OpenMed/multicare-articles huggingface dataset:
Severe Rhabdomyolysis as Complication of Interaction between Atorvastatin and Fusidic Acid in a Patient in Lifelong Antibiotic Prophylaxis: A Dangerous Combination
Authors: Anirban Nandy, Shahin Gaïni
Journal: Case Rep Med (2016)
MeSH terms: Case Reports

Atorvastatin and HMG-CoA reductase inhibitors are the most frequently used medication in the world due to very few adverse toxic side effects. One potentially life threatening adverse effect is caused by clinically significant statin induced rhabdomyolysis, either independently or in combination with fusidic acid. The patient in our case who previously had cardiac insufficiency, atrial fibrillation, and thoracic aorta aneurysm and was treated with insertion of an endovascular metallic stent in the aorta is presented in the report. He had an inoperable aortitis with an infected stent and para-aortic abscesses with no identified microorganism. The patient responded well to empirical antibiotic treatment with combination therapy of fusidic acid and moxifloxacin. This treatment was planned as a lifelong prophylactic treatment. The patient had been treated with atorvastatin for several years. He developed severe rhabdomyolysis when he was started on fusidic acid and moxifloxacin. The patient made a fast recovery after termination of treatment with atorvastatin and fusidic acid. We here report a life threatening complication of rhabdomyolysis that physicians must be aware of. This can happen either in atorvastatin monotherapy or as a complication of pharmacokinetic interaction between atorvastatin and fusidic acid.
Chronic Hepatitis C with Cyanosis
Authors: Mahmood Alawainati, Jawad Khamis, Muneer Abdulla, Saeed Alsaeed
Journal: Case Reports Hepatol (2019)
MeSH terms: Case Reports

Background:
There are multiple aetiologies for dyspnea in patients with liver disease, including pneumonia, pulmonary embolism, hepatic hydrothorax, portopulmonary syndrome, and hepatopulmonary syndrome. The aim of this paper is to emphasize the importance of early diagnosis and management of hepatopulmonary syndrome.
Case presentation:
We report a case of a 65-year-old male who was known to have chronic hepatitis C presented with one-year history of shortness of breath and cyanosis. The initial impression of pulmonary embolism was excluded by comprehensive diagnostic investigations. The correlation between the clinical picture and investigations raised the possibility of hepatopulmonary syndrome which was confirmed by contrast-enhanced transthoracic echocardiography.
Conclusions:
High suspicion is required to diagnose hepatopulmonary syndrome in patients with liver disease and hypoxemia. Screening for this complication is appropriate in liver transplant candidates, and diagnosed patients should be evaluated extensively for liver transplant.
Gene Therapy Using Plasmid DNA Encoding Vascular Endothelial Growth Factor 164 and Fibroblast Growth Factor 2 Genes for the Treatment of Horse Tendinitis and Desmitis: Case Reports
Authors: Milomir Kovac, Yaroslav A Litvin, Ruslan O Aliev, Elena Yu Zakirova, Catrin S Rutland, Andrey P Kiyasov, Albert A Rizvanov
Journal: Front Vet Sci (2017)
Keywords: fibroblast growth factor, gene therapy, horse, suspensory ligament, tendon, vascular endothelial growth factor
MeSH terms: Case Reports

In this clinical study, for the first time we used the direct gene therapy to restore severe injuries of the suspensory ligament branch and superficial digital flexor tendon in horses (Equus caballus). We injected the plasmid DNA encoding two therapeutic species-specific growth factors: vascular endothelial growth factor 164 and fibroblast growth factor 2 at the site of injury in the suspensory ligament branch and tendon. Treatment effects were evaluated with the use of clinical observation and ultrasound imaging during a period of a few months. We showed that gene therapy used within a period of 2-3 months after the injury resulted in the complete recovery of functions and full restoration of the severely damaged suspensory ligament and superficial digital flexor tendon.
Mediastinal lymph node metastases in lung cancer presenting as pure ground-glass nodules: A surgical case report
Authors: Yohei Honda, Soichi Oka, Yasuhiro Chikaishi, Masaaki Inoue, Junichi Yoshida, Daisei Yasuda
Journal: Int J Surg Case Rep (2020)
Keywords: bulla wall, mediastinal lymph nodes metastases, multifocal ground-glass nodules, pure ground-glass nodules
MeSH terms: Case Reports

Introduction:
Generally, lung cancer representing as Ground-glass nodules is associated with an early stage and good prognosis. However, we herein report a rare case of pure ground-glass nodules with mediastinal lymph node metastases.
Presentation of case:
A 69-year-old man underwent video assisted thoracic surgery right upper lobectomy with mediastinal lymph node dissection due to multifocal Ground-glass nodules in the right upper lobe of the lung. Histopathologically, six lung adenocarcinomas were present simultaneously. Furthermore, we detected mediastinal lymph nodes metastases that contain micropapillary component. The lung lesion containing micropapillary component was a pure Ground-glass nodule that adjoining pulmonary bulla on CT findings.
Discussion:
Generally, lung cancer presenting as pure ground-glass nodules is associated with an early stage and good prognosis. However, the necessity of evaluating the mediastinal lymph nodes in pure ground-glass nodules is controversial. It is reported that lung cancer adjoining the wall of a bulla tends to have a poor prognosis, even when small in size. Therefore, Ground-glass nodules with metastases might have a different pathogenesis than other nodules.
Conclusion:
Adenocarcinoma appearing as pure Ground-glass nodules is associated with early stage lung cancer and a good prognosis. However, the findings in our patient indicate the importance and necessity of evaluating the mediastinal lymph nodes for metastases intraoperatively.
Mesenchymal Stem Cell Therapy Overcomes Steroid Resistance in Severe Gastrointestinal Acute Graft-Versus-Host Disease
Authors: Kyoko Moritani, Reiji Miyawaki, Kiriko Tokuda, Fumihiro Ochi, Minenori Eguchi-Ishimae, Hisamichi Tauchi, Mariko Eguchi, Eiichi Ishii, Kozo Nagai
Journal: Case Rep Transplant (2019)
MeSH terms: Case Reports

The authors describe the high effectiveness of human mesenchymal stem cell (hMSC) therapy to treat steroid-refractory gastrointestinal acute graft-versus-host Disease (aGVHD) in a 15-year-old boy with acute lymphoblastic leukemia (ALL). He received allogeneic hematopoietic stem cell transplantation due to high-risk hypodiploid ALL. Around the time of engraftment, he developed severe diarrhea following high-grade fever and erythema. Although methylprednisolone pulse therapy was added to tacrolimus and mycophenolate mofetil, diarrhea progressed up to 5000~6000 ml/day and brought about hypocalcemia, hypoalbuminemia, and edema. Daily fresh frozen plasma (FFP), albumin, and calcium replacements were required to maintain blood circulation. After aGVHD was confirmed by colonoscopic biopsy, MSC therapy was administered. The patient received 8 biweekly intravenous infusions of 2×106 hMSCs/kg for 4 weeks, after which additional 4 weekly infusions were performed. A few weeks after initiation, diarrhea gradually resolved, and at the eighth dose of hMSC, lab data improved without replacements. MSC therapy successfully treated steroid-refractory gastrointestinal GVHD without complications. Despite life-threatening diarrhea, the regeneration potential of children and adolescents undergoing SMC therapy successfully supports restoration of gastrointestinal damage. Even with its high treatment costs, SMC therapy should be proactively considered in cases where young patients suffer from severe gastrointestinal GVHD.
Zinner's Syndrome: A Rare Diagnosis of Dysuria Based on Imaging
Authors: Ahmed Ibrahimi, Abdelmoughit Hosni, Idriss Ziani, Fatima Zahra Laamrani, Hachem El Sayegh, Laila Jroundi, Lounis Benslimane, Yassine Nouini
Journal: Case Rep Urol (2020)
MeSH terms: Case Reports

Zinner's syndrome is a rare congenital malformation of the seminal vesicle and ipsilateral upper urinary tract, due to developmental arrest in early embryogenesis of the Müllerian duct. Clinical presentation is nonspecific and includes voiding symptoms such as dysuria, ejaculatory disorders, and hypogastric or perineal pain. The diagnosis is made with imaging techniques, notably Magnetic Resonance Imaging (MRI) which remains the gold standard exam for diagnosis confirmation and therapeutic management. Treatment options depend on the severity of symptoms, the size of the cyst, and the complications. Herein, we report a rare case of a 33-year-old young patient who presented recurrent dysuria and ejaculatory disorders for the last 5 years. Imaging studies revealed an empty left renal fossa, with cystic pelvic mass related to the seminal vesicle and which was compatible with the diagnosis of Zinner's syndrome. The patient underwent successful laparoscopic removal of the cyst and seminal vesicle, with total disappearance of urinary and sexual complaints with a 3-year follow-up.
Woven Coronary Artery Disease Successfully Managed with Percutaneous Coronary Intervention: A New Case Report
Authors: Yakup Alsancak, Burak Sezenoz, Sedat Turkoglu, Adnan Abacı
Journal: Case Rep Cardiol (2015)

Woven coronary artery is relatively rare and can be complicated in both acute and chronic phases. A few case reports have been published until now. Herein we report a case with right woven coronary artery managed with drug-eluted stent implantation without complication.
Kounis Syndrome as First Manifestation of Allergic Sensitization
Authors: D Forlani, G Scarano, A D'Alleva, M Di Marco, L Paloscia, A Gatta, L Della Valle, A Farinelli, A Lumaca, C Petrarca, R Paganelli, L Di Giampaolo, M Di Gioacchino
Journal: Case Rep Med (2019)
MeSH terms: Case Reports

Mast cells are abundant in the heart, among myocardial fibers, around coronary arteries, within arterial intima and intramural vessels, and in atherosclerotic plaques. Their mediators can be released during anaphylaxis and be responsible for acute coronary syndrome. This condition has been described as Kounis syndrome (KS). We report three cases of acute myocardial ischemia, which fulfill the definition for KS. In Cases 1 and 2, the association of intense chest pain with acute urticaria after an allergenic contact (wasp sting and betalactam antibiotic administration, respectively) was suspected to be an attack of angina related to an allergic reaction. No signs of an allergic reaction were observed in Case 3, but only the history of a wasp sting suggested its relationship to loss of consciousness and heart ischemia when hypersensitivity to venom was ascertained. These cases strongly recommend measurement of anaphylactic biomarkers, such as tryptase, during acute coronary syndromes to detect the possible involvement of an allergic reaction. Conversely, measurement of cardiac biomarkers during anaphylaxis, even without obvious signs of myocardial ischemia, might identify patients at risk of myocardial injury.
Extremely varied phenotypes in granular corneal dystrophy type 2 heterozygotes
Authors: Kyung Eun Han, Seung-il Choi, Woo Suk Chung, Se Hwan Jung, Nicholas Katsanis, Tae-im Kim, Eung Kweon Kim
Journal: Mol Vis (2012)
MeSH terms: Asian People / genetics, Cornea / metabolism, Corneal Dystrophies, Hereditary / genetics, Extracellular Matrix Proteins / genetics, Transforming Growth Factor beta / genetics, Research Support, Non-U.S. Gov't, Adult, Aged, Aged, 80 and over, Case-Control Studies, Cells, Cultured, Cornea / pathology, Corneal Dystrophies, Hereditary / metabolism, Corneal Dystrophies, Hereditary / pathology, DNA Mutational Analysis, Female, Fibroblasts / metabolism, Fibroblasts / pathology, Gene Expression, Genetic Variation, Heterozygote, Humans, Male, Middle Aged, Pedigree, Phenotype, Severity of Illness Index, Extracellular Matrix Proteins, Transforming Growth Factor beta, betaIG-H3 protein, Corneal dystrophy Avellino type

Purpose:
To investigate the phenotypic variability of patients bearing the heterozygous R124H mutation in the TGFBI (transforming growth factor-beta-induced) gene that causes granular corneal dystrophy type 2 (GCD2).
Methods:
We describe the phenotypic range of GCD2 heterozygotes for the common R124H mutation in TGFBI; seven with an extremely mild phenotype and six with an extremely severe phenotype. Detailed slit-lamp photographs of these patients were generated. All patients had no history of ocular surgery and were diagnosed as being heterozygous for GCD2 by DNA analysis from peripheral blood. Expression levels of transforming growth factor-beta-induced protein (TGFBIp) were compared among cultured corneal fibroblasts from ten normal donors.
Results:
We report profound differences in the severity of the phenotype across our case series. Two patients with a mild phenotype were diagnosed as unaffected at presentation; however follow-up examinations revealed granular deposits. Importantly, we also observed familial clustering of phenotypic variance; five patients from two families with a mild phenotype showed a similarly mild phenotype within family members. Similarly, six patients from two families with severe phenotypes showed corneal deposits with similar patterns and severity within each distinct family, but distinct patterns between families. TGFBIp expressions from different donor derived cultured corneal fibroblasts were different between one another.
Conclusions:
GCD2 heterozygotes have extremely varied phenotypes between individual patients. However phenotypes were broadly consistent within families, suggesting that the observed variable expressivity might be regulated by other genetic factors that could influence the abundance of TGFBIp or the function of the pathway. From a clinical perspective, our data also highlighted that genetic analysis and meticulous slit-lamp examination in both eyes at multiple time intervals is necessary.
Primary Hypothyroidism with Pituitary Hyperplasia in an Omani Girl
Authors: Wafa Abdallah Fadle, Ali Al Reesi, Saud Al-Shabibi, Maryam Khamis Al-Badi
Journal: Case Rep Endocrinol (2022)
MeSH terms: Case Reports

Pituitary hyperplasia secondary to primary hypothyroidism (PHPH) is uncommon in children and is reversible with thyroxine therapy. We report an Omani girl who presented at the age of 13 years and 6 months with profound primary hypothyroidism due to Hashimoto's thyroiditis and secondary pituitary hyperplasia and hyperprolactinemia. Pituitary magnetic resonance imaging confirmed the presence of pituitary hyperplasia which regressed during follow-up after the administration of thyroxine therapy. The diagnosis of PHPH is very important in both children and adults in order to avoid unnecessary brain surgery or medical treatment for a presumed pituitary mass or adenoma. To our knowledge, this patient represents the first case of an Omani child presenting with PHPH.
Non-typhoidal Salmonella myocarditis in an immunocompetent young adult with diarrhea
Authors: Lamprini Markaki, Nikolaos Spernovasilis, Dimitris Lempidakis, Evangelos Kokorakis, Ioannis Gialamas, Stylianos Petousis, Diamantis Kofteridis, Emmanuel Simantirakis
Journal: Pan Afr Med J (2019)
Keywords: salmonella, immunocompetent, myocarditis
MeSH terms: Diarrhea / microbiology, Myocarditis / diagnosis, Salmonella Infections / diagnosis, Salmonella enterica / isolation & purification, Case Reports, Adult, Humans, Immunocompetence, Male, Myocarditis / microbiology, Salmonella Infections / microbiology

Myocarditis is the inflammation of the heart muscle and it is caused by a wide range of infectious and non-infectious conditions. Non-typhoidal Salmonella infection, a common foodborne illness worldwide, only rarely causes myocarditis. We describe a case of an immunocompetent adult with Salmonella enterica serovar Typhimurium myocarditis who had a favorable outcome due to early recognition of the causative factor and prompt initiation of appropriate treatment.
Severe Immune Thrombocytopenia Following MMR Vaccination with Rapid Recovery: A Case Report and Review of Literature
Authors: Majd Akbik, Dima Naddeh, Anas A Ashour, Azzam Ashour
Journal: Int Med Case Rep J (2020)
Keywords: mmr vaccine, case report, immune thrombocytopenia, thrombocytopenia
MeSH terms: Case Reports

Immune thrombocytopenia (ITP) is an autoimmune disease that occurs following viral illnesses and may also infrequently occur after measles, mumps, and rubella (MMR) vaccination. ITP typically presents with the sudden appearance of a petechial rash, bruising, and/or bleeding in an otherwise healthy-appearing child. However, ITP following MMR vaccine does not commonly cause severely depleted platelets. We report a case of ITP after MMR vaccination in a 13-month-old baby boy, who presented with petechial rash all over his body. The child had severe thrombocytopenia but was successfully treated with a single dose of intravenous immunoglobulin without complications. The study highlights that ITP post-MMR vaccine is an easily treatable condition.
Isolated gastrointestinal metastasis of breast carcinoma: a case report
Authors: M A Titi, A Anabtawi, A D Newland
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Purpose. Gastrointestinal tract is one of the rare locations for breast cancer metastasis. This paper shows such metastasis may occur even in the absence of breast metastasis in other more common locations. Case Report. A 64-year old female was admitted to the hospital with abdominal discomfort and diarrhea. She had breast carcinoma treated 7 years previously with normal follow-up since. Colonoscopy showed hepatic flexure thickening that was confirmed to be breast metastasis. Staging investigations showed upper and lower gastrointestinal tract metastasis with negative findings elsewhere. Conclusion. Although more common causes for gastrointestinal symptoms should be excluded, however, a high index of suspicion of metastatic breast cancer is needed when such patients develop gastrointestinal symptoms.
Autonomic hyperreflexia after spinal cord injury managed successfully with intravenous lidocaine: a case report
Authors: Pedro Leão, Paulo Figueiredo
Journal: Patient Saf Surg (2016)
Keywords: autonomic hyperreflexia, intravenous lidocaine, patient safety, spinal cord injury
MeSH terms: Case Reports

Background:
Some paraplegic patients may wish undergo some surgical procedures, like urological procedures, without anesthesia. However, these patients can develop autonomic hyperreflexia if cystoscopy is performed without anesthesia.
Case presentation:
We present a case of severe autonomic hyperreflexia in a 44-year-old male with spinal cord injury at the level of T4 during urologic procedure under sedation and analgesia successfully treated with intravenous lidocaine.
Conclusions:
This case illustrates that patients with spinal cord injuries are likely to develop autonomic hyperreflexia during urological procedures performed without anesthesia. Health professionals should educate spinal cord injury patients regarding risks of this serious condition and be aware to prevent and manage autonomic hyperreflexia. In an acute episode, nifedipine, nitrates and captopril are the most commonly used and recommended agents. To our knowledge, this is the first case report of severe autonomic hyperreflexia treated successfully with intravenous lidocaine.
Giant Omphalocele Complicated by Postoperative Duodenal Obstruction
Authors: Sunita Ojha, Shobha Parashar, Dharmil Doshi, Rajiv Kumar Bansal
Journal: APSP J Case Rep (2017)
Keywords: duodenal obstruction, giant omphalocele, postoperative complication
MeSH terms: Case Reports

Omphalocele is a congenital defect in the abdominal wall, usually treated at birth or within 1-2 years of life depending on condition of patient and size and contents of the defect. We repaired a giant omphalocele without mesh in a 9-year-old girl. She developed duodenal obstruction in the postoperative period requiring another laparotomy and duodeno-jejunostomy to bypass obstruction.
Ovarian Mixed Malignant Brenner-Mucinous Tumor with Signet Ring Cells
Authors: Baharak Khadang, Atilla Omeroglu
Journal: Case Rep Pathol (2020)
MeSH terms: Case Reports

Mucinous carcinomas with signet ring cells in the ovary, particularly those composed predominantly of signet ring cells, are extremely rare, and in vast majority of cases, they represent metastasis from another site such as the stomach, appendix, pancreaticobiliary tract, bladder, and breast (Hristov et al., 2007, Kiyokawa et al., 2006, Vang et al., 2006, Young, 2006). Malignant Brenner tumor is also rare comprising less than 0.5% of ovarian carcinoma. Although mixed Brenner-Mucinous tumors are relatively common, the combination of a primary ovarian signet ring carcinoma with a malignant Brenner tumor is unique and to the best of our knowledge not previously reported in the literature.
Scrotal calcinosis: a case report and review of pathogenesis and surgical management
Authors: Usman M Tela, M Bashir Ibrahim
Journal: Case Rep Urol (2012)

Idiopathic scrotal calcinosis is an uncommon benign disorder of the scrotal skin which is characterized by multiple calcified intradermal nodules. We report a 33-year old with asymptomatic multiple calcified scrotal skin nodules. He had wide excision of the lesions and direct closure of the scrotum. We review the pathogenesis and surgical treatment options for this rare disease of the scrotum.
Case report: Artery of Percheron infarction as a rare complication during atrial fibrillation ablation
Authors: Xin Xie, Xuecheng Wang, Jinbo Yu, Xiaoqian Zhou, Liya Shi, Jian Zhou, Yizhang Wu, Zijun Chen, Baowei Zhang, Xiaorong Li, Bing Yang
Journal: Front Cardiovasc Med (2022)
Keywords: artery of percheron, atrial fibrillation, catheter ablation, complication, stroke
MeSH terms: Case Reports

The incidence of stroke or transient ischemic attacks (TIA) in atrial fibrillation (AF) catheter ablation procedures is around 1% and may be unnoted under anesthesia. The artery of Percheron (AOP) infarction is a rare kind of stroke with heterogeneity in manifestation, which further makes the perioperative early detection and diagnosis a challenge. Herein, we present one patient who underwent AF ablation and presented mental status alteration after withdrawing anesthetics. An emergency head CT was obtained, which revealed no apparent pathological changes. A late MRI test confirmed the diagnosis of AOP infarction. With oral anticoagulants and rehabilitation therapies, the patient's awareness improved and fully recovered on the sixth-month follow-up. Variability in manifestation, no positive radiological finding on initial CT, and a low incidence has made few clinicians to gain much experience with this type of infarct, which delays the diagnosis and initiation of appropriate treatment.