OpenMed/multicare-articles huggingface dataset:
Deep Venous Thrombosis in Patients with Erythema Nodosum Leprosum in the Use of Thalidomide and Systemic Corticosteroid in Reference Service in Belo Horizonte, Minas Gerais
Authors: Luiz Alberto Bomjardim Pôrto, Maria Aparecida de Faria Grossi, Edilamar Silva de Alecrim, Marcus Henrique de Souza Brito Xavier, Frederico Paiva E Silva, Amalia Sathler Pires, Fabianny Sanglard da Silva, Sandra Lyon
Journal: Case Rep Dermatol Med (2019)
MeSH terms: Case Reports

Introduction:
Erythema nodosum leprosum (ENL) is a type of lepra reaction treated with corticosteroids and thalidomide, but this association increases the risk of deep venous thrombosis (DVT).
Objective:
To report cases of ENL with DVT in the use of thalidomide/corticosteroid associated.
Methodology:
The study was conducted between December 2015 and December 2016 at the Eduardo de Menezes Hospital (HEM-FHEMIG).
Results:
A clinical case series of 16 patients, eight from HEM-FHEMIG and eight from the literature. DVT occurred on 4 continents, mainly in adults and men. All patients were multibacillary; four people had pulmonary embolism (PE); there were 11 unilateral and five bilateral DVT cases; 12 cases were proximal, two distal, and two unspecified. Pharmacological thromboprophylaxis was used on two individuals. Outcome after DVT, 14 patients improved, one had sequelae, and one died.
Discussion:
DVT increased in association with thalidomide/corticosteroid in multiple myeloma, but this complication is poorly described in ENL. In proximal DVT, there was a greater risk of PE and sequelae venous insufficiency. After DVT, start anticoagulation. ASA 100mg/day as prophylaxis for DVT in case of this drug association in ENL is recommended.
Conclusion:
The article illustrates the incidence increase of DVT because of the thalidomide/corticosteroid combination in ENL. When this association is necessary, use ASA 100mg/day as prophylaxis.
Hepatoid Adenocarcinoma of the Stomach: A Challenging Diagnostic and Therapeutic Disease through a Case Report and Review of the Literature
Authors: Najla Fakhruddin, Hisham F Bahmad, Tarek Aridi, Yara Yammine, Rami Mahfouz, Fouad Boulos, Ahmad Awada, Fadi Farhat
Journal: Front Med (Lausanne) (2017)
Keywords: alpha fetoprotein, case report, hepatoid adenocarcinoma, liver metastasis, stomach
MeSH terms: Case Reports

Hepatoid adenocarcinoma of the stomach (HAS) is a rare aggressive tumor with hepatocellular differentiation. HAS often produces alpha fetoprotein (AFP) and metastasizes to the lymph nodes and the liver. Molecular studies revealed Her2 amplification and overexpression, association with p53 mutations, but no association with KRAS mutations. EGFR and BRAF mutations have not yet been evaluated in hepatoid carcinoma of the stomach so far. Hereby, we present a case of a 41-year-old female patient with HAS with high AFP level and liver metastases. Molecular analysis revealed Her2 overexpression by immunohistochemistry (IHC), but no EGFR, KRAS, or BRAF mutations were detected. The patient underwent chemotherapy type DCX (docetaxel, cisplatinum, and capecitabine) every 3 weeks with partial response after two cycles, maintained for eight cycles, and then was on maintenance therapy with trastuzumab for 7 months before relapsing and dying 18 months from the day of diagnosis. Conclusively, HAS may be misdiagnosed as hepatocellular carcinoma; therefore, it should be considered in the differential diagnosis of multiple hepatic nodules with high AFP and no history of hepatitis, liver fibrosis or cirrhosis.
Robotic-assisted laparoscopic "salvage" rectopexy for recurrent ileoanal J-pouch prolapse
Authors: Madhu Ragupathi, Chirag B Patel, Diego I Ramos-Valadez, Eric M Haas
Journal: Gastroenterol Res Pract (2010)
MeSH terms: Case Reports

Total restorative proctocolectomy with ileal pouch-anal anastomosis (RP/IPAA) has become the standard of care for the surgical treatment of ulcerative colitis. Despite its correlation with an excellent quality of life and favorable long-term outcomes, RP/IPAA has been associated with several complications. Prolapse of the ileoanal pouch is a rare and debilitating complication that should be considered in the differential diagnosis of pouch failure. Limited data exist regarding the prevalence and treatment of pouch prolapse. We present the case of a recurrent J-pouch prolapse treated with a novel minimally invasive "salvage" approach involving a robotic-assisted laparoscopic rectopexy with mesh.
Atypical haemolytic uremic syndrome with posterior reversible encephalopathy syndrome in an adolescent: a rare case report
Authors: Sneha Kenjale, Keta Vagha, Jayant Vagha, Ashish Varma, Lavanya Ram Krishnan, Dewang Ghode
Journal: Pan Afr Med J (2022)
Keywords: posterior encephalopathy, case report, renal failure, renal hypertension, schistocytes
MeSH terms: Anemia, Hemolytic, Atypical Hemolytic Uremic Syndrome, Posterior Leukoencephalopathy Syndrome / diagnosis, Posterior Leukoencephalopathy Syndrome / etiology, Shiga-Toxigenic Escherichia coli, Case Reports, Adolescent, Child, Humans, Kidney, Male

Atypical hemolytic uremic syndrome (aHUS) is a group of disorders that affect kidneys which is rare type of HUS that differs from classical hemolytic uremic syndrome (HUS) by absence of prodromal phase consisting of episodes of diarrhoea due to preceding shiga toxin E. coli (STEC-HUS) infection and is 5% of all HUS cases. Approximately 50% cases present with clinical triad of hemolytic anemia, thrombocytopenia and renal insufficiency. However, it can have unusual clinical features in form of central nervous system involvement. This case, of a 15-year-old Indian boy, is one such rare presentation of atypical haemolytic uremic syndrome associated with posterior reversible encephalopathy syndrome (PRES), or reversible posterior leukoencephalopathy syndrome (RPLS) who presented with anaemia, anasarca, papilledema, hypertension, episodic seizures and significant magnetic resonance imaging (MRI) brain findings. We report this uncommon combination of two syndromes to provide useful insight for clinicians to approach and diagnose such presentation in paediatric patients.
MSA Mimic? Rare Occurrence of Anti-Hu Autonomic Failure and Thymoma in a Patient with Parkinsonism: Case Report and Literature Review
Authors: Vito A G Ricigliano, Barbara Fossati, Lorenzo Saraceno, Michele Cavalli, Elena Bazzigaluppi, Giovanni Meola
Journal: Front Neurosci (2018)
Keywords: msa, parkinson, anti-hu, dysautonomia, paraneoplastic syndrome
MeSH terms: Case Reports

Thymoma is a tumor originating from thymic gland, frequently manifesting with paraneoplastic neurological disorders. Its association with paraneoplastic dysautonomia is relatively uncommon. Here, we describe the challenging case of a 71 year-old female who developed subacute autonomic failure with digestive pseudo-obstruction, dysphagia, urinary tract dysfunction and orthostatic hypotension complicating an underlying extrapyramidal syndrome that had started 3 months before hospital admission. Autonomic symptoms had 2-month course and acutely worsened just before and during hospitalization. Combination of severe dysautonomia and parkinsonism mimicked rapidly progressing multiple system atrophy. However, diagnostic exams showed thymic tumor with positive anti-Hu antibodies on both serum and cerebrospinal fluid. Complete response of dysautonomia to immunoglobulins followed by thymectomy confirmed the diagnosis of anti-Hu-related paraneoplastic neurological syndrome. With regards to extrapyramidal symptoms, despite previous descriptions of paraneoplastic parkinsonism caused by other antineuronal antibodies, in our case no relation between anti-Hu and parkinsonism could be identified. A literature review of published reports describing anti-Hu positivity in thymic neoplasms highlighted that a definite autonomic disease due to anti-Hu antibodies is extremely rare in patients with thymoma but without myasthenia gravis, with only one case published so far.
Case report: Transcatheter arterial embolization in a newborn with cervical rapidly involuting congenital hemangioma and Kasabach-Merritt phenomenon
Authors: Ying-Hsuan Peng, Ming-Chih Lin, Wei-Li Liu, Sheng-Ling Jan
Journal: Front Pediatr (2023)
Keywords: kasabach–merritt phenomenon, coagulopathy, congenital hemangioma, infants, transarterial embolization
MeSH terms: Case Reports

Congenital hemangiomas (CHs) are rare vascular tumors and do not exhibit progressive postnatal growth. The incidence is less than 3% of all hemangiomas. Most CHs have a favorable prognosis; however, the Kasabach-Merritt phenomenon (KMP) is a rare but life-threatening complication in CHs that requires aggressive treatment. Medical treatments with corticosteroids and interferon have been suggested. Surgical resection can be considered for the treatment of complicated CHs in medically resistant lesions. Vascular embolization could be an alternative method if surgery is not considered feasible. Herein, we report a case of a 9-day-old newborn who underwent arterial embolization for a CH with KMP, combined with sirolimus treatment, and the outcome was favorable. The hemangioma completely regressed by 3 months and rapidly involuting congenital hemangioma (RICH) was diagnosed. Our successful experience with treating RICH associated with KMP revealed that RICH can have potentially serious complications although they usually resolve rapidly after birth without treatment. Surgical resection is considered to be the standard method for the treatment of medically resistant vascular tumors, but it is difficult to perform during the active phase of KMP due to acute bleeding and severe coagulopathy. Arterial embolization is feasible and can be used as an alternative to surgical resection, even in small babies.
Prophylaxis of Upper Airway Infections in a Patient with Partial IgA Deficiency: Concurrent Use of Sublingual Immunotherapy with Inactivated Whole-Cell Bacterial Extract and Der p1
Authors: Paula F Aarestrup, Matheus F Aarestrup, Beatriz J V Aarestrup, Fernando M Aarestrup
Journal: Case Rep Otolaryngol (2020)
MeSH terms: Case Reports

Selective IgA deficiency is the most common type of primary immunodeficiency, but there is not yet a specific effective treatment. The most prevalent clinical manifestations are infectious diseases of the respiratory system. We report herein the case of an 11-year-old female with selective IgA deficiency and recurring episodes of respiratory infections associated with rhinitis and asthma. We evaluated the efficacy of sublingual immunotherapy combined with inactivated whole-cell bacterial extract and Der p1-specific immunotherapy. After 18 months of clinical follow-up, we observed a significant reduction in the number of episodes of respiratory infections associated with control of atopic diseases. We also observed a 3-fold increase in serum IgA levels compared to treatment initiation. This case demonstrates the potential utility of the concurrent use of sublingual immunotherapy with inactivated whole-cell bacterial extract and Der p1 for successful control of allergy and infection in partial selective IgA deficiency.
Ganglion of the Sternoclavicular Joint: A Rare Location of an Uncommon Pediatric Mass
Authors: Jacob Musiol, Jacob Hansen, Jonathan Wood
Journal: Case Rep Radiol (2020)
MeSH terms: Case Reports

This is a case of a two-year-old boy with a ganglion arising from the sternoclavicular joint. Ganglia are rare in the pediatric population, with less than 2% occurring under the age of 2 years old. Additionally, sternoclavicular joint ganglia are also exceedingly rare. The case illustrates the importance of keeping ganglion within the differential diagnosis for palpable subcutaneous masses, even in young children, especially when they are seen to connect to the joint.
Long-Term Clinical Benefit in EGFR-Mutant Lung Adenocarcinoma With Local Squamous Cell Carcinoma Transformation After EGFR TKI Resistance: A Case Report
Authors: Junru Ye, Yutong Ma, Qiuxiang Ou, Junrong Yan, Bin Ye, Yuping Li
Journal: Front Oncol (2022)
Keywords: egfr tki, pd-l1, adenocarcinoma, case report, squamous cell carcinoma
MeSH terms: Case Reports

The histological transformation from adenocarcinoma (ADC) to squamous cell carcinoma (SCC) is rare but recurrently occurs post TKI treatment in EGFR-mutated non-small cell lung cancer patients with a very limited number of clinical cases published. The outcome of patients after SCC onset is poor as no established treatment guidelines were available. Here we report a case who was initially diagnosed with lung ADC with EGFR L858R driver mutation and demonstrated a partial response (PR) to gefitinib for 27 months before disease progression. The rapidly progressive lung metastatic lesions were determined as an SCC histology with positive PD-L1 expression. Besides EGFR L858R, the metastatic SCC harbored the amplification of CD274 and PDCD1LG2 detected by targeted next-generation sequencing (NGS), which encode PD-L1 and PD-L2, respectively. The disease remained stable on the combination therapy of pembrolizumab plus chemotherapy for eight months until the primary ADC lesion progressed. After the failure of progressed primary ADC lesion with radiotherapy and immunotherapy, systemic ADC metastases were developed in multiple locations including kidney, liver, and chest wall with EGFR L858R mutation but negative PD-L1 expression. The patient then received the combination therapy of bevacizumab plus chemotherapy and the disease remained stable for five months. Since August 2021, afatinib has been administrated which led to a PR and the disease has remained stable up till present. This study demonstrated a primary lung ADC who developed systemic ADC metastases and local SCC transformation with distinct molecular features. The patient has achieved long-term clinical benefit upon multiple lines of chemotherapy and immunotherapy, which provided valuable insight into the treatment of advanced SCC-transformed lung ADC patients.
Merkel Cell Carcinoma with Distant Metastasis to the Clivus Causing Symptoms Mimicking Tolosa-Hunt Syndrome: A Case Report and Literature Review
Authors: Kwo Wei David Ho, Peter A Drew, Miguel Chuquilin
Journal: Front Neurol (2017)
Keywords: merkel cell carcinoma, tolosa–hunt syndrome, cavernous sinus, clivus, cranial nerve palsies, metastasis
MeSH terms: Case Reports

Merkel cell carcinoma (MCC) is an uncommon but highly malignant neuroendocrine tumor of the skin. MCC can metastasize, but involvement of the central nervous system is rare. Here, we report a case of rapidly progressing metastatic MCC to the clivus and bilateral cavernous sinus in an immunocompromised patient. This case is unique in that it is the first case report showing MCC metastasis to the clivus from a distant site. It also demonstrates that a MCC metastasis can masquerade with symptoms of Tolosa-Hunt syndrome. A literature review on MCC with CNS metastasis is presented.
A Case Report of Long-Term Survival following Hepatic Arterial Infusion of L-Folinic Acid Modulated 5-Fluorouracil Combined with Intravenous Irinotecan and Cetuximab Followed by Hepatectomy in a Patient with Initially Unresectable Colorectal Liver Metastases
Authors: Kobe Van Bael, Yanina Jansen, Teofila Seremet, Benedikt Engels, Georges Delvaux, Bart Neyns
Journal: Case Rep Oncol Med (2015)

A 43-year-old women admitted to our hospital for weight loss, anorexia, and abdominal pain was diagnosed with sigmoid neoplasm and multiple bilobar liver metastases. This patient received six cycles of systemic FOLFOX prior to a laparoscopically assisted anterior resection of the rectosigmoid for a poorly differentiated invasive adenocarcinoma T2N2M1, K-RAS negative (wild type). Hepatic arterial infusion (HAI) of L-folinic acid modulated 5-fluorouracil (LV/5-FU) with intravenous (iv) irinotecan (FOLFIRI) and cetuximab as adjuvant therapy resulted in a complete metabolic response (CR) with CEA normalization. A right hepatectomy extended to segment IV was performed resulting in (FDG-)PET negative remission for 7 months. Solitary intrahepatic recurrence was effectively managed by local radiofrequent ablation following 6c FOLFIRI plus cetuximab iv. Multiple lung lesions and recurrence of pulmonary and local lymph node metastases were successfully treated with fractionated stereotactic radiotherapy (50 Gy) and iv LV/5-FU/oxaliplatin (FOLFOX) plus cetuximab finally switched to panitumumab with CR as a result. At present the patient is in persistent complete remission of her stage IV colorectal cancer, more than 5 years after initial diagnosis of the advanced disease. Multidisciplinary treatment with HAI of chemotherapy (LV/5-FU + CPT-11) plus EGFR-inhibitor can achieve CR of complex unresectable LM and can even result in hepatectomy with possible long-term survival.
Massive gastric dilation caused by gastric outlet obstruction in the setting of peptic ulcer disease-A case report
Authors: C S Costa, N Pratas, H Capote
Journal: Int J Surg Case Rep (2020)
Keywords: case report, gastric outlet obstruction, peptic ulcer disease
MeSH terms: Case Reports

Background:
The prevalence of Peptic Ulcer Disease has decreased as did its elective surgical treatment, however its complications continue to occur. Gastric Outlet Obstruction is the least frequent complication of Peptic Ulcer disease.
Case summary:
In this report, we present a case of massive gastric dilation due to gastric outlet obstruction, that needed emergency surgery due to perforation. A subtotal gastrectomy with a Billroth II reconstruction was performed.
Discussion:
Usually non-operative management is tried first, with medical therapy and endoscopic dilation. Emergent surgery is rarely needed, but in this patient, despite trying to optimize his condition first, the ulcer perforation precipitated surgical management.
Conclusion:
Although Gastric Outlet Obstruction is the least frequent complication of Peptic Ulcer Disease and usually non-operative treatment is tried first, surgery may be necessary.
Endotipsitis in an Immunocompetent Patient With Lactobacillus Bacteremia
Authors: Aleeya Shareef, Tahir Khan, Mohammad Shahid, Mustafa Musleh, Ehsan Shabbir
Journal: Cureus (2023)
Keywords: endotipsitis, infection of tips, lactobacillus, tips complications, transjugular intrahepatic portosystemic shunt (tips)
MeSH terms: Case Reports

Transjugular intrahepatic portosystemic shunt (TIPS) is a procedure commonly performed to decompress portal venous pressure since the early 1990s. Endotipsitis, which refers to persistent bacteremia caused by endovascular infection of the TIPS stent, is a rare but serious complication of this procedure. Very few cases of endotipsitis have been reported worldwide. We report the case of an immunocompetent patient diagnosed with endotipsitis, an atypical risk factor for Lactobacillus infection. This case report adds to the literature on underreported complications of TIPS, highlighting an urgent need for introducing clinical practice guidelines regarding the definition, diagnosis, and treatment of endotipsitis.
Fracture of a Femoral Revision Stem following a Technical Failure
Authors: Falko Herold, Henk Eijer
Journal: Case Rep Orthop (2018)
MeSH terms: Case Reports

We report about a fracture of a modular, uncemented femoral revision stem (Zimmer, Revitan®) due to a not previously described intraoperative technical problem. During implantation, a small ring, part of the proximal part of the trial stem, was left on the distal part of the definite stem. Following this, the top screwcap of the proximal part of the definite stem could not be tightened properly. However, the stem was thought to be stable, and the situation left. Two and a half years later, the proximal part of the stem fractured and the situation became unstable. It is very useful to know about this ring and that it should always be removed, otherwise, there is possibility that it may be left on the definite distal part of the stem with the possibility of a later fracture.
Diagnosis and treatment of status epilepticus in a pediatric renal recipient
Authors: Gao Hongjun, Luo Xiangdong, Liang Taisheng, Lu Shangguang, Liang Fangfang, Dong Yu, Tan Zhen, Wu Zhen
Journal: Case Rep Transplant (2011)
MeSH terms: Case Reports

We elaborate on the retrospective analysis of clinical data on a patient afflicted with grand mal seizures following a kidney transplant. The 16-year-old female patient was hospitalized for chronic glomerulonephritis. She experienced an epileptic seizure and was treated with carbamazepine. Renal transplantation was performed; the function of the transplant kidney was normal. However, grand mal seizures, which required intravenous and luminal intramuscular diazepam injections for control, began on the fourth postoperative day and lasted for 3 days, occurring approximately 10 to 20 times per day. On the sixth day, the patient fell into a deep comatose state and developed the inability to move the right side of her body, hypomyotonia, type 1 respiratory failure, and a pulmonary infection. She was given a breathing machine to assist with respiration. At the same time, she was given protection from infection, tranquilization, treatment for dehydration and diuresis, supportive therapy for the right side of her body, and adjustment of her immunosuppressants. On the 12th postoperative day, the patient's consciousness gradually returned; on the 15th day, the breathing machine was removed with recovery of myodynamia; on the 27th day, she was fully cured with no neurological sequelae.
Chicken's best friend? Livestock guardian dog bonding with free-ranging chickens
Authors: R A McKellar, T L Kreplins, P A Fleming
Journal: Transl Anim Sci (2023)
Keywords: maremma, alpaca, behavior, poultry, predation, predator

Growth in the free-range and pastured egg industries has increased globally, necessitating improvements in predator control. Some egg producers are turning to the use of livestock guardian dogs (LGD; Canis familiaris) to protect hens from predation. We worked on a property where pastured layer hens were protected by two Maremma LGDs that were released from their chicken enclosure for 2-3 nights a week. GPS tracking showed that the dogs were more strongly bonded to people than the chickens, spending most of their time at night (96.1% of location data) close to the farmhouse and only 0.09% near their chicken paddock. Despite this lack of attendance, we found no change in the paddock space use by chickens with or without the dogs present (P = 0.999). Furthermore, camera trapping revealed 40 red fox (Vulpes vulpes) events over the 46-d monitoring period, with less fox activity on nights when the LGDs were allowed to roam the property and motion-activated spotlights were also deployed (P = 0.048). An online survey of 59 poultry producers found strong belief in the effectiveness of LGDs, although half the respondents (52%) indicated that they were still experiencing predation issues. There was no association with the reported degree of human bonding of their LGDs, but respondents were more likely to report current issues with predators if they owned 100 or more chickens (P = 0.031). The present case study as well as the farmer survey have identified that LGDs can be strongly bonded to people. Although there was no evidence of subsequently increased risk of predation, bonding with people could draw LGDs away from the animals they should be defending, with predation risk for poultry likely to depend on how far away LGDs move from their livestock.
Endobronchial lipoma: an unusual cause of bronchial obstruction
Authors: Dianbo Cao, Yutian Sun, Sirui Yang
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

Endobronchial lipoma is a rare benign tumor. It is difficult to differentiate benign endobronchial lipoma from their malignant counterparts, as their symptoms and complications are almost alike. Here, we describe the clinical and radiological features of EL in two cases. Multislice CT (MSCT) may play an important role in the diagnosis for EL.