OpenMed/multicare-articles huggingface dataset:
Case report: Central venous catheter thrombosis complicated by chronic thromboembolic disease/pulmonary hypertension in two children requiring parenteral nutrition
Authors: Maja Hanuna, Joseph Pattathu, Joscha Buech, Christine Kamla, Nikolaus Kneidinger, Juergen Behr, Katrin Milger, Tobias Veit, Marina Nagel, Jan Abicht, Robert Dalla-Pozza, Marcus Fischer, Andre Jakob, Matthias Hermann, Rene Schramm, Laura L Rosenthal, Nikolaus Haas, Jürgen Hörer, Christian Hagl, Sebastian G Michel
Journal: Front Cardiovasc Med (2023)
Keywords: chronic thromboembolic pulmonary hypertension, hickmann-catheter, parenteral nutrition (pn), pulmonary embolism, pulmonary endarterectomy
MeSH terms: Case Reports

Chronic thromboembolic pulmonary hypertension is a rare but life-threatening complication of long-term central venous catheters (CVC) in children. However, evidence in terms of potential treatment strategies and outcome data remains scarce. We describe two cases of CVC-related thrombosis (Hickman-catheter) complicated by recurrent pulmonary emboli. One patient experienced a complete thromboembolic obstruction of the right pulmonary artery with normal pulmonary pressures and the second patient suffered from a central thromboembolic obstruction of both pulmonary arteries associated with severe pulmonary hypertension. Both patients successfully underwent surgical thromboendarterectomy with deep hypothermic circulatory arrest.
A Unique Case of IGF-2 Induced Hypoglycemia Associated with Hepatocellular Carcinoma
Authors: Prachi Rana, Brian Kim
Journal: Case Rep Endocrinol (2019)
MeSH terms: Case Reports

Tumor-induced hypoglycemia (TIH) associated with hepatocellular carcinoma (HCC) results from tumor production of insulin-like growth factor 2 (IGF-2), resulting in recurrent hypoglycemia. Serum levels of insulin-like growth factor 1 (IGF-1), insulin-like growth factor 2 (IGF-2), or pro-insulin-like growth factor 2 (pro-IGF-2) are required for the diagnosis. However, due to the limited availability of testing in many laboratories, this condition is often overlooked. As this condition is often overlooked, prompt recognition and implementation of tumor directed therapies and/or systemic therapies can help mitigate the consequences of hypoglycemia. We present a 38-year-old man with advanced multifocal HCC who presented with abdominal pain and was found to have recurrent symptomatic hypoglycemia. Evaluation revealed elevated levels of IGF-2, suggesting a diagnosis of HCC with production of IGF-2.
Severe anaphylaxis after pelvic examination: a case report of dual latex and chlorhexidine allergies
Authors: Mongkhon Sompornrattanaphan, Piyawut Kreetapirom, Yuttana Srinoulprasert, Duangjit Kanistanon, Anchalika Klinniyom, Chamard Wongsa, Torpong Thongngarm
Journal: Allergy Asthma Clin Immunol (2019)
Keywords: anaphylaxis, chlorhexidine, hypersensitivity, latex allergy, pelvic examination
MeSH terms: Case Reports

Background:
Natural rubber latex and chlorhexidine have previously been identified as causative substances in perioperative anaphylaxis. A pelvic examinations is generally considered noninvasive, however, this procedure is rarely associated with severe allergic reactions. We reported a rare case of dual latex and chlorhexidine allergies which caused anaphylaxis after pelvic examination in a woman with a history of latex-related fruits allergy.
Case presentation:
A 54-year-old woman had severe anaphylaxis after a pelvic examination due to dual latex and chlorhexidine (CHX) allergies. The gynecologist used CHX for the vaginal preparation and wore latex-containing gloves with lubricating gel during the examination. In vivo and in vitro tests revealed CHX sensitization by a positive skin prick test to chlorhexidine at a very low concentration (0.002 mg/mL), and a positive basophil activation test to CHX. Latex allergy was confirmed by a positive specific IgE to latex and a positive glove-use test at 20 min. An analysis of specific IgE to latex component revealed positive results for Hev b 1, 5, 6.02, and 11. As she also had a past history of fruit allergy, prick-to-prick testing with latex-related fruits was performed. The results were positive for avocado, banana, jackfruit, kiwi, and longan.
Conclusions:
Concomitant mucosal exposure of both natural rubber latex and CHX in highly sensitized patients during pelvic examinations can lead to severe anaphylaxis. Pre-procedural screening for an allergy to latex or CHX, or to any other allergen, should be performed in patients where there is suspicion of a specific allergy due to a previous allergic reaction. Increased awareness of these two allergens in all healthcare settings may improve patient safety.
Abdominal compartment syndrome caused by massive pyonephrosis in an infant with primary obstructive megaureter
Authors: Silvia K Kavaguti, Barbara R Mackevicius, Murilo F de Andrade, Silvio Tucci Jr, Ana P C P Carlotti
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

The authors report a case of abdominal compartment syndrome caused by massive pyonephrosis in an infant with primary obstructive megaureter successfully treated with emergency surgical decompression.
The Endoscopic Removal of Eroded Foreign Bodies in the Ureter
Authors: David Anthony Kurz, Phillip Mucksavage
Journal: J Endourol Case Rep (2016)
MeSH terms: Case Reports

A complication of using foreign materials in surgery is potential erosion into nearby tissues. The endoscopic removal of foreign bodies that have eroded into the urinary tract is a safe and minimally invasive option that has previously been described, most commonly in the bladder and urethra. We present the case of a patient who had a remote history of a pyeloplasty and was found to have different foreign bodies eroding into the ureter causing symptoms. To our knowledge, this is the first case where a patient presented with two different types of ureteral foreign body erosions that were each effectively treated endoscopically.
A Novel Homozygous TTC7A Missense Mutation Results in Familial Multiple Intestinal Atresia and Combined Immunodeficiency
Authors: Wenjun Mou, Shen Yang, Ruolan Guo, Libing Fu, Li Zhang, Weihong Guo, Jingbin Du, Jianxin He, Qinghua Ren, Chanjuan Hao, Jingang Gui, Jinshi Huang
Journal: Front Immunol (2021)
Keywords: combined immunodeficiency, multiple intestinal atresia, neonatal sepsis, prohibited lymphocyte development, tetratricopeptide repeat domain 7a
MeSH terms: Intestinal Atresia / genetics, Mutation, Missense / genetics, Proteins / genetics, Severe Combined Immunodeficiency / genetics, Case Reports, Research Support, Non-U.S. Gov't, Child, Humans, Intestinal Atresia / immunology, Male, Mutation, Missense / immunology, Proteins / immunology, Severe Combined Immunodeficiency / immunology, Proteins, TTC7A protein, human, Intestinal Atresia, Multiple

Rare autosomal-recessive variants in tetratricopeptide repeat domain 7A (TTC7A) gene have been shown to cause intestinal and immune disorders of variable severity. Missense mutations in TTC7A gene, usually retaining most of the functional motifs, is associated with relative milder clinical presentations. In this study, we reported a patient who was suffering from severe multiple intestinal atresia (MIA) with combined immunodeficiency (CID) that led to the pyloric diaphragm, ileum atresia, colon stenosis, and multiple episodes of sepsis. In spite of several surgeries and supportive treatment, the patient died of severe sepsis and multiple organ failure at age of 3 months. The whole exome sequencing (WES) of peripheral blood samples identified a novel homozygous TTC7A missense mutation (c. 206T>C, p. L69P), inherited from his parents with consanguineous marriage. In silico analysis revealed that a hydrogen bond present between Gly65 and Leu69 in the wild-type TTC7A was disrupted by the Leu69Pro mutation. Moreover, this homozygous missense mutation led to a reduced TTC7A expression in lymphocytes and intestinal tissues, accompanied by impeded lymphocyte development. Further studies demonstrated that the PI4K-FAM126A-EFR3A pathway was impaired in colon tissues. Our data strongly support the linkage of severe MIA-CID with the missense mutation in TTC7A gene. More knowledge of the TTC7A protein functions will have important therapeutic implications for patients with MIA-CID.
Pleomorphic adenoma of hard palate: a case report
Authors: Zemmouri Yousra, Chbicheb Saliha
Journal: Pan Afr Med J (2021)
Keywords: benign mixed tumour, case report, hard palate, pleomorphic adenoma, salivary gland
MeSH terms: Adenoma, Pleomorphic / diagnosis, Palatal Neoplasms / diagnosis, Palate, Hard / pathology, Case Reports, Adenoma, Pleomorphic / pathology, Adenoma, Pleomorphic / surgery, Adult, Humans, Male, Palatal Neoplasms / pathology, Palatal Neoplasms / surgery, Palate, Hard / surgery

Pleomorphic adenoma is a benign mixed tumor, which is composed of myoepithelial and epithelial cells. A fibrous capsule separates these cells from the surrounding tissues. Pleomorphic adenoma is the most common salivary gland tumour accounting for 40-70% of all major and minor salivary gland tumours. It is also the commonest minor salivary gland benign tumours accounting for 70% of all tumours. Hard palate is the commonest site followed by upper lip, buccal mucosa, tongue, floor of mouth, retromolar trigone. This case report discusses a case of pleomorphic adenoma of hard palate in an old man after complete excision of the tumour, which was confirmed by a biopsy specimen.
Histoplasmosis cluster, golf course, Canada
Authors: Heather Anderson, Lance Honish, Geoff Taylor, Marcia Johnson, Chrystyna Tovstiuk, Anne Fanning, Gregory Tyrrell, Robert Rennie, Joy Jaipaul, Crystal Sand, Steven Probert
Journal: Emerg Infect Dis (2006)
MeSH terms: Disease Outbreaks, Golf, Histoplasmosis / epidemiology, Case Reports, Adolescent, Adult, Canada / epidemiology, Female, Humans, Lung Diseases, Fungal / epidemiology, Male

We report a cluster of 4 cases of acute histoplasmosis (1 culture proven and 3 with positive serology, of which 2 were symptomatic) associated with exposure to soil during a golf course renovation. Patients in western Canada with compatible symptoms should be tested for histoplasmosis, regardless of their travel or exposure history.
Sexual and reproductive health knowledge and behavior among adolescents living with HIV in Zambia: a case study
Authors: Therese Ntigwa Ndongmo, Clement Bertin Ndongmo, Charles Michelo
Journal: Pan Afr Med J (2017)
Keywords: hiv, zambia, adolescents, knowledge and behavior, sexual reproductive health
MeSH terms: HIV Infections / epidemiology, Health Knowledge, Attitudes, Practice, Reproductive Health / statistics & numerical data, Sexual Behavior / statistics & numerical data, Adolescent, Child, Cross-Sectional Studies, Female, Health Services Needs and Demand, Health Surveys, Humans, Male, Pregnancy, Pregnancy in Adolescence / statistics & numerical data, Sexually Transmitted Diseases / epidemiology, Young Adult, Zambia / epidemiology

Introduction:
As HIV infected adolescents mature into adulthood, they are confronted with issues related to sexuality and sexual reproductive health (SRH). An estimated 68,000 adolescents aged 10-19 years are living with HIV in Zambia. The current study explores their sexuality and SRH experience and needs.
Methods:
This was a mixed method analytical cross-sectional study. Adolescents at a tertiary hospital were surveyed on their sexuality and SRH experiences. Bivariate analyses on SPSS were used to assess factors associated with selected behaviors. Emerging themes from open-ended questions qualitative data were explored using content analysis.
Results:
A total of 148 adolescents (63.5% females) aged 15-19 years were surveyed. Majority (77.0%) had secondary education; 77.2% currently in school; 40.1 % had a boy or girlfriend; 15.1% have ever had sex, of whom only 61.1 % reported consistent condom use. About 68.9 % expressed intention to have children; 2.1% of girls had been pregnant before. Of 52 respondents, 19.2% had a sexually transmitted infection (STI) before. Not being in school was a significant predictor, for knowing where to access information about sex (OR= 2.53; 95% CI:1.10-5.82; p=0.02), and also for ever gone there (OR=2.61; 95% CI:1.04-6.58; p=0.03).
Conclusion:
The survey of HIV infected adolescents attending a tertiary hospital in Zambia found that their sexuality and SRH needs remain similar to those of the general adolescent population in terms of counseling in sexual matters, family planning and STI services. More efforts are needed to provide for adolescent health care needs, especially those living with HIV.
An Atypical Case of Bartonella henselae Osteomyelitis and Hepatic Disease
Authors: Dionna M Mathews, Katie M Vance, Pamela M McMahon, Catherine Boston, Michael T Bolton
Journal: Case Rep Pediatr (2018)
MeSH terms: Case Reports

Bartonella henselae is a Gram-negative bacterium and the causative agent of cat scratch disease (CSD). Atypical presentations of B. henselae that involve the musculoskeletal, hepatosplenic, cardiac, or neurologic systems are rare. In this case report, we describe a case of B. henselae osteomyelitis involving bilateral iliac bones complicated by hepatic lesions in a 12-year-old immunocompetent female patient. Although B. henselae is a rare cause of osteomyelitis, it should be considered when patients who present with fever, pain, and lymphadenopathy do not respond to routine osteomyelitis therapy.
Chemotherapy-induced toxic epidermal necrolysis in a patient with multiple myeloma, a case report and literature review
Authors: Rui X, Meidan W, Gongqiang W, Longyi Z, Xiaoxia W, Wei C, Chenhui W
Journal: Front Oncol (2023)
Keywords: stevens–johnson syndrome, adverse drug reaction, lenalidomide, multiple myeloma, toxic epidermal necrolysis, tumor microenvironment
MeSH terms: Case Reports

Rationale and patient concerns:
Toxic epidermal necrolysis (TEN) and Stevens-Johnson syndrome (SJS) are severe drug-induced skin reactions associated with a high mortality rate. The patient in this case report developed TEN after receiving the Velcade-lenalidomide-dexamethasone (VRD) regimen for the treatment of multiple myeloma (MM). The patient's concerns included the progression of the rash, pain, itching, and potential long-term complications. TEN is a life-threatening condition that requires prompt medical intervention and hospitalization.
Interventions:
The treatment approach for the patient included discontinuation of the causative medication (lenalidomide) and comprehensive supportive therapy. Supportive measures included the administration of systemic corticosteroids (methylprednisolone), intravenous immunoglobulin infusion, pain relief medication (ebastine), antibiotic prophylaxis, laminar bed use, and regular dressing changes. The goal was to alleviate symptoms, promote skin and mucous membrane healing, and prevent complications such as infection.
Diagnosis:
The patient was diagnosed with stage III A DS and stage III ISS MM, specifically of the immunoglobulin G (λ) type. Diagnostic procedures included CT and MRI scans, bone marrow testing through flow cytometry and morphology analysis, and laboratory tests to assess blood markers. The diagnosis of TEN was made based on the clinical presentation, skin biopsy, and exclusion of other potential causes.
Outcomes:
With the implemented interventions, the patient's condition gradually improved, and the rash resolved without any residual scarring. The patient's skin and mucosa healed, blood markers improved, and bone pain was relieved. The patient was discharged within a month of receiving the final treatment with bortezomib and dexamethasone. The patient got partial response(PR) of multiple myeloma.
Lessons:
Drug-induced SJS/TEN is more prevalent in Asian populations, potentially due to differences in human leukocyte antigen (HLA) alleles. The use of systemic corticosteroid therapy in SJS/TEN cases is controversial due to the potential risks of immune suppression and complications. Balancing the immune response to prevent SJS/TEN while maintaining an effective cytotoxic immune response for tumor control remains a challenge. Lenalidomide, an immunomodulatory agent, can enhance antitumor immune responses but also contribute to the pathogenesis of SJS/TEN. Increased awareness of HLA variations and frequently mutated genes in different malignancies can help prevent SJS/TEN and improve patient outcomes.
Severe Short Stature in an Adolescent Male with Prader-Willi Syndrome and Congenital Adrenal Hyperplasia: A Therapeutic Conundrum
Authors: Meredith Wasserman, Erin M Mulvihill, Angela Ganan-Soto, Serife Uysal, Jose Bernardo Quintos
Journal: Case Rep Endocrinol (2017)
MeSH terms: Case Reports

Congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency results in excess androgen production which can lead to early epiphyseal fusion and short stature. Prader-Willi syndrome (PWS) is a genetic disorder resulting from a defect on chromosome 15 due to paternal deletion, maternal uniparental disomy, or imprinting defect. Ninety percent of patients with PWS have short stature. In this article we report a patient with simple-virilizing CAH and PWS who was overtreated with glucocorticoids for CAH and not supplemented with growth hormone for PWS, resulting in a significantly short adult height.
Atraumatic Left Distal Radial Artery Aneurysm
Authors: Joseph Maalouly, Dany Aouad, Elias Saidy, Antonios Tawk, Georges Baaklini, Chawki Cortbawi
Journal: Case Rep Orthop (2019)
MeSH terms: Case Reports

Distal radial artery aneurysms are an uncommon pathological entity in the field of surgery. Moreover, distal radial artery aneurysms of idiopathic etiology are even rarer. Herein, we present a rare case of idiopathic/atraumatic left radial artery aneurysm. A 73-year-old female patient presented with a chief complaint of a pulsatile mass located on her left wrist. Radiological imaging showed the presence of a distal radial artery aneurysm which was successfully surgically excised with subsequent ligation of the radial artery. Some of the etiologies and operative management of distal radial artery aneurysm in the anatomical snuffbox to what is in accordance with the literature are discussed. Distal radial artery aneurysms are rare. Hence, their misdiagnosis may lead to wrongful management and increase in morbidity. The appropriate management of distal radial aneurysm is almost always surgical.
Colorectal microcarcinoids in association with long-term exposure to urinary content: a case report and review of the literature
Authors: Grace W Weyant, Dipti M Karamchandani, Negar Rassaei
Journal: Case Rep Pathol (2015)

Long-term exposure of colonic mucosa to urinary content and its association with increased risk of infection, mechanical and biochemical irritation, and malignancy have been described in the literature. Existing case reports and studies depict the low but distinct risk of malignancy in gastrointestinal segments which come in contact with urinary content as a result of surgical correction of urinary tract abnormalities. However, these reports are largely limited to colonic adenocarcinoma and urothelial cell carcinoma. Late urointestinal carcinoma in patients with ileal incorporation into the urinary tract has also been reported. To the best of our knowledge, however, there is only one case report documenting neuroendocrine (NE) cell hyperplasia in colonic mucosa after long-term cystoplasty. Our case is the first to describe microcarcinoids and diffuse NE hyperplasia occurring in a patient with congenital anorectal anomalies, resulting in long-term exposure of colonic mucosa to fecal stream and urinary content. This case, in conjunction with the reported cases in the literature, raises the distinct possibility of an association between exposure of colonic mucosa to urine and long-term development of malignancy, including NE neoplasms.
Postmenopausal tuberculosis endometritis
Authors: Kemal Güngördük, Volkan Ulker, Ahmet Sahbaz, Cemal Ark, Ali Ismet Tekirdag
Journal: Infect Dis Obstet Gynecol (2007)
MeSH terms: Endometritis / microbiology, Endometrium / diagnostic imaging, Endometrium / pathology, Mycobacterium tuberculosis / isolation & purification, Postmenopause, Tuberculosis, Female Genital / diagnostic imaging, Tuberculosis, Female Genital / microbiology, Tuberculosis, Female Genital / pathology, Case Reports, Endometritis / diagnostic imaging, Endometritis / pathology, Female, Humans, Middle Aged, Mycobacterium tuberculosis / genetics, Ultrasonography, Uterine Hemorrhage / microbiology, Uterine Hemorrhage / pathology

Tuberculosis remains a global health problem, primarily in developing countries with inadequate health services. A significant portion of tuberculosis in these settings is extrapulmonary, including tuberculosis of the genitourinary tract. Patients with genital tuberculosis are usually young women detected during work up for infertility. After menopause, tuberculosis of the endometrium is a rare possibility probably because of the decreased vascularity of the tissues. We present a case of endometrial tuberculosis with postmenopausal vaginal bleeding.
Low carbohydrate diet-based intervention for obstructive sleep apnea and primary hypothyroidism in an obese Japanese man
Authors: Yoshio Tokuchi, Yayoi Nakamura, Yusuke Munekata, Fumio Tokuchi
Journal: Asia Pac Fam Med (2016)
Keywords: continuous positive airway pressure, hypothyroidism, levothyroxine replacement, low-carbohydrate diet, obesity, obstructive sleep apnea
MeSH terms: Case Reports

Background:
Obesity is a major risk factor for obstructive sleep apnea (OSA), and weight loss is necessary in the overall management of obese patients with OSA. However, primary care physicians can provide only limited weight loss with lifestyle interventions, usually reducing a patient's body weight by only 2.5 kg or less after 6-18 months.
Case presentation:
A 45-year-old Japanese man was referred to our clinic owing to obesity, daytime sleepiness, and snoring during sleep. His weight was 130.7 kg and his body mass index (BMI) was 41.0 kg/m(2). He underwent polysomnography, which revealed OSA with an apnea-hypopnea index of 71.2 events/h (normal, <5 events/h). His laboratory results were as follows: thyroid stimulating hormone, >500 μIU/mL; free triiodothyronine, 1.4 pg/mL; free thyroxine, <0.15 ng/dL; thyroid peroxidase antibody, 10 IU/mL; thyroglobulin antibody, >4000 IU/mL; total cholesterol (TC), 335 mg/dL; high-density lipoprotein cholesterol, 45 mg/dL; triglycerides (TGs), 211 mg/dL; low-density lipoprotein cholesterol, 248 mg/dL; fasting blood sugar, 86 mg/dL; and glycated hemoglobin (HbA1c), 6.1 %. These results showed that he also had primary hypothyroidism (Hashimoto's disease). Continuous positive airway pressure (CPAP), levothyroxine replacement, and a low-carbohydrate diet (LCD) were initiated. CPAP use and a euthyroid condition induced by 175 μg/day levothyroxine allowed the patient to proactively reduce his body weight. After 18 months, the patient achieved a weight reduction of 32.4 kg (25 % of his initial weight) and a BMI reduction of 10.2 kg/m(2), as well as improved laboratory results, including an HbA1c level of 5.3 %, TC level of 194 mg/dL, and TG level of 89 mg/dL.
Conclusion:
An LCD may be an effective intervention for weight loss in obese Japanese patients with OSA. Further studies are needed to investigate the weight loss effect of an LCD compared with a conventional calorie-restricted diet. Hopefully, this case report will help to improve the management of obese Asian patients with OSA who typically consume a higher amount of carbohydrates.