OpenMed/multicare-articles huggingface dataset:
Immunoelectron microscopy findings in a patient with C3 glomerulonephritis
Authors: Masato Sawamura, Naoki Sawa, Hiroki Mizuno, Yuki Oba, Daisuke Ikuma, Akinari Sekine, Masayuki Yamanouchi, Eiko Hasegawa, Tatsuya Suwabe, Masanori Suzuki, Kei Kono, Keiichi Kinowaki, Kenichi Ohashi, Takashi Ehara, Yoichiro Ikeda, Toshihiro Sawai, Yoshifumi Ubara
Journal: Clin Nephrol Case Stud (2023)
Keywords: c3 glomerulonephritis, dense deposit disease, immunoelectron microscopy, immunofluorescence microscopy, light microscopy
MeSH terms: Case Reports

We performed a kidney biopsy in a 36-year-old man to evaluate microscopic hematuria and proteinuria. Light microscopy showed increased mesangial matrix and partial swelling of the glomerular basement membrane (GBM), and immunofluorescence showed positive staining only for C3. Immunoelectron microscopy showed that gold particle-labeled C3 was localized in the electron-dense and moderately electron-dense deposits shown by electron microscopy in the mesangium, the thickened GBM near the paramesangium, and the thickened distal portion of the GBM but was not localized in the non-thickened GBM. Gold-labeled immunoglobulin G, κ, and λ were not seen. C3 glomerulonephritis was more evident in gold-labeled electron microscopy, which further clarified the localization of C3 deposition.
The rare Hematological disorder; A man with Hemophagocytic Lymphohistiocytosis (HLH)
Authors: Majid Gholizadeh, Shirin Kianersi, Leila Noorazar, Vahid Kaveh, Elham Roshandel, Sina Salari
Journal: Caspian J Intern Med (2021)
Keywords: fever, hemophagocytic lymphohistiocytosis, splenomegaly
MeSH terms: Case Reports

Background:
Hemophagocytic lymphohistiocytosis (HLH) is a rare disease with different causes. HLH has been categorized into two sub-groups; primary HLH which is associated with some gene mutations and secondary HLH that is developed by various causes, such as autoimmune disease, infections, and malignancies. However, the symptoms of both groups are identical and if left untreated, it will result in death.
Case presentation:
In this study, we reported a 39 years old man had symptoms such as fever, weakness and chill for a month period of time. Firstly, due to pancytopenia in peripheral blood findings and clinical manifestations, he had been diagnosed with myelodysplastic syndrome (MDS) with an excess blast but the elevated liver enzymes and bilirubin were not consistent with this diagnosis. Hence, we recommended more investigation such as CT scan, bone marrow aspiration and bone marrow biopsy with immunohistochemistry tests. Finally, we found macrophages and histiocyte in bone marrow biopsy smear with Wright-Giemsa staining that engulfed the cells such as platelets and lymphocytes, so HLH syndrome was confirmed and treatment program with latest approved protocols started for the patient.
Conclusion:
HLH syndrome is a life-threatening disease that can be saved if timely diagnosed. Therefore, more consideration of all the laboratory findings and clinical signs of the patient can help to diagnose the disease more accurately. Also, we did a review of its pathophysiology, symptoms and therapeutic treatments.
Buttock necrosis following uterine artery embolization: A case report
Authors: Savitri Chandrasekaran, Ramez Antakia, Mojolaoluwa Olugbemi
Journal: Int J Surg Case Rep (2023)
Keywords: buttock necrosis, case report, embolization, fibroid, skin graft, uterine artery
MeSH terms: Case Reports

Introduction and importance:
Fibroid is a very common benign tumor of the uterus for which uterine artery embolization is one of the treatment modalities of choice. Uterine artery embolization (UAE) is a minimally invasive procedure used in the management of fibroids, nowadays mostly performed by interventional radiologists. A rare complication of the procedure is buttock necrosis which has been observed in this case. If not identified at an early stage, it may result in extensive damage to a large surface area of the skin hence this case report is of clinical relevance as it is essential to be aware of the complications of UAE and be cautious.
Case presentation:
Our report is regarding a 37-year-old female who presented to the emergency department with a gradually increasing excruciatingly painful lesion on the left buttock 12 days after undergoing a uterine artery embolization. Examination revealed a necrotic lesion involving 40 % surface area of the left buttock.
Clinical discussion:
There are a few other such cases reported in literature. All these cases, including ours, prove that buttock necrosis is an established complication which is highly possible following uterine artery embolization. This complication is likely due to reflux of embolic material into gluteal artery.
Conclusion:
This case warranted extensive debridement and plastic surgery referral for skin grafting. Although a rare scenario, being a dangerous and distressful one for patients, ability to recognize this complication at an early stage will aid in the management and mental well-being of the patient.
Unusual combination of lesions of the traumatic hand: closed central slip laceration of the extensor and interphalangeal thumb joint's dislocation (a case report)
Authors: Hassan Boussakri, Mohamad Azarkane, Omar Dahmani, Mohamad Elidrissi, Mohamed Shimi, Abdelhalim Elibrahimi, Abdelmajid Elmrini
Journal: Pan Afr Med J (2014)
Keywords: traumatic hand, boutonniere deformity, pincer grasp, thumb dislocation
MeSH terms: Hand Deformities, Acquired / etiology, Hand Injuries / complications, Lacerations / complications, Tendon Injuries / complications, Thumb / injuries, Case Reports, Accidental Falls, Hand Deformities, Acquired / diagnostic imaging, Hand Deformities, Acquired / physiopathology, Hand Injuries / diagnostic imaging, Hand Injuries / rehabilitation, Hand Strength, Humans, Immobilization, Male, Middle Aged, Physical Therapy Modalities, Radiography, Range of Motion, Articular, Recovery of Function, Rupture / complications, Rupture / rehabilitation, Tendon Injuries / diagnostic imaging, Tendon Injuries / rehabilitation, Thumb / diagnostic imaging

From the functional standpoint, the hand is one of the most important organs of the body. However, its significance depends largely upon the pincer action of the thumb-index. The management of traumatic lesions of the hand is nowadays' subject of numerous scientific discussions. We present here the case of a patient with a recent laceration of the central slip of the extensor tendon with boutonniere deformity linked to a dislocated interphalangeal thumb of the same hand with a loss of force of the clip thumb and index finger. This combination is a rare lesional of the traumatic hand that has not been previously reported in any orthopedic literature. It was observed after adopting the orthopedic treatment that the range of motion of its joint was at the same level as its healthy side without observing any redislocations during the 6-month follow-up period.
Paratesticular Angiomyofibroblastoma-Like Tumor: Unusual Case of a Solidocystic Form
Authors: Issam Msakni, Dorra Ghachem, Mohamed Amine Bani, Faten Gargouri, Nada Mansouri, Ramzi Khiari, Fethi Bougrine, Ammar Bouziani, Besma Laabidi
Journal: Case Rep Med (2017)
MeSH terms: Case Reports

The angiomyofibroblastoma-like tumor of the male genital tract is a rare benign tumor. A total of 34 cases have been reported in the literature. We herein report an exceptional case of solidocystic form in its paratesticular location, in a 79-year-old man. Clinical examination objectified a right testicular induration. Macroscopic examination of the orchidectomy objectified a paratesticular solidocystic tumor formation. Microscopically, the solid area was composed of vessels with small caliber and turgidity of endothelial cells. These vessels were surrounded by clusters of epithelioid cells, sometimes having the appearance of giant cells. They were associated with spindle cells. The cystic area was uncoated. Immunohistochemically, the fusiform cells expressed Desmin and Smooth Muscle Actin. Endothelial cells and clusters of cells surrounding large vessels expressed CD34. The expression of receptors for estrogen and progesterone was negative. To our knowledge, this is the second solidocystic case of angiomyofibroblastoma-like tumor of male genital tract.
Pulmonary echinococcosis mimicking multiple lung metastasis of breast cancer: the role of fluoro-deoxy-glucose positron emission tomography
Authors: Yavuz Kurt, Ilker Sücüllü, Ali Ilker Filiz, Muammer Urhan, Mehmet Levhi Akin
Journal: World J Surg Oncol (2008)
MeSH terms: Breast Neoplasms / pathology, Carcinoma, Ductal, Breast / secondary, Echinococcosis, Pulmonary / diagnostic imaging, Lung Neoplasms / diagnosis, Lung Neoplasms / secondary, Positron-Emission Tomography, Case Reports, Albendazole / therapeutic use, Antineoplastic Combined Chemotherapy Protocols / therapeutic use, Biopsy, Needle, Breast Neoplasms / diagnosis, Breast Neoplasms / therapy, Carcinoma, Ductal, Breast / diagnosis, Carcinoma, Ductal, Breast / therapy, Combined Modality Therapy, Diagnosis, Differential, Echinococcosis, Pulmonary / diagnosis, Female, Fluorodeoxyglucose F18, Follow-Up Studies, Humans, Immunohistochemistry, Middle Aged, Treatment Outcome, Fluorodeoxyglucose F18, Albendazole

Background:
Echinococcosis is still a serious problem particularly in endemic areas such as South and Central America, Mediterranean countries, and Russia. Furthermore, hydatid cysts of the lung are often indistinguishable from a variety of other pulmonary lesions such as lung tumors
Case presentation:
We herein present a 56 year old woman with breast cancer who presented with bilateral pulmonary nodules due to echinococcosis granulosis that mimicked metastatic breast cancer to the lung.
Conclusion:
During the evaluation of the malignancies which could metastasize to the lung, it must be kept in mind that the appearance of bilateral multiple pulmonary masses can also be the sign of a pulmonary echinococcosis especially in endemic areas. FDG-PET with its known high negative predictive value in characterizing indeterminate pulmonary nodules >1 cm is very helpful to characterize this kind of lesions.
Clear cell variant of oral squamous cell carcinoma: case report and review
Authors: Rutuja Narsing Mukkanwar, Sangeeta Palaskar, Rasika Pawar, Darshana Rajesh Shah
Journal: Autops Case Rep (2022)
Keywords: carcinoma, squamous cell, mouth neoplasms, sarcoma, clear cell, squamous cell carcinoma of head and neck
MeSH terms: Case Reports

The clear cell variant of Oral Squamous Cell Carcinoma (OSCC) is an uncommon histological variant. Kuo first discovered it in the skin, and Frazier et al. found it in the oral cavity. We know of only nine cases of clear cell variant of OSCC reported in the literature till now. The present case is in a 60-year-old male patient with an ulcer on the left posterolateral border of the tongue. The patient had a history of chewing tobacco for 22 years. Clinical examination showed features of malignant ulcer associated with pain and discomfort. Histopathological examination revealed sheets and islands of atypical epithelial cells with clear cytoplasm, nuclear and cellular pleomorphism, and few keratin pearls in the connective tissue suggesting OSCC. Various special stains were performed to identify clear cells. Periodic Acid Schiff-Diastase (PAS-D) and Mucicarmine stains showed positive and negative reactions in clear cells, respectively. Immunohistochemical (IHC) analysis for cytokeratin (AE1/AE3) showed diffuse positivity in clear cells and other epithelial cells. Based on special stains and IHC markers, we confirmed the diagnosis as a clear cell variant of OSCC. This variant is rare and presents diagnostic challenges. It is said to be aggressive in nature. More such cases should be reported to understand its biological behavior and prognosis.
Successful closure of the ventricular septal defect;A rare complication after transcatheter aortic valve replacement
Authors: Saadet Demirtas Inci, Murat Tulmaç, Cagatay Tunca, Tolgahan Efe, Hakan Güllü
Journal: J Cardiovasc Thorac Res (2022)
Keywords: aortic valve stenosis, transcatheter aortic valve replacement, ventricular septal defect
MeSH terms: Case Reports

In this report, we present a patient with ventricular septal defect (VSD) that was detected at follow-up one month after transcatheter aortic valve implantation (TAVI) and successfully closed percutaneously. Before the procedure, a 29 mm Portico self-expanding aortic valve prosthesis was placed in the heavy calcific aortic valve position, and then the balloon was dilated due to aortic insufficiency and excellent results were obtained. One month after TAVI, the patient complained of shortness of breath at rest, and on physical examination a pansystolic murmur was detected. Transthoracic echocardiography (TTE) revealed a well-functioning prosthetic aortic valve; however, a VSD was detected causing left-to-right shunt in the interventricular septum. Later, we performed the interventional treatment of the defect using the Amplatzer muscular VSD occluder device with the transfemoral approach. Currently, five months after the combined procedure, the patient showed a significant improvement in symptoms and no significant shunt was observed.
Atypical presentation of herpes simplex virus type 1 infection in paediatric burns patients in a large tertiary hospital, South Africa
Authors: Mpho L Sikhosana, Asma Salloo, Monica Birkhead, Kerrigan McCarthy
Journal: Afr J Lab Med (2019)
Keywords: south africa, burns, herpes simplex virus type 1, paediatrics
MeSH terms: Case Reports

Introduction:
Herpes simplex virus has been reported in the literature to commonly complicate burn wounds. However, there is paucity of such data in the South African setting.
Case presentation:
Eight paediatric burns patients with ages ranging between 10 months and 5 years presented with a febrile maculopapular rash illness in a paediatric ward of a large South African tertiary hospital. The rash became vesicular in three cases, involving the limbs and face. Varicella was suspected.
Management and outcome:
Medical records of suspected cases were reviewed. Blood, vesicular fluid and scab samples were collected. Electron microscopy of vesicular fluid revealed herpes virus particles. Laboratory testing confirmed herpes simplex virus type 1.
Conclusion:
Herpes simplex virus type 1 infection can present atypically in burns patients.
Presumptive Haematomyelia Secondary to Warfarin Toxicosis in a Dog
Authors: Carlos Blanco, Meritxell Moral, Juan José Minguez, Valentina Lorenzo
Journal: Case Rep Vet Med (2022)
MeSH terms: Case Reports

A 3-year-old male entire Boxer was presented for a 6-day history of progressive symmetric nonambulatory tetraparesis with diffuse spinal hyperesthesia. Eight days prior to admission, the dog ingested warfarin accidentally, exhibiting systemic clinical signs of intoxication 2 days later. Upon referral, the dog was nonambulatory with paretic thoracic limbs and plegia with absent nociception on pelvic limbs, spinal reflexes were decreased to absent in all four limbs, and urinary and faecal incontinence were noticed. Magnetic resonance imaging (MRI) of the cervical, thoracic, and lumbar regions of the vertebral column revealed intramedullary lesions extending from the first cervical segments to the conus medullaris consistent with extensive intramedullary haemorrhages. Despite management with vitamin K1 and physiotherapy, 6 weeks later, improvement was limited to thoracic limb motor function, and euthanasia was elected. This case reports an extensive presumptive haematomyelia with severe neurological deficits suspected to be secondary to warfarin intoxication in a dog.
Endoscopic reduction of a volvulus of the sigmoid colon in pregnancy: case report and a comprehensive review of the literature
Authors: Zia Aftab, Adriana Toro, Abdelrahmam Abdelaal, Mohammed Dasovky, Salahdin Gehani, Abdelatif Abdel Mola, Isidoro Di Carlo
Journal: World J Emerg Surg (2014)
Keywords: endoscopic reduction, pregnancy, sigmoid volvulus
MeSH terms: Review

Sigmoid volvulus is a rare, but serious, complication that can occur during pregnancy. We present a case of a 33-year-old pregnant female in the third trimester with a sigmoid volvulus. Detorsion of the volvulus was performed during colonoscopy. The patient underwent an elective sigmoidectomy at a later date. Prompt diagnosis of the volvulus sigmoid is critical to minimize fetal and maternal morbidity and mortality. Sigmoidoscopic detorsion or surgical resection are the treatment options, depending on bowel viability. A review of the literature was done.
Spontaneous Heterotopic Pregnancy Associated with Massive Intraperitoneal Haemorrhage and a Normal Heart Rate, Illustrating the Concept of Relative Bradycardia
Authors: Charles Gallaher, Farshad Tahmasebi, Ahmad Sayasneh, Gautam Mehra
Journal: Case Rep Obstet Gynecol (2019)
MeSH terms: Case Reports

A 28-year-old, 9 and a half weeks pregnant (spontaneous conception) multigravida presented with abdominal pain and vaginal bleeding. On examination, her abdomen was diffusely tender, particularly in the right iliac fossa, though guarding was absent. Transabdominal and transvaginal ultrasonography demonstrated a viable intrauterine pregnancy and large-volume intraperitoneal haemoperitoneum; the right ovary could not be identified. The patient became hypotensive with decreased responsiveness, yet her heart rate remained normal. She proceeded to surgery where a ruptured right tubal ectopic pregnancy was identified and right salpingectomy was performed. Estimated blood loss was 3900ml. Postoperative recovery was uneventful. Ultrasound 3 days after surgery demonstrated a viable intrauterine pregnancy of gestational age 9 weeks + 1 day. The patient remains well. Her anomaly scan at 20 weeks and 6 days showed normal growth, amniotic fluid, and Dopplers with no obvious structural defects. She is currently 27 weeks pregnant and will be rescanned at 36 weeks.
Management of aplastic anaemia in pregnancy in a resource poor centre
Authors: Celestine Osita John, Kaladada Korubo, Rosemary Ogu, Chigozirim Faith Mmom, Alpheus Gogo Mba, Ezenwa-Ahanene Chidiadi, Chris Akani
Journal: Pan Afr Med J (2016)
Keywords: aplastic anaemia, absolute neutrophil count, bone marrow, cyclosporine, platelet concentrate, pregnancy, transfusion
MeSH terms: Anemia, Aplastic / therapy, Pregnancy Complications, Hematologic / therapy, Pregnancy Outcome, Case Reports, Adult, Anemia, Aplastic / complications, Anemia, Aplastic / diagnosis, Biopsy, Blood Transfusion / methods, Cesarean Section / methods, Female, Humans, Nigeria, Oligohydramnios / diagnosis, Pre-Eclampsia / diagnosis, Pregnancy, Pregnancy Complications, Hematologic / diagnosis, Pregnancy Complications, Hematologic / pathology

Aplastic anaemia occurring in pregnancy is a rare event with life threatening challenges for both mother and child. We present a successful fetomaternal outcome despite the challenges in the management of this rare condition in a tertiary but resource poor centre. This is case of a 37 year old Nigerian woman G6P0+5managed with repeated blood transfusions from 28 weeks of gestation for bone marrow biopsy confirmed aplastic anaemia following presentation with weakness and gingival bleeds. She had a cesarean section at 37 weeks for pre-eclampsia and oligohydraminous with good feto-maternal outcome. She was managed entirely with fresh whole blood and received 21 units. Aplastic Anaemia in Pregnancy is a rare event with poor feto maternal prognosis. Successful management is possible with good multi-disciplinary approach and availability of supportive comprehensive obstetric care.
A Case of Acoustic Shock with Post-trauma Trigeminal-Autonomic Activation
Authors: Alain Londero, Nicolas Charpentier, Damien Ponsot, Philippe Fournier, Laurent Pezard, Arnaud J Noreña
Journal: Front Neurol (2017)
Keywords: acoustic shock, inflammation, otalgia, pain, referred pain, tinnitus and hyperacousis, trigeminal nerve
MeSH terms: Case Reports

This study reports the case of an acoustic shock injury (ASI), which did not result in a significant hearing loss, but was followed by manifold chronic symptoms both within (tinnitus, otalgia, tingling in the ear, tension in the ear, and red tympanum) and outside the ears (blocked nose, pain in the neck/temporal region). We suggest that these symptoms may result from a loop involving injury to middle ear muscles, peripheral inflammatory processes, activation and sensitization of the trigeminal nerve, the autonomic nervous system, and central feedbacks. The pathophysiology of this ASI is reminiscent of that observed in post-traumatic trigeminal-autonomic cephalalgia. This framework opens new and promising perspectives on the understanding and medical management of ASI.
Bubbles in the Box: Recurrent Pneumothorax From Bronchopleural Fistula in Rheumatoid Arthritis
Authors: Ahmed Taha, Randa Hazam, Jim Tseng, Lusine Nahapetyan, Masoud Alzeerah, Asm Islam
Journal: J Investig Med High Impact Case Rep (2019)
Keywords: bronchial fistula, methotrexate, rheumatoid arthritis
MeSH terms: Arthritis, Rheumatoid / complications, Bronchial Fistula / etiology, Pleural Diseases / etiology, Pneumothorax / etiology, Case Reports, Aged, Antirheumatic Agents / therapeutic use, Arthritis, Rheumatoid / drug therapy, Bronchial Fistula / diagnostic imaging, Female, Humans, Methotrexate / therapeutic use, Multiple Pulmonary Nodules, Pleural Diseases / diagnostic imaging, Pneumonectomy, Pneumothorax / diagnostic imaging, Radiography, Thoracic, Recurrence, Tomography, X-Ray Computed, Antirheumatic Agents, Methotrexate

When considering rheumatoid arthritis (RA)-associated pulmonary diseases, interstitial lung disease and pleural disease are the most common RA-associated pulmonary manifestations while spontaneous pneumothorax and bronchopleural fistula (BPF) are among the extremely rare ones. To the best of our knowledge, all the previous reports of RA-associated BPFs were attributed to peripherally located pulmonary nodules that necrotized, burst into the pleural cavity, and eventually lead to the fistula formation. However, we hereby present the first case of BPF in an RA patient that formed in the absence of any underlying rheumatic pulmonary nodules. Additionally, our patient was on chronic methotrexate therapy, and there are no data in the literature that suggest methotrexate-induced parenchymal lung disease can predispose to BPF formation. Our report is the first to introduce a probe to further investigate this association.