OpenMed/multicare-articles huggingface dataset:
A case of nephrotic syndrome showing contemporary presence of apolipoprotein E2 homozygote glomerulopathy and membranous nephropathy-like findings modified by apolipoprotein E Toyonaka
Authors: Hisako Hirashima, Toshiyuki Komiya, Naoya Toriu, Shigeo Hara, Akira Matsunaga, Takao Saito, Eri Muso
Journal: Clin Nephrol Case Stud (2018)
Keywords: apolipoprotein e toyonaka, apolipoprotein e deposition, apolipoprotein e2/2, lipoprotein glomerulopathy, membranous nephropathy, type iii hyperlipoproteinemia
MeSH terms: Case Reports

A 79-year-old man was admitted to our hospital for proteinuria due to nephrotic syndrome. Renal biopsy revealed focal sclerosis and foam cell infiltration in the glomerulus. In addition, electron microscopic findings (EM) revealed peculiar electron-dense deposits (EDDs) in both sides of the glomerular basement membrane. Although subepithelial deposits had spike formation highly resembling those seen in membranous nephropathy (MN), immunoglobulins and complements were not identified by immunofluorescence study, and microbubbles appeared in high magnification of EM different from the immune disease. The analysis of apolipoprotein (Apo) E showed an elevated concentration of plasma ApoE. The phenotype, genotype, and DNA sequence studies revealed homozygous ApoE2/2 and a novel missense mutation called ApoE Toyonaka (Ser197Cys). This case may confirm the independent responsibility of ApoE2/2 and ApoE Toyonaka for ApoE2 homozygote glomerulopathy and MN-like EDD findings, respectively.
Orthopedic considerations with eosinophilic fasciitis: a case report and literature review
Authors: Jason Samona
Journal: Case Rep Orthop (2012)
MeSH terms: Case Reports

Eosinophilic fasciitis (EF) or Shulman's disease is a very rare condition first described in 1974 by Dr. Shulman in patients with diffuse fasciitis and eosinophilia. Fewer than 300 cases have been reported worldwide in the past 35 years. The current understanding of the disease in the medical community relies only on a few large case series and multiple case reports. The proposed etiology, pathological mechanisms, and consensus for therapy are obscure or lacking. The presentation of the disease is variable, but certain signs and symptoms have been associated with EF. The extreme rarity of the disease, the large constellation of signs and symptoms, as well as the lack of knowledge about eosinophilic fasciitis and make this disease difficult to recognize and treat. Through the review of the literature, there is only one other case by Yamanishi where recurrent asthma has been seen to be associated with eosinophilic fasciitis. To the knowledge of the authors of this paper this patient represents the second recorded incident. The case described by the authors of this paper demonstrated an initial biopsy of mixed cell fasciitis including eosinophils, compared to the eosinophil-rich sample taken at a later date. This could be a unique aspect to the pathology of the disease not previously discovered. Similar scenarios were not noted in a review of the literature. A change in the pathological findings as shown in this case from non-eosinophil-rich sample to one rich in eosinophils is unique in a patient actively suffering from EF. The authors of this paper propose that an allergic reaction (at the patient's puncture site) occurred, which initially caused the left hand symptoms that led to the patient's first presentation to the hospital. This is a unique causative agent, not found in the review of the literature. Through a review of the literature and the presentation of this patient, the authors propose an underlying dysregulation of the immune system, leading to the initiation or synergistic perpetuation of EF. This is a unique outlook on the disease pathology, not explained much in the medical literature.
ALK-Positive Squamous Cell Carcinoma Dramatically Responded to Alectinib
Authors: Ray Sagawa, Takehiko Ohba, Eisaku Ito, Susumu Isogai
Journal: Case Rep Oncol Med (2018)
MeSH terms: Case Reports

Anaplastic lymphoma kinase (ALK) rearrangement is usually observed in patients with adenocarcinoma. Herein, we report a case of squamous cell carcinoma (SCC) with ALK rearrangement treated with alectinib. The patient was a 73-year-old woman without a smoking history. She consulted us with nonproductive cough and loss of appetite. Computed tomography scan revealed a mass in the left lower lobe of the lung. According to the pathological examinations, we diagnosed the tumor as SCC. Because the patient had never smoked, we searched for driver mutations and found that the tumor harbored ALK rearrangement. We began treatment with alectinib, and the tumor remarkably reduced in volume. No severe adverse events were observed. Although there are only few reports of SCC with ALK rearrangement, this case implies that clinicians should consider searching for driver mutations in patients with SCC when there are atypical findings or characteristics.
Surgical disaster following hernia mesh infection and erroneous treatment strategy: A case report
Authors: Arnolds Jezupovs
Journal: Int J Surg Case Rep (2020)
Keywords: case report, enteroatmospheric fistula, mesh infection, surgical errors, ventral hernia
MeSH terms: Case Reports

Introduction:
The aim of the current case presentation is to demonstrate the calamity of hernia mesh infection arising from an erroneous surgical strategy.
Presentation of case:
A patient with a recurrent gigantic ventral hernia and chronic hernia mesh infection is presented. 56 months and five surgeries were necessary to resolve the hernia mesh infection, and 7 months were required to deal with the complications following mesh explantation. During the last hospitalization, 18 surgical interventions under general anesthesia, 12 radiologic, 13 microbiological and 41 laboratory examinations were performed. Seven antibiotics were prescribed for 112 days in total.
Discussion:
It is challenging for an ordinary surgeon to be up to speed with the latest evidence-based practices if dealing with a surgical domain not practiced regularly. Tactical errors play as big a role as errors in surgical technique. A surgical strategy varying between error and accuracy can catalyze a chain reaction of complications and surgical errors, finally resulting in life-threatening complications.
Conclusion:
The case report demonstrates the impact of an erroneous surgical strategy on the treatment process and highlights the difficulties related to hernia mesh infection.
Risk factors and characterization of Plasmodium vivax-associated admissions to pediatric intensive care units in the Brazilian Amazon
Authors: Ellen Fátima Caetano Lança, Belisa Maria Lopes Magalhães, Sheila Vitor-Silva, André Machado Siqueira, Silvana Gomes Benzecry, Márcia Almeida Araújo Alexandre, Connor O'Brien, Quique Bassat, Marcus Vinícius Guimarães Lacerda
Journal: PLoS One (2012)
MeSH terms: Malaria, Vivax / complications, Malaria, Vivax / epidemiology, Multicenter Study, Adolescent, Brazil / epidemiology, Child, Child, Preschool, Coinfection / epidemiology, Female, Hospitalization, Humans, Infant, Intensive Care Units, Pediatric, Malaria, Falciparum / complications, Malaria, Falciparum / epidemiology, Malaria, Falciparum / mortality, Malaria, Vivax / mortality, Male, Parasitemia / epidemiology, Plasmodium vivax, Retrospective Studies, Risk Factors, Severity of Illness Index

Background:
Plasmodium vivax is responsible for a significant proportion of malaria cases worldwide and is increasingly reported as a cause of severe disease. The objective of this study was to characterize severe vivax disease among children hospitalized in intensive care units (ICUs) in the Western Brazilian Amazon, and to identify risk factors associated with disease severity.
Methods and findings:
In this retrospective study, clinical records of 34 children, 0-14 years of age hospitalized in the 11 public pediatric and neonatal ICUs of the Manaus area, were reviewed. P. falciparum monoinfection or P. falciparum/P. vivax mixed infection was diagnosed by microscopy in 10 cases, while P. vivax monoinfection was confirmed in the remaining 24 cases. Two of the 24 patients with P. vivax monoinfection died. Respiratory distress, shock and severe anemia were the most frequent complications associated with P. vivax infection. Ninety-one children hospitalized with P. vivax monoinfections but not requiring ICU were consecutively recruited in a tertiary care hospital for infectious diseases to serve as a reference population (comparators). Male sex (p = 0.039), age less than five years (p = 0.028), parasitemia greater than 500/mm(3) (p = 0.018), and the presence of any acute (p = 0.023) or chronic (p = 0.017) co-morbidity were independently associated with ICU admission. At least one of the WHO severity criteria for malaria (formerly validated for P. falciparum) was present in 23/24 (95.8%) of the patients admitted to the ICU and in 17/91 (18.7%) of controls, making these criteria a good predictor of ICU admission (p = 0.001). The only investigated criterion not associated with ICU admission was hyperbilirubinemia (p = 0.513)].
Conclusions:
Our study points to the importance of P. vivax-associated severe disease in children, causing 72.5% of the malaria admissions to pediatric ICUs. WHO severity criteria demonstrated good sensitivity in predicting severe P. vivax infection in this small case series.
Hydatidosis of the pelvic cavity: a big masquerade
Authors: Peyman Varedi, Seyed Reza Saadat Mostafavi, Rambod Salouti, Daryoush Saedi, Seyed Ali Nabavizadeh, Kaveh Samimi, Tahereh Larijani, Mohsen Darabi, Seyed Mehdi Mousavi, Ahmad Ostadali Makhmalbaf
Journal: Infect Dis Obstet Gynecol (2008)
MeSH terms: Echinococcosis / diagnosis, Pelvic Infection / diagnosis, Pelvic Infection / parasitology, Case Reports, Abdominal Pain / etiology, Adult, Albendazole / therapeutic use, Anthelmintics / therapeutic use, Diagnosis, Differential, Echinococcosis / surgery, Female, Humans, Pelvic Infection / drug therapy, Pelvic Infection / surgery, Treatment Outcome, Weight Loss, Anthelmintics, Albendazole

We report and discuss a case of primary hydatidosis of the pelvic cavity in a woman who presented with severe weight loss and abdominal pain. This unusual presentation was initially considered as a tumor process until surgical exploration and microscopic studies confirmed the diagnosis. The gynecologists should be aware of possibility of primary hydatid cyst of the pelvic cavity and should be considered in the differential diagnosis of cystic pelvic masses, especially in areas where the disease is endemic.
STA-MCA Bypass as a "Bridge" to Pituitary Surgery in a Patient with an Adenoma Occluding the Internal Carotid Artery: Case Report and Review of the Literature
Authors: Luigi A Lanterna, Carlo Brembilla, Antonio Signorelli, Paolo Gritti, Emanuele Costi, Gianluigi Dorelli, Claudio Bernucci
Journal: Case Rep Neurol Med (2015)

Occlusion of the intracranial internal carotid artery (ICA) by a pituitary adenoma with resulting cerebral ischemia is a very rare but devastating occurrence. The authors present a case in which a condition of symptomatic ICA occlusion due to a giant pituitary adenoma was successfully treated using a preliminary extraintracranial bypass as a "bridge" to the tumor removal. A 52-year-old patient presented with a minor stroke followed by pressure-dependent transient ischemic attacks consistent with a condition of hypoperfusion. MR imaging and a digital subtraction angiography revealed a pituitary adenoma occluding the ICA on the right side. He underwent a superficial temporal artery to middle cerebral artery (STA-MCA) bypass with the aim of revascularizing the ischemic hemisphere and reducing the risk of perioperative stroke or stroke evolution. The patient was subsequently operated on to remove the adenoma through a transsphenoidal approach. The postoperative course was uneventful and the patient has suffered no further ischemic events. When there are no emergency indications to decompress the optical pathways but the patient is at risk of impending stroke because of ICA occlusion, a two-step strategy consisting of a bypass and subsequent removal of the pituitary adenoma may be a valuable option.
A case report of thrombosed varicosities of pubic collateral veins: Ideal treatment strategy and contribution of era imaging technologies in diagnosis
Authors: Daniel Paramythiotis, Patroklos Goulas, Petros Bangeas, Argiris Giannopoulos, Kostantinos Kapoulas, Vasileios Rafailidis, Georgios Papadopoulos, Kiriakos Ktenidis, Anna Kalogera-Fountzila, Antonis Michalopoulos
Journal: SAGE Open Med Case Rep (2018)
Keywords: venous thromboembolism, collateral circulation, deep vein thrombosis, low-molecular-weight heparin, venous recanalization
MeSH terms: Case Reports

Collateral circulation is an alternative path occurring in case of venous or artery obstruction. This path may usually develop after primary recanalization. In our case, a 62-year-old woman presented to our Emergency Department complaining about a suprapubic swelling with a cyanotic discoloration of the overlying skin for the past 10 days for which she had been previously prescribed antibiotics. Investigation with ultrasound and contrast-enhanced computed tomography was performed. An imaging study revealed thrombosed pubic varicose collateral veins due to deep vein obstruction and occlusion of the left external iliac vein. The patient was treated with low-molecular-weight heparin, and swelling subsided gradually. Collateral veins of the abdominal wall and over the pubic tubercle are highly predictive of deep venous obstructive disease proximal to the groin level. These collaterals should never be removed, and the patient should be subjected to a diligent laboratory and imaging investigation.
Painless lump over the forehead which turned painful: an unusual presentation of hepatocellular carcinoma
Authors: S P Susheela, S Revannasiddaiah, A S Basavalingaiah, I Madabhavi
Journal: BJR Case Rep (2015)
MeSH terms: Case Reports

Hepatocellular carcinoma (HCC) is one of the most common malignancies and is known to most often present with symptomatology pertaining to local hepatic disease. Although HCC is known to metastasize to lungs, abdominal lymph nodes, adrenal glands and the vertebral column, it is rather rare to come across patients with skull metastasis. The manifestation of a solitary frontal bone metastasis leading to a painless lump over the forehead as the initial presenting feature of HCC is highly unusual. This case report pertains to a 40-year-old male patient who had initially observed a painless lump over his forehead that was gradually increasing in size over a span of 3 months. He sought medical attention when, after several months, the "painless lump" suddenly became painful. Investigations revealed the involvement of both the outer and the inner table of the frontal bone, and a biopsy revealed the histopathology to be that of HCC. On further investigation, he was found to have systemic disseminated disease involving both the left and right lungs and vertebrae and treatment was initiated with sorafenib. Despite an initial partial response, the patient subsequently succumbed to hepatic failure. This case report illustrates the fact that HCC can silently progress, and even lead to dissemination and distant metastases before becoming clinically evident.
Spontaneous Progressive Muscle Weakness with Persistent Leukocytosis
Authors: Sameer A Hirji, Manish M Karamchandani, Jonathan W Scott, Matthew T Menard
Journal: Case Rep Surg (2019)
MeSH terms: Case Reports

Iliacus compartment syndrome is a rare clinical condition which can result in a severe, unilateral, femoral neuropraxia. Recognition of this syndrome as the cause of a developing neuropathy is often delayed given a lack of familiarity with this clinical diagnosis and the retroperitoneal location of the iliacus muscle. Prompt diagnosis is important to avoid risk of consequent muscle necrosis, rhabdomyolysis, and possibly permanent nerve injury. We describe a case of iliacus compartment syndrome in an elderly, frail woman with end-stage renal disease, anticoagulated for atrial fibrillation, who presented with subacute, progressive lower extremity muscle weakness and pain in the setting of complicated metabolic derangements. She was found to have a spontaneous large hematoma in her left iliacus muscle on computed tomography scan. Despite an initial diagnostic delay, she was successfully managed with an iliacus fasciotomy, which led to complete resolution of her symptoms.
Case Report: Multidisciplinary Approach for a Rare Case of Thymic Vascular Malformation
Authors: Federico Raveglia, Laura Moneghini, Maurizio Cariati, Alessandro Baisi, Angelo Guttadauro, Ugo Cioffi, Marco Scarci
Journal: Front Surg (2021)
Keywords: case report, multidisciplinary approach, residual thymus, venous vascular malformation, vessel embolization
MeSH terms: Case Reports

We report the rare case of a 2.5 cm in size mass diagnostic for residual thymus associated with venous vascular malformation (ISSVA classification, 2008) in a 58 years old man. Diagnosis was obtained only after surgical removal that was complicated by a sudden massive bleeding (about 1,500 cc) requiring emergency conversion to median sternotomy. Difficulty in preoperative diagnosis, rarity of histologic pattern, and surgical challenges make this case very interesting for surgeons, pathologists and radiologist. Our message, dealing with mediastinal masses, is: (a) differential diagnosis between the more frequent solid antero-superior mediastinal tumors and vascular malformation should be always considered (b) preoperative angiography should always be performed in case of uncertain diagnosis (c) coil embolization should always be considered to reduce potentially fatal bleeding (d) histologic differentiation with other thymic neoplasms must be always considered.
Uncommon Surgical Emergencies in the Adult Gynecologic Patient: Two Cases of Missed Diagnosis of Outflow Tract Obstruction from Congenital Uterine Anomalies
Authors: Bailey McGuinness, Natalia Llarena, Tommaso Falcone, Elliott G Richards
Journal: Case Rep Obstet Gynecol (2022)
MeSH terms: Case Reports

Gynecologic emergencies may result from congenital uterine anomalies (CUAs) with outflow tract obstruction. Not limited to the "classic" presentation of an adolescent amenorrheic pain patient, such anomalies should be part of the differential diagnosis for adult female patients presenting with severe pelvic pain. Obstructed rudimentary noncommunicating cavitary horns may result in severe chronic or acute pain and necessitate urgent surgical management. While two-dimensional (2D) ultrasound is often the initial diagnostic tool, three-dimensional (3D) ultrasound and MRI can accurately delineate CUAs for definitive diagnosis. When excision of a rudimentary horn is required, a laparoscopic approach is preferable. This case series focuses on two adult patients with severe pelvic pain due to unicornuate uteruses with obstructed noncommunicating cavitated rudimentary horns. Both cases involve a delayed diagnosis, the inability to make the diagnosis at standard surgical observation, and the resultant need for urgent surgical management.
Cervical Paraganglioma Mimicking Thyroid Nodule: A Rare Clinical Case
Authors: Berna İmge Aydoğan, Serpil Dizbay Sak, Sevim Güllü
Journal: Case Rep Endocrinol (2016)

Objective. Paraganglioma is a rare neuroendocrine tumor. When it is located in the neck, it is commonly misdiagnosed as other thyroid neoplasms. Case Report. We report a case of cervical paraganglioma in a 55-year-old female. Patient was admitted to our clinic with goiter and neck pain. Thyroid ultrasonography revealed a 20 mm solitary, heterogeneous nodule located in the upper pole of left thyroid lobe. Fine needle aspiration cytology was nondiagnostic. She underwent left lobectomy and histopathology showed paraganglioma. Discussion. Cervical paragangliomas should be considered in the differential diagnosis of thyroid nodules.
Ansa pancreatica: a rare cause of acute recurrent pancreatitis
Authors: Abdelilah El Bakouri, Othmane El Yamine, Mounir Bouali, Fatima Zahra Bensardi, Khalid El Hattabi, Abdelaziz Fadil
Journal: Pan Afr Med J (2020)
Keywords: ansa pancreatica, acute pancreatitis, magnetic resonance cholangiopancreatography, sphincterotomy
MeSH terms: Cholangiopancreatography, Endoscopic Retrograde, Cholangiopancreatography, Magnetic Resonance, Pancreatitis / diagnostic imaging, Case Reports, Adult, Female, Gallstones / diagnostic imaging, Humans, Pancreatitis / etiology, Pancreatitis / surgery, Recurrence, Sphincterotomy / methods

Acute pancreatitis is an inflammation of the pancreas that can be caused in rare situations by ansa pancreatica, it is a rare anatomic variation of the pancreatic ducts. It is a communication between the main pancreatic duct (Wirsung) and the accessory pancreatic duct (Santorini). We report a case of the patient, in a 44-year-old, non-alcoholic, hospitalized for acute pancreatitis stage C of Baltazar. A magnetic resonance Cholangiopancreatography (MRCP) was performed which showed a gallstone and ansa pancreatica, than an endoscopic retrograde cholangiopancreatography (ERCP) revealed an ansa pancreatica with a common bile duct clear, a sphincterotomy of the major papilla was performed. It is still not clear whether the presence of these two pathologies is a coincidence or if the ansa pancreatica is the cause of acute pancreatitis. New studies are necessary to clarify these points.
Long-Term Follow-Up after Conservative Surgical Treatment of Odontogenic Myxoma: A Case Report and Literature Review
Authors: Hitoshi Sato, Yuji Kurihara, Sunao Shiogama, Kotaro Saka, Yuya Kurasawa, Masakatsu Itose, Atsutoshi Yaso, Tatsuo Shirota
Journal: Case Rep Dent (2019)
MeSH terms: Case Reports

Odontogenic myxoma (OM) is a relatively rare, benign odontogenic tumor with locally aggressive behavior, but it is a nonmetastasizing neoplasm of the jaw bones. Although radical resection with an appropriate surgical margin is recommended, emerging evidence has suggested that a more conservative approach will result in acceptable recurrence rates with less morbidity if careful long-term follow-up is provided. A 56-year-old Japanese man with odontogenic myxoma of the left mandible was conservatively treated by surgical enucleation and curettage because he desired functional and cosmetic preservation. During a follow-up period of 100 months, the patient has remained clinically and radiologically free of recurrence. As far as we can ascertain, 20 reports published after 1990 described 37 patients with mandibular OM that had been treated by conservative surgery. Tumors recurred during a mean follow-up of 49.2 ± 42.8 months in 7 (18.9%) patients, and only one of five patients who were followed up for over 100 months developed recurrence. The rate of recurrence decreased from 24.0% to 8.3% when follow-up exceeded 60 months. Although enucleation and curettage have proven effective, the risk of recurrence remains considerable and long-term follow-up is indispensable. More evidence of long-term outcomes after conservative surgery for OM is needed.
Donor acquired visceral leishmaniasis following liver transplantation
Authors: Amritpal Dhaliwal, Abhishek Chauhan, Dinesh Aggarwal, Pretin Davda, Miruna David, Rasoul Amel-Kashipaz, Rachel Brown, Martin Dedicoat, Fiona Clark, Tahir Shah, Ahmed Mohamed Elsharkawy, Ines Ushiro-Lumb, Peter Chiodini, Omar El-Sherif, Matthew Armstrong, James W Ferguson
Journal: Frontline Gastroenterol (2021)
Keywords: liver transplantation
MeSH terms: Case Reports

Patients who undergo solid organ transplantation are at risk of opportunistic infection associated with immunosuppression. We report a case of confirmed donor derived visceral leishmaniasis (VL), in a patient following liver transplantation causing fever and pancytopenia. The diagnosis was confirmed by bone marrow biopsy, with confirmed positive donor serology, with no other route of transmission. To our knowledge, this is the first case report in the United Kingdom and Europe, of confirmed organ donor transmission of VL. This case report highlights an important consideration of donor derived infections, in the context of solid organ transplantation.