OpenMed/multicare-articles huggingface dataset:
Sustained false-positive results for hepatitis A virus immunoglobulin M: A case report and literature review
Authors: Youwen Tan, Li Chen
Journal: Open Med (Wars) (2021)
Keywords: false-positive, hepatitis a, immunoglobulin m
MeSH terms: Case Reports

Hepatitis A virus immunoglobulin M (HAV-IgM) is often used to diagnose acute hepatitis A virus (HAV) infection serologically. However, false-positive test results can interfere with the diagnosis. A 56-year-old woman was readmitted to the hospital owing to abnormal liver function tests for the last 18 months. She had been diagnosed with acute HAV and was hospitalized in isolation based on a positive HAV-IgM test 18 months ago. Regular follow-up after discharge showed abnormal liver function and an elevated level of antinuclear antibodies and immunoglobulin G. For the last 15 days, the patient had fatigue, decreased appetite, and yellow urine, signaling recrudescence. Liver function tests were also abnormal. Liver biopsy revealed histological changes consistent with typical autoimmune hepatitis. After 2 months of methylprednisolone treatment, liver function returned to normal, and HAV-IgM turned negative. The diagnosis of acute HAV in nonendemic areas requires a comprehensive analysis of epidemic history, clinical characteristics, etiology, etc.
Pseudomonas aeruginosa Septic Arthritis and Osteomyelitis after Closed Reduction and Percutaneous Pinning of a Supracondylar Humerus Fracture: A Case Report and Review of the Literature
Authors: Adam M Wegner, John C Wuellner, Brian M Haus
Journal: Case Rep Orthop (2017)
MeSH terms: Case Reports

Infectious complications of closed reduction and percutaneous pinning of supracondylar humerus fractures are exceedingly rare. Although postoperative Pseudomonas infection is a feared complication associated with noncompliance and a wet cast, there are no reports in the literature of this occurring. We present the devastating complication of a pediatric patient who developed Pseudomonas aeruginosa subperiosteal abscess, osteomyelitis, and elbow septic arthritis after presenting to the clinic multiple times with a wet cast after closed reduction and percutaneous pinning of a supracondylar humerus fracture. We describe the treatment course for this patient, followed by the sequelae of posterolateral rotary instability. This case not only confirms that patients can get Pseudomonas infections if they get their cast wet but also stresses the importance of patient communication and compliance in preventing unfortunate complications.
Case Report: Ileo-Ileal Intussusception Secondary to Inflammatory Fibroid Polyp: A Rare Cause of Intestinal Obstruction
Authors: Claudio Guerci, Francesco Colombo, Gloria Goi, Pietro Zerbi, Barbara Pirrò, Piergiorgio Danelli
Journal: Front Surg (2022)
Keywords: ifp, fibroid polyp, histology, intussusception, laparoscopy, surgery
MeSH terms: Case Reports

Introduction:
Intussusception is a telescoping of a bowel segment into another and it can be a surgical urgency. Most adult intussusceptions arise from a lead point which can be benign or malignant. For this reason, intussusception in adults should undergo surgery. Here we describe a case of ileal inflammatory fibroid polyp (IFP), presenting with ileo-ileal intussusception and obstruction.
Case report:
A 54-year-old Caucasian woman presented for acute abdominal pain. A radiography and a CT of the abdomen were performed, which showed signs of occlusion due to an ileo-ileal intussusception. An urgent laparoscopy was performed, the intussusception was extracorporeally reduced, the ileal segment involved was resected, and an ileo-ileal anastomosis was performed. The intussusception seemed to be caused by a 3-cm intra-mural lesion.
Discussion:
Intussusception is a surgical concern. While most cases are idiopathic in children, 90% of adult intussusceptions are caused by underlying diseases. Therefore, intussusception in adults should undergo surgery. Radiology is necessary for the diagnosis: the CT scan helps localizing the lesion and shows pathognomonic signs. This case report analyzes an intussusception caused by an inflammatory fibroid polyp. Accurate diagnosis of IFP is only possible with histopathological examination, helped by immunohistochemistry. The differential diagnosis is important because some lesions are malignant.
Conclusion:
We reported a case of intussusception caused by an IFP. The diagnosis was made with a CT scan together with intraoperative findings and histopathological examination, which excluded potential differential diagnoses. The patient underwent an explorative laparoscopy, with an ileal resection and anastomosis. Due to the risk of malignancy, surgery is mandatory.
Type II Autoimmune Hepatitis and Small Duct Sclerosing Cholangitis in a Seven Years Old Child: An Overlap Syndrome?
Authors: Andrea Domenico Pratico, Stefania Salafia, Patrizia Barone, Mario La Rosa, Salvatore Leonardi
Journal: Hepat Mon (2013)
Keywords: anti-liver kidney microsome antibody, hepatitis, autoimmune, liver diseases, primary sclerosing cholangitis
MeSH terms: Case Reports

Introduction:
Autoimmune hepatitis is an inflammatory disease with multifactorial ethiopatogenesis, characterized by lympho-monocytic infiltration of liver, presence of serum autoantibodies (ANA, SMA, LKM-1) and high levels of immunoglobulins. Overlap syndromes are defined as the association of autoimmune hepatitis with cholestatic diseases such as primary biliary cirrhosis and primary sclerosing cholangitis. The boundaries of these syndromes as distinct pathological entities are still matter of debate and they could be part of a major liver autoimmune disease. Furthermore, cholestatic diseases may present even with atypical features (AMA-negative primary cirrohosis, primary sclerosing cholangitis with normal cholangiography).
Case presentation:
We herein describe a case of a 7 year-old child affected by an overlap syndrome between type 2 autoimmune hepatitis and small duct primary sclerosing cholangitis. Although characterized by a severe onset, the disease showed a good response to treatment with prednisone and azathioprine.
Conclusions:
The association of type 2 autoimmune hepatitis and small duct primary cholangitis has been rarely reported in literature and this report adds new data on this still unclear entity.
A Case of Disseminated Hypopigmented Keratoses Improved with Oral Acitretin
Authors: Ali Haydar Eskiocak, Cumhur İbrahim Bassorgun, Sarp Uzun, Soner Uzun
Journal: Case Rep Dermatol Med (2017)
MeSH terms: Case Reports

Disseminated hypopigmented keratosis is a distinct clinical entity and only few cases have been reported so far. Here, we present a 21-year-old man with almost 10-year history of hypopigmented, nonfollicular, keratotic lichenoid papules occurring on the extensor surfaces of the extremities, back and lumber region. Histopathological examination showed orthohyperkeratosis, irregular acanthosis, and sporadic papillomatosis with a normal amount of melanin and number of melanocytes. In addition, no marked inflammation or melanophages were seen. In order to exclude other possible causes, we performed laboratory tests and radiological examination which were all found to be normal. As the clinical and histopathological features of our patient were taken into account, it was considered to be compatible with the diagnosis of disseminated hypopigmented keratoses. So far, only topical therapies have been used with failure in the previously reported cases except one patient. Considering the extensive lesions, we treated the present patient with 5% salicylic acid in addition to oral acitretin and significant regression in all lesions was achieved, particularly on the keratosis.
Full-term abdominal extrauterine pregnancy complicated by post-operative ascites with successful outcome: a case report
Authors: Gwinyai Masukume, Elton Sengurayi, Alfred Muchara, Emmanuel Mucheni, Wedu Ndebele, Solwayo Ngwenya
Journal: J Med Case Rep (2013)

Introduction:
Advanced abdominal (extrauterine) pregnancy is a rare condition with high maternal and fetal morbidity and mortality. Because the placentation in advanced abdominal pregnancy is presumed to be inadequate, advanced abdominal pregnancy can be complicated by pre-eclampsia, which is another condition with high maternal and perinatal morbidity and mortality. Diagnosis and management of advanced abdominal pregnancy is difficult.
Case presentation:
We present the case of a 33-year-old African woman in her first pregnancy who had a full-term advanced abdominal pregnancy and developed gross ascites post-operatively. The patient was successfully managed; both the patient and her baby are apparently doing well.
Conclusion:
Because most diagnoses of advanced abdominal pregnancy are missed pre-operatively, even with the use of sonography, the cornerstones of successful management seem to be quick intra-operative recognition, surgical skill, ready access to blood products, meticulous post-operative care and thorough assessment of the newborn.
Aortic valve replacement via right anterolateral thoracotomy in the case of a patient with extreme mediastinal right-shift following pneumonectomy
Authors: Mathias Wilhelmi, Thomas Rodt, Issam Ismail, Axel Haverich
Journal: J Cardiothorac Surg (2013)
MeSH terms: Aortic Valve / surgery, Heart Valve Prosthesis Implantation, Case Reports, Aged, Aortic Valve Stenosis / surgery, Carcinoma, Bronchogenic / surgery, Humans, Imaging, Three-Dimensional, Lung Neoplasms / surgery, Male, Minimally Invasive Surgical Procedures, Pneumonectomy / methods, Thoracotomy / methods, Tomography, X-Ray Computed

We report on the case of a 68-year-old male patient with the history of right pneumonectomy due to bronchial carcinoma, who was referred for aortic valve replacement due to severe calcified aortic stenosis. Pre-operative chest X-ray and computed tomography (CT) revealed an unusually pronounced mediastinal shift to the right. Despite this unusual anatomy, we decided to perform surgery using the right anterolateral thoracotomy following thorough pre-operative planning using 3D-volume rendering of the CT data-set. This approach yielded excellent exposure of the aortic root and the ascending aorta, respectively. Following an uneventful operative and post-operative course the patient could be discharged on post-OP day 6.Although only occasionally described for aortic valve replacement a right anterolateral thoracotomy may represent a valuable surgical approach, particular in patients with unusual anatomy, e.g. a mediastinal right-shift. However, thorough pre-operative planning, i.e. using visualization and planning techniques such as 3D-volume rendering should be mandatory as it provides information crucial to facilitate surgical steps and thus, may help avoid severe surgical complications.
Case report: Depressive disorder with peripartum onset camouflages suspected intracranial tuberculoma
Authors: Halwa Zakia, Shelly Iskandar
Journal: Front Psychiatry (2022)
Keywords: depression, intracranial tuberculoma, meningitis tuberculosis, neuroimaging, postpartum depression
MeSH terms: Case Reports

Background:
Co-occuring psychological symptoms and rare medical illnesses like intracranial tuberculoma add difficulties in diagnosing and treatment. The present report discussed a rare case of a young woman with tuberculoma and depressive disorder with peripartum onset.
Case presentation:
The patient was a 22-year-old woman. She underwent a cesarean section due to premature rupture of the membrane. She had developed behavioral changes for 3 months before admission and had been brought to general practitioner for several times during pregnancy. Her symptoms worsen after she underwent a cesarean section. She refused to answer doctor's and family's questions and she showed symptoms of depression. She was diagnosed with depressive disorder with peripartum onset and treated according to her diagnosis. However, she also experienced intermittent headaches which lead to suspicion that there was an organic cause for her complaints. Computed tomography (CT) was done and revealed suspected intracranial tuberculoma and meningitis. She died due to respiratory distress before she got adequate treatment for her illnesses.
Conclusion:
The possibility of neurocognitive disorder due to infection such as intracranial tuberculoma should be considered as an additional diagnosis (co-occuring disease) or differential diagnosis in people who develop psychiatric symptoms, especially in areas with high tuberculosis incidence.
Case Report: Dynamic Interdependencies Between Complementary and Alternative Medicine (CAM) Practice, Urinary Interleukin-6 Levels, and Fatigue in a Breast Cancer Survivor
Authors: Magdalena Singer, Michaela Ott, Harald R Bliem, Birgit Hladschik-Kermer, Francisco M Ocaña-Peinado, Emil Chamson, Christian Schubert
Journal: Front Psychiatry (2021)
Keywords: cam, il-6, breast cancer, cancer survivor, fatigue, integrative single-case study, qualitative method, time series analysis
MeSH terms: Case Reports

Background: This study investigated the influence of complementary and alternative medicine (CAM) techniques (i.e., Jin Shin Jyutsu, music, physiotherapy, Tai Chi, and energy healing) on urinary interleukin-6 (IL-6) levels and fatigue in a 49-year-old breast cancer survivor suffering from cancer-related fatigue and depression. Data were sampled under conditions of "life as it is lived." Methods: For 28 days, a female breast cancer survivor collected her full urine output in 12-h intervals from about 8 a.m. to 8 p.m. and from about 8 p.m. to 8 a.m. These urine samples were used to determine urinary IL-6 levels through ELISA and creatinine concentrations via HPLC. In 12-h intervals (every morning and evening), the patient completed the DIARI, which included fatigue measurement and notes on incidents and activities such as CAM practice. In addition, the patient was interviewed weekly to identify meaningful everyday incidents. In this context, CAM practice was also discussed. Time series analysis consisted of ARIMA modeling and cross-correlational analyses (p < 0.05). Results: When each CAM technique was considered separately in time series analysis, CAM was consistently associated with increases in urinary IL-6 release and decreases in fatigue. Furthermore, when all CAM techniques experienced as positive were included in one time series, a biphasic urinary IL-6 response pattern was found in which CAM practice was first preceded by decreases in IL-6 by 12-0 h and then followed by increases in IL-6 after 108-120 h. Finally, cross-correlations between IL-6 and fatigue showed that increases in IL-6 were followed by decreases in fatigue intensity after 48-60 h and, conversely, that decreases in fatigue intensity were followed by decreases in IL-6 after 24-36 h and 48-60 h. Conclusion: IL-6 increases and fatigue decreases highlight potential health-promoting effects of CAM practice. Moreover, a cyclic IL-6 pattern in response to all CAM activities experienced as positive underscores that CAM was meaningful to the patient. Additionally, a negative feedback circuit between IL-6 and fatigue intensity was detected. Taken together, this study confirms the necessity of integrating subjective meaning and dynamic complexity into biopsychosocial research in order to understand human functioning under real-life conditions.
Periprosthetic joint infection of a total hip arthroplasty with Candida parapsilosis
Authors: Laurence Vergison, Alexander Schepens, Koen Liekens, Renata De Kesel, Hans Van der Bracht, Jan Victor
Journal: Int J Surg Case Rep (2020)
Keywords: candida parapsilosis, case report, fluconazole, fungal periprosthetic infection, surgical treatment
MeSH terms: Case Reports

Introduction:
Fungal periprosthetic joint infection (PJI) is a disruptive and complex complication of joint arthroplasty. We present a case of a fungal PJI with Candida parapsilosis after a total hip arthroplasty (THA).
Presentation of case:
A 73-year-old woman with a history of ovarian cancer with peritoneal metastases, was treated with a THA, due to symptomatic arthritis of the right hip. One month after surgery, she had difficulties walking. Inflammatory parameters were mildly increased. Aspiration of a subcutaneous abscess diagnosed Candida parapsilosis. A two-stage revision arthroplasty without spacer was performed. During a six-week prosthesis-free interval, intravenous fluconazole 400 mg was given. After reimplantation, fluconazole was continued for two weeks intravenously and life-long perorally. Follow-up of the patient after six months showed no recurrence of infection.
Discussion:
This case revealed that when PJI is suspected, a low treshold for joint aspiration is important. Two-stage revision with systematic antifungal therapy is the preferred treatment of fungal PJI. Our case demonstrated a good result with a prosthesis-free interval. Fluconazole is the preferred antifungal treatment and it should be applied for at least six months or longer.
Conclusion:
To our knowledge, this is the first case of a fungal PJI with Candida parapsilosis after a THA treated with a two-stage revision arthroplasty without spacer and a life-long fluconazole treatment.
DMS: Delusional Misidentification Syndrome or Dead Moneyman and Sex Offender? A Case Report of Reverse Capgras Syndrome
Authors: Elizabeth Kim, Rachael Murphy, Maggie Driscoll
Journal: Case Rep Psychiatry (2022)
MeSH terms: Case Reports

Delusional misidentification syndromes (DMSs) are delusional phenomena where individuals believe that one has been altered or replaced. Here, we present the case of Ms. JS, who exemplifies one such DMS, Reverse Capgras Syndrome, which refers to the delusion that one has been replaced by an imposter. She endorsed psychosis and suicidality centered on her belief that she was in fact American financier and convicted sex offender Jeffrey Epstein. Her delusion was eventually resolved with medication management and therapy. In this report, we review Reverse Capgras Syndrome in the context of existing research on trauma-related pathology and the neural basis of self. We also demonstrate the success of resolving what was initially concerning for a fixed delusion with patient-centered medication management and therapy. This case is presented as a vital contribution to the literature to bring awareness to a rare disorder with a poorly understood etiology that had a favorable outcome. Here, it is suggested that DMS may arise due to disrupted functional connectivity between highly coordinated brain networks, as evidenced by its occurrence in both organic neural disease and, as in this patient, trauma-related psychopathology.
Normal T and B Cell Responses Against SARS-CoV-2 in a Family With a Non-Functional Vitamin D Receptor: A Case Report
Authors: Martin Kongsbak-Wismann, Fatima A H Al-Jaberi, Jonas Damgård Schmidt, Mustafa Ghanizada, Cecilie Bo Hansen, Daniel Villalba Lopez, Anders Woetmann, Niels Ødum, Charlotte Menné Bonefeld, Anette Stryhn, Peter Garred, Søren Buus, Carsten Geisler
Journal: Front Immunol (2021)
Keywords: covid-19, hvdrr, sars-cov-2, adaptive immunity, vitamin d
MeSH terms: B-Lymphocytes / immunology, CD4-Positive T-Lymphocytes / immunology, CD8-Positive T-Lymphocytes / immunology, Familial Hypophosphatemic Rickets / genetics, Receptors, Calcitriol / genetics, SARS-CoV-2 / immunology, Case Reports, Research Support, Non-U.S. Gov't, Adaptive Immunity / genetics, Adaptive Immunity / immunology, COVID-19 / immunology, Familial Hypophosphatemic Rickets / immunology, Female, Humans, Immunologic Memory / immunology, Lymphocyte Count, Vitamin D / blood, Vitamin D / therapeutic use, Receptors, Calcitriol, VDR protein, human, Vitamin D

The coronavirus disease 2019 (COVID-19) pandemic has severely impacted daily life all over the world. Any measures to slow down the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and to decrease disease severity are highly requested. Recent studies have reported inverse correlations between plasma levels of vitamin D and susceptibility to SARS-CoV-2 infection and COVID-19 severity. Therefore, it has been proposed to supplement the general population with vitamin D to reduce the impact of COVID-19. However, by studying the course of COVID-19 and the immune response against SARS-CoV-2 in a family with a mutated, non-functional vitamin D receptor, we here demonstrate that vitamin D signaling was dispensable for mounting an efficient adaptive immune response against SARS-CoV-2 in this family. Although these observations might not directly be transferred to the general population, they question a central role of vitamin D in the generation of adaptive immunity against SARS-CoV-2.
Two Cases of Armour Thyroid Interference in Thyroglobulin Monitoring for Thyroid Cancer
Authors: Michelle Ponder, Elizabeth Lamos, Kashif Munir
Journal: Case Rep Endocrinol (2021)
MeSH terms: Case Reports

Thyroglobulin (Tg) monitoring is the biochemical standard for surveillance of recurrent differentiated thyroid cancer (DTC). Several assays are available to quantify Tg levels: immunometric assay (IMA), radioimmunoassay (RIA), and the newer liquid chromatography tandem mass spectrometry (LC-MS). It is well known that a number of entities can interfere with the accuracy of testing, and at this point in time, no one assay perfectly balances high sensitivity with low risk of interference. In this case study, we present two cases in which treatment with desiccated thyroid extract (Armour thyroid) led to a sudden elevation in Tg, which resolved when Armour thyroid was discontinued. This elevation occurred when Tg was measured with both IMA and LC-MS, which suggests direct interference from porcine Tg rather than heterophilic or thyroglobulin antibody (TgAb) interference. We suggest that patients with a history of DTC not be treated with desiccated thyroid extracts consistent with guidelines. Furthermore, more advances need to be made in the area of Tg testing to improve specificity and avoid detection of nonhuman Tg and other similar proteins.