OpenMed/multicare-articles huggingface dataset:
Case report: Percutaneous adrenal arterial embolization cures resistant hypertension
Authors: Yaqiong Zhou, Dan Wang, Qiting Liu, Jixin Hou, Peijian Wang
Journal: Front Cardiovasc Med (2022)
Keywords: ablation, adrenal arterial embolization, case report, hypertension, primary aldosteronism
MeSH terms: Case Reports

Background:
Primary aldosteronism is a common cause of resistant hypertension. Patients with primary aldosteronism due to aldosterone-producing adenoma are generally treated with unilateral adrenalectomy or medical therapy. Superselective adrenal arterial embolization is an alternative treatment for patients with unilateral primary aldosteronism.
Case summary:
We present a 39-year-old male patient with a 5-year history of primary aldosteronism and secondary hypertension. The patient refused adrenalectomy while accepted pharmacotherapy. Despite taking adequate dose of spironolactone, the patient experienced repeatedly muscle weakness due to hypokalemia and had poor blood pressure control with left ventricular hypertrophy and renal dysfunction. Aldosterone-producing adenoma in the left adrenal gland was confirmed by computerized tomography and adrenal venous sampling. The left middle adrenal artery, which was confirmed to provide the main arterial supply to the aldosterone-producing adenoma, was embolized by injecting 2 ml ethanol. The embolization normalized his blood pressure for up to 3 months and reversed left ventricular hypertrophy.
Conclusion:
Superselective adrenal arterial embolization could be an alternative treatment for patients with aldosterone-producing adenoma who refuse adrenalectomy.
Multiple Renal Abscesses due to ESBL Extended-Spectrum Beta-Lactamase-Producing Escherichia coli Causing Acute Pyelonephritis and Bacteremia: A Case Report with a Good Outcome (No Drainage Required)
Authors: Abdalla Khalil, Musaad Qurash, Asem Saleh, Rasha Ali, Mohamed Elwakil
Journal: Case Rep Infect Dis (2016)

Extended-spectrum beta-lactamase-producing Enterobacteriaceae urinary tract infections are challenging infections with increased mortality, morbidity, and failure of therapy. A 44-year-old Saudi male diabetic patient was seen at the ER of IMC Hospital with features of acute pyelonephritis: fever, burning urine, and left flank pain for three days. He was treated for cystitis at the Endocrine Clinic two weeks prior to his ER visit with nitrofurantoin and levofloxacin orally according to urine culture and sensitivity result. The patient was admitted, received IV meropenem, and continued to be febrile for three days. His urine and blood culture at ER grew the same ESBL-producing E. coli as in his urine culture from the Endocrine Clinic. His abdomen CT scan showed two left renal abscesses at the upper and middle poles. His temperature resolved on the fourth day of IV therapy. Intravenous meropenem was continued for 4 weeks after inserting PICC line and the patient was followed up by home healthcare. He was feeling better with occasional left flank pain and repeated abdomen CT scan showed complete resolution of both renal abscesses.
Perinephric abscess caused by ruptured retrocecal appendix: MDCT demonstration
Authors: Nisar Ahmad Wani, Mir Farooq, Tariq Gojwari, Tasleem Kosar
Journal: Urol Ann (2010)
Keywords: perinephric abscess, multidetector-row ct-mdct, retrocecal appendicitis
MeSH terms: Case Reports

Acute appendicitis may occasionally become extraordinarily complicated and life threatening yet difficult to diagnose. One such presentation is described in a 60-year-old man who was brought to the hospital due to right lumbar pain and fever for the last 15 days. Ultrasonography showed a right perinephric gas and fluid collection. Abdominal computed tomography with multidetector-row CT (MDCT) revealed gas-containing abscess in the right retroperitoneal region involving the perinephric space, extending from the lower pole of the right kidney up to the bare area of the liver. Inflamed retrocecal appendix was seen on thick multiplanar reformat images with its tip at the lower extent of the abscess. Laparotomy and retroperitoneal exploration were performed immediately and a large volume of foul smelling pus was drained. A ruptured retrocecal appendix was confirmed as the cause of the abscess.
Hyperresponsiveness to antihistamines in spontaneous urticaria and heat urticaria
Authors: J Durda, B Wedi, V Martin, K Breuer
Journal: Allergol Select (2017)
Keywords: cast, flowcast, h1 antihistamine, h1 receptor, drug hypersensitivity, urticaria
MeSH terms: Case Reports

Background:
H1 antihistamines are important drugs for the treatment of urticaria and are commonly well tolerated. Cases of hypersensitivity reactions to antihistamines have rarely been reported, the underlying pathomechanism is unknown yet.
Case report:
We report the case of a 28-year-old female patient suffering from chronic spontaneous urticaria who experienced severe episodes of wheals and flares induced by different H1 antihistamines.
Methods:
We performed skin prick tests (SPT) with a diversity of H1 antihistamines and CAST and FlowCAST analyses. Moreover, a placebo controlled oral challenge test to mizolastin was done.
Results:
We saw positive SPT reactions to nearly all H1 antihistamines tested with the exception of mizolastin. We observed neither a release of sulfidoleukotrienes nor an upregulation of basophil activation markers in the CAST and FlowCAST analyses. The oral challenge test with mizolastine resulted in the development of generalized wheals and flares.
Conclusion:
H1 antihistamines are effective drugs for the treatment of urticaria, but they may lead to hypersensitivity reactions in rare cases. Because of the negative CAST and FlowCAST results, an IgE-mediated pathomechanism is improbable. We propose that hypersensitivity reactions to H1 antihistamines may be induced by a paradox H1 receptor activation.
Cutaneous mucormycosis complicating a polymicrobial wound infection following a dog bite
Authors: Dalila Zachary, Kimberly Chapin, Linda Binns, Karen Tashima
Journal: Case Rep Infect Dis (2011)
MeSH terms: Case Reports

We report a case of cutaneous mucormycosis and Enterobacter infection developing in a 50-year-old diabetic woman following a dog bite that showed delayed development and diagnosis in comparison with typical zygomycotic cutaneous lesions.
Complete pathological response of high grade appendicular neoplasm induced Pseudomyxoma Peritonei (PMP) after neoadjuvant intra-peritoneal chemotherapy: A case report
Authors: Naveen Padmanabhan, Haruaki Ishibashi, Kazurou Nishihara, Shouzou Sako, Kanji Katayama, Satoshi Wakama, Yasuyuki Kamada, Yutaka Yonemura
Journal: Int J Surg Case Rep (2020)
Keywords: appendiceal neoplasms, case report, cytoreductive surgery, hipec, intraperitoneal chemotherapy, pseudomyxoma peritonei
MeSH terms: Case Reports

Background:
Pseudomyxoma Peritonei (PMP) is clinical syndrome characterized by mucinous ascites and gelatinous tumor deposits in the peritoneal cavity. Complete Cytoreduction and Hyperthermic intraperitoneal perfusion is the contemporary standard of care for PMP. A novel treatment approach with Intraperitoneal (IP) chemotherapy has been developed for patients with disease not amenable for complete cytoreduction.
Case presentation:
A 72 year old lady had PMP arising from high grade appendicular neoplasm with extensive intraabdominal spread not suitable for complete cytoreduction (PCI -19; multiple mesenteric deposits). Novel approach with tumor debulking and Neoadjuvant Intraperitoneal chemotherapy was done. Excellent clinical response was obtained after 12 sessions of IP chemotherapy with cisplatin and docetaxel. Subsequently she underwent Complete cytoreductive surgery with peritonectomy and Hyperthermic intraperitoneal chemotherapy. Pathological examination of surgical specimens revealed only acellular mucin with no viable tumor cells indicating a complete response.
Discussion:
Complete pathological response after IP chemotherapy in extensive PMP is rare. Nevertheless the results are encouraging as the systemic therapy hasn't yielded successful outcomes. IP chemotherapy has the advantage of achieving high intraperitoneal concentrations and down staging the tumor spread.
Conclusion:
Neoadjuvant Intra-peritoneal chemotherapy is a promising neoadjuvant strategy in patients who are poor candidates for upfront resection due to extent of disease or performance status, perhaps better than systemic therapy.
An Unusual Presentation of Pseudothrombotic Microangiopathy in a Patient with Autoimmune Atrophic Gastritis
Authors: Alexandre Malek, Roy Nasnas
Journal: Case Rep Hematol (2016)

Introduction. We hereby describe the case of a young female patient who presented with pseudothrombotic microangiopathy, as well as pancytopenia accompanied by autoimmune atrophic gastritis. Case Presentation. A 36-year-old Caucasian woman presented to the emergency department with fatigue and dyspnea on minimal exertion. Physical examination was unremarkable except for pallor and noninjected conjunctiva. Laboratory tests revealed high LDH and low hemoglobin, white blood cells, platelets, and haptoglobin. The peripheral blood smear showed schistocytes suggestive of pseudothrombotic microangiopathy. Low cobalamin level and hyperhomocysteinemia were also detected. Autoimmune atrophic gastritis was confirmed by gastric biopsy and positive anti-intrinsic factor antibodies. Vitamin B12 supplements were given which led to rapid recovery and normalization of blood parameters. Conclusion. This case highlights the importance and serves as a reminder to clinicians to rule out cobalamin deficiency and autoimmune atrophic gastritis in patients presenting with a picture suggestive of thrombotic thrombocytopenic purpura and pancytopenia, which was completely reversible after appropriate replacement therapy without recurring to unnecessary and invasive procedures such as plasma exchange.
Case Report: Culture-Dependent Postures in Japanese Patients With Schizophrenia
Authors: Akihiro Koreki, Teruki Koizumi, Kamiyu Ogyu, Mitsumoto Onaya
Journal: Front Psychiatry (2021)
Keywords: japan, culture dependent, fear, guilty, schizophrenia, social cognition
MeSH terms: Case Reports

Cross-cultural understanding of psychiatric symptoms is important in the current globalised society. Lack of knowledge regarding culture-dependent manifestations of psychiatric illnesses may lead to misjudgement by clinicians, resulting in inappropriate treatment. We present the cases of two patients with schizophrenia who showed Japanese-culture-dependent postures (seiza and dogeza). Seiza is a Japanese style of formal floor sitting. Dogeza includes bowing and touching the forehead to the floor while sitting in a kneeling position. When patients with schizophrenia perform these postures in a clinical setting, clinicians receive plenty of information regarding the patients' clinical states, including schizophrenia-related fear/tension, accusatory auditory verbal hallucinations, and pathological guilt.
A Complex Cardiac Mass Originating from Interatrial Septum in a Patient with History of Kidney Cancer: A Case Report and Literature Review
Authors: Negar Faramarzi, Sumit Sohal, Roshanak Habibi, Muhammad Sikander Akbar
Journal: Case Rep Cardiol (2018)
MeSH terms: Case Reports

Cardiac tumors are a rare phenomenon, and most cases are secondary to metastatic cancers rather than primary tumors. Renal cell carcinoma (RCC) is notorious for metastasis to cardiac tissue. Tumor thrombus migration to the renal vein and inferior vena cava happens in up to 10% of patients with RCC. Transitional cell carcinomas are another form of renal cancer, which may metastasize to the heart and are associated with widespread metastasis. Here, we report a patient with a past medical history of metastatic transitional cell cancer of renal pelvis under treatment with checkpoint inhibitor therapy presenting with shortness of breath. He had disseminated metastasis to bones, pleural space, lungs, and muscles. A large mass was found in the interatrial septum with invasion to the right and left atrium. The mass had a cystic component protruding into the left atrium. He passed away a few days after presentation.
Inborn Errors of Immunity in the Premature Infant: Challenges in Recognition and Diagnosis
Authors: Scott M Gordon, Amy E O'Connell
Journal: Front Immunol (2021)
Keywords: autoinflamatory diseases, herpes simplex virus, inborn errors of immunity, infection, necrotizing entercolitis, prematurity, primary immunodeficiency, sepsis
MeSH terms: Delayed Diagnosis, Immunologic Deficiency Syndromes / diagnosis, Infant, Premature, Diseases / diagnosis, Infections / etiology, Case Reports, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Review, Bacterial Infections / etiology, Bronchopulmonary Dysplasia / complications, Candida parapsilosis, Candidiasis, Invasive / complications, Child, Diagnosis, Differential, Enterocolitis, Necrotizing / complications, Fatal Outcome, Female, Genetic Association Studies, Humans, Immunologic Deficiency Syndromes / complications, Immunologic Deficiency Syndromes / genetics, Infant, Newborn, Infant, Premature, Infant, Premature, Diseases / genetics, Inflammation, Intensive Care Units, Neonatal, Lymphohistiocytosis, Hemophagocytic / diagnosis, Male, Meningitis, Bacterial / etiology, Recurrence, Sepsis / etiology

Due to heightened awareness and advanced genetic tools, inborn errors of immunity (IEI) are increasingly recognized in children. However, diagnosing of IEI in premature infants is challenging and, subsequently, reports of IEI in premature infants remain rare. This review focuses on how common disorders of prematurity, such as sepsis, necrotizing enterocolitis, and bronchopulmonary dysplasia, can clinically overlap with presenting signs of IEI. We present four recent cases from a single neonatal intensive care unit that highlight diagnostic dilemmas facing neonatologists and clinical immunologists when considering IEI in preterm infants. Finally, we present a conceptual framework for when to consider IEI in premature infants and a guide to initial workup of premature infants suspected of having IEI.
Neuronal Differentiation in a Pituitary Macroadenoma with Focal Small Blue Round Cell Morphology: Report of a Rare Pattern
Authors: Hisham Alkhalidi
Journal: Case Rep Pathol (2020)
MeSH terms: Case Reports

Ganglion cell-containing pituitary adenomas that are neurofilament protein-positive are the exceedingly rare form of pituitary ganliocytomas. We report a case of a 23-year-old male patient who presented with a clinical picture of acromegaly in addition to raised prolactin level. Histopathology showed areas exhibiting pseudopapillary and solid proliferation of round and monotonous blue cells. The immunohistochemistry showed strong reactivity for synaptophysin and growth hormone and focal reactivity to prolactin. Fibrous bodies are confirmed using cytokeratin immunostain, in keeping with sparsely granulated somatotroph component. The patient remained free of recurrence after one year of radiological follow-up.
Solid pseudopapillary tumor of the pancreas: a rare entity in children
Authors: Ghita Berrada, Soukaina Belaaroussi, Kamilia Chbani, Siham Salam, Dalal Laoudiyi, Lahcen Ouzidane, Asmaa El Kebir, Nisrine Bennani Guebessi, Samira Benayad, Farida Mernissi, Mehdi Karkouri, Salma Anis, Mounia Al Zemmouri
Journal: Pan Afr Med J (2020)
Keywords: pseudopapillar, children, pancreas, tumor
MeSH terms: Pancreatic Neoplasms / diagnosis, Case Reports, Child, Female, Humans, Morocco, Pancreatic Neoplasms / pathology, Pancreatic Neoplasms / therapy, Prognosis

Solid pseudopapillary tumors (SPTs) constitute 0.2 to 2.7% of non-endocrine primary tumors of the pancreas and comprise the majority (70%) of pediatric pancreatic neoplasms. These tumors are of unclear pathogenesis, low malignancy and favorable prognosis. Surgical resection offers an excellent chance for longterm survival, even in the presence of distant metastasis. The objective of this study is to review our experience in the management of SPT in a 12 years old girl at the pediatric hospital of the University hospital of Casablanca, in Morocco and provide an update on current management in pediatric population.
Mini Transsternal Approach to the Anterior High Thoracic Spine (T1-T4 Vertebrae)
Authors: Christian Brogna, Bhaskar Thakur, Leslie Fiengo, Sandra Maria Tsoti, Alessandro Landi, Giulio Anichini, Francesco Vergani, Irfan Malik
Journal: Biomed Res Int (2016)
MeSH terms: Sternotomy / methods, Sternum / surgery, Thoracic Vertebrae / surgery, Case Reports, Adult, Female, Humans, Intervertebral Disc Displacement / surgery, Kyphosis / surgery, Magnetic Resonance Imaging, Male, Middle Aged, Spinal Neoplasms / surgery, Spondylitis, Ankylosing / surgery

Purpose. The anterior high thoracic spine is one of the most complex segments to be accessed surgically due to anatomical constraints and transitional characteristics. We describe in detail the mini transsternal approach to metastatic, infective, traumatic, and degenerative pathologies of T1 to T4 vertebral bodies. We analyse our surgical series, indications, and outcomes. Methods. Over a 5-year period 18 consecutive patients with thoracic myelopathy due to metastatic, infective, traumatic, and degenerative pathologies with T1 to T4 vertebral bodies involvement received a mini transsternal approach with intraoperative monitoring. Frankel scoring system was used to grade the neurological status. Results. Mean follow-up was 40 months. 78% patients improved in Frankel grade after surgery and 22% patients remained unchanged. Average operation time was 210 minutes. There were no intraoperative complications. One patient developed postoperative pneumonia successfully treated with antibiotics. Conclusion. The mini transsternal is a safe approach for infective, metastatic, traumatic, and degenerative lesions affecting the anterior high thoracic spine and the only one allowing an early and direct visualisation of the anterior theca. This approach overcomes the anatomical constraints of this region and provides adequate room for optimal reconstruction and preservation of spinal alignment in the cervicothoracic transition zone with good functional patient outcomes.
A Challenging Case of Kikuchi-Fujimoto Disease Associated with Systemic Lupus Erythematosus and Review of the Literature
Authors: Mihaela Găman, Ana-Maria Vlădăreanu, Camelia Dobrea, Minodora Onisâi, Cristina Marinescu, Irina Voican, Daniela Vasile, Horia Bumbea, Diana Cîşleanu
Journal: Case Rep Hematol (2018)
MeSH terms: Case Reports

Kikuchi-Fujimoto disease (KFD) or histiocytic necrotizing lymphadenitis is a rare disease that is frequently underdiagnosed due to clinical features that are similar to those of non-Hodgkin lymphomas, systemic lupus erythematosus (SLE), or infectious reactive lymphadenopathy. An excisional biopsy is required. We report a young Caucasian female diagnosed with KFD with skin lesions, complicating with SLE. The clinical course, laboratory, and CT findings are described, as are histopathologic features, for a better recognition of this rare disorder in clinical practice.
Circumscribed Palmar Hypokeratosis With Superimposed Actinic Keratosis
Authors: Erica Aukerman, Megana Rao, Azadeh Samiei, Maria C Bell, Sahand Rahnama-Moghadam
Journal: Cureus (2023)
Keywords: actinic keratosis, circumscribed palmar hypokeratosis, hand, non-melanoma skin cancer, psoriasis
MeSH terms: Case Reports

A man in his late 70s with a history of psoriasis and non-melanoma skin cancer presented with a progressive rash on his right thenar eminence. He first noticed it about one year ago. He denied any pruritus in the affected region but did note some overlying skin breakdown. He had used topical betamethasone and calcipotriene cream in the past with minimal improvement. Physical examination revealed a pink atrophic plaque with linear hyperkeratotic borders and central fissuring on the right thenar eminence extending into the first webspace. A shave biopsy revealed hypokeratosis with a rim of surrounding hyperkeratosis and associated parakeratosis, basal keratinocyte atypia, and lichenoid inflammation. These histopathological features were consistent with circumscribed palmar hypokeratosis and central actinic keratosis. Circumscribed palmar hypokeratosis is often considered a benign entity, but there have been reports suggesting an association with premalignancy. The decision was made to treat with 5-fluorouracil and calcipotriene cream twice daily for six weeks. At his two-month follow-up, he endorsed a robust reaction, which was further suggestive of premalignant change. He had a near-complete resolution of the rash. This case features circumscribed palmar hypokeratosis and suggests a novel treatment option for patients who develop concomitant actinic keratosis.
Case Report: Atypical Manifestations Associated With FOXP3 Mutations. The "Fil Rouge" of Treg Between IPEX Features and Other Clinical Entities?
Authors: Micaela Gentile, Maurizio Miano, Paola Terranova, Stefano Giardino, Maura Faraci, Filomena Pierri, Enrico Drago, Daniela Verzola, Gianmarco Ghiggeri, Enrico Verrina, Andrea Angeletti, Barbara Cafferata, Alice Grossi, Isabella Ceccherini, Gianluca Caridi, Francesca Lugani, Lorenzo Nescis, Enrico Fiaccadori, Luca Lanino, Daniela Fenoglio, Edoardo La Porta
Journal: Front Immunol (2022)
Keywords: alps, foxp3, ipex, ngs, membranous glomerulopathy, regulatory t cells
MeSH terms: Autoimmune Diseases, Genetic Diseases, X-Linked / diagnosis, Genetic Diseases, X-Linked / genetics, Glomerulonephritis, Membranous, Case Reports, Child, Preschool, Female, Forkhead Transcription Factors / metabolism, Humans, Immunoglobulin G / genetics, Male, Mutation, T-Lymphocytes, Regulatory, FOXP3 protein, human, Forkhead Transcription Factors, Immunoglobulin G

Introduction:
The Forkhead box protein P3 (FOXP3) is a transcription factor central to the function of regulatory T cells (Treg). Mutations in the FOXP3 gene lead to a systemic disease called immune dysregulation, polyendocrinopathy, and enteropathy, an X-linked syndrome (IPEX) characterized by the triad of early-onset intractable diarrhea, type 1 diabetes, and eczema. An atypical presentation of IPEX has been reported.
Method:
We report rare cases with equivocal clinical associations that included inflammatory, kidney, and hematologic involvements screened with massively parallel sequencing techniques.
Results:
Two patients with hemizygous mutations of FOXP3 [c.779T>A (p.L260Q)] and [c.1087A>G (p.I363V)] presented clinical manifestations not included in typical cases of IPEX: one was a 16-year-old male patient with an initial clinical diagnosis of autoimmune lymphoproliferative syndrome (ALPS) and who developed proteinuria and decreased kidney function due to membranous nephropathy, an autoimmune renal condition characterized by glomerular sub-epithelial antibodies. The second patient was a 2-year-old child with bone marrow failure who developed the same glomerular lesions of membranous nephropathy and received a bone marrow transplantation. High levels of IgG4 in serum, bone marrow, and kidney led to the definition of IgG4-related kidney disease (IgG4 RKD) in this young boy. The circulating Treg levels were normal in the former case and very low in the second.
Conclusion:
Two atypical associations of functional mutations of FOXP3 that include ALPS and IgG4 RKD are described. Membranous nephropathy leading to renal failure completed in both cases the clinical phenotypes that should be included in the clinical panorama of FOXP3 failure.