </li>",
    " </ul>",
    " </p>",
    " </div>",
    " <div id=\"topicAgreement\">",
    " Use of UpToDate is subject to the",
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    target=\"_blank\">",
    " Subscription and License Agreement",
    " </a>",
    " .",
    " </div>",
    " <div class=\"headingAnchor\" id=\"references\">",
    " <h1>",
    " REFERENCES",
    " </h1>",
    " <ol id=\"reference\">",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1012/abstract/1\">",
    " Blohm&eacute; I, Johansson S. Renal pelvic neoplasms and atypical urothelium
    in patients with end-stage analgesic nephropathy. Kidney Int 1981; 20:671.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1012/abstract/2\">",
    " McCredie M, Stewart JH, Carter JJ, et al. Phenacetin and papillary necrosis:
    independent risk factors for renal pelvic cancer. Kidney Int 1986; 30:81.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1012/abstract/3\">",
    " Piper JM, Tonascia J, Matanoski GM. Heavy phenacetin use and bladder cancer
    in women aged 20 to 49 years. N Engl J Med 1985; 313:292.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1012/abstract/4\">",
    " Chow WH, McLaughlin JK, Linet MS, et al. Use of analgesics and risk of renal
    cell cancer. Int J Cancer 1994; 59:467.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1012/abstract/5\">",
    " Dubach UC, Rosner B, St&uuml;rmer T. An epidemiologic study of abuse of
    analgesic drugs. Effects of phenacetin and salicylate on mortality and
    cardiovascular morbidity (1968 to 1987). N Engl J Med 1991; 324:155.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1012/abstract/6\">",
    " McCredie M, Stewart JH, Mathew TH, et al. The effect of withdrawal of
    phenacetin-containing analgesics on the incidence of kidney and urothelial cancer
    and renal failure. Clin Nephrol 1989; 31:35.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1012/abstract/7\">",
    " McCredie M, Stewart JH. Does paracetamol cause urothelial cancer or renal
    papillary necrosis? Nephron 1988; 49:296.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1012/abstract/8\">",
    " Nanra RS. Analgesic nephropathy in the 1990s--an Australian perspective.
    Kidney Int Suppl 1993; 42:S86.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1012/abstract/9\">",
    " Jensen OM, Knudsen JB, Tomasson H, S&oslash;rensen BL. The Copenhagen case-
    control study of renal pelvis and ureter cancer: role of analgesics. Int J Cancer
    1989; 44:965.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1012/abstract/10\">",
    " Castelao JE, Yuan JM, Gago-Dominguez M, et al. Non-steroidal anti-
    inflammatory drugs and bladder cancer prevention. Br J Cancer 2000; 82:1364.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1012/abstract/11\">",
    " Nanra RS, Stuart-Taylor J, de Leon AH, White KH. Analgesic nephropathy:
    etiology, clinical syndrome, and clinicopathologic correlations in Australia.
    Kidney Int 1978; 13:79.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1012/abstract/12\">",
    " Mihatsch MJ, Hofer HO, Gudat F, et al. Capillary sclerosis of the urinary
    tract and analgesic nephropathy. Clin Nephrol 1983; 20:285.",
    " </a>",
    " </li>",
    " </ol>",
    " </div>",
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    " INTRODUCTION",
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    " URINARY TRACT MALIGNANCY",
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    " ATHEROSCLEROSIS",
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    " SUMMARY",
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    " </span>",
    " <span class=\"link\">",
    " urn:lims:b498:s2700828",
    " </span>",
    " </span>",
    " <span class=\"content\">",
    " TB (tuberculosis) has been seen in patients started on this drug. These
    patients were exposed to TB in the past, but never got the infection. You will be
    tested to see if you have been exposed to TB before starting this drug.",
    " </span>",
    " </li>",
    " <li class=\"statement\">",
    " <span class=\"attributes\" style=\"display:none;\">",
    " <span class=\"entity\">",
    " &bull;",
    " </span>",
    " <span class=\"link\">",
    " urn:lims:b498:s2700487",
    " </span>",
    " </span>",
    " <span class=\"content\">",
    " Very bad infections have happened in patients who take this drug. Talk with
    the doctor.",
    " </span>",
    " </li>",
    " <li class=\"statement\">",
    " <span class=\"attributes\" style=\"display:none;\">",
    " <span class=\"entity\">",
    " &bull;",
    " </span>",
    " <span class=\"link\">",
    " urn:lims:b498:s2700602",
    " </span>",
    " </span>",
    " <span class=\"content\">",
    " Sometimes drugs are not safe when you take them with certain other drugs.
    Taking them together can cause bad side effects. This is one of those drugs. Be
    sure to talk to your doctor about all the drugs you take.",
    " </span>",
    " </li>",
    " <li class=\"statement\">",
    " <span class=\"attributes\" style=\"display:none;\">",
    " <span class=\"entity\">",
    " &bull;",
    " </span>",
    " <span class=\"link\">",
    " urn:lims:b498:s2700454",
    " </span>",
    " </span>",
    " <span class=\"content\">",
    " This drug comes with an extra patient fact sheet called a Medication Guide.
    Read it with care. Read it again each time this drug is refilled.",
    " </span>",
    " </li>",
    " </ul>",
    " </div>",
    " <div class=\"ord-stmt yya-os drugH1Div\" id=\"F10028385\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " What is this drug used for?",
    " </span>",
    " <ul class=\"statements\" style=\"list-style-type:none;\">",
    " <li class=\"statement\">",
    " <span class=\"attributes\" style=\"display:none;\">",
    " <span class=\"entity\">",
    " &bull;",
    " </span>",
    " <span class=\"link\">",
    " urn:lims:b498:s2692045",
    " </span>",
    " </span>",
    " <span class=\"content\">",
    " It is used to treat rheumatoid arthritis.",
    " </span>",
    " </li>",
    " <li class=\"statement\">",
    " <span class=\"attributes\" style=\"display:none;\">",
    " <span class=\"entity\">",
    " &bull;",
    " </span>",
    " <span class=\"link\">",
    " urn:lims:b498:s2880359",
    " </span>",
    " </span>",
    " <span class=\"content\">",
    " It is used to treat juvenile arthritis.",
    " </span>",
    " </li>",
    " </ul>",
    " </div>",
    " <div class=\"ord-stmt coi-os drugH1Div\" id=\"F10028384\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " What do I need to tell my doctor before I take this drug?",
    " </span>",
    " <ul class=\"statements\" style=\"list-style-type:none;\">",
    " <li class=\"statement\">",
    " <span class=\"attributes\" style=\"display:none;\">",
    " <span class=\"entity\">",
    " &bull;",
    " </span>",
    " <span class=\"link\">",
    " urn:lims:b498:s2705271",
    " </span>",
    " </span>",
    " <span class=\"content\">",
    " If you have an allergy to tocilizumab or any other part of this drug.",
    " </span>",
    " </li>",
    " <li class=\"statement\">",
    " <span class=\"attributes\" style=\"display:none;\">",
    " <span class=\"entity\">",
    " &bull;",
    " </span>",
    " <span class=\"link\">",
    " urn:lims:b498:s2705171",
    " </span>",
    " </span>",
    " <span class=\"content\">",
    " If you are allergic to any drugs, foods, or other substances. Tell your
    doctor about the allergy and what signs you had, like rash; hives; itching;
    shortness of breath; wheezing; cough; swelling of face, lips, tongue, or throat; or
    any other signs.",
    " </span>",
    " </li>",
    " <li class=\"statement\">",
    " <span class=\"attributes\" style=\"display:none;\">",
    " <span class=\"entity\">",
    " &bull;",
    " </span>",
    " <span class=\"link\">",
    " urn:lims:b498:s2701047",
    " </span>",
    " </span>",
    " <span class=\"content\">",
    " If you are breast-feeding.",
    " </span>",
    " </li>",
    " </ul>",
    " </div>",
    " <div class=\"ord-stmt yye-os drugH1Div\" id=\"F10028389\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " What are some things I need to know or do while I take this drug?",
    " </span>",
    " <ul class=\"statements\" style=\"list-style-type:none;\">",
    " <li class=\"statement\">",
    " <span class=\"attributes\" style=\"display:none;\">",
    " <span class=\"entity\">",
    " &bull;",
    " </span>",
    " <span class=\"link\">",
    " urn:lims:b498:s2696985",
    " </span>",
    " </span>",
    " <span class=\"content\">",
    " Hepatitis B testing may be done. A hepatitis B infection may get worse
    during care.",
    " </span>",
    " </li>",
    " <li class=\"statement\">",
    " <span class=\"attributes\" style=\"display:none;\">",
    " <span class=\"entity\">",
    " &bull;",
    " </span>",
    " <span class=\"link\">",
    " urn:lims:b498:s2697568",
    " </span>",
    " </span>",
    " <span class=\"content\">",
    " Long-term use may raise your chance of cancer.",
    " </span>",
    " </li>",
    " <li class=\"statement\">",
    " <span class=\"attributes\" style=\"display:none;\">",
    " <span class=\"entity\">",
    " &bull;",
    " </span>",
    " <span class=\"link\">",
    " urn:lims:b498:s2697596",
    " </span>",
    " </span>",
    " <span class=\"content\">",
    " Very bad infections have been reported with use of this drug. If you have
    any infection, are taking antibiotics now or in the recent past, or have many
    infections, talk with your doctor.",
    " </span>",
    " </li>",
    " <li class=\"statement\">",
    " <span class=\"attributes\" style=\"display:none;\">",
    " <span class=\"entity\">",
    " &bull;",
    " </span>",
    " <span class=\"link\">",
    " urn:lims:b498:s2697613",
    " </span>",
    " </span>",
    " <span class=\"content\">",
    " Talk with your doctor before getting any vaccines. Use with this drug may
    either raise the chance of an infection or make the vaccine not work as well.",
    " </span>",
    " </li>",
    " <li class=\"statement\">",
    " <span class=\"attributes\" style=\"display:none;\">",
    " <span class=\"entity\">",
    " &bull;",
    " </span>",
    " <span class=\"link\">",
    " urn:lims:b498:s2697206",
    " </span>",
    " </span>",
    " <span class=\"content\">",
    " If you have high blood sugar (diabetes), talk with your doctor. You may be
    more likely to get infections.",
    " </span>",
    " </li>",
    " <li class=\"statement\">",
    " <span class=\"attributes\" style=\"display:none;\">",
    " <span class=\"entity\">",
    " &bull;",
    " </span>",
    " <span class=\"link\">",
    " urn:lims:b498:s2697290",
    " </span>",
    " </span>",
    " <span class=\"content\">",
    " If you have liver disease, talk with your doctor.",
    " </span>",
    " </li>",
    " <li class=\"statement\">",
    " <span class=\"attributes\" style=\"display:none;\">",
    " <span class=\"entity\">",
    " &bull;",
    " </span>",
    " <span class=\"link\">",
    " urn:lims:b498:s2697342",
    " </span>",
    " </span>",
    " <span class=\"content\">",
    " If you have stomach ulcers, talk with your doctor.",
    " </span>",
    " </li>",
    " <li class=\"statement\">",
    " <span class=\"attributes\" style=\"display:none;\">",
    " <span class=\"entity\">",
    " &bull;",
    " </span>",
    " <span class=\"link\">",
    " urn:lims:b498:s2697311",
    " </span>",
    " </span>",
    " <span class=\"content\">",
    " If you have MS (multiple sclerosis) or other nerve disease, talk with your
    doctor.",
    " </span>",
    " </li>",
    " <li class=\"statement\">",
    " <span class=\"attributes\" style=\"display:none;\">",
    " <span class=\"entity\">",
    " &bull;",
    " </span>",
    " <span class=\"link\">",
    " urn:lims:b498:s2698463",
    " </span>",
    " </span>",
    " <span class=\"content\">",
    " Have your blood work checked often. Talk with your doctor.",
    " </span>",
    " </li>",
    " <li class=\"statement\">",
    " <span class=\"attributes\" style=\"display:none;\">",
    " <span class=\"entity\">",
    " &bull;",
    " </span>",
    " <span class=\"link\">",
    " urn:lims:b498:s2696717",
    " </span>",
    " </span>",
    " <span class=\"content\">",
    " Check all drugs you are taking with your doctor. This drug may not mix well
    with some other drugs.",
    " </span>",
    " </li>",
    " <li class=\"statement\">",
    " <span class=\"attributes\" style=\"display:none;\">",
    " <span class=\"entity\">",
    " &bull;",
    " </span>",
    " <span class=\"link\">",
    " urn:lims:b498:s2699677",
    " </span>",
    " </span>",
    " <span class=\"content\">",
    " Keep a list of all your drugs (prescription, natural products, vitamins,
    OTC) with you. Give this list to your doctor.",
    " </span>",
    " </li>",
    " <li class=\"statement\">",
    " <span class=\"attributes\" style=\"display:none;\">",
    " <span class=\"entity\">",
    " &bull;",
    " </span>",
    " <span class=\"link\">",
    " urn:lims:b498:s2697633",
    " </span>",
    " </span>",
    " <span class=\"content\">",
    " Tell dentists, surgeons, and other doctors that you use this drug.",
    " </span>",
    " </li>",
    " <li class=\"statement\">",
    " <span class=\"attributes\" style=\"display:none;\">",
    " <span class=\"entity\">",
    " &bull;",
    " </span>",
    " <span class=\"link\">",
    " urn:lims:b498:s2697641",
    " </span>",
    " </span>",
    " <span class=\"content\">",
    " Tell your doctor if you are pregnant or plan on getting pregnant. You will
    need to talk about the benefits and risks of using this drug while you are
    pregnant.",
    " </span>",
    " </li>",
    " </ul>",
    " </div>",
    " <div class=\"ord-stmt yyf-os drugH1Div\" id=\"F10028390\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " What are some side effects of this drug?",
    " </span>",
    " <ul class=\"statements\" style=\"list-style-type:none;\">",
    " <li class=\"statement\">",
    " <span class=\"attributes\" style=\"display:none;\">",
    " <span class=\"entity\">",
    " &bull;",
    " </span>",
    " <span class=\"link\">",
    " urn:lims:b498:s2698315",
    " </span>",
    " </span>",
    " <span class=\"content\">",
    " You may have more chance of getting an infection. Wash hands often. Stay
    away from people with infections, colds, or flu.",
    " </span>",
    " </li>",
    " <li class=\"statement\">",
    " <span class=\"attributes\" style=\"display:none;\">",
    " <span class=\"entity\">",
    " &bull;",
    " </span>",
    " <span class=\"link\">",
    " urn:lims:b498:s2698119",
    " </span>",
    " </span>",
    " <span class=\"content\">",
    " Headache.",
    " </span>",
    " </li>",
    " <li class=\"statement\">",
    " <span class=\"attributes\" style=\"display:none;\">",
    " <span class=\"entity\">",
    " &bull;",
    " </span>",
    " <span class=\"link\">",
    " urn:lims:b498:s2698134",
    " </span>",
    " </span>",
    " <span class=\"content\">",
    " High blood pressure.",
    " </span>",
    " </li>",
    " <li class=\"statement\">",
    " <span class=\"attributes\" style=\"display:none;\">",
    " <span class=\"entity\">",
    " &bull;",
    " </span>",
    " <span class=\"link\">",
    " urn:lims:b498:s2698189",
    " </span>",
    " </span>",
    " <span class=\"content\">",
    " Irritation where the shot is given.",
    " </span>",
    " </li>",
    " <li class=\"statement\">",
    " <span class=\"attributes\" style=\"display:none;\">",
    " <span class=\"entity\">",
    " &bull;",
    " </span>",
    " <span class=\"link\">",
    " urn:lims:b498:s2698328",
    " </span>",
    " </span>",
    " <span class=\"content\">",
    " Unsafe allergic effects may rarely happen.",
    " </span>",
    " </li>",
    " </ul>",
    " </div>",
    " <div class=\"ord-stmt yyh-os drugH1Div\" id=\"F10028392\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " What are some side effects that I need to call my doctor about right away?",
    " </span>",
    " <ul class=\"statements\" style=\"list-style-type:none;\">",
    " <li class=\"statement\">",
    " <span class=\"attributes\" style=\"display:none;\">",
    " <span class=\"entity\">",
    " &bull;",
    " </span>",
    " <span class=\"link\">",
    " urn:lims:b498:s2698721",
    " </span>",
    " </span>",
    " <span class=\"content\">",
    " If you think there has been an overdose, call 1-800-222-1222 (the American
    Association of Poison Control Centers), your local poison control center
    (file://www.aapcc.org), or emergency room (ER) right away.",
    " </span>",
    " </li>",
    " <li class=\"statement\">",
    " <span class=\"attributes\" style=\"display:none;\">",
    " <span class=\"entity\">",
    " &bull;",
    " </span>",
    " <span class=\"link\">",
    " urn:lims:b498:s2699066",
    " </span>",
    " </span>",
    " <span class=\"content\">",
    " Signs of an allergic reaction, like rash; hives; itching; red, swollen,
    blistered, or peeling skin with or without fever; wheezing; tightness in the chest
    or throat; trouble breathing or talking; unusual hoarseness; or swelling of the
    mouth, face, lips, tongue, or throat.",
    " </span>",
    " </li>",
    " <li class=\"statement\">",
    " <span class=\"attributes\" style=\"display:none;\">",
    " <span class=\"entity\">",
    " &bull;",
    " </span>",
    " <span class=\"link\">",
    " urn:lims:b498:s2699077",
    " </span>",
    " </span>",
    " <span class=\"content\">",
    " Signs of infection. These include a fever of 100.5&deg;F (38&deg;C) or
    higher, chills, very bad sore throat, ear or sinus pain, cough, more sputum or
    change in color of sputum, pain with passing urine, mouth sores, wound that will
    not heal, or anal itching or pain.",
    " </span>",
    " </li>",
    " <li class=\"statement\">",
    " <span class=\"attributes\" style=\"display:none;\">",
    " <span class=\"entity\">",
    " &bull;",
    " </span>",
    " <span class=\"link\">",
    " urn:lims:b498:s2698640",
    " </span>",
    " </span>",
    " <span class=\"content\">",
    " Trouble breathing.",
    " </span>",
    " </li>",
    " <li class=\"statement\">",
    " <span class=\"attributes\" style=\"display:none;\">",
    " <span class=\"entity\">",
    " &bull;",
    " </span>",
    " <span class=\"link\">",
    " urn:lims:b498:s2699094",
    " </span>",
    " </span>",
    " <span class=\"content\">",
    " Swelling in your legs or belly.",
    " </span>",
    " </li>",
    " <li class=\"statement\">",
    " <span class=\"attributes\" style=\"display:none;\">",
    " <span class=\"entity\">",
    " &bull;",
    " </span>",
    " <span class=\"link\">",
    " urn:lims:b498:s2699105",
    " </span>",
    " </span>",
    " <span class=\"content\">",
    " Any bruising or bleeding.",
    " </span>",
    " </li>",
    " <li class=\"statement\">",
    " <span class=\"attributes\" style=\"display:none;\">",
    " <span class=\"entity\">",
    " &bull;",
    " </span>",
    " <span class=\"link\">",
    " urn:lims:b498:s2699031",
    " </span>",
    " </span>",
    " <span class=\"content\">",
    " Very bad headache.",
    " </span>",
    " </li>",
    " <li class=\"statement\">",
    " <span class=\"attributes\" style=\"display:none;\">",
    " <span class=\"entity\">",
    " &bull;",
    " </span>",
    " <span class=\"link\">",
    " urn:lims:b498:s2698658",
    " </span>",
    " </span>",
    " <span class=\"content\">",
    " Feeling very tired or weak.",
    " </span>",
    " </li>",
    " <li class=\"statement\">",
    " <span class=\"attributes\" style=\"display:none;\">",
    " <span class=\"entity\">",
    " &bull;",
    " </span>",
    " <span class=\"link\">",
    " urn:lims:b498:s2699008",
    " </span>",
    " </span>",
    " <span class=\"content\">",
    " Very bad belly pain.",
    " </span>",
    " </li>",
    " <li class=\"statement\">",
    " <span class=\"attributes\" style=\"display:none;\">",
    " <span class=\"entity\">",
    " &bull;",
    " </span>",
    " <span class=\"link\">",
    " urn:lims:b498:s2698981",
    " </span>",
    " </span>",
    " <span class=\"content\">",
    " Not able to eat.",
    " </span>",
    " </li>",
    " <li class=\"statement\">",
    " <span class=\"attributes\" style=\"display:none;\">",
    " <span class=\"entity\">",
    " &bull;",
    " </span>",
    " <span class=\"link\">",
    " urn:lims:b498:s2698634",
    " </span>",
    " </span>",
    " <span class=\"content\">",
    " Dark urine or yellow skin or eyes.",
    " </span>",
    " </li>",
    " <li class=\"statement\">",
    " <span class=\"attributes\" style=\"display:none;\">",
    " <span class=\"entity\">",
    " &bull;",
    " </span>",
    " <span class=\"link\">",
    " urn:lims:b498:s2698603",
    " </span>",
    " </span>",
    " <span class=\"content\">",
    " Any rash.",
    " </span>",
    " </li>",
    " <li class=\"statement\">",
    " <span class=\"attributes\" style=\"display:none;\">",
    " <span class=\"entity\">",
    " &bull;",
    " </span>",
    " <span class=\"link\">",
    " urn:lims:b498:s2698977",
    " </span>",
    " </span>",
    " <span class=\"content\">",
    " Side effect or health problem is not better or you are feeling worse.",
    " </span>",
    " </li>",
    " </ul>",
    " </div>",
    " <div class=\"ord-stmt yyc-os drugH1Div\" id=\"F10028387\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " How is this drug best taken?",
    " </span>",
    " <ul class=\"statements\" style=\"list-style-type:none;\">",
    " <li class=\"statement\">",
    " <span class=\"attributes\" style=\"display:none;\">",
    " <span class=\"entity\">",
    " &bull;",
    " </span>",
    " <span class=\"link\">",
    " urn:lims:b498:s2698578",
    " </span>",
    " </span>",
    " <span class=\"content\">",
    " You will need a TB (tuberculosis) test before starting this drug.",
    " </span>",
    " </li>",
    " <li class=\"statement\">",
    " <span class=\"attributes\" style=\"display:none;\">",
    " <span class=\"entity\">",
    " &bull;",
    " </span>",
    " <span class=\"link\">",
    " urn:lims:b498:s2695989",
    " </span>",
    " </span>",
    " <span class=\"content\">",
    " It is given as a shot into a vein over a period of time.",
    " </span>",
    " </li>",
    " </ul>",
    " </div>",
    " <div class=\"ord-stmt yyj-os drugH1Div\" id=\"F10028394\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " General drug facts",
    " </span>",
    " <ul class=\"statements\" style=\"list-style-type:none;\">",
    " <li class=\"statement\">",
    " <span class=\"attributes\" style=\"display:none;\">",
    " <span class=\"entity\">",
    " &bull;",
    " </span>",
    " <span class=\"link\">",
    " urn:lims:b498:s2699675",
    " </span>",
    " </span>",
    " <span class=\"content\">",
    " If your symptoms or health problems do not get better or if they become
    worse, call your doctor.",
    " </span>",
    " </li>",
    " <li class=\"statement\">",
    " <span class=\"attributes\" style=\"display:none;\">",
    " <span class=\"entity\">",
    " &bull;",
    " </span>",
    " <span class=\"link\">",
    " urn:lims:b498:s2699673",
    " </span>",
    " </span>",
    " <span class=\"content\">",
    " Do not share your drugs with others and do not take anyone else's drugs.",
    " </span>",
    " </li>",
    " <li class=\"statement\">",
    " <span class=\"attributes\" style=\"display:none;\">",
    " <span class=\"entity\">",
    " &bull;",
    " </span>",
    " <span class=\"link\">",
    " urn:lims:b498:s2699678",
    " </span>",
    " </span>",
    " <span class=\"content\">",
    " Keep all drugs out of the reach of children and pets.",
    " </span>",
    " </li>",
    " <li class=\"statement\">",
    " <span class=\"attributes\" style=\"display:none;\">",
    " <span class=\"entity\">",
    " &bull;",
    " </span>",
    " <span class=\"link\">",
    " urn:lims:b498:s2699709",
    " </span>",
    " </span>",
    " <span class=\"content\">",
    " If you have any questions about this drug, please talk with your doctor,
    pharmacist, or other health care provider.",
    " </span>",
    " </li>",
    " <li class=\"statement\">",
    " <span class=\"attributes\" style=\"display:none;\">",
    " <span class=\"entity\">",
    " &bull;",
    " </span>",
    " <span class=\"link\">",
    " urn:lims:b498:s3302581",
    " </span>",
    " </span>",
    " <span class=\"content\">",
    " In Canada, take any unused drugs to the pharmacy. Also, visit
    file://www.hc-sc.gc.ca/hl-vs/iyh-vsv/med/disposal-defaire-eng.php#th to learn about
    the right way to get rid of unused drugs.",
    " </span>",
    " </li>",
    " <li class=\"statement\">",
    " <span class=\"attributes\" style=\"display:none;\">",
    " <span class=\"entity\">",
    " &bull;",
    " </span>",
    " <span class=\"link\">",
    " urn:lims:b498:s2699677",
    " </span>",
    " </span>",
    " <span class=\"content\">",
    " Keep a list of all your drugs (prescription, natural products, vitamins,
    OTC) with you. Give this list to your doctor.",
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    qoOo+tFQWf/Z);\">",
    " </div>",
    " <div class=\"lgnd\">",
    " Blue sclera in a child with osteogenesis imperfecta.",
    " <div class=\"footnotes\">",
    " </div>",
    " <div class=\"reference\">",
    " Reproduced with permission from: www.visualdx.com. Copyright Logical Images,
    Inc.",
    " </div>",
    " </div>",
    " </div>",
    " </div>",
    "</div>"].join("\n");
    var script_f0_63_1014=[""].join("\n");
    var outline_f0_63_1014=null;
    var title_f0_63_1015="Thiopental: Drug information";
    var content_f0_63_1015=[" <noscript>",
    " <div id=\"javascriptDisabled\">",
    " It seems to us that you have your JavaScript turned off on your browser.
    JavaScript is required in order for our site to behave correctly. Please enable
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    " <img alt=\"UpToDate\" src=\"./../images/wk_utd-rgb.myextg\" width=\"220px\">",
    " </img>",
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    " Official reprint from UpToDate",
    " <sup>",
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    " www.uptodate.com",
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    " <a class=\"TOPIC\" href=\"#\" id=\"printHeaderPrint\" rel=\"2\" title=\"Click
    here to print\">",
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    " Back",
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    " </div>",
    " </div>",
    " <!-- TC:TOPIC_PAGE -->",
    " <div id=\"topicContent\">",
    " <div id=\"drugTitle\">",
    " Thiopental: Drug information",
    " </div>",
    " <div id=\"lexiTitleImg\">",
    " <img height=\"17\" src=\"./../images/lexiComp/Lexicomp_2012_71x17.myextg\"
    width=\"71\"/>",
    " </div>",
    " <div class=\"clear\">",
    " </div>",
    " <div id=\"drugCopy\">",
    " Copyright 1978-2013 Lexicomp, Inc. All rights reserved.",
    " </div>",
    " <div id=\"topicText\">",
    " (For additional information",
    " <a class=\"drug drug_patient\" href=\"UTD.htm?36/19/37171?source=see_link\">",
    " see \"Thiopental: Patient drug information\"",
    " </a>",
    " and",
    " <a class=\"drug drug_pediatric\" href=\"UTD.htm?11/13/11478?
    source=see_link\">",
    " see \"Thiopental: Pediatric drug information\"",
    " </a>",
    " )",
    " <br/>",
    " For abbreviations and symbols that may be used in Lexicomp (",
    " <a class=\"graphic graphic_table\" href=\"UTD.htm?23/39/24183\">",
    " show table",
    " </a>",
    " )",
    " <div class=\"list ubnlist drugH1Div drugBrandNames\" id=\"F226996\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Brand Names: U.S.",
    " </span>",
    " <ul>",
    " <li>",
    " Pentothal&reg; [DSC]",
    " </li>",
    " </ul>",
    " </div>",
    " <div class=\"ex_sect_xr thclist drugH1Div drugBrandNames\" id=\"F227028\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Pharmacologic Category",
    " </span>",
    " <ul>",
    " <li>",
    " Anticonvulsant, Barbiturate;",
    " </li>",
    " <li>",
    " Barbiturate;",
    " </li>",
    " <li>",
    " General Anesthetic",
    " </li>",
    " </ul>",
    " </div>",
    " <div class=\"block doa drugH1Div\" id=\"F227000\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Dosing: Adult",
    " </span>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " <b>",
    " Anesthesia:",
    " </b>",
    " I.V.:",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " <i>",
    " Induction:",
    " </i>",
    " 3-5 mg/kg",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " <i>",
    " Maintenance:",
    " </i>",
    " 25-100 mg as needed",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " <b>",
    " Increased intracranial pressure:",
    " </b>",
    " I.V.: Children and Adults: 1.5-5 mg/kg/dose; repeat as needed to control
    intracranial pressure",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " <b>",
    " Seizures:",
    " </b>",
    " I.V.: 75-250 mg/dose, repeat as needed",
    " </p>",
    " </div>",
    " <div class=\"block dop drugH1Div\" id=\"F227012\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Dosing: Pediatric",
    " </span>",
    " <p>",
    " (For additional information",
    " <a class=\"drug drug_pediatric\" href=\"UTD.htm?11/13/11478?
    source=see_link\">",
    " see \"Thiopental: Pediatric drug information\"",
    " </a>",
    " )",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " <b>",
    " Anesthesia:",
    " </b>",
    " I.V.:",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " <i>",
    " Induction:",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:6em;text-align:justify;\">",
    " Infants: 5-8 mg/kg",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:6em;text-align:justify;\">",
    " Children 1-12 years: 5-6 mg/kg",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " <i>",
    " Maintenance:",
    " </i>",
    " Children: 1 mg/kg as needed",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " <b>",
    " Increased intracranial pressure:",
    " </b>",
    " I.V.: Children: 1.5-5 mg/kg/dose; repeat as needed to control intracranial
    pressure",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " <b>",
    " Seizures:",
    " </b>",
    " I.V.: Children: 2-3 mg/kg/dose, repeat as needed",
    " </p>",
    " </div>",
    " <div class=\"block doe drugH1Div\" id=\"F227001\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Dosing: Geriatric",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " Refer to adult dosing.",
    " </p>",
    " </div>",
    " <div class=\"block dor drugH1Div\" id=\"F227002\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Dosing: Renal Impairment",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " Cl",
    " <sub>",
    " cr",
    " </sub>",
    " &lt;10 mL/minute: Administer 75% of normal dose.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " <b>",
    " Note:",
    " </b>",
    " Accumulation may occur with chronic dosing due to lipid solubility. Prolonged
    recovery may result from redistribution of thiopental from fat stores.",
    " </p>",
    " </div>",
    " <div class=\"block foc drugH1Div\" id=\"F226979\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Dosage Forms: U.S.",
    " </span>",
    " <p style=\"text-indent:0em;text-align:justify;display:inline\">",
    " Excipient information presented when available (limited, particularly for
    generics); consult specific product labeling. [DSC] = Discontinued product",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Injection, powder for reconstitution, as sodium:",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " Pentothal&reg;: 250 mg [DSC], 400 mg [DSC], 500 mg [DSC], 1 g [DSC] [contains
    sodium 105 mg/g]",
    " </p>",
    " </div>",
    " <div class=\"block geq drugH1Div\" id=\"F226963\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Generic Equivalent Available: U.S.",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " No",
    " </p>",
    " </div>",
    " <div class=\"block prod-avail drugH1Div\" id=\"F14960845\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Product Availability",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " Pentothal&reg; (thiopental injection): Hospira Pharmaceuticals, the sole
    manufacturer, has discontinued all Pentothal&reg; products. Product is currently
    unavailable in the U.S. and in Canada.",
    " </p>",
    " </div>",
    " <div class=\"block csi drugH1Div\" id=\"F227030\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Controlled Substance",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " C-III",
    " </p>",
    " </div>",
    " <div class=\"block adm drugH1Div\" id=\"F226982\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Administration",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " Administer slowly over 20-30 seconds. Rapid I.V. injection may cause
    hypotension or decreased cardiac output; avoid extravasation, necrosis may occur.
    Check I.V. catheter placement prior to administration. If inadvertent intra-
    arterial administration occurs, treat with a local anesthetic (eg, lidocaine 1%, 5
    mL) and/or papaverine (20-40 mg), preferably through the catheter used for the
    thiopental injection.",
    " </p>",
    " </div>",
    " <div class=\"block scp drugH1Div\" id=\"F227035\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Compatibility",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " Stable in D",
    " <sub>",
    " 5",
    " </sub>",
    " <sup>",
    " 1",
    " </sup>",
    " /",
    " <sub>",
    " 4",
    " </sub>",
    " NS, D",
    " <sub>",
    " 5",
    " </sub>",
    " <sup>",
    " 1",
    " </sup>",
    " /",
    " <sub>",
    " 2",
    " </sub>",
    " NS, D",
    " <sub>",
    " 5",
    " </sub>",
    " W,",
    " <sup>",
    " 1",
    " </sup>",
    " /",
    " <sub>",
    " 2",
    " </sub>",
    " NS, NS;",
    " <b>",
    " incompatible",
    " </b>",
    " with D",
    " <sub>",
    " 5",
    " </sub>",
    " LR, D",
    " <sub>",
    " 10",
    " </sub>",
    " W, D",
    " <sub>",
    " 10",
    " </sub>",
    " NS, LR;",
    " <b>",
    " variable stability (consult detailed reference)",
    " </b>",
    " in D",
    " <sub>",
    " 5",
    " </sub>",
    " NS.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " <b>",
    " Y-site administration: Compatible:",
    " </b>",
    " Bivalirudin, fentanyl, furosemide, hetastarch in lactate electrolyte
    injection (Hextend&reg;), milrinone, nitroglycerin, propofol, ranitidine,
    remifentanil.",
    " <b>",
    " Incompatible:",
    " </b>",
    " Alfentanil, ascorbic acid, atracurium, atropine, diltiazem, dobutamine,
    dopamine, ephedrine, epinephrine, fenoldopam, hydromorphone, labetalol, midazolam,
    nicardipine, norepinephrine, pancuronium, pantoprazole, phenylephrine,
    succinylcholine, sufentanil, vecuronium.",
    " <b>",
    " Variable (consult detailed reference):",
    " </b>",
    " Cisatracurium, heparin, lidocaine, lorazepam, morphine.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " <b>",
    " Compatibility in syringe: Compatible:",
    " </b>",
    " Aminophylline, hyaluronidase, neostigmine, pentobarbital, propofol,
    scopolamine, tubocurarine.",
    " <b>",
    " Incompatible:",
    " </b>",
    " Chlorpromazine, dimenhydrinate, diphenhydramine, doxapram, ephedrine,
    glycopyrrolate, meperidine, morphine, pantoprazole, prochlorperazine edisylate,
    promethazine, sodium bicarbonate.",
    " <b>",
    " Variable (consult detailed reference):",
    " </b>",
    " Hydrocortisone sodium succinate.",
    " </p>",
    " </div>",
    " <div class=\"block use drugH1Div\" id=\"F226981\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Use",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " Induction of anesthesia; control of convulsive states; treatment of elevated
    intracranial pressure",
    " </p>",
    " </div>",
    " <div class=\"block mst drugH1Div\" id=\"F5174562\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Medication Safety Issues",
    " </span>",
    " <div class=\"collapsible\">",
    " <span class=\"collapsible-title\">",
    " High alert medication:",
    " </span>",
    " <div class=\"collapsible-wrap\">",
    " <p style=\"text-indent:-2em;margin-left:4em;\">",
    " The Institute for Safe Medication Practices (ISMP) includes this medication
    among its list of drugs which have a heightened risk of causing significant patient
    harm when used in error.",
    " </p>",
    " </div>",
    " </div>",
    " </div>",
    " <div class=\"block ars drugH1Div\" id=\"F227026\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Adverse Reactions Significant",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " Frequency not defined.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Cardiovascular: Bradycardia, hypotension, syncope",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Central nervous system: Drowsiness, lethargy, CNS excitation or depression,
    impaired judgment, &ldquo;hangover&rdquo; effect, confusion, somnolence, agitation,
    hyperkinesia, ataxia, nervousness, headache, insomnia, nightmares, hallucinations,
    anxiety, dizziness, shivering",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Dermatologic: Rash, exfoliative dermatitis, Stevens-Johnson syndrome",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Gastrointestinal: Nausea, vomiting, constipation",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Hematologic: Agranulocytosis, thrombocytopenia, megaloblastic anemia, immune
    hemolytic anemia (rare)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Local: Pain at injection site, thrombophlebitis with I.V. use",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Renal: Oliguria",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Respiratory: Laryngospasm, respiratory depression, apnea (especially with
    rapid I.V. use), hypoventilation, sneezing, cough, bronchospasm",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Miscellaneous: Gangrene with inadvertent intra-arterial injection,
    anaphylaxis, anaphylactic reactions",
    " </p>",
    " </div>",
    " <div class=\"block coi drugH1Div\" id=\"F226985\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Contraindications",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " Hypersensitivity to thiopental, barbiturates, or any component of the
    formulation; status asthmaticus; severe cardiovascular disease; porphyria
    (variegate or acute intermittent); should not be administered by intra-arterial
    injection",
    " </p>",
    " </div>",
    " <div class=\"block war drugH1Div\" id=\"F226967\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Warnings/Precautions",
    " </span>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " <b>",
    " <i>",
    " Concerns related to adverse effects:",
    " </i>",
    " </b>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " &bull; Hypotension: May cause hypotension; use with caution in
    hemodynamically unstable patients (hypotension or shock).",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " &bull; Laryngospasm/bronchospasms: May cause laryngospasm or bronchospasms;
    use with extreme caution in patients with reactive airway diseases (asthma or
    COPD).",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " &bull; Paradoxical stimulatory response: May cause paradoxical responses,
    including agitation and hyperactivity, particularly in acute pain and pediatric
    patients.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " &bull; Respiratory depression: May cause respiratory depression; use with
    caution patients with respiratory disease.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " <b>",
    " <i>",
    " Disease-related concerns:",
    " </i>",
    " </b>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " &bull; Addison's disease: Use with caution in patients with Addison's
    disease; may prolong or potentiate hypnotic effect.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " &bull; Anemia: Use with caution in patients with severe anemia; may prolong
    or potentiate hypnotic effect.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " &bull; Aneurysms: Use with caution in patients with unstable aneurysms.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " &bull; Cardiovascular disease: Use with caution in patients with
    cardiovascular disease.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " &bull; Hepatic impairment: Use with caution in patients with hepatic
    impairment; may prolong or potentiate hypnotic effect.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " &bull; Myasthenia gravis: Use with caution in patients with myasthenia
    gravis; may prolong or potentiate hypnotic effect.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " &bull; Myxedema: Use with caution in patients with myxedema; may prolong or
    potentiate hypnotic effect.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " &bull; Renal impairment: Use with caution in patients with renal impairment;
    may prolong or potentiate hypnotic effect.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " &bull; Substance abuse: Use with caution in patients with a history of drug
    abuse; potential for drug dependency exists.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " <b>",
    " <i>",
    " Concurrent drug therapy issues:",
    " </i>",
    " </b>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " &bull; Sedatives: Effects with other sedative drugs or ethanol may be
    potentiated.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " <b>",
    " <i>",
    " Special populations:",
    " </i>",
    " </b>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " &bull; Debilitated patients: Use with caution in patients who are
    debilitated.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " &bull; Elderly: Use with caution in the elderly.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " &bull; Excessively premedicated patients: Use with caution in patients
    excessively premedicated; may prolong or potentiate hypnotic effect.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " &bull; Pediatrics: Use with caution in children.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " <b>",
    " <i>",
    " Other warnings/precautions:",
    " </i>",
    " </b>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " &bull; Acute pain: Do not administer to patients in acute pain.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " &bull; Appropriate use: Administer only by I.V. route.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " &bull; Cumulative effect: Repeated dosing or continuous infusions may cause
    cumulative effects.",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " &bull; Withdrawal: Anticonvulsants should not be discontinued abruptly
    because of the possibility of increasing seizure frequency; therapy should be
    withdrawn gradually to minimize the potential of increased seizure frequency,
    unless safety concerns require a more rapid withdrawal.",
    " </p>",
    " </div>",
    " <div class=\"block cyt drugH1Div\" id=\"F13300133\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Metabolism/Transport Effects",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " None known.",
    " </p>",
    " </div>",
    " <div class=\"block dri drugH1Div\" id=\"F226972\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Drug Interactions",
    " </span>",
    " <br/>",
    " <br/>",
    " <div class=\"lexi\" id=\"lexiInteractAddInfo\">",
    " (For additional information:",
    " <a class=\"dip\" href=\"./drug-interaction\" target=\"_blank\">",
    " Launch Lexi-Interact&trade; Drug Interactions Program",
    " </a>",
    " )",
    " </div>",
    " <div class=\"lexi\" id=\"lexiInteractImgB\">",
    " <img border=\"0\" height=\"17\"
    src=\"./../images/lexiComp/Lexicomp_2012_71x17.myextg\" width=\"71\"/>",
    " </div>",
    " <div class=\"clear\">",
    " </div>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Acetaminophen: Barbiturates may increase the metabolism of Acetaminophen.
    This may 1) diminish the effect of acetaminophen; and 2) increase the risk of liver
    damage.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Alcohol (Ethyl): CNS Depressants may enhance the CNS depressant effect of
    Alcohol (Ethyl).",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Azelastine (Nasal): CNS Depressants may enhance the CNS depressant effect of
    Azelastine (Nasal).",
    " <i>",
    " Risk X: Avoid combination",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Beta-Blockers: Barbiturates may decrease the serum concentration of Beta-
    Blockers.",
    " <b>",
    " Exceptions:",
    " </b>",
    " Atenolol; Levobunolol; Metipranolol; Nadolol.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Buprenorphine: CNS Depressants may enhance the CNS depressant effect of
    Buprenorphine. Management: Consider reduced doses of CNS depressants used in
    combination with buprenorphine. Consider avoiding other CNS depressants in
    patients thought to be at high risk of buprenorphine overuse or self-injection.",
    " <i>",
    " Risk D: Consider therapy modification",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Calcium Channel Blockers: Barbiturates may increase the metabolism of Calcium
    Channel Blockers. Management: Monitor for decreased therapeutic effects of calcium
    channel blockers with concomitant barbiturate therapy. Calcium channel blocker dose
    adjustments may be necessary. Nimodipine Canadian labeling contraindicates
    concomitant use with phenobarbital.",
    " <b>",
    " Exceptions:",
    " </b>",
    " Clevidipine.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Carbonic Anhydrase Inhibitors: May enhance the adverse/toxic effect of
    Anticonvulsants (Barbiturate). Specifically, osteomalacia and rickets.",
    " <b>",
    " Exceptions:",
    " </b>",
    " Brinzolamide; Dorzolamide.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Chloramphenicol: Barbiturates may increase the metabolism of Chloramphenicol.
    Chloramphenicol may decrease the metabolism of Barbiturates.",
    " <i>",
    " Risk D: Consider therapy modification",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " CNS Depressants: May enhance the adverse/toxic effect of other CNS
    Depressants.",
    " <b>",
    " Exceptions:",
    " </b>",
    " Levocabastine (Nasal).",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Contraceptives (Estrogens): Barbiturates may diminish the therapeutic effect
    of Contraceptives (Estrogens). Contraceptive failure is possible. Management: Use
    of a non-hormonal contraceptive is recommended.",
    " <i>",
    " Risk D: Consider therapy modification",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Contraceptives (Progestins): Barbiturates may diminish the therapeutic effect
    of Contraceptives (Progestins). Contraceptive failure is possible. Management: Use
    of alternative, nonhormonal contraceptives is recommended.",
    " <i>",
    " Risk D: Consider therapy modification",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Corticosteroids (Systemic): Barbiturates may decrease the serum concentration
    of Corticosteroids (Systemic).",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " CycloSPORINE (Systemic): Barbiturates may increase the metabolism of
    CycloSPORINE (Systemic).",
    " <i>",
    " Risk D: Consider therapy modification",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Disopyramide: Barbiturates may increase the metabolism of Disopyramide.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Divalproex: May decrease the metabolism of Barbiturates. Barbiturates may
    decrease the serum concentration of Divalproex.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Doxycycline: Barbiturates may decrease the serum concentration of
    Doxycycline.",
    " <i>",
    " Risk D: Consider therapy modification",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Droperidol: May enhance the CNS depressant effect of CNS Depressants.
    Management: Consider dose reductions of droperidol or of other CNS agents (e.g.,
    opioids, barbiturates) with concomitant use.",
    " <i>",
    " Risk D: Consider therapy modification",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Etoposide: Barbiturates may decrease the serum concentration of Etoposide.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Etoposide Phosphate: Barbiturates may decrease the serum concentration of
    Etoposide Phosphate. Barbiturates may increase the metabolism, via CYP isoenzymes,
    of etoposide phosphate.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Felbamate: Barbiturates may decrease the serum concentration of Felbamate.
    Felbamate may increase the serum concentration of Barbiturates. Management:
    Monitor for elevated barbiturate concentrations/toxicity if felbamate is
    initiated/dose increased, or reduced concentrations/effects if felbamate is
    discontinued/dose decreased. Refer to phenobarbital dosing guidelines for patients
    receiving that agent.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Fosphenytoin: Barbiturates may enhance the CNS depressant effect of
    Fosphenytoin. Barbiturates may decrease the serum concentration of Fosphenytoin.
    Fosphenytoin may increase the serum concentration of Barbiturates.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " HydrOXYzine: May enhance the CNS depressant effect of Barbiturates.
    Management: Consider a decrease in the barbiturate dose, as appropriate, when used
    together with hydroxyzine. With concurrent use, monitor patients closely for
    excessive response to the combination.",
    " <i>",
    " Risk D: Consider therapy modification",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Ketorolac (Nasal): May diminish the therapeutic effect of Anticonvulsants.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Ketorolac (Systemic): May diminish the therapeutic effect of
    Anticonvulsants.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " LamoTRIgine: Barbiturates may decrease the serum concentration of
    LamoTRIgine. Management: See lamotrigine prescribing information for specific age-
    dependent dosing guidelines regarding concurrent use with a barbiturate, as well as
    for adjusting lamotrigine dosing if concurrent barbiturate therapy is
    discontinued.",
    " <i>",
    " Risk D: Consider therapy modification",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Magnesium Sulfate: May enhance the CNS depressant effect of CNS
    Depressants.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Mefloquine: May diminish the therapeutic effect of Anticonvulsants.
    Mefloquine may decrease the serum concentration of Anticonvulsants. Management:
    Mefloquine is contraindicated for malaria prophylaxis in persons with a history of
    convulsions. Monitor anticonvulsant concentrations and treatment response closely
    with concurrent use.",
    " <i>",
    " Risk D: Consider therapy modification",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Meperidine: Barbiturates may enhance the CNS depressant effect of Meperidine.
    Barbiturates may increase serum concentrations of the active metabolite(s) of
    Meperidine.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Methadone: Barbiturates may enhance the CNS depressant effect of Methadone.
    Barbiturates may decrease the serum concentration of Methadone.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Metyrosine: CNS Depressants may enhance the sedative effect of Metyrosine.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Mirtazapine: CNS Depressants may enhance the CNS depressant effect of
    Mirtazapine.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Multivitamins/Minerals (with ADEK, Folate, Iron): May decrease the serum
    concentration of Barbiturates.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Paraldehyde: CNS Depressants may enhance the CNS depressant effect of
    Paraldehyde.",
    " <i>",
    " Risk X: Avoid combination",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Perampanel: May enhance the CNS depressant effect of CNS Depressants.
    Management: Patients taking perampanel with any other drug that has CNS depressant
    activities should avoid complex and high-risk activities, particularly those such
    as driving that require alertness and coordination, until they have experience
    using the combination.",
    " <i>",
    " Risk D: Consider therapy modification",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Phenytoin: May enhance the CNS depressant effect of Barbiturates.
    Barbiturates may decrease the serum concentration of Phenytoin. Phenytoin may
    increase the serum concentration of Barbiturates.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Pramipexole: CNS Depressants may enhance the sedative effect of
    Pramipexole.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Primidone: May enhance the adverse/toxic effect of Barbiturates. Primidone is
    converted to phenobarbital, and thus becomes additive with existing barbiturate
    therapy.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Propafenone: Barbiturates may decrease the serum concentration of
    Propafenone.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Pyridoxine: May increase the metabolism of Barbiturates. Apparent in high
    pyridoxine doses (eg, 200 mg/day)",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " QuiNIDine: Barbiturates may enhance the hepatotoxic effect of QuiNIDine.
    Barbiturates may decrease the serum concentration of QuiNIDine.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Rifamycin Derivatives: May increase the metabolism of Barbiturates.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " ROPINIRole: CNS Depressants may enhance the sedative effect of ROPINIRole.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Rotigotine: CNS Depressants may enhance the sedative effect of Rotigotine.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Selective Serotonin Reuptake Inhibitors: CNS Depressants may enhance the
    adverse/toxic effect of Selective Serotonin Reuptake Inhibitors. Specifically, the
    risk of psychomotor impairment may be enhanced.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Sodium Oxybate: May enhance the CNS depressant effect of CNS Depressants.
    Management: Consider alternatives to combined use. When combined use is needed,
    consider minimizing doses of one or more drugs. Use of sodium oxybate with alcohol
    or sedative hypnotics is contraindicated.",
    " <i>",
    " Risk D: Consider therapy modification",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Teniposide: Barbiturates may decrease the serum concentration of Teniposide.
    Management: Consider alternatives to combined treatment with barbiturates and
    teniposide due to the potential for decreased teniposide concentrations. If the
    combination cannot be avoided, monitor teniposide response closely.",
    " <i>",
    " Risk D: Consider therapy modification",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Theophylline Derivatives: Barbiturates may decrease the serum concentration
    of Theophylline Derivatives.",
    " <b>",
    " Exceptions:",
    " </b>",
    " Dyphylline.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Thiazide Diuretics: Barbiturates may enhance the orthostatic hypotensive
    effect of Thiazide Diuretics.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Tricyclic Antidepressants: Barbiturates may increase the metabolism of
    Tricyclic Antidepressants.",
    " <i>",
    " Risk D: Consider therapy modification",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Valproic Acid: May decrease the metabolism of Barbiturates. Barbiturates may
    decrease the serum concentration of Valproic Acid.",
    " <i>",
    " Risk C: Monitor therapy",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Vitamin K Antagonists (eg, warfarin): Barbiturates may increase the
    metabolism of Vitamin K Antagonists.",
    " <i>",
    " Risk D: Consider therapy modification",
    " </i>",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;\">",
    " Zolpidem: CNS Depressants may enhance the CNS depressant effect of Zolpidem.
    Management: Reduce the Intermezzo brand sublingual zolpidem dose to 1.75 mg for men
    who are also receiving other CNS depressants. No such dose change is recommended
    for women. Avoid use with other CNS depressants at bedtime; avoid use with
    alcohol.",
    " <i>",
    " Risk D: Consider therapy modification",
    " </i>",
    " </p>",
    " </div>",
    " <div class=\"block prf drugH1Div\" id=\"F226974\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Pregnancy Risk Factor",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " C (",
    " <a class=\"graphic graphic_table\" href=\"UTD.htm?16/42/17068\">",
    " show table",
    " </a>",
    " )",
    " </p>",
    " </div>",
    " <div class=\"block dic drugH1Div\" id=\"F226987\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Dietary Considerations",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " Some products may contain sodium.",
    " </p>",
    " </div>",
    " <div class=\"block fee drugH1Div\" id=\"F16323959\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Pricing: U.S. (Medi-Span&reg;)",
    " </span>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " <b>",
    " Solution (reconstituted)",
    " </b>",
    " (Pentothal Intravenous)",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:4em;text-align:justify;\">",
    " 500 mg (1): $49.74",
    " </p>",
    " </div>",
    " <div class=\"block mop drugH1Div\" id=\"F226976\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Monitoring Parameters",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " Respiratory rate, heart rate, blood pressure",
    " </p>",
    " </div>",
    " <div class=\"block rer drugH1Div\" id=\"F226980\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Reference Range",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " Therapeutic: Hypnotic: 1-5 mcg/mL (SI: 4.1-20.7 micromole/L); Coma: 30-100
    mcg/mL (SI: 124-413 micromole/L); Anesthesia: 7-130 mcg/mL (SI: 29-536
    micromole/L); Toxic: &gt;10 mcg/mL (SI: &gt;41 micromole/L)",
    " </p>",
    " </div>",
    " <div class=\"list fbnlist drugH1Div drugBrandNames\" id=\"F6038840\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " International Brand Names",
    " </span>",
    " <ul>",
    " <li>",
    " Anesthal (IN);",
    " </li>",
    " <li>",
    " Bensulf (AR);",
    " </li>",
    " <li>",
    " Hypnostan (FI);",
    " </li>",
    " <li>",
    " Intraval (AE, BB, BH, BM, BS, BZ, CY, EG, GB, GY, IQ, IR, JM, JO, KW, LB,
    LY, OM, PR, QA, SA, SR, SY, TT, YE);",
    " </li>",
    " <li>",
    " Nesdonal (HR, LU, NL);",
    " </li>",
    " <li>",
    " Pental (TR);",
    " </li>",
    " <li>",
    " Pentazol (PH);",
    " </li>",
    " <li>",
    " Penthal (PH);",
    " </li>",
    " <li>",
    " Penthotal (CN);",
    " </li>",
    " <li>",
    " Pentotex (MY);",
    " </li>",
    " <li>",
    " Pentothal (AU, BB, BE, BM, BS, BZ, CH, DK, FI, FR, GR, GY, ID, IL, IT, JM,
    LU, NO, NZ, PH, PT, PY, SE, SG, SR, TT, TW, UY, VE);",
    " </li>",
    " <li>",
    " Pentothal Sodico (ES, PE);",
    " </li>",
    " <li>",
    " Pentothal Sodium (ES, PL);",
    " </li>",
    " <li>",
    " Thionembutal (BR);",
    " </li>",
    " <li>",
    " Thionyl (KP);",
    " </li>",
    " <li>",
    " Thiopen (PK, TH);",
    " </li>",
    " <li>",
    " Thiopental (AE, BH, CY, EG, IQ, IR, JO, KW, LB, LY, OM, PL, QA, SA, SY,
    YE);",
    " </li>",
    " <li>",
    " Thiopental Biochemie (AT);",
    " </li>",
    " <li>",
    " Tiobarbital (ES);",
    " </li>",
    " <li>",
    " Tiopental (CO, CR, GT, HN, HR, NI);",
    " </li>",
    " <li>",
    " Tiopental Sodico (AR);",
    " </li>",
    " <li>",
    " Trapanal (DE, HU)",
    " </li>",
    " </ul>",
    " </div>",
    " <div class=\"block pha drugH1Div\" id=\"F226966\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Mechanism of Action",
    " </span>",
    " <p style=\"text-indent:0em;display:inline\">",
    " Short-acting barbiturate with sedative, hypnotic, and anticonvulsant
    properties. Barbiturates depress the sensory cortex, decrease motor activity, alter
    cerebellar function, and produce drowsiness, sedation, and hypnosis. In high doses,
    barbiturates exhibit anticonvulsant activity; barbiturates produce dose-dependent
    respiratory depression.",
    " </p>",
    " </div>",
    " <div class=\"block phk drugH1Div\" id=\"F226984\"
    xmlns=\"file://www.w3.org/1999/xhtml\">",
    " <span class=\"drugH1\">",
    " Pharmacodynamics/Kinetics",
    " </span>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Onset of action: Anesthetic: I.V.: 30-60 seconds",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Duration: 5-30 minutes",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Distribution: V",
    " <sub>",
    " d",
    " </sub>",
    " : ~1.6 L/kg",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Protein binding: 72% to 86%",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Metabolism: Hepatic, primarily to inactive metabolites but pentobarbital is
    also formed",
    " </p>",
    " <p style=\"text-indent:-2em;margin-left:2em;text-align:justify;\">",
    " Half-life elimination: 3-11.5 hours; decreased in children",
    " </p>",
    " </div>",
    " </div>",
    " <div id=\"topicAgreement\">",
    " Use of UpToDate is subject to the",
    " <a class=\"licenseLink\" href=\"./license\" id=\"sla_in_page\"
    target=\"_blank\">",
    " Subscription and License Agreement",
    " </a>",
    " .",
    " </div>",
    " <div class=\"headingAnchor\" id=\"references\">",
    " <h1>",
    " REFERENCES",
    " </h1>",
    " <ol id=\"reference\">",
    " <li>",
    " <div class=\"reference\">",
    " Morgan DJ, Blackman GL, Paull JD, et al, &ldquo;Pharmacokinetics and Plasma
    Binding of Thiopental. I: Studies in Surgical Patients,&rdquo;",
    " <i>",
    " Anesthesiology",
    " </i>",
    " , 1981, 54(6):468-73.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/63/1015/abstract-text/7235274 /pubmed\" id=\"7235274 \"
    target=\"_blank\">",
    " 7235274",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " <li>",
    " <div class=\"reference\">",
    " Russo H and Bressolle F, &ldquo;Pharmacodynamics and Pharmacokinetics of
    Thiopental,&rdquo;",
    " <i>",
    " Clin Pharmacokinet",
    " </i>",
    " , 1998, 35(2):95-134.",
    " <span class=\"pubmed-id\">",
    " [PubMed",
    " <a href=\"UTD.htm?0/63/1015/abstract-text/9739479/pubmed\" id=\"9739479\"
    target=\"_blank\">",
    " 9739479",
    " </a>",
    " ]",
    " </span>",
    " </div>",
    " </li>",
    " </ol>",
    " </div>",
    " <div id=\"topicVersionRevision\">",
    " Topic 9990 Version 43.0",
    " </div>",
    " </div>",
    " <div id=\"footer\">",
    " <div id=\"supportFooter\">",
    " <span class=\"sfInfo\">",
    " &copy; 2013 UpToDate, Inc. All rights reserved.",
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    " Subscription and License Agreement",
    " </a>",
    " <span class=\"sfInfo\">",
    " <span class=\"pipeSpace\">",
    " |",
    " </span>",
    " Release: 21.3 - C21.34",
    " </span>",
    " <br/>",
    " <span class=\"sfInfo\">",
    " Licensed to:",
    " <span class=\"emphasis\">",
    " Morehouse School of Medicine",
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    " |",
    " </span>",
    " Support Tag: [0505-91.202.164.29-B6FAD70B64-S473950.14]",
    " <br/>",
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    "</div>"].join("\n");
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    " <a href=\"#\" title=\"Collapse Topic Outline\">",
    " <img alt=\"\" src=\"./../images/orange_arrow_left.myextg\"/>",
    " </a>",
    " </div>",
    " <div id=\"innerOutline\">",
    " <h1>",
    " TOPIC OUTLINE",
    " </h1>",
    " <div id=\"outline\">",
    " <ul>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F226996\">",
    " Brand Names: U.S.",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F227028\">",
    " Pharmacologic Category",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F227000\">",
    " Dosing: Adult",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F227012\">",
    " Dosing: Pediatric",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F227001\">",
    " Dosing: Geriatric",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F227002\">",
    " Dosing: Renal Impairment",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F226979\">",
    " Dosage Forms: U.S.",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F226963\">",
    " Generic Equivalent Available: U.S.",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F14960845\">",
    " Product Availability",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F227030\">",
    " Controlled Substance",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F226982\">",
    " Administration",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F227035\">",
    " Compatibility",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F226981\">",
    " Use",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F5174562\">",
    " Medication Safety Issues",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F227026\">",
    " Adverse Reactions Significant",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F226985\">",
    " Contraindications",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F226967\">",
    " Warnings/Precautions",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F13300133\">",
    " Metabolism/Transport Effects",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F226972\">",
    " Drug Interactions",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F226974\">",
    " Pregnancy Risk Factor",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F226987\">",
    " Dietary Considerations",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F16323959\">",
    " Pricing: U.S. (Medi-Span&reg;)",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F226976\">",
    " Monitoring Parameters",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F226980\">",
    " Reference Range",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F6038840\">",
    " International Brand Names",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F226966\">",
    " Mechanism of Action",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#F226984\">",
    " Pharmacodynamics/Kinetics",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a href=\"#references\">",
    " REFERENCES",
    " </a>",
    " </li>",
    " </ul>",
    " </div>",
    " <h1>",
    " <div class=\"openRelatedGraphics\" id=\"DRUG_GEN/9990\" rel=\"outline_link\">",
    " GRAPHICS",
    " <a class=\"graphics_icon\" href=\"#\" title=\"View All Related Graphics\">",
    " View All",
    " </a>",
    " </div>",
    " </h1>",
    " <div id=\"relatedGraphics\">",
    " <ul>",
    " <li class=\"plainItem\">",
    " <div class=\"openRelatedGraphics\" id=\"DRUG_GEN/9990|TAB\">",
    " <a href=\"#\" title=\"TABLES\">",
    " TABLES",
    " </a>",
    " </div>",
    " </li>",
    " <li class=\"bulletItem\">",
    " <a class=\"graphic graphic_table\" href=\"UTD.htm?23/39/24183\"
    title=\"Lexicomp clinical abbreviations\">",
    " Lexicomp clinical abbreviations",
    " </a>",
    " </li>",
    " </ul>",
    " </div>",
    " <h1>",
    " RELATED TOPICS",
    " </h1>",
    " <div id=\"relatedTopics\">",
    " <ul>",
    " <li class=\"plainItem\">",
    " <a class=\"drug drug_patient\" href=\"UTD.htm?36/19/37171?
    source=related_link\">",
    " Thiopental: Patient drug information",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"drug drug_pediatric\" href=\"UTD.htm?11/13/11478?
    source=related_link\">",
    " Thiopental: Pediatric drug information",
    " </a>",
    " </li>",
    " </ul>",
    " </div>",
    " </div>"].join("\n");
    var title_f0_63_1016="Overview of the treatment of Cushing's syndrome";
    var content_f0_63_1016=[" <noscript>",
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    " <!-- TC:TOPIC_PAGE -->",
    " <div id=\"topicContent\">",
    " <div id=\"topicTitle\">",
    " Overview of the treatment of Cushing's syndrome",
    " </div>",
    " <div id=\"topicContributors\">",
    " <div>",
    " <a id=\"authors\">",
    " </a>",
    " <a class=\"contributor contributor_credentials contributorType\"
    href=\"UTD.htm?0/63/1016/contributors\">",
    " Author",
    " </a>",
    " <br/>",
    " <a class=\"contributor contributor_credentials\" href=\"UTD.htm?
    0/63/1016/contributors\">",
    " Lynnette K Nieman, MD",
    " </a>",
    " <br/>",
    " </div>",
    " <div>",
    " <a class=\"contributor contributor_credentials contributorType\"
    href=\"UTD.htm?0/63/1016/contributors\">",
    " Section Editor",
    " </a>",
    " <br/>",
    " <a class=\"contributor contributor_credentials\" href=\"UTD.htm?
    0/63/1016/contributors\">",
    " Andre Lacroix, MD",
    " </a>",
    " <br/>",
    " </div>",
    " <div>",
    " <a class=\"contributor contributor_credentials contributorType\"
    href=\"UTD.htm?0/63/1016/contributors\">",
    " Deputy Editor",
    " </a>",
    " <br/>",
    " <a class=\"contributor contributor_credentials\" href=\"UTD.htm?
    0/63/1016/contributors\">",
    " Kathryn A Martin, MD",
    " </a>",
    " <br/>",
    " </div>",
    " </div>",
    " <div id=\"disclosures\">",
    " <a href=\"UTD.htm?0/63/1016/contributor-disclosure\" target=\"_blank\">",
    " Disclosures",
    " </a>",
    " </div>",
    " <div id=\"reviewProcess\">",
    " <span>",
    " All topics are updated as new evidence becomes available and our",
    " </span>",
    " <a href=\"/home/editorial-policy\" target=\"_blank\">",
    " peer review process",
    " </a>",
    " <span>",
    " is complete.",
    " </span>",
    " </div>",
    " <div id=\"literatureReviewDate\">",
    " <span class=\"emphasis\">",
    " Literature review current through:",
    " </span>",
    " Oct 2013.",
    " <span class=\"pipeSpace\">",
    " |",
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    " <span class=\"emphasis\">",
    " This topic last updated:",
    " </span>",
    " Jan 17, 2013.",
    " </div>",
    " <div id=\"topicText\">",
    " <p class=\"headingAnchor\" id=\"H1\">",
    " <span class=\"h1\">",
    " INTRODUCTION",
    " </span>",
    " &nbsp;&mdash;&nbsp;The hypercortisolemia in Cushing's syndrome is usually due
    to a corticotropin (ACTH)-producing pituitary tumor (Cushing's disease), ectopic
    ACTH secretion by a nonpituitary tumor, or cortisol secretion by an adrenal adenoma
    or carcinoma. There are also very rare tumors that secrete corticotropin-releasing
    hormone (CRH) ectopically, and occasional cases are caused by cortisol secretion by
    ACTH-independent macronodular or micronodular hyperplasia of the adrenal cortex.",
    " </p>",
    " <p>",
    " Treatment should be directed, whenever possible, at the primary cause of the
    syndrome. It is therefore dependent upon accurate differential diagnosis [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1016/abstract/1\">",
    " 1",
    " </a>",
    " ]. (See",
    " <a class=\"medical medical_review\" href=\"UTD.htm?30/31/31225?
    source=see_link\">",
    " \"Establishing the cause of Cushing's syndrome\"",
    " </a>",
    " .)",
    " </p>",
    " <p>",
    " This topic provides an overview of the various therapeutic options available
    in the treatment of Cushing's syndrome. A detailed review of therapy for Cushing's
    disease and primary adrenal causes of hypercortisolism is presented separately.",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H2\">",
    " <span class=\"h1\">",
    " GENERAL PRINCIPLES",
    " </span>",
    " &nbsp;&mdash;&nbsp;Ideal therapy of Cushing's syndrome would achieve the
    following goals [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1016/abstract/1,2\">",
    " 1,2",
    " </a>",
    " ]:",
    " </p>",
    " <p>",
    " <ul class=\"bulletCompact-block\">",
    " <li>",
    " Reverse the clinical manifestations by reducing cortisol secretion to
    normal",
    " </li>",
    " <li>",
    " Eradicate any tumor threatening the health of the patient",
    " </li>",
    " <li>",
    " Avoid permanent dependence upon medications",
    " </li>",
    " <li>",
    " Avoid permanent hormone deficiency",
    " </li>",
    " </ul>",
    " </p>",
    " <p>",
    " In individual patients, however, one or more of the last three goals may have
    to be sacrificed to achieve the essential first goal. The therapeutic protocols
    described below proceed from permanently curing the disorder by resecting or
    ablating its cause to merely controlling the hypercortisolism in patients in whom a
    cure cannot be achieved. Each stage in the treatment should provide maximum
    probability of cure with the least chance of permanent endocrine deficiency or
    other undesirable side effects.",
    " </p>",
    " <p>",
    " Specific treatment may be delayed during diagnostic testing or while drug
    adjustments are made to achieve eucortisolism. During this time, treatment of co-
    morbidities such as hypertension, osteoporosis, and diabetes should be instituted,
    and the use of medications to prevent thrombosis or bone loss should be
    considered.",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H3\">",
    " <span class=\"h1\">",
    " EXOGENOUS CUSHING'S SYNDROME",
    " </span>",
    " &nbsp;&mdash;&nbsp;The treatment of Cushing's syndrome due to exogenous
    therapy is to stop the glucocorticoid. Most patients who have taken enough
    glucocorticoid for a long enough time to cause Cushing's syndrome will have a
    period of hypothalamic-pituitary adrenal insufficiency when therapy is
    discontinued. Thus, gradual withdrawal is necessary. (See",
    " <a class=\"medical medical_review\" href=\"UTD.htm?22/42/23208?
    source=see_link&amp;anchor=H18#H18\">",
    " \"Pharmacologic use of glucocorticoids\", section on 'HPA axis suppression'",
    " </a>",
    " .)",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H4\">",
    " <span class=\"h1\">",
    " CUSHING'S DISEASE",
    " </span>",
    " &nbsp;&mdash;&nbsp;The approach to the treatment of Cushing's disease as
    outlined here is consistent with a 2008 consensus statement on the treatment of
    ACTH-dependent Cushing's syndrome [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1016/abstract/3\">",
    " 3",
    " </a>",
    " ].",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H5\">",
    " <span class=\"h2\">",
    " Transsphenoidal surgery",
    " </span>",
    " &nbsp;&mdash;&nbsp;The treatment of choice for Cushing's disease is
    transsphenoidal microadenomectomy when a clearly circumscribed microadenoma can be
    identified at surgery (",
    " <a class=\"graphic graphic_algorithm graphicRef76949 \" href=\"UTD.htm?
    33/49/34589\">",
    " algorithm 1",
    " </a>",
    " ). In the remaining patients, subtotal (85 to 90 percent) resection of the
    anterior pituitary may be indicated if future fertility is not desired.",
    " </p>",
    " <p>",
    " It is difficult to predict residual pituitary function after partial
    hypophysectomy; some patients have normal pituitary function even after subtotal
    hypophysectomy. However, the more extensive the resection, the greater the risk of
    loss of pituitary function. (See",
    " <a class=\"medical medical_review\" href=\"UTD.htm?17/26/17834?
    source=see_link\">",
    " \"Primary therapy of Cushing's disease: Transsphenoidal surgery and pituitary
    irradiation\"",
    " </a>",
    " .)",
    " </p>",
    " <p>",
    " A practical approach to the uncertainty of surgical localization is to make a
    contract among the endocrinologist, the patient, and the neurosurgeon before
    surgery. If the neurosurgeon finds a microadenoma, he removes it. If he does not
    and fertility is not a concern of the patient, he performs a more extensive
    resection, proceeding to a subtotal hypophysectomy if no adenoma is found. Among
    expert pituitary neurosurgeons, the cure rate approximates 70 to 80 percent, but
    late recurrences reduce the permanent cure rate to approximately 60 to 70
    percent.",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H609003423\">",
    " <span class=\"h2\">",
    " Medical therapy",
    " </span>",
    " &nbsp;&mdash;&nbsp;Although the hypercortisolism of Cushing&rsquo;s disease is
    primarily treated surgically, medical therapy is often required when surgery is
    delayed, contraindicated, or unsuccessful. Adrenal enzyme inhibitors are the most
    commonly used drugs, but adrenolytic agents, drugs that target the pituitary, and
    glucocorticoid-receptor antagonists also have been used. Medical therapy targeting
    the corticotroph tumor such as",
    " <a class=\"drug drug_general\" href=\"UTD.htm?7/2/7206?source=see_link\">",
    " cabergoline",
    " </a>",
    " or",
    " <a class=\"drug drug_general\" href=\"UTD.htm?27/21/27989?source=see_link\">",
    " pasireotide",
    " </a>",
    " can result in normalization of 24-hour urinary free cortisol in 20 to 40
    percent of them, especially if they have only mild hypercortisolism. This topic is
    reviewed in detail separately. (See",
    " <a class=\"medical medical_review\" href=\"UTD.htm?3/0/3081?
    source=see_link\">",
    " \"Medical therapy of hypercortisolism (Cushing&rsquo;s syndrome)\"",
    " </a>",
    " .)",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H349412676\">",
    " <span class=\"h3\">",
    " Aggressive corticotroph tumors",
    " </span>",
    " &nbsp;&mdash;&nbsp;While up to one-third of pituitary tumors, mostly
    macroadenomas, are locally invasive, a few are more aggressive and 0.1 to 0.2
    percent are carcinomas that metastasize in the central nervous system or
    systemically. These aggressive tumors are resistant to treatment and result in
    death, usually within several months, or occasionally after several years [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1016/abstract/4\">",
    " 4",
    " </a>",
    " ]. Chemotherapy may offer temporary remission in a minority of patients. In a
    review of 20 patients with aggressive tumors refractory to conventional treatment,
    the alkylating agent",
    " <a class=\"drug drug_general\" href=\"UTD.htm?10/47/11000?source=see_link\">",
    " temozolomide",
    " </a>",
    " resulted in a partial response in approximately two-thirds of patients [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1016/abstract/5\">",
    " 5",
    " </a>",
    " ]. The use of immunohistochemical demonstration of low expression of the DNA-
    repair enzyme O6-methylguanine-DNA methyltransferase (MGMT) appeared to predict
    responsiveness to the agent. While preliminary, these reports offer a new approach
    to patients with aggressive or metastatic tumors.",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H6\">",
    " <span class=\"h2\">",
    " Pituitary irradiation",
    " </span>",
    " &nbsp;&mdash;&nbsp;For patients in whom fertility is an important concern and
    in whom a tumor is not found or who are not cured by transsphenoidal resection of a
    tumor, pituitary irradiation is one of the next treatment options; it may also be
    considered as primary therapy for children under age 18. Conventional megavoltage
    linear accelerator after transsphenoidal surgery will correct the hypercortisolism
    in up to 85 percent of adults when used after debulking surgery and in 85 percent
    of children when used as monotherapy [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1016/abstract/6,7\">",
    " 6,7",
    " </a>",
    " ]. Stereotactic radiotherapy provides less irradiation to neuronal tissues,
    but experience with this technique is limited.",
    " </p>",
    " <p>",
    " Maximum benefit is usually achieved within six to 12 months, but may require
    two to three years, and during this time period hypercortisolism should be
    controlled with one or several adrenal enzyme inhibitors. Pituitary irradiation may
    also decrease the occurrence of Nelson's syndrome in patients not cured by
    irradiation for whom adrenalectomy becomes necessary.",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H7\">",
    " <span class=\"h2\">",
    " Adrenalectomy",
    " </span>",
    " &nbsp;&mdash;&nbsp;Bilateral total adrenalectomy with lifelong daily
    glucocorticoid and mineralocorticoid replacement therapy is the final definitive
    cure, and may be preferred by some patients instead of radiation therapy. In one
    series, laparoscopic adrenalectomy was successful in 42 patients with Cushing's
    disease who had not been cured by previous pituitary surgery, radiotherapy",
    " <span class=\"nowrap\">",
    " and/or",
    " </span>",
    " medical therapy [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1016/abstract/8\">",
    " 8",
    " </a>",
    " ]. (See",
    " <a class=\"medical medical_review\" href=\"UTD.htm?19/2/19496?
    source=see_link\">",
    " \"Persistent or recurrent Cushing&rsquo;s disease: Surgical adrenalectomy\"",
    " </a>",
    " .)",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H9\">",
    " <span class=\"h1\">",
    " ECTOPIC ACTH AND CRH SYNDROMES",
    " </span>",
    " &nbsp;&mdash;&nbsp;The optimal therapy of the ectopic ACTH syndrome is
    surgical excision of the tumor, thereby removing the source of ACTH and curing the
    metabolic disorder. In several reports, remission occurred after removal of 28 of
    34, 10 of 12 and 10 of 26 pulmonary carcinoid tumors and eight of nine localized
    neuroendocrine or other carcinoid tumors [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1016/abstract/9-11\">",
    " 9-11",
    " </a>",
    " ]. Other tumors are more likely to be metastatic, so that they cannot be
    treated by surgical excision.",
    " </p>",
    " <p>",
    " In patients with metastases limited to the liver, resection or cryoablation of
    the metastases or even liver transplantation may result in cure [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1016/abstract/12\">",
    " 12",
    " </a>",
    " ]. In a study of 103 patients with neuroendocrine carcinomas metastatic to the
    liver, 60 percent of patients were alive two years after liver transplantation and
    47 percent, half of whom were disease-free, were alive after five years [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1016/abstract/13\">",
    " 13",
    " </a>",
    " ]. Patients who were less than 50 years old, had primary lung or bowel tumors,
    and had pretransplant somatostatin treatment had the best prognosis. In most
    patients, however, the tumor is not resectable at the time of diagnosis.
    Chemotherapy",
    " <span class=\"nowrap\">",
    " and/or",
    " </span>",
    " radiotherapy may be helpful.",
    " </p>",
    " <p>",
    " For those patients with nonresectable tumors, the hypercortisolism can be
    controlled with adrenal enzyme inhibitors, such as",
    " <a class=\"drug drug_general\" href=\"UTD.htm?32/34/33312?source=see_link\">",
    " ketoconazole",
    " </a>",
    " ,",
    " <a class=\"drug drug_general\" href=\"UTD.htm?15/12/15556?source=see_link\">",
    " metyrapone",
    " </a>",
    " , and",
    " <a class=\"drug drug_general\" href=\"UTD.htm?15/34/15908?source=see_link\">",
    " etomidate",
    " </a>",
    " . (See",
    " <a class=\"medical medical_review\" href=\"UTD.htm?3/0/3081?
    source=see_link&amp;anchor=H18#H18\">",
    " \"Medical therapy of hypercortisolism (Cushing&rsquo;s syndrome)\", section
    on 'Adrenal enzyme inhibitors'",
    " </a>",
    " .)",
    " </p>",
    " <p>",
    " <ul class=\"bullet-block\">",
    " <li>",
    " Therapy with an adrenal enzyme inhibitor can be continued for a prolonged
    period in patients in whom a tumor cannot be identified. Such patients should be
    reexamined periodically with 111-In-pentetreotide, CT, or MRI for several years, if
    necessary, until the tumor can be located and treated [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1016/abstract/10,11\">",
    " 10,11",
    " </a>",
    " ].",
    " </li>",
    " <li>",
    " Some patients have indolent tumors and a long life expectancy but cannot be
    cured surgically. These patients can be treated with",
    " <a class=\"drug drug_general\" href=\"UTD.htm?15/58/16293?
    source=see_link\">",
    " mitotane",
    " </a>",
    " to achieve a medical adrenalectomy. (See",
    " <a class=\"medical medical_review\" href=\"UTD.htm?3/0/3081?
    source=see_link\">",
    " \"Medical therapy of hypercortisolism (Cushing&rsquo;s syndrome)\"",
    " </a>",
    " .)",
    " </li>",
    " </ul>",
    " </p>",
    " <p>",
    " Bilateral surgical adrenalectomy may be used as an alternative to",
    " <a class=\"drug drug_general\" href=\"UTD.htm?15/58/16293?source=see_link\">",
    " mitotane",
    " </a>",
    " &nbsp;(",
    " <a class=\"graphic graphic_figure graphicRef68665 \" href=\"UTD.htm?
    12/49/13085\">",
    " figure 1",
    " </a>",
    " ) [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1016/abstract/9-11\">",
    " 9-11",
    " </a>",
    " ].",
    " </p>",
    " <p>",
    " The prognosis is dictated by the nature of the tumor and the severity of the
    hypercortisolism. Most patients with overt metastases at the time of presentation
    die of the cancer within one year, although patients with indolent tumors may
    survive for many years. Patients with small-cell lung cancer, medullary thyroid
    cancer, and gastrinoma have a particularly poor prognosis [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1016/abstract/10,11\">",
    " 10,11",
    " </a>",
    " ]. Regardless of the prognosis, no patient should suffer from the effects of
    persistent hypercortisolism, because it can readily be controlled.",
    " </p>",
    " <p>",
    " Patients whose hypercortisolism is controlled by any means may occasionally
    develop rebound",
    " <strong>",
    " thymic hyperplasia",
    " </strong>",
    " . Recognition of this condition is important because it may be confused
    radiologically with tumor recurrence or metastasis in the anterior mediastinum [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1016/abstract/14\">",
    " 14",
    " </a>",
    " ].",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H10\">",
    " <span class=\"h2\">",
    " Glucocorticoid antagonists",
    " </span>",
    " &nbsp;&mdash;&nbsp;The glucocorticoid (as well as progestin) antagonist",
    " <a class=\"drug drug_general\" href=\"UTD.htm?1/45/1753?source=see_link\">",
    " mifepristone",
    " </a>",
    " (RU 486) was used successfully for nine weeks in one patient [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1016/abstract/15\">",
    " 15",
    " </a>",
    " ]. (See",
    " <a class=\"medical medical_review\" href=\"UTD.htm?25/16/25866?
    source=see_link\">",
    " \"Therapeutic use and adverse effects of progesterone receptor antagonists
    and selective progesterone receptor modulators\"",
    " </a>",
    " .)",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H11\">",
    " <span class=\"h2\">",
    " Somatostatin analogues",
    " </span>",
    " &nbsp;&mdash;&nbsp;",
    " <a class=\"drug drug_general\" href=\"UTD.htm?42/7/43128?source=see_link\">",
    " Octreotide",
    " </a>",
    " , a long-acting analogue of somatostatin, rapidly reduces ectopic ACTH
    secretion by some nonpituitary tumors, but does not usually reduce tumor size [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1016/abstract/16,17\">",
    " 16,17",
    " </a>",
    " ]. Uptake of 111-In-pentetreotide by the tumor also predicts a positive
    response to the drug [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1016/abstract/18\">",
    " 18",
    " </a>",
    " ]. The agent may be given either as a twice daily or monthly injection and is
    expensive [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1016/abstract/19\">",
    " 19",
    " </a>",
    " ]. It therefore has limited value in treating patients with the ectopic ACTH
    syndrome.",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H12\">",
    " <span class=\"h2\">",
    " Ectopic CRH secretion",
    " </span>",
    " &nbsp;&mdash;&nbsp;Ectopic CRH secretion is a very rare disorder, having been
    proved in only a small number of cases, mostly with fairly well-differentiated
    pulmonary carcinoid tumors [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1016/abstract/20\">",
    " 20",
    " </a>",
    " ]. The treatment and prognosis of this condition is the same as for ectopic
    ACTH secretion. The Cushing's syndrome can easily be controlled, but the ultimate
    prognosis depends upon the malignancy of the tumor and whether it can be completely
    resected.",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H13\">",
    " <span class=\"h1\">",
    " PRIMARY ADRENAL DISEASES",
    " </span>",
    " &nbsp;&mdash;&nbsp;Several different adrenal diseases can cause Cushing's
    syndrome; the approach to such patients is generally directed at removal of the
    adrenal gland(s). Adrenal tumors should be removed with unilateral adrenalectomy
    while bilateral adrenalectomy is required for bilateral micronodular and most
    patients with macronodular adrenal hyperplasia.",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H14\">",
    " <span class=\"h2\">",
    " Adrenal tumors",
    " </span>",
    " &nbsp;&mdash;&nbsp;Adenomas are always cured with unilateral adrenalectomy.
    (See",
    " <a class=\"medical medical_review\" href=\"UTD.htm?33/37/34390?
    source=see_link&amp;anchor=H3#H3\">",
    " \"Treatment of adrenocortical adenomas\", section on 'Surgery'",
    " </a>",
    " .)",
    " </p>",
    " <p>",
    " In comparison, resectable carcinomas recur in approximately 50 percent of
    cases and usually have a relatively modest response to either irradiation or
    chemotherapy.",
    " <a class=\"drug drug_general\" href=\"UTD.htm?15/58/16293?source=see_link\">",
    " Mitotane",
    " </a>",
    " offers such patients the only specific adrenocortical cytotoxic drug currently
    available. In patients with inoperable, residual or recurrent disease, it is
    usually palliative and does not prolong life [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1016/abstract/21,22\">",
    " 21,22",
    " </a>",
    " ]. However, it may prevent recurrence when administered to patients who have
    no detectable disease after initial surgery [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1016/abstract/23\">",
    " 23",
    " </a>",
    " ]. The management of adrenocortical carcinoma is reviewed in detail
    separately. (See",
    " <a class=\"medical medical_review\" href=\"UTD.htm?39/51/40762?
    source=see_link\">",
    " \"Treatment of adrenocortical carcinoma\"",
    " </a>",
    " .)",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H15\">",
    " <span class=\"h2\">",
    " ACTH-independent bilateral adrenal hyperplasia",
    " </span>",
    " &nbsp;&mdash;&nbsp;There are two forms of ACTH-independent bilateral adrenal
    hyperplasia: primary pigmented nodular adrenocortical disease (PPNAD, also called
    micronodular adrenal hyperplasia); and macronodular adrenal hyperplasia. (See",
    " <a class=\"medical medical_review\" href=\"UTD.htm?21/35/22072?
    source=see_link\">",
    " \"Cushing's syndrome due to primary pigmented nodular adrenocortical
    disease\"",
    " </a>",
    " and",
    " <a class=\"medical medical_review\" href=\"UTD.htm?0/45/730?
    source=see_link\">",
    " \"Cushing's syndrome due to ACTH-independent macronodular adrenal
    hyperplasia\"",
    " </a>",
    " .)",
    " </p>",
    " <p>",
    " Surgical bilateral adrenalectomy is uniformly effective in PPNAD; subtotal or
    unilateral adrenalectomy should not be performed since recurrence can occur [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1016/abstract/24,25\">",
    " 24,25",
    " </a>",
    " ]. Bilateral adrenalectomy is also indicated in most patients with
    macronodular adrenal hyperplasia [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1016/abstract/26\">",
    " 26",
    " </a>",
    " ]. However, in some patients with moderate elevations of serum cortisol,
    unilateral adrenalectomy may provide long term control of hypercortisolism [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1016/abstract/27,28\">",
    " 27,28",
    " </a>",
    " ].",
    " </p>",
    " <p>",
    " Bilateral adrenalectomy is now usually performed by laparoscopy and causes
    permanent adrenal insufficiency, but not Nelson's syndrome. In selected cases with
    macronodular adrenal hyperplasia and aberrant hormone receptors, pharmacological
    blockade on the aberrant receptor can result in long-term normalization of cortisol
    secretion [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1016/abstract/29,30\">",
    " 29,30",
    " </a>",
    " ].",
    " </p>",
    " <p>",
    " Although medical treatment does not cure ACTH-independent micronodular or
    macronodular adrenal hyperplasia, the adrenal enzyme inhibitors (",
    " <a class=\"drug drug_general\" href=\"UTD.htm?15/12/15556?source=see_link\">",
    " metyrapone",
    " </a>",
    " or",
    " <a class=\"drug drug_general\" href=\"UTD.htm?32/34/33312?source=see_link\">",
    " ketoconazole",
    " </a>",
    " ) can be given to reduce cortisol secretion in an attempt to improve the
    patient's physical condition before surgery. As with adrenocortical tumors, ACTH
    secretion will not increase and override the pharmacologic blockade. (See",
    " <a class=\"medical medical_review\" href=\"UTD.htm?3/0/3081?
    source=see_link\">",
    " \"Medical therapy of hypercortisolism (Cushing&rsquo;s syndrome)\"",
    " </a>",
    " .)",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H16\">",
    " <span class=\"h1\">",
    " COURSE AFTER EFFECTIVE THERAPY",
    " </span>",
    " &nbsp;&mdash;&nbsp;Physical symptoms and signs of Cushing's syndrome disappear
    gradually over a period of two to 12 months. Hypertension and glucose intolerance
    improve but may not disappear.",
    " </p>",
    " <p>",
    " The osteoporosis of Cushing's syndrome begins to improve about six months
    after the hypercortisolemia is cured, improves rapidly during the ensuing two
    years, and more gradually thereafter, but may not normalize [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1016/abstract/31-33\">",
    " 31-33",
    " </a>",
    " ]. For patients with marked bone loss, oral bisphosphonate therapy is
    recommended; calcium supplementation, vitamin D, and gonadal steroid replacement
    may also be useful [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1016/abstract/34\">",
    " 34",
    " </a>",
    " ]. (See",
    " <a class=\"medical medical_review\" href=\"UTD.htm?17/36/17994?
    source=see_link\">",
    " \"Prevention and treatment of glucocorticoid-induced osteoporosis\"",
    " </a>",
    " .)",
    " </p>",
    " <p>",
    " Cushing's syndrome also impairs health-related quality of life (HRQL), which
    partially, but not completely resolves after transsphenoidal surgery. This was
    illustrated in a study of 23 patients with Cushing's disease who completed a SF
    (short-form) 36 survey (which evaluates HRQL) before and after transsphenoidal
    surgery, and in a group of 343 Cushing's patients who were in remission for up to
    25 years after surgery (mostly pituitary, but some had adrenal or ectopic
    Cushing&rsquo;s) [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1016/abstract/35\">",
    " 35",
    " </a>",
    " ]. The following results were seen:",
    " </p>",
    " <p>",
    " <ul class=\"bullet-block\">",
    " <li>",
    " Active Cushing's disease was associated with low physical and mental summary
    scores on the HRQL survey; after transsphenoidal surgery, all HRQL parameters
    improved, but did not normalize in these patients.",
    " </li>",
    " <li>",
    " In the cross-sectional analysis of patients in remission, a small, but
    significant impairment of physical and mental summary scores on the HRQL survey was
    seen.",
    " </li>",
    " </ul>",
    " </p>",
    " <p>",
    " In adults, psychiatric symptoms improve, but underlying psychopathology may
    persist, and one study found an increase in the frequency of suicidal ideation and
    panic [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1016/abstract/36\">",
    " 36",
    " </a>",
    " ]. Cognitive deficits persist despite improvement, but not normalization, of
    apparent brain volume [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1016/abstract/37,38\">",
    " 37,38",
    " </a>",
    " ]. One study of 11 children found a decline in IQ and cognitive performance at
    one year after curative surgery, in the absence of psychopathology, despite
    reversal of cerebral atrophy [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1016/abstract/39\">",
    " 39",
    " </a>",
    " ].",
    " </p>",
    " <p>",
    " In children, bone density and growth rate both increase after treatment,
    although neither returns to normal [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1016/abstract/40\">",
    " 40",
    " </a>",
    " ].",
    " <br/>",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H17\">",
    " <span class=\"h1\">",
    " PROGNOSIS",
    " </span>",
    " &nbsp;&mdash;&nbsp;Untreated Cushing's syndrome is often fatal, with most
    deaths being due to cardiovascular, thromboembolic, or hypertensive complications
    or bacterial or fungal infections. Years ago there was a 50 percent mortality five
    years after the development of symptoms [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1016/abstract/41\">",
    " 41",
    " </a>",
    " ], but the prognosis is much better now.",
    " </p>",
    " <p>",
    " Cushing's disease is virtually always curable, although rarely patients may
    die of perioperative or other complications [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1016/abstract/42\">",
    " 42",
    " </a>",
    " ]. No patient with Cushing's syndrome of any cause should die from persistent
    hypercortisolism, since cortisol production can always be controlled by adrenal
    enzyme inhibitors,",
    " <a class=\"drug drug_general\" href=\"UTD.htm?15/58/16293?source=see_link\">",
    " mitotane",
    " </a>",
    " , or adrenalectomy. However, patients with ectopic ACTH secretion or
    adrenocortical carcinoma may have a poor prognosis associated with the underlying
    tumor. In addition, patients with severe Cushing's syndrome may die from
    opportunistic infections before completion of diagnostic studies [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1016/abstract/43-45\">",
    " 43-45",
    " </a>",
    " ]. Increased coagulability is also associated with deep vein thrombosis,
    pulmonary edema, and myocardial infarction [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1016/abstract/46\">",
    " 46",
    " </a>",
    " ].",
    " <br/>",
    " </p>",
    " <p class=\"headingAnchor\" id=\"PATIENT_INFORMATION\">",
    " <span class=\"h1\">",
    " INFORMATION FOR PATIENTS",
    " </span>",
    " &nbsp;&mdash;&nbsp;UpToDate offers two types of patient education materials,
    &ldquo;The Basics&rdquo; and &ldquo;Beyond the Basics.&rdquo; The Basics patient
    education pieces are written in plain language, at the 5",
    " <sup>",
    " th",
    " </sup>",
    " to 6",
    " <sup>",
    " th",
    " </sup>",
    " grade reading level, and they answer the four or five key questions a patient
    might have about a given condition. These articles are best for patients who want a
    general overview and who prefer short, easy-to-read materials. Beyond the Basics
    patient education pieces are longer, more sophisticated, and more detailed. These
    articles are written at the 10",
    " <sup>",
    " th",
    " </sup>",
    " to 12",
    " <sup>",
    " th",
    " </sup>",
    " grade reading level and are best for patients who want in-depth information
    and are comfortable with some medical jargon.",
    " </p>",
    " <p>",
    " Here are the patient education articles that are relevant to this topic. We
    encourage you to print or e-mail these topics to your patients. (You can also
    locate patient education articles on a variety of subjects by searching on
    &ldquo;patient info&rdquo; and the keyword(s) of interest.)",
    " </p>",
    " <p>",
    " <ul class=\"bullet-block\">",
    " <li>",
    " Basics topics (see",
    " <a class=\"medical medical_basics\" href=\"UTD.htm?5/61/6099?
    source=see_link\">",
    " \"Patient information: Cushing's syndrome (The Basics)\"",
    " </a>",
    " )",
    " </li>",
    " <li>",
    " Beyond the Basics topics (see",
    " <a class=\"medical medical_patient\" href=\"UTD.htm?13/19/13619?
    source=see_link\">",
    " \"Patient information: Cushing's syndrome (Beyond the Basics)\"",
    " </a>",
    " and",
    " <a class=\"medical medical_patient\" href=\"UTD.htm?10/47/10994?
    source=see_link\">",
    " \"Patient information: Cushing's syndrome treatment (Beyond the Basics)\"",
    " </a>",
    " )",
    " </li>",
    " </ul>",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H18\">",
    " <span class=\"h1\">",
    " SUMMARY",
    " </span>",
    " &nbsp;&mdash;&nbsp;The goal of treatment of all patients with Cushing's
    syndrome is to achieve normalization of hypothalamic-pituitary-adrenal function.",
    " </p>",
    " <p>",
    " <ul class=\"bullet-block\">",
    " <li>",
    " Optimal treatment involves localization and complete removal of an ACTH-
    secreting or cortisol-secreting adrenal tumor. (See",
    " <a class=\"local\" href=\"#H2\">",
    " 'General principles'",
    " </a>",
    " above.)",
    " </li>",
    " <li>",
    " In patients with Cushing&rsquo;s disease who were not cured by pituitary
    surgery, medical therapy targeting the corticotroph tumor such as",
    " <a class=\"drug drug_general\" href=\"UTD.htm?7/2/7206?source=see_link\">",
    " cabergoline",
    " </a>",
    " or",
    " <a class=\"drug drug_general\" href=\"UTD.htm?27/21/27989?
    source=see_link\">",
    " pasireotide",
    " </a>",
    " can result in normalization of 24-hour urinary free cortisol in 20 to 40
    percent of them, especially if they have only mild hypercortisolism. (See",
    " <a class=\"local\" href=\"#H609003423\">",
    " 'Medical therapy'",
    " </a>",
    " above.)",
    " </li>",
    " <li>",
    " Pituitary irradiation is another second-line treatment for persistent or
    recurrent Cushing's disease. Adrenal enzyme inhibitors must be used to control
    hypercortisolism until it is effective in approximately 85 percent of them. (See",
    " <a class=\"local\" href=\"#H6\">",
    " 'Pituitary irradiation'",
    " </a>",
    " above.)",
    " </li>",
    " <li>",
    " Bilateral adrenalectomy is a definitive treatment for ACTH-secreting
    pituitary or ectopic tumors. (See",
    " <a class=\"local\" href=\"#H7\">",
    " 'Adrenalectomy'",
    " </a>",
    " above.)",
    " </li>",
    " <li>",
    " Metastatic or occult ectopic ACTH-secreting tumors may respond to
    somatostatin analog treatment, adrenal enzyme inhibitors or",
    " <a class=\"drug drug_general\" href=\"UTD.htm?15/58/16293?
    source=see_link\">",
    " mitotane",
    " </a>",
    " . (See",
    " <a class=\"local\" href=\"#H9\">",
    " 'Ectopic ACTH and CRH syndromes'",
    " </a>",
    " above.)",
    " </li>",
    " <li>",
    " The physical symptoms and signs of Cushing's syndrome disappear gradually
    over a period of two to 12 months after effective cure of Cushing syndrome.
    Hypertension, osteoporosis and glucose intolerance improve but may not disappear.
    (See",
    " <a class=\"local\" href=\"#H16\">",
    " 'Course after effective therapy'",
    " </a>",
    " above.)",
    " </li>",
    " <li>",
    " Patients may have impaired quality of life for many years despite remission
    of hypercortisolism. However the long-term prognosis of cured patients who had
    benign disease is excellent. The prognosis of patients with malignancy is variable
    and relates to the ability to control hypercortisolism and treat the cancer. (See",
    " <a class=\"local\" href=\"#H17\">",
    " 'Prognosis'",
    " </a>",
    " above and",
    " <a class=\"local\" href=\"#H9\">",
    " 'Ectopic ACTH and CRH syndromes'",
    " </a>",
    " above.)",
    " </li>",
    " </ul>",
    " </p>",
    " </div>",
    " <div id=\"topicAgreement\">",
    " Use of UpToDate is subject to the",
    " <a class=\"licenseLink\" href=\"./license\" id=\"sla_in_page\"
    target=\"_blank\">",
    " Subscription and License Agreement",
    " </a>",
    " .",
    " </div>",
    " <div class=\"headingAnchor\" id=\"references\">",
    " <h1>",
    " REFERENCES",
    " </h1>",
    " <ol id=\"reference\">",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1016/abstract/1\">",
    " Orth DN. Cushing's syndrome. N Engl J Med 1995; 332:791.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1016/abstract/2\">",
    " Orth DN, Liddle GW. Results of treatment in 108 patients with Cushing's
    syndrome. N Engl J Med 1971; 285:243.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1016/abstract/3\">",
    " Biller BM, Grossman AB, Stewart PM, et al. Treatment of adrenocorticotropin-
    dependent Cushing's syndrome: a consensus statement. J Clin Endocrinol Metab 2008;
    93:2454.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1016/abstract/4\">",
    " Kaltsas GA, Mukherjee JJ, Plowman PN, et al. The role of cytotoxic
    chemotherapy in the management of aggressive and malignant pituitary tumors. J Clin
    Endocrinol Metab 1998; 83:4233.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1016/abstract/5\">",
    " Annamalai AK, Dean AF, Kandasamy N, et al. Temozolomide responsiveness in
    aggressive corticotroph tumours: a case report and review of the literature.
    Pituitary 2012; 15:276.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1016/abstract/6\">",
    " Estrada J, Boronat M, Mielgo M, et al. The long-term outcome of pituitary
    irradiation after unsuccessful transsphenoidal surgery in Cushing's disease. N Engl
    J Med 1997; 336:172.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1016/abstract/7\">",
    " Jennings AS, Liddle GW, Orth DN. Results of treating childhood Cushing's
    disease with pituitary irradiation. N Engl J Med 1977; 297:957.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1016/abstract/8\">",
    " Chow JT, Thompson GB, Grant CS, et al. Bilateral laparoscopic adrenalectomy
    for corticotrophin-dependent Cushing's syndrome: a review of the Mayo Clinic
    experience. Clin Endocrinol (Oxf) 2008; 68:513.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1016/abstract/9\">",
    " Aniszewski JP, Young WF Jr, Thompson GB, et al. Cushing syndrome due to
    ectopic adrenocorticotropic hormone secretion. World J Surg 2001; 25:934.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1016/abstract/10\">",
    " Ilias I, Torpy DJ, Pacak K, et al. Cushing's syndrome due to ectopic
    corticotropin secretion: twenty years' experience at the National Institutes of
    Health. J Clin Endocrinol Metab 2005; 90:4955.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1016/abstract/11\">",
    " Isidori AM, Kaltsas GA, Pozza C, et al. The ectopic adrenocorticotropin
    syndrome: clinical features, diagnosis, management, and long-term follow-up. J Clin
    Endocrinol Metab 2006; 91:371.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1016/abstract/12\">",
    " Miller CA, Ellison EC. Therapeutic alternatives in metastatic neuroendocrine
    tumors. Surg Oncol Clin N Am 1998; 7:863.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1016/abstract/13\">",
    " Lehnert T. Liver transplantation for metastatic neuroendocrine carcinoma: an
    analysis of 103 patients. Transplantation 1998; 66:1307.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1016/abstract/14\">",
    " Tabarin A, Catargi B, Chanson P, et al. Pseudo-tumours of the thymus after
    correction of hypercortisolism in patients with ectopic ACTH syndrome: a report of
    five cases. Clin Endocrinol (Oxf) 1995; 42:207.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1016/abstract/15\">",
    " Nieman LK, Chrousos GP, Kellner C, et al. Successful treatment of Cushing's
    syndrome with the glucocorticoid antagonist RU 486. J Clin Endocrinol Metab 1985;
    61:536.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1016/abstract/16\">",
    " von Werder K, Muller OA, Stalla GK. Somatostatin analogs in ectopic
    corticotropin production. Metabolism 1996; 45:129.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1016/abstract/17\">",
    " Bertagna X, Favrod-Coune C, Escourolle H, et al. Suppression of ectopic
    adrenocorticotropin secretion by the long-acting somatostatin analog octreotide. J
    Clin Endocrinol Metab 1989; 68:988.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1016/abstract/18\">",
    " Krenning EP, Kwekkeboom DJ, Bakker WH, et al. Somatostatin receptor
    scintigraphy with [111In-DTPA-D-Phe1]- and [123I-Tyr3]-octreotide: the Rotterdam
    experience with more than 1000 patients. Eur J Nucl Med 1993; 20:716.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1016/abstract/19\">",
    " Oberg K. Established clinical use of octreotide and lanreotide in oncology.
    Chemotherapy 2001; 47 Suppl 2:40.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1016/abstract/20\">",
    " Ur E, Grossman A. Corticotropin-releasing hormone in health and disease: an
    update. Acta Endocrinol (Copenh) 1992; 127:193.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1016/abstract/21\">",
    " Luton JP, Cerdas S, Billaud L, et al. Clinical features of adrenocortical
    carcinoma, prognostic factors, and the effect of mitotane therapy. N Engl J Med
    1990; 322:1195.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1016/abstract/22\">",
    " Wooten MD, King DK. Adrenal cortical carcinoma. Epidemiology and treatment
    with mitotane and a review of the literature. Cancer 1993; 72:3145.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1016/abstract/23\">",
    " Bodie B, Novick AC, Pontes JE, et al. The Cleveland Clinic experience with
    adrenal cortical carcinoma. J Urol 1989; 141:257.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1016/abstract/24\">",
    " Sarlis NJ, Chrousos GP, Doppman JL, et al. Primary pigmented nodular
    adrenocortical disease: reevaluation of a patient with carney complex 27 years
    after unilateral adrenalectomy. J Clin Endocrinol Metab 1997; 82:1274.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1016/abstract/25\">",
    " Porpiglia F, Fiori C, Bovio S, et al. Bilateral adrenalectomy for Cushing's
    syndrome: a comparison between laparoscopy and open surgery. J Endocrinol Invest
    2004; 27:654.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1016/abstract/26\">",
    " Malchoff, CD, MacGillvray, D, Malchoff, DM. Adrenocortical hormone-
    independent adrenal hyperplasia. Endocrinologist 1996; 6:79.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1016/abstract/27\">",
    " Ogura M, Kusaka I, Nagasaka S, et al. Unilateral adrenalectomy improves
    insulin resistance and diabetes mellitus in a patient with ACTH-independent
    macronodular adrenal hyperplasia. Endocr J 2003; 50:715.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1016/abstract/28\">",
    " Lamas C, Alfaro JJ, Lucas T, et al. Is unilateral adrenalectomy an
    alternative treatment for ACTH-independent macronodular adrenal hyperplasia?: Long-
    term follow-up of four cases. Eur J Endocrinol 2002; 146:237.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1016/abstract/29\">",
    " Lacroix A, Hamet P, Boutin JM. Leuprolide acetate therapy in luteinizing
    hormone--dependent Cushing's syndrome. N Engl J Med 1999; 341:1577.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1016/abstract/30\">",
    " Lacroix A, Tremblay J, Rousseau G, et al. Propranolol therapy for ectopic
    beta-adrenergic receptors in adrenal Cushing's syndrome. N Engl J Med 1997;
    337:1429.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1016/abstract/31\">",
    " Lufkin EG, Wahner HW, Bergstralh EJ. Reversibility of steroid-induced
    osteoporosis. Am J Med 1988; 85:887.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1016/abstract/32\">",
    " Hermus AR, Smals AG, Swinkels LM, et al. Bone mineral density and bone
    turnover before and after surgical cure of Cushing's syndrome. J Clin Endocrinol
    Metab 1995; 80:2859.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1016/abstract/33\">",
    " Di Somma C, Pivonello R, Loche S, et al. Effect of 2 years of cortisol
    normalization on the impaired bone mass and turnover in adolescent and adult
    patients with Cushing's disease: a prospective study. Clin Endocrinol (Oxf) 2003;
    58:302.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1016/abstract/34\">",
    " Canalis E, Giustina A. Glucocorticoid-induced osteoporosis: summary of a
    workshop. J Clin Endocrinol Metab 2001; 86:5681.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1016/abstract/35\">",
    " Lindsay JR, Nansel T, Baid S, et al. Long-term impaired quality of life in
    Cushing's syndrome despite initial improvement after surgical remission. J Clin
    Endocrinol Metab 2006; 91:447.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1016/abstract/36\">",
    " Dorn LD, Burgess ES, Friedman TC, et al. The longitudinal course of
    psychopathology in Cushing's syndrome after correction of hypercortisolism. J Clin
    Endocrinol Metab 1997; 82:912.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1016/abstract/37\">",
    " Bourdeau I, Bard C, No&euml;l B, et al. Loss of brain volume in endogenous
    Cushing's syndrome and its reversibility after correction of hypercortisolism. J
    Clin Endocrinol Metab 2002; 87:1949.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1016/abstract/38\">",
    " Forget H, Lacroix A, Cohen H. Persistent cognitive impairment following
    surgical treatment of Cushing's syndrome. Psychoneuroendocrinology 2002; 27:367.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1016/abstract/39\">",
    " Merke DP, Giedd JN, Keil MF, et al. Children experience cognitive decline
    despite reversal of brain atrophy one year after resolution of Cushing syndrome. J
    Clin Endocrinol Metab 2005; 90:2531.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1016/abstract/40\">",
    " Devoe DJ, Miller WL, Conte FA, et al. Long-term outcome in children and
    adolescents after transsphenoidal surgery for Cushing's disease. J Clin Endocrinol
    Metab 1997; 82:3196.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1016/abstract/41\">",
    " PLOTZ CM, KNOWLTON AI, RAGAN C. The natural history of Cushing's syndrome.
    Am J Med 1952; 13:597.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1016/abstract/42\">",
    " J&auml;ger F, J&auml;ger E, Heintz A, Junginger T. Synchronous bilateral
    endoscopic adrenalectomy: experiences after 18 operations. Surg Endosc 2004;
    18:314.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1016/abstract/43\">",
    " Anthony LB, Greco FA. Pneumocystis carinii pneumonia: a complication of
    Cushing's syndrome. Ann Intern Med 1981; 94:488.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1016/abstract/44\">",
    " Graham BS, Tucker WS Jr. Opportunistic infections in endogenous Cushing's
    syndrome. Ann Intern Med 1984; 101:334.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1016/abstract/45\">",
    " Sarlis NJ, Chanock SJ, Nieman LK. Cortisolemic indices predict severe
    infections in Cushing syndrome due to ectopic production of adrenocorticotropin. J
    Clin Endocrinol Metab 2000; 85:42.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1016/abstract/46\">",
    " Van Zaane B, Nur E, Squizzato A, et al. Hypercoagulable state in Cushing's
    syndrome: a systematic review. J Clin Endocrinol Metab 2009; 94:2743.",
    " </a>",
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    " <h1>",
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    " SUMMARY",
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    " <a class=\"outlineLink\" href=\"#H1\">",
    " INTRODUCTION",
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    " GENERAL PRINCIPLES",
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    " EXOGENOUS CUSHING'S SYNDROME",
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    " CUSHING'S DISEASE",
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    " Transsphenoidal surgery",
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    " Medical therapy",
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    " - Aggressive corticotroph tumors",
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    " Pituitary irradiation",
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    " Adrenalectomy",
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    " ECTOPIC ACTH AND CRH SYNDROMES",
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    " <a class=\"outlineLink\" href=\"#H10\">",
    " Glucocorticoid antagonists",
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    " <a class=\"outlineLink\" href=\"#H11\">",
    " Somatostatin analogues",
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    " </li>",
    " <li class=\"bulletItem\">",
    " <a class=\"outlineLink\" href=\"#H12\">",
    " Ectopic CRH secretion",
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    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#H13\">",
    " PRIMARY ADRENAL DISEASES",
    " </a>",
    " </li>",
    " <li class=\"bulletItem\">",
    " <a class=\"outlineLink\" href=\"#H14\">",
    " Adrenal tumors",
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    " </li>",
    " <li class=\"bulletItem\">",
    " <a class=\"outlineLink\" href=\"#H15\">",
    " ACTH-independent bilateral adrenal hyperplasia",
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    " </li>",
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    " <a class=\"outlineLink\" href=\"#H16\">",
    " COURSE AFTER EFFECTIVE THERAPY",
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    " </li>",
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    " <a class=\"outlineLink\" href=\"#H17\">",
    " PROGNOSIS",
    " </a>",
    " </li>",
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    " <a class=\"outlineLink\" href=\"#PATIENT_INFORMATION\">",
    " INFORMATION FOR PATIENTS",
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    " SUMMARY",
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    " REFERENCES",
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    " </li>",
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    " <h1>",
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    " <a class=\"graphic graphic_algorithm\" href=\"UTD.htm?33/49/34589\"
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    " Treatment Cushings disease",
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    " Rx of ectopic ACTH secretion",
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    " <h1>",
    " RELATED TOPICS",
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    " <ul>",
    " <li class=\"plainItem\">",
    " <a class=\"medical medical_review\" href=\"UTD.htm?0/45/730?
    source=related_link\">",
    " Cushing's syndrome due to ACTH-independent macronodular adrenal
    hyperplasia",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"medical medical_review\" href=\"UTD.htm?21/35/22072?
    source=related_link\">",
    " Cushing's syndrome due to primary pigmented nodular adrenocortical disease",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"medical medical_review\" href=\"UTD.htm?30/31/31225?
    source=related_link\">",
    " Establishing the cause of Cushing's syndrome",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"medical medical_review\" href=\"UTD.htm?3/0/3081?
    source=related_link\">",
    " Medical therapy of hypercortisolism (Cushing&rsquo;s syndrome)",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"medical medical_patient\" href=\"UTD.htm?13/19/13619?
    source=related_link\">",
    " Patient information: Cushing's syndrome (Beyond the Basics)",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"medical medical_basics\" href=\"UTD.htm?5/61/6099?
    source=related_link\">",
    " Patient information: Cushing's syndrome (The Basics)",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"medical medical_patient\" href=\"UTD.htm?10/47/10994?
    source=related_link\">",
    " Patient information: Cushing's syndrome treatment (Beyond the Basics)",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"medical medical_review\" href=\"UTD.htm?19/2/19496?
    source=related_link\">",
    " Persistent or recurrent Cushing&rsquo;s disease: Surgical adrenalectomy",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"medical medical_review\" href=\"UTD.htm?22/42/23208?
    source=related_link\">",
    " Pharmacologic use of glucocorticoids",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"medical medical_review\" href=\"UTD.htm?17/36/17994?
    source=related_link\">",
    " Prevention and treatment of glucocorticoid-induced osteoporosis",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"medical medical_review\" href=\"UTD.htm?17/26/17834?
    source=related_link\">",
    " Primary therapy of Cushing's disease: Transsphenoidal surgery and pituitary
    irradiation",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"medical medical_review\" href=\"UTD.htm?25/16/25866?
    source=related_link\">",
    " Therapeutic use and adverse effects of progesterone receptor antagonists and
    selective progesterone receptor modulators",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"medical medical_review\" href=\"UTD.htm?33/37/34390?
    source=related_link\">",
    " Treatment of adrenocortical adenomas",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"medical medical_review\" href=\"UTD.htm?39/51/40762?
    source=related_link\">",
    " Treatment of adrenocortical carcinoma",
    " </a>",
    " </li>",
    " </ul>",
    " </div>",
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    5Cp/F/XY//2Q==);\">",
    " </div>",
    " <div class=\"lgnd\">",
    " Large aggregates of histiocytes forming tight, well-demarcated granulomas are
    present in the dermis. The granulomas lack any signs of caseating necrosis and are
    surrounded by a small number of lymphocytes.",
    " <div class=\"footnotes\">",
    " </div>",
    " <div class=\"reference\">",
    " Courtesy of Shane A Meehan, MD.",
    " </div>",
    " </div>",
    " </div>",
    " </div>",
    "</div>"].join("\n");
    var script_f0_63_1017=[""].join("\n");
    var outline_f0_63_1017=null;
    var title_f0_63_1018="Clinical manifestations and diagnosis of primary
    myelofibrosis";
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    " <div id=\"topicContent\">",
    " <div id=\"topicTitle\">",
    " Clinical manifestations and diagnosis of primary myelofibrosis",
    " </div>",
    " <div id=\"topicContributors\">",
    " <div>",
    " <a id=\"authors\">",
    " </a>",
    " <a class=\"contributor contributor_credentials contributorType\"
    href=\"UTD.htm?0/63/1018/contributors\">",
    " Author",
    " </a>",
    " <br/>",
    " <a class=\"contributor contributor_credentials\" href=\"UTD.htm?
    0/63/1018/contributors\">",
    " Ayalew Tefferi, MD",
    " </a>",
    " <br/>",
    " </div>",
    " <div>",
    " <a class=\"contributor contributor_credentials contributorType\"
    href=\"UTD.htm?0/63/1018/contributors\">",
    " Section Editor",
    " </a>",
    " <br/>",
    " <a class=\"contributor contributor_credentials\" href=\"UTD.htm?
    0/63/1018/contributors\">",
    " Richard A Larson, MD",
    " </a>",
    " <br/>",
    " </div>",
    " <div>",
    " <a class=\"contributor contributor_credentials contributorType\"
    href=\"UTD.htm?0/63/1018/contributors\">",
    " Deputy Editor",
    " </a>",
    " <br/>",
    " <a class=\"contributor contributor_credentials\" href=\"UTD.htm?
    0/63/1018/contributors\">",
    " Stephen A Landaw, MD, PhD",
    " </a>",
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    " peer review process",
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    " <span class=\"emphasis\">",
    " Literature review current through:",
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    " Oct 2013.",
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    " This topic last updated:",
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    " Jan 31, 2013.",
    " </div>",
    " <div id=\"topicText\">",
    " <p class=\"headingAnchor\" id=\"H1\">",
    " <span class=\"h1\">",
    " INTRODUCTION",
    " </span>",
    " &nbsp;&mdash;&nbsp;Primary myelofibrosis (PMF) [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/1,2\">",
    " 1,2",
    " </a>",
    " ], previously called chronic idiopathic myelofibrosis (CIMF) in the 2001 WHO
    classification [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/3\">",
    " 3",
    " </a>",
    " ], and also known as agnogenic myeloid metaplasia, is one of the chronic
    myeloproliferative disorders, which are collectively characterized by clonal
    proliferation of myeloid cells with variable morphologic maturity and hematopoietic
    efficiency (",
    " <a class=\"graphic graphic_figure graphicRef56283 \" href=\"UTD.htm?
    24/16/24835\">",
    " figure 1",
    " </a>",
    " )&nbsp;[",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/1,4\">",
    " 1,4",
    " </a>",
    " ].",
    " </p>",
    " <p>",
    " Acute myelofibrosis, a term that has been applied to the clinical picture
    occasionally seen in patients with acute megakaryoblastic leukemia (FAB M7), is
    discussed separately. (See",
    " <a class=\"medical medical_review\" href=\"UTD.htm?38/50/39720?
    source=see_link\">",
    " \"Classification of acute myeloid leukemia\"",
    " </a>",
    " .)",
    " </p>",
    " <p>",
    " The clinical manifestations and diagnosis of PMF will be reviewed here [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/5,6\">",
    " 5,6",
    " </a>",
    " ]. The pathogenetic mechanisms, prognosis, and treatment of this disorder are
    discussed separately. (See",
    " <a class=\"medical medical_review\" href=\"UTD.htm?24/30/25064?
    source=see_link\">",
    " \"Pathogenetic mechanisms in primary myelofibrosis\"",
    " </a>",
    " and",
    " <a class=\"medical medical_review\" href=\"UTD.htm?36/3/36922?
    source=see_link\">",
    " \"Prognosis and treatment of primary myelofibrosis\"",
    " </a>",
    " .)",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H2\">",
    " <span class=\"h1\">",
    " EPIDEMIOLOGY",
    " </span>",
    " &nbsp;&mdash;&nbsp;PMF is the least frequent among the chronic
    myeloproliferative diseases (CMPDs). One study reported an estimated incidence of
    1.5 per 100,000 per year in Olmsted County, Minnesota [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/7\">",
    " 7",
    " </a>",
    " ]. This incidence figure is higher than those reported from western Australia
    and northern Israel.",
    " </p>",
    " <p>",
    " PMF occurs mainly in middle aged and elderly patients. The median age at
    presentation is 67 years [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/7\">",
    " 7",
    " </a>",
    " ]. Approximately 5 and 17 percent of the patients are diagnosed before the age
    of 40 and 50 years, respectively [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/8\">",
    " 8",
    " </a>",
    " ]. The condition is rare in childhood [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/9\">",
    " 9",
    " </a>",
    " ]; a familial occurrence has been reported in several kindreds. Both the
    familial and the idiopathic forms in childhood may be associated with congenital
    anomalies and chromosome abnormalities [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/10,11\">",
    " 10,11",
    " </a>",
    " ].",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H3\">",
    " <span class=\"h1\">",
    " CLINICAL MANIFESTATIONS",
    " </span>",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H4\">",
    " <span class=\"h2\">",
    " Signs and symptoms",
    " </span>",
    " &nbsp;&mdash;&nbsp;The most common presenting complaint is that of severe
    fatigue, occurring in 50 to 70 percent of patients (",
    " <a class=\"graphic graphic_table graphicRef75473 \" href=\"UTD.htm?
    41/62/42987\">",
    " table 1",
    " </a>",
    " ) [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/7,8,12-15\">",
    " 7,8,12-15",
    " </a>",
    " ]. Symptoms due to an enlarged spleen have been described in 25 to 50 percent
    of patients, while a smaller number note weight loss and 5 to 20 percent experience
    other signs of a hypermetabolic state such as low-grade fever and night sweats [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/8,14\">",
    " 8,14",
    " </a>",
    " ]. Approximately 15 to 30 percent are asymptomatic, with the diagnosis being
    made during investigation of splenomegaly (occurring in at least 90 percent of
    patients), hepatomegaly (40 to 70 percent), or abnormal blood findings [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/8,14,15\">",
    " 8,14,15",
    " </a>",
    " ]. Enlargement of the spleen and liver are due to the marked extramedullary
    hematopoiesis associated with PMF.",
    " </p>",
    " <p>",
    " <ul class=\"bullet-block\">",
    " <li>",
    " <strong>",
    " Pulmonary hypertension",
    " </strong>",
    " &mdash; Pulmonary hypertension has been detected in patients with AMM; while
    often asymptomatic, it has been associated with reduced overall survival [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/16-18\">",
    " 16-18",
    " </a>",
    " ].",
    " </li>",
    " <li>",
    " <strong>",
    " Pruritus",
    " </strong>",
    " &mdash; In our series of 566 consecutive patients with PMF, pruritus was
    documented in 16 percent [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/19\">",
    " 19",
    " </a>",
    " ]. This symptom did not correlate with karyotype, risk category, overall
    survival, leukemic transformation, or plasma levels of 20 cytokines known to be
    abnormally expressed in PMF.",
    " </li>",
    " </ul>",
    " </p>",
    " <p>",
    " A symptom assessment form has been devised for measuring clinical improvement
    in therapeutic trials [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/20\">",
    " 20",
    " </a>",
    " ].",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H19956477\">",
    " <span class=\"h3\">",
    " Thrombotic events",
    " </span>",
    " &nbsp;&mdash;&nbsp;The incidence of arterial and venous thrombotic events in
    PMF (2 per 100 patient-years) is approximately the same as that seen in ET (1 to",
    " <span class=\"nowrap\">",
    " 3/100",
    " </span>",
    " patient-years), and significantly lower than that seen in PV",
    " <span class=\"nowrap\">",
    " (5.5/100",
    " </span>",
    " patient-years) [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/21\">",
    " 21",
    " </a>",
    " ]. In a retrospective analysis of 205 patients with PMF, 13.2 percent had
    experienced a thrombotic event at or prior to their diagnosis, and 10.7 percent
    developed post-diagnosis thrombosis at a median follow-up of 31 months [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/22\">",
    " 22",
    " </a>",
    " ]. On multivariate analysis, a history of thrombosis was the only predictive
    variable; 71 percent of the venous events were temporally associated with other
    exogenous risk factors for thrombosis (eg, surgery, line placement, hormonal
    therapy).",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H5\">",
    " <span class=\"h2\">",
    " Splenomegaly",
    " </span>",
    " &nbsp;&mdash;&nbsp;Splenomegaly, often marked, is the hallmark of AMM [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/23\">",
    " 23",
    " </a>",
    " ]. The spleen may be so large that its lower border is below the pelvic brim
    and its right border extends across the midline. In two series, 38 percent of
    patients had splenomegaly that extended more than 10 cm below the left costal
    margin [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/24\">",
    " 24",
    " </a>",
    " ] and 23 percent had massive splenomegaly that extended over 16 cm below the
    left costal margin [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/8\">",
    " 8",
    " </a>",
    " ].",
    " </p>",
    " <p>",
    " Symptoms due to splenic disease often figure prominently in PMF. Patients may
    note a dragging sensation in the left upper abdomen, and the spleen may compress
    the patient's stomach, leading to early satiety. Severe left upper quadrant pain,
    with or without left shoulder pain, may result from multiple",
    " <span class=\"nowrap\">",
    " and/or",
    " </span>",
    " recurrent episodes of splenic infarction or perisplenitis.",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H6\">",
    " <span class=\"h2\">",
    " Hepatomegaly",
    " </span>",
    " &nbsp;&mdash;&nbsp;Palpable hepatomegaly is present in 40 to 70 percent of
    patients. Portal hypertension may develop as a result of increased splanchnic flow
    due to splenomegaly",
    " <span class=\"nowrap\">",
    " and/or",
    " </span>",
    " intrahepatic obstruction associated with extramedullary hematopoiesis [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/25\">",
    " 25",
    " </a>",
    " ]. Complications include ascites, esophageal and gastric varices,
    gastrointestinal bleeding and hepatic encephalopathy.",
    " </p>",
    " <p>",
    " Portal vein thrombosis is a recognized complication of PMF and other chronic
    myeloproliferative disorders [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/25\">",
    " 25",
    " </a>",
    " ] and may precede the clinical onset of the disease [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/26\">",
    " 26",
    " </a>",
    " ]. (See",
    " <a class=\"medical medical_review\" href=\"UTD.htm?34/43/35514?
    source=see_link\">",
    " \"Hypercoagulable disorders associated with malignancy\"",
    " </a>",
    " .)",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H7\">",
    " <span class=\"h2\">",
    " Extramedullary hematopoiesis",
    " </span>",
    " &nbsp;&mdash;&nbsp;Foci of extramedullary hematopoiesis (EMH) may occur in
    almost any organ [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/27-29\">",
    " 27-29",
    " </a>",
    " ]. Organ involvement may present as splenomegaly, hepatomegaly,
    lymphadenopathy, pleural, pericardial or abdominal effusions, or involvement of the
    gastrointestinal or genitourinary tracts or lung, leading to symptoms such as
    dysuria and respiratory distress [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/30-33\">",
    " 30-33",
    " </a>",
    " ]. Involvement of the central nervous system may be associated with increased
    intracranial pressure, altered sensorium, motor and sensory impairment, including
    cord compression [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/34,35\">",
    " 34,35",
    " </a>",
    " ].",
    " </p>",
    " <p>",
    " Involvement of the skin is rare, but may present as erythematous plaques,
    nodules, erythema, ulcers or bullae [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/36\">",
    " 36",
    " </a>",
    " ]. In a literature review of 13 such cases, nine showed that all three
    hematopoietic cell lines (myeloid, erythroid, and megakaryocytic) were present in
    these lesions [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/37\">",
    " 37",
    " </a>",
    " ].",
    " </p>",
    " <p>",
    " In our series of 27 patients with an antemortem diagnosis of extramedullary
    hematopoiesis other than in the liver or spleen, involved sites were as follows [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/29\">",
    " 29",
    " </a>",
    " ]:",
    " </p>",
    " <p>",
    " <ul class=\"bulletCompact-block\">",
    " <li>",
    " In or surrounding the vertebral column (especially thoracic) &mdash; 7",
    " </li>",
    " <li>",
    " Lymph nodes &mdash; 4",
    " </li>",
    " <li>",
    " Retroperitoneum &mdash; 4",
    " </li>",
    " <li>",
    " Lungs or pleura &mdash; 3",
    " </li>",
    " <li>",
    " Genitourinary system &mdash; 2",
    " </li>",
    " <li>",
    " Skin &mdash; 2",
    " </li>",
    " <li>",
    " Other sites (thalamus, right atrium, mouth, muscle, bowel) &mdash; 5",
    " </li>",
    " </ul>",
    " </p>",
    " <p>",
    " Foci of EMH may develop",
    " <span class=\"nowrap\">",
    " and/or",
    " </span>",
    " enlarge significantly after splenectomy, perhaps due to the loss of filtering
    function of the spleen [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/38,39\">",
    " 38,39",
    " </a>",
    " ]. This may be especially critical in the liver [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/32,40\">",
    " 32,40",
    " </a>",
    " ]. As an example, a study of 10 patients with PMF undergoing splenectomy found
    hepatic EMH in all those in whom an intraoperative liver biopsy was performed [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/40\">",
    " 40",
    " </a>",
    " ]. Following splenectomy, a significant increase in liver size and in serum
    concentrations of alkaline phosphatase, bilirubin,",
    " <span class=\"nowrap\">",
    " and/or",
    " </span>",
    " gamma-glutamyl transpeptidase were seen in all patients. Two patients
    developed acute liver failure and died three and four weeks postsplenectomy. In
    contrast, no liver changes were observed in 10 patients with chronic myeloid
    leukemia who also underwent splenectomy. (See",
    " <a class=\"medical medical_review\" href=\"UTD.htm?36/3/36922?
    source=see_link&amp;anchor=H15#H15\">",
    " \"Prognosis and treatment of primary myelofibrosis\", section on
    'Splenectomy'",
    " </a>",
    " .)",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H8\">",
    " <span class=\"h2\">",
    " Bone and joint involvement",
    " </span>",
    " &nbsp;&mdash;&nbsp;A number of skeletal changes may accompany the marrow
    fibrosis in PMF. These abnormalities may be asymptomatic but can cause severe bone
    and joint tenderness or pain, especially in the lower extremities, that is
    difficult to treat.",
    " </p>",
    " <p>",
    " <ul class=\"bullet-block\">",
    " <li>",
    " Osteosclerosis is characterized by a diffuse or patchy increase in bone
    density on radiologic studies and increased prominence of bony trabeculae. A
    mottled radiographic appearance of the bone has been described in 25 to 66 percent
    of patients with PMF [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/14\">",
    " 14",
    " </a>",
    " ]. This pattern may be confused with metastatic carcinoma.",
    " </li>",
    " <li>",
    " Periostitis can lead to debilitating bony pain.",
    " </li>",
    " <li>",
    " Cortical bone blood flow is considerably increased in PMF, resulting in
    a \"superscan\" phenomenon on bone scintigraphy. It is often clinically evident as
    an increase in warmth over the tibiae and knees.",
    " </li>",
    " <li>",
    " Secondary gout due to chronic overproduction of uric acid can lead to acute
    monoarticular or chronic polyarticular arthritis. (See",
    " <a class=\"medical medical_review\" href=\"UTD.htm?4/49/4890?
    source=see_link\">",
    " \"Clinical manifestations and diagnosis of gout\"",
    " </a>",
    " .)",
    " </li>",
    " <li>",
    " Osteolytic lesions are rare, and usually reflect the presence of a solitary
    myeloid sarcoma, also called granulocytic sarcoma or chloroma [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/41\">",
    " 41",
    " </a>",
    " ]. (See",
    " <a class=\"medical medical_review\" href=\"UTD.htm?19/58/20393?
    source=see_link&amp;anchor=H11#H11\">",
    " \"Clinical manifestations, pathologic features, and diagnosis of acute
    myeloid leukemia\", section on 'Myeloid sarcoma'",
    " </a>",
    " .)",
    " </li>",
    " </ul>",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H9\">",
    " <span class=\"h1\">",
    " LABORATORY FINDINGS",
    " </span>",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H10\">",
    " <span class=\"h2\">",
    " Anemia",
    " </span>",
    " &nbsp;&mdash;&nbsp;Anemia with hemoglobin less than 10",
    " <span class=\"nowrap\">",
    " g/dL",
    " </span>",
    " is seen in approximately 50 percent of patients with PMF and 20 percent
    present with a hemoglobin less than 8",
    " <span class=\"nowrap\">",
    " g/dL",
    " </span>",
    " [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/8\">",
    " 8",
    " </a>",
    " ]. The causes are multiple and include:",
    " </p>",
    " <p>",
    " <ul class=\"bulletCompact-block\">",
    " <li>",
    " Reduction in medullary erythropoietic sites",
    " </li>",
    " <li>",
    " Ineffective erythropoiesis associated with extramedullary sites of red blood
    cell (RBC) production",
    " </li>",
    " <li>",
    " Splenic sequestration and destruction of circulating RBCs",
    " </li>",
    " <li>",
    " Bleeding due to thrombocytopenia or other complications such as varices
    resulting from portal vein thrombosis",
    " </li>",
    " <li>",
    " Autoimmune hemolysis",
    " </li>",
    " <li>",
    " Dilutional \"anemia\" may be present in patients with large spleens and
    expanded plasma volumes, but normal red blood cell mass.",
    " </li>",
    " <li>",
    " Influence of thrombopoietin receptor (Mpl) mutations [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/42\">",
    " 42",
    " </a>",
    " ]",
    " </li>",
    " </ul>",
    " </p>",
    " <p>",
    " One or more of the above mechanisms may be responsible for anemia in any
    particular patient. A number of isotopic techniques are available for assessment of
    these mechanisms but are rarely used [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/43\">",
    " 43",
    " </a>",
    " ].",
    " </p>",
    " <p>",
    " After the onset of anemia, most patients experience a progressive decline in
    the hemoglobin concentration, requiring frequent red blood cell transfusions. The
    peripheral smear is quite characteristic, showing anisocytosis (ie, red cells of
    varying size), poikilocytosis (ie, red cells of varying shape), teardrop-shaped red
    blood cells (dacrocytes), nucleated red blood cells, and variable degrees of
    polychromasia (",
    " <a class=\"graphic graphic_picture graphicRef68110 \" href=\"UTD.htm?
    29/43/30390\">",
    " picture 1",
    " </a>",
    " and",
    " <a class=\"graphic graphic_picture graphicRef55274 \" href=\"UTD.htm?
    42/37/43606\">",
    " picture 2",
    " </a>",
    " ). Why dacrocytes form in PMF is not understood; splenectomy and chemotherapy
    reduce, but do not eliminate, the number of such cells in the circulation [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/44,45\">",
    " 44,45",
    " </a>",
    " ].",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H11\">",
    " <span class=\"h2\">",
    " Platelet and white blood cell abnormalities",
    " </span>",
    " &nbsp;&mdash;&nbsp;The platelet and white blood cell (WBC) counts are variable
    in PMF. Marked leukocytosis (WBC",
    " <span class=\"nowrap\">",
    " &gt;30,000/&micro;L)",
    " </span>",
    " and thrombocytosis (platelet count",
    " <span class=\"nowrap\">",
    " &gt;500,000/&micro;L)",
    " </span>",
    " occur at diagnosis in approximately 11 and 13 percent of patients,
    respectively, while leukopenia and thrombocytopenia are seen in 8 and 26 percent,
    respectively [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/8,24\">",
    " 8,24",
    " </a>",
    " ]. The variable leukocyte count reflects variation in the number of
    neutrophils. Immature cells from the neutrophilic series are always present as part
    of the leukoerythroblastic blood picture and myeloblasts may be seen in the
    peripheral smear, usually amounting to less than 5 percent of the total WBC count
    (",
    " <a class=\"graphic graphic_picture graphicRef68110 \" href=\"UTD.htm?
    29/43/30390\">",
    " picture 1",
    " </a>",
    " ). Hypersegmented neutrophils may also be seen (",
    " <a class=\"graphic graphic_picture graphicRef58820 \" href=\"UTD.htm?
    4/47/4854\">",
    " picture 3",
    " </a>",
    " ).",
    " </p>",
    " <p>",
    " Thrombocytopenia becomes more common with disease progression. Platelets may
    be abnormally large with altered granulation; in addition, fragmented
    megakaryocytes are also seen on the peripheral smear. Abnormal platelet function is
    common [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/46\">",
    " 46",
    " </a>",
    " ] although the correlation between these abnormalities and clinical bleeding
    is weak.",
    " </p>",
    " <p>",
    " Bleeding complications are usually associated with thrombocytopenia,
    esophageal or gastric varices, the use of nonsteroidal antiinflammatory drug,",
    " <span class=\"nowrap\">",
    " and/or",
    " </span>",
    " acquired deficiency of factor V [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/47\">",
    " 47",
    " </a>",
    " ]. A few patients have mild prolongation of the prothrombin and partial
    thromboplastin times along with decreased levels of factor V and VIII. Laboratory
    features of disseminated intravascular coagulation (DIC) may accompany these
    abnormalities and may not be apparent until surgery is performed.",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H12\">",
    " <span class=\"h3\">",
    " Circulating CD34+ cells",
    " </span>",
    " &nbsp;&mdash;&nbsp;In an Italian multicenter study, the median absolute number
    of circulating CD34+ hematopoietic precursor cells in 84 consecutive patients with
    PMF (92 CD34+",
    " <span class=\"nowrap\">",
    " cells/microL;",
    " </span>",
    " range: 0 to 2460) was 400 times that of healthy normal subjects (normal range:
    0.15 to 0.35",
    " <span class=\"nowrap\">",
    " cells/microL)",
    " </span>",
    " [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/48\">",
    " 48",
    " </a>",
    " ]. A value of 15 CD34+",
    " <span class=\"nowrap\">",
    " cells/microL",
    " </span>",
    " in patients not on therapy could be used diagnostically to separate patients
    with PMF from those with Ph chromosome-negative chronic myeloproliferative
    diseases, with positive and negative predictive values of 98 and 85 percent,
    respectively.",
    " </p>",
    " <p>",
    " In this study, CD34+ counts progressively increased as disease severity
    increased; overall survival and the interval to blast crisis were significantly
    shorter in patients with &gt;300 CD34+",
    " <span class=\"nowrap\">",
    " cells/microL.",
    " </span>",
    " However, our serial studies in 94 patients did not support an independent
    prognostic value for peripheral blood CD34 counts in PMF [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/49\">",
    " 49",
    " </a>",
    " ].",
    " </p>",
    " <p>",
    " Circulating endothelial progenitor cells with CD34, CD133, and VEGF receptor-2
    positivity have also been detected in patients with PMF [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/50\">",
    " 50",
    " </a>",
    " ]. Their significance is unclear.",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H13\">",
    " <span class=\"h2\">",
    " Abnormal laboratory tests",
    " </span>",
    " &nbsp;&mdash;&nbsp;Patients with PMF may have nonspecific abnormalities in a
    variety of laboratory tests. These include: elevations in the serum concentrations
    of alkaline phosphatase, lactate dehydrogenase, uric acid, leukocyte alkaline
    phosphatase, and vitamin B12 [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/51,52\">",
    " 51,52",
    " </a>",
    " ]. The increase in alkaline phosphatase may be due to liver involvement or
    bone disease, the increase in lactate dehydrogenase may result from ineffective
    hematopoiesis , hyperuricemia is due to enhanced turnover of hematopoietic tissue
    and can cause gout or uric acid stones, and the increase in serum vitamin B12
    reflects an increased neutrophil mass.",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H14\">",
    " <span class=\"h2\">",
    " Bone marrow examination",
    " </span>",
    " &nbsp;&mdash;&nbsp;There are a number of methodologies available for
    evaluation of marrow involvement in patients with PMF; although, as will be
    described in the next section, the diagnosis is often strongly suspected from the
    clinical presentation alone. Furthermore, the bone marrow may not reveal extensive
    replacement of the marrow by fibrosis, which is considered to be the hallmark of
    the disease.",
    " </p>",
    " <p>",
    " Marrow can be aspirated",
    " <span class=\"nowrap\">",
    " and/or",
    " </span>",
    " biopsied directly, and it can be imaged with magnetic resonance imaging (MRI)
    or scintigraphy. These techniques can be used for initial diagnosis and prognosis,
    and for monitoring the course of the disease.",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H15\">",
    " <span class=\"h3\">",
    " Bone marrow aspiration",
    " </span>",
    " &nbsp;&mdash;&nbsp;The bone marrow in PMF is often difficult to aspirate,
    usually yielding a \"dry\" tap. In addition, the results of aspiration alone, if
    successful, are not diagnostic. The most common findings are neutrophilic and
    megakaryocytic hyperplasia.",
    " </p>",
    " <p>",
    " Megakaryocytes are often morphologically abnormal with both micro- and macro-
    megakaryocytes. Granulocytes may show hyperlobulation, and erythroid precursors may
    be normal or increased. These morphologic changes in megakaryocytes help to
    distinguish",
    " <span class=\"nowrap\">",
    " early/prefibrotic",
    " </span>",
    " PMF from essential thrombocythemia. (See",
    " <a class=\"local\" href=\"#H22\">",
    " 'Other chronic myeloproliferative disorders'",
    " </a>",
    " below.)",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H16\">",
    " <span class=\"h3\">",
    " Bone marrow biopsy",
    " </span>",
    " &nbsp;&mdash;&nbsp;Bone marrow biopsy is necessary to demonstrate fibrosis (",
    " <a class=\"graphic graphic_picture graphicRef57384 \" href=\"UTD.htm?
    17/34/17961\">",
    " picture 4",
    " </a>",
    " ) [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/53-55\">",
    " 53-55",
    " </a>",
    " ]. Some degree of fibrosis is seen in almost all patients; the fibrosis is
    typically extensive and visualized better with a silver stain (reticulin) or a
    trichrome stain (mature collagen) (",
    " <a class=\"graphic graphic_picture graphicRef69139 \" href=\"UTD.htm?
    24/19/24886\">",
    " picture 5",
    " </a>",
    " ). Bone marrow sinusoids are expanded and there is intravascular
    hematopoiesis. The fibrosis is generally associated with atypical megakaryocytic
    hyperplasia and thickening and distortion of the bony trabeculae
    (osteosclerosis).",
    " </p>",
    " <p>",
    " In some patients, however, the bone marrow is markedly hypercellular with
    scant bone marrow fibrosis; this is called the cellular phase of PMF. The diagnosis
    of PMF in this setting is made from the clinical and peripheral smear findings
    after chronic myeloid leukemia and polycythemia vera have been excluded.",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H17\">",
    " <span class=\"h3\">",
    " Bone marrow imaging with MRI",
    " </span>",
    " &nbsp;&mdash;&nbsp;The major source of the MRI signal from bone is the fat and
    water content of bone marrow, with little or no signal arising from bone or normal
    marrow cells. Thus, MRI can demonstrate conversion of fatty marrow (intense or
    bright signal) to cellular",
    " <span class=\"nowrap\">",
    " and/or",
    " </span>",
    " fibrotic marrow (markedly low intensity signal) [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/56,57\">",
    " 56,57",
    " </a>",
    " ]. However, the value of this technique for replacing bone marrow biopsy or
    for staging or prognostic purposes is not clear [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/58\">",
    " 58",
    " </a>",
    " ].",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H18\">",
    " <span class=\"h3\">",
    " Isotopic marrow imaging",
    " </span>",
    " &nbsp;&mdash;&nbsp;Erythropoietically-active marrow can be directly imaged
    using isotopes of iron (Fe-52 or Fe-59) or indium (In-111) [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/59\">",
    " 59",
    " </a>",
    " ]. These techniques may be useful for determining patterns of marrow loss,
    extension into the long bones, or sites of extramedullary erythropoiesis.",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H19\">",
    " <span class=\"h2\">",
    " JAK2 gene mutation",
    " </span>",
    " &nbsp;&mdash;&nbsp;In multiple reports, 43 to 63 percent of patients with PMF
    have shown presence of the JAK2 V617F gene mutation, a mutation also seen in
    virtually all patients with PV and in approximately 50 percent of those with ET.
    (See",
    " <a class=\"medical medical_review\" href=\"UTD.htm?20/52/21322?
    source=see_link&amp;anchor=H12#H12\">",
    " \"Overview of the myeloproliferative neoplasms\", section on 'Mutations in
    PV, ET, and PMF'",
    " </a>",
    " .)",
    " </p>",
    " <p>",
    " Presence of this mutation and its allele burden, and their relationship to
    clinical manifestations, overall survival, and leukemic transformation are under
    active investigation [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/60-67\">",
    " 60-67",
    " </a>",
    " ]. (See",
    " <a class=\"medical medical_review\" href=\"UTD.htm?36/3/36922?
    source=see_link&amp;anchor=H5#H5\">",
    " \"Prognosis and treatment of primary myelofibrosis\", section on 'JAK2
    mutational burden'",
    " </a>",
    " .)",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H20\">",
    " <span class=\"h1\">",
    " TRANSFORMATION TO ACUTE LEUKEMIA",
    " </span>",
    " &nbsp;&mdash;&nbsp;Acute leukemia occurs as a terminal event in a minority of
    patients with PMF, many of whom have not had prior treatment with alkylating agents
    or radiotherapy [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/68-72\">",
    " 68-72",
    " </a>",
    " ]. Most of the leukemic transformations have been of myeloid origin; however,
    lymphoid, erythroid, megakaryocytic, and mixed lineage leukemias have occasionally
    been described. Localized foci of leukemic blasts (ie, myeloid sarcoma, also called
    granulocytic sarcoma or chloroma) are rarely seen in PMF.",
    " </p>",
    " <p>",
    " The largest reported experience comes from our series of 2333 consecutive
    patients with PMF, 91 of whom (3.9 percent) fulfilled criteria for acute leukemic
    transformation; all were myeloid in origin [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/68\">",
    " 68",
    " </a>",
    " ]. A clonal abnormality was present in 49 of the 51 patients in whom
    cytogenetic studies were performed, and karyotypic evolution was documented in the
    majority of patients with serial studies.",
    " </p>",
    " <p>",
    " In a separate analysis of 311 patients with PMF, the following two factors at
    the time of diagnosis were independent predictors of leukemic transformation [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/73\">",
    " 73",
    " </a>",
    " ]:",
    " </p>",
    " <p>",
    " <ul class=\"bulletCompact-block\">",
    " <li>",
    " Circulating blasts &ge;3 percent",
    " </li>",
    " <li>",
    " Platelet count",
    " <span class=\"nowrap\">",
    " &lt;100,000/microL",
    " </span>",
    " </li>",
    " </ul>",
    " </p>",
    " <p>",
    " In this series, 77, 19, and 4 percent of patients had none, one, or both of
    these risk factors, respectively, with rates of leukemic transformation of 6, 18,
    and 18 percent, respectively. Treatment-related factors included use of an
    erythropoiesis-stimulating agent and",
    " <a class=\"drug drug_general\" href=\"UTD.htm?26/0/26629?source=see_link\">",
    " danazol",
    " </a>",
    " .",
    " </p>",
    " <p>",
    " Establishing the presence of leukemic transformation in PMF is often
    difficult, primarily because abnormal cell counts and immature cells in the
    peripheral blood are part of the disease process. Furthermore, bone marrow biopsy
    may not reveal clear evidence of leukemia. In such patients, the diagnosis is
    established from tissue leukemic deposits or at autopsy.",
    " </p>",
    " <p>",
    " Leukemic transformation is associated with a poor prognosis. In our series of
    91 patients, treatment with AML-like induction therapy yielded a complete remission
    rate of zero and a treatment-related mortality of 33 percent [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/68\">",
    " 68",
    " </a>",
    " ]. Overall survival was dismal, with a median survival of 2.6 months (range: 0
    to 24 months), and was similarly poor for patients receiving induction
    chemotherapy, low-intensity chemotherapy, or supportive care alone. (See",
    " <a class=\"medical medical_review\" href=\"UTD.htm?27/56/28554?
    source=see_link&amp;anchor=H6#H6\">",
    " \"Prognosis and treatment of polycythemia vera\", section on 'Acute
    leukemia/MDS'",
    " </a>",
    " .)",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H21\">",
    " <span class=\"h1\">",
    " DIFFERENTIAL DIAGNOSIS",
    " </span>",
    " &nbsp;&mdash;&nbsp;There are several other causes of bone marrow fibrosis that
    should be considered before the diagnosis of PMF is confirmed (",
    " <a class=\"graphic graphic_table graphicRef64288 \" href=\"UTD.htm?
    42/22/43371\">",
    " table 2",
    " </a>",
    " ). The diagnosis of PMF is generally tenable if and only if the patient
    shows",
    " <strong>",
    " all",
    " </strong>",
    " of the following features on initial presentation (",
    " <a class=\"graphic graphic_table graphicRef51995 \" href=\"UTD.htm?
    24/59/25531\">",
    " table 3",
    " </a>",
    " ):",
    " </p>",
    " <p>",
    " <ul class=\"bulletCompact-block\">",
    " <li>",
    " Nucleated RBCs in the peripheral blood",
    " </li>",
    " <li>",
    " Teardrop RBCs in the peripheral blood smear",
    " </li>",
    " <li>",
    " Early WBC forms in the peripheral blood",
    " </li>",
    " <li>",
    " Palpable splenomegaly",
    " </li>",
    " </ul>",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H22\">",
    " <span class=\"h2\">",
    " Other chronic myeloproliferative disorders",
    " </span>",
    " &nbsp;&mdash;&nbsp;PMF must be distinguished from the other chronic
    myeloproliferative neoplasms (MPNs) (",
    " <a class=\"graphic graphic_figure graphicRef56283 \" href=\"UTD.htm?
    24/16/24835\">",
    " figure 1",
    " </a>",
    " ). CML, myelodysplastic syndrome (MDS), and mast cell disease may be
    accompanied by substantial bone marrow fibrosis [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/51,74-78\">",
    " 51,74-78",
    " </a>",
    " ]. It is therefore imperative that careful morphologic and cytogenetic
    examination be carried out before a diagnosis of PMF is made [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/54,55\">",
    " 54,55",
    " </a>",
    " ]:",
    " </p>",
    " <p>",
    " <ul class=\"bullet-block\">",
    " <li>",
    " Demonstration of the Philadelphia (Ph) chromosome by conventional
    cytogenetics or the",
    " <span class=\"nowrap\">",
    " bcr/abl",
    " </span>",
    " fusion signal by fluorescence in situ hybridization (FISH) mandates a
    diagnosis of CML. (See",
    " <a class=\"medical medical_review\" href=\"UTD.htm?30/49/31512?
    source=see_link\">",
    " \"Molecular genetics of chronic myeloid leukemia\"",
    " </a>",
    " .)",
    " </li>",
    " <li>",
    " The presence of dyserythropoiesis (dysplastic bone marrow hyperplasia or
    even occasional hypoplasia, associated with variable degrees of peripheral blood
    cytopenia with or without monocytosis) suggests a diagnosis of MDS, especially in
    the absence of splenomegaly [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/75,76\">",
    " 75,76",
    " </a>",
    " ]. Chronic myelomonocytic leukemia (CMML), has features of both MDS and MPN,
    with dysplastic changes, monocytosis, hepatosplenomegaly, and lymphadenopathy.
    (See",
    " <a class=\"medical medical_review\" href=\"UTD.htm?40/57/41882?
    source=see_link&amp;anchor=H64021195#H64021195\">",
    " \"Clinical manifestations and diagnosis of the myelodysplastic syndromes\",
    section on 'Chronic myelomonocytic leukemia'",
    " </a>",
    " .)",
    " </li>",
    " <li>",
    " The traditional group of Ph-negative chronic myeloproliferative neoplasms
    includes PMF, polycythemia vera (PV), and essential thrombocythemia (ET) [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/79\">",
    " 79",
    " </a>",
    " ]. Among these three disorders, PV is readily identified by the presence of
    an increased red cell mass. The differentiation between PMF and ET is dependent
    primarily on bone marrow morphology, the degree of bone marrow fibrosis and
    splenomegaly, and the presence of peripheral blood leukoerythroblastosis in PMF [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/80\">",
    " 80",
    " </a>",
    " ]. (See",
    " <a class=\"medical medical_review\" href=\"UTD.htm?9/32/9738?
    source=see_link\">",
    " \"Diagnostic approach to the patient with suspected polycythemia vera\"",
    " </a>",
    " .)",
    " </li>",
    " <li>",
    " <strong>",
    " Prefibrotic PMF",
    " </strong>",
    " &mdash;",
    " <span class=\"nowrap\">",
    " Early/prefibrotic",
    " </span>",
    " PMF can mimic ET in its presentation; careful morphologic examination is
    necessary for distinguishing between the two. Megakaryocytes are large and mature-
    appearing in ET, while those in prefibrotic PMF display abnormal maturation with
    hyperchromatic and irregularly folded nuclei [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/6,81\">",
    " 6,81",
    " </a>",
    " ]. This distinction is important since, in two studies, thrombotic
    complications, overall survival, leukemic transformation, and rates of progression
    to overt myelofibrosis were significantly worse in prefibrotic PMF [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/82,83\">",
    " 82,83",
    " </a>",
    " ].",
    " </li>",
    " </ul>",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H23\">",
    " <span class=\"h2\">",
    " Acute myelofibrosis",
    " </span>",
    " &nbsp;&mdash;&nbsp;Acute myelofibrosis is a syndrome characterized by severe
    bone marrow fibrosis associated with fever and pancytopenia, teardrop RBCs, and a
    leukoerythroblastic blood picture [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/84,85\">",
    " 84,85",
    " </a>",
    " ]. However, unlike PMF, the spleen is often not palpable in acute
    myelofibrosis and in some instances the bone marrow may show excess
    megakaryoblasts, suggesting a diagnosis of acute megakaryoblastic leukemia (FAB
    classification M7). This distinction is critical since the appropriate treatment
    for acute myelofibrosis is antileukemic chemotherapy with or without hematopoietic
    cell transplantation. (See",
    " <a class=\"medical medical_review\" href=\"UTD.htm?38/50/39720?
    source=see_link\">",
    " \"Classification of acute myeloid leukemia\"",
    " </a>",
    " .)",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H24\">",
    " <span class=\"h2\">",
    " Secondary forms of myelofibrosis",
    " </span>",
    " &nbsp;&mdash;&nbsp;Hematologic diseases that commonly develop changes
    characteristic of myelofibrosis include postpolycythemic myeloid metaplasia (PPM)
    and post-thrombocythemic myeloid metaplasia (PTM). In a study of 37 patients with
    PPM and 29 with PTM &lt;60 years of age, adverse prognostic indicators included
    older age, anemia, a prior history of PV, and adverse cytogenetics (ie, presence of
    cytogenetic abnormalities other than 13q- or 20q-) [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/86\">",
    " 86",
    " </a>",
    " ].",
    " </p>",
    " <p>",
    " Other hematologic conditions associated with bone marrow fibrosis include
    hairy cell leukemia, lymphoma, and multiple myeloma [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/87-90\">",
    " 87-90",
    " </a>",
    " ]. Nonhematologic causes of bone marrow fibrosis are rare and include the
    following:",
    " </p>",
    " <p>",
    " <ul class=\"bullet-block\">",
    " <li>",
    " Malignancy metastatic to the bone marrow [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/91-93\">",
    " 91-93",
    " </a>",
    " ]",
    " </li>",
    " <li>",
    " Autoimmune disorders (eg, systemic lupus erythematosus, scleroderma, mixed
    connective tissue disease, polymyositis) and primary pulmonary hypertension [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/94-98\">",
    " 94-98",
    " </a>",
    " ]",
    " </li>",
    " <li>",
    " Secondary hyperparathyroidism associated with vitamin D deficiency [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/99,100\">",
    " 99,100",
    " </a>",
    " ] or renal osteodystrophy [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/101-103\">",
    " 101-103",
    " </a>",
    " ].",
    " </li>",
    " </ul>",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H25\">",
    " <span class=\"h1\">",
    " DIAGNOSIS",
    " </span>",
    " &nbsp;&mdash;&nbsp;Patients with PMF first come to medical attention with some
    constellation of the following findings: nonspecific systemic symptoms,
    splenomegaly, hepatomegaly (both due to EMH), anemia, and either high or low
    platelet and WBC counts (",
    " <a class=\"graphic graphic_table graphicRef75473 \" href=\"UTD.htm?
    41/62/42987\">",
    " table 1",
    " </a>",
    " ). The peripheral smear provides the first clue to the diagnosis of PMF. The
    characteristic features include teardrop-shaped RBCs and the characteristic
    leukoerythroblastic findings of myelophthisis (replacement of normal marrow
    elements by fibrosis or tumor), nucleated erythrocytes and granulocyte precursors
    (myelocytes, metamyelocytes, and blasts) (",
    " <a class=\"graphic graphic_picture graphicRef68110 \" href=\"UTD.htm?
    29/43/30390\">",
    " picture 1",
    " </a>",
    " ).",
    " </p>",
    " <p>",
    " However, a similar blood picture can be produced by bone marrow infiltration
    by metastatic cancer (especially prostate or breast) or infectious granulomata.
    Thus, bone marrow biopsy is required for demonstration of fibrosis and the absence
    of clusters of malignant cells (",
    " <a class=\"graphic graphic_picture graphicRef70576 \" href=\"UTD.htm?
    2/11/2228\">",
    " picture 6",
    " </a>",
    " ) or granulomata.",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H26\">",
    " <span class=\"h2\">",
    " Primary myelofibrosis: WHO criteria",
    " </span>",
    " &nbsp;&mdash;&nbsp;There is no \"gold standard\" for the diagnosis of PMF,
    although criteria have been proposed by the Italian Society of Hematology (",
    " <a class=\"graphic graphic_table graphicRef51995 \" href=\"UTD.htm?
    24/59/25531\">",
    " table 3",
    " </a>",
    " ), the World Health Organization, and others [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/54,104-106\">",
    " 54,104-106",
    " </a>",
    " ].",
    " </p>",
    " <p>",
    " The 2008 WHO criteria include a combination of the following findings (",
    " <a class=\"graphic graphic_table graphicRef66012 \" href=\"UTD.htm?
    26/8/26764\">",
    " table 4",
    " </a>",
    " ) [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/2,54,107\">",
    " 2,54,107",
    " </a>",
    " ]:",
    " </p>",
    " <p>",
    " <ul class=\"bulletCompact-block\">",
    " <li>",
    " Presence of megakaryocyte proliferation and atypia, usually accompanied by
    reticulin",
    " <span class=\"nowrap\">",
    " and/or",
    " </span>",
    " collagen",
    " </li>",
    " <li>",
    " WHO criteria for PV, CML, MDS, or other myeloid neoplasm not met",
    " </li>",
    " <li>",
    " Demonstration of a clonal marker (eg, JAK2 or MPL)",
    " </li>",
    " <li>",
    " Leukoerythroblastosis",
    " </li>",
    " <li>",
    " Palpable splenomegaly",
    " </li>",
    " <li>",
    " Anemia",
    " </li>",
    " <li>",
    " Increased serum lactate dehydrogenase level",
    " </li>",
    " </ul>",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H27\">",
    " <span class=\"h2\">",
    " Myelofibrosis following PV or ET",
    " </span>",
    " &nbsp;&mdash;&nbsp;An International Working Group for Myelofibrosis Research
    and Treatment has proposed criteria for the diagnosis of post-PV and post-ET
    myelofibrosis, which includes a combination of the following major (first two, both
    required) and minor (last five, at least two required) findings [",
    " <a class=\"abstract\" href=\"UTD.htm?0/63/1018/abstract/108\">",
    " 108",
    " </a>",
    " ]:",
    " </p>",
    " <p>",
    " <ul class=\"bulletCompact-block\">",
    " <li>",
    " Documentation of a previous diagnosis of either PV or ET as defined by WHO
    criteria",
    " </li>",
    " <li>",
    " Presence of increased bone marrow fibrosis",
    " </li>",
    " <li>",
    " Progressive anemia or loss of phlebotomy requirement",
    " </li>",
    " <li>",
    " Leukoerythroblastic blood picture",
    " </li>",
    " <li>",
    " Increasing degree of splenomegaly",
    " </li>",
    " <li>",
    " Development of constitutional symptoms (ie, weight loss, night sweats,
    unexplained fever)",
    " </li>",
    " <li>",
    " Increased serum lactate dehydrogenase (post-ET MF only)",
    " </li>",
    " </ul>",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H28\">",
    " <span class=\"h1\">",
    " SUMMARY AND RECOMMENDATIONS",
    " </span>",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H29\">",
    " <span class=\"h2\">",
    " Suspecting the diagnosis",
    " </span>",
    " &nbsp;&mdash;&nbsp;Primary myelofibrosis (PMF, chronic idiopathic
    myelofibrosis, agnogenic myeloid metaplasia) should be suspected in a patient
    presenting with splenomegaly along with immature cells of the granulocyte series,
    nucleated red cells, and tear drop-shaped red cells in the peripheral blood. (See",
    " <a class=\"local\" href=\"#H3\">",
    " 'Clinical manifestations'",
    " </a>",
    " above and",
    " <a class=\"local\" href=\"#H9\">",
    " 'Laboratory findings'",
    " </a>",
    " above.)",
    " </p>",
    " <p class=\"headingAnchor\" id=\"H30\">",
    " <span class=\"h2\">",
    " Making the diagnosis",
    " </span>",
    " &nbsp;&mdash;&nbsp;PMF is diagnosed when the following are present (",
    " <a class=\"graphic graphic_table graphicRef66012 \" href=\"UTD.htm?
    26/8/26764\">",
    " table 4",
    " </a>",
    " ). (See",
    " <a class=\"local\" href=\"#H25\">",
    " 'Diagnosis'",
    " </a>",
    " above.)",
    " </p>",
    " <p>",
    " <ul class=\"bulletCompact-block\">",
    " <li>",
    " Presence of megakaryocyte proliferation and atypia, usually accompanied by
    reticulin",
    " <span class=\"nowrap\">",
    " and/or",
    " </span>",
    " collagen",
    " </li>",
    " <li>",
    " WHO criteria for PV, CML, MDS, or other myeloid neoplasm not met",
    " </li>",
    " <li>",
    " Demonstration of a clonal marker (eg, JAK2 or MPL)",
    " </li>",
    " <li>",
    " Leukoerythroblastosis",
    " </li>",
    " <li>",
    " Palpable splenomegaly",
    " </li>",
    " <li>",
    " Anemia",
    " </li>",
    " <li>",
    " Increased serum lactate dehydrogenase level",
    " </li>",
    " </ul>",
    " </p>",
    " </div>",
    " <div id=\"topicAgreement\">",
    " Use of UpToDate is subject to the",
    " <a class=\"licenseLink\" href=\"./license\" id=\"sla_in_page\"
    target=\"_blank\">",
    " Subscription and License Agreement",
    " </a>",
    " .",
    " </div>",
    " <div class=\"headingAnchor\" id=\"references\">",
    " <h1>",
    " REFERENCES",
    " </h1>",
    " <ol id=\"reference\">",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/1\">",
    " Mesa RA, Verstovsek S, Cervantes F, et al. Primary myelofibrosis (PMF), post
    polycythemia vera myelofibrosis (post-PV MF), post essential thrombocythemia
    myelofibrosis (post-ET MF), blast phase PMF (PMF-BP): Consensus on terminology by
    the international working group for myelofibrosis research and treatment (IWG-MRT).
    Leuk Res 2007; 31:737.",
    " </a>",
    " </li>",
    " <li>",
    " Thiele J, Kvasnicka HM, Tefferi A, et al. Primary myelofibrosis. In: WHO
    Classification of Tumours of haematopoietic and lymphoid tissues, Swerdlow SH,
    Campo E, Harris NL (Eds), IARC Press, Lyon 2008. p.44.",
    " </li>",
    " <li>",
    " Thiele J, Pierre R, Imbert M, et al. Chronic idiopathic myelofibrosis. In:
    World Health Organization Classification of Tumours. Pathology and Genetics of
    Tumours of Haematopoietic and Lymphoid Tissues, Jaffe ES, Harris NL, Stein H,
    Vardiman JW (Eds), IARC Press, Lyon 2001. p.35.",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/4\">",
    " Tefferi A. Myelofibrosis with myeloid metaplasia. N Engl J Med 2000;
    342:1255.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/5\">",
    " Reilly JT, McMullin MF, Beer PA, et al. Guideline for the diagnosis and
    management of myelofibrosis. Br J Haematol 2012; 158:453.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/6\">",
    " Tefferi A. Primary myelofibrosis: 2013 update on diagnosis, risk-
    stratification, and management. Am J Hematol 2013; 88:141.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/7\">",
    " Mesa RA, Silverstein MN, Jacobsen SJ, et al. Population-based incidence and
    survival figures in essential thrombocythemia and agnogenic myeloid metaplasia: an
    Olmsted County Study, 1976-1995. Am J Hematol 1999; 61:10.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/8\">",
    " Visani G, Finelli C, Castelli U, et al. Myelofibrosis with myeloid
    metaplasia: clinical and haematological parameters predicting survival in a series
    of 133 patients. Br J Haematol 1990; 75:4.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/9\">",
    " DeLario MR, Sheehan AM, Ataya R, et al. Clinical, histopathologic, and
    genetic features of pediatric primary myelofibrosis--an entity different from
    adults. Am J Hematol 2012; 87:461.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/10\">",
    " Mallouh AA, Sa'di AR. Agnogenic myeloid metaplasia in children. Am J Dis
    Child 1992; 146:965.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/11\">",
    " Bonduel M, Sciuccati G, Torres AF, et al. Familial idiopathic myelofibrosis
    and multiple hemangiomas. Am J Hematol 1998; 59:175.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/12\">",
    " Smith RE, Chelmowski MK, Szabo EJ. Myelofibrosis: a review of clinical and
    pathologic features and treatment. Crit Rev Oncol Hematol 1990; 10:305.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/13\">",
    " Cervantes F, Pereira A, Esteve J, et al. Identification of 'short-lived' and
    'long-lived' patients at presentation of idiopathic myelofibrosis. Br J Haematol
    1997; 97:635.",
    " </a>",
    " </li>",
    " <li>",
    " Silverstein MN. Agnogenic myeloid metaplasia, Publishing Sciences Group,
    Acton, MA 1975.",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/15\">",
    " Varki A, Lottenberg R, Griffith R, Reinhard E. The syndrome of idiopathic
    myelofibrosis. A clinicopathologic review with emphasis on the prognostic variables
    predicting survival. Medicine (Baltimore) 1983; 62:353.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/16\">",
    " Garc&iacute;a-Manero G, Schuster SJ, Patrick H, Martinez J. Pulmonary
    hypertension in patients with myelofibrosis secondary to myeloproliferative
    diseases. Am J Hematol 1999; 60:130.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/17\">",
    " Dingli D, Utz JP, Krowka MJ, et al. Unexplained pulmonary hypertension in
    chronic myeloproliferative disorders. Chest 2001; 120:801.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/18\">",
    " Cortelezzi A, Gritti G, Del Papa N, et al. Pulmonary arterial hypertension
    in primary myelofibrosis is common and associated with an altered angiogenic
    status. Leukemia 2008; 22:646.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/19\">",
    " Vaa BE, Wolanskyj AP, Roeker L, et al. Pruritus in primary myelofibrosis:
    Clinical and laboratory correlates. Am J Hematol 2011.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/20\">",
    " Mesa RA, Kantarjian H, Tefferi A, et al. Evaluating the serial use of the
    Myelofibrosis Symptom Assessment Form for measuring symptomatic improvement:
    performance in 87 myelofibrosis patients on a JAK1 and JAK2 inhibitor (INCB018424)
    clinical trial. Cancer 2011; 117:4869.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/21\">",
    " Barbui T, Carobbio A, Cervantes F, et al. Thrombosis in primary
    myelofibrosis: incidence and risk factors. Blood 2010; 115:778.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/22\">",
    " Elliott MA, Pardanani A, Lasho TL, et al. Thrombosis in myelofibrosis: prior
    thrombosis is the only predictive factor and most venous events are provoked.
    Haematologica 2010; 95:1788.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/23\">",
    " O'Reilly RA. Splenomegaly in 2,505 patients in a large university medical
    center from 1913 to 1995. 1913 to 1962: 2,056 patients. West J Med 1998; 169:78.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/24\">",
    " Dupriez B, Morel P, Demory JL, et al. Prognostic factors in agnogenic
    myeloid metaplasia: a report on 195 cases with a new scoring system. Blood 1996;
    88:1013.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/25\">",
    " Wanless IR, Peterson P, Das A, et al. Hepatic vascular disease and portal
    hypertension in polycythemia vera and agnogenic myeloid metaplasia: a
    clinicopathological study of 145 patients examined at autopsy. Hepatology 1990;
    12:1166.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/26\">",
    " Valla D, Casadevall N, Huisse MG, et al. Etiology of portal vein thrombosis
    in adults. A prospective evaluation of primary myeloproliferative disorders.
    Gastroenterology 1988; 94:1063.",
    " </a>",
    " </li>",
    " <li>",
    " Lichtman MA. Idiopathic myelofibrosis (agnogenic myeloid metaplasia). In:
    Williams' Hematology, 5th ed, Beutler E, Lichtman MA, Coller BS, Kipps TJ (Eds),
    McGraw-Hill, New York 1995. p.331.",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/28\">",
    " Georgiades CS, Neyman EG, Francis IR, et al. Typical and atypical
    presentations of extramedullary hemopoiesis. AJR Am J Roentgenol 2002; 179:1239.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/29\">",
    " Koch CA, Li CY, Mesa RA, Tefferi A. Nonhepatosplenic extramedullary
    hematopoiesis: associated diseases, pathology, clinical course, and treatment. Mayo
    Clin Proc 2003; 78:1223.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/30\">",
    " Bartlett RP, Greipp PR, Tefferi A, et al. Extramedullary hematopoiesis
    manifesting as a symptomatic pleural effusion. Mayo Clin Proc 1995; 70:1161.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/31\">",
    " Knobel B, Melamud E, Virag I, Meytes D. Ectopic medullary hematopoiesis as a
    cause of ascites in agnogenic myeloid metaplasia. Case report and review of the
    literature. Acta Haematol 1993; 89:104.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/32\">",
    " Liot&eacute; F, Yeni P, Teillet-Thiebaud F, et al. Ascites revealing
    peritoneal and hepatic extramedullary hematopoiesis with peliosis in agnogenic
    myeloid metaplasia: case report and review of the literature. Am J Med 1991;
    90:111.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/33\">",
    " Yusen RD, Kollef MH. Acute respiratory failure due to extramedullary
    hematopoiesis. Chest 1995; 108:1170.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/34\">",
    " Lundh B, Brandt L, Cronqvist S, Eyrich R. Intracranial myeloid metaplasia in
    myelofibrosis. Scand J Haematol 1982; 28:91.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/35\">",
    " Koch BL, Bisset GS 3rd, Bisset RR, Zimmer MB. Intracranial extramedullary
    hematopoiesis: MR findings with pathologic correlation. AJR Am J Roentgenol 1994;
    162:1419.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/36\">",
    " Loewy G, Mathew A, Distenfeld A. Skin manifestation of agnogenic myeloid
    metaplasia. Am J Hematol 1994; 45:167.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/37\">",
    " Mizoguchi M, Kawa Y, Minami T, et al. Cutaneous extramedullary hematopoiesis
    in myelofibrosis. J Am Acad Dermatol 1990; 22:351.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/38\">",
    " Fedeli G, Certo M, Cannizzaro O, et al. Extramedullary hematopoiesis
    involving the esophagus in myelofibrosis. Am J Gastroenterol 1990; 85:1512.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/39\">",
    " Schreibman D, Brenner B, Jacobs R, et al. Small intestinal myeloid
    metaplasia. JAMA 1988; 259:2580.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/40\">",
    " L&oacute;pez-Guillermo A, Cervantes F, Bruguera M, et al. Liver dysfunction
    following splenectomy in idiopathic myelofibrosis: a study of 10 patients. Acta
    Haematol 1991; 85:184.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/41\">",
    " Hermann G, Feldman F, Abdelwahab IF, Klein MJ. Skeletal manifestations of
    granulocytic sarcoma (chloroma). Skeletal Radiol 1991; 20:509.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/42\">",
    " Guglielmelli P, Pancrazzi A, Bergamaschi G, et al. Anaemia characterises
    patients with myelofibrosis harbouring Mpl mutation. Br J Haematol 2007; 137:244.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/43\">",
    " Najean Y, Cacchione R, Castro-Malaspina H, Dresch C. Erythrokinetic studies
    in myelofibrosis: their significance for prognosis. Br J Haematol 1978; 40:205.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/44\">",
    " DiBella NJ, Silverstein MN, Hoagland HC. Effect of splenectomy on teardrop-
    shaped erythrocytes in agnogenic myeloid metaplasia. Arch Intern Med 1977;
    137:380.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/45\">",
    " Manoharan A, Hargrave M, Gordon S. Effect of chemotherapy on tear drop
    poikilocytes and other peripheral blood findings in myelofibrosis. Pathology 1988;
    20:7.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/46\">",
    " Baker RI, Manoharan A. Platelet function in myeloproliferative disorders:
    characterization and sequential studies show multiple platelet abnormalities, and
    change with time. Eur J Haematol 1988; 40:267.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/47\">",
    " Hasegawa DK, Bennett AJ, Coccia PF, et al. Factor V deficiency in
    Philadelphia-positive chronic myelogenous leukemia. Blood 1980; 56:585.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/48\">",
    " Barosi G, Viarengo G, Pecci A, et al. Diagnostic and clinical relevance of
    the number of circulating CD34(+) cells in myelofibrosis with myeloid metaplasia.
    Blood 2001; 98:3249.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/49\">",
    " Arora B, Sirhan S, Hoyer JD, et al. Peripheral blood CD34 count in
    myelofibrosis with myeloid metaplasia: a prospective evaluation of prognostic value
    in 94 patients. Br J Haematol 2005; 128:42.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/50\">",
    " Massa M, Rosti V, Ramajoli I, et al. Circulating CD34+, CD133+, and vascular
    endothelial growth factor receptor 2-positive endothelial progenitor cells in
    myelofibrosis with myeloid metaplasia. J Clin Oncol 2005; 23:5688.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/51\">",
    " Thiele J, Kvasnicka HM, Werden C, et al. Idiopathic primary osteo-
    myelofibrosis: a clinico-pathological study on 208 patients with special emphasis
    on evolution of disease features, differentiation from essential thrombocythemia
    and variables of prognostic impact. Leuk Lymphoma 1996; 22:303.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/52\">",
    " Beer PA, Campbell PJ, Green AR. Comparison of different criteria for the
    diagnosis of primary myelofibrosis reveals limited clinical utility for measurement
    of serum lactate dehydrogenase. Haematologica 2010; 95:1960.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/53\">",
    " Thiele J, Kvasnicka HM, Facchetti F, et al. European consensus on grading
    bone marrow fibrosis and assessment of cellularity. Haematologica 2005; 90:1128.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/54\">",
    " Tefferi A, Thiele J, Orazi A, et al. Proposals and rationale for revision of
    the World Health Organization diagnostic criteria for polycythemia vera, essential
    thrombocythemia, and primary myelofibrosis: recommendations from an ad hoc
    international expert panel. Blood 2007; 110:1092.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/55\">",
    " Vener C, Fracchiolla NS, Gianelli U, et al. Prognostic implications of the
    European consensus for grading of bone marrow fibrosis in chronic idiopathic
    myelofibrosis. Blood 2008; 111:1862.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/56\">",
    " Moulopoulos LA, Dimopoulos MA. Magnetic resonance imaging of the bone marrow
    in hematologic malignancies. Blood 1997; 90:2127.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/57\">",
    " Rozman C, Cervantes F, Rozman M, et al. Magnetic resonance imaging in
    myelofibrosis and essential thrombocythaemia: contribution to differential
    diagnosis. Br J Haematol 1999; 104:574.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/58\">",
    " Kaplan KR, Mitchell DG, Steiner RM, et al. Polycythemia vera and
    myelofibrosis: correlation of MR imaging, clinical, and laboratory findings.
    Radiology 1992; 183:329.",
    " </a>",
    " </li>",
    " <li>",
    " Landaw SA. Tissue imaging and cell survival studies for evaluating patients
    with hematologic disorders. In: Williams' Hematology, 5th ed, Beutler E, Lichtman
    MA, Coller B, et al. (Eds), McGraw-Hill, New York 1995. p.L12.",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/60\">",
    " Tefferi A, Lasho TL, Schwager SM, et al. The JAK2(V617F) tyrosine kinase
    mutation in myelofibrosis with myeloid metaplasia: lineage specificity and clinical
    correlates. Br J Haematol 2005; 131:320.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/61\">",
    " Campbell PJ, Griesshammer M, D&ouml;hner K, et al. V617F mutation in JAK2 is
    associated with poorer survival in idiopathic myelofibrosis. Blood 2006;
    107:2098.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/62\">",
    " Barosi G, Bergamaschi G, Marchetti M, et al. JAK2 V617F mutational status
    predicts progression to large splenomegaly and leukemic transformation in primary
    myelofibrosis. Blood 2007; 110:4030.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/63\">",
    " Mesa RA, Powell H, Lasho T, et al. JAK2(V617F) and leukemic transformation
    in myelofibrosis with myeloid metaplasia. Leuk Res 2006; 30:1457.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/64\">",
    " Mesa RA, Powell H, Lasho T, et al. A longitudinal study of the JAK2(V617F)
    mutation in myelofibrosis with myeloid metaplasia: analysis at two time points.
    Haematologica 2006; 91:415.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/65\">",
    " Kr&ouml;ger N, Badbaran A, Holler E, et al. Monitoring of the JAK2-V617F
    mutation by highly sensitive quantitative real-time PCR after allogeneic stem cell
    transplantation in patients with myelofibrosis. Blood 2007; 109:1316.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/66\">",
    " Ruiz-Arg&uuml;elles GJ, Garc&eacute;s-Eisele J, Reyes-N&uacute;&ntilde;ez V,
    et al. Clearance of the Janus kinase 2 (JAK2) V617F mutation after allogeneic stem
    cell transplantation in a patient with myelofibrosis with myeloid metaplasia. Am J
    Hematol 2007; 82:400.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/67\">",
    " Tefferi A, Lasho TL, Huang J, et al. Low JAK2V617F allele burden in primary
    myelofibrosis, compared to either a higher allele burden or unmutated status, is
    associated with inferior overall and leukemia-free survival. Leukemia 2008;
    22:756.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/68\">",
    " Mesa RA, Li CY, Ketterling RP, et al. Leukemic transformation in
    myelofibrosis with myeloid metaplasia: a single-institution experience with 91
    cases. Blood 2005; 105:973.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/69\">",
    " Cervantes F, Tassies D, Salgado C, et al. Acute transformation in
    nonleukemic chronic myeloproliferative disorders: actuarial probability and main
    characteristics in a series of 218 patients. Acta Haematol 1991; 85:124.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/70\">",
    " Ragni MV, Shreiner DP. Spontaneous \"remission' of agnogenic myeloid
    metaplasia and termination in acute myeloid leukemia. Arch Intern Med 1981;
    141:1481.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/71\">",
    " Hern&aacute;ndez JM, San Miguel JF, Gonz&aacute;lez M, et al. Development of
    acute leukaemia after idiopathic myelofibrosis. J Clin Pathol 1992; 45:427.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/72\">",
    " Passamonti F, Rumi E, Elena C, et al. Incidence of leukaemia in patients
    with primary myelofibrosis and RBC-transfusion-dependence. Br J Haematol 2010;
    150:719.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/73\">",
    " Huang J, Li CY, Mesa RA, et al. Risk factors for leukemic transformation in
    patients with primary myelofibrosis. Cancer 2008; 112:2726.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/74\">",
    " Dekmezian R, Kantarjian HM, Keating MJ, et al. The relevance of reticulin
    stain-measured fibrosis at diagnosis in chronic myelogenous leukemia. Cancer 1987;
    59:1739.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/75\">",
    " Singh M, Bofinger A, Taylor K, Ba Pe R. Myelodysplasia with myelofibrosis--a
    distinct subgroup within the myelodysplastic syndromes. Pathology 1994; 26:69.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/76\">",
    " Vallesp&iacute; T, Imbert M, Mecucci C, et al. Diagnosis, classification,
    and cytogenetics of myelodysplastic syndromes. Haematologica 1998; 83:258.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/77\">",
    " Poulsen LW, Melsen F, Bendix K. A histomorphometric study of haematological
    disorders with respect to marrow fibrosis and osteosclerosis. APMIS 1998;
    106:495.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/78\">",
    " Georgii A, Buhr T, Buesche G, et al. Classification and staging of Ph-
    negative myeloproliferative disorders by histopathology from bone marrow biopsies.
    Leuk Lymphoma 1996; 22 Suppl 1:15.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/79\">",
    " Damashek W. Some speculations on the myeloproliferative disorders. Blood
    1951; 6:732.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/80\">",
    " Thiele J, Kvasnicka HM, M&uuml;llauer L, et al. Essential thrombocythemia
    versus early primary myelofibrosis: a multicenter study to validate the WHO
    classification. Blood 2011; 117:5710.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/81\">",
    " Kvasnicka HM, Thiele J. Prodromal myeloproliferative neoplasms: the 2008 WHO
    classification. Am J Hematol 2010; 85:62.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/82\">",
    " Barbui T, Thiele J, Passamonti F, et al. Survival and disease progression in
    essential thrombocythemia are significantly influenced by accurate morphologic
    diagnosis: an international study. J Clin Oncol 2011; 29:3179.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/83\">",
    " Barbui T, Thiele J, Carobbio A, et al. Disease characteristics and clinical
    outcome in young adults with essential thrombocythemia versus early/prefibrotic
    primary myelofibrosis. Blood 2012; 120:569.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/84\">",
    " List AF, Kummet TD, Kerr DM. Acute myelofibrosis: response to recombinant
    human interferon alpha-2a. Leuk Res 1990; 14:321.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/85\">",
    " Amberger DM, Saleem A, Kemp BL, Truong LD. Acute myelofibrosis--a leukemia
    of pluripotent stem cell. A report of three cases and review of the literature. Ann
    Clin Lab Sci 1990; 20:409.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/86\">",
    " Dingli D, Schwager SM, Mesa RA, et al. Presence of unfavorable cytogenetic
    abnormalities is the strongest predictor of poor survival in secondary
    myelofibrosis. Cancer 2006; 106:1985.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/87\">",
    " Burthem J, Cawley JC. The bone marrow fibrosis of hairy-cell leukemia is
    caused by the synthesis and assembly of a fibronectin matrix by the hairy cells.
    Blood 1994; 83:497.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/88\">",
    " Stevenson JP, Schwarting R, Schuster SJ. Analysis of clonality using X-
    linked polymorphisms in a patient with multiple myeloma and myelofibrosis. Am J
    Hematol 1998; 59:79.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/89\">",
    " Abildgaard N, Bendix-Hansen K, Kristensen JE, et al. Bone marrow fibrosis
    and disease activity in multiple myeloma monitored by the aminoterminal propeptide
    of procollagen III in serum. Br J Haematol 1997; 99:641.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/90\">",
    " Schmidt U, Ruwe M, Leder LD. Multiple myeloma with bone marrow biopsy
    features simulating concomitant chronic idiopathic myelofibrosis. Nouv Rev Fr
    Hematol 1995; 37:159.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/91\">",
    " Kiely JM, Silverstein MN. Metastatic carcinoma simulating agnogenic myeloid
    metaplasia and myelofibrosis. Cancer 1969; 24:1041.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/92\">",
    " Yablonski-Peretz T, Sulkes A, Polliack A, et al. Secondary myelofibrosis
    with metastatic breast cancer simulating agnogenic myeloid metaplasia: report of a
    case and review of the literature. Med Pediatr Oncol 1985; 13:92.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/93\">",
    " O'Keane JC, Wolf BC, Neiman RS. The pathogenesis of splenic extramedullary
    hematopoiesis in metastatic carcinoma. Cancer 1989; 63:1539.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/94\">",
    " Pereira RM, Velloso ER, Menezes Y, et al. Bone marrow findings in systemic
    lupus erythematosus patients with peripheral cytopenias. Clin Rheumatol 1998;
    17:219.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/95\">",
    " Paquette RL, Meshkinpour A, Rosen PJ. Autoimmune myelofibrosis. A steroid-
    responsive cause of bone marrow fibrosis associated with systemic lupus
    erythematosus. Medicine (Baltimore) 1994; 73:145.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/96\">",
    " Bass RD, Pullarkat V, Feinstein DI, et al. Pathology of autoimmune
    myelofibrosis. A report of three cases and a review of the literature. Am J Clin
    Pathol 2001; 116:211.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/97\">",
    " Rizzi R, Pastore D, Liso A, et al. Autoimmune myelofibrosis: report of three
    cases and review of the literature. Leuk Lymphoma 2004; 45:561.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/98\">",
    " Popat U, Frost A, Liu E, et al. High levels of circulating CD34 cells,
    dacrocytes, clonal hematopoiesis, and JAK2 mutation differentiate myelofibrosis
    with myeloid metaplasia from secondary myelofibrosis associated with pulmonary
    hypertension. Blood 2006; 107:3486.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/99\">",
    " Yetgin S, Ozsoylu S, Ruacan S, et al. Vitamin D-deficiency rickets and
    myelofibrosis. J Pediatr 1989; 114:213.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/100\">",
    " Walka MM, D&auml;umling S, Hadorn HB, et al. Vitamin D dependent rickets
    type II with myelofibrosis and immune dysfunction. Eur J Pediatr 1991; 150:665.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/101\">",
    " Rao DS, Shih MS, Mohini R. Effect of serum parathyroid hormone and bone
    marrow fibrosis on the response to erythropoietin in uremia. N Engl J Med 1993;
    328:171.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/102\">",
    " Weinberg SG, Lubin A, Wiener SN, et al. Myelofibrosis and renal
    osteodystrophy. Am J Med 1977; 63:755.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/103\">",
    " Nomura S, Ogawa Y, Osawa G, et al. Myelofibrosis secondary to renal
    osteodystrophy. Nephron 1996; 72:683.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/104\">",
    " Barosi G, Ambrosetti A, Finelli C, et al. The Italian Consensus Conference
    on Diagnostic Criteria for Myelofibrosis with Myeloid Metaplasia. Br J Haematol
    1999; 104:730.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/105\">",
    " Barosi G. Myelofibrosis with myeloid metaplasia: diagnostic definition and
    prognostic classification for clinical studies and treatment guidelines. J Clin
    Oncol 1999; 17:2954.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/106\">",
    " Spivak JL, Silver RT. The revised World Health Organization diagnostic
    criteria for polycythemia vera, essential thrombocytosis, and primary
    myelofibrosis: an alternative proposal. Blood 2008; 112:231.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/107\">",
    " Tefferi A, Skoda R, Vardiman JW. Myeloproliferative neoplasms: contemporary
    diagnosis using histology and genetics. Nat Rev Clin Oncol 2009; 6:627.",
    " </a>",
    " </li>",
    " <li>",
    " <a class=\"nounderline abstract\" href=\"UTD.htm?0/63/1018/abstract/108\">",
    " Barosi G, Mesa RA, Thiele J, et al. Proposed criteria for the diagnosis of
    post-polycythemia vera and post-essential thrombocythemia myelofibrosis: a
    consensus statement from the International Working Group for Myelofibrosis Research
    and Treatment. Leukemia 2008; 22:437.",
    " </a>",
    " </li>",
    " </ol>",
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    " <h1>",
    " TOPIC OUTLINE",
    " </h1>",
    " <div id=\"outline\">",
    " <ul>",
    " <li>",
    " <a class=\"sr_button\" href=\"#H28\" id=\"summRecButton\">",
    " <span>",
    " SUMMARY &amp; RECOMMENDATIONS",
    " </span>",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#H1\">",
    " INTRODUCTION",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#H2\">",
    " EPIDEMIOLOGY",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#H3\">",
    " CLINICAL MANIFESTATIONS",
    " </a>",
    " </li>",
    " <li class=\"bulletItem\">",
    " <a class=\"outlineLink\" href=\"#H4\">",
    " Signs and symptoms",
    " </a>",
    " </li>",
    " <li class=\"dashItem\">",
    " <a class=\"outlineLink\" href=\"#H19956477\">",
    " - Thrombotic events",
    " </a>",
    " </li>",
    " <li class=\"bulletItem\">",
    " <a class=\"outlineLink\" href=\"#H5\">",
    " Splenomegaly",
    " </a>",
    " </li>",
    " <li class=\"bulletItem\">",
    " <a class=\"outlineLink\" href=\"#H6\">",
    " Hepatomegaly",
    " </a>",
    " </li>",
    " <li class=\"bulletItem\">",
    " <a class=\"outlineLink\" href=\"#H7\">",
    " Extramedullary hematopoiesis",
    " </a>",
    " </li>",
    " <li class=\"bulletItem\">",
    " <a class=\"outlineLink\" href=\"#H8\">",
    " Bone and joint involvement",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#H9\">",
    " LABORATORY FINDINGS",
    " </a>",
    " </li>",
    " <li class=\"bulletItem\">",
    " <a class=\"outlineLink\" href=\"#H10\">",
    " Anemia",
    " </a>",
    " </li>",
    " <li class=\"bulletItem\">",
    " <a class=\"outlineLink\" href=\"#H11\">",
    " Platelet and white blood cell abnormalities",
    " </a>",
    " </li>",
    " <li class=\"dashItem\">",
    " <a class=\"outlineLink\" href=\"#H12\">",
    " - Circulating CD34+ cells",
    " </a>",
    " </li>",
    " <li class=\"bulletItem\">",
    " <a class=\"outlineLink\" href=\"#H13\">",
    " Abnormal laboratory tests",
    " </a>",
    " </li>",
    " <li class=\"bulletItem\">",
    " <a class=\"outlineLink\" href=\"#H14\">",
    " Bone marrow examination",
    " </a>",
    " </li>",
    " <li class=\"dashItem\">",
    " <a class=\"outlineLink\" href=\"#H15\">",
    " - Bone marrow aspiration",
    " </a>",
    " </li>",
    " <li class=\"dashItem\">",
    " <a class=\"outlineLink\" href=\"#H16\">",
    " - Bone marrow biopsy",
    " </a>",
    " </li>",
    " <li class=\"dashItem\">",
    " <a class=\"outlineLink\" href=\"#H17\">",
    " - Bone marrow imaging with MRI",
    " </a>",
    " </li>",
    " <li class=\"dashItem\">",
    " <a class=\"outlineLink\" href=\"#H18\">",
    " - Isotopic marrow imaging",
    " </a>",
    " </li>",
    " <li class=\"bulletItem\">",
    " <a class=\"outlineLink\" href=\"#H19\">",
    " JAK2 gene mutation",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#H20\">",
    " TRANSFORMATION TO ACUTE LEUKEMIA",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#H21\">",
    " DIFFERENTIAL DIAGNOSIS",
    " </a>",
    " </li>",
    " <li class=\"bulletItem\">",
    " <a class=\"outlineLink\" href=\"#H22\">",
    " Other chronic myeloproliferative disorders",
    " </a>",
    " </li>",
    " <li class=\"bulletItem\">",
    " <a class=\"outlineLink\" href=\"#H23\">",
    " Acute myelofibrosis",
    " </a>",
    " </li>",
    " <li class=\"bulletItem\">",
    " <a class=\"outlineLink\" href=\"#H24\">",
    " Secondary forms of myelofibrosis",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#H25\">",
    " DIAGNOSIS",
    " </a>",
    " </li>",
    " <li class=\"bulletItem\">",
    " <a class=\"outlineLink\" href=\"#H26\">",
    " Primary myelofibrosis: WHO criteria",
    " </a>",
    " </li>",
    " <li class=\"bulletItem\">",
    " <a class=\"outlineLink\" href=\"#H27\">",
    " Myelofibrosis following PV or ET",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"outlineLink\" href=\"#H28\">",
    " SUMMARY AND RECOMMENDATIONS",
    " </a>",
    " </li>",
    " <li class=\"bulletItem\">",
    " <a class=\"outlineLink\" href=\"#H29\">",
    " Suspecting the diagnosis",
    " </a>",
    " </li>",
    " <li class=\"bulletItem\">",
    " <a class=\"outlineLink\" href=\"#H30\">",
    " Making the diagnosis",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a href=\"#references\">",
    " REFERENCES",
    " </a>",
    " </li>",
    " </ul>",
    " </div>",
    " <h1>",
    " <div class=\"openRelatedGraphics\" id=\"HEME/4529\" rel=\"outline_link\">",
    " GRAPHICS",
    " <a class=\"graphics_icon\" href=\"#\" title=\"View All Related Graphics\">",
    " View All",
    " </a>",
    " </div>",
    " </h1>",
    " <div id=\"relatedGraphics\">",
    " <ul>",
    " <li class=\"plainItem\">",
    " <div class=\"openRelatedGraphics\" id=\"HEME/4529|FIG\">",
    " <a href=\"#\" title=\"FIGURES\">",
    " FIGURES",
    " </a>",
    " </div>",
    " </li>",
    " <li class=\"bulletItem\">",
    " <a class=\"graphic graphic_figure\" href=\"UTD.htm?24/16/24835\"
    title=\"figure 1\">",
    " Organiz heme malignancies",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <div class=\"openRelatedGraphics\" id=\"HEME/4529|PIC\">",
    " <a href=\"#\" title=\"PICTURES\">",
    " PICTURES",
    " </a>",
    " </div>",
    " </li>",
    " <li class=\"bulletItem\">",
    " <a class=\"graphic graphic_picture\" href=\"UTD.htm?29/43/30390\"
    title=\"picture 1\">",
    " Leukoerythroblastic blood smear",
    " </a>",
    " </li>",
    " <li class=\"bulletItem\">",
    " <a class=\"graphic graphic_picture\" href=\"UTD.htm?42/37/43606\"
    title=\"picture 2\">",
    " Tear drop cells",
    " </a>",
    " </li>",
    " <li class=\"bulletItem\">",
    " <a class=\"graphic graphic_picture\" href=\"UTD.htm?4/47/4854\"
    title=\"picture 3\">",
    " Megaloblastic smear",
    " </a>",
    " </li>",
    " <li class=\"bulletItem\">",
    " <a class=\"graphic graphic_picture\" href=\"UTD.htm?17/34/17961\"
    title=\"picture 4\">",
    " Myelofibrosis bone marrow",
    " </a>",
    " </li>",
    " <li class=\"bulletItem\">",
    " <a class=\"graphic graphic_picture\" href=\"UTD.htm?24/19/24886\"
    title=\"picture 5\">",
    " Myelofibrosis marrow collagen",
    " </a>",
    " </li>",
    " <li class=\"bulletItem\">",
    " <a class=\"graphic graphic_picture\" href=\"UTD.htm?2/11/2228\"
    title=\"picture 6\">",
    " Metastatic cancer marrow",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <div class=\"openRelatedGraphics\" id=\"HEME/4529|TAB\">",
    " <a href=\"#\" title=\"TABLES\">",
    " TABLES",
    " </a>",
    " </div>",
    " </li>",
    " <li class=\"bulletItem\">",
    " <a class=\"graphic graphic_table\" href=\"UTD.htm?41/62/42987\" title=\"table
    1\">",
    " Clinical and lab features of primary myelofibrosis",
    " </a>",
    " </li>",
    " <li class=\"bulletItem\">",
    " <a class=\"graphic graphic_table\" href=\"UTD.htm?42/22/43371\" title=\"table
    2\">",
    " Causes of bone marrow fibrosis",
    " </a>",
    " </li>",
    " <li class=\"bulletItem\">",
    " <a class=\"graphic graphic_table\" href=\"UTD.htm?24/59/25531\" title=\"table
    3\">",
    " Diagnostic criteria MMM",
    " </a>",
    " </li>",
    " <li class=\"bulletItem\">",
    " <a class=\"graphic graphic_table\" href=\"UTD.htm?26/8/26764\" title=\"table
    4\">",
    " Proposed criteria for PMF",
    " </a>",
    " </li>",
    " </ul>",
    " </div>",
    " <h1>",
    " RELATED TOPICS",
    " </h1>",
    " <div id=\"relatedTopics\">",
    " <ul>",
    " <li class=\"plainItem\">",
    " <a class=\"medical medical_review\" href=\"UTD.htm?38/50/39720?
    source=related_link\">",
    " Classification of acute myeloid leukemia",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"medical medical_review\" href=\"UTD.htm?4/49/4890?
    source=related_link\">",
    " Clinical manifestations and diagnosis of gout",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"medical medical_review\" href=\"UTD.htm?40/57/41882?
    source=related_link\">",
    " Clinical manifestations and diagnosis of the myelodysplastic syndromes",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"medical medical_review\" href=\"UTD.htm?19/58/20393?
    source=related_link\">",
    " Clinical manifestations, pathologic features, and diagnosis of acute myeloid
    leukemia",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"medical medical_review\" href=\"UTD.htm?9/32/9738?
    source=related_link\">",
    " Diagnostic approach to the patient with suspected polycythemia vera",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"medical medical_review\" href=\"UTD.htm?34/43/35514?
    source=related_link\">",
    " Hypercoagulable disorders associated with malignancy",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"medical medical_review\" href=\"UTD.htm?30/49/31512?
    source=related_link\">",
    " Molecular genetics of chronic myeloid leukemia",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"medical medical_review\" href=\"UTD.htm?20/52/21322?
    source=related_link\">",
    " Overview of the myeloproliferative neoplasms",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"medical medical_review\" href=\"UTD.htm?24/30/25064?
    source=related_link\">",
    " Pathogenetic mechanisms in primary myelofibrosis",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"medical medical_review\" href=\"UTD.htm?27/56/28554?
    source=related_link\">",
    " Prognosis and treatment of polycythemia vera",
    " </a>",
    " </li>",
    " <li class=\"plainItem\">",
    " <a class=\"medical medical_review\" href=\"UTD.htm?36/3/36922?
    source=related_link\">",
    " Prognosis and treatment of primary myelofibrosis",
    " </a>",
    " </li>",
    " </ul>",
    " </div>",
    " </div>"].join("\n");
    var title_f0_63_1019="Dextromethorphan-DXM street names";
    var content_f0_63_1019=[" <div id=\"graphicsToolbar\">",
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    " &copy;2013 UpToDate",
    " <sup>",
    " &reg;",
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    " <a href=\"?imageKey=EM
    %2F66199&amp;source=image_view&amp;view=print&amp;elapsedTimeMs=10\"
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    " <a class=\"etacLink\" href=\"#\">",
    " <img alt=\"Email graphic(s)\" src=\"./../images/icn_email.myextg\"
    title=\"Email graphic(s)\"/>",
    " </a>",
    " <a class=\"icontxt textLink etacLink\" href=\"#\" title=\"Email graphic(s)\">",
    " Email",
    " </a>",
    " </div>",
    " </div>",
    " <div class=\"graphic\">",
    " <div class=\"figure\">",
    " <div class=\"ttl\">",
    " Common street names for dextromethorphan",
    " </div>",
    " <div class=\"cntnt\">",
    " <table cellspacing=\"0\">",
    " <tr>",
    " <td>",
    " Triple C (C-C-C)",
    " </td>",
    " </tr>",
    " <tr>",
    " <td>",
    " Candy",
    " </td>",
    " </tr>",
    " <tr>",
    " <td>",
    " Dex",
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    " </tr>",
    " <tr>",
    " <td>",
    " DM",
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    " </tr>",
    " <tr>",
    " <td>",
    " Drex",
    " </td>",
    " </tr>",
    " <tr>",
    " <td>",
    " Red Devils",
    " </td>",
    " </tr>",
    " <tr>",
    " <td>",
    " Robo",
    " </td>",
    " </tr>",
    " <tr>",
    " <td>",
    " Rojo",
    " </td>",
    " </tr>",
    " <tr>",
    " <td>",
    " Skittles",
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    " </tr>",
    " <tr>",
    " <td>",
    " Tussin",
    " </td>",
    " </tr>",
    " <tr>",
    " <td>",
    " Velvet",
    " </td>",
    " </tr>",
    " <tr>",
    " <td>",
    " Vitamin D",
    " </td>",
    " </tr>",
    " </table>",
    " </div>",
    " <div class=\"lgnd\">",
    " <div class=\"footnotes\">",
    " </div>",
    " <div class=\"reference\">",
    " </div>",
    " </div>",
    " </div>",
    " </div>",
    "</div>"].join("\n");
    var script_f0_63_1019=[""].join("\n");
    var outline_f0_63_1019=null;
    var title_f0_63_1020="Toxicity adjuvant IFN alfa";
    var content_f0_63_1020=[" <div id=\"graphicsToolbar\">",
    " <div id=\"graphicsCopy\">",
    " &copy;2013 UpToDate",
    " <sup>",
    " &reg;",
    " </sup>",
    " </div>",
    " <div id=\"graphicsLinks\">",
    " <a href=\"?imageKey=ONC
    %2F71277&amp;source=image_view&amp;view=print&amp;elapsedTimeMs=7\" onclick=\"\">",
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    title=\"Print this page\"/>",
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    %2F71277&amp;source=image_view&amp;view=print&amp;elapsedTimeMs=7\" onclick=\"\"
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    " Print",
    " </a>",
    " <a class=\"etacLink\" href=\"#\">",
    " <img alt=\"Email graphic(s)\" src=\"./../images/icn_email.myextg\"
    title=\"Email graphic(s)\"/>",
    " </a>",
    " <a class=\"icontxt textLink etacLink\" href=\"#\" title=\"Email graphic(s)\">",
    " Email",
    " </a>",
    " </div>",
    " </div>",
    " <div class=\"graphic\">",
    " <div class=\"figure\">",
    " <div class=\"ttl\">",
    " Toxicity profile of high-dose interferon-alfa in patients with melanoma",
    " </div>",
    " <div class=\"cntnt\">",
    " <table cellspacing=\"0\">",
    " <tbody>",
    " <tr>",
    " <td class=\"subtitle1\" colspan=\"1\" rowspan=\"2\">",
    " Adverse event",
    " </td>",
    " <td class=\"subtitle1\" colspan=\"2\" rowspan=\"1\">",
    " Patients,",
    "percent",
    " </td>",
    " </tr>",
    " <tr>",
    " <td class=\"subtitle2\">",
    " All grades* (n = 143)",
    " </td>",
    " <td class=\"subtitle2\">",
    " Grade 3/4&bull; (range)",
    " </td>",
    " </tr>",
    " <tr>",
    " <td>",
    " Fatigue",
    " </td>",
    " <td>",
    " 96",
    " </td>",
    " <td>",
    " 21-24",
    " </td>",
    " </tr>",
    " <tr>",
    " <td>",
    " Fever",
    " </td>",
    " <td>",
    " 81",
    " </td>",
    " <td>",
    " 18",
    " </td>",
    " </tr>",
    " <tr>",
    " <td>",
    " Myalgia",
    " </td>",
    " <td>",
    " 75",
    " </td>",
    " <td>",
    " 4-17",
    " </td>",
    " </tr>",
    " <tr>",
    " <td>",
    " Nausea",
    " </td>",
    " <td>",
    " 66",
    " </td>",
    " <td>",
    " 5-9",
    " </td>",
    " </tr>",
    " <tr>",
    " <td>",
    " Vomiting",
    " </td>",
    " <td>",
    " 66",
    " </td>",
    " <td>",
    " 5",
    " </td>",
    " </tr>",
    " <tr>",
    " <td>",
    " Myelosuppression",
    " </td>",
    " <td>",
    " 92",
    " </td>",
    " <td>",
    " 26-60",
    " </td>",
    " </tr>",
    " <tr>",
    " <td>",
    " Increased AST",
    " </td>",
    " <td>",
    " 63",
    " </td>",
    " <td>",
    " 14-29",
    " </td>",
    " </tr>",
    " <tr>",
    " <td>",
    " Depression/neuropsychiatric/neuropsychologic",
    " </td>",
    " <td>",
    " 40",
    " </td>",
    " <td>",
    " 2-10",
    " </td>",
    " </tr>",
    " </tbody>",
    " </table>",
    " </div>",
    " <div class=\"lgnd\">",
    " <div class=\"footnotes\">",
    " AST: aspartate aminotransferase.",
    " <br>",
    " * Based upon data from 143 patients treated with high-dose interferon-alfa
    in ECOG trial 1684.",
    " <br>",
    " &bull; Based upon combined data from ECOG 1684, 1690, and 1694.",
    " </br>",
    " </br>",
    " </div>",
    " <div class=\"reference\">",
    " Reproduced with permission from: Kirkwood, JM, Bender, C, Agarwala, S, et al.
    Mechanisms and management of toxicities associated with high-dose interferon of
    alfa-2b therapy. J Clin Oncol 2002; 20:3703. Copyright &copy;2002 American Society
    of Clinical Oncology.",
    " </div>",
    " </div>",
    " </div>",
    " </div>",
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    " </a>",
    " <a class=\"icontxt textLink etacLink\" href=\"#\" title=\"Email graphic(s)\">",
    " Email",
    " </a>",
    " </div>",
    " </div>",
    " <div class=\"graphic\">",
    " <div class=\"figure\">",
    " <div class=\"ttl\">",
    " Research assessment methods for depression in terminally ill patients",
    " </div>",
    " <div class=\"cntnt\">",
    " <table cellspacing=\"0\">",
    " <tbody>",
    " <tr>",
    " <td class=\"subtitle1_single\">",
    " Diagnostic classification systems",
    " </td>",
    " </tr>",
    " <tr>",
    " <td class=\"indent1\">",
    " Diagnostic and Statistical Manual, 4th edition",
    " <sup>",
    " [1]",
    " </sup>",
    " (DSM-IV)",
    " </td>",
    " </tr>",
    " <tr>",
    " <td class=\"indent1\">",
    " Endicott Substitution Criteria",
    " <sup>",
    " [2]",
    " </sup>",
    " </td>",
    " </tr>",
    " <tr>",
    " <td class=\"indent1\">",
    " Research Diagnostic Criteria",
    " <sup>",
    " [3]",
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    " (RDC)",
    " </td>",
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    " <tr>",
    " <td class=\"subtitle1_single\">",
    " Structured diagnostic interviews",
    " </td>",
    " </tr>",
    " <tr>",
    " <td class=\"indent1\">",
    " Schedule for Affective Disorders and Schizophrenia",
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    " [4]",
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    " </tr>",
    " <tr>",
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    " Diagnostic Interview Schedule",
    " <sup>",
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    " <tr>",
    " <td class=\"indent1\">",
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    " <tr>",
    " <td class=\"subtitle1_single\">",
    " Screening instruments - self-report",
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    " Hospital Anxiety and Depression Scale",
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    " (HADS)",
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    " <td class=\"indent1\">",
    " Beck Depression Inventory, Short Form",
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    " (BDI-SF)",
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    " <tr>",
    " <td class=\"indent1\">",
    " Zung Self-Rating Depression Scale",
    " <sup>",
    " [10-14]",
    " </sup>",
    " </td>",
    " </tr>",
    " <tr>",
    " <td class=\"indent1\">",
    " Rotterdam Symptom Checklist",
    " <sup>",
    " [15]",
    " </sup>",
    " </td>",
    " </tr>",
    " <tr>",
    " <td class=\"indent1\">",
    " Carroll Depression Rating Scale",
    " <sup>",
    " [16]",
    " </sup>",
    " </td>",
    " </tr>",
    " </tbody>",
    " </table>",
    " </div>",
    " <div class=\"lgnd\">",
    " <div class=\"footnotes\">",
    " * Designed for use with RDC criteria.",
    " <br>",
    " &bull; Designed for use with DSM-III criteria. Diagnostic and Statistical
    Manual, 3rd edition (DSM-III).",
    " </br>",
    " </div>",
    " <div class=\"reference\">",
    " 1. American Psychiatric Association. Diagnostic and Statistical Manual of
    Mental Disorders, 4th ed. Washington DC: Author, 1994.",
    " <br>",
    " 2. Endicott, J. Cancer 1984; 53:2243.",
    " <br>",
    " 3. Spitzer, RL, et al. Arch Gen Psychiatry 1978; 10:1.",
    " <br>",
    " 4. Endicott, J, et al. Arch Gen Psychiatry 1978; 35:837.",
    " <br>",
    " 5. Robins, LN, et al. Arch Gen Psychiatry 1981; 38:381.",
    " <br>",
    " 6. Spitzer, RL, Williams, JBW, Gibbon, M, First, MB. Structured Clinical
    Interview for DSM-III-R. American Psychiatric Press, Washington DC 1990.",
    " <br>",
    " 7. Goldberg, DP. Manual of the General Health Questionnaire. NFER
    Publishing, Windsor, England 1978.",
    " <br>",
    " 8. Zigmond, AS, et al. Acta Psychiatr Scand 1983; 67:361.",
    " <br>",
    " 9. Beck, AT, et al. Postgrad Med 1972; 52:81.",
    " <br>",
    " 10. Passik, SD, et al. J Clin Oncol 1998; 16:1594.",
    " <br>",
    " 11. Dugan, W, et al. Psychooncology 1998; 7:483.",
    " <br>",
    " 12. Passik, SD, et al. J Pain Symptom Manage 2000; 19:329.",
    " <br>",
    " 13. Passik, SD, et al. J Pain Symptom Manage 2001; 21:273.",
    " <br>",
    " 14. McDonald, MV, et al. Oncol Nurs Forum 1999; 26:593.",
    " <br>",
    " 15. de Haes, JC, et al. Br J Cancer 1990; 62:1034.",
    " <br>",
    " 16. Carroll, BJ, et al. Br J Psychiatry 1981; 138:194.",
    " </br>",
    " </br>",
    " </br>",
    " </br>",
    " </br>",
    " </br>",
    " </br>",
    " </br>",
    " </br>",
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    " </br>",
    " </br>",
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    " Behavioral and cognitive neurology",
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    " Cerebrovascular disease",
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    " CNS infections",
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    " Critical care neurology",
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    " Demyelinating diseases",
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    " Epilepsy and EEG",
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    " <br/>",
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    " Headache",
    " </a>",
    " <br/>",
    " </tds>",
    " <tds valign=\"top\" width=\"33%\">",
    " <a class=\"tocItem\" href=\"UTD.htm?25/20/25934\">",
    " Medical neurology",
    " </a>",
    " <br/>",
    " <a class=\"tocItem\" href=\"UTD.htm?16/24/16782\">",
    " Movement disorders",
    " </a>",
    " <br/>",
    " <a class=\"tocItem\" href=\"UTD.htm?13/20/13646\">",
    " Neurodegenerative disease",
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    " <br/>",
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    " Neurologic systems and symptoms",
    " </a>",
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    " Neurology calculators",
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    " Neuromuscular disease",
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    " Spinal disease and back pain",
    " </a>",
    " <br/>",
    " <a class=\"tocItem\" href=\"UTD.htm?28/19/28981\">",
    " What's new in neurology",
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    " </div>",
    " <div class=\"lgnd\">",
    " An intracellular calcium pyrophosphate crystal is shown, which is pale blue
    when aligned with the axis of the compensator on polarized light microscopic
    examination. Note the rhomboid shape of the calcium-pyrophosphate crystal.",
    " <div class=\"footnotes\">",
    " </div>",
    " <div class=\"reference\">",
    " Courtesy of H Ralph Schumacher, MD, and Tim Jansen, MD.",
    " </div>",
    " </div>",
    " </div>",
    " </div>",
    "</div>"].join("\n");
    var script_f0_63_1023=[""].join("\n");
    var outline_f0_63_1023=null;

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