Body Disorders And Conditions

Hairy cell leukemia (HCL) is a rare cancer of the blood. It affects B cells, a type of white blood cell (lymphocyte).

HCL is caused by the abnormal growth of B cells. The cells can look "hairy" under the microscope because they have fine projections coming from their surface.

HCL can lead to low numbers of normal blood cells.

The cause of this disease is unknown. It affects men more often than women. The average age of onset is 55. Hairy cell leukemia is rare.

• Easy bruising or bleeding
• Excessive sweating (especially at night)
• Fatigue
• Feeling full after eating only a small amount
• Recurrent infections and fevers
• Swollen lymph glands
• Weakness
• Weight loss

Chronic myelogenous leukemia is cancer that starts inside bone marrow, the soft tissue inside bones that helps form blood cells. The cancer grows from cells that produce white blood cells.

See also:

• Acute myeloid leukemia (CML)
• Chronic lymphocytic leukemia (CLL)
• Leukemia

CML can occur in adults (usually middle-aged) and children. The disease affects 1 to 2 people per 100,000 and makes up 7 - 20% cases of leukemia. It is usually associated with a chromosome abnormality called the Philadelphia chromosome.

Exposure to ionizing radiation is one possible trigger for this chromosome abnormality. Such exposure could occur from a nuclear disaster or from treatment of a previous cancer such as thyroid cancer or Hodgkin's lymphoma. It takes many years to develop leukemia from this cause. However, most people treated for cancer with radiation do not go on to develop leukemia, and most patients with CML have not been exposed to radiation.

CML causes rapid growth of the blood-forming cells (myeloid precursors) in the bone marrow, blood, and body tissues.

Chronic myelogenous leukemia is grouped into several phases:

• Chronic
• Accelerated
• Blast crisis

The chronic phase can last for months or years. The disease may have few or no symptoms during this time. Most people are diagnosed during this stage, when they are having blood drawn for other reasons.

The accelerated phase is a more dangerous phase, during which the leukemia cells grow more quickly. This phase may be associated with fever (without infection), bone pain, and a swollen spleen.

If untreated, CML progresses to the blast crisis phase. Bleeding and infection may occur due to bone marrow failure. Other possible symptoms include:

• Bleeding and bruising
• Excessive sweating (night sweats)
• Fatigue
• Low-grade fever
• Pressure under the left ribs from a swollen spleen
• Sudden appearance of small red marks on the skin (petechiae)
• Weakness

Chronic lymphocytic leukemia is cancer of the white blood cells (lymphocytes).

See also:

• Acute lymphocytic leukemia (ALL)
• Chronic myelogenous leukemia (CML)
• Leukemia

Chronic lymphocytic leukemia (CLL) causes a slow increase in the number of white blood cells called B cells in the bone marrow. The cancerous cells spread from the blood marrow to the blood, and can also affect the lymph nodes and other organs. CLL eventually causes the bone marrow to fail and weakens the immune system.

The reason for this increase in B cells is unknown. There is no link to radiation, cancer-causing chemicals, or viruses.

CLL primarily effects adults. The average age of patients with this type of leukemia is 70. It is rarely seen in people younger than 40. The disease is more common in Jewish people of Russian or East European descent, and is uncommon in Asians.

Symptoms usually develop gradually. Many cases of CLL are detected by routine blood tests in people who do not have any symptoms.

Symptoms that can occur include:

• Abnormal bruising (occurs late in the disease)
• Enlarged lymph nodes, liver, or spleen
• Excessive sweating, night sweats
• Fatigue
• Fever
• Infections that keep coming back (recur)
• Loss of appetite or becoming full too quickly (early satiety)
• Unintentional weight loss

Acute myeloid leukemia (AML) is cancer that starts inside bone marrow, the soft tissue inside bones that helps form blood cells. The cancer grows from cells that would normally turn into white blood cells.

Acute means the disease develops quickly.

See also:

• Chronic lymphocytic leukemia (CLL)
• Chronic myelogenous leukemia (CML)
• Leukemia

Acute myeloid leukemia (AML) is one of the most common types of leukemia among adults. This type of cancer is rare under age 40. It generally occurs around age 65. (This article focuses on AML in adults.)

AML is more common in men than women.

Persons with this type of cancer have abnormal cells inside their bone marrow. The cells grow very fast, and replace healthy blood cells. The bone marrow, which helps the body fight infections, eventually stops working correctly. Persons with AML become more prone to infections and have an increased risk for bleeding as the numbers of healthy blood cells decrease.

Most of the time, a doctor cannot tell you what caused AML. However, the following things are thought to lead to some types of leukemia, including AML:

• Certain chemicals (for example, benzene)
• Certain chemotherapy drugs, including etoposide and drugs known as alkylating agents
• Radiation

Problems with your genes may also play a role in the development of AML.

You have an increased risk for AML if you have or had any of the following:

• A weakened immune system (immunosuppression) due to an organ transplant
• Blood disorders, including:
  • Polycythemia vera
  • Essential thrombocythemia
  • Myelodysplasia (refractory anemia)
• Exposure to radiation and chemicals

• Abnormal menstrual periods
• Bleeding from the nose
• Bleeding gums
• Bruising
• Bone pain or tenderness
• Fatigue
• Fever
• Paleness
• Shortness of breath (gets worse with exercise)
• Skin rash or lesion
• Swollen gums (rare)
• Weight loss

ALL makes up 80% of childhood acute leukemias. Most cases occur in children ages 3 - 7. The disease may also occur in adults.

In acute leukemia, cancerous cells multiply quickly and replace normal cells. Cancerous cells take over normal parts of the bone marrow, causing bone marrow failure. A person with ALL is more likely to bleed and have infections because there are fewer normal blood cells.

Most cases of ALL have no obvious cause. However, the following may play a role in the development of leukemia:

• Chromosome problems
• Radiation
• Some chemotherapy drugs
• Toxins such as benzene

Persons with Down syndrome or who have a brother or sister with leukemia are at increased risk for ALL.

• Bleeding gums
• Bone pain or tenderness
• Easy bruising
• Excessive or prolonged bleeding
• Fatigue
• Fever
• Joint pain
• Infection
• Menstrual irregularities
• Nosebleeds
• Paleness
• Palpitations
• Pinpoint red spots on the skin (petechiae)
• Shortness of breath (made worse by exercise)
• Swollen glands (lymphadenopathy)
• Swollen gums
• Unintentional weight loss

Metabolic syndrome is a name for a group of risk factors that occur together and increase the risk for coronary artery disease, stroke, and type 2 diabetes.

Metabolic syndrome is becoming more and more common in the United States. Researchers are not sure whether the syndrome is due to one single cause, but all of the syndrome's risk factors are related to obesity.

Metabolic syndrome is associated with many conditions and risk factors. The two most important risk factors are:

• Extra weight around the middle of the body (central obesity). The body may be described as "apple-shaped."
• Insulin resistance, in which the body cannot use insulin effectively. Insulin is needed to help control the amount of sugar in the body.

Insulin helps blood sugar (glucose) enter cells. If you have insulin resistance, your body doesn't respond to insulin and blood sugar cannot get into cells. As a result, the body produces more and more insulin. Insulin and blood sugar levels rise, affecting kidney function and raising the level of blood fats, such as triglycerides.

Other risk factors include:

• Aging
• Genes that make you more likely to develop this condition (genetic predisposition)
• Hormonal changes
• Lack of exercise

• Extra weight around your waist (central or abdominal obesity)

Type 2 diabetes is a chronic (lifelong) disease marked by high levels of sugar (glucose) in the blood. Type 2 diabetes is the most common form of diabetes.

See also:

• Diabetes
• Gestational diabetes
• Type 1 diabetes
• Metabolic syndrome

Diabetes is caused by a problem in the way your body makes or uses insulin. Insulin is needed to move blood sugar (glucose) into cells, where it is stored and later used for energy.

When you have type 2 diabetes, the body does not respond correctly to insulin. This is called insulin resistance. Insulin resistance means that fat, liver, and muscle cells do not respond normally to insulin. As a result blood sugar does not get into cells to be stored for energy.

When sugar cannot enter cells, abnormally high levels of sugar build up in the blood. This is called hyperglycemia. High levels of blood sugar often trigger the pancreas to produce more and more insulin, but it not enough to keep up with the body's demand.

People who are overweight are more likely to have insulin resistance, because fat interferes with the body's ability to use insulin.

Type 2 diabetes usually occurs gradually. Most people with the disease are overweight at the time of diagnosis. However, type 2 diabetes can also develop in those who are thin, especially the elderly.

Family history and genetics play a large role in type 2 diabetes. Low activity level, poor diet, and excess body weight (especially around the waist) significantly increase your risk for type 2 diabetes.

Other risk factors include:

• Age greater than 45 years
• HDL cholesterol of less than 35 mg/dL or triglyceride level of greater than 250 mg/dL
• High blood pressure
• History of gestational diabetes
• Previously identified impaired glucose tolerance by your doctor
• Race/ethnicity (African Americans, Hispanic Americans, and Native Americans all have high rates of diabetes)

Often, people with type 2 diabetes have no symptoms at all. If you do have symptoms, they may include:

• Blurred vision
• Erectile dysfunction
• Fatigue
• Frequent or slow-healing infections
• Increased appetite
• Increased thirst
• Increased urination

Type 1 diabetes is a chronic (lifelong) disease that occurs when the pancreas does not produce enough insulin to properly control blood sugar levels.

See also:

• Diabetes
• Gestational diabetes
• Type 2 diabetes

There are several forms of diabetes. Type 1 diabetes used to be called juvenile or insulin-dependent diabetes. Type 1 diabetes can occur at any age, but it is most often diagnosed in children, adolescents, or young adults.

Insulin is a hormone produced by special cells, called beta cells, in the pancreas, an organ located in the area behind your stomach. Insulin is needed to move blood sugar (glucose) into cells, where it is stored and later used for energy. In type 1 diabetes, these cells produce little or no insulin.

Without enough insulin, glucose builds up in the bloodstream instead of going into the cells. The body is unable to use this glucose for energy. This leads to the symptoms of type 1 diabetes.

Within 5 - 10 years, the insulin-producing beta cells of the pancreas are completely destroyed and the body can no longer produce insulin.

The exact cause is unknown, but most likely there is a viral or environmental trigger in genetically susceptible people that causes an immune reaction. The body's white blood cells mistakenly attack the insulin-producing pancreatic beta cells.

Some people will have no symptoms before they are diagnosed with diabetes.

Others may notice these symptoms as the first signs of type 1 diabetes, or when the blood sugar is high:

• Feeling tired or fatigued
• Feeling hungry
• Being very thirsty
• Urinating more often
• Losing weight without trying
• Having blurry eyesight
• Losing the feeling or feeling tingling in your feet

For others, warning symptoms that they are becoming very sick may be the first signs of type 1 diabetes, or may happen when the blood sugar is very high (see: diabetic ketoacidosis):

• Deep, rapid breathing
• Dry skin and mouth
• Flushed face
• Fruity breath odor
• Nausea or vomiting, unable to keep down fluids
• Stomach pain

Low blood sugar (hypoglycemia) can develop quickly in people with diabetes who are taking insulin. Symptoms typically appear when the blood sugar level falls below 70. Watch for:

• Headache
• Hunger
• Nervousness
• Rapid heartbeat (palpitations)
• Shaking
• Sweating
• Weakness

Gestational diabetes is high blood sugar (diabetes) that starts or is first diagnosed during pregnancy.

Risk factors for gestational diabetes include:

• African or Hispanic ancestry
• Being older than 25 when pregnant
• Family history of diabetes
• Giving birth to a previous baby that weighed more than 9 pounds
• Obesity
• Recurrent infections
• Unexplained miscarriage or death of a newborn

Usually there are no symptoms, or the symptoms are mild and not life threatening to the pregnant woman. Often, the blood glucose level returns to normal after delivery.

Symptoms may include:

• Blurred vision
• Fatigue
• Frequent infections, including those of the bladder, vagina, and skin
• Increased thirst
• Increased urination
• Nausea and vomiting
• Weight loss in spite of increased appetite

However, high blood sugar levels in the mother can cause problems in the baby. These problems can include:

• Birth injury (trauma) because of the baby's large size
• Increased chance of diabetes and obesity
• Jaundice
• Large size at birth
• Low blood sugar (hypoglycemia)

Rarely, the unborn baby dies in the womb late in the pregnancy. Mothers with gestational diabetes have an increased risk for high blood pressure during pregnancy and delivery by c-section.

The goal of treatment is to reduce blood pressure so that you have a lower risk of complications.

There are many different medicines that can be used to treat high blood pressure, including:

• Alpha blockers
• Angiotensin-converting enzyme (ACE) inhibitors
• Angiotensin receptor blockers (ARBs)
• Beta-blockers
• Calcium channel blockers
• Central alpha agonists
• Diuretics
• Renin inhibitors, including aliskiren (Tekturna)
• Vasodilators

Your doctor may also tell you to exercise, lose weight, and follow a healthier diet. If you have pre-hypertension, your doctor will recommend the same lifestyle changes to bring your blood pressure down to a normal range.

Often, a single blood pressure drug may not be enough to control your blood pressure, and you may need to take two or more drugs. It is very important that you take the medications prescribed to you. If you have side effects, your health care provider can substitute a different medication.

Most of the time, there are no symptoms. Symptoms that may occur include:

• Chest pain
• Confusion
• Ear noise or buzzing
• Irregular heartbeat
• Nosebleed
• Tiredness
• Vision changes

If you have a severe headache or any of the symptoms above, see your doctor right away. These may be signs of a complication or dangerously high blood pressure called malignant hypertension.