OpenMed/multicare-articles huggingface dataset:
Successful Management of the Fetal Severe Anemia Associated with Jra Alloimmunization by Intrauterine Transfusion of Jr(a+) Red Blood Cells
Authors: Masatake Toshimitsu, Shinichi Nagaoka, Shuusaku Kobori, Yuichiro Takahashi, Jun Murotsuki
Journal: Case Rep Obstet Gynecol (2019)
MeSH terms: Case Reports

Objective:
We present a case of fetal severe anemia associated with Jra alloimmunization, which was managed using Doppler measurement of the peak systolic velocity of the fetal middle cerebral artery (MCA-PSV) and intrauterine transfusion (IUT) of Jr(a+) red blood cells (RBCs). We also review the previous case reports on fetal or neonatal anemia associated with Jra alloimmunization.
Case report:
A woman with Jra alloimmunization was referred to our department at 29 weeks of gestation. As fetal MCA-PSV exceeded 1.55 multiples of the median, fetal blood sampling was performed and demonstrated severe anemia. During the course, a total of two IUTs were performed using Jr(a+) RBCs. The neonate was delivered by repeated cesarean section at 35 weeks of gestation and showed no apparent signs of hemolysis.
Conclusion:
Based on the literature review, fetal anemia associated with Jra alloimmunization becomes severe during mid-gestation and may not develop during late gestation. The severity of fetal anemia is predicted by MCA-PSV Doppler assessment rather than the maternal anti-Jra titers. Timely IUT of Jr(a+) RBCs can help to prolong the pregnancy to term in emergency situations wherein compatible blood of Jr(a-) RBCs is not available soon.
Case Report: Thromboembolism and Hemorrhagic Pericardial Effusion-The Janus Face of Primary Pericardial Angiosarcoma
Authors: Fei F Chen, Shu F Jiang, Chang Dong, Ying Che, Lin Y Du, Zhi Y Li, Zhi Q Yang, Yi C Zhao, Ying Liu
Journal: Front Cardiovasc Med (2021)
Keywords: cardiac angiosarcoma, cardiac tamponade, hemoptysis, pulmonary metastasis, pulmonary thromboembolism
MeSH terms: Case Reports

Background: Primary cardiac angiosarcomas, especially those originating in the pericardium, are extremely rare and aggressive tumors with poor prognosis. These types of malignant tumors have diverse clinical presentations and are often masked by other comorbidities. Case Summary: Our hospital reported a 59-year-old woman who initially presented with pulmonary thromboembolism (PTE) and was subsequently treated with low-molecular-weight heparin. However, she experienced acute pericardial tamponade after anticoagulation therapy, where no obvious mass was primarily identified upon imaging, both in the pericardium or within the heart. Emergency pericardiocentesis and drainage were performed, where a total of 210 mL of bloody effusion was drained. Four months later, she was hospitalized with progressive hemoptysis and dyspnea. A large mixed mass occupying the right pericardium was later identified by coronary computed tomography angiography (CCTA). The mass was consistent with the right atrium, with heterogeneous thickened pericardium and localized moderate pericardial effusion. CCTA and positron emission tomography scans later showed metastases in both lungs and bilateral pleura. Nodules in hilar and mediastinal lymph nodes were also significant. Ultrasound-guided biopsy was performed, and the patient was ultimately diagnosed with an angiosarcoma based on final positive results for both CD31 and CD34 markers. The patient refused chemotherapy and passed away while waiting for her pathology results. The patient survived for 6 months since the first reported episode of PTE. Conclusions: Our case indicates that patients presenting with both embolism and hemorrhage should urgently be channeled to a clinical specialist to confirm any malignant etiology. This would be beneficial to confirm an early diagnosis and lengthen the duration of patient survival. However, the diagnosis of primary cardiac angiosarcoma is still challenging and requires multiple imaging modalities and biopsies in order to assist the accurate diagnosis of disease and achieve effective patient management.
Surgical mistake causing an high recto-vaginal fistula. A case report with combined surgical and endoscopic approach: therapeutic considerations
Authors: Michele Danzi, Fabozzi Massimiliano, Reggio Stefano, Pannullo Mario, Amato Bruno, Grimaldi Luciano
Journal: BMC Surg (2013)
MeSH terms: Colposcopy, Medical Errors, Rectovaginal Fistula / etiology, Rectovaginal Fistula / surgery, Case Reports, Aged, Combined Modality Therapy, Female, Humans

Background:
Rectovaginal fistulas (RVFs) have multiple causes, size and location on which the surgical treatment depends.
Description:
The Authors consider different approaches to RVFs and describe a clinical case of recurrent high RVF.
Conclusions:
Most RVFs can be successfully repaired, although many interventions may be necessary. A colostomy with delayed repair may improve RVFs outcome. Moreover, several authors indicate Mucosal Advancement Flap and Babcock-Bacon technique as the treatments of choice respectively for low and high RVFs (complex and recurrent) and emphasize the placement of endoscopic prothesis in cases of difficult healing of the anastomosis.
Nontraditional Use of TEE to Evaluate Hepatic Vasculature and Guide Surgical Management in Orthotopic Liver Transplantation
Authors: Narjeet Khurmi, Mitchell Seman, Brantley Gaitan, Scott Young, David Rosenfeld, Emmanouil Giorgakis, Winston Hewitt, Amit Mathur
Journal: Case Rep Transplant (2019)
MeSH terms: Case Reports

Intraoperative Transesophageal Echocardiography (TEE) during orthotopic liver transplant (OLT) is used to gather real-time information on cardiovascular function and intravascular volume status. We report a case where nonstandard TEE views were used to inspect the hepatic vasculature after allograft implantation. A 29-year-old male with secondary biliary cirrhosis with a MELD score of 20 underwent OLT using a liver from a 21-year-old brain-dead donor. Postreperfusion TEE, using the modified hepatic vein views, confirmed the presence of an inferior vena cava (IVC) suprahepatic anastomotic stenosis and hepatic vein and IVC thrombus resulting in hepatic venous outflow obstruction, allograft congestion, and hemodynamic instability. These nonstandard TEE images established the extent of suprahepatic caval outflow obstruction, in which intraoperative ultrasound was unable to definitively demonstrate. This guided real-time surgical decision-making in the postimplantation phase of the operation-ultimately leading to hepatic vein and IVC thrombectomy and revision of suprahepatic caval anastomosis.
Eyelid Edema: A Rare Cause of a Common Sign
Authors: Andreia Soares, Cristina Almeida, Cristina Freitas, Marco Sales-Sanz, Sara Ribeiro
Journal: Case Rep Ophthalmol Med (2017)
MeSH terms: Case Reports

We report a 48-year-old female patient who presented to the emergency room with right eyelid edema, with 3 days of evolution. She had suffered minor trauma to this eye one week before. She reported episodes of right eyelid swelling of spontaneous resolution since the occurrence of a traumatic brain injury 5 years ago. Ophthalmological examination showed a soft and painless eyelid edema of the right eye. Brain computed tomography showed an area of bone discontinuity of the orbital roof with brain herniation and a CSF leak into the eyelid (blepharocele). Magnetic resonance confirmed the result of TC and revealed an area of frontal encephalomalacia. Ibuprofen (800 mg/day) was prescribed, with complete resolution within 20 days. She was evaluated by Neurosurgery with no indication of surgery due to the resolution of the edema and absence of symptoms. Blepharocele is a rare entity that should be considered in the differential diagnosis of unilateral eyelid edema. It can be secondary to an orbital fracture or congenital lesion.
Brain Tumor-Associated Psychosis and Spirituality-A Case Report
Authors: Lars Levi Dutschke, Sarah Steinau, Roland Wiest, Sebastian Walther
Journal: Front Psychiatry (2017)
Keywords: auditory hallucinations, brain tumor, dysembryogenic neuroepithelial tumor, psychopathology, psychosis, spirituality
MeSH terms: Case Reports

This case report describes a patient with a dysembryogenic neuroepithelial tumor localized in the posterior thalamus and internal capsule, which presented with psychosis including religiously determined severe self-mutilation, auditory hallucinations, and rituals. The patient's history includes periodic religiousness over decades of her life suggesting that spirituality in this case might be a symptom of tumor progression. Our case reports on the topology-related effect of lesions on different brain networks involved in the phenomenology of the patient's psychotic symptoms.
Effectiveness of Thrombolytic Therapy in Acute Embolic Stroke due to Infective Endocarditis
Authors: Siva P Sontineni, Aryan N Mooss, Venkata G Andukuri, Susan Marie Schima, Dennis Esterbrooks
Journal: Stroke Res Treat (2010)
MeSH terms: Case Reports

Objective. To identify the role of thrombolytic therapy in acute embolic stroke due to infective endocarditis. Design. Case report. Setting. University hospital. Patient. A 70-year-old male presented with acute onset aphasia and hemiparesis due to infective endocarditis. His head computerized tomographic scan revealed left parietal sulcal effacement. He was given intravenous tissue plasminogen activator with significant resolution of the neurologic deficits without complications. Main Outcome Measures. Physical examination, National Institute of Health Stroke Scale, radiologic examination results. Conclusions. Thrombolytic therapy in selected cases of stroke due to infective endocarditis manifesting as major neurologic deficits can be considered as an option after careful consideration of risks and benefits. The basis for such favorable response rests in the presence of fibrin as a major constituent of the vegetation. The risk of precipitating hemorrhage with thrombolytic therapy especially with large infarcts and mycotic aneurysms should be weighed against the benefits of averting a major neurologic deficit.
An unusual case of adamantinoma of long bone
Authors: Arvind Kumar, Ruchi Sharma, Anil Kumar Verma, Abhijeet Tiwari, Jyoti Mishra
Journal: Autops Case Rep (2021)
Keywords: adamantinoma, diaphyses, tibia
MeSH terms: Case Reports

Adamantinoma of the long bones is an exceedingly rare and slow-growing tumor that affects the diaphysis of long bones, particularly the tibia. Based on the pattern of the epithelial cell component and the presence or absence of the osteofibrous dysplasia-like element, several histological variants have been described, such as (i) tubular (the most frequent), (ii) basaloid, (iii) squamous, (iv) spindle variant, (v) osteofibrous dysplasia -like variant, and (vi) Ewing's sarcoma - like adamantinoma (the least frequent). The diagnosis may be challenging since this tumor may be mistakenly interpreted as carcinoma, myoepithelial tumor, osteofibrous dysplasia, and vascular tumor. We report the case of a 41-year-old male who presented with swelling over the right leg associated with pain. The X-ray showed a lytic lesion of the right-sided tibia. The diagnosis of adamantinoma was made based on the clinico-radiological, histomorphology, and immunohistochemical findings. Histologically, classic adamantinoma is a biphasic tumor characterized by epithelial and osteofibrous components in varying proportions and differentiating patterns. The diagnosis can be confirmed by immunohistochemistry for demonstrating sparse epithelial cell nests when the radiological features are strongly consistent with adamantinoma. This case is highlighted because the epithelial component can lead to a misdiagnosis, particularly when the clinico-radiological features are overlooked. Adamantinoma of long bones has the potential for local recurrence and may metastasize to the lungs, lymph nodes, or other bones. The prognosis is good if early intervention is taken.
A neonate with late-onset hypocalcemia due to unrecognized maternal hyperparathyroidism and a systematic overview of similar cases
Authors: Georgios Mitsiakos, Georgios N Katsaras, Ilias Chatziioannidis, Anastasia Gkampeta, Christina Mitsiakou, Nikolaos Nikolaidis
Journal: Ger Med Sci (2021)
Keywords: hyperparathyroidism, hypocalcemia, neonates, seizures
MeSH terms: Hypercalcemia, Hyperparathyroidism / complications, Hyperparathyroidism / diagnosis, Hypocalcemia / diagnosis, Hypocalcemia / etiology, Parathyroid Neoplasms / complications, Parathyroid Neoplasms / diagnosis, Parathyroid Neoplasms / surgery, Pregnancy Complications / diagnosis, Case Reports, Female, Humans, Infant, Newborn, Parathyroid Hormone, Pregnancy, Parathyroid Hormone

Objective: Neonatal seizures are alarming manifestations of an underlying significant disorder demanding immediate attention and intervention. Hypocalcemia, although rare, must be considered in the differential diagnosis of neonatal seizures. Method: We present an unusual case of a 10-day-old infant with unexplained symptomatic hypocalcemia, experiencing multiple episodes of focal tonic-clonic seizures, born by an entirely asymptomatic mother. Moreover, we conducted a systematic search in PubMed and Scopus databases to present a clinical overview of all similar cases. Result: Maternal laboratory investigation revealed markedly increased calcium levels with concomitant high parathyroid hormone levels due to a parathyroid adenoma, undiagnosed during antenatal checkup. Conclusion: This is one of the few cases in the literature where neonatal symptomatology led to the diagnosis of undiagnosed maternal hyperparathyroidism. Early detection and appropriate management of neonatal hypocalcemia could eliminate serious maternal and fetal morbidity.
Suspected "t-cell-mediated" hypereosinophilic syndrome presenting with cerebral watershed infarcts
Authors: S Dujardin, R Schots, S De Raedt
Journal: Case Rep Neurol Med (2011)
MeSH terms: Case Reports

We describe a case of suspected "T-cell-mediated" hypereosinophilic syndrome presenting with cerebral watershed infarcts. An extensive search for potential embolic sources was negative, supporting the hypothesis that cerebrovascular endothelial dysfunction could have caused the infarcts.
21-Year-Old Pregnant Woman with MODY-5 Diabetes
Authors: Anastasia Mikuscheva, Elliot McKenzie, Adel Mekhail
Journal: Case Rep Obstet Gynecol (2017)
MeSH terms: Case Reports

The term "Maturity-Onset Diabetes of the Young" (MODY) was first described in 1976 and is currently referred to as monogenic diabetes. There are 14 known entities accounting for 1-2% of diabetes and they are frequently misdiagnosed as either type 1 or type 2 diabetes. MODY-5 is an entity of monogenic diabetes that is associated with genitourinary malformations and should be considered by obstetricians in pregnant women with a screen positive for diabetes, genitourinary malformations, and fetal renal anomalies. Correct diagnosis of monogenic diabetes has implications on managing patients and their families. We are reporting a case of a 21-year-old pregnant woman with a bicornuate uterus, fetal renal anomalies, and a family history of diabetes that were suggestive of a MODY-5 diabetes.
Desmoid tumor of the buttock in a preadolescent child
Authors: Yogesh Kumar Sarin, Nita Khurana
Journal: APSP J Case Rep (2011)
Keywords: aggressive fibromatosis, desmoid tumor, fibrosarcoma, musculoaponeurotic fibromatosis, recurrence
MeSH terms: Case Reports

Extra-abdominal desmoid tumors are circumscribed but non-capsulated neoplasms of differentiated fibrous tissue arising from musculoaponeurotic tissues. They tend to be locally infiltrative, resulting in a high rate of local recurrence without metastasis, following surgical resection. We report a 9-year-old boy who had a large desmoid tumor in his right buttock that was successfully excised.
Intraocular Plasmablastic Lymphoma in a HIV Patient
Authors: Carolline Fontes Alves Mariano, Glauce Lunardelli Trevisan, Antonio Augusto Velasco E Cruz, Fernando Chahud
Journal: Case Rep Pathol (2017)
MeSH terms: Case Reports

Plasmablastic lymphoma (PBL) is a rare B-cell lymphoma occurring mainly in HIV patients. The tumor frequently involves extranodal sites such as the oral cavity, nasal cavity, gastrointestinal tract, skin, and lungs. The neoplastic cells are characterized by a plasmablastic appearance and typical immunophenotype that indicates plasma cell differentiation. Herein, we report a case of intraocular involvement by plasmablastic lymphoma in a HIV patient with a long history of cytomegalovirus retinitis and loss of vision. After an evisceration performed to control the blind, painful eye a diagnosis of PBL was made by examining the eye contents. Two months later, a biopsy of cervical lymph node revealed nodal lymphoma of the same type. To the best of our knowledge, this is the second case of intraocular PBL reported in English literature.
Solid Pseudopapillary Neoplasms Are Rare, Indolent Pancreatic Tumors in Young Women
Authors: Amin Dalili, Mohsen Aliakbarian, Mehdi Karimi-Shahri, Alireza Samadi, Sara Raji
Journal: Case Rep Surg (2020)
MeSH terms: Case Reports

Introduction. Solid pseudopapillary neoplasm (SPN) is a rare and indolent pancreatic tumor with low malignant potential which frequently occurs in reproductive-age females. Complete resection is almost always the curative option. Case Presentation. We present a 20-year-old woman with acute epigastric pain and vomiting in multiple episodes. Abdominal ultrasound showed a hypoechoic lesion with the probable source in the pancreas. Following that, CT scans and Endoscopic Ultrasound (EUS) manifested a 9 × 7.5 cm-sized hypodense mass with heterogeneous well-defined margins in the pancreas suggesting the diagnosis of SPN. Whipple's procedure was performed. Histopathological examination and immunohistochemistry confirmed SPN without evidence of malignancy. Discussion. SPN is known as a tumor with a favorable prognosis and a long survival rate after complete resection. However, some literature focused on minimally invasive surgery as an alternative surgical approach.
A Cryptogenic Stroke Associated With Infective Endocarditis and Antiphospholipid Antibody Syndrome: Case Report and Literature Review
Authors: Lei Chen, Ping Zhang, Xuan Zhu, Minmin Zhang, Benqiang Deng
Journal: Front Neurol (2022)
Keywords: antiphospholipid antibody syndrome (aps), cryptogenic stroke, embolic, infective endocarditis, surgery
MeSH terms: Case Reports

Introduction:
Accurate definition of stroke etiology is crucial, as this will guide effective targets for treatment. Both antiphospholipid antibody syndrome (APS) and infective endocarditis (IE) can be independent risk factors for ischemic stroke in young adults. When an embolic stroke occurs with IE and APS simultaneously, the origin of the embolic source is difficult to identify.
Case report:
A 19-year-old man was admitted to the hospital for the onset of stroke. A diagnosis of APS accompanied by IE was made after a series of examinations. We identified aortic valve vegetation as the embolic source. Although both APS and IE can induce valve vegetation, we considered IE to be the primary cause according to the infective clues. Despite treatment with ampicillin, the patient's fever persisted, and surgical aortic valve replacement was performed urgently. The patient recovered without recurrence of stroke during the 1-year follow-up.
Conclusion:
A considerable challenge for physicians is evaluating all the signs suggestive of embolic sources in acute stroke and identifying the primary etiology when there are multiple causes. Early diagnosis and surgical intervention for bicuspid aortic valve (BAV) vegetation complicated by acute stroke may yield favorable clinical results.
Isolated Pancreatic Tuberculosis Mimicking Pancreatic Cancer: A Diagnostic Challenge
Authors: Abhishek Bhurwal, Muhammad Masoodul Haq, Sunil Sapru, Matthew Tortora, Dhanasekaran Ramasamy
Journal: Case Rep Gastrointest Med (2018)
MeSH terms: Case Reports

Isolated pancreatic tuberculosis is an exceedingly rare condition, even in areas of the world where the disease is highly prevalent. Abdominal tuberculosis is a common form of extrapulmonary tuberculosis but involvement of the pancreas is very rare. We report a case of isolated pancreatic tuberculosis presenting as a pancreatic mass in a patient with persistent abdominal pain and jaundice. Clinically and radiologically, the mass mimicked a malignant pancreatic tumor with a vastly different prognostic implication and therapeutic approach. Endoscopic ultrasound with fine-needle aspiration (EUS-FNA) can provide valuable diagnostic information in this scenario. After the tissue showed evidence of acid-fast bacilli and the cultures showed growth of Mycobacterium tuberculosis, antituberculosis therapy was initiated. Conservative management is usually successful in alleviating symptoms and leading to a cure. The excellent response to ATT makes it imperative that these patients are diagnosed early and managed appropriately to avoid unnecessary surgery and associated morbidity.
Case Report: Atrial myxoma combined with hyperthyroidism in an adolescent with literature review
Authors: Mengjin Hao, Libo Wang, Dashi Ma, Weiying Guo
Journal: Front Oncol (2023)
Keywords: carney complex, graves’ disease, adolescent female, atrial myxoma, diagnosis
MeSH terms: Case Reports

The most common primary cardiac tumors in adults are atrial myxomas, with adolescent-onset being uncommon. In this case report, a 15-year-old female was hospitalized with cerebrovascular embolism and later diagnosed with a left atrial myxoma. She had previously shown signs of distal vascular micro thrombosis, including recurring bilateral lower extremity rash, which are crucial for the early diagnosis and differential diagnosis of atrial mucinous neoplasm. We reviewed the various clinical symptoms and diagnostic approaches to identify left atrial mucinous neoplasm. This patient also had a combination of endocrine-related diseases. We reviewed the diagnostic approach for the Carney Complex (CNC) and discussed the role of thyroid disease in diagnosing CNC.
Moya moya disease in a child: a case report
Authors: Jagdish P Goyal, Sanjeev S Rao, Sangita Trivedi
Journal: Case Rep Neurol Med (2011)
MeSH terms: Case Reports

We report a case of 8-year-old female child who was admitted at our hospital with complaints of transient ischemic attacks and left-sided hemiparesis. On MR angiography, the child was diagnosed to have Moya Moya disease. Moya Moya disease is a rare cause of cerebral stroke in children. The patient was treated conservatively and referred to a higher centre for specific neurosurgery. Neurosurgical revascularization process leads to favourable outcome.
Emtricitabine-induced pure red cell aplasia
Authors: Nithendra Manickchund, Camille du Plessis, Melanie-Anne A John, Thandekile C Manzini, Bernadett I Gosnell, Richard J Lessells, Yunus S Moosa
Journal: South Afr J HIV Med (2019)
Keywords: adverse drug reaction, antiretroviral, drug induced, emtricitabine, pure red cell aplasia, rare drug toxicity
MeSH terms: Case Reports

Introduction:
Anemia is common in HIV. Parvo B19 infection is a well-recognised cause of red cell aplasia. Other causes of persistent pure red cell aplasia (PRCA) include anti-retroviral drugs such as zidovudine and lamivudine. We describe a case of PRCA that strongly implicates emtricitabine as the probable cause.
Patient presentation:
Patient was HIV positive and on treatment with a fixed drug combination consisting of tenofovir, emtricitabine and efavirenz for 3 months when she developed severe transfusion dependent anemia. The anemia, attributed to PRCA, was persistent and transfusion dependent for about one year.
Management and outcome:
Replacement of emtricitabine with abacavir resulted in a prompt, complete and lasting resolution of the anaemia, suggesting an etiologic role of emtricitabine in the PRCA.
Conclusion:
Emtricitibine is a rare cause of pure red cell aplasia.