OpenMed/multicare-articles huggingface dataset:
Infiltrating Lipoma of the Right Ventricle Involving the Interventricular Septum and Tricuspid Valve: Report of a Rare Case and Literature Review
Authors: Lingyun Fang, Lin He, Yan Chen, Mingxing Xie, Jing Wang
Journal: Medicine (Baltimore) (2016)
MeSH terms: Heart Neoplasms / diagnosis, Lipoma / diagnosis, Case Reports, Review, Echocardiography, Female, Heart Neoplasms / diagnostic imaging, Heart Neoplasms / pathology, Heart Neoplasms / surgery, Heart Septum / pathology, Heart Ventricles / pathology, Humans, Lipoma / diagnostic imaging, Lipoma / pathology, Lipoma / surgery, Magnetic Resonance Imaging, Middle Aged, Tricuspid Valve / pathology

Cardiac lipoma, which are primary cardiac tumors, are rare entities often detected incidentally during imaging. There have been very few reports on the right ventricle (RV) lipoma. Here, we present a case of RV infiltrating lipoma involving the interventricular septum (IVS) and the tricuspid valve. Clinical symptoms, diagnostic procedures, multimodality imaging characteristics, and treatment are discussed, and the complete clinical data of this case and relevant details of retrospective literature are reviewed. The study described the case of a 48-year-old woman who suffered from occasional palpitation after exertion for 10 years. Imaging examinations, including echocardiography and cardiovascular magnetic resonance imaging (MRI), revealed a large mass adherent to the IVS and the right ventricular wall that was consistent with lipoma. The patient underwent surgical repair of the tricuspid valve and excision of the partial mass. The gross specimen revealed piles of 5 × 4 × 3 cm fragments with yellowish appearance and pathological results showed infiltrating lipoma.Lipoma is often asymptomatic and diagnosed incidentally. Surgical excision is the main therapeutic intervention, which is always performed in cases of symptomatic lipoma or when malignancy is suspected. Multimodality imaging would be great help in the diagnosis of cardiac lipoma. Echocardiography is a convenient method for follow-up.
Multiple morphological phenotypes of monoclonal immunoglobulin disease on renal biopsy: Significance of treatment
Authors: Sreedhar Adapa, Venu Madhav Konala, Srikanth Naramala, Cynthia C Nast
Journal: Clin Nephrol Case Stud (2020)
Keywords: al amyloidosis, light chain cast nephropathy (lccn), monoclonal fibrillary glomerulonephritis, monoclonal immunoglobulin deposition disease (midd), proximal tubulopathy
MeSH terms: Case Reports

Plasma cell dyscrasias frequently involve the kidney causing renal dysfunction. Multiple morphologic manifestations of κ light chain disease occurring simultaneously in the same kidney biopsy are uncommon and suggest local microenvironment effects in addition to structural properties of the light chain. A 61-year-old female presented with new onset renal failure and proteinuria. Serological workup revealed monoclonal gammopathy with elevated κ : λ ratio of 1,371. Renal biopsy revealed several paraprotein manifestations including κ light chain deposition disease, monoclonal fibrillary glomerulonephritis, cryocrystalglobulenemia and fibrillar/microtubular cast nephropathy. There was also incidental leukocyte chemotactic factor 2 amyloidosis (ALECT 2), negative for κ light chain and confirmed by immunohistochemistry (IHC). Bone marrow biopsy revealed 10 - 20% κ restricted plasma cells. The patient received 10 cycles of CyBorD (cyclophosphamide, bortezomib, and dexamethasone) chemotherapy. Renal function improved with decreased κ : λ ratio. Repeat bone marrow biopsy showed no evidence of abnormal plasma cells by IHC. The renal recovery demonstrates there may be response to chemotherapy irrespective of the morphologic manifestations of light chain-related injury. Additionally, if amyloid is not demonstrated to be of light chain origin, other amyloid types should be considered.
Hyponatremia due to Severe Primary Hypothyroidism in an Infant
Authors: Nickolas T Agathis, Ingrid M Libman, Michael L Moritz
Journal: Front Pediatr (2015)
Keywords: child development, hyponatremia, hypothyroidism, infant, newborn, thyroxine
MeSH terms: Case Reports

Hyponatremia has been reported in the elderly with hypothyroidism and myxedema, but this has not been a universal finding in clinical studies and there have been only a few reports in children. We report a case of an infant who developed hyponatremia due to severe primary hypothyroidism. A 4-month-old ex-preterm male, who had been euthyroid on the newborn screen, developed unexplained hospital-acquired hyponatremia (serum Na 124 mEq/L) while on full oral feeds. He was euvolemic, appeared well and was without myxedema. An evaluation of hyponatremia was negative with the exception of severe primary hypothyroidism (TSH 315.4 IU/mL, repeat 540 IU/mL). The hyponatremia resolved with thyroxine supplementation. This case demonstrates that severe hypothyroidism can result in hyponatremia in infants. It is critical to consider hypothyroidism in the evaluation of an infant with unexplained hyponatremia as untreated hypothyroidism can lead to profound developmental delays.
Delayed Yet Successful Mechanical Thrombectomy for Phlegmasia Cerulea Dolens in a Limb with Severe Arterial Disease and May-Thurner Syndrome
Authors: Ahmad Said, Phillip Kraft, Luay Sayed
Journal: Case Rep Vasc Med (2020)
MeSH terms: Case Reports

Phlegmasia cerulea dolens (PCD) is a rare but life-threatening complication of acute deep venous thrombosis that lacks consensus regarding the approach to management. We present a case of PCD developing shortly after a spinal surgery and manifesting as acute swelling and discoloration in a leg with existing severe atherosclerotic arterial disease. The patient's critical limb ischemia was completely and rapidly reversed by percutaneous mechanical thrombectomy using the ClotTriever device despite a delay in treatment. An underlying iliac vein compression "May-Thurner" syndrome was discovered using intravascular ultrasound and treated with angioplasty. This case identifies mechanical thrombectomy using the ClotTriever system as a possible effective and safe treatment for PCD.
Disseminated plasma cell myeloma presenting as massive pleural effusion
Authors: Kanahasubramanian Anand Babu, Lakshmikanthan Sundararajan, Pandurangan Prabu, Ashok Parameswaran
Journal: Eur Clin Respir J (2015)
Keywords: plasma cell myeloma, massive pleural effusion, myelomatous pleural effusion, pleural fluid cytology
MeSH terms: Case Reports

Plasma cell myeloma (PCM) is a hematologic malignancy of plasma cell origin and usually associated with the presence of lytic bone lesions. Pleural effusions are rarely associated with PCM and most often signify a concurrent disease process. Malignant myelomatous pleural effusions are even more unusual and carry a poor prognosis. We report a unique case of unsuspected PCM with thoracic involvement in the form of massive left side pleural effusion. Pleural fluid cytology revealed numerous atypical plasma cells. Subsequently on further workup, urine Bence Jones protein was positive. Bone marrow aspiration and biopsy and computed tomography of the chest and abdomen revealed features consistent with multiple myeloma.
Is the concept of delirious mania valid in the elderly? A case report and a review of the literature
Authors: Pramudith M Maldeniya, Akshya Vasudev
Journal: Case Rep Psychiatry (2013)

Delirious mania has been well recognized in the published literature and in the clinic. Over the years there has been refinement of understanding of its clinical features, course, and treatment. The literature suggests that delirious mania should be considered in individuals who present with a constellation of sudden onset delirium, mania, and psychosis. However, delirious mania is not recognized under a formal classification system nor are there any formal guidelines for its treatment. We, as such, question if the concept of delirious mania in the elderly is valid. We present a case of an elderly man with marked features of delirium with minimal manic or psychotic features who had a previous diagnosis of bipolar I disorder. On thorough clinical assessments no identifiable cause of his delirium was found. We therefore considered his presentation to be more likely due to delirious mania. Electroconvulsive therapy was considered and offered to which he responded very well. We invite the reader to consider whether delirious mania is a valid concept in the elderly, where features of delirium may be more prominent than manic or psychotic features.
Treatment of Class II Division 2 Malocclusion Using the Forsus Fatigue Resistance Device and 5-Year Follow-Up
Authors: Ezgi Atik, Ilken Kocadereli
Journal: Case Rep Dent (2016)

This case report presents the treatment of a 14-year-and-8-month-old boy with Class II division 2 mandibular retrusion, severe deep bite, and concave profile. The Forsus fatigue resistance device (FRD) was effective in correcting both skeletal and dental parameters. At 5-year posttreatment follow-up, the teeth were well aligned and the occlusion was stable. FRD application with appropriate treatment time can result with prominent changes in the facial profile and dentition, and the outcomes can be maintained at the long-term follow-up periods.
Prenatal Diagnosis of Umbilical Cord Ulcer: A Report of Two Cases
Authors: Daisuke Katsura, Suzuko Moritani, Shunichiro Tsuji, Kaori Hayashi, Kazutaka Yamada, Shinsuke Tokoro, Kounosuke Suzuki, Fuminori Kimura, Takashi Murakami
Journal: Case Rep Obstet Gynecol (2019)
MeSH terms: Case Reports

Umbilical cord ulcer is related to fetal intestinal atresia or meconium; perforation of the ulcer causes fetal deterioration leading to fetal and neonatal death owing to fetal hemorrhage. However, to the best of our knowledge, a method to diagnose umbilical cord ulcer prenatally is not available. No reports exist about the prenatal findings before perforation of umbilical cord ulcer using ultrasonography. We encountered two cases of umbilical cord ulcer showing ultrasonographic finding of a linear echo around the umbilical cord. Umbilical cord ulcers with an exposed umbilical cord artery in the first case and with perforation of the artery in the second case were diagnosed postnatally. When we encounter such ultrasonographic finding, especially with polyhydramnios and high amniotic bile acid concentration in cases of fetal intestinal atresia, risk of perforation of the umbilical cord ulcer should be included in the differential diagnosis.
Case report: Acute pericarditis following hepatic microwave ablation for liver metastasis
Authors: Anna Giulia Pavon, Vladimir Rubimbura, Anna Nowacka, Arnaud Hocquelet, Jurg Schwitter, David C Rotzinger
Journal: Front Cardiovasc Med (2023)
Keywords: cardia tamponade, cardiovascular magnetic resonance, metastasis, microwave ablation (mw ablation), pericarditis
MeSH terms: Case Reports

Hepatic microwave ablation (MWA) is a growing treatment modality in the field of primary and secondary liver cancer. One potential side effect is thermal damage to adjacent structures, including the pericardium if the hepatic lesion is located near the diaphragm. Hemorrhagic cardiac tamponade is known to be a rare but potentially life-threatening complication. Here we present the first case of cardiac complication following MWA treatment in a 55-year-old man who presented with late cardiac tamponade. Adequate and timely management is essential, and clinicians should be fully aware of the need to perform early transthoracic echocardiography to detect signs of pericardial effusion when cardiac involvement is suspected.
Case series of reports of pruritus and sipuleucel-T submitted to the Food and Drug Administration Adverse Event Reporting System
Authors: Graça M Dores, Silvia Perez-Vilar, Manette T Niu
Journal: J Pharm Health Care Sci (2019)
Keywords: adverse events, castration-resistant, faers, provenge, pruritus, sipuleucel-t

Sipuleucel-T, an autologous active cellular immunotherapy, is indicated for the treatment of asymptomatic or minimally symptomatic castration-resistant prostate cancer. The U.S. Food and Drug Administration Adverse Event Reporting System (FAERS) received a report of pruritus without rash following the second dose of sipuleucel-T in a patient who had otherwise not started any new medications concurrent with the first and second doses of sipuleucel-T. No further sipuleucel-T was administered, but symptoms persisted for at least 6 weeks despite treatment with several medications aimed at symptomatic relief of pruritus. Rash is the only dermatologic adverse event included in the sipuleucel-T U.S. package insert. A search of the FAERS database yielded seven additional U.S. reports of pruritus and sipuleucel-T identified as the primary suspect medication; two of these occurred prior to the administration of sipuleucel-T (following leukapheresis). In data mining analyses, pruritus following sipuleucel-T was not reported more frequently than expected when compared to all other adverse event-drug/biologic combinations in FAERS. Thus, pruritus following sipuleucel-T administration was rarely, but not disproportionately, reported to FAERS. Although we cannot exclude the possibility that diabetes, malignancy, or other conditions may have contributed to pruritus in our index patient, in view of the timing of sipuleucel-T therapy and onset of symptoms, a drug/biologic-related reaction is plausible. In the appropriate clinical scenario, sipuleucel-T (or its components) should not be overlooked as a potential etiological agent in pruritus.
Acute angle closure glaucoma secondary to polypoidal choroidal vasculopathy - a devastating complication
Authors: Prabu Baskaran, Manavi D Sindal, Pankaja Dhoble, Seema Ramakrishnan, Venkatesh Rengaraj, Pradeep Ramulu
Journal: GMS Ophthalmol Cases (2017)
Keywords: angle closure glaucoma (acg), hemorrhagic choroidal detachment (cd), polypoidal choroidal vasculopathy (pcv)
MeSH terms: Case Reports

Acute angle closure glaucoma (ACG) in the setting of polypoidal choroidal vasculopathy (PCV) is a catastrophic complication that has been documented infrequently in literature. Ours is the second only report that describes hemorrhagic choroidal detachment as an event leading to acute angle closure glaucoma in PCV patients and the first one to describe the use of diode cyclophotocoagulation (CPC) for this condition. The purpose of this article is to familiarize readers with this entity that has an extremely dismal visual prognosis. Ours is a descriptive case report of two patients with PCV complicated by sudden onset hemorrhagic choroidal detachment (CD) and acute ACG. Both patients had severe pain with no perception of light at presentation with an acute angle closure attack. Both underwent diode CPC for pain relief and control of intraocular pressure (IOP). Both our patients did not regain any vision, but their pain was relieved by diode CPC. Both eyes eventually became phthisical. Acute ACG following massive hemorrhagic CD is a rare but grave complication of PCV, not amenable to treatment. Diode CPC is an effective palliative modality of management to achieve pain relief in such cases.
Orbital apex syndrome due to invasive aspergillosis in an immunocompetent patient
Authors: Grace D Cullen, Tara M Davidson, Zachary A Yetmar, Bobbi S Pritt, Daniel C DeSimone
Journal: IDCases (2021)
Keywords: immunocompetent, orbital apex syndrome, staphylococcus aureus, aspergillus
MeSH terms: Case Reports

Infection is a rare cause of orbital apex syndrome (OAS) and most commonly occurs in immunocompromised hosts. We report a case of OAS in an elderly immunocompetent female due to invasive aspergillosis and Staphylococcus aureus co-infection. The patient required both surgical debridement and prolonged courses of antibiotic and antifungal therapy. Invasive fungal disease must be considered in cases of OAS, even in patients without classic risk factors.
Anomalous right coronary artery: a multimodality hunt for the origin
Authors: J Gilmour, H Kafka, G Ropchan, A M Johri
Journal: Case Rep Cardiol (2011)
MeSH terms: Case Reports

Anomalous origin of the right coronary artery from the pulmonary artery (ARCAPA) is a rare congenital anomaly. Although there have been several cases of ARCAPA reported in the literature, we present a case which highlights the challenges of diagnosing this rare condition and the incremental value of using multiple imaging modalities. A healthy 48 year old female presented with angina and exertional shortness of breath. She had a normal cardiovascular examination, negative cardiac enzymes and an unremarkable chest X-ray. She did, however, have T-wave inversions in leads V1-V3. Transthoracic echocardiography (TTE), as the first imaging investigation, led to an initial provisional diagnosis of a coronary-cameral fistula. It showed unusual colour Doppler signals in the right ventricle and a prominent pattern of diastolic flow within the right ventricular myocardium, especially along the interventricular septum. A subsequent multimodality approach, correlating images from angiography, CT and MRI was instrumental in confirming the diagnosis of ARCAPA and planning for surgical correction. Cardiac CT and MRI are non-invasive, three-dimensional imaging modalities with high diagnostic accuracy for coronary artery anatomic anomalies. If echocardiography and conventional angiography have been inconclusive, cardiac CT and MRI are especially important diagnostic tools.
Case Report: Filling Defect in Posterior Semicircular Canal on MRI With Balanced Steady-State Gradient-Echo Sequences After Labyrinthine Ischemia in the Common Cochlear Artery Territory as an Early Sign of Fibrosis
Authors: Andrea Castellucci, Emanuela Pepponi, Annalisa Bertellini, Caterina Senesi, Margherita Bettini, Cecilia Botti, Salvatore Martellucci, Pasquale Malara, Silvia Delmonte, Francesco Maria Crocetta, Martina Fornaciari, Francesca Lusetti, Giovanni Bianchin, Angelo Ghidini
Journal: Front Neurol (2021)
Keywords: common cochlear artery, inner ear mri, labyrinthine fibrosis, labyrinthine ischemia, posterior semicircular canal, vestibular-evoked myogenic potentials, video-head impulse test
MeSH terms: Case Reports

We describe a rare case of posterior semicircular canal (PSC) fibrosis following acute labyrinthine ischemia in the territory supplied by the common cochlear artery (CCA) and review the relevant literature. A 71-year-old man with multiple vascular risk factors presented 12 days after the onset of acute vertigo and profound left-sided hearing loss. Right-beating spontaneous nystagmus with downbeat components elicited by mastoid vibrations and headshaking was detected. The video head impulse test (vHIT) revealed an isolated hypofunction of the left PSC, whereas vestibular evoked myogenic potentials (VEMPs) showed ipsilateral saccular loss. The clinical presentation and instrumental picture were consistent with acute ischemia in the territory supplied by left CCA. Compared to previous imaging, a new MRI of the brain with 3D-FIESTA sequences highlighted a filling defect in the left PSC, consistent with fibrosis. Hearing function exhibited mild improvement after steroid therapy and hyperbaric oxygen sessions, whereas vHIT abnormalities persisted over time. To the best of our knowledge, this is the only case in the literature reporting a filling defect on MRI, consistent with semicircular canal fibrosis following acute labyrinthine ischemia. Moreover, PSC fibrosis was related with poor functional outcome. We therefore suggest using balanced steady-state gradient-echo sequences a few weeks following an acute lesion of inner ear sensors to detect signal loss within membranous labyrinth consistent with post-ischemic fibrosis. Besides addressing the underlying etiology, signal loss might also offer clues on the functional behavior of the involved sensor over time. In cases of acute loss of inner ear function, a careful bedside examination supplemented by instrumental assessments, including vHIT and VEMPs, of vestibular receptors and afferents may be completed by MRI with balanced steady-state gradient-echo sequences at a later time to confirm the diagnosis and address both etiology and functional outcome.
Mutation in collagen II alpha 1 isoforms delineates Stickler and Wagner syndrome phenotypes
Authors: Khanh-Nhat Tran-Viet, Vincent Soler, Valencia Quiette, Caldwell Powell, Tammy Yanovitch, Ravikanth Metlapally, Xiaoyan Luo, Nicholas Katsanis, Erica Nading, Terri L Young
Journal: Mol Vis (2013)
MeSH terms: Arthritis / genetics, Collagen Type II / genetics, Connective Tissue Diseases / genetics, Hearing Loss, Sensorineural / genetics, Mutation / genetics, Retinal Degeneration / genetics, Retinal Detachment / genetics, Case Reports, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Adolescent, Adult, Aged, Base Sequence, Collagen Type II / metabolism, DNA Mutational Analysis, DNA, Complementary / genetics, Family, Female, Gene Expression Regulation, Humans, Male, Molecular Sequence Data, Pedigree, Phenotype, Protein Isoforms / genetics, Protein Isoforms / metabolism, Versicans / deficiency, COL2A1 protein, human, Collagen Type II, DNA, Complementary, Protein Isoforms, Versicans, Hyaloideoretinal degeneration of Wagner, Stickler syndrome, type 1

Purpose:
Stickler syndrome is an arthro-ophthalmopathy with phenotypic overlap with Wagner syndrome. The common Stickler syndrome type I is inherited as an autosomal dominant trait, with causal mutations in collagen type II alpha 1 (COL2A1). Wagner syndrome is associated with mutations in versican (VCAN), which encodes for a chondroitin sulfate proteoglycan. A three-generation Caucasian family variably diagnosed with either syndrome was screened for sequence variants in the COL2A1 and VCAN genes.
Methods:
Genomic DNA samples derived from saliva were collected from all family members (six affected and four unaffected individuals). Complete sequencing of COL2A1 and VCAN was performed on two affected individuals. Direct sequencing of remaining family members was conducted if the discovered variants followed segregation.
Results:
A base-pair substitution (c.258C>A) in exon 2 of COL2A1 cosegregated with familial disease status. This known mutation occurs in a highly conserved site that causes a premature stop codon (p.C86X). The mutation was not seen in 1,142 ethnically matched control DNA samples.
Conclusions:
Premature stop codons in COL2A1 exon 2 lead to a Stickler syndrome type I ocular-only phenotype with few or no systemic manifestations. Mutation screening of COL2A1 exon 2 in families with autosomal dominant vitreoretinopathy is important for accurate clinical diagnosis.