OpenMed/multicare-articles huggingface dataset:
Graves' disease causing pancytopenia and autoimmune hemolytic anemia at different time intervals: a case report and a review of the literature
Authors: Peyman Naji, Geetika Kumar, Shabana Dewani, William A Diedrich, Ankur Gupta
Journal: Case Rep Med (2013)

Graves' disease (GD) is associated with various hematologic abnormalities but pancytopenia and autoimmune hemolytic anemia (AIHA) are reported very rarely. Herein, we report a patient with GD who had both of these rare complications at different time intervals, along with a review of the related literature. The patient was a 70-year-old man who, during a hospitalization, was also noted to have pancytopenia and elevated thyroid hormone levels. Complete hematologic workup was unremarkable and his pancytopenia was attributed to hyperthyroidism. He was started on methimazole but unfortunately did not return for followup and stopped methimazole after a few weeks. A year later, he presented with fatigue and weight loss. Labs showed hyperthyroidism and isolated anemia (hemoglobin 7 g/dL). He had positive direct Coombs test and elevated reticulocyte index. He was diagnosed with AIHA and started on glucocorticoids. GD was confirmed with elevated levels of thyroid stimulating immunoglobulins and thyroid uptake and scan. He was treated with methimazole and radioactive iodine ablation. His hemoglobin improved to 10.7 g/dL at discharge without blood transfusion. Graves' disease should be considered in the differential diagnosis of hematologic abnormalities. These abnormalities in the setting of GD generally respond well to antithyroid treatment.
Lessons I have learned from my patients: everyday life with primary orthostatic tremor
Authors: Marie Vidailhet, Emmanuel Roze, Lucie Maugest, Cécile Gallea
Journal: J Clin Mov Disord (2017)
MeSH terms: Case Reports

Background:
Primary orthostatic tremor is a rare disorder that is still under-diagnosed or misdiagnosed. Motor symptoms are fairly characteristics but the real impact on the patient's every day life and quality of life is under-estimated. The "how my patients taught me" format describes the impact on the patients' every day life with their own words, which is rarely done.
Case presentation:
A 46 year old lady was diagnosed primary orthostatic tremor (POT) based on the cardinal symptoms: feelings of instability, leg tremor and fear of falling in the standing position, improvement with walking and disappearance while sitting, frequency of Tremor in the 13-18Hz range, normal neurological examination. She gives illustrative examples of her disability in every day life activity (shower, public transportation, shopping). She reports how she felt stigmatized by her "invisible disorder". As a consequence, she developed anxiety depression and social phobia. All these troubles are unknown or under recognized by doctors and family.
Conclusions:
We review the clinical signs of POT that may help to increase the awareness of doctors and improve the diagnosis accuracy, based on the motor symptoms and description of the every day life disability, as reported by the patient. Non-motor symptoms (including somatic concerns, anxiety, depression, and social phobia) should be better considered in POT as they have a major impact on quality of life. Pharmacological treatments (clonazepam, gabapentin) may be helpful but have a limited effect over the years as the patients experience a worsening of their condition. On the long term follow-up, there are still unmet needs in POT, and new therapeutic avenues may be based on the pathophysiology by modulating the cerebello-thalamo-cortical network.
Refractory Sexual Arousal Subsequent to Sacral Neuromodulation
Authors: Dani Zoorob, Amanda S Deis, Kathryn Lindsay
Journal: Case Rep Obstet Gynecol (2019)
MeSH terms: Case Reports

Background:
Sacral neuromodulation has become a widely used treatment for lower urinary tract symptom and dysfunction. It has been observed to benefit sexual function in the domains of arousal and desire. Studies have yet to report markedly increased arousal symptoms as an adverse effect.
Case:
We present the case of a 57-year-old woman who developed symptomatic persistent genital arousal following implantation of a neuromodulator. Despite device reprogramming, a trial of the device being shut off, and eventual device removal, she continued to have residual new-onset undesired genital hyper-arousal symptoms.
Conclusion:
Our patient demonstrated markedly increased and persistent arousal symptoms that may be the result of upregulated or alternative activation of sacral nerve pathways. While other case reports describe improvement in persistent genital arousal disorder symptoms through neuromodulation, no studies mention hyperarousal symptoms as an adverse side effect after sacral neuromodulator placement nor persistence despite removal of the implant.
Abdominal tumor in a 14-year-old adolescent: imperforate hymen, resulting in hematocolpos-a case report and review of the literature
Authors: George Marios Makris, Doris Macchiella, Dennis Vaidakis, Charalampos Chrelias, Marco Johannes Battista, Charalampos Siristatidis
Journal: Case Rep Obstet Gynecol (2015)

Background. Abdominal masses in female adolescents are uncommon. A rare cause of this condition is hematocolpos due to imperforate hymen. Case. We present a case of an unusually massive asymptomatic abdominal bulk in a 14-year-old female patient, who sought for medical advice after unusual abdominal pain lasting for few weeks. The patient was otherwise asymptomatic, apart from an unusual dramatic expansion of her abdominal wall during the last month. We describe the surgical management and the follow-up of the patient. Summary and Conclusion. Clinicians should keep in mind that an imperforate hymen can cause abdominal growth due to hematocolpos and include it in the differential diagnosis of such a clinical entity in female adolescents. 2D ultrasound is usually efficient for the confirmation of the diagnosis of hematocolpos, but 3D ultrasound is more accurate. Wide excision should be undertaken, as an initial approach, to avoid recurrence.
Anemia in Patients with Type 2 Diabetes Mellitus
Authors: Jéssica Barbieri, Paula Caitano Fontela, Eliane Roseli Winkelmann, Carine Eloise Prestes Zimmermann, Yana Picinin Sandri, Emanelle Kerber Viera Mallet, Matias Nunes Frizzo
Journal: Anemia (2015)

The objective of this study was to evaluate the prevalence of anemia in DM2 patients and its correlation with demographic and lifestyle and laboratory variables. This is a descriptive and analytical study of the type of case studies in the urban area of the Ijuí city, registered in programs of the Family Health Strategy, with a total sample of 146 patients with DM2. A semistructured questionnaire with sociodemographic and clinical variables and performed biochemical test was applied. Of the DM2 patients studied, 50 patients had anemia, and it was found that the body mass items and hypertension and hematological variables are significantly associated with anemia of chronic disease. So, the prevalence of anemia is high in patients with DM2. The set of observed changes characterizes the anemia of chronic disease, which affects quality of life of diabetic patients and is associated with disease progression, development, and comorbidities that contribute significantly to increasing the risk of cardiovascular diseases.
Delivery of Retained Second Twin in Case of Omphalopagus Conjoined Twins: Abdominovaginal Approach
Authors: Wondimagegnehu Sisay Woldeyes
Journal: Case Rep Obstet Gynecol (2018)
MeSH terms: Case Reports

Conjoined twin is a rare complication of monozygotic twins resulting from incomplete splitting of an embryo into two separate twins or early secondary fusion of two originally separated embryos. When diagnosed at early gestation, one can get adequate time to counsel the family on whether to continue with the pregnancy and proper intervention can be planned. On the other hand, undiagnosed cases may be first recognized in labor after they have caused labor-related complications. In the present case report, an undiagnosed case of a conjoined twin has presented in labor followed by delivery of one baby with the retention of the second baby. This presented a unique challenge to the managing team and required hysterotomy to effect delivery of the unborn baby. We report this case to highlight the importance of early diagnosis of a conjoined twin. On another hand where this does not happen and a conjoined twin is suspected for the first time after it has caused labor-related complications, the management should be individualized based on the clinical circumstance.
Management of difficult airway in intratracheal tumor surgery
Authors: Amit Goyal, Isha Tyagi, Prabhat Tewari, Surendra K Agarwal, Rajan Syal
Journal: BMC Ear Nose Throat Disord (2005)

Background:
Tracheal malignancies are usual victim of delay in diagnosis by virtue of their symptoms resembling asthma. Sometimes delayed diagnosis may lead to almost total airway obstruction. For difficult airways, not leaving any possibility of manipulation into neck region or endoscopic intervention, femorofemoral cardiopulmonary bypass can be a promising approach.
Case presentation:
We are presenting a case of tracheal adenoid cystic carcinoma (cylindroma) occupying about 90% of the tracheal lumen. It was successfully managed by surgical excision of mass by sternotomy and tracheotomy under femorofemoral cardiopulmonary bypass (CPB).
Conclusion:
Any patient with recurrent respiratory symptoms should be evaluated by radiological and endoscopic means earlier to avoid delay in diagnosis of such conditions. Femorofemoral cardiopulmonary bypass is a relatively safe way of managing certain airway obstructions.
Osteoblastoma of scaphoid of the carpus: a case report
Authors: Hanane Bahouq, Fedoua Allali, Najia Hajjaj-Hassouni
Journal: Pan Afr Med J (2011)
Keywords: morocco, osteoblastoma, hand, proximal row carpectomy, scaphoid
MeSH terms: Bone Neoplasms / surgery, Osteoblastoma / surgery, Scaphoid Bone / surgery, Case Reports, Adolescent, Bone Neoplasms / pathology, Female, Humans, Osteoblastoma / pathology, Scaphoid Bone / pathology, Tendon Transfer / methods

Osteoblastoma is a rather uncommon tumor, especially when located in the wrist (and hand). Its diagnosis therefore appears to be problematic. We describe a case of osteoblastoma of the scaphoid bone and its management. To our knowledge, this is the fourth case of osteoblatoma of the carpus reported in the literature. Proximal row carpectomy was chosen because of the aggressive nature of the tumor. A tendon transfer was performed in the same session for wrist stabilization. Other authors have opted for a more conservative approach (tumor curettage with bone grafting).
Case Report: Stroke Chameleon: Acute Large Vessel Occlusion in the Posterior Circulation With Paroxysmal Sympathetic Hyperactivity as the First Manifestation
Authors: Juntao Yin, Wan Wang, Yu Wang, Guofeng Li, Yongmei Kong, Xiaoqiang Li, Yingdong Xu, Yuqing Wei
Journal: Front Neurosci (2022)
Keywords: acute large vessel occlusion, endovascular treatment, multiple lesions, paroxysmal sympathetic hyperactivity, posterior circulation
MeSH terms: Case Reports

Paroxysmal sympathetic hyperactivity (PSH) is a neurological emergency mostly secondary to traumatic brain injury (TBI). Acute large vessel occlusion (LVO) in the posterior circulation with PSH as the initial manifestation is uncommon. It may lead to catastrophic consequences for patients if not detected and treated timely. Here, we present three patients with acute LVO in the posterior circulation with PSH as the initial symptom. All patients were male and averaged 63 years old. The PSH Assessment Measure (PSH-AM) scores of all cases were > 17. Brain imaging showed that multiple lesions in posterior circulation were involved in three patients. Although the prognosis of all patients was poor, PSH symptoms disappeared in all patients after endovascular treatment. These cases suggests that acute posterior circulation-related ischemic stroke should be considered with PSH occurring as the first symptom. Extensive disconnection due to multiple lesions in posterior circulation may play an important role in the occurrence and development of PSH. Endovascular treatment may be effective for PSH caused by acute posterior circulation-related ischemic stroke. This is worthy of further study in the future.
An interesting case of familial chylomicronemia syndrome in a cleft palate child
Authors: H S Adenwalla, P V Narayanan, C J Rajshree, Rati Santhakumar
Journal: Indian J Plast Surg (2008)
Keywords: familial hyperlipoprotenemia, lipoprotein lipase
MeSH terms: Case Reports

Familial chylomicronemia syndrome is a very rare condition with an incidence of one in one million. We report such a condition detected incidentally in a cleft child.
Case report: Braid-like right coronary artery with chest pain
Authors: Wenbo Wang, Lan Lan, Huijuan Hu
Journal: Front Cardiovasc Med (2023)
Keywords: braid-like coronary artery, coronary angiography, coronary artery dissection introduction, coronary variant, thrombus recanalization, woven coronary artery
MeSH terms: Case Reports

Braid-like coronary artery is very rare. It is featured by the division of the coronary artery into multiple tortuous small channels that later converge into a normal lumen at any segment of the coronary artery. We presented a case of a 27-year-old male patient with occasional chest pain. In coronary CT angiography (CCTA) and coronary angiography, a braid-like appearance was found in the right coronary artery. After multidisciplinary discussion, it was speculated to be a woven coronary artery (WCA). We conducted a literature review about woven coronary arteries.
A Case of Nongerminomatous Germ Cell Tumor of the Pineal Region: Risks and Advantages of Biopsy by Endoscopic Approach
Authors: Mauro Dobran, Davide Nasi, Fabrizio Mancini, Maurizio Gladi, Massimo Scerrati
Journal: Case Rep Med (2018)
MeSH terms: Case Reports

A 21-year-old male was admitted to our department with headache and drowsiness. CT scan and MRI revealed acute obstructive hydrocephalus caused by a pineal region mass. The serum and CSF levels of beta-human chorionic gonadotropin (beta-hCG) were 215 IU/L and 447 IU/L, respectively, while levels of alpha-fetoprotein (AFP) were normal. A germ cell tumor (GCT) was suspected, and the patient underwent endoscopic third ventriculostomy (ETV) with biopsy. After four days from surgery, the tumor bled with mass expansion and ETV stoma occlusion; thus, a ventriculoperitoneal shunt was positioned. After ten months, the tumor metastasized to the thorax and abdomen with progression of intracerebral tumor mass. Despite the aggressive nature of this tumor, ETV remains a valid approach for a pineal region mass, but in case of GCT, the risk of bleeding should be taken into account, during and after the surgical procedure.
Extranodal natural killer/T-cell lymphoma invading a patient's heart: A rare case report and literature review
Authors: Yifei Xiang, Xueqin Lin, Xiaoling Cai, Shuang Qu, Kai-Yang Lin
Journal: Front Oncol (2022)
Keywords: pet-ct, extranodal natural killer/t-cell lymphoma, heart failure, poor prognosis, targeted therapy
MeSH terms: Case Reports

Extranodal NK/T-cell lymphoma (ENKTL) is a rare but aggressive subtype of non-Hodgkin lymphoma, which is derived from NK cells or T cells. There are very few cases of ENKTL invading the heart. Only 12 cases of ENKTL invading the heart have been reported in the English literature. Due to the rarity of this lymphoma, an effective therapeutic strategy has not been defined. Here, we present a case of a 51-year-old Chinese male with extranodal NK/T-cell lymphoma invading the heart and review the literature. The patient received a chemotherapy regimen of PD1 monoclonal antibody (Sintilimab) in combination with first-line P-Gemox. The patient survived for 2 months after diagnosis.
Hairy Cell Leukemia Presenting with Isolated Skeletal Involvement Successfully Treated by Radiation Therapy and Cladribine: A Case Report and Review of the Literature
Authors: Ipek Yonal-Hindilerden, Fehmi Hindilerden, Sanem Bulut-Dereli, Eren Yıldız, Ibrahim Oner Dogan, Meliha Nalcaci
Journal: Case Rep Hematol (2015)

We describe an unusual case of hairy cell leukemia (HCL) in a 55-year-old male presenting with isolated skeletal disease as the initial manifestation without abnormal peripheral blood counts, bone marrow involvement, or splenomegaly. To the best of our knowledge, there have been only two previous reports of a similar case. The patient presented with pain in the right femur. Anteroposterior radiographs of both femurs revealed mixed lytic-sclerotic lesions. PET scan showed multiple metastatic lesions on axial skeleton, pelvis, and both femurs. Histopathological examination of the bone biopsy revealed an infiltrate of HCL. Localized radiation therapy to both proximal femurs and subsequently 4 weeks later, a 7-day course of 0.1 mg/kg/day cladribine provided complete remission with relief of symptoms and resolution of bone lesions. We addressed the manifestations and management of HCL patients with skeletal involvement.
Treatment of Miller Class I Gingival Recession with Using Nonpedicle Adipose Tissue after Bichectomy Surgical Technique: A Case Report
Authors: Carmen Lucia Mueller Storrer, Leonardo Luiz Muller, Janes Francio Pissaia, Carla Frehner Andrade, Claudia Roberta Tenório Trevisani, Tatiana Miranda Deliberador
Journal: Case Rep Dent (2019)
MeSH terms: Case Reports

Gingival recession is an oral health problem that affects a large part of the population. Several treatments are suggested in the current literature; among them is the use of buccal fat pad grafting. The objective of this case report is to describe the treatment of a Miller Class I gingival recession using a nonpedicled buccal fat pad graft immediately after performing the surgery for buccal fat pad removal (bichectomy technique). First, bilateral surgical removal of the buccal fat pad was performed with the main objective of eliminating oral mucosa biting. The recipient site was prepared to receive a portion of the fat pad that was cut and macerated in a size that was sufficient to cover the recession. The patient was followed up at 15, 30, 60, and 365 days postsurgery, and the results showed an elimination of the oral mucosa biting and complete coverage of the gingival recession. It was concluded that the nonpedicled buccal fat pad graft is another option for the treatment of Miller Class I recessions.
Liquorice Intoxication Can Lead to Cardiac Arrest!
Authors: Rachid Attou, Sébastien Redant, Patrick M Honore, Thierry Preseau, Philippe Hantson, David De Bels
Journal: Case Rep Emerg Med (2020)
MeSH terms: Case Reports

A 45-year-old man was admitted to the Emergency Department with fatigue and muscular weakness. Soon after hospital admission, he developed "torsades de pointe" and was successfully resuscitated. The admission laboratory investigations had revealed a profound hypokalemia (1.65 mmol/L). The patient had a long-term use of alcohol-free "pastis" in an attempt to reduce his chronic ethanol consumption. As the beverage likely contained a significant amount of liquorice, the diagnosis of glycyrrhizin chronic intoxication was suspected. The diagnosis of liquorice-related pseudohyperaldosteronism was assessed by normal plasma aldosterone levels and low plasma renin activity. Intravenous and oral supplementation of potassium was required for 5 days, and the patient had an uneventful follow-up.
Atypical location of primary cardiac lymphoma in the left heart with atypical clinical presentation: A case report and literature review
Authors: Yongjia Qiang, Kuan Zeng, Bin Zhang, Ruicong Guan, Yuqiang Liu, Zhuxuan Liu, Haohua Xu, Xinyi Zhang, Yanting Ren, Baoping Deng, Yanqi Yang
Journal: Front Surg (2023)
Keywords: biopsy, case report, chemotherapy, complete remission, immunotherapy, lymphoma, primary cardiac tumors
MeSH terms: Case Reports

Background:
Primary cardiac lymphoma (PCL) is a rare and aggressive cardiac tumor with very poor prognosis that occurs mostly in the right cardiac cavity. Early diagnosis and treatment may improve its prognosis. In the present report, we describe the diagnosis and treatment of a primary cardiac diffuse large B-cell lymphoma (PC-DLBCL) with atypical location and clinical presentation. Additionally, a literature review was conducted to summarize the current knowledge of the disease.
Case presentation:
A 71-year-old man visited his local hospital because of syncope, recurrent chest tightness, shortness of breath, palpitations, and profuse sweating for more than 20 days. Chest radiography revealed a mediastinal mass. Cardiac computed tomography (CT) showed multiple enlarged mediastinal lymph nodes. Transthoracic echocardiography (TTE) showed a cardiac mass in the posterior-inferior wall of the left atrium. He was then transferred to our hospital for positron emission tomography-CT (PET-CT) which showed active uptake of fluorodeoxyglucose both in the cardiac mass and in the multiple enlarged mediastinal lymph nodes. Biopsy of the enlarged mediastinal lymph nodes was carried out by using video-assisted thoracic surgery (VATS) technique, and pathological examination confirmed the subtype of PC-DLBCL, Stage IV, NCCN IPI 3. Therefore, the patient received a combination of chemotherapy and immunotherapy with R-CDOP (rituximab, cyclophosphamide, liposome doxorubicin, vincristine, and prednisone). After four courses of treatment in 4 months, the cardiac lymphoma and the enlarged mediastinal lymph nodes achieved complete remission with mild side effects of the chemotherapy.
Conclusion:
Early diagnosis and a precise choice of chemotherapy and immunotherapy based on cardiac imaging and pathological examination may improve the prognosis of PC-DLBCL in an atypical location.