OpenMed/multicare-articles huggingface dataset:
The Central Nervous System Effects and Mimicry of Common Variable Immunodeficiency (CVID): A Case Report with Literature Review
Authors: Sohail Farshad, Fernando Figueroa Rodriguez, Alexandra Halalau, Joseph Skender, Cory Rasmussen, Martin Pevzner
Journal: Case Rep Rheumatol (2019)
MeSH terms: Case Reports

There is a scarceness of information on the central nervous system effects of common variable immunodeficiency (CVID). A 30-year-old woman with a history of recurrent upper respiratory infections, vitiligo, and immune thrombocytopenic purpura presented with right-sided numbness. Magnetic resonance imaging (MRI) of the thoracic spine revealed a signal hyperintensity. MRI of the brain demonstrated FLAIR hyperintensity in the right middle frontal gyrus. Cerebral spinal fluid was unremarkable. Serum immunoglobulins revealed hypogammaglobulinemia. Endobronchial and subsequent mediastinum biopsies were all negative for sarcoidosis and malignancy. No infectious etiology was found. She was treated with glucocorticoids and intravenous immunoglobulin (IVIG) replacement therapy for CVID-associated myelitis. Follow-up MRI showed improvement; however, her numbness persisted despite these treatments, which led to an outside physician adding methotrexate for their suspicion of sarcoidosis. Her symptoms remained stable for two years, but when the methotrexate dose was weaned, her numbness worsened. Upon review, the treatment team refuted the diagnosis of sarcoidosis but continued treatment with prednisone, IVIG, and methotrexate for CVID-associated myelitis, from which her symptoms have stabilized. Here, we discuss CVID-associated neurological complications, its similarities to sarcoidosis, and a literature review with treatment regimens and outcomes.
Management of stent-related tracheoesophageal fistula in complex post-tuberculosis tracheobronchial stenosis: A case report
Authors: Yang Bai, Yuting Yin, Jing Chi, Shuang Li, Yishi Li, Shuliang Guo
Journal: Front Med (Lausanne) (2022)
Keywords: case report, complication, post-tuberculosis tracheobronchial stenosis, self-expandable metallic stent, tracheoesophageal fistula
MeSH terms: Case Reports

Background:
The covered self-expandable metallic stents (SEMS) have been used to manage benign tracheobronchial stenosis, especially the complex post-tuberculosis (TB) tracheobronchial stenosis (PTTS) with cartilage destruction or malacia. This procedure could lead to stent-related tracheoesophageal fistula (TEF).
Case presentation:
A 21-year-old woman, who had one covered Y-shaped SEMS inserted to manage complex PTTS 2 years ago, presented with dyspnea and frequent coughing on drinking water. The bronchoscopy confirmed extensive granulation tissue hyperplasia and a TEF on the upper edge of the covered SEMS. The covered SEMS was removed in three steps, and another fully covered Y-shape SEMS (Microtech Co., Ltd., Nanjing, China) was inserted to restore patency in the tracheobronchial tree and occlude the TEF orifice. Recombinant bovine basic fibroblast growth factor (rbFGF) (6,000 IU/time) was sprayed into and around the fistula through the V-System single-use cannula via the flexible bronchoscope every other week. The patient showed sustained clinical and radiographic improvement, and the TEF healed.
Conclusion:
We presented a three-step bronchoscopic approach to managing a stent-related TEF in a patient with complex PTTS. Subsequently, regular bronchoscopic debridement of granulation tissue developing on the upper edge of SEMS is necessary to maintain the stent patency and reduce the risk of recurrent stent-related TEF. A fully covered SEMS associated with the local administration of rbFGF seems to offer an alternative simplified one-stage procedure for the temporary management of TEF combined with complex PTTS in non-surgical candidates.
A case of bilateral visual loss after spinal cord surgery
Authors: Jemal Shifa, Worknehe Abebe, Negussie Bekele, Dereje Habte
Journal: Pan Afr Med J (2016)
Keywords: visual loss, anemia, anesthesia, complication
MeSH terms: Laminectomy / methods, Postoperative Complications / pathology, Prone Position, Vision Disorders / etiology, Case Reports, Adolescent, Anesthesia, General, Humans, Laminectomy / adverse effects, Male, Prednisolone / administration & dosage, Spinal Cord / surgery, Syringomyelia / surgery, Prednisolone

Visual loss is a rare but potentially devastating postoperative complication of prone spinal surgery with a reported incidence of 0.017 to 0.1 percent. We present a case of post-operative bilateral visual loss in a patient who had a laminectomy in prone position under general anesthesia. A 17-year-old male patient with large syringomyelia extending from C2 - T2 level had a surgical procedure done under general anesthesia (GA) in prone position that lasted four hours. After the surgical procedure, the patient presented to the Ophthalmology Clinic of Princess Marina Hospital, with a complaint of visual loss of the right eye followed by left, of one week duration. The patient never had a visual impairment in the past. Physical examination, fundal examination and CT scan revealed no primary cause for the visual loss. In this patient the absence of any finding in the optic disc and the retina and the normal CT scan, suggests that the most likely diagnosis is posterior ischemic optic neuropathy. The patient was treated with prednisolone tablet daily and showed mild improvement in vision.
Leiomyosarcoma after Total Laparoscopic Hysterectomy with Power Morcellation
Authors: Tsukasa Takahashi, Tomohisa Ugajin, Noriaki Imai, Atsushi Hayasaka, Nobuo Yaegashi, Takeo Otsuki
Journal: Case Rep Obstet Gynecol (2019)
MeSH terms: Case Reports

Introduction:
Power morcellation is an effective and minimally invasive technique used to remove specimen tissues or the uterus in total laparoscopic hysterectomy (TLH). However, it has the risk of intraperitoneal dissemination of tissue and can cause a parasitic myoma. We report a case of leiomyosarcoma that occurred 4 years after TLH with power morcellation for fibroids.
Case:
A 52-year-old woman was referred to our hospital with a pelvic mass. She was diagnosed to have submucosal fibroids and had undergone TLH with power morcellation 4 years previously. The uterus weighed 398 g at that time. At present, a parasitic myoma was suspected, owing to the diagnosis of fibroids on the initial pathological evaluation. She underwent laparotomy, and the tumor was removed. Although the pathological evaluation confirmed the tumor to be a leiomyosarcoma, a review of the initial tissue did not show the presence of any malignancy. Since there was no metastasis, she was followed-up without additional treatment.
Conclusion:
Even if the initial pathologic evaluation suggests a benign mass, parasitic myoma and even sarcoma can occur after TLH with power morcellation. Considering the risk of dissemination and occult malignancy, the use of power morcellation should be avoided if there are alternative options to remove the tumor.
Cyclosporine-A-Induced Intracranial Thrombotic Complications: Systematic Review and Cases Report
Authors: Si-Ying Song, Zhong-Ao Wang, Yu-Chuan Ding, Xun-Ming Ji, Ran Meng
Journal: Front Neurol (2021)
Keywords: case report, cerebral arterial infarction, cerebral venous sinus thrombosis, cyclosporine-a, systematic review
MeSH terms: Case Reports

This study reported two cases of intracranial thrombotic events of aplastic anemia (AA) under therapy with cyclosporine-A (CsA) and reviewed both drug-induced cerebral venous thrombosis (CVT) and CsA-related thrombotic events systematically. We searched PubMed Central (PMC) and EMBASE up to Sep 2019 for publications on drug-induced CVT and Cs-A-induced thrombotic events. Medical subject headings and Emtree headings were used with the following keywords: "cyclosporine-A" and "cerebral venous thrombosis OR cerebral vein thrombosis" and "stroke OR Brain Ischemia OR Brain Infarction OR cerebral infarction OR intracerebral hemorrhage OR intracranial hemorrhage." We found that CsA might be a significant risk factor in inducing not only CVT but also cerebral arterial thrombosis in patients with AA.
Primary cardiac lymphoma with isolated parenchymal central nervous system relapse: report of two cases and review of the literature
Authors: Juan Montoro, Lucia Mattia, Paola Bertazzoni, Sarah Liptrott, Nicola Colombo, Maurizio Civelli, Lorenzo Preda, Daniele Laszlo, Giovanni Martinelli, Niccolò Frungillo
Journal: Ecancermedicalscience (2014)
Keywords: central nervous system, diffuse large b-cell lymphoma, primary cardiac lymphoma
MeSH terms: Case Reports

Primary cardiac lymphoma (PCL) is a rare subset of non-Hodgkin's lymphoma involving the heart and/or pericardium with no or minimal evidence of extracardiac involvement at presentation. Distant relapses have infrequently been observed. We report two cases of this disorder that showed isolated central nervous system (CNS) relapse. Diagnosis by endomyocardial biopsy was consistent with diffuse large B-cell lymphoma. After immunochemotherapy they achieved complete remission (CR). Eight and five weeks after, isolated CNS relapses were observed respectively. The first patient was treated with high-dose methotrexate (HD-MTX) and high-dose cytarabine, resulting in a second CR. She then went onto receive autologous stem-cell transplantation but unfortunately died shortly after because of infection. The second patient received systemic CNS prophylaxis with HD-MTX, and later she was treated with an induction chemotherapy strategy with evidencing of progressive disease after two courses of treatment. She was subsequently initiated on a salvage therapy with cytarabine, followed by whole-brain radiotherapy, and autologous stem-cell transplant (ASCT), finally achieving a complete remission. Isolated CNS relapse is a very uncommon pattern in PCL and a standard approach to treatment is not yet well established. Nevertheless, the importance of CNS evaluation, using magnetic resonance imaging (MRI) and lumbar puncture, in patients with PCL should be considered, and further studies are recommended to determine the appropriate management of this complication.
Systemic Relapse in a Young Adult Patient with Primary CNS Diffuse Large B-Cell Lymphoma
Authors: Adam Khorasanchi, Zachary Benson, Misty Hall, Nelya Ebadirad, Mohammad H Gharavi, Patrick Willard, Miranda Chimzar, John McKay, Gary Simmons, Victor Yazbeck
Journal: Case Rep Hematol (2022)
MeSH terms: Case Reports

Primary central nervous system diffuse large B-cell lymphoma (PCNS-DLBCL) is a rare form of non-Hodgkin's lymphoma, characterized by an aggressive disease course. While CNS relapse is common, systemic relapse is rare with no consensus on optimal treatment. This paper presents an unusual case of advanced PCNS-DLBCL with systemic relapse, including adrenal gland involvement. A review of the existing literature and a discussion on the management of systemic relapse in PCNS-DLBCL is also provided.
Fatal Necrotizing Encephalopathy after Treatment with Nivolumab for Squamous Non-Small Cell Lung Cancer: Case Report and Review of the Literature
Authors: Markus Leitinger, Mihael V Varosanec, Slaven Pikija, Romana E Wass, Dave Bandke, Serge Weis, Michael Studnicka, Susanne Grinzinger, Mark R McCoy, Larissa Hauer, Johann Sellner
Journal: Front Immunol (2018)
Keywords: autoreactive antibodies, encephalitis, humoral and cellular immune response, immune checkpoint inhibitors, neurodegeneration, neuroinflammation, nivolumab
MeSH terms: Antineoplastic Agents, Immunological / adverse effects, Brain Diseases / chemically induced, Nivolumab / adverse effects, Case Reports, Review, Aged, Brain / diagnostic imaging, Brain / drug effects, Brain / pathology, Brain Diseases / diagnostic imaging, Brain Diseases / pathology, Carcinoma, Non-Small-Cell Lung / diagnostic imaging, Carcinoma, Non-Small-Cell Lung / drug therapy, Carcinoma, Non-Small-Cell Lung / pathology, Fatal Outcome, Female, Humans, Lung Neoplasms / diagnostic imaging, Lung Neoplasms / drug therapy, Lung Neoplasms / pathology, Antineoplastic Agents, Immunological, Nivolumab

Immune checkpoint inhibitors are antibodies, which enhance cellular and humoral immune responses and are approved for the treatment of various tumors. Immune-related adverse events (irAE) involving different organs and systems are, however, among the side-effects. Recent reports of severe persistent neurological deficits and even fatal cases underpin the need for better understanding of the exact pathomechanisms of central nervous system (CNS) toxicity. To our knowledge, we report the first biopsy-proven case of fatal necrotizing encephalopathy after treatment with nivolumab. Nivolumab targets the immune-check point inhibitor programmed cell death-1 and was used for squamous non-small cell lung cancer. Partly reversible neurologic and psychiatric symptoms and unremarkable brain magnetic resonance imaging (MRI) were observed after the first course. Neurological symptoms progressed and recurrent seizures developed after the second course. Brain MRI disclosed multiple edematous and confluent supra- and infratentorial lesions, partly with contrast-enhancement. We excluded autoimmune and paraneoplastic causes and performed ancillary investigations to rule out common and opportunistic infections. Eventually, postmortem histopathological analysis of the brain revealed a necrotizing process, which contrasts previous cases reporting parenchymal immune cell infiltration or demyelination. Appropriate diagnostic pathways and treatment algorithms need to be implemented for the work-up of CNS toxicity and irAEs related to immune checkpoint inhibitor treatment.
Penile Mondor's in a Covid-19 patient on prophylactic anti-thrombosis with rivaroxaban: a case report
Authors: Murat Tuğrul Eren, Hakan Özveri, Hilal Kurtoğlu
Journal: Afr J Urol (2021)
Keywords: covid-19, drugs and medicines, venous thromboembolism

Background:
Penile Mondor's disease (PMD) is thrombophlebitis of the superficial dorsal vein of the penis. Following the occurrence of thrombotic events in the affected veins, the lumen often becomes occluded with fibrin and inflammatory cells. A hyper-coagulative state is one of the underlying causes although most cases of PMD are idiopathic. Coronavirus disease-2019 infection (COVID-19) is associated with frequent thrombotic events. Inflammation and thrombosis play a central role in the course and outcome of COVID-19, which can predispose to both venous and arterial thromboembolism. In this report, we present a 33-year-old male patient diagnosed with PMD during the subacute phase of COVID-19 infection while on prophylactic antithrombotic treatment.
Case presentation:
A 33-year-old male patient was diagnosed as PMD which occurred during the subacute phase of COVID-19 infection, while he was on active treatment of COVID-19 by prophylactic antithrombotic Rivaroxaban 15 mg therapy and curative antiviral medication. There was no recent sexual intercourse or trauma to the genitals. His PCR test for COVID-19 had become negative, and antibody test was positive at the time of his PMD's onset. Rivaroxaban was replaced by Enoxaparin (8000 IU/0.8 ml.), a low molecular weight heparin administered subcutaneously and twice daily. On the third day of this medication, all coagulative measurements returned to normal. PMD disappeared in the second week.
Conclusion:
Low-dose Rivaroxaban 15 mg is not safe for some COVID-19-associated thromboembolism prophylaxis, and careful follow-up is critical due to the possibility of a wide range of pathologic thrombotic manifestations in COVID-19 infection.
Boron Neutron Capture Therapy for Recurrent Glioblastoma Multiforme: Imaging Evaluation of a Case With Long-Term Local Control and Survival
Authors: Shosei Shimizu, Kei Nakai, Yinuo Li, Masashi Mizumoto, Hiroaki Kumada, Eiichi Ishikawa, Tetsuya Yamamoto, Akira Matsumura, Hideyuki Sakurai
Journal: Cureus (2023)
Keywords: adl (activities of daily living), boron neutron capture therapy (bnct), glioblastoma, particle therapy, radiation therapy
MeSH terms: Case Reports

Glioblastoma (GBM) is difficult to cure with conventional multimodal treatment and has an extremely poor prognosis. Boron neutron capture therapy (BNCT) is a new particle therapy for malignant tumors in the brain and head and neck region. This radiotherapy utilizes a nuclear reaction between neutrons and a nonradioactive isotope, boron-10. In this method, a boron compound is administered transvenously into the body. The boron compound has the property of being selectively taken up only by the cells of malignant tumors, and the subsequent irradiation with neutrons can destroy malignant tumor cells without damaging normal cells. Since the irradiation dose to normal tissues is reduced in BNCT, it may be possible to re-irradiate malignant tumors that recur after radiotherapy. Clinical trials have reported prolonged survival and safety of BNCT in a small number of patients with refractory malignancies, including GBM, but these reports do not address quality of life or activities of daily living (ADL) after treatment, and there is no information on the assessment of local control by imaging. Here, we report a case of GBM that recurred after surgery, 60 Gy of conventional radiotherapy and standard treatment with temozolomide. The patient achieved long-term local control and survival over five years after BNCT and was able to maintain ADL at home without any specialist care. We describe the case with evaluation using longitudinal magnetic resonance imaging (MRI).
Gastric Intussusceptions in a Red Corn Snake (Pantherophis guttatus) Associated with Cryptosporidiosis
Authors: Marjorie Bercier, Whitney Zoll, Justin F Rosenberg, Robson Giglio, Lenice McCoy, William L Castleman, Matthew D Johnson, Darryl J Heard
Journal: Case Rep Vet Med (2017)
MeSH terms: Case Reports

A 3-year-old female red corn snake (Pantherophis guttatus) was presented for a three-week history of anorexia and decreased defecations. On physical examination, a soft midbody intracoelomic swelling was palpated. Transcutaneous coelomic ultrasound revealed a target-like mass on a transverse section of the stomach, suggesting the presence of a gastrointestinal intussusception. On exploratory coeliotomy, a double compounded esophagogastric and gastroduodenal intussusception was diagnosed and reduced surgically. A gastropexy was also performed to prevent recurrence. On histopathology, the gastric glandular mucosa showed moderate to marked proliferation. Diffusely lining the luminal surface of glandular epithelium and free within the lumen were a myriad of protozoa consistent with Cryptosporidium sp. A diagnosis of chronic proliferative gastritis due to Cryptosporidium sp. was made based on these findings. Intussusceptions are rare in reptiles and are infrequently reported in snakes. This is the first report of a double compounded intussusception in a nonmammalian species and the first report of an intussusception involving the stomach in a snake with gastritis due to Cryptosporidium sp.
Laparoscopic repair of a Morgagni hernia
Authors: J M Sherigar, A D Dalal, J R Patel
Journal: J Minim Access Surg (2005)
Keywords: diaphragmatic hernia, laparoscopy, morgagni hernia
MeSH terms: Case Reports

We report a case of laparoscopic repair of symptomatic Morgagni hernia (MH) in an adult. A tension-free closure of the defect was carried out using a polypropylene mesh. The recovery was quick and uneventful. Two years after surgery, the patient is doing well. A search of the English-language surgical literature revealed a total of 55 cases of laparoscopic repair of MH reported: 40 in adults and 15 in children. The various modalities of diagnosis, operative techniques, and disease presentation are discussed.
Case Report: Healing a Traumatic Birth
Authors: Phyllis Klaus
Journal: Front Psychol (2020)
Keywords: birth, breastfeeding, perinatal, pregnancy, trauma
MeSH terms: Case Reports

One needs to recognize that the perinatal period is a vulnerable time where negative attitudes, words and actions can have an emotionally damaging effect on birthing women, who are especially sensitive to how they are treated, because of their high oxytocin levels. This case report depicts a traumatic birth in which the mother was needlessly separated from her baby and also harshly treated by the personnel, which had an emotionally devastating impact on the mother/baby relationship. This case report will demonstrate how psychotherapy was used to heal this distress.
Tuberculosis infection following immune checkpoint inhibitor treatment for advanced cancer: a case report and literature review
Authors: Chen Lin, Guixiang Xu, Shuyan Gao, Tao Feng, Shuang Li
Journal: Front Immunol (2023)
Keywords: drug-related adverse reactions, immune checkpoint inhibitors, interferon-γ release assay, tuberculosis, tuberculosis screening
MeSH terms: Carcinoma, Squamous Cell, Latent Tuberculosis, Tuberculosis / diagnosis, Tuberculosis / drug therapy, Review, Case Reports, Aged, Female, Humans, Immune Checkpoint Inhibitors / adverse effects, Immunotherapy / adverse effects, Male, Immune Checkpoint Inhibitors

Objective:
To investigate the clinical features of active tuberculosis (TB) infection due to immune checkpoint inhibitors (ICIs) treatment in patients with advanced cancer.
Methods:
We report the diagnosis and treatment of a case of pulmonary malignancy (squamous cell carcinoma, cT4N3M0 IIIC), secondary to active TB infection following ICIs therapy. Moreover, we summarize and analyze other related cases collected from the China National Knowledge Infrastructure (CNKI), Wanfang Database, PubMed, the Web of Science, and EMBASE (up to October 2021).
Results:
A total of 23 patients, including 20 males and 3 females who were aged 49-87 years with a median age of 65 years, were included in the study. Twenty-two patients were diagnosed by Mycobacterium tuberculosis culture or DNA polymerase chain reaction (PCR), while the remaining patient was diagnosed by tuberculin purified protein derivative and pleural biopsy. One case had an interferon-gamma release assay (IGRA) to rule out latent TB infection prior to the application of ICI. Fifteen patients received an anti-tuberculosis regimen. Among the 20 patients with a description of clinical regression, 13 improved and 7 died. Seven of the patients who improved were treated with ICI again and four of them did not experience a recurrence or worsening of TB. The case diagnosed in our hospital also improved after receiving anti-TB treatment after stopping ICI therapy, and continued chemotherapy on the basis of anti-TB treatment, and his condition is relatively stable at present.
Conclusion:
Due to the lack of specificity of TB infection following ICIs therapy, patients should be followed for fever and respiratory symptoms for 6.3 months after drug administration. It is recommended that IGRA should be performed before ICIs therapy and the development of TB during immunotherapy in patients who are positive in IGRA should be closely monitored. The symptoms of TB in most patients can be improved with ICIs withdrawal and anti-TB treatment, but there is still a need to be alert to the potentially fatal risk of TB.
Systemic ALK-positive anaplastic large cell lymphoma involving implant site: a fortuitous association
Authors: Mayur Parkhi, Charanpreet Singh, Rajender Kumar, Pankaj Malhotra, Amanjit Bal
Journal: Autops Case Rep (2021)
Keywords: anaplastic lymphoma kinase, femoral fractures, lymphoma, large-cell, anaplastic, prostheses and implants
MeSH terms: Case Reports

Anaplastic lymphoma kinase (ALK) positive, anaplastic large cell lymphoma involving the non-mammary implant is an extremely rare presentation. Irrespective of the type or site, the implant-associated primary ALCL is morphologically and immunophenotypically similar to ALK-negative ALCLs. Herein, we present the case of a 42-year-old male who developed a lytic lesion after an implant for a right femur fracture. The lytic lesion biopsy revealed anaplastic large cell lymphoma with ALK protein expression. Imaging findings showed the widespread dissemination of disease all over the body, entrapping the implant too. ALCL involving the bone implant is a very unusual and rare presentation that needs to be documented.