OpenMed/multicare-articles huggingface dataset:
Case Report: Composite Angioimmunoblastic T-Cell Lymphoma and Epstein-Barr Virus-Positive B-Cell Lymphoproliferative Disorder as Other Iatrogenic Immunodeficiency-Associated Lymphoproliferative Disorders
Authors: Seiji Kakiuchi, Kimikazu Yakushijin, Ikumi Takagi, Junpei Rikitake, Hiroaki Akiyama, Hiroyuki Matsuba, Yoshitake Hayashi, Kazuyoshi Kajimoto, Nobuko Iwata
Journal: Front Med (Lausanne) (2020)
Keywords: epstein-barr virus reactivation, angioimmunoblastic t-cell lymphoma (aitl), clonal expansion, composite lymphoma, methotrexate
MeSH terms: Case Reports

Immunosuppressants are widely used to treat patients with rheumatoid arthritis (RA), and their adverse effects have been known to cause other iatrogenic immunodeficiency-associated lymphoproliferative disorders (OIIA-LPDs). We report a patient with RA who had been treated with methotrexate (MTX) and tacrolimus (TAC) and who developed whole body lymphadenopathy. We simultaneously confirmed angioimmunoblastic T-cell lymphoma (AITL) through a right cervical lymph node biopsy and Epstein-Barr virus-positive B-cell lymphoproliferative disorder (EBV-positive B-LPD) through a bone marrow examination. After cessation of immunosuppressant therapy, both LPDs completely disappeared. Patients with AITL are occasionally reported to develop B-cell lymphoma through reactivation of the EBV, which leads to clonal expansion in the microenvironment. Immunohistochemistry results revealed that both LPD components were positive for EBV-encoded RNA. Moreover, in this patient, the plasma EBV DNA level was found to be high; therefore, EBV infection was a probable etiology. Synchronous coexistence of AITL and B-LPD as an OIIA-LPD has rarely been reported. This case report is the first to discuss the disappearance of both LPDs on withdrawal of immunosuppressants only. AITL occasionally accompany B-LPD; however, this composite lymphoma comprised AITL and B-LPD, and OIIA-LPDs should not be overlooked.
Implant Treatment with 12-Year Follow-Up in a Patient with Severe Chronic Periodontitis: A Case Report and Literature Review
Authors: Keisuke Seki, Yoshiyuki Hagiwara
Journal: Case Rep Dent (2019)
MeSH terms: Case Reports

Tooth loss among adults is associated with progressive periodontitis. Implant prosthetic treatment has long been utilized in periodontal patients. Even when the implants are applied, ongoing management of periodontal disease and control of inflammation is necessary to maintain a healthy oral cavity. Lack of appropriate periodontal treatment can result in recurrence of periodontal disease during a maintenance period; loss of the supportive capacity of the periodontal tissues will increase the susceptibility of residual teeth to traumatic force. For this reason, it is worthwhile to improve oral function by applying implants as a fixed device. Here, we report that implant treatment in a patient with generalized severe chronic periodontitis helped maintain the periodontal and peri-implant tissue for a long term. We propose that initial periodontal treatment and ongoing supportive therapy can help maintain implants in patients with severe periodontitis. In addition, we reviewed case reports in the English literature so far.
Acute pulmonary embolism following corticosteroid administration in acute severe ulcerative colitis with gastrointestinal bleeding: A case report
Authors: Xuhan Liu, Xia Peng, Chunyan Rong, Weihua Zhang
Journal: Front Cardiovasc Med (2022)
Keywords: vte, corticosteroids, infliximab, pulmonary embolism, ulcerative colitis
MeSH terms: Case Reports

Background:
Ulcerative colitis often leads to gastrointestinal bleeding and venous thromboembolism (VTE). At present, there is no clear conclusion about anticoagulant therapy for these patients. Treatment for ulcerative colitis usually includes 5-aminosalicylic acid, corticosteroid, and biologics. Acute ulcerative colitis, usually caused by infection, is usually severe and can be life-threatening.
Case presentation:
We report the development of VTE in a patient with severe acute ulcerative colitis who experienced gastrointestinal bleeding following hormonal therapy. The patient's indicators suggested that his blood was hypercoagulable and that his prognosis was poor.
Conclusion:
Patients with ulcerative colitis are prone to form VTE. The use of corticosteroids during treatment increases the risk of thrombus. Anticoagulation strategy for patients with ulcerative colitis after gastrointestinal bleeding is a problem that needs to be discussed.
Giant abdominal cyst in a young female patient: A case report
Authors: Cláudia Leite, Bruno Barbosa, Natália Santos, Ana Oliveira, Carlos Casimiro
Journal: Int J Surg Case Rep (2020)
Keywords: abdominal cyst, abdominal distension, adnexectomy, case report, mucinous cystadenoma, ovarian cyst
MeSH terms: Case Reports

Introduction:
Most abdominal cysts derive from the ovary. The range of differential diagnoses is wide. Unfortunately, imaging studies not always determine its origin.
Presentation of case:
The authors present the case of a 20-year-old female patient, admitted to the emergency department due to abdominal pain and distension, whose imaging studies revealed a gigantic abdominal cyst of unknown origin. She underwent an exploratory laparotomy that disclosed an ovarian cyst that was removed by a left adnexectomy. It weighed 10Kg and was 60 cm wide. The pathology report showed a mucinous cyst adenoma.
Discussion:
Once a patient present with an abdominal cyst, one should always consider the extensive list of differential diagnoses. In premenopausal women, ovarian cysts are very frequent. Cysts may grow to considerable size. Our patient was symptomatic, malnourished and dehydrated. Neither ultrasonography nor computed tomography were able to define the origin of the cyst. Persistent ovarian cysts larger than 10 cm, particularly if symptomatic, should be considered for surgery.
Conclusion:
Progressive abdominal distension in premenopausal women should raise suspicion of an ovarian tumor, such as mucinous cystadenoma. These tumours are benign, but when their size is considerable, complications do arise and their surgical removal may be life threatening.
Acute Upper Extremity Arterial Occlusion Diagnosed on POCUS in the Emergency Department
Authors: Derrick Huang, Jacob Ruzicka, Leoh León, Latha Ganti
Journal: POCUS J (2023)
Keywords: emergency medicine, point of care ultrasound, arterial embolism, brachial artery occlusion, embolectomy, upper extremity ischemia
MeSH terms: Case Reports

Upper extremity acute limb ischemia (ALI) is a limb-threatening and potentially lethal pathology that is most commonly caused by vascular embolization. Outcomes of limb ischemia are time-sensitive due to the correlation between a longer time from symptom onset to intervention with a vastly higher risk of amputation. In this report, point of care ultrasound (POCUS) was utilized to rapidly diagnose a patient with a proximal right brachial artery embolic occlusion, prompting expedited surgical consultation and successful embolectomy. POCUS can provide a focused vascular examination of the limbs to expedite diagnosis of time-sensitive ALI and facilitate timely medical intervention and surgical consultation.
Tympanosclerosis Presenting as Mass: Workup and Differential
Authors: Jonnae Y Barry, Saranya Reghunathan, Abraham Jacob
Journal: Case Rep Otolaryngol (2016)

Introduction. Tympanosclerosis is a commonly encountered entity within ENT clinics and primary care settings. Recognizing ear pathology is essential for correct management. Oftentimes the diagnosis is clear; however in certain cases further workup to rule out other more insidious disease processes is warranted. Case Report. We present a case of tympanosclerosis which presented as an ear mass without classic appearance of tympanosclerosis. Through imaging and biopsy the diagnosis of tympanosclerosis was made. The patient was treated surgically with good outcome. Discussion. Various ear pathologies, with different treatment algorithms, may present as clinically similar to one another. Differential diagnosis for this case included tympanosclerosis, cholesteatoma, or other middle ear masses. We review these entities and discuss their pathophysiology and implications on management.
A five-year followup of human seminal plasma allergy in an 18-year-old woman
Authors: Ole D Wolthers
Journal: Case Rep Med (2012)
MeSH terms: Case Reports

Case reports of women with the rare condition of human seminal plasma allergy have indicated that the condition may be associated with life-threatening anaphylactic reactions in relation to coitus. Few observations, if any, of long-term outcome of the condition are available. The aim of this paper was to present a case diagnosed in an 18-year-old girl who presented with generalized urticaria, nasal congestion and secretion, conjunctivitis, and periorbital and labial oedema 6-8 hours after coitus. During five years of followup the condition improved clinically significantly. Due to intimacy concerns and the low prevalence of the condition robust long term data on the natural course of the condition are difficult to obtain. The present case suggests that in some patients the condition may improve over time.
A Rare Tumor in the Common Bile Duct: A Case Report
Authors: Mustafa Suker, Katharina Biermann, Casper van Eijck, Michael Doukas
Journal: J Pancreat Cancer (2017)
Keywords: epstein–barr virus infections, biliary tract neoplasms, lymphoepithelial-like carcinoma
MeSH terms: Case Reports

Background: Lymphoepithelial-like carcinoma (LEC) is rarely found in organs outside the nasopharyngeal area. This is the first case report of Epstein-Barr virus (EBV)-associated LEC of the extrahepatic tract. As it is very difficult to distinguish between LEC and adenocarcinoma in the clinical presentation, this article can give more insight into how the pathological analysis can help with the diagnosis. Case presentation: A 37-year-old Caucasian male with a history of Crohn's disease and primary sclerosing cholangitis presented with cholestasis. A computed tomography scan revealed a tumor in the pancreatic head without invasion into the surrounding organs. The patient underwent an uncomplicated pylorus-preserving pancreaticoduodenectomy, with pathology revealing an epithelial carcinoma of the common bile duct with metastases in 4 of the 18 resected lymph nodes. In situ hybridization demonstrated extensive EBV positivity in the tumor cells, and in serum, positive IgG anti-EBV was found. The diagnosis of EBV-associated LEC was hereby confirmed. The postoperative course was uneventful and 18 months after surgery there is no recurrence. Conclusion: In the case of an epithelial tumor in the periampullary region, one should consider EBV-associated LEC as this tumor may have a lot of similarity with the adenocarcinoma but has lower rates of recurrence after surgery and better overall survival.
Thyrotoxicosis Associated with Ustekinumab Treatment for Psoriasis
Authors: Bayanne Olabi, Shanti Ayob
Journal: Case Rep Dermatol Med (2020)
MeSH terms: Case Reports

Biologic treatments have revolutionised the management of psoriasis in recent years; however, data on their safety profile in large populations and long-term effects are being gathered on an ongoing basis. Ustekinumab is a monoclonal antibody that targets interleukin-12/23 used in the treatment of moderate-to-severe psoriasis. Here, we report the case of a 32-year-old Caucasian gentleman who developed thyrotoxicosis following the commencement of ustekinumab treatment. Following control of thyroid status by the Endocrinology team, this recurred after recommencement of ustekinumab on two further occasions over a 5-year period. This is the second known reported association of this nature. Awareness of these possible adverse effects is imperative in managing patients and informing decision-making, and further long-term studies will help elucidate the precise safety profiles of biologic treatments.
Laparoscopic Repair of Internal Transmesocolic Hernia of Transverse Colon
Authors: Tomokazu Kishiki, Toshiyuki Mori, Yoshikazu Hashimoto, Hiroyoshi Matsuoka, Nobutsugu Abe, Tadahiko Masaki, Masanori Sugiyama
Journal: Case Rep Surg (2015)

Introduction. Internal hernias are often misdiagnosed because of their rarity, with subsequent significant morbidity. Case Presentation. A 61-year-old Japanese man with no history of surgery was referred for intermittent abdominal pain. CT suggested the presence of a transmesocolic internal hernia. The patient underwent a surgical procedure and was diagnosed with transmesocolic internal hernia. We found internal herniation of the small intestine loop through a defect in the transverse mesocolon, without any strangulation of the small intestine. We were able to complete the operation laparoscopically. The patient's postoperative course was uneventful and the patient was discharged on postoperative day 6. Discussion. Transmesocolic hernia of the transverse colon is very rare. Transmesocolic hernia of the sigmoid colon accounts for 60% of all other mesocolic hernias. Paraduodenal hernias are difficult to distinguish from internal mesocolic transverse hernias. We can rule out paraduodenal hernias with CT. Conclusion. The patient underwent a surgical procedure and was diagnosed with transmesocolic internal hernia. We report a case of a transmesocolic hernia of the transverse colon with intestinal obstruction that was diagnosed preoperatively and for which laparoscopic surgery was performed.
Rapid Onset of B12 Deficiency in the Setting of Worsening Multiple Myeloma: Correlations between B12 Deficiency and Multiple Myeloma
Authors: Karan Seegobin, Satish Maharaj, Grant Nelson, Jeremy Carlson, Cherisse Baldeo, Rafik Jacob
Journal: Case Rep Oncol Med (2017)
MeSH terms: Case Reports

A 67-year-old female with a relapse of multiple myeloma after being in remission for approximately 2 years following autologous stem cell transplant presented with worsening pancytopenia, over a three-month period. There were an increase in her monoclonal spike at 3.13 g/dL on serum protein electrophoresis, low serum B12 levels, and positive intrinsic factor antibodies. Three months before, she had normal B12 levels and a significantly lower monoclonal spike of 1.07 g/dL. She was diagnosed with B12 deficiency with pernicious anaemia in the setting of her worsening myeloma. Multiple myeloma (MM) has been linked with B12 deficiency and pernicious anaemia. Several mechanisms have been described regarding the pathogenesis of B12 deficiency in such patients. Increased tumour activity can further perpetuate the development of B12 deficiency in such patients. With regard to our case, the increase in tumour activity and onset of pernicious anaemia could have contributed to the rapid development of B12 deficiency. In contrast to this, rapid development of B12 deficiency could also signify relapse or worsening of the myeloma as seen in our case. Physicians ought to consider B12 deficiency in patients with worsening pancytopenia and myeloma.
Placement of covered self-expandable metal biliary stent for the treatment of severe postsphincterotomy bleeding: outcomes of two cases
Authors: Marta Di Pisa, Ilaria Tarantino, Luca Barresi, Davide Cintorino, Mario Traina
Journal: Gastroenterol Res Pract (2010)
MeSH terms: Case Reports

We report two cases of severe postsphincterotomy bleeding in an adult and a pediatric patient treated, as first options, with available techniques to induce hemostasis without success. Because of persisting bleeding, an expandable, partially covered, metallic stent was placed into the choledocho to mechanically compress the bleeding site. The bleeding was stopped. In the following days, both patients remained hemodynamically stable with no further episodes of bleeding. We believe that the application of a covered metallic stent in a severe postendoscopic-sphincterotomy bleeding, refractory to injection therapy, should be considered to avoid additional interventions, which carry a higher risk of complications, even in pediatric patients.
A Cardiogenic Shock due to an Acute MI with LCA Arising from the Right Coronary Sinus Successfully Treated with PCI
Authors: Rayyan Jadeed, Klaus Pethig, Dirk Böcker
Journal: Case Rep Cardiol (2019)
MeSH terms: Case Reports

Coronary artery anomalies (CAAs) are a diverse group of congenital anomalies with an incidence ranging from 0.17% in autopsy cases to 1.2% in patients undergoing coronary angiography. The left coronary artery (LCA) originating from the right coronary sinus is a very rare CAA with a frequency of 0.03%. We present a very rare case of a cardiogenic shock as a consequence of an acute anterolateral myocardial infarction by a totally occlusive lesion in the long left main stem with a complete LCA arising from the right coronary sinus in an 85-year-old female. This lesion was successfully treated with 2 drug-eluting stents. This is perhaps the first published case about cardiogenic shock due to an acute myocardial infarction associated with this type of coronary anomalies, and it presents a special challenge in the catheter laboratory.
25-Gauge Vitrectomy in Open Eye Injury with Retained Foreign Body
Authors: G Sborgia, N Recchimurzo, A Niro, L Sborgia, A Sborgia, G Alessio
Journal: J Ophthalmol (2017)

Purpose. Ocular trauma with retained foreign body is an important cause of visual impairment in working-age population. Clinical status impacts on the timing and planning of surgery. In the last year small gauge vitrectomy has become safer and more efficient, extending the range of pathologies successfully treated. Aims. To evaluate the safety and outcomes in patients with open eye injury with retained foreign body that underwent early 25-gauge vitrectomy. Methods. In this retrospective, noncomparative, interventional case series, we performed 25-gauge vitrectomy on 10 patients affected by open globe injuries with retained foreign body, over 3 years. We analyzed age, wound site, foreign body characteristics, ocular lesions correlated, relative afferent pupillary defect, visual acuity, and intraocular pressure. Follow-up evaluations were performed at 1, 3, and 6 months. According to the clinical status we performed other procedures to manage ocular correlated lesions. Results. The median age of patients was 37 years. The foreign body median size was 3.5 mm (size range, 1 to 10 mm). 25-gauge vitrectomy was performed within 12 hours of trauma. Foreign body removal occurred via a clear corneal or scleral tunnel incision or linear pars plana scleral access. Visual acuity improved in all patients. Endophthalmitis was never reported. Only two cases reported postoperative ocular hypertension resolved within the follow-up. Retinal detachment recurred in one case only. Conclusions. 25-gauge vitrectomy could be considered as early approach to manage open globe injuries with a retained posterior segment foreign body in selected cases with good outcomes and low complication rate.
Class III Orthodontic Camouflage: Is the "Ideal" Treatment Always the Best Option? A Documented Case Report
Authors: Lorenzo Rustico, Vincenzo Ronsivalle, Flavia Iaculli, Gianrico Spagnuolo, Gaetano Isola, Antonino Lo Giudice
Journal: Case Rep Dent (2022)
MeSH terms: Case Reports

Angle's Class III is one of the most complex malocclusions to treat. In nongrowing skeletal class III malocclusions, the choice between orthognathic surgery and camouflage treatment remains a challenge to the orthodontist. In class III borderline cases, clinicians are called to find the best compromise between functional and aesthetics outcomes, with the latter which often turns in avoiding worsening of profile characteristics, which makes the treatment of these patients quite challenging. This case report describes a borderline nongrowing patient with skeletal class III malocclusion, upper incisor proclination and spacing, lower crowding, and arch width discrepancy, which has already undergone previous orthodontic treatment. The orthodontic treatment involved the mandibular first premolar extraction, resulting in class I canine relation with good overjet and overbite as well as good arch coordination. The orthodontic camouflage improved the dental relationship with normalization of upper incisor inclination without a relevant retroclination of lower incisors; the skeletal facial pattern of the patient experienced a slight improvement. The tendency to skeletal class III has remained nearly unaffected. Treatment outcomes were stable after 1-year posttreatment follow-up.
Electrocardiogram acquisition errors or myocardial infarct
Authors: Sari U M Vanninen, Kjell C Nikus
Journal: Case Rep Cardiol (2011)
MeSH terms: Case Reports

Incorrect lead placement may result in unnecessary therapeutic interventions. We present a case report of 53-year-old man with new inferior T-wave inversions in the 12-lead electrocardiogram (ECG) noted during routine followup of hypertension without any cardiovascular symptoms.
Severe major vessel injury during peadicle screw removal: a case report
Authors: ShengYu Fu, Gang Ju, Xiang Dai, Haijun Li, Aibing Huang
Journal: Front Surg (2023)
Keywords: case report, iatrogenic vascular injury, implant removal, inferior vena cava, pedicle screw
MeSH terms: Case Reports

Introduction:
Pedicle screw fixation (PSF) has been the standard therapy for the treatment of various spinal diseases. Although complications are identified regularly, iatrogenic vascular injury is one of the rare but life-threatening complications. In this literature, we describe the first case of inferior vena cava (IVC) injury during pedicle screw removal.
Case description:
A 31-year-old man was treated by percutaneous pedicle screw fixation for an L1 compression fracture. After a year, the fracture healed well and hardware removal surgery was performed. During the procedure, the hardware on the right was removed unremarkably except for the L2 pedicle screw which slipped into the retroperitoneum because of the improper technique. The CT angiogram revealed the screw had breached the anterior cortex of the L2 vertebral body and penetrated the IVC. After multidisciplinary cooperation, the defect of IVC was reconstructed and the L2 screw was removed from the posterior approach in the end.
Result:
The patient recovered well and was discharged after 3 weeks without further events. The removal of the contralateral implants was unremarkable at 7 months postoperatively. At the 3-year follow-up, the patient returned to his normal daily activity without any complaints.
Conclusion:
Although pedicle screw removal is a rather simple procedure, severe complications may have occurred from this procedure. Surgeons should keep vigilant to avoid the complication noted in this case.
Sevoflurane prolonged the QTc interval and increased transmural dispersion of repolarization in a patient with long QT syndrome 3: a case report
Authors: Atsuhiro Kitaura, Shinichi Nakao, Shinichi Hamasaki, Kei Houri, Takatoshi Tsujimoto, Seishi Kimura, Mayuka Matsushima
Journal: JA Clin Rep (2017)
Keywords: arrhythmia, long qt syndrome type 3, qtc, sevoflurane, torsades de pointes, tp-e

We report that sevoflurane not only caused marked QTc interval prolongation but also increased transmural dispersion of repolarization in a patient with long QT syndrome 3 (LQT3). A 16-year-old male with LQT3 underwent a shoulder operation. He experienced no episode of syncope or cardiac arrest, but his preoperative electrocardiography (ECG) showed marked QTc interval prolongation (631 ms) and Tp-e interval prolongation (126 ms). Anesthesia was induced with propofol and maintained with 2% sevoflurane and remifentanil. Although no lethal arrhythmias occurred in the perioperative period, not only the QTc interval but also Tp-e interval was further prolonged by sevoflurane. While sevoflurane has been recognized as a safe anesthetic in terms of QT interval prolongation, even in patients with long QT syndromes, we believe that sevoflurane might be avoided for poorly controlled LQT3 patients.