Idio Health Dictionary

No known cause.... idiopathic

A generally unexpected, so unpredictable, abnormal reaction to a drug caused by a constitutional defect in the patient. In some cases the underlying disorder is already known or discovered after the ?rst event, so that the drug in question can be avoided thereafter. The abnormal sensitivity of patients with PORPHYRIAS to BARBITURATES is an example. Hereditary biochemical defects of red blood cells are responsible for many drug-induced haemolytic anaemias (see under ANAEMIA) and for FAVISM. Porphyria variegata, the South African variety of porphyria, is an example of an inborn error of metabolism which was without serious symptoms until the advent of barbiturate drugs, prescription of which is now strongly discouraged. If anyone with this metabolic disorder takes barbiturates, the consequences may be fatal.... idiosyncrasy

See BELL’S PALSY.... idiopathic facial nerve palsy

Sometimes described as thrombocytopenia, this is an autoimmune disorder in which blood PLATELETS are destroyed. This disturbs the blood’s coagulative properties (see COAGULATION) and spontaneous bleeding (PURPURA) occurs into the skin. The disease may be acute in children but most recover without treatment. Adults may develop a more serious, chronic variety which requires treatment with CORTICOSTEROIDS and sometimes SPLENECTOMY. Should the disease persist despite these treatments, intravenous immunoglobulin or immunosuppressive drugs (see IMMUNOSUPPRESSION) are worth trying. Should the bleeding be or become life-threatening, concentrates of platelets should be administered.... idiopathic thrombocytopenic purpura (itp)

Previously called juvenile rheumatoid arthritis and juvenile chronic arthritis, this is a set of related conditions of unknown cause affecting children. Characteristically, the synovial membrane of a joint or joints becomes in?amed and swollen for at leat six weeks (and often very much longer – even years). About 1 in 10,000 children develop it each year, many of whom have certain HLA genetic markers, thought to be important in determining who gets the illness. In?ammatory CYTOKINES play a big part.

Clinical features There are various types. The oligoarthritic type involves 1–4 joints (usually knee or ankle) which become hot, swollen and painful. One complication is an in?ammation of the eyes – UVEITIS. The condition often ‘burns out’, but may reappear at any time, even years later.

The polyarthritic type is more like RHEUMATOID ARTHRITIS in adults, and the child may have persistent symptoms leading to major joint deformity and crippling.

The systemic type, previously called Still’s disease, presents with a high fever and rash, enlarged liver, spleen and lymph nodes, and arthritis – although the latter may be mild. In some children the illness becomes recurrent; in others it dies down only to return as polyarthritis.

Complications These include uveitis, which can lead to loss of vision; a failure to thrive; osteoporosis (see under BONE, DISORDERS OF); joint deformity; and psychosocial diffculties.

Treatment This includes ANTIPYRETICS and ANALGESICS, including NON-STEROIDAL ANTIINFLAMMATORY DRUGS (NSAIDS), intra-articular steroid injections, anti-tumour necrosis factor drugs and steroids.

Physiotherapy is vital, and children may need to wear splints or other orthotic devices to alleviate deformity and pain. Orthopaedic operative procedures may be necessary.... juvenile idiopathic arthritis (jia)

(ITP) An autoimmune disorder in which platelets are destroyed, leading to bleeding beneath the skin (see purpura).... idiopathic thrombocytopaenic purpura

see persistent idiopathic facial pain.... chronic idiopathic facial pain

(benign intracranial hypertension, pseudotumour cerebri) a syndrome of raised pressure within the skull in the absence of a clear structural cause, such as a tumour. Although the cause is not certain, proposed mechanisms include impaired reabsorption of cerebrospinal fluid or venous outflow from the brain. The symptoms include headache, vomiting, double vision, and *papilloedema. The diagnosis is made by finding a high opening pressure at *lumbar puncture in the absence of a causative structural abnormality on brain imaging. It can improve spontaneously but drug therapy or neurosurgical treatment may be required to protect the patient’s vision.... idiopathic intracranial hypertension

(ITP) an *autoimmune disease in which platelets are destroyed, leading to spontaneous bruising (see purpura). Acute ITP is a relatively mild disease of children, who usually recover without treatment. A chronic form of the disease, typically affecting adults, is more serious, requiring treatment with corticosteroids or, if there is no response, with splenectomy. If both fail, immunosuppressant drugs may be effective. Platelet concentrates are used for life-threatening bleeding.... idiopathic thrombocytopenic purpura

n. the antigen-binding site of an antibody, which confers antigenicity.... idiotype

adj. affecting or peculiar to the ventricles of the heart. The term is most often used to describe the very slow beat of the heart’s ventricles under the influence of their own natural subsidiary pacemaker (idioventricular rhythm). An accelerated idioventricular rhythm of 80–120 beats per minute is often seen in patients a few hours after being admitted with a heart attack (see myocardial infarction). Its presence is a good sign since it usually indicates restoration of blood flow down the occluded coronary artery.... idioventricular

(atypical facial pain, chronic idiopathic facial pain) a chronic pain in the face that has no known cause and does not fit the classic presentation of other cranial neuralgias. It may be stress-related, and in some cases appears to be associated with defective metabolism of *tyramine. Treatment may involve the use of antidepressants.... persistent idiopathic facial pain

(IPF) a serious interstitial lung disease, formerly called cryptogenic fibrosing alveolitis (see alveolitis). It is characterized by progressive fibrous scarring of the lung and increased numbers of inflammatory cells in the alveoli and surrounding tissues. The disease is usually diagnosed on clinical grounds on a basis of worsening breathlessness, inspiratory crackles at the lung bases on auscultation, clubbing of the fingers or toes, bilateral radiographic shadowing predominantly in the lower zones of the chest X-ray, subpleural *honeycomb change on CT scanning of the chest, and restrictive lung function on spirometry. It is also called usual interstitial pneumonia (UIP; see interstitial pneumonia), a term used by lung pathologists for the most common cellular pattern seen on biopsy. Treatment includes *pirfenidone, corticosteroids, and immunosuppressants.... idiopathic pulmonary fibrosis

(JIA, Still’s disease) any one of a group of conditions characterized by inflammation of the joints lasting longer than 6 weeks and occurring before the age of 16. The causes are unknown but immunological and infective mechanisms are suspected. JIA can affect either four or fewer joints (pauciarticular JIA) or more than four (polyarticular JIA). There are two recognized types of pauciarticular JIA: type 1, which generally affects girls below the age of four; and type 2 (juvenile-onset spondylarthropathy), which generally affects boys over the age of nine. There are also two types of polyarticular JIA, depending on the presence or absence of a particular antibody in the blood. There is a great range of severity of these diseases. Treatment consists of pain management and prevention of subsequent deformity or limitation of movement (e.g. contractures). Long-term joint damage is prevented by use of medications similar to those used in rheumatoid arthritis.... juvenile idiopathic arthritis