OpenMed/multicare-articles huggingface dataset:
Moderate hyperosmolar hyponatremia caused by excessive off-label use of icodextrin during peritoneal dialysis
Authors: Harshad Chaudhari, Smita Mahendrakar, Apokbo Akporotu, Michael Yudd
Journal: Clin Nephrol Case Stud (2023)
Keywords: hyponatremia, icodextrin, osmolal gap, peritoneal dialysis
MeSH terms: Case Reports

Icodextrin use during the long dwell of a peritoneal dialysis (PD) regimen is commonly used to increase ultrafiltration. Its use may cause a mild and clinically insignificant degree of hyponatremia. We describe a patient who was admitted twice to our medical center on an atypical continuous ambulatory peritoneal dialysis (CAPD) regimen utilizing solely icodextrin with 2 exchanges (12-hour dwells). On both admissions, he had hyperosmolar hyponatremia in the 120-mmol/L range with a large osmolal gap. After icodextrin was stopped and his PD prescription was switched to dextrose solutions, both hyponatremia corrected and the osmolal gap quickly disappeared. The accumulation of osmotically active solute in extracellular fluids results in efflux of water from the cellular compartment and produces both hyponatremia and hypertonicity [1]. This tonic effect occurs most frequently with hyperglycemia, but other substances can also cause this, including mannitol, sorbitol, glycine, and maltose [1, 2]. In this report, we present a patient with end-stage renal disease (ERSD) on an atypical off-label PD regimen utilizing solely icodextrin solutions who developed hyperosmolar hyponatremia in the 120-mmol/L range, with a large osmolal gap. This appeared to be due to absorbed metabolites of icodextrin, mainly maltose.
Treatment of congenital short palate using bilateral buccal musculomucosal flaps
Authors: Shinji Kobayashi, Yukie Ohashi, Ryouko Fukushima, Takashi Hirakawa, Toshihiko Fukawa, Toshihiko Satake, Jiro Maegawa
Journal: Case Reports Plast Surg Hand Surg (2020)
Keywords: congenital short palate, levator veli palatini muscle, randall classification, buccal musculomucosal flap, velopharyngeal insufficiency
MeSH terms: Case Reports

A case of congenital short palate was treated by bilateral buccal musculomucosal flaps. The levator veli palatini muscle formed a continuous sling, but the anterior portion was attached to the posterior border of the hard palate. The speech outcome improved from severe to normal.
Classical Hodgkin Lymphoma Presenting with Severe, Recurrent Hypothermic Episodes
Authors: Jonas Juul Hansen, Hans Beier Ommen, Lars Christian Gormsen, Francesco Annibale d'Amore, Peter Martin Hjørnet Kamper
Journal: Case Rep Hematol (2018)
MeSH terms: Case Reports

We report a case presenting with recurrent episodes of severe hypothermia preceding the diagnosis of Hodgkin lymphoma. The episodes of hypothermia were accompanied by other symptoms of autonomic dysfunction, mainly hypotension, which could be caused by autonomic neuropathy as part of a paraneoplastic syndrome. In comparison with previous reports describing an association between the presence of hypothermia and an adverse outcome, the present patient has responded well to lymphoma-specific treatment and is currently in an ongoing complete remission. Due to the peculiar cyclic pattern of the hypothermic episodes presented in this case, we hypothesize whether intermittent release of disease-related chemo- and cytokines could be a plausible pathogenetic explanation.
Mesenteric Lymph Node Recurrence of a Primary Colorectal Leiomyosarcoma
Authors: Amélie Beauchamp, Roy Hajjar, Sharmila Khullar, Mathieu Latour, Frank Schwenter, Herawaty Sebajang
Journal: Case Rep Surg (2020)
MeSH terms: Case Reports

Primary colorectal leiomyosarcoma is an excessively rare entity. It is associated with an aggressive behavior and typically favor hematogenous spread. The current standard of care is surgical resection. A 49-year-old patient presented with a 2-month history of fever. A PET-scan revealed a hypermetabolic mass in the transverse colon, and colonoscopy confirmed a tumor. A right hemicolectomy was performed. Histopathological diagnosis was of a leiomyosarcoma. Fourteen months after the surgery, a follow-up abdominal scan revealed a 2 cm mesenteric lymph node that was hypermetabolic on PET-scan. The mesenteric lymph node was resected and histopathology confirmed a leiomyosarcoma metastasis. This case opens the controversy on the management of rare lymph node recurrences in colorectal leiomyosarcoma.
A Giant Childhood Mesenteric Lipoblastoma With Extensive Maturation
Authors: Anthony I Squillaro, Monica D Chow, Fernando Arias, Evita T Sadimin, Yi-Horng Lee
Journal: Front Pediatr (2020)
Keywords: lipoblastoma, lipoma, mesenteric tumors, pediatric tumors, soft tissue tumors
MeSH terms: Case Reports

Abdominal lipoblastomas are uncommon soft tissue tumors in children and rarely arise from the mesentery. Due to intraabdominal location and slow growth, these masses can go unnoticed for long periods of time and often found on surgical exploration. We present a case of a 12-year-old male with years of abdominal distension accompanied by new onset early satiety that was found to have an intra-abdominal mass. He underwent an exploratory laparotomy revealing a large 33 x 27 x 15 cm rubbery mesenteric mass displacing the entire intra-abdominal contents, connected by a single vascular pedicle and encasing a loop of small intestine. The mass was resected and the patient did well without signs of recurrence. Histology confirmed the presence of mature adipocytes but on further cytogenetic analysis, a translocation between chromosomes 2 and 8 at the 12q arm was detected, which is often associated with lipoblastomas. This case represents the one of the largest mesenteric lipoblastomas that matured extensively to lipoma-like histology at the time of surgical resection.
Chronic recurrent multifocal osteomyelitis with concomitant features of juvenile idiopathic arthritis
Authors: Elena Tsitsami, Vasiliki Dermentzoglou, Mary Moschovi, George P Chrousos
Journal: Case Rep Rheumatol (2011)
MeSH terms: Case Reports, Retracted Publication

We report a case of a 13-year-old girl with chronic recurrent multifocal osteomyelitis (CRMO) who developed severe arthritis in four different joints within the first year from the onset of the disease. Her multiple vertebrae lesions showed significant amelioration after a 2-month treatment with prednisolone. In parallel, the initial severe symmetrical arthritis of both knees showing overt synovitis and joint effusion, in the absence of lesions in the metaphyses of the femur or the tibia, responded remarkably well in intra-articular triamcinolone hexacetonide injections. However, upon discontinuation of prednisolone, the patient developed severe arthritis of her right ankle and the proximal interphalangeal joint of her right middle finger. Thus, prednisolone was reinitiated combined with methotrexate, and the patient went into remission, which persists one year after prednisolone tapering. The appearance of arthritis in both knees in the absence of bone lesions and the emergence of severe arthritis of the ankle after remission of spinal bone lesions suggest that CRMO and juvenile idiopathic arthritis may coexist and be causally related.
Successful Implementation of Extracorporeal Membrane Oxygenation Support as a Bridge to Heart-Lung Transplantation in an Eisenmenger's Syndrome Patient With Paradoxical Coronary Embolism
Authors: James Zhang, Sumit Patel, Leonardo Clavijo, David Laughrun
Journal: J Investig Med High Impact Case Rep (2019)
Keywords: ecmo, eisenmenger’s syndrome, heart-lung transplantation
MeSH terms: Eisenmenger Complex / surgery, Embolism, Paradoxical / complications, Extracorporeal Membrane Oxygenation, Heart-Lung Transplantation, ST Elevation Myocardial Infarction / surgery, Case Reports, Coronary Angiography, Eisenmenger Complex / physiopathology, Electrocardiography, Embolism, Paradoxical / diagnostic imaging, Female, Hemodynamics, Humans, Hypertension, Pulmonary / physiopathology, Hypertension, Pulmonary / surgery, Respiratory Insufficiency / physiopathology, Respiratory Insufficiency / surgery, ST Elevation Myocardial Infarction / diagnostic imaging, Treatment Outcome, Young Adult

We report a case of a 23-year-old female with a history of unrepaired ventricular septal defect and pulmonary arterial hypertension with Eisenmenger's syndrome (ES) presenting with chest pain. Electrocardiography demonstrated new anterior Q waves and anterolateral ST elevations, and coronary angiography revealed a large organized thrombus in the mid-left anterior descending artery consistent with paradoxical coronary embolism. Patient was treated with percutaneous coronary intervention and aggressive anticoagulation management. Intensive care unit course was complicated by respiratory failure requiring intubation due to hospital-acquired pneumonia in the setting of severe pulmonary hypertension. Patient was emergently initiated on veno-venous extracorporeal membrane oxygenation support (ECMO) as a bridge to heart-lung transplantation. After initiation of ECMO, patient displayed significant clinical improvement and underwent successful heart-lung transplantation. This case highlights veno-venous ECMO as a bridge to heart-lung transplantation in acutely decompensated patients with ES, and is the first reported case of paradoxical coronary embolism in a patient with ES.
Severe growing-up phobia, a condition explained in a 14-year-old boy
Authors: Laurencia Perales-Blum, Myrthala Juárez-Treviño, Daniela Escobedo-Belloc
Journal: Case Rep Psychiatry (2014)

We present the clinical case of a 14-year-old boy with gerascophobia or an excessive fear of aging, who felt his body development as a threat, to the point where he took extreme measures to stop or otherwise hide growth. He had a history of separation anxiety, sexual abuse, and suffering bullying. He presented with anxious and depressive symptoms and food restriction, criticized his body image, had negative feelings towards the maturation process, suffered at the thought of being rejected, and was preoccupied with certain physical characteristics. We conducted an analysis of biological, psychological, and environmental factors and their possible interactions and established treatment with psychotherapy and fluoxetine. Because of the favorable results, this approach could be considered a good option in such cases.
Branch facial nerve trauma after superficial temporal artery biopsy: a case report
Authors: Richard A Rison
Journal: J Med Case Rep (2011)

Introduction:
Giant cell arteritis is an emergency requiring prompt diagnosis and treatment. Superficial temporal artery biopsy is the gold diagnostic standard. Complications are few and infrequent; however, facial nerve injury has been reported, leaving an untoward cosmetic outcome. This case report is to the best of our knowledge only the fourth one presented in the available literature so far regarding facial nerve injury from superficial temporal artery biopsy.
Case presentation:
A 73-year-old Caucasian woman presented for neurological evaluation regarding eyebrow and facial asymmetry after a superficial temporal artery biopsy for presumptive giant cell arteritis-induced cephalalgia.
Conclusion:
Damage to branches of the facial nerve may occur after superficial temporal artery biopsy, resulting in eyebrow droop. Although an uncommon and sparsely reported complication, all clinicians of various specialties involved in the care of these patients should be aware of this given the gravity of giant cell arteritis and the widespread use of temporal artery biopsy.
Metastatic malignant melanoma presenting as an appendiceal mucocele
Authors: A A Alduaij, M B Resnick, M Kawata, V E Pricolo
Journal: J Oncol (2011)
MeSH terms: Case Reports

Melanoma metastatic to the appendix is extremely rare. Here we describe a case of a 31-year-old female from Bolivia with a remote history of metastatic malignant melanoma first diagnosed as a cutaneous malignant melanoma ten years prior to this presentation. The patient was being followed for a mucocele which on resection was found to be metastatic melanoma. "Mucocele" is a generic diagnosis that warrants further characterization and treatment.
Secondary headache due to aspergillus sellar abscess simulating a pituitary neoplasm: case report and review of literature
Authors: Wenyao Hong, Yuqing Liu, Mingwu Chen, Kun Lin, Zhengjian Liao, Shengyue Huang
Journal: Springerplus (2015)
Keywords: aspergillus, fungal, pituitary neoplasm, sellar abscess

Fungal sellar abscess is rare. A 42-year-old man was admitted with 2-month headache characterized by right peri-orbital pain. An intrasellar mass was found to be simulated a pituitary neoplasm after magnetic resonance imaging examination, and operated on via an endoscopic trans-sphenoidal approach. Milk-like pus and a mass of ash black mixed and necrotic material were found and removed. Histopathology revealed numerous aspergillus hyphae. Itraconazole was given on a dosage of 200 mg twice a day orally for 6 weeks. No recurrence was observed during follow-up. Complete surgical resection through endoscopic trans-sphenoidal approach combined with systemic anti-fungal therapy, should be considered as the optimal treatment.
Liesegang rings in xanthogranulomatous pyelonephritis: a case report
Authors: Karla Laís Pegas, Maria Isabel Edelweiss, Eduardo Cambruzzi, Cláudio Galleano Zettler
Journal: Patholog Res Int (2010)
MeSH terms: Case Reports

Liesegang rings are concentric noncellular lamellar structures, rarely seen in vivo, occurring as a consequence of the accumulation of insoluble products in a colloidal matrix. These characteristic structures are a rare phenomenon usually found in association with cystic or inflammatory lesions and may be mistaken for parasites. The authors examined Liesegang rings from an inflammatory kidney lesion identified previously as a tumoral lesion on computerized tomography. On microscopic evaluation, Liesegang rings can be mistaken for eggs and larvae of parasites, psammoma bodies and calcification. Special stains like PAS, Grocott, von Kossa and Masson's trichrome facilitate the diagnosis.
Case report: Diarrhea-associated hemolytic uremic syndrome in the Era of COVID-19
Authors: Gina M Richardson, Sharon W Su, Sandra Iragorri
Journal: Front Pediatr (2022)
Keywords: covid-19, shiga toxin-producing e coli, acute kideny injury, case report, hemolytic uremic syndrome, thrombotic microagiopathy
MeSH terms: Case Reports

Over the past two years, a growing number of SARS-CoV-2 infection-associated clinical pediatric phenotypes have been identified, including a hemolytic uremic syndrome (HUS) form of thrombotic microangiopathy. Oregon's high prevalence of Shiga toxin-producing Escherichia coli (STEC) infections gives it a unique perspective to discuss the impact of COVID-19 and HUS. We seek to highlight SARS-CoV-2 as a potential new infectious etiology of severe diarrhea-associated HUS, based on two cases from Portland, Oregon, occurring in non-COVID-19 immunized children. The first case is a previously healthy ten-year-old who presented with SARS-CoV-2 infection and bloody diarrhea after an appendectomy, followed by full-blown oligo-anuric HUS. Second is a previously healthy six-year-old who presented with short-lived bloody diarrhea, rapidly evolving to HUS, and who tested positive for COVID-19 via polymerase chain reaction and STEC toxins one and two. These two cases highlight two main points. First, SARS-CoV-2 must be included in the differential diagnosis of diarrhea-associated HUS, either as the sole agent or concurrent with a STEC infection. Second, when managing STEC gastroenteritis the recommendation has been to maintain excellent hydration as a strategy to prevent the progression to oligo-anuric acute kidney injury and HUS. This strategy may need to be re-evaluated in a patient with SARS-CoV-2 infection or co-infection.
Thoracoabdominal Aortic Aneurysm in a HIV-positive Patient
Authors: Márcio Luís Lucas, Ívia Binotto, Paulo Behar, Nilon Erling Jr, Eduardo Lichtenfels, Newton Aerts
Journal: Braz J Cardiovasc Surg (2017)
MeSH terms: Aortic Aneurysm, Abdominal / surgery, Aortic Aneurysm, Thoracic / surgery, HIV Infections / complications, Case Reports, Angiography, Aortic Aneurysm, Abdominal / diagnostic imaging, Aortic Aneurysm, Thoracic / diagnostic imaging, Blood Vessel Prosthesis Implantation / methods, Endovascular Procedures, Humans, Male, Middle Aged, Tomography, X-Ray Computed

Advent of antiretroviral therapy has increased survival of patients with human immunodeficiency virus (HIV) infections, with the result that some of these patients now develop degenerative diseases, such as atherosclerotic aneurysms. Degenerative thoracoabdominal aortic aneurysm is rare in HIV patients. In this report, a 63-year-old male patient with HIV submitted to open repair of thoracoabdominal aortic aneurysm. The patient did not suffer any type of complication in the perioperative period and remained well in a 28-month follow-up period. In summary, open repair still remains a good alternative for aortic complex aneurysms even in HIV patients.
Proteus syndrome: evaluation of the immunological profile
Authors: Vassilios Lougaris, Vincenzo Salpietro, Maricia Cutrupi, Manuela Baronio, Daniele Moratto, M R Pizzino, Kshitij Mankad, Silvana Briuglia, Carmelo Salpietro, Alessandro Plebani
Journal: Orphanet J Rare Dis (2016)
MeSH terms: Proteus Syndrome / diagnosis, Proteus Syndrome / immunology, Case Reports, Letter, Adolescent, B-Lymphocytes / immunology, Female, Humans, Proteus Syndrome / complications, Pulmonary Embolism / diagnosis, Pulmonary Embolism / etiology, Pulmonary Embolism / immunology, T-Lymphocytes / immunology

Proteus syndrome (PS) is an extremely rare and complex disease characterized by malformations and overgrowth of different tissues. Prognosis of affected patients may be complicated by premature death, mostly due to pulmonary embolism and respiratory failure. To date, immunological data in Proteus syndrome are scarse.We report on the novel immunologic findings of a 15 years old girl affected with PS. Detailed T and B cell evaluation revealed maturational alterations for both subsets and functional hyperactivation for the latter. Such findings have not been reported previously in PS and may be the spy of more complex immune abnormalities in this syndrome.
Pulmonary interstitial cholesterol crystals associated with diffuse lung cysts in adult: a case report and literature review
Authors: Min Zhang, Hong-Tao Tie, Cheng-Long Wang, Qing-Chen Wu
Journal: J Cardiothorac Surg (2016)
MeSH terms: Cholestasis / diagnosis, Cysts / diagnosis, Pneumonia / diagnosis, Case Reports, Review, Adult, Cholestasis / complications, Cholesterol / analysis, Crystallization, Cysts / complications, Female, Giant Cells / pathology, Humans, Lung Diseases / complications, Lung Diseases / diagnosis, Pneumonia / complications, Pneumothorax / etiology, Tomography, X-Ray Computed, Cholesterol, Cholesterol pneumonia

Background:
Cholesterol pneumonitis or endogenous lipoid pneumonia (ELP) result from the accumulation of endogenous cholesterol esters in the lungs, leading to a fibroblastic interstitial inflammatory process, and may be complicated by a secondary bacterial or fungal infection. Striking features were cholesterol clefts in the alveolar and interstitial spaces and alveolar wall-thickening with lymphocytic infiltrations, which was called pulmonary interstitial and intra-alveolar cholesterol granulomas (PICG).
Case presentation:
We report a case of pneumothorax with diffuse lung cysts and pulmonary interstitial cholesterol in a 26-year-old woman. Our case is unique because development of PICG or ELP has been observed in children, but rarely in adult. Most cases could be linked to exogenous sources like inhalation of lipid material or gastroesophageal reflex (GER). In our case, no signs of GER could be discovered. Diffuse lung cysts coexisting with pulmonary interstitial cholesterol crystals are never reported. Additionally, no multinucleated giant cells or granuloma are found pathologically, which make the diagnosis of PICG or lipoid pneumonia difficult.
Conclusions:
Pulmonary interstitial cholesterol crystals may develop gradually and evenly distributed throughout the entire lung and resulted in severe distortion of the native structure of the lung.
Sextuple Tumors in Head and Neck Area: Evidence of Field Cancerization
Authors: Carla Bento Nelem-Colturato, Patrícia Maluf Cury, Thiago Machado Pereira, Isabelle Silva Cosso, Kellin Pivato, Luiz Evaristo Ricci Volpato, Alvaro Henrique Borges
Journal: Case Rep Pathol (2018)
MeSH terms: Case Reports

Background:
Field cancerization is a phenomenon in which prolonged exposure to carcinogens induces changes throughout the epithelium leaving the field ready for the appearance of premalignant or malignant lesions. These alterations can promote the development of multiple carcinomas and explain the appearance of recurrences and second primary tumors. The objective of this study was to report the case of a patient who developed six oral cavity tumors in five years of treatment and, also, demonstrate the immunohistochemical changes for p53 and Ki-67, routinely used to assess dysplasic regions.
Case report:
When altered, p53 and Ki-67 suggest the presence of field cancers, an area with genetically altered cells, presenting a high risk of developing premalignant and malignant lesions. This phenomenon explains the recurrence of malignant neoplasms after tumor resections.
Conclusion:
In addition, early identification of potentially malignant lesions in cases of second primary tumors is essential for effective treatment and patient survival, which usually have an unwelcoming prognosis.