OpenMed/multicare-articles huggingface dataset:
Unidentified Neuronal Surface IgG Autoantibodies in a Case of Hashimoto's Encephalopathy
Authors: Marina Mané-Damas, Anita Vinke, Carolin Hoffmann, Shenghua Zong, Mario Losen, Peter C Molenaar, Jan Damoiseaux, Suzanne Koudijs, Rob P W Rouhl, Pilar Martinez-Martinez
Journal: Front Immunol (2020)
Keywords: hashimoto encephalopathy, autoantibodies, autoimmune encephalitis, case report, pathogenicity
MeSH terms: Autoantibodies / immunology, Encephalitis / etiology, Hashimoto Disease / etiology, Immunoglobulin G / immunology, Neurons / immunology, Case Reports, Research Support, Non-U.S. Gov't, Adolescent, Autoantigens / immunology, Autoimmune Diseases / etiology, Autoimmune Diseases / metabolism, Autoimmune Diseases / pathology, Autoimmunity, Biomarkers, Electroencephalography, Encephalitis / diagnosis, Encephalitis / metabolism, Fluorescent Antibody Technique, Hashimoto Disease / diagnosis, Hashimoto Disease / metabolism, Humans, Immunohistochemistry, Male, Neurons / metabolism, Autoantibodies, Autoantigens, Biomarkers, Immunoglobulin G, Hashimoto's encephalitis

Hashimoto's encephalopathy is an encephalitis of presumed autoimmune origin characterized by the presence of autoantibodies against thyroid proteins. We present a case of a young patient with pre-existing Hashimoto's thyroiditis and progressive cognitive complaints, absence-like episodes, and sporadic bilateral epileptiform frontal and frontotemporal activity. No abnormalities were observed during the neurological examination and on MRI. Antibodies to thyroid peroxidase (TPO) were elevated and remained positive while the symptoms were present. Levothyroxine and methylprednisolone did not ameliorate the complaints. Subsequent treatment with high-dose intravenous immunoglobulins (IVIG) led to improved cognitive functions and to the disappearance of the absence-like-episodes. Patient's serum, but not CSF, gave a characteristic IgG-specific hippocampal pattern in rat brain immunohistochemistry; this immunoreactivity was maintained after specific and complete depletion of TPO antibodies. Serum IgG bound to primary neurons in cell culture, likely targeting a yet unidentified neuronal surface antigen. The clinical response to IVIG suggests but does not prove, that the circulating novel autoantibodies may induce the encephalopathy. It would be of interest to investigate more patients with Hashimoto's encephalopathy for the presence of neuronal surface autoantibodies, to define their role in the disease and their target antigen(s).
Open Glenoid Augmentation With Scapular Spine Autograft for Recurrent Shoulder Instability: A Report of Two Cases
Authors: Rafat H Solaiman, Trenton Cooper, Bradley Nelson, Marc A Tompkins
Journal: Cureus (2023)
Keywords: arthroscopy, glenoid bone defect, open glenoid augmentation, scapular spine autograft, shoulder dislocation, shoulder instability
MeSH terms: Case Reports

Optimal treatment for patients with significant glenoid bone loss after severe shoulder dislocation remains a topic of discussion, as there are many autograft and allograft techniques for glenoid augmentation. Several studies have identified scapular spine autograft to be a potential option for restoring glenohumeral stability, however, there is limited clinical data for this procedure. We present two cases in which patients suffered from anterior glenoid bone loss and recurrent shoulder instability who underwent open glenoid augmentation with scapular spine autograft. Both patients report a full return to activity with no functional limitations. Open glenoid augmentation with a scapular spine autograft is a viable option for patients with anterior glenoid bone loss and recurrent shoulder instability.
Cytarabine-Induced Encephalitis
Authors: Christine Lenfant, Nathalie Greiner, Thierry Duprez
Journal: J Belg Soc Radiol (2021)
Keywords: cerebellar encephalitis, cerebellar toxicity, cytarabine, cytosar, neurotoxicity
MeSH terms: Case Reports

Teaching Point: Central nervous system adverse effects of cytarabine treatment include aseptic meningitis, myelopathy, and more rarely, encephalopathy, seizures, and cerebellar dysfunction. This case illustrates a cytarabine-induced encephalitis with predominant cerebellar involvement.
MRSA endocarditis of bovine Contegra valved conduit: a case report
Authors: Gani Bajraktari, Rozafa Olloni, Irfan Daullxhiu, Fadil Ademaj, Zana Vela, Mubekir Pajaziti
Journal: Cases J (2009)

Background:
Different techniques are used for the right ventricular outflow tract reconstruction, including homo- or porcine xenografts, which have several limitations. Contegra, a bovine jugular vein graft, is an interesting alternative to overcome these limitations. It consists of a bovine jugular vein with a naturally integrated valve in it. Isolated pulmonary valve endocarditis is extremely rare.
Case presentation:
We report the case of a 20 years old male patient with acute endocarditis of bovine Contegra valved conduit, four years after right ventricular outflow tract reconstruction and atrial septal defect correction, associated with acute glomerulonephritis, renal failure and severe anemia, secondary to methicillin-resistant Staphylococcus aureus infection (MRSA).
Conclusion:
We present a complex patient with acute endocarditis of bovine Contegra valved conduit. We believe that the presentation of this case should encourage the researchers for the discussing of the implantation of this conduit and the prevention of endocarditis in these patients.
One-Stage Laparoscopic Surgery for Pulmonary Sequestration and Hiatal Hernia in a 2-Year-Old Girl
Authors: Hisayuki Miyagi, Shohei Honda, Hiromi Hamada, Masashi Minato, Momoko W Ara, Akinobu Taketomi
Journal: European J Pediatr Surg Rep (2018)
Keywords: gastroesophageal reflux, hiatal hernia, laparoscopic, one-stage, pulmonary sequestration
MeSH terms: Case Reports

We herein report a case of one-stage laparoscopic surgery for extralobar pulmonary sequestration (EPS) and hiatal hernia. Our patient was a 2-year-old girl who was diagnosed as a mediastinal mass lesion. Postnatal computed tomography revealed that the mediastinal mass was an EPS. Two weeks after birth, the patient developed gastroesophageal reflux (GER), and esophagography showed a hiatal hernia. At 2 years of age, she underwent one-stage laparoscopic Nissen's fundoplication for GER with resection of the EPS in the posterior mediastinum. The sequestrated lung was grasped via the esophageal hiatus; three aberrant blood vessels were dissected to allow removal of the sequestration through the umbilical port site. The esophageal hiatus was repaired and Nissen's fundoplication was performed laparoscopically. The patient's postoperative course was uneventful, with no recurrence of GER symptoms for 1 year. We conclude that one-stage laparoscopic surgery is useful for patients with EPS and hiatal hernia.
Primary Stromal Breast Sarcoma with Concomitant Contralateral Carcinoma: A Rare Case from Syria
Authors: Rawan Al Khudari, Mohannad Homsi, Hasan Al Zohaily, Maher S Saifo
Journal: Case Rep Oncol Med (2019)
MeSH terms: Case Reports

Bilateral breast cancers are rare cases encountered and are usually the same type in both sides. Only very few cases were reported to have different histological types of neoplasia involving sarcoma. Moreover, sarcomas rarely originate from the breast as a primary lesion whereas the common presentation is having angiosarcoma following radiotherapy. In this report, we present a rare case of a Syrian 43-year-old woman having two distinct primary lesions in the breasts: invasive ductal carcinoma and contralateral stromal sarcoma.
Fetus in fetu: A report of two cases
Authors: Ibrahim Karaman, Derya Erdoğan, Semire Ozalevli, Ayşe Karaman, Y Hakan Cavuşoğlu, M Kemal Aslan, Ozden Cakmak
Journal: J Indian Assoc Pediatr Surg (2008)
Keywords: fetus in fetu, newborn, teratoma
MeSH terms: Case Reports

Fetus in fetu is a rare condition that has been defined as the presence of one of the twins in the body of the other. It is most frequently located in retroperitoneal area; however, it has been reported in other locations as well. This report presents two cases of "fetus in fetu" cases: one located in the retroperitoneal area and the other in the sacrococcygeal area.
A deadly prescription: combination of methotrexate and trimethoprim-sulfamethoxazole
Authors: Mohsin Hamid, Bilal Lashari, Irfan Ahsan, Ida Micaily, Usman Sarwar, Joseph Crocetti
Journal: J Community Hosp Intern Med Perspect (2018)
Keywords: methotrexate, deadly drug interaction, folinic acid rescue, pancytopenia, trimethoprim-sulfamethoxazole
MeSH terms: Case Reports

Methotrexate (MTX) is a chemotherapeutic synthetic(s) phase cell cycle inhibitor, and its role has evolved as an immunological agent in autoimmune diseases like rheumatoid arthritis, psoriasis, and systemic lupus erythematosus, etc. Trimethoprim-sulfamethoxazole (TS) is one of the most widely prescribed antibiotics commonly used for urinary tract infections, exacerbations of chronic bronchitis, traveler's diarrhea, and pneumocystis pneumonia. Both MTX and TS can have significantly overlapping side effects involving dermatologic, renal, and hematological systems, and the combination of these can be deadly. Our case is about the combination of MTX and TS that leads to mucocutaneous ulceration, leukopenia, and renal insufficiency. The purpose of this case is to increase awareness of potentially significant toxicity from the combination of MTX with TS. Abbreviations: MTX: methotrexate; TS: trimethoprim-sulfamethoxazole; ED: emergency department; IV: intravenous; GI: gastrointestinal; NSAIDs: nonsteroidal anti-inflammatory drugs.
A case report on radiation-induced angiosarcoma of breast post skin-sparing mastectomy and reconstruction with transverse rectus abdominal muscle
Authors: Adil Aljarrah, Claude Nos, Krishna B Clough, Marie Aude Lefrere-Belda, Fabrice Lecuru
Journal: Ecancermedicalscience (2014)
Keywords: tram, breast carcinoma-angiosarcoma-radiotherapy
MeSH terms: Case Reports

Radiation-induced angiosarcomas (RIA) are rare tumours that can affect breast cancer patients following treatment with breast conservative surgery and radiotherapy. Their diagnosis is often delayed because of their benign appearance and the difficulty in differentiation from radiation-induced skin changes. We report here a case of RIA which occurred seven years after radiotherapy to highlight awareness of the disease and the role of careful histological evaluation of these tumours.
A Fatal Bacteremia Caused by Hypermucousviscous KPC-2 Producing Extensively Drug-Resistant K64-ST11 Klebsiella pneumoniae in Brazil
Authors: Tatiana Amabile de Campos, Laura Fernandes Gonçalves, Kelly Grace Magalhães, Vicente de Paulo Martins, Georgios Joannis Pappas Júnior, Gisele Peirano, Johann D D Pitout, Guilherme Bartolomeu Gonçalves, João Pedro Rueda Furlan, Eliana Guedes Stehling, André Pitondo-Silva
Journal: Front Med (Lausanne) (2018)
Keywords: kpc-2, klebsiella pneumoniae, st11, xdr, antimicrobial resistance, hypermucousviscous, virulence
MeSH terms: Case Reports

We report a fatal bacteremia caused by Klebsiella pneumoniae in a 60-70-year-old patient from Brazil. The genomic analysis of three isolates (from blood culture, nasal and anal swabs) showed that the bacteremia was caused by a KPC-2 producing extensively drug-resistant K64-ST11 hypermucousviscous K. pneumoniae (hmKP) harboring several virulence and antimicrobial resistance genes. Although the isolates did not present virulence markers associated with hypervirulent K. pneumoniae (hvKP), they showed invasion and toxicity to epithelial Hep-2 cells; resistance to cell microbicidal mechanisms; and blood and human serum survival, evidencing their pathogenic potential. This study highlights the risk of infection caused by hmKp strains not characterized as hvKP as well as the clinical implications and difficulty of treatment, especially in elderly or immunocompromised patients.
Case Report: A Novel Homozygous Mutation in MYF5 Due to Paternal Uniparental Isodisomy of Chromosome 12 in a Case of External Ophthalmoplegia With Rib and Vertebral Anomalies
Authors: Qianqian Li, Xiaofan Zhu, Chenguang Yu, Lin Shang, Ranran Li, Xia Wang, Yaping Yang, Jingjing Meng, Xiangdong Kong
Journal: Front Genet (2022)
Keywords: chromosome 12, external ophthalmoplegia with rib and vertebral anomalies, homozygous mutation, paternal uniparental isodisomy, the myogenic factor 5 gene, trio-based exome sequencing
MeSH terms: Case Reports

External ophthalmoplegia with rib and vertebral anomalies (EORVA) is characterized by congenital nonprogressive external ophthalmoplegia, ptosis, scoliosis, torticollis, vertebral, and rib anomalies, caused by homozygous mutations in the myogenic factor 5 gene (MYF5) located on chromosome 12q21.31. Uniparental disomy (UPD) is a rare inheritance of a pair of chromosomes originating from only one parent. This study describes a case of an 8-year-old boy with ptosis, scoliosis, and dysmorphic hypoplastic ribs with fusion anomalies. Trio-based exome sequencing (trio-ES) identified a novel homozygous mutation c.191delC (p.Ala64Valfs*33) in MYF5 in the proband, with the father being heterozygous and the mother wild-type, as verified by Sanger sequencing. UPD identified from trio-ES variant call format data suggested the possibility of paternal UPD of chromosome 12 (UPD12pat) in the proband, further confirmed to be a complete isodisomy type of UPD by genome-wide single nucleotide polymorphism array. MYF5 was significantly downregulated by 69.14% (**p < 0.01) in HeLa cells transfected with mutant MYF5 containing c.191delC compared to those transfected with the wild-type MYF5, resulting in a truncated protein with a size of ∼20 kDa. In conclusion, this study identified a novel homozygous mutation in MYF5, broadening the genetic spectrum of EORVA and further deepening the understanding of this rare disease.
Symptomatic loosening of a total knee arthroplasty caused by a tibial chondrosarcoma - a case report
Authors: Jakob T Sieker, Maximilian Rudert, Andre F Steinert
Journal: Springerplus (2014)
Keywords: aseptic loosening, bone tumor, chondrosarcoma, total knee arthroplasty

Premature implant loosening following total knee arthroplasty (TKA) can have several causes. In this article we report on a rare case of a 74 year old male patient suffering tibial component loosening 14 month after primary TKA. The patient did neither have any malignancies nor joint arthroplasty before. Upon clinical examination the range of motion in the diseased knee was painfully restricted to 80° of knee flexion, with the patient increasingly suffering sleeping and resting pain, and also at weight bearing. In standard radiographs, loosening of the TKA due to a large osteolysis at the tibial component was evident. Local computed tomography (CT) of the right knee revealed loosening of the tibial component due to a presumably malign bone tumor. For determination of the final diagnosis a representative biopsy of the tumor was taken by open surgery prior to the tumor resection. Histopathologic evaluation of the biopsy revealed a periprosthetic myxoid chondrosarcoma of the proximal tibia. Pre-operative staging examination included CT scans of lung and abdomen, as well as a bone scintigraphy which revealed no signs of tumor metastasis in the body. Surgical management comprised wide tumor resection and implantation of a hinged tumor knee arthroplasty with replacements of the distal femur and proximal tibia, as well as a patella tendon replacement using a synthetic ligament. Revision surgery was necessary twice due to impaired wound healing and critical soft tissue coverage, and treatment included a gastrocnemius muscle flap with skin mesh graft covering. Unfortunately long-term follow-up examinations could not be obtained, as the patient deceased due to an alveolitis during rehabilitation. In summary, the specifics of this rare case of aseptic TKA loosening, and the unusual circumstances of chondrosarcoma diagnosis and treatment are informative for those providing surgical treatment of similar cases.
Clinical Characteristics of Six Cases of Tracheobronchopathia Osteochondroplastica
Authors: Rong Guo, Mingming Zhou, Xiaohui Wei, Ling Niu
Journal: Can Respir J (2020)
MeSH terms: Bronchoscopy / methods, Hemoptysis / etiology, Hemoptysis / therapy, Osteochondrodysplasias / diagnosis, Osteochondrodysplasias / etiology, Osteochondrodysplasias / physiopathology, Osteochondrodysplasias / therapy, Patient Care Management / methods, Symptom Assessment / methods, Tomography, X-Ray Computed / methods, Tracheal Diseases / diagnosis, Tracheal Diseases / etiology, Tracheal Diseases / physiopathology, Tracheal Diseases / therapy, Case Reports, Anti-Infective Agents / therapeutic use, Diagnosis, Differential, Diagnostic Errors / prevention & control, Expectorants / therapeutic use, Female, Humans, Male, Middle Aged, Anti-Infective Agents, Expectorants, Tracheobronchopathia osteoplastica

Objective:
To investigate the clinical characteristics of tracheobronchopathia osteochondroplastica (TO).
Methods:
The clinical data of six patients with TO from November 2016 to November 2018 were retrospectively analyzed. The etiology, clinical manifestations, diagnosis, and treatment of TO were summarized.
Result:
All six patients with TO were middle-aged males, confirmed by histopathological examination. The main clinical symptoms were cough, sputum, hemoptysis, chest pain, and repeated pulmonary infection. Some patients could make a preliminary diagnosis by chest CT, and bronchoscopy showed that TO mainly occurred in the trachea and the main bronchus and was more likely to invade the right bronchus. The treatment mainly includes anti-infection, phlegm-resolving, and other symptomatic treatment.
Conclusion:
TO is a benign disease predisposing to adults, and males are more likely to be affected. Its clinical manifestations are lack of specificity, and the cause may be related to chronic infection. Bronchoscopy combined with histopathological examination is the primary approach for the diagnosis of TO. There is no well-recognized treatment standard for TO, and the judgment of therapeutic effect is inconsistent. It is necessary to improve the understanding of this disease from a clinical perspective.